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Magnetic random-access memory (MRAM), which stores information through control of the magnetization direction, offers promising features as a viable nonvolatile memory alternative, including high endurance and successful large-scale commercialization. Recently, MRAM applications have extended beyond traditional memories, finding utility in emerging computing architectures such as in-memory computing and probabilistic bits. In this work, we report highly reliable MRAM-based security devices, known as physical unclonable functions (PUFs), achieved by exploiting nanoscale perpendicular magnetic tunnel junctions (MTJs). By intentionally randomizing the magnetization direction of the antiferromagnetically coupled reference layer of the MTJs, we successfully create an MRAM-PUF. The proposed PUF shows ideal uniformity and uniqueness and, in particular, maintains performance over a wide temperature range from -40 to +150 °C. Moreover, rigorous testing with more than 1584 challenge-response pairs of 64 bits each confirms resilience against machine learning attacks. These results, combined with the merits of commercialized MRAM technology, would facilitate the implementation of MRAM-PUFs.
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We selectively improved the viewing angle characteristics and light extraction efficiency of blue thermally activated delayed fluorescence (TADF) organic light-emitting diodes (OLEDs) by tailoring a nanofiber-shaped Si3N4 layer, which was used as an internal scattering layer. The diameter of the polymer nanofibers changed according to the mass ratio of polyacrylonitrile (PAN) and poly(methyl methacrylate) (PMMA) in the polymer solution for electrospinning. The Si3N4 nanofiber (SNF) structure was fabricated by etching an Si3N4 film using the PAN/PMMA nanofiber as a mask, making it easier to adjust parameters, such as the diameter, open ratio, and height, even though the SNF structure was randomly shaped. The SNF structures exhibited lower transmittance and higher haze with increasing diameter, showing little correlation with their height. However, all the structures demonstrated a total transmittance of over 80%. Finally, by applying the SNF structures to the blue TADF OLEDs, the external quantum efficiency was increased by 15.6%. In addition, the current and power efficiencies were enhanced by 23.0% and 25.6%, respectively. The internal light-extracting SNF structure also exhibited a synergistic effect with the external light-extracting structure. Furthermore, when the viewing angle changed from 0° to 60°, the peak wavelength and CIE coordinate shift decreased from 20 to 6 nm and from 0.0561 to 0.0243, respectively. These trends were explained by the application of Snell's law to the light path and were ultimately validated through finite-difference time-domain simulations.
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The recent discovery of room-temperature ferromagnetism in 2D van der Waals (vdW) materials, such as Fe3GaTe2 (FGaT), has garnered significant interest in offering a robust platform for 2D spintronic applications. Various fundamental operations essential for the realization of 2D spintronics devices are experimentally confirmed using these materials at room temperature, such as current-induced magnetization switching or tunneling magnetoresistance. Nevertheless, the potential applications of magnetic skyrmions in FGaT systems at room temperature remain unexplored. In this work, the current-induced generation of magnetic skyrmions in FGaT flakes employing high-resolution magnetic transmission soft X-ray microscopy is introduced, supported by a feasible mechanism based on thermal effects. Furthermore, direct observation of the current-induced magnetic skyrmion motion at room temperature in FGaT flakes is presented with ultra-low threshold current density. This work highlights the potential of FGaT as a foundation for room-temperature-operating 2D skyrmion device applications.
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Hierarchical superstructures have novel shape-dependent properties, but well-defined anisotropic carbon superstructures with controllable size, shape, and building block dimensionality have rarely been accomplished thus far. Here, a hierarchical assembly technique is presented that uses spinodal decomposition (SD) to synthesize anisotropic oblate particles of mesoporous carbon superstructure (o-MCS) with nanorod arrays by integrating block-copolymer (BCP) self-assembly and polymer-polymer interface behaviors in binary blends. The interaction of major and minor phases in binary polymer blends leads to the formation of an anisotropic oblate particle, and the BCP-rich phase enables ordered packing and unidirectional alignment of carbon nanorods. Consequently, this approach enables precise control over particles' size, shape, and over the dimensionality of their components. Exploiting this functional superstructure, o-MCS are used as an anode material in potassium-ion batteries, and achieve a notable specific capacity of 156 mA h g-1 at a current density of 2 A g-1, and long-term stability for 3000 cycles. This work presents a significant advancement in the field of hierarchical superstructures, providing a promising strategy for the design and synthesis of anisotropic carbon materials with controlled properties, offering promising applications in energy storage and beyond.
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Anisotropic lens-shaped nitrogen-doped carbon (Lens-NMC) with unidirectionally aligned mesopores was achieved via perpendicular block copolymer self-assembly at the polymer interface. Lens-NMC is applied as a potassium-ion battery anode material as a next-generation battery system.
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Aim: While the relationship between impaired kidney function and non-vitamin K antagonist oral anticoagulants (NOACs) is well established, there is limited research exploring the association between an elevated estimated glomerular filtration rate (eGFR) and the efficacy of NOACs, especially concerning the outcomes of acute ischemic stroke (AIS). This study aimed to examine the association between higher-than-normal eGFR and the severity of AIS during the use of NOACs using a nationwide multicenter stroke registry in Korea. Material and methods: This study utilized data from the Korean Stroke Registry (KSR) database, examining information from 2,379 patients with AIS, who had atrial fibrillation (AF) and a history of utilizing NOACs prior to hospitalization due to incident stroke occurring between 2016 and 2021. Patients with a history involving two or more types of anticoagulants or one or more forms of antiplatelet agents were excluded. Baseline characteristics, medical history, medication usage, CHADS2-VASc score, and the anticoagulation and risk factors in atrial fibrillation (ATRIA) score were evaluated. Renal function was assessed using eGFR levels and calculated with the Cockcroft-Gault equation. The severity of stroke was measured by the National Institutes of Health Stroke Scale as an outcome. For sensitivity analysis, further evaluation was performed using eGFR levels according to the modification of diet in renal disease (MDRD) study equation. Results: The mean age of subjects was 76.1 ± 8.9 years. The moderate-to-severe stroke severity group exhibited an elevation in creatinine levels. The eGFR of 60 to 89 mL/min/1.73 m2 group was associated with a decreased risk of moderate-to-severe stroke severity [hazard ratio (HR)] (0.77, 95% confidence interval (CI) [0.61, 0.98], p = 0.031) compared to the eGFR≥90 mL/min/1.73 m2 group. An increment of 10 units in eGFR was marginally associated with an increased risk of moderate-to-severe stroke severity (HR: 1.03, 95% CI [1.00, 1.07], p = 0.054). Conclusion: The study revealed that individuals with eGFR ≥ 90 mL/min/1.73 m2 had an association linked to an increased risk of moderate-to-severe stroke severity. Our study suggests that patients taking NOACs with higher-than-normal eGFR levels may have an increased severity of AIS.
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Background and Purpose: Cardiac biomarkers including, elevated troponin (ET) and prolonged heart rate-corrected QT (PQTc) interval on electrocardiography are known to frequent and have a prognostic significance in patients with acute ischemic stroke (AIS). However, it is still challenging to practically apply the results for appropriate risk stratification. This study evaluate whether combining ET and PQTc interval can better assess the long-term prognosis in AIS patients. Methods: In this prospectively registered observational study between May 2007 and December 2011, ET was defined as serum troponin-I ≥ 0.04â ng/ml and PQTc interval was defined as the highest tertile of sex-specific QTc interval (men ≥ 469â ms or women ≥ 487â ms). Results: Among the 1,668 patients [1018 (61.0%) men; mean age 66.0 ± 12.4 years], patients were stratified into four groups according to the combination of ET and PQTc intervals. During a median follow-up of 33 months, ET (hazard ratio [HR]: 4.38, 95% confidence interval [CI]: 2.94-6.53) or PQTc interval (HR: 1.53, 95% CI: 1.16-2.01) alone or both (HR: 1.77, 95% CI: 1.16-2.71) was associated with increased all-cause mortality. Furthermore, ET, PQTc interval alone or both was associated with vascular death, whereas only ET alone was associated with non-vascular death. Comorbidity burden, especially atrial fibrillation and congestive heart failure, and stroke severity gradually increased both with troponin value and QTc-interval. Conclusions: In patients with AIS, combining ET and PQTc interval on ECG enhances risk stratification for long-term mortality while facilitating the discerning ability for the burden of comorbidities and stroke severity.
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BACKGROUND: Ventricular tachyarrhythmia is a potentially fatal outcome of cardiac surgery. Abrupt changes in the hemodynamics after surgical correction of valvular heart disease (VHD) can lead to alterations in ventricular repolarization. We compared the difference between temporal changes in repolarization parameters after correction of left-sided VHD. METHODS: We retrospectively analyzed the electrograms of patients who underwent surgical correction of isolated VHD between 2006 and 2015 at Asan Medical Center, including mitral stenosis (MS), mitral regurgitation (MR), aortic stenosis (AS), and aortic regurgitation (AR). Ventricular repolarization parameters were measured at pre-specified time intervals after index surgery using a custom-made ECG analysis program. We compared repolarization parameters, including QT and corrected QT intervals, T peak-to-end interval, and corrected T peak-to-end interval. RESULTS: Analysis of 8265 ECGs from 2110 patients (266 MS, 1059 MR, 421 AS, and 364 AR) was performed. Patients with AS were characterized by older age and more comorbidities than other VHDs. The corrected QT interval showed a peak value immediately after surgery and decreased thereafter in the AS groups. However, a gradual increase over 1 month after surgery in AR, MS, and MR groups was observed. The corrected T peak-to-end interval increased in the MS and MR groups and was unchanged in the AS and AR groups. CONCLUSIONS: The repolarization parameters of surgery changed dynamically after left-sided valvular surgery. Understanding differential temporal change of repolarization parameters according to the type of VHD would help clinicians avoid fatal arrhythmias related to the repolarization changes.
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Estenose da Valva Aórtica , Doenças das Valvas Cardíacas , Insuficiência da Valva Mitral , Humanos , Eletrocardiografia , Estudos Retrospectivos , Arritmias Cardíacas/cirurgia , Doenças das Valvas Cardíacas/cirurgia , Comorbidade , Insuficiência da Valva Mitral/cirurgiaRESUMO
BACKGROUND AND PURPOSE: We investigated the impact of comorbidity burden on troponin elevation, with separate consideration of neurological conditions, in patients with acute ischemic stroke (AIS). METHODS: This prospective, observational cohort study consecutively enrolled patients with AIS for 2 years. Serum cardiac troponin I was repeatedly measured, and disease-related biomarkers were collected for diagnosis of preassigned comorbidities, including atrial fibrillation (AF), ischemic heart disease (IHD), myocardial hypertrophy (MH), heart failure (HF), renal insufficiency (RI), and active cancer. The severity of neurological deficits and insular cortical ischemic lesions were assessed as neurological conditions. Adjusted associations between these factors and troponin elevation were determined using a multivariate ordinal logistic regression model and area under the receiver operating characteristic curve (AUC). Cox proportional hazards model was used to determine the prognostic significance of comorbidity beyond neurological conditions. RESULTS: Among 1,092 patients (66.5±12.4 years, 63.3% male), 145 (13.3%) and 335 (30.7%) had elevated (≥0.040 ng/mL) and minimally-elevated (0.040-0.010 ng/mL) troponin, respectively. In the adjusted analysis, AF, MH, HF, RI, active cancer, and neurological deficits were associated with troponin elevation. The multivariate model with six comorbidities and two neurological conditions exhibited an AUC of 0.729 (95% confidence interval [CI], 0.698-0.759). In Cox regression, AF, IHD, and HF were associated with adverse cardio-cerebrovascular events, whereas HF and active cancer were associated with mortality. CONCLUSION: Troponin elevation in patients with AIS can be explained by the burden of comorbidities in combination with neurological status, which explains the prognostic significance of troponin assay.
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Physical unclonable function (PUFs) utilize inherent random physical variations of solid-state devices and are a core ingredient of hardware security primitives. PUFs promise more robust information security than that provided by the conventional software-based approaches. While silicon- and memristor-based PUFs are advancing, their reliability and scalability require further improvements. These are currently limited by output fluctuations and associated additional peripherals. Here, highly reliable spintronic PUFs that exploit field-free spin-orbit-torque switching in IrMn/CoFeB/Ta/CoFeB structures are demonstrated. It is shown that the stochastic switching polarity of the perpendicular magnetization of the top CoFeB can be achieved by manipulating the exchange bias directions of the bottom IrMn/CoFeB. This serves as an entropy source for the spintronic PUF, which is characterized by high entropy, uniqueness, reconfigurability, and digital output. Furthermore, the device ensures a zero bit-error-rate under repetitive operations and robustness against external magnetic fields, and offers scalable and energy-efficient device implementations.
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Octahedral symmetry is one of the parameters to tune the functional properties of complex oxides. VO2, a complex oxide with a 3d1 electronic system, exhibits an insulator-metal transition (IMT) near room temperature (â¼68 °C), accompanying a change in the octahedral structure from asymmetrical to symmetrical. However, the role of octahedral symmetry in VO2 on the IMT characteristics is unclear. Crystal and electronic structure analyses combined with density-functional-theory calculations showed the bandwidth-controlled IMT characteristics of monoclinic VO2 with high octahedral symmetry. The expanded apical V-O length for a high octahedral symmetry of a VO2 film increased the bandwidth of the conduction band by depressing V 3d-O 2p hybridization. As a result, the interdimer hopping energy increased and thereby decreased the IMT temperature, although the short V-V chain enhanced electron correlation. These findings suggest that octahedral symmetry can control the IMT characteristics of VO2 by changing the orbital occupancy.
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We aimed to investigate the relationship between cataract surgery and all-cause and cause-specific mortality in Korean elderly patients with cataract using the Korean National Health Insurance Service-Senior cohort database. Elderly patients (≥60 years) diagnosed with cataract from 2002 through 2012 were included. The baseline characteristics included demographics and systemic and ocular comorbidities. Adjusted Cox regression models with time-varying covariates for cataract surgery were used to assess the relationship between cataract surgery and mortality. The study cohort included 241,062 patients, of whom 127,941 were in the cataract surgery group and 113,121 were in the cataract diagnosis group. The incidence of all-cause mortality was 3.62 deaths/100 person-years and 3.19 deaths/100 person-years in the cataract surgery and cataract diagnosis groups, respectively. Cataract surgery was associated with a decreased hazard of all-cause mortality after adjusting for demographics as well as systemic and ocular comorbidities (hazard ratio (HR), 0.93; p < 0.001). A protective association was noted between cataract surgery and mortality from vascular (HR, 0.92; p < 0.001) or neurologic (HR, 0.64; p < 0.001) causes. Patients with cataract who were 85 years of age and older, women, those who had lower income, and a Charlson comorbidity index score of 5 or more, or those without glaucoma revealed the largest reductions in mortality hazards resulting from cataract surgery.
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Background and Objectives: Cerebral aneurysms can cause disability or death during rupture, but information on the etiology of cerebral aneurysms is currently lacking. Periodontal disease causes both systemic inflammation and local inflammation of the oral cavity. Systemic inflammation is a major cause of cerebral aneurysms. The aim of our study was to determine whether the presence of periodontal disease is related to the occurrence of unruptured cerebral aneurysms in a nationwide population-based cohort. Materials and Methods: We analyzed data on demographics, previous medical history, and laboratory test results of 209,620 participants from the Korean National Health Insurance System-Health Screening Cohort. The presence of periodontal disease and oral hygiene parameters, including the number of lost teeth, tooth brushing frequency per day, dental visits for any reason, and expert teeth scaling, were investigated. The occurrences of unruptured cerebral aneurysms (I67.1) were defined according to the International Statistical Classification of Diseases Related Health Problems-10. Results: The mean age of the participants was 53.7 ± 8.7 years, and 59.4% were male. Periodontal disease was found in 20.9% of the participants. A total of 2160 (1.0%) cases of unruptured cerebral aneurysms developed after 10.3 years of median follow up. In multivariate analysis, the presence of periodontal disease was significantly associated with an increased risk of unruptured cerebral aneurysms (hazard ratio: 1.21, 95% confidence interval: 1.09-1.34, p < 0.001). Conclusion: The presence of periodontal disease could be associated with the occurrence of unruptured cerebral aneurysms. It should be noted that when periodontal diseases are present, the risk of aneurysms is increased in the future.TRANSLATE with x EnglishArabicHebrewPolishBulgarianHindiPortugueseCatalanHmong DawRomanianChinese SimplifiedHungarianRussianChinese TraditionalIndonesianSlovakCzechItalianSlovenianDanishJapaneseSpanishDutchKlingonSwedishEnglishKoreanThaiEstonianLatvianTurkishFinnishLithuanianUkrainianFrenchMalayUrduGermanMalteseVietnameseGreekNorwegianWelshHaitian CreolePersian// TRANSLATE with COPY THE URL BELOW Back EMBED THE SNIPPET BELOW IN YOUR SITE Enable collaborative features and customize widget: Bing Webmaster PortalBack//.
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Aneurisma Intracraniano , Doenças Periodontais , Adulto , Estudos de Coortes , Humanos , Aneurisma Intracraniano/epidemiologia , Masculino , Pessoa de Meia-Idade , Doenças Periodontais/complicações , Doenças Periodontais/epidemiologia , República da Coreia/epidemiologia , Escovação DentáriaRESUMO
Two-dimensional (2D) porous inorganic nanomaterials have intriguing properties as a result of dimensional features and high porosity, but controlled production of circular 2D shapes is still challenging. Here, we designed a simple approach to produce 2D porous inorganic nanocoins (NCs) by integrating block copolymer (BCP) self-assembly and orientation control of microdomains at polymer-polymer interfaces. Multicomponent blends containing BCP and homopoly(methyl methacrylate) (hPMMA) are designed to undergo macrophase separation followed by microphase separation. The balanced interfacial compatibility of BCP allows perpendicularly oriented lamellar-assembly at the interfaces between BCP-rich phase and hPMMA matrix. Disassembly of lamellar structures and calcination yield ultrathin 2D inorganic NCs that are perforated by micropores. This approach enables control of the thickness, size, and chemical composition of the NCs. 2D porous and acidic aluminosilicate NC (AS-NC) is used to fabricate an ultrathin and lightweight functional separator for lithium-sulfur batteries. The AS-NC layer acts as an ionic sieve to selectively block lithium polysulfides. Abundant acid sites chemically capture polysulfides, and micropores physically exclude them, so sulfur utilization and cycle stability are increased.
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BACKGROUND AND PURPOSE: This study aimed to evaluate the comparative efficacy and safety of 4 non-vitamin K antagonist oral anticoagulants (NOACs) and warfarin in Asians with non-valvular atrial fibrillation in real-world practice through a network meta-analysis of observational studies. METHODS: We searched multiple comprehensive databases (PubMed, Embase, and Cochrane library) for studies published until August 2020. Hazard ratios and 95% confidence intervals were used for the pooled estimates. Efficacy outcomes included ischemic stroke (IS), stroke/systemic embolism (SSE), myocardial infarction (MI), and all-cause mortality, and safety outcomes included major bleeding, gastrointestinal (GI) bleeding, and intracerebral hemorrhage (ICH). The P score was calculated for ranking probabilities. Subgroup analyses were separately performed in accordance with the dosage range of NOACs ("standard-" and "low-dose"). RESULTS: A total of 11, 6, and 8 studies were allocated to the total population, standard-dose group, and low-dose group, respectively. In the total study population, edoxaban ranked the best in terms of IS and ICH prevention and apixaban ranked the best for SSE, major bleeding, and GI bleeding. In the standard-dose regimen, apixaban ranked the best in terms of IS and SSE prevention. For major bleeding, GI bleeding, and ICH, edoxaban ranked the best. In the low-dose regimen, edoxaban ranked the best for IS, SSE, GI bleeding, and ICH prevention. For major bleeding prevention, apixaban ranked best. CONCLUSIONS: All 4 NOACs had different efficacy and safety outcomes according to their type and dosage. Apixaban and edoxaban might be relatively better and more well-balanced treatment for Asian patients with non-valvular atrial fibrillation.
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Fibrilação Atrial , Inibidores do Fator Xa , Acidente Vascular Cerebral , Varfarina/farmacologia , Anticoagulantes/farmacologia , Povo Asiático/estatística & dados numéricos , Fibrilação Atrial/etiologia , Fibrilação Atrial/prevenção & controle , Inibidores do Fator Xa/classificação , Inibidores do Fator Xa/farmacologia , Humanos , Avaliação de Resultados em Cuidados de Saúde , Acidente Vascular Cerebral/complicações , Acidente Vascular Cerebral/tratamento farmacológicoRESUMO
In this study, we investigated the effect of an Al2O3barrier layer in an all-solid-state inorganic Li-based nano-ionic synaptic transistor (LST) with Li3PO4electrolyte/WOxchannel structure. Near-ideal synaptic behavior in the ultralow conductance range (â¼50 nS) was obtained by controlling the abrupt ion migration through the introduction of a sputter-deposited thin (â¼3 nm) Al2O3interfacial layer. A trade-off relationship between the weight update linearity and on/off ratio with varying Al2O3layer thickness was also observed. To determine the origin of the Al2O3barrier layer effects, cyclic voltammetry analysis was conducted, and the optimal ionic diffusivity and mobility were found to be key parameters in achieving ideal synaptic behavior. Owing to the controlled ion migration, the retention characteristics were considerably improved by the Al2O3barrier. Finally, a highly improved pattern recognition accuracy (83.13%) was achieved using the LST with an Al2O3barrier of optimal thickness.
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BACKGROUND: We assessed the feasibility of a hybrid monitoring system (minimal on-site monitoring + strategic central monitoring) used at the academic research office at Asan Medical Center (Seoul, Korea) in monitoring investigator-sponsored oncology trials. METHODS: Monitoring findings in three oncology trials conducted between 2014 and 2017 were compared. A confirmatory source data verification (SDV) was carried out in the low-risk trial and compared with the central monitoring findings. The economic advantages of central monitoring were tested by calculating the monitoring hours per patient. RESULTS: A total of 50, 118, 228 patients were enrolled in the high-, intermediate-, and low-risk trials, respectively. The high-risk trial was monitored through 42 on-site visits (1299 findings); the intermediate-risk trial had 79 monitorings (on-site, 24%; central, 76%; 1464 findings); the low-risk trial had 197 monitorings (on-site, 4%; central, 96%; 3364 findings). Central monitoring was more effective than on-site monitoring in revealing minor errors such as "missing case report forms" and "data outliers" (both P < 0.0001), and showed comparable results in revealing major issues such as investigational product compliance and delayed reporting of serious adverse events (both P > 0.05). Confirmatory SDV in the low-risk trial revealed more findings than central monitoring in the "inconsistent data" and "inappropriate adverse event" categories. The total monitoring hours per patient were lower in the intermediate- and low-risk trials than in the high-risk trial (8.1 and 7.3 vs. 14.3 h, respectively). CONCLUSION: Our hybrid monitoring system showed acceptable feasibility in revealing both major and minor issues in multi-center oncology investigator-sponsored trials.
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Neoplasias , Estudos de Viabilidade , Humanos , Neoplasias/tratamento farmacológico , República da CoreiaRESUMO
Background and Purpose: The aim of this study was to determine the relationship between the heart rate-corrected QT (QTc) interval and the risk of incident long-term mortality in patients with acute ischemic stroke (AIS), considering the impact of sex differences on clinical characteristics, outcomes, and QTc intervals. Methods: We analyzed prospectively registered data included patients with AIS who visited the emergency room within 24 h of stroke onset and underwent routine cardiac testing, such as measurements of cardiac enzymes and 12-lead ECG. QTc interval was corrected for heart rate using Fridericia's formula and was stratified by sex-specific quartiles. Cox proportional hazards models were used to examine the association between baseline QTc interval and incident all-cause death. Results: A total of 1,668 patients with 1,018 (61.0%) men and mean age 66.0 ± 12.4 years were deemed eligible. Based on the categorized quartiles of the QTc interval, cardiovascular risk profile, and stroke severity increased with prolonged QTc interval, and the risk of long-term mortality increased over a median follow-up of 33 months. Cox proportional hazard model analysis showed that the highest quartile of QTc interval (≥479 msec in men and ≥498 msec in women; hazard ratio [HR]: 1.49, 95% confidence interval [CI]: 1.07-2.08) was associated with all-cause death. Furthermore, dichotomized QTc interval prolongation, defined by the highest septile of the QTc interval (≥501 ms in men and ≥517 m in women: HR: 1.33, 95% CI: 1.00-1.80) was significantly associated with all-cause mortality after adjusting for all clinically relevant variables, such as stroke severity. Conclusions: Prolonged QTc interval was associated with increased risk of long-term mortality, in parallel with the increasing trend of prevalence of cardiovascular risk profiles and stroke severity, across sex differences in AIS patients.
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OBJECTIVE: The efficacy of antidepressants in post-stroke depressive symptoms (PSD) varies. We aimed to examine whether the effect of escitalopram on PSD differs according to individual depressive symptoms and stroke lesion location. METHODS: This is a post hoc analysis of EMOTION (ClinicalTrials.gov, NCT01278498), a randomized, placebo-controlled, double-blind trial that examined the efficacy of escitalopram on depression in acute stroke patients (237 with placebo, 241 with escitalopram). Depressive symptoms were evaluated with the 10-item Montgomery-Åsberg Depression Rating Scale (MADRS). Changes in MADRS and individual item scores at 12 weeks were compared between the treatment groups and among the stroke lesion location groups. Stroke lesion locations were grouped according to the anatomical distribution of serotonin fibers that originate from the midbrain/pons and spread to the forebrain via subcortical structures: "Midbrain-Pons," "Frontal-Subcortical," and "Others." Least-squares means were calculated to demonstrate the independent effect of lesion location. RESULTS: Total MADRS scores decreased more significantly in the escitalopram than in the placebo group, while a significant effect of escitalopram was observed in only 3 items: apparent sadness, reported sadness, pessimistic thoughts. In the lesion location analyses, escitalopram users in the Frontal-Subcortical group showed significant improvement in total MADRS scores (placebo [n = 130] vs. escitalopram [n = 148], least-square mean [95% CI]: -2.3 [-3.5 to -0.2] vs. -4.5 [-5.5 to -3.4], p = .005), while those in the Midbrain-Pons and Others groups did not. CONCLUSIONS: The effect of escitalopram on PSD may be more prominent in patients with particular depressive symptoms and stroke lesion locations, suggesting the need for tailored treatment strategies.
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Transtorno Depressivo Maior , Acidente Vascular Cerebral , Citalopram/uso terapêutico , Depressão/tratamento farmacológico , Depressão/etiologia , Método Duplo-Cego , Escitalopram , Humanos , Inibidores Seletivos de Recaptação de Serotonina/uso terapêutico , Acidente Vascular Cerebral/complicações , Acidente Vascular Cerebral/tratamento farmacológico , Resultado do TratamentoRESUMO
Studies on the hydrogen incorporated M1 phase of VO2 film have been widely reported. However, there are few works on an M2 phase of VO2. Recently, the M2 phase in VO2 has received considerable attention due to the possibility of realizing a Mott transition field-effect transistor. By varying the postannealing environment, systematic variations of the M2 phase in (020)-oriented VO2 films grown on Al2O3(0001) were observed. The M2 phase converted to the metallic M1 phase at first and then to the metallic rutile phase after hydrogen annealing (i.e., for H2/N2 mixture and H2 environments). From the diffraction and spectroscopy measurements, the transition is attributed to suppressed electron interactions, not structural modification caused by hydrogen incorporation. Our results suggest the understanding of the phase transition process of the M2 phase by hydrogen incorporation and the possibility of realization of the M2 phased-based Mott transition field-effect transistor.