Factors Associated with Major Errors on Death Certificates.

The objective of this study was to investigate errors on death certificates and factors associated with the occurrence of major errors. A retrospective analysis was conducted for six months in 2020 at a university training hospital. Errors were judged as major and minor errors according to the contribution to the process of determining the cause of death. Death certificates were classified into two groups with major errors (ME group) and without major errors (non-ME group). General characteristics of the death certificates, the main cause of death (cancer, cardiovascular disease, cerebrovascular disease, digestive disease, respiratory disease, genitourinary disease, intentional self-harm, external causes, and other causes), the number of causes of deaths written on the death certificate, and major and minor errors were investigated. The ME group had 127 cases out of 548 death certificates. The number of causes of deaths written on the death certificates and the total number of errors were higher in the ME group than in the non-ME group. Cardiovascular disease, cerebrovascular disease, digestive disease, respiratory disease, external causes, and other diseases as causes of deaths had higher risks of major errors on death certificates than cancer as a cause of death. The group with cancer as a cause of death had the lowest incidence of major errors and fewer causes of deaths. To reduce major errors, continuous education and feedback are needed for those who are qualified to issue a death certificate.

Direct Growth of Highly Conductive Large-Area Stretchable Graphene.

The direct synthesis of inherently defect-free, large-area graphene on flexible substrates is a key technology for soft electronic devices. In the present work, in situ plasma-assisted thermal chemical vapor deposition is implemented in order to synthesize 4 in. diameter high-quality graphene directly on 10 nm thick Ti-buffered substrates at 100 °C. The in situ synthesized monolayer graphene displays outstanding stretching properties coupled with low sheet resistance. Further improved mechanical and electronic performances are achieved by the in situ multi-stacking of graphene. The four-layered graphene multi-stack is shown to display an ultralow resistance of ≈6 Ω sq-1, which is consistently maintained during the harsh repeat stretching tests and is assisted by self-p-doping under ambient conditions. Graphene-field effect transistors fabricated on polydimethylsiloxane substrates reveal an unprecedented hole mobility of ≈21 000 cm2 V-1 s-1 at a gate voltage of -4 V, irrespective of the channel length, which is consistently maintained during the repeat stretching test of 5000 cycles at 140% parallel strain.

Glucocorticoids Are Associated with an Increased Risk for Vertebral Fracture in Patients with Rheumatoid Arthritis.

OBJECTIVE: To identify the effects of glucocorticoids (GC) on various types of fractures in patients with rheumatoid arthritis (RA). METHODS: We used the Korean National Healthcare Claims database from 2010 to establish a retrospective cohort of patients with RA ≥ 19 years old. We then followed those patients through December 2013. The incidence rates of total and major fractures were calculated. We evaluated the effects of GC dose and duration on fractures using multivariable logistic regression analyses. We also examined the influence of GC on fractures in RA patients without a history of osteoporosis. RESULTS: A total of 11,599 fractures was observed in 9964 out of 138,240 patients with RA. During followup, 68.2% of patients used oral GC for > 3 months. Adjusted analysis showed the risk of vertebral fractures was increased by the following characteristics: duration of GC ≥ 6 months (OR 1.76, p < 0.01); mean dose of GC ≥ 2.5 mg (OR range = 1.37-1.71, p < 0.01); and highest daily dose of GC ≥ 10 mg (OR range = 1.23-1.75, p < 0.03). However, neither the duration nor the dose of oral GC increased the risk of hip and nonvertebral/nonhip fractures in patients with RA. Consistent results were observed in RA patients without osteoporosis. CONCLUSION: Longer duration and higher dose of oral GC in patients with RA increased the risk of vertebral fractures. However, the dose and duration of GC did not influence the risk of hip and nonvertebral/nonhip fractures.

Prevalence of lung cancer in patients with interstitial lung disease is higher than in those with chronic obstructive pulmonary disease.

We aimed to explore lung cancer prevalence in interstitial lung disease (ILD) patients with or without connective tissue disorder (CTD) and idiopathic pulmonary fibrosis (IPF) in comparison with chronic obstructive pulmonary disorder (COPD).We evaluated lung cancer prevalence associated with ILD and IPF using Korean Health Insurance Review and Assessment Service (HIRA) data from January to December 2011. This database (HIRA-NPS-2011-0001) was sampled using random sampling of outpatients; 1,375,842 sample cases were collected, and 670,258 (age ≥ 40 ys) were evaluated. Patients with ILDs, IPF, CTD, or COPD were identified using the International Classification of Disease-10 diagnostic codes.Lung cancer prevalence rates per 100,000 persons for the sample population and those with ILD, IPF, CTD-ILD, and COPD were 420, 7334, 7404, 7272, and 4721, respectively. Lung cancer prevalence was significantly higher in those with ILD than in those with COPD (P < .01).More attention should be paid to lung cancer development in those with ILD as well as COPD.

Defect-Free Graphene Synthesized Directly at 150 °C via Chemical Vapor Deposition with No Transfer.

Direct graphene synthesis on substrates via chemical vapor deposition (CVD) is an attractive approach for manufacturing flexible electronic devices. The temperature for graphene synthesis must be below ∼200 °C to prevent substrate deformation while fabricating flexible devices on plastic substrates. Herein, we report a process whereby defect-free graphene is directly synthesized on a variety of substrates via the introduction of an ultrathin Ti catalytic layer, due to the strong affinity of Ti to carbon. Ti with a thickness of 10 nm was naturally oxidized by exposure to air before and after the graphene synthesis, and the various functions of neither the substrates nor the graphene were influenced. This report offers experimental evidence of high-quality graphene synthesis on Ti-coated substrates at 150 °C via CVD. The proposed methodology was applied to the fabrication of flexible and transparent thin-film capacitors with top electrodes of high-quality graphene.

Impact of anti-rheumatic treatment on cardiovascular risk in Asian patients with rheumatoid arthritis.

OBJECTIVES: To estimate the incidence of cardiovascular disease (CVD) in Asian patients with rheumatoid arthritis (RA) and to evaluate the impact of anti-rheumatic treatment on the development of CVD. METHODS: A retrospective cohort of Asian patients with RA was established to identify the incidence rate (IR) of CVD in RA patients. The cohort was generated using the Korean National Healthcare claims database, which contained claims from Jan 2009 to Dec 2013. A total of 137,512 RA patients were identified; individuals with a history of CVD for 6 months or more before the index date were excluded. Nested case-control samples were drawn from the full study population with a case:control ratio of 1:4 (n = 7102 cases; n = 27,018 controls without CVD). A conditional multivariate regression model was used to evaluate the impact of anti-rheumatic treatment on the development of CVD in RA patients after matching for age, sex, RA index date, comorbidities, and drug use (e.g., antiplatelet agents and cholesterol-lowering agents). RESULTS: The IR for development of overall CVD in RA patients was 182.1 (95% CI: 178.4-185.9) per 10,000 person-years. In models adjusted for other CVD risk factors, disease-modifying anti-rheumatic drugs (DMARDs) (OR = 0.79) were protective against CVD, and biologic DMARDs were not significantly associated with CVD risk (OR = 0.85). Corticosteroids (OR = 1.26) and NSAIDs (nonselective NSAIDs: OR = 1.32, Cox-2 inhibitors: OR = 1.31) were risk factors for CVD in RA patients. CONCLUSIONS: The use of DMARDs is protective against CVD, while corticosteroids and NSAIDs increased the risk of CVD in RA patients.

Wrinkle-free graphene electrodes in zinc tin oxide thin-film transistors for large area applications.

Wrinkle-free graphene was used to form the source-drain electrodes in thin film transistors based on a zinc tin oxide (ZTO) semiconductor. A 10 nm thick titanium adhesion layer was applied prior to transferring a conductive graphene film on top of it by chemical detachment. The formation of an interlayer oxide between titanium and graphene allows the achievement of uniform surface roughness over the entire substrate area. The resulting devices were thermally treated in ambient air, and a substantial decrease in field effect mobility is observed with increasing annealing temperature. The increase in electrical resistivity of the graphene film at higher annealing temperatures may have some influence, however the growth of the oxide interlayer at the ZTO/Ti boundary is suggested to be most influential, thereby inducing relatively high contact resistance.

Development of a Korean Fracture Risk Score (KFRS) for Predicting Osteoporotic Fracture Risk: Analysis of Data from the Korean National Health Insurance Service.

BACKGROUND: Asian-specific prediction models for estimating individual risk of osteoporotic fractures are rare. We developed a Korean fracture risk prediction model using clinical risk factors and assessed validity of the final model. METHODS: A total of 718,306 Korean men and women aged 50-90 years were followed for 7 years in a national system-based cohort study. In total, 50% of the subjects were assigned randomly to the development dataset and 50% were assigned to the validation dataset. Clinical risk factors for osteoporotic fracture were assessed at the biennial health check. Data on osteoporotic fractures during the follow-up period were identified by ICD-10 codes and the nationwide database of the National Health Insurance Service (NHIS). RESULTS: During the follow-up period, 19,840 osteoporotic fractures were reported (4,889 in men and 14,951 in women) in the development dataset. The assessment tool called the Korean Fracture Risk Score (KFRS) is comprised of a set of nine variables, including age, body mass index, recent fragility fracture, current smoking, high alcohol intake, lack of regular exercise, recent use of oral glucocorticoid, rheumatoid arthritis, and other causes of secondary osteoporosis. The KFRS predicted osteoporotic fractures over the 7 years. This score was validated using an independent dataset. A close relationship with overall fracture rate was observed when we compared the mean predicted scores after applying the KFRS with the observed risks after 7 years within each 10th of predicted risk. CONCLUSION: We developed a Korean specific prediction model for osteoporotic fractures. The KFRS was able to predict risk of fracture in the primary population without bone mineral density testing and is therefore suitable for use in both clinical setting and self-assessment. The website is available at http://www.nhis.or.kr.

Achieving Antifingerprinting and Antibacterial Effects in Smart-Phone Panel Applications Using ZnO Thin Films without a Protective Layer.

When crystalline ZnO films with a thickness of 30 nm and hydrophilic properties were deposited at room temperature onto a glass substrate via radio frequency sputtering, they exhibited antifingerprinting qualities following annealing treatment that was simple and accomplished at low temperature (100 °C). Hydrophobic properties were achieved using as-deposited ZnO films with hydrophilic properties via annealing treatment without the deposition of a protective layer with hydrophobic properties. The annealed 30 nm ZnO films showed a high transmittance (∼91.3%) comparable to that of a glass substrate at a wavelength of 550 nm. The annealed films showed strong antibacterial activity against E. coli and S. aureus bacteria. The ZnO films with a thickness of 30 nm showed predominant mechanical durability with strong antibacterial activity for smart-phone panel applications.

Realization of large-area wrinkle-free monolayer graphene films transferred to functional substrates.

Structural inhomogeneities, such as the wrinkles and ripples within a graphene film after transferring the free-standing graphene layer to a functional substrate, degrade the physical and electrical properties of the corresponding electronic devices. Here, we introduced titanium as a superior adhesion layer for fabricating wrinkle-free graphene films that is highly applicable to flexible and transparent electronic devices. The Ti layer does not influence the electronic performance of the functional substrates. Experimental and theoretical investigations confirm that the strong chemical interactions between Ti and any oxygen atoms unintentionally introduced on/within the graphene are responsible for forming the clean, defect-free graphene layer. Our results accelerate the practical application of graphene-related electronic devices with enhanced functionality. The large-area monolayer graphenes were prepared by a simple attachment of the Ti layer with the multi-layer wrinkle-free graphene films. For the first time, the graphene films were addressed for applications of superior bottom electrode for flexible capacitors instead of the novel metals.

Enhanced transparency, mechanical durability, and antibacterial activity of zinc nanoparticles on glass substrate.

Homogeneously distributed zinc nanoparticles (NPs) on the glass substrate were investigated for the transmittance, mechanical durability, and antibacterial effect. The buffered Ti NPs between Zn NPs and glass substrate were studied for an enhancement of the transmittance and mechanical endurance. The Ti NPs buffered Zn NPs showed a high transmittance of approximately 91.5% (at a wavelength of 550 nm) and a strong antibacterial activity for Staphylococcus aureus and Escherichia coli bacteria. The buffered Ti NPs are attractive for an excellent mechanical endurance of the Zn NPs. The Zn NPs did not require the protection layer to prevent the degradation of the performance for both the antibacterial effect and the transmittance.