Investigation of thermal conductivity for liquid metal composites using the micromechanics-based mean-field homogenization theory.

For the facile use of liquid metal composites (LMCs) for soft, stretchable and thermal systems, it is crucial to understand and predict the thermal conductivity of the composites as a function of liquid metal (LM) volume fraction and applied strain. In this study, we investigated the effective thermal conductivity of LMCs based on various mean-field homogenization frameworks including Eshelby, Mori-Tanaka, differential and double inclusion methods. The double inclusion model turned out to make the prediction closest to the experimental results in a wide range of LM volume fractions. Interestingly, we found that the theoretical models based on the assumption of ideal LM dispersion and zero interfacial resistance underestimated the thermal conductivity compared to the experimental results in a low volume fraction regime. By considering the accompanied variations in the LM inclusion's aspect ratios under a typical size distribution of inclusions (∼µm), the change of effective thermal conductivity was predicted under a uniaxial 300% tensile strain. Our study will deepen the understanding of the thermal properties of LMCs and support the designs of stretchable thermal interfaces and packaging with LMCs in the future.

Epidemiological Characteristics of COVID-19 Outbreak at Fitness Centers in Cheonan, Korea.

BACKGROUND: In February 2020, a coronavirus disease 2019 (COVID-19) outbreak was reported in fitness centers in Cheonan, Korea. METHODS: From February 24 to March 13, an epidemiological investigation was conducted on the fitness center outbreak. All those who were screened were tested for severe acute respiratory syndrome coronavirus-2 (SARS CoV-2) using real-time reverse transcriptase polymerase chain reaction. Contacts were traced and self-isolated for 14 days. We determined the epidemiological characteristics of confirmed cases of SARS-CoV-2 infection, and estimated the time-dependent reproduction number to assess the transmission dynamics of the infection. RESULTS: A total of 116 cases were confirmed, and 1,687 contacts were traced. The source cases were 8 Zumba instructors who led aerobics classes in 10 fitness centers, and had the largest average number of contacts. A total of 57 Zumba class participants, 37 of their family members, and 14 other contacts were confirmed as cases. The attack rate was 7.3%. The contacts at Zumba classes and homes had a higher attack rate than other contacts. The mean serial interval (± standard deviation) were estimated to be 5.2 (± 3.8) days. The time-dependent reproduction number was estimated to be 6.1 at the beginning of the outbreak, but it dropped to less than 1, 2 days after the epidemiological investigation was launched. CONCLUSION: The results suggest that the COVID-19 outbreak was effectively contained with rigorous contact tracing, isolating, and testing in combination with social distancing without a lock-down.

Tape transfer printing of a liquid metal alloy for stretchable RF electronics.

In order to make conductors with large cross sections for low impedance radio frequency (RF) electronics, while still retaining high stretchability, liquid-alloy-based microfluidic stretchable electronics offers stretchable electronic systems the unique opportunity to combine various sensors on our bodies or organs with high-quality wireless communication with the external world (devices/systems), without sacrificing enhanced user comfort. This microfluidic approach, based on printed circuit board technology, allows large area processing of large cross section conductors and robust contacts, which can handle a lot of stretching between the embedded rigid active components and the surrounding system. Although it provides such benefits, further development is needed to realize its potential as a high throughput, cost-effective process technology. In this paper, tape transfer printing is proposed to supply a rapid prototyping batch process at low cost, albeit at a low resolution of 150 µm. In particular, isolated patterns can be obtained in a simple one-step process. Finally, a stretchable radio frequency identification (RFID) tag is demonstrated. The measured results show the robustness of the hybrid integrated system when the tag is stretched at 50% for 3000 cycles.

Comparison of clinical efficacy and safety of clopidogrel resinate with clopidogrel bisulfate in patients undergoing percutaneous coronary intervention.

OBJECTIVE: A new polymeric salt form of clopidogrel, clopidogrel resinate (CR), is a resinate complex of the (+)-clopidogrel optical isomer wherein the (+)-clopidogrel isomer binds to a water-soluble cation exchange resin via sulfonic acid groups. CR was approved for marketing by the Korean Food and Drug Administration based on a Phase I bioequivalence study. However, no data are available regarding its impact on adverse clinical outcomes in patients undergoing percutaneous coronary intervention (PCI). METHODS: Clopidogrel bisulfate (CB) was used exclusively from January 2004 through April 2010, after which CR was exclusively administered from May 2010 through September 2011, in 8 centers. We categorized the overall population (N = 10,487) into two groups according to the prescribed clopidogrel type: CB (n = 9,127) or CR (n = 1,360). To minimize the covariate imbalance and confounding in comparing CB and CR, we used a multivariable Cox proportional hazard regression model and the propensity score (PS) method to identify a 1:1 matched cohort (n = 2,470). We compared cumulative adverse outcomes during a 1-year follow-up after PCI in the overall population and in the PS-matched cohort. RESULTS: In the overall population, there is no difference in the 1-year cumulative event rates between the two groups (CB : CR) : composite of any death, nonfatal myocardial infarction or stroke (6.0 % vs. 6.0 %, adjusted HR, 0.82; 95 % CI, 0.61-1.11, p = 0.57), stent thrombosis (0.4 % vs. 0.2 %; adjusted HR, 0.40; 95 % CI, 0.09-1.72, p = 0.31), and bleeding (0.9 % vs. 0.6 %; adjusted HR, 0.67; 95 % CI, 0.28-1.58, p = 0.22). In the PS-matched cohort, the overall findings were consistent. CONCLUSIONS: In this large real-world PCI population, CR was as effective and as safe as CB in preventing adverse clinical outcomes.

Major depressive disorder, panic disorder, and post-traumatic stress disorder in Korean subway drivers.

PURPOSE: The purposes of this study are to investigate the prevalence of major depressive disorder, panic disorder, and post-traumatic stress disorder (PTSD) in Korean subway drivers, and find the association between these disorders and the drivers' person-under-train (PUT) experiences. METHODS: A total of 826 subway drivers who participated in a cross-sectional work and health survey were included for this study. The Korean version of the Composite International Diagnostic Interview 2.1 was applied to assess major depressive disorder, panic disorder, and PTSD. The date of PUT, whether victim died, and how many PUTs the drivers experienced were asked using a structured questionnaire. RESULTS: The standardized prevalence ratios (SPRs) for lifetime prevalence of panic disorder and PTSD in subway drivers were 13.3 (95 % confidence interval [CI] 6.6-22.4) and 2.1 (95 % CI 1.1-3.4), respectively. In lifetime prevalence, after adjusting for age, education, income, and working career, the drivers who experienced PUT had significantly higher risks for panic disorder (odds ratio [OR] = 4.2, 95 % CI 1.2-16.6) and PTSD (OR = 4.4, 95 % CI 1.3-16.4). In 1-year prevalence, the drivers who experienced PUT had a significantly higher risk for PTSD (OR = 11.7, 95 % CI 1.9-225.8). There was no significant value of SPR and OR in major depressive disorder. CONCLUSIONS: This study suggests that Korean subway drivers are at higher risk for panic disorder and PTSD compared to the general population, and PUT experience is associated with panic disorder and PTSD. Drivers who have experienced PUT should be treated quickly, sympathetically, and sensitively by a psychological professional and their colleagues, so they can return to work soon.

Secretome analysis of Magnaporthe oryzae using in vitro systems.

Magnaporthe oryzae is a devastating blast fungal pathogen of rice (Oryza sativa L.) that causes dramatic decreases in seed yield and quality. During the early stages of infection by this pathogen, the fungal spore senses the rice leaf surface, germinates, and penetrates the cell via an infectious structure known as an appressorium. During this process, M. oryzae secretes several proteins; however, these proteins are largely unknown mainly due to the lack of a suitable method for isolating secreted proteins during germination and appressoria formation. We examined the secretome of M. oryzae by mimicking the early stages of infection in vitro using a glass plate (GP), PVDF membrane, and liquid culture medium (LCM). Microscopic observation of M. oryzae growth revealed appressorium formation on the GP and PVDF membrane resembling natural M. oryzae-rice interactions; however, appresorium formation was not observed in the LCM. Secreted proteins were collected from the GP (3, 8, and 24 h), PVDF membrane (24 h), and LCM (48 h) and identified by two-dimensional gel electrophoresis (2DE) followed by tandem mass spectrometry. The GP, PVDF membrane, and LCM-derived 2D gels showed distinct protein patterns, indicating that they are complementary approaches. Collectively, 53 nonredundant proteins including previously known and novel secreted proteins were identified. Six biological functions were assigned to the proteins, with the predominant functional classes being cell wall modification, reactive oxygen species detoxification, lipid modification, metabolism, and protein modification. The in vitro system using GPs and PVDF membranes applied in this study to survey the M. oryzae secretome, can be used to further our understanding of the early interactions between M. oryzae and rice leaves.

Diffusion-weighted imaging and FDG PET/CT: predicting the prognoses with apparent diffusion coefficient values and maximum standardized uptake values in patients with invasive ductal carcinoma.

BACKGROUND: FDG PET/CT and DWI are both functional modalities that indirectly represent the biological characteristics of cancer, but there are few studies exploring the association between the two modalities and prognostic factors. Our study attempted to evaluate the mutual association by comparing the prognostic factors, SUV(max) value of PET/CT, and ADC values associated with diffusion imaging in invasive ductal carcinoma (IDC) patients. METHODS: Patients with pathologically confirmed IDC were recruited. There were 118 patients who underwent MRI, including DWI, FDG PET/CT, and immunohistochemical staining of the surgical specimen. Histologic analysis was done on tumor size, lymph node metastasis, expression of estrogen receptors (ER), progesterone receptors (PR), human epidermal growth factor receptor 2 (HER2), Ki-67, and epidermal growth factor receptors (EGFR). The relationship among ADC values, SUV(max) and prognostic factors were evaluated. RESULTS: There was significant association between the ADC value and ER-positive and HER2-negative expression. Significant associations were noted between SUV(max) and tumor size, lymph node metastasis, histologic grade, ER and PR expression, EGFR and Ki-67. However, there was no significant correlation between the ADC value and SUV(max). CONCLUSIONS: Even though there was no correlation between ADC and SUV(max), both indexes are useful for predicting the prognosis of IDC.

Platform Design and Preliminary Test Result of an Insect-like Flapping MAV with Direct Motor-Driven Resonant Wings Utilizing Extension Springs.

In this paper, we propose a platform for an insect-like flapping winged micro aerial vehicle with a resonant wing-driving system using extension springs (FMAVRES). The resonant wing-driving system is constructed using an extension spring instead of the conventional helical or torsion spring. The extension spring can be mounted more easily, compared with a torsion spring. Furthermore, the proposed resonant driving system has better endurance compared with systems with torsion springs. Using a prototype FMAVRES, it was found that torques generated for roll, pitch, and yaw control are linear to control input signals. Considering transient responses, each torque response as an actuator is modelled as a simple first-order system. Roll, pitch, and yaw control commands affect each other. They should be compensated in a closed loop controller design. Total weight of the prototype FMAVRES is 17.92 g while the lift force of it is 21.3 gf with 80% throttle input. Thus, it is expected that the new platform of FMAVRES could be used effectively to develop simple and robust flapping MAVs.

Comparative efficacy and safety of fimasartan in patients with hypertension: A network meta-analysis of randomized controlled trials.

Hypertension is a prevalent risk factor for cardiovascular disease. Angiotensin II receptor blockers are widely prescribed to patients with hypertension, while new drugs are continuously developed. However, data on comparative efficacy and safety of novel agents, such as fimasartan, are scarce. Here, we aimed to collect clinical evidence on different angiotensin II receptor blockers using a network meta-analysis. Randomized controlled trials whose follow-up time is within 12 weeks were identified from eight databases via a systematic literature review. Of the 7909 possibly relevant studies, 61 studies with 14,249 adult patients were included in the analysis. These studies were further subjected to quality appraisal using Cochran's Risk of Bias, and sitting systolic blood pressure was considered the primary endpoint. A Bayesian random effect generalized linear model was used for the network meta-analysis, and the treatment rank probability was determined. Olmesartan (standardized mean difference -0.987 [-1.29, -0.729]) and fimasartan (standardized mean difference -0.966 [-1.21, -0.745]) showed the highest rank probabilities (37% and 35%) in the 4-week group, considering the primary endpoint. Furthermore, the odds ratio of adverse events for all agents did not differ significantly from that of the placebo. The treatment rank of angiotensin II receptor blockers varied depending on the outcome type and follow-up period considerably. Fimasartan rapidly lowered blood pressure in 4 weeks, which was further maintained until 12 weeks, indicating its competent efficacy and tolerability. Our findings may help medical practitioners and patients to select the best angiotensin II receptor blocker against hypertension.

A Wearable Textile-Embedded Dielectric Elastomer Actuator Haptic Display.

With advances in mobile computing and virtual/augmented reality technologies, communicating through touch using wearable haptic devices is poised to enrich and augment current information delivery channels that typically rely on sight and hearing. To realize a wearable haptic device capable of effective data communication, both ergonomics and haptic performance (i.e., array size, bandwidth, and perception accuracy) are essential considerations. However, these goals often involve challenging and conflicting requirements. We present an integrated approach to address these conflicts, which includes incorporating multilayered dielectric elastomer actuators, a lumped-parameter model of the skin, and a wearable frame in the design loop. An antagonistic arrangement-consisting of an actuator deforming the skin-was used to achieve effective force transmission while maintaining a low profile, and the effect of the wearable frame and structure was investigated through lumped-model analysis and human perception studies.

Correlation of the apparent diffusion coefficient value and dynamic magnetic resonance imaging findings with prognostic factors in invasive ductal carcinoma.

PURPOSE: To evaluate the correlation of the mean and minimal apparent diffusion coefficient values (ADC(mean) , ADC(minimal) ) and dynamic magnetic resonance imaging (MRI) findings with prognostic factors in invasive ductal carcinoma. MATERIALS AND METHODS: A total of 107 women with invasive ductal cancer underwent breast MRI. The ADC(mean) and ADC(minimal) of the cancers were computed. MRI findings were retrospectively evaluated according to the Breast Imaging Reporting and Data System (BI-RADS) lexicon: mass or nonmass type, mass shape, mass margin, nonmass distribution, and enhancement pattern. Histological records were reviewed for tumor size, lymph node metastasis, histologic grade, and expression of estrogen receptors (ER), progesterone receptors (PR), c-erbB-2(HER2), Ki-67, and epidermal growth factor receptors (EGFR). Correlations of ADC values and MR findings with prognostic factors were determined using the Mann-Whitney U-test and the Kruskal-Wallis test. RESULTS: The mean ADC(minimal) was 0.78 ± 0.24 (× 10⁻³ mm² /s), and the mean ADC(mean) was 1.01 ± 0.23 (× 10⁻³ mm² /s). There was a significant correlation of the ADC(mean) value with ER expression (P = 0.027) and HER2 expression (P = 0.018). There was no significant relationship between ADC(minimal) and prognostic factors or between ADC(mean) and traditional prognostic factors, PR, Ki-67 and EGFR. The majority of the mass type lesions were less than 5 cm in size and the majority of nonmass type lesions were more than 2 cm in size (P = 0.022). The margin of mass was significantly associated with lymph node metastasis (P = 0.031), ER expression (P = 0.013), PR expression (P = 0.036), HER2 expression (P = 0.019), and EGRF expression (P = 0.041). The rim internal enhancement was significantly correlated with Ki-67 expression (P = 0.008). CONCLUSION: The low ADC(mean) value was related to positive expression of ER and negative expression of HER2. A spiculated margin was related to a good prognosis, but rim enhancement was associated with a poor prognosis.

Clinical significance of incidental finding of focal activity in the breast at 18F-FDG PET/CT.

OBJECTIVE: The purpose of this study was to determine the clinical significance of the incidental finding of hypermetabolic foci in the breast at (18)F-FDG PET/CT in patients with malignant disease other than breast cancer or during a screening examination. MATERIALS AND METHODS: The files of 13,897 women who underwent FDG PET/CT from November 2004 to October 2009 were retrospectively reviewed. Forty-eight patients with incidental breast uptake had undergone either tissue confirmation or clinical follow-up with additional sonographic imaging. The following four variables were evaluated: age, maximum standard uptake value (SUV(max)) of breast uptake at FDG PET, findings in the CT portion of PET/CT, and sonographic findings. Malignancy rates were calculated for each variable. RESULTS: Malignancy was diagnosed in 18 (37.5%) patients and a benign condition in 30 (62.5%) patients. Statistically significant differences in malignancy rate were found between the groups with SUV(max) less than 2 (24.2%) and the group with SUV(max) of 2 or greater (66.7%) and between the group with lesions in a BI-RADS ultrasound category lower than 4 (10.7%) and the group with lesions in category 4 or higher (75.0%) (p < 0.05). There was no significant difference in malignancy rates between the groups younger than 45 years (11.1%) and 45 years and older (53.3%) or between the group with lesions in a BI-RADS category lower than 4 (30.2%) and that with lesions in category 4 or higher (100%) on the CT portion of PET/CT. CONCLUSION: Incidental hypermetabolic foci in the breast may represent malignancy in as many as 37.5% of cases. The SUV(max) and sonographic findings can be useful for differentiating benign from malignant lesions.

Gender differences in 12-week antidepressant treatment outcomes for a naturalistic secondary care cohort: the CRESCEND study.

This study aimed to determine whether men and women with depression differ in socio-demographic, treatment-related characteristics, and in their responses to treatment with antidepressants, as well as to explore differences in treatment outcomes by menopausal status. From a nationwide sample of 18 hospitals in South Korea, 723 depressive patients were recruited. After baseline evaluation, they received naturalistic clinician-determined antidepressant interventions. Assessment scales for evaluating depression (HAMD), anxiety (HAMA), global severity (CGI-s), and functioning (SOFAS) were administered at baseline and re-evaluated at 1, 2, 4, 8, and 12 weeks later. At baseline, women were older, less educated, less likely to be employed, had lower income, were more likely to be married, and had longer illness duration than men. There were no gender differences in the treatment-regime received. After adjustment for baseline status, women were more likely to achieve HAMD remission (OR=1.51), HAMD response (OR=1.64), and HAMA response (OR=1.61). Women also experienced shorter times to HAMD response, HAMA response, and CGI-s remission. Postmenopausal women showed higher HAMA response with newer dual action antidepressants than premenopausal women. Women were found to have better outcomes following antidepressant treatment than men, and postmenopausal women had a better response on anxiety symptoms with newer dual action antidepressants.

Direct versus video laryngoscopic intubation by novice prehospital intubators with and without chest compressions: A pilot manikin study.

OBJECTIVES: To evaluate whether chest compressions affect the time taken for intubation (TTI) using the Macintosh laryngoscope and two portable video laryngoscopes (VLs) (GlideScope Ranger and Airway Scope) when used by novice prehospital caregivers, and to compare the TTIs and rates of successful intubation among the three laryngoscopes with and without chest compressions in a manikin model. METHODS: This was a pilot randomized crossover study. Twenty paramedic students and paramedics who had no clinical experience with tracheal intubation and had never used any of two VLs participated in the study. After a one-hour training session for the VLs, participants performed intubations on a Laerdal Resusci Anne Simulator placed on the floor. Each paramedic used all three laryngoscopes, with the order of usage being randomly assigned. The TTIs and rates of successful intubation among the three laryngoscopes, with and without ongoing chest compressions, were compared. RESULTS: The difference between the TTIs using each laryngoscope with and without chest compressions was not significant (Macintosh: 2.99 sec, p = 0.06; GlideScope Ranger: 2.04 sec, p = 0.11; and Airway Scope: 0.91 sec, p = 0.10). The median TTI using the Airway Scope (15.46 sec) was significantly shorter than those for the Macintosh (24.14 sec) and the GlideScope Ranger (24.12 sec) during chest compressions (p = 0.028 and p = 0.004, respectively). There were no significant differences in the rates of successful intubation among the three laryngoscopes on each condition (without chest compressions, p = 0.15; with chest compressions, p = 0.27), but the cumulative success rates related to the TTI were significantly greater with the Airway Scope than with the other devices in both conditions. CONCLUSION: In this pilot study, chest compressions did not significantly affect the TTI using the Macintosh laryngoscope and two portable VLs when used by novice prehospital caregivers in the manikin model on the floor. Considering the fairly short training time, two portable VLs may be potentially useful adjuncts for tracheal intubation during chest compressions for novice prehospital caregivers. Further studies are required to validate whether these findings are clinically relevant.

Deliberate self-poisoning: factors associated with recurrent self-poisoning.

OBJECTIVE: To investigate potential risk factors associated with the repetition of deliberate self-poisoning (DSP). METHODS: Retrospective medical record review of all patients who presented to the emergency department of a tertiary teaching hospital after DSP between January 1, 2000, and December 31, 2009. Repetition of a suicide attempt was determined from reported episodes before the index episode or from 2 visits to the same hospital during the study period. Demographic information, clinical variables, and other variables at the first suicide attempt were investigated for factors associated with repetition of DSP. RESULTS: Of the 967 patients, 203 (21%) presented with repeated suicide attempts. Patients with repeat suicide attempts differed in sex, occupation, living condition, method of DSP, history of psychiatric treatment, reversibility, and psychiatric diagnosis. In the multivariate regression analysis, the only reliable associated factors for repeat suicide attempt were sex (P = .001), living condition (P < .001), method of DSP (P < .036), and history of psychiatric treatment (P < .001). CONCLUSION: Early psychological intervention and close observation is required for patients who are female, living without a family, use antidepressants, and have a history of psychiatric treatment.

Tracheal intubation using Macintosh and 2 video laryngoscopes with and without chest compressions.

PURPOSE: The aim of the study was to compare the time taken for intubation (TTI) using the Macintosh and 2 video laryngoscopes (VLs) (GlideScope [GVL]; Saturn Biomedical System, Burnaby, British Columbia, Canada, and Airway Scope [AWS]; Pentax, Tokyo, Japan) with and without chest compressions by experienced intubators in a mannequin model. METHODS: This was a randomized crossover study. Twenty-two experienced physicians who have limited experience in the VLs participated in the study. The TTI using 3 laryngoscopes with and without compressions were compared. RESULTS: Median TTI difference between 2 conditions was only significant in the AWS (1.64 seconds; P = .01). There were no significant differences in the TTI between the Macintosh and the GVL or the AWS during compressions. CONCLUSION: In a mannequin model, the Macintosh or the GVL was not affected by chest compressions. The TTI using the AWS was delayed by compressions but not clinically significant. Considering the lack of experience, 2 VLs may be useful adjuncts for intubation by experienced intubators during chest compressions.

The associative factors of delayed-onset rhabdomyolysis in patients with doxylamine overdose.

OBJECTIVES: The aim of this study was to investigate the associative factors of rhabdomyolysis in patients with doxylamine overdose who had normal creatine phosphokinase levels at admission. METHODS: This study included 169 patients who visited the emergency department of a tertiary teaching hospital after doxylamine overdose between January 1, 1998, and March 31, 2009. Demographic information, clinical variables, and laboratory data were investigated for the associative factors of rhabdomyolysis. RESULTS: Thirty-five (21%) of the 169 patients developed rhabdomyolysis. Patients who developed rhabdomyolysis differed from those who did not in the amount of doxylamine ingested, sex, heart rate, initial value of serum creatinine, and alanine aminotransferase. In the multivariate regression analysis, the only reliable predictors of rhabdomyolysis were the amount of doxylamine ingested (P = .004) and heart rate (P < .001). CONCLUSION: Observation and laboratory follow-up are required for patients with large reported ingestions or tachycardia on admission, even if their creatine phosphokinase levels were normal.

Role of sonographic elastography in the differential diagnosis of axillary lymph nodes in breast cancer.

OBJECTIVES: The purpose of this study was to evaluate the diagnostic utility of sonographic elastography in differentiating reactive and metastatic axillary lymph nodes in breast cancer. METHODS: A total of 64 lymph nodes (reactive, n = 33; metastatic, n = 31) from 62 patients with breast cancer were examined by both B-mode sonography and elastography from April to July 2009. Two experienced radiologists retrospectively assessed B-mode sonograms by the sum of scores for 4 criteria: short diameter, shape, hilum, and cortical thickening. Elastographic images were given scores of 1 to 4 according to the percentage of high-elasticity areas in the lymph nodes. We compared the diagnostic performance of B-mode sonography, elastography, and combined examinations. We also calculated the strain ratio of the lymph node and subcutaneous fat tissue. RESULTS: The elasticity score for malignant lymph nodes (mean, 3.1) was higher than the score for benign lymph nodes (mean, 2.2; P < .0001). With a cutoff between elasticity scores of 2 and 3, elastography showed 80.7% sensitivity, 66.7% specificity, and 73.4% accuracy. With a cutoff between B-mode sonographic scores of 1 and 2, B-mode sonography showed 74.2% sensitivity and 78.8% specificity. Combined B-mode and elastographic sonography showed higher sensitivity (87.1%) than B-mode sonography alone. With a strain ratio cutoff point of 2.3, sensitivity was 82.8%, and specificity was 56.3%. CONCLUSIONS: Sonographic elastography may increase the sensitivity of B-mode sonography in the detection of metastatic axillary lymph nodes.

Clinical characteristics of depressed patients with a history of suicide attempts: results from the CRESCEND study in South Korea.

South Korea is a country with one of the highest suicide rates in the world, and the suicide rate is still on the rise. The purpose of this study was to determine the sociodemographic and clinical characteristics of suicide attempts and risk factors related to suicide attempts among depressed patients in South Korea. Among the 1183 participants, 21.4% had a history of a suicide attempt. When the severity of depression was controlled, the risk factors for patients who attempted suicide included younger age, experienced significant life events before 12 years of age, psychotic symptoms, and previous depressive episodes. The characteristics of attempted suicide in depressed patients in South Korea can be summarized as a high suicide attempt rate with no difference in the number of suicide attempts and lethality between males and females. This unique tendency is probably related to the sociodemographic and cultural characteristics of South Korea.

Observer variability in the sonographic evaluation of thyroid nodules.

OBJECTIVE: Inter- and intraobserver variabilities in the description and diagnostic categorization of sonographic (US) features of thyroid nodules were evaluated. METHODS: The current study was conducted on 72 malignant nodules and 61 benign nodules. The US findings for each thyroid nodule were analyzed twice at a 6-week interval by five radiologists. The analyses were in accordance with the guidelines proposed by the Thyroid Study Group of the Korean Society of Neuroradiology and Head and Neck Radiology (TSGKSNRHNR). Inter- and intraobserver variabilities were calculated using Cohen's kappa statistics. The sensitivity, specificity, positive-predictive value, and negative-predictive value in the assessment of the diagnostic accuracy using these guidelines were calculated. RESULT: The interobserver agreement was fair to substantial for US features and categorization. Of the US features of the thyroid nodules, internal content (solid versus cystic) showed substantial agreement (k = 0.64). There was moderate agreement with regard to shape, echogenicity, calcification, and diagnostic categories (k = 0.42, 0.57, 0.55, and 0.55, respectively). There was fair agreement for margin, echotexture, and capsule invasion (k = 0.34, 0.26, and 0.32, respectively). With regard to intraobserver agreement, there was moderate to substantial agreement for all US features except for echotexture and capsule invasion, which showed fair agreement. In particular, there was moderate to almost perfect agreement for the diagnostic category. The sensitivity, specificity, positive-predictive value, and negative-predictive value were 65.3%-81.9%, 60.7%-68.9%, 69.7%-73.8%, and 66.6%-75.5%, respectively. CONCLUSION: There were high degrees of inter- and intraobserver agreement using the "Guidelines for diagnostic thyroid ultrasonography," of the TSGKSNRHNR in the description and categorization of thyroid nodules.