Comparison of high-flow nasal cannula oxygen therapy and conventional reserve-bag oxygen therapy in carbon monoxide intoxication: A pilot study.

BACKGROUND: High-flow nasal cannula oxygen (HFNC) creates a positive pressure effect through high-flow rates compared to conventional oxygen therapy. The purpose of this human pilot study is to compare the effects of HFNC and conventional oxygen therapy on the rate of carbon monoxide (CO) clearance from the blood in patients with mild to moderate CO poisoning. METHODS: CO-poisoned Patients randomly received 100% oxygen from a rebreathing reserve mask (NBO2, flow of 15 L/min) or HFNC (flow of 60 L/min). The fraction of COHb value (fCOHb) was measured in 30-min intervals until it fell to under 10%. We determined the Half-life time of fCOHb (fCOHb t1/2). RESULTS: A total of 22 patients had fCOHb levels ≥ 10% at the time of ED arrival, with 9 of them having fCOHb level ranging between 25% and 50%. There was no significant difference in the fCOHbt1/2 between the HFNC group and NBO2 group. However, the mean fCOHbt1/2 in the HFNC group (48.5 ±â€¯12.4 min) has a smaller standard deviation than that in the NBO2 group (99.3 ±â€¯93.38 min). There were significant between-group differences in the mean COHbt1/2 among the patients with fCOHb levels less than 25% (HFNC 43.6 ±â€¯10.6 vs. NBO2 134.2 ±â€¯111.3). CONCLUSIONS: In this pilot randomized controlled trial study, HFNC therapy did not reduce fCOHbt1/2 compared to NBO2 therapy but could be beneficial in maintaining a constant fCOHbt1/2 as well as in reducing fCOHbt1/2 in mild CO poisoning patients compared to conventional NBO2 therapy. However, further studies with a larger number of patients are needed to establish HFNC therapy as an alternative therapy for CO poisoning patients.

Early diffusion-weighted imaging and outcome prediction of comatose survivors after suicidal hanging.

PURPOSE: Early outcome prediction after suicidal hanging is challenging in comatose survivors. We analysed the early patterns of brain diffusion-weighted magnetic resonance imaging (DWI) abnormalities in comatose survivors after suicidal hanging. METHODS: After suicidal hanging, 18 comatose survivors were prospectively evaluated from January 2013 to December 2016. DWI was performed within 3 h after hanging in comatose survivors. We evaluated Utstein style variables and analysed abnormal spatial profile of signal intensity on DWI, brain apparent diffusion coefficient (ADC) values, and qualitative DWI scores to predict neurological outcomes. RESULTS: All hanging associated cardiac arrest (CA) patients demonstrated bad neurological outcomes; 80% of non-CA comatose patients experienced good neurological outcomes. In hanging survivors with CA, cortical grey matter structures and deep grey nuclei exhibited profound ADC reductions and high DWI scores within 3 h after hanging, which was associated with diffuse anoxic brain damage with poor cerebral performance categories scores. CA comatose survivors had significantly lower ADC values and higher DWI scores compared to non-CA comatose survivors in the cortex and deep grey nuclei. CONCLUSION: Although the presence of CA is the most important clinical prognosticator in hanging-associated comatose survivors, HSI abnormalities and low ADC values in the cortex and deep grey nuclei on DWI performed within 3 h after hanging are well-correlated with unfavourable outcomes regardless of therapeutic hypothermia. Therefore, early DWI may increase the sensitivity of poor outcome prediction and may be an effective combinatorial screening method when available prognostic variables are not reliable or conclusive.

Efficient Planar Perovskite Solar Cells Using Passivated Tin Oxide as an Electron Transport Layer.

Planar perovskite solar cells using low-temperature atomic layer deposition (ALD) of the SnO2 electron transporting layer (ETL), with excellent electron extraction and hole-blocking ability, offer significant advantages compared with high-temperature deposition methods. The optical, chemical, and electrical properties of the ALD SnO2 layer and its influence on the device performance are investigated. It is found that surface passivation of SnO2 is essential to reduce charge recombination at the perovskite and ETL interface and show that the fabricated planar perovskite solar cells exhibit high reproducibility, stability, and power conversion efficiency of 20%.

A Study on the Electrical Properties of Atomic Layer Deposition Grown InOx on Flexible Substrates with Respect to N2O Plasma Treatment and the Associated Thin-Film Transistor Behavior under Repetitive Mechanical Stress.

Indium oxide (InOx) films were deposited at low processing temperature (150 °C) by atomic layer deposition (ALD) using [1,1,1-trimethyl-N-(trimethylsilyl)silanaminato]indium (InCA-1) as the metal precursor and hydrogen peroxide (H2O2) as the oxidant. As-deposited InOx exhibits a metallic conductor-like behavior owing to a relatively high free-carrier concentration. In order to control the electron density in InOx layers, N2O plasma treatment was carried out on the film surface. The exposure time to N2O plasma was varied (600-2400 s) to evaluate its effect on the electrical properties of InOx. In this regard, thin-film transistors (TFTs) utilizing this material as the active layer were fabricated on polyimide substrates, and transfer curves were measured. As the plasma treatment time increases, the TFTs exhibit a transition from metal-like conductor to a high-performance switching device. This clearly demonstrates that the N2O plasma has an effect of diminishing the carrier concentration in InOx. The combination of low-temperature ALD and N2O plasma process offers the possibility to achieve high-performance devices on polymer substrates. The electrical properties of InOx TFTs were further examined with respect to various radii of curvature and repetitive bending of the substrate. Not only does prolonged cyclic mechanical stress affect the device properties, but the bending direction is also found to be influential. Understanding such behavior of flexible InOx TFTs is anticipated to provide effective ways to design and achieve reliable electronic applications with various form factors.

A Study on the Growth Behavior and Stability of Molecular Layer Deposited Alucone Films Using Diethylene Glycol and Trimethyl Aluminum Precursors, and the Enhancement of Diffusion Barrier Properties by Atomic Layer Deposited Al2O3 Capping.

As a route to the production of organic-inorganic hybrid multilayers, the growth behavior of molecular layer deposited (MLD) alucone and atomic layer deposited (ALD) Al2O3 films on top of each other was examined. MLD alucone films were prepared using trimethyl aluminum and diethylene glycol precursors, the latter resulting in faster growth rates than ethylene glycol precursors. The sensitivity of individual alucone films with respect to ambient exposure was found to be related to moisture permeation and hydration reactions, of which the mechanism is studied by density functional theory calculations. Deleterious effects such as thickness reduction over time could be suppressed by applying a protective Al2O3 layer on top of alucone. A preliminary nucleation period was required in the ALD process of Al2O3 films on alucone surfaces, prior to reaching a linear regime where the thickness increases linearly with respect to the number of ALD cycles. The same behavior was observed for alucone growing on Al2O3. The protective Al2O3 films were found to effectively suppress moisture permeation, thus isolating the underlying alucone from the surrounding environment. The water vapor transmission rate was greatly reduced when an Al2O3/alucone/Al2O3 multilayer stack was formed, which suggests that proper combinations of organic/inorganic hybrid structures may provide chemically stable platforms, especially for mechanically flexible applications.

Highly conducting, transparent, and flexible indium oxide thin film prepared by atomic layer deposition using a new liquid precursor Et2InN(SiMe3)2.

Highly conductive indium oxide films, electrically more conductive than commercial sputtered indium tin oxide films films, were deposited using a new liquid precursor Et2InN(SiMe3)2 and H2O by atomic layer deposition (ALD) at 225-250 °C. Film resistivity can be as low as 2.3 × 10(-4)-5.16 × 10(-5) Ω·cm (when deposited at 225-250 °C). Optical transparency of >80% at wavelengths of 400-700 nm was obtained for all the deposited films. A self-limiting ALD growth mode was found 0.7 Å/cycle at 175-250 °C. X-ray photoelectron spectroscopy depth profile analysis showed pure indium oxide thin film without carbon or any other impurity. The physical and chemical properties were systematically analyzed by transmission electron microscopy, electron energy loss spectroscopy, X-ray diffraction, optical spectrometer, and hall measurement; it was found that the enhanced electrical conductivity is attributed to the oxygen deficient InOx phases.

Effects of the Addition of Ecklonia cava Powder on the Selected Physicochemical and Sensory Quality of White Pan Bread.

Physicochemical properties and consumer perception of white pan bread as influenced by the addition of Ecklonia cava powder (ECP) were investigated. Freeze-dried Ecklonia cava were ground, sieved through a laboratory sieve and a fraction with particles less than 250 µm was used. Amount of ECP added (0~3%) to the bread was found to affect the bread quality significantly (P<0.05). pH, bread height, and volume of the control was significantly higher than others (P<0.05) and decreased significantly (P<0.05) with the addition of ECP. Moisture content showed no significant differences (P>0.05). There were distinctive color changes with the addition of the powder: L*- and a*-values decreased but b*-value increased significantly (P<0.05). The hardness of bread was found to increase but both cohesiveness and springiness showed a reverse trend with the addition of the powder. Consumer acceptance test indicated that ECP content 1% on wheat flour could be the recommended supplementation level for the consumers without sacrificing sensory quality.

Steady and Dynamic Shear Rheological Properties of Buckwheat Starch-galactomannan Mixtures.

This study investigated the effects of galacomannans (guar gum, tara gum, and locust bean gum) on the rheological properties of buckwheat starch pastes under steady and dynamic shear conditions. The power law and Casson models were applied to describe the flow behavior of the buckwheat starch and galactomannan mixtures. The values of the apparent viscosity (ηa,100), consistency index (K), and yield stress (σoc) for buckwheat starch-galactomannan mixtures were significantly greater than those for the control, indicating that there was a high synergism of the starch with galactomannans. The magnitudes of storage modulus (G') and loss modulus (G″) for the starch-galactomannan mixtures increased with increasing frequency (ω). The dynamic moduli (G', G″), and complex viscosity (η*) for the buckwheat starch-galactomannan mixtures were significantly higher than those for the control.

Tamsulosin Monotherapy versus Combination Therapy with Antibiotics or Anti-Inflammatory Agents in the Treatment of Chronic Pelvic Pain Syndrome.

PURPOSE: Chronic pelvic pain syndrome (CPPS) is treated by use of various protocols. We compared tamsulosin monotherapy with tamsulosin in combination with antibiotics or anti-inflammatory agents and evaluated the efficacy of these treatments in patients with CPPS. METHODS: Patients (n=107) who were younger than 55 years and diagnosed with CPPS were randomly assigned to treatment with tamsulosin at 0.2 mg (group A), tamsulosin at 0.2 mg plus anti-inflammatory drugs (group B) or tamsulosin at 0.2 mg plus antibiotics (group C) daily. We applied the National Institutes of Health-Chronic Prostatitis Symptom Index (NIH-CPSI) and the International Prostate Symptom Score (IPSS) to evaluate 100 patients who were treated for 12 weeks (7 withdrew). Scores of the three groups were compared by analysis of variance and we also evaluated subscores, which included pain, voiding and quality of life (QoL). RESULTS: All three groups showed statistically significant decreases in NIH-CPSI score, IPSS and subscore scores (P<0.05). There were no statistically significant differences between the groups except for the QoL domain of the IPSS (group A vs. C; P<0.01). CONCLUSIONS: Tamsulosin monotherapy for 12 weeks was effective for treating patients with CPPS, compared with combination therapy with antibiotics or anti-inflammatory drugs.

Engineering ethanologenic Escherichia coli for levoglucosan utilization.

Levoglucosan is a major product of biomass pyrolysis. While this pyrolyzed biomass, also known as bio-oil, contains sugars that are an attractive fermentation substrate, commonly-used biocatalysts, such as Escherichia coli, lack the ability to metabolize this anhydrosugar. It has previously been shown that recombinant expression of the levoglucosan kinase enzyme enables use of levoglucosan as carbon and energy source. Here, ethanologenic E. coli KO11 was engineered for levoglucosan utilization by recombinant expression of levoglucosan kinase from Lipomyces starkeyi. Our engineering strategy uses a codon-optimized gene that has been chromosomally integrated within the pyruvate to ethanol (PET) operon and does not require additional antibiotics or inducers. Not only does this engineered strain use levoglucosan as sole carbon source, but it also ferments levoglucosan to ethanol. This work demonstrates that existing biocatalysts can be easily modified for levoglucosan utilization.

[Development and evaluation of "Hospice Smart Patient" service program].

PURPOSE: The purpose of this study was to develop and implement the Hospice Smart Patient Program and to evaluate its effectiveness. METHODS: It was quasi-experimental non-equivalent pre-post study. Breast cancer patients who underwent surgery, chemotherapy or radiotherapy, or who needed palliative care, participated in the study. Participants were divided into two groups, experimental and control groups based on their preferences. The program was developed after literature review and discussion among experts on hospice and palliative care. Participants who were in the experimental group received either face-to-face or phone "Hospice Smart Patient" Service at least once a week for 5 months. RESULTS: There was a significant difference in quality of life and communication skill between the two groups after the service was provided. In addition, participants in experimental group showed improved decision making skills, mastery sense, and understanding of hospice and palliative care, which would be beneficial in improving their quality of life. CONCLUSION: We have concluded that the "Hospice Smart Patient" Program is useful for cancer patients in decision making, improving self-control and choosing hospice care to improve their quality of life.

[Prediction of optimal gluteal intramuscular needle length by skinfold thickness measurements in Korean adults].

PURPOSE: This study was conducted to assess optimal needle length for gluteal intramuscular injections (IM) via simple skinfold thickness (SFT). METHODS: For this study, 190 healthy adults were recruited and grouped into eight groups according to gender and body mass index (BMI) (kg/m²). The Korean Society for the Study of Obesity criteria defines a BMI under 20 as underweight, 20.1-22.9 as normal, 23-24.9 as overweight and over 25 as obese. For each participant, the SFT of dorsoguteal (DG) and ventrogluteal (VG) sites were measured using a caliper. Subcutaneous tissue thickness was acquired through ultrasonic images. RESULTS: For men in the overweight and obese groups at the DG site, for the obese group at the VG site, and for women in the normal weight, overweight and obese groups at both sites, the mean subcutaneous tissue thickness exceeded 1.84 cm, the minimal length for a 1 inch needle used for IM. At the DG site, optimal intramuscular needle length (OINL) was 1.4 times in women and 1.0 times in men compared to SFT. At the VG site, OINL was 1.3 times in women and 0.9 times in men compared to SFT. CONCLUSION: The results of this study suggest that SFT is a reliable index to determine optimal needle length with minimal effort prior to IM.

The value-congruence model of memory for emotional experiences: an explanation for cultural differences in emotional self-reports.

In 3 studies, the authors found support for the value-congruence model that accounts for cultural variations in memory for emotional experiences. In Study 1, the authors found that in the made-in-the-U.S. scenario condition, European Americans were more accurate than were Asian Americans in their retrospective frequency judgments of emotions. However, in the made-in-Japan scenario condition, European Americans were less accurate than were Asian Americans. In Study 2, the authors demonstrated that value orientation mediates the CulturexType of Event congruence effect. In Study 3 (a daily event sampling study), the authors showed that the congruence effect was explained by the importance of parental approval. In sum, emotional events congruent with personal values remain in memory longer and influence retrospective frequency judgments of emotion more than do incongruent events.

[The development and effects of a self-management program for patients with Parkinson's disease].

PURPOSE: This study was done to develop and examine the effects of a self-management program (SMP) on physical, psychological functions, and symptoms in patients with Parkinson's disease(PD). METHODS: In a two-group pre-and post-test design, a total of 40 patients were assigned to the experimental group(21) or the control group (19). The experimental group received eight weekly 2-hour sessions for 10-15 literate adults of all ages, while the control group did not receive any intervention. RESULTS: The experimental group showed significant improvements in muscle strength, balance, self-efficacy, depression, quality of life(QL), quality of sleep, and discomfort of constipation. It also reduced the number of participants using assistive walking devices. There were no significant changes in fear of falling and duration of sleep. CONCLUSION: The eight week SMP in patients with PD was found to be significantly effective in enhancing muscle strength, balance, self-efficacy, QL, and quality of sleep. It also decreased depression, discomfort of constipation, and assistive walking devices. These results suggest that a SMP can have effects on physical, psychological functions and symptoms in patients with PD. Further research with a larger sample and for a longer follow up period is needed to expand our understanding of the effects of a SMP for patients with PD.

The dynamics of daily events and well-being across cultures: when less is more.

The authors examined cultural and individual differences in the relation between daily events and daily satisfaction. In a preliminary study, they established cross-cultural equivalence of 50 daily events. In the main study, participants in the United States, Korea, and Japan completed daily surveys on the 50 events and daily satisfaction for 21 days. The multilevel random coefficient model analyses showed that (a) the within-person association between positive events and daily satisfaction was significantly stronger among Asian American, Korean, and Japanese participants than among European American participants and (b) the within-person association between positive events and daily satisfaction was significantly weaker among individuals high in global life satisfaction than among those low in global life satisfaction. The findings demonstrate a weaker effect of positive events on daily well-being among individuals and cultures high in global well-being.