A Simple Nomogram for Predicting Stroke-Associated Pneumonia in Patients with Acute Ischemic Stroke.

The purpose of this study was to develop a prediction model for stroke-associated pneumonia (SAP) based on risk factors for SAP and to suggest nursing interventions to prevent SAP. In addition, a nomogram was developed to enhance its utility in nursing practice. The retrospective cohort study included 551 patients hospitalized for acute ischemic stroke at a university hospital in South Korea. Data were collected through a structured questionnaire and a review of the electronic medical record (EMR). In the development of a predictive model for SAP, multivariate logistic regression analysis showed that independent risk factors for SAP were age ≥ 65 years, National Institute of Health Stroke Scale (NIHSS) score ≥ 7, nasogastric tube feeding, and C-reactive protein (CRP) ≥ 5.0 mg/dL. The logit model was used to construct the SAP prediction nomogram, and the area under the curve (AUC) of the nomogram was 0.94. Furthermore, the slope of the calibration plot was close to the 45-degree line, indicating that the developed nomogram may be useful for predicting SAP. It is necessary to monitor the age, NIHSS score, nasogastric tube feeding status, and CRP level of stroke patients and identify high-risk groups using the developed nomogram to provide active nursing interventions to prevent SAP.

Role of α-Defensin and the Microbiome in Prosthetic Joint Infection: A Prospective Cohort Study in Korea.

The utility of α-defensin (AD), leukocyte esterase (LE) levels, and metagenomics sequencing as diagnostic tools for prosthetic joint infection (PJI) has been suggested, but there are few studies among the Asian population. This study aimed to evaluate the diagnostic performance of various biomarkers for PJI and the role of the microbiome in the synovial fluid of patients with prostheses. Patients with suspected knee PJI were enrolled, and their blood and synovial fluid were collected. The cases were classified into the PJI and non-PJI groups. Significant differences between the two groups were observed in the levels of AD (4698 µg/L vs. 296 µg/L, p < 0.001) and positivity for LE (62.5% vs. 21.1%, p = 0.01). AD had 94.4% sensitivity and 89.5% specificity for diagnosing PJI, whereas LE had 37.5% sensitivity and 100% specificity. Microbiome taxonomic profiling showed high sensitivity. The number of operational taxonomic units and the richness of the microbiome in the synovial fluid were higher in the non-PJI than in the PJI group. AD has shown encouraging results in the Asian population as a diagnostic biomarker for PJI, and LE can be used as a diagnostic adjunct. The bacterial richness of the synovial fluid is likely associated with infections.

Immunogenicity and Safety of Vaccines against Coronavirus Disease in Actively Treated Patients with Solid Tumors: A Prospective Cohort Study.

PURPOSE: We aimed to assess the humoral response to and reactogenicity of coronavirus disease 2019 (COVID-19) vaccination according to the vaccine type and to analyze factors associated with immunogenicity in actively treated solid cancer patients (CPs). Materials and Methods: Prospective cohorts of CPs, undergoing anticancer treatment, and healthcare workers (HCWs) were established. The participants had no history of previous COVID-19 and received either mRNA-based or adenovirus vector-based (AdV) vaccines as the primary series. Blood samples were collected before the first vaccination and after 2 weeks for each dose vaccination. Spike-specific binding antibodies (bAbs) in all participants and neutralizing antibodies (nAbs) against severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) wild-type, Delta, and Omicron variants in CPs were analyzed and presented as the geometric mean titer. RESULTS: Age-matched 20 HCWs and 118 CPs were included in the analysis. The bAb seroconversion rate and antibody concentrations after the first vaccination were significantly lower in CPs than in HCWs. After the third vaccination, antibody levels in CPs with a primary series of AdV were comparable to those in HCWs, but nAb titers against the Omicron variant did not quantitatively increase in CPs with AdV vaccine as the primary series. The incidence and severity of adverse reactions post-vaccination were similar between CPs and HCWs. CONCLUSION: CPs displayed delayed humoral immune response after SARS-CoV-2 vaccination. The booster dose elicited comparable bAb concentrations between CPs and HCWs, regardless of the primary vaccine type. Neutralization against the Omicron variant was not robustly elicited following the booster dose in some CPs, implying the need for additional interventions to protect them from COVID-19.

A heterologous AZD1222 priming and BNT162b2 boosting regimen more efficiently elicits neutralizing antibodies, but not memory T cells, than the homologous BNT162b2 regimen.

BACKGROUND: Comparative analyses of SARS-CoV-2-specific immune responses elicited by diverse prime-boost regimens are required to establish efficient regimens for the control of COVID-19. METHOD: In this prospective observational cohort study, spike-specific immunoglobulin G (IgG) and neutralizing antibodies (nAbs) alongside spike-specific T-cell responses in age-matched groups of homologous BNT162b2/BNT162b2 or AZD1222/AZD1222 vaccination, heterologous AZD1222/BNT162b2 vaccination, and prior wild-type SARS-CoV-2 infection/vaccination were evaluated. RESULTS: Peak immune responses were achieved after the second vaccine dose in the naïve vaccinated groups and after the first dose in the prior infection/vaccination group. Peak titers of anti-spike IgG and nAb were significantly higher in the AZD1222/BNT162b2 vaccination and prior infection/vaccination groups than in the BNT162b2/BNT162b2 or AZD1222/AZD1222 groups. However, the frequency of interferon-γ-producing CD4+ T cells was highest in the BNT162b2/BNT162b2 vaccination group. Similar results were observed in the analysis of polyfunctional T cells. When nAb and CD4+T-cell responses against the Delta variant were analyzed, the prior infection/vaccination group exhibited higher responses than the groups of other homologous or heterologous vaccination regimens. CONCLUSION: nAbs are efficiently elicited by heterologous AZD1222/BNT162b2 vaccination, as well as prior infection/vaccination, whereas spike-specific CD4+T-cell responses are efficiently elicited by homologous BNT162b2 vaccination. Variant-recognizing immunity is more efficiently generated by prior infection/vaccination than the other homologous or heterologous vaccination regimens.

In Vitro Replication Inhibitory Activity of Xanthorrhizol against Severe Acute Respiratory Syndrome Coronavirus 2.

In spite of the large number of repositioned drugs and direct-acting antivirals in clinical trials for the management of the ongoing COVID-19 pandemic, there are few cost-effective therapeutic options for severe acute respiratory syndrome (SARS) coronavirus 2 (SCoV2) infection. In this paper, we show that xanthorrhizol (XNT), a bisabolane-type sesquiterpenoid compound isolated from the Curcuma xanthorrhizza Roxb., a ginger-line plant of the family Zingiberaceae, displays a potent antiviral efficacy in vitro against SCoV2 and other related coronaviruses, including SARS-CoV-1 (SCoV1) and a common cold-causing human coronavirus. XNT reduced infectious SCoV2 titer by ~3-log10 at 20 µM and interfered with the replication of the SCoV1 subgenomic replicon, while it had no significant antiviral effects against hepatitis C virus and noroviruses. Further, XNT exerted similar antiviral functions against SCoV2 variants, such as a GH clade strain and a delta strain currently predominant worldwide. Neither SCoV2 entry into cells nor the enzymatic activity of viral RNA polymerase (Nsp12), RNA helicase (Nsp13), or the 3CL main protease (Nsp5) was inhibited by XNT. While its CoV replication inhibitory mechanism remains elusive, our results demonstrate that the traditional folk medicine XNT could be a promising antiviral candidate that inhibits a broad range of SCoV2 variants of concern and other related CoVs.

Association Between Suicide and Drinking Habits in Adolescents.

OBJECTIVES: Adolescent suicide is a serious social problem. Adolescent alcohol use is one of the most important risk factors for adolescent suicide. This study aimed to identify the relationship between drinking habits and suicide among Korean adolescents. METHODS: Data from the 14th and 15th Korean Youth Risk Behavior Web-based Survey, conducted in 2018 and 2019, were used for analysis. Multiple logistic regression analysis was used to identify the relationship between drinking habits-including the age of drinking initiation, frequency of drinking, average drinking amount, frequency of drunkenness-and suicidal ideation, plans, and attempts. RESULTS: Even after adjusting for age, sex, school grade, academic achievement, socioeconomic status, depression, stress, and drinking habits, the frequencies of drinking and drunkenness increased the risk of suicide attempts. Suicide attempts were associated with the frequency of drinking in girls and middle school students, and with the frequency of drunkenness in boys and high school students. CONCLUSION: This study identified associations between drinking habits (the age of drinking initiation, frequency of drinking, average amount of drinking, frequency of drunkenness) and suicidal behavior in adolescents. Our findings suggest that to prevent adolescent suicide, it might be necessary to investigate drinking habits, including the frequencies of drinking and drunkenness. Moreover, considering the differences in sex and school grade, it is important to include the individual group characteristics when evaluating drinking habits.

Understanding the Connection Between the Gut-Brain Axis and Stress/Anxiety Disorders.

PURPOSE OF REVIEW: We review the association of the microbiota-gut-brain axis and anxiety disorder or stress. RECENT FINDING: The microbiota-gut-brain axis mechanism encompasses a bidirectional relationship between the brain and gastrointestinal organs. Dysregulation of the microbiota-gut-brain axis has been actively revealed in the context of various psychiatric diseases such as neurodevelopmental disorders, schizophrenia, anxiety disorders, and depression. We suggest that onset of anxiety disorders may be correlated with activation of a microbiota-gut-brain mechanism involving the immune system, neurotransmitters, and the hormonal system. By applying a microbiota-gut-brain axis mechanism, the possibility of using gastrointestinal system drugs such as probiotics and antibiotics as treatments for anxiety disorders is a possibility. Although modification of the microbiota-gut-brain axis mechanism has yet to be adopted clinically, it is expected that novel strategies employing this mechanism will be developed and deployed as new treatments not only for anxiety disorders, but also other psychiatric diseases.

Plasma level of brain-derived neurotrophic factor (BDNF) in patients with postpartum depression.

Postpartum depression occurs in 10-15% of mothers. Brain-derived neurotrophic factor (BDNF) is a nerve growth factor that plays a role in neuroplasticity. We hypothesized that the concentration of BDNF is related to reproduction and childbirth, and that women with postpartum depression show alteration in BDNF level. A total of 104 pregnant women was selected as subjects, and 60 non-pregnant women were selected as normal controls. Symptoms of depression were evaluated in the pregnant study subjects using the diagnostic criteria outlined in the Edinburgh Postnatal Depression Scale (EPDS). The pregnant subjects were divided into three groups of perinatal non-depressed controls (n = 61), postpartum depression-recovery (n = 18), and postpartum depression (n = 25). The plasma concentration of BDNF was higher in the pregnant group than in non-pregnant controls and lower in the postpartum depression group at 6 weeks after delivery than in the perinatal non-depressed group. In the postpartum depression-recovery group, the BDNF concentration increased at 6 weeks after delivery compared to that at 24 weeks of gestation. This study found significant changes in plasma BDNF concentration in depressed pregnant women.

Genome Sequences of Two GH Clade SARS-CoV-2 Strains Isolated from Patients with COVID-19 in South Korea.

We report the genome sequences of two GH clade severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) strains isolated from nasopharyngeal swabs from patients with coronavirus disease 2019 (COVID-19) in South Korea. These strains had two mutations in the untranslated regions and seven nonsynonymous substitutions in open reading frames, compared with Wuhan/Hu-1/2019, showing 99.96% sequence identity.

Association between the IL10 rs1800896 Polymorphism and Tardive Dyskinesia in Schizophrenia.

OBJECTIVE: Interleukin-10 (IL-10) is a major immunoregulatory cytokine and its gene plays a fundamental role in anti-inflammatory and immunosuppressive activity. This study aimed to examine the association between the IL10 gene promoter -1082G/A polymorphism (rs1800896) and tardive dyskinesia (TD) in schizophrenia. METHODS: Two hundred and eighty unrelated Korean schizophrenic patients participated in this study (105 TD and 175 non-TD patients). TD was diagnosed using the Research Diagnostic Criteria for TD and Abnormal Involuntary Movement Scale (AIMS). Genotyping was performed by RT-PCR and high-resolution melting curve analysis. RESULTS: The distributions of genotypic frequencies did not differ between patients with and without TD (χ2=4.33, p=0.115). However, allelic frequencies of the two groups were different (χ2=4.45, p=0.035); the A allele frequency was higher in TD. The total AIMS scores of the three genotypes were not different (F=1.33, p=0.266). However, the total AIMS scores of the A allele carrier and the A allele non-carrier were significantly different (t=5.79, p<0.001). Logistic regression analaysis showed that IL10 -1082G/A genotype significantly predicts presence of TD (p=0.045) after adjusting for covariates such as age and treatment duration. CONCLUSION: This finding suggests that the A allele of rs1800896 may be associated with TD development following a low IL-10 function.

Improvement of Electrical Performance in P-Channel LTPS Thin-Film Transistor with a-Si:H Surface Passivation.

We report the effects of surface passivation by depositing a hydrogenated amorphous silicon (a-Si:H) layer on the electrical characteristics of low temperature polycrystalline silicon thin film transistors (LTPS TFTs). The intrinsic a-Si:H layer was optimized by hydrogen dilution and its structural and electrical characteristics were investigated. The a-Si:H layer in the transition region between a-Si:H and µc-Si:H resulted in superior device characteristics. Using a-Si:H passivation layer, the field-effect mobility of the LTPS TFT was increased by 78.4% compared with conventional LTPS TFT. Moreover, the leakage current measured at VGS of 5 V was suppressed because the defect sites at the poly-Si grain boundaries were well passivated. Our passivation layer, which allows thorough control of the crystallinity and passivation-quality, should be considered as a candidate for high performance LTPS TFTs.

Electron Beam Irradiated Al Doped ZnO Thin Films as Efficient Tunnel Recombination Junction for Hydrogenated Amorphous Silicon/Cu(In,Ga)Se2 Tandem Solar Cells.

A tunnel recombination junction (TRJ) layer for hydrogenated amorphous silicon (a-Si:H)/ Cu(In,Ga)Se2 (CIGS) tandem solar cells is investigated. An Al-doped zinc oxide (AZO) thin film is applied to the TRJ, and the influence of electron beam (e-beam) irradiation on defects along the TRJ is investigated. The AZO thin films are prepared using radio frequency (RF) sputtering and the e-beam is irradiated at 200 W RF power and 2 keV DC power for 5 min. In the e-beam irradiated AZO thin film, the number of oxygen vacancies and Zn interstitials increases, which in turn strengthens the effect of defect-enhanced tunnel recombination.

Analysis of Laser Injection Condition and Electrical Properties in Local BSF for Laser Fired Contact c-Si Solar Cell Applications.

A crystalline silicon (c-Si) local-back-contact (LBC) solar cell for which a laser-condition-optimized surface-recombination velocity (SRV), a contact resistance (Rc), and local back surface fields (LBSFs) were utilized is reported. The effect of the laser condition on the rear-side electrical properties of the laser-fired LBC solar cell was studied. The Nd:YAG-laser (1064-nm wavelength) power and frequency were varied to obtain LBSF values with a lower contact resistance. A 10-kHz laser power of 44 mW resulted in an Rc of 0.125 ohms with an LBSF thickness of 2.09 µm and a higher open-circuit voltage (VOC) of 642 mV.

Boron Oxygen Pair Effect in p+ Emitter and Nanosized Boron Rich Layer by Fold Coordination Analysis for Crystalline Silicon Solar Cell Applications.

N-type substrates possess better material characteristics than p-type substrates for high efficiency mass producible Si solar cells with HIT, IBC structures. The major drawbacks of these structures are a complicated fabrication process and an expensive unit cost. In this paper, the boron emitter doping profile of a nanosized boron rich layer (BRL), for which the boron and oxygen concentrations are correlated, is optimized to fabricate high efficiency solar cells on an n-type substrate. Boron doping was carried out using a BBr3 furnace with varying oxygen gas ratios and the surface was treated with acid etching. The effect of the oxygen on the nanosized BRL was analyzed using both FTIR spectroscopy and XPS, where by conductivity and the Si-B bond were observed for the three-fold and four-fold coordinated borons, respectively. The results showed that the oxygen quantities in the boron doped emitter and the nanosized BRL affected the characteristics of the solar cell. Regarding the solar cells that were fabricated using the boron emitter and shallow emitter (90 ohm/sq) processes, the open-circuit voltage increased by 54 mV and the short circuit current (J(sc)) increased by 3.7 mA/cm2. The J(sc) increase was due to an increased quantum efficiency in the short wavelength range. The shallow emitter etch back process minimized the boron-oxygen defects in the doping profile.

Method for Fabricating Textured High-Haze ZnO:Al Transparent Conduction Oxide Films on Chemically Etched Glass Substrates.

We developed a technique for forming textured aluminum-doped zinc oxide (ZnO:Al) transparent conductive oxide (TCO) films on glass substrates, which were etched using a mixture of hydrofluoric (HF) and hydrochloric (HCl) acids. The etching depth and surface roughness increased with an increase in the HF content and the etching time. The HF-based residues produced insoluble hexafluorosilicate anion- and oxide impurity-based semipermeable films, which reduced the etching rate. Using a small amount of HCl dissolved the Ca compounds, helping to fragment the semipermeable film. This formed random, complex structures on the glass substrates. The angled deposition of three layers of ZnO:Al led to the synthesis of multiscaled ZnO:Al textures on the glass substrates. The proposed approach resulted in textured ZnO:Al TCO films that exhibited high transmittance (-80%) and high haze (> 40%) values over wavelengths of 400-1000 nm, as well as low sheet resistances (< 18 Ω/sq)..Si tandem solar cells based on the ZnO:Al textured TCO films exhibited photocurrents and cell efficiencies that were 40% higher than those of cells with conventional TCO films.

Effective Light Trapping in Thin Film Silicon Solar Cells with Nano- and Microscale Structures on Glass Substrate.

For thin film silicon-based solar cells, effective light trapping at a broad range of wavelengths (400-1100 nm) is necessary. Normally, etching is only carried out with TCOs, such as SnO2:F and impurity doped ZnO, to form nano-sized craters in the surface morphology to confer a light trapping effect. However, in this study, prior to ZnO:Al etching, periodic structures on the glass substrates were made by photolithography and wet etching to increase the light scattering and internal reflection. The use of periodic structures on the glass substrate resulted in higher haze ratios in the range from 550 nm to 1100 nm, which is the optical absorption wavelength region for thin film silicon solar cells, than obtained by simple ZnO:Al etching. The periodically textured glass with micro-sized structures compensates for the low haze ratio at the middle and long wavelengths of wet etched ZnO:Al. ZnO:Al was deposited on the periodically textured glass, after which the ZnO:Al surface was also etched randomly using a mixed acid solution to form nano-sized craters. The thin film silicon solar cells with 350-nm-thick amorphous silicon absorber layer deposited on the periodic structured glass and etched ZnO:Al generated up to 10.68% more photocurrent, with 11.2% increase of the conversion efficiency compared to the cell deposited on flat glass and etched ZnO:Al.

Improving Memory Characteristics of Hydrogenated Nanocrystalline Silicon Germanium Nonvolatile Memory Devices by Controlling Germanium Contents.

Nonvolatile memory (NVM) with silicon dioxide/silicon nitride/silicon oxynitride (ONO(n)) charge trap structure is a promising flash memory technology duo that will fulfill process compatibility for system-on-panel displays, down-scaling cell size and low operation voltage. In this research, charge trap flash devices were fabricated with ONO(n) stack gate insulators and an active layer using hydrogenated nanocrystalline silicon germanium (nc-SiGe:H) films at a low temperature. In this study, the effect of the interface trap density on the performance of devices, including memory window and retention, was investigated. The electrical characteristics of NVM devices were studied controlling Ge content from 0% to 28% in the nc-SiGe:H channel layer. The optimal Ge content in the channel layer was found to be around 16%. For nc-SiGe:H NVM with 16% Ge content, the memory window was 3.13 V and the retention data exceeded 77% after 10 years under the programming condition of 15 V for 1 msec. This showed that the memory window increased by 42% and the retention increased by 12% compared to the nc-Si:H NVM that does not contain Ge. However, when the Ge content was more than 16%, the memory window and retention property decreased. Finally, this research showed that the Ge content has an effect on the interface trap density and this enabled us to determine the optimal Ge content.

Enhanced Haze Ratio on Glass by Novel Vapor Texturing Method.

State-of-the-art optical trapping designs are required to enhance the light trapping capabilities of tandem thin film silicon solar cells. The wet etch process is used to texture the glass surface by dipping in diluted acidic solutions such as HNO3 (nitric acid) and HF (hydrofluoric acid). For vapor texturing, the vapor was generated by adding silicon to HF:HNO3 acidic solution. The anisotropic etching of vapor textured wafers resulted in an etching depth of about 2.78 µm with reduced reflectance of 5%. We achieved a high haze value of 74.6% at a 540 nm wavelength by increasing the etching time and HF concentration.