The continuous development of a complete and objective automatic grading system of facial signs from selfie pictures: Asian validation study and application to women of three ethnic origins, differently aged.

OBJECTIVE: To evaluate the capacity of the automatic detection system to accurately grade, from smartphones' selfie pictures, the severity of seven new facial signs added to the nine previously integrated. METHODS: A two-step approach was conducted: first, to check on 112 Korean women, how the AI-based automatic grading system may correlate with dermatological assessments, taken as reference; second, to confirm on 1140 women of three ancestries (African, Asian, and Caucasian) the relevance of the newly input facial signs. RESULTS: The sixteen specific Asian facial signs, detected automatically, were found significantly (P < .0001) highly correlated with the clinical evaluations made by two Korean dermatologists (wrinkles: r = .90; sagging: r = .75-.95; vascular: r = .85; pores: r = .60; pigmentation: r = .50-.80). When applied at a larger scale on women of different ethnicities, new signs were found of good accuracy and reproducibility, albeit depending on ethnicity. Due to contrast with the innate skin complexion, the facial signs dealing with skin pigmentation were found of a much higher relevance among Asian women than African or Caucasian women. The automatic gradings were even found of a slightly higher accuracy than the clinical gradings. CONCLUSION: The previously used automatic grading system is now completed by adding new facial signs apt at being detected. The continuous development is now integrating some limitations with regard to the constitutive skin complexion of the self-pictured subjects. Presenting reproducible assessments, highly correlated with medical grading, this system could change tremendously clinical researches, like in epidemiological studies, where it offers an easy, fast, affordable, and confidential approach in the objective quantification of facial signs.

Polymer-Assisted Nanoimprinting for Environment- and Phase-Stable Perovskite Nanopatterns.

Despite the great interest in inorganic halide perovskites (IHPs) for a variety of photoelectronic applications, environmentally robust nanopatterns of IHPs have hardly been developed mainly owing to the uncontrollable rapid crystallization or temperature and humidity sensitive polymorphs. Herein, we present a facile route for fabricating environment- and phase-stable IHP nanopatterns over large areas. Our method is based on nanoimprinting of a soft and moldable IHP adduct. A small amount of poly(ethylene oxide) was added to an IHP precursor solution to fabricate a spin-coated film that is soft and moldable in an amorphous adduct state. Subsequently, a topographically prepatterned elastomeric mold was used to nanoimprint the film to develop well-defined IHP nanopatterns of CsPbBr3 and CsPbI3 of 200 nm in width over a large area. To ensure environment- and phase-stable black CsPbI3 nanopatterns, a polymer backfilling process was employed on a nanopatterned CsPbI3. The CsPbI3 nanopatterns were overcoated with a thin poly(vinylidene fluoride-co-trifluoroethylene) (PVDF-TrFE) film, followed by thermal melting of PVDF-TrFE, which formed the air-exposed CsPbI3 nanopatterns laterally confined with PVDF-TrFE. Our polymer backfilled CsPbI3 nanopatterns exhibited excellent environmental stability over one year at ambient conditions and for 10 h at 85 °C, allowing the development of arrays of two-terminal, parallel-type photodetectors with nanopatterned photoactive CsPbI3 channels. Our polymer-assisted nanoimprinting offers a fast, low-pressure/temperature patterning method for high-quality nanopatterns on various substrates over a large area, overcoming conventional costly time-consuming lithographic techniques.

Epitaxially Grown Ferroelectric PVDF-TrFE Film on Shape-Tailored Semiconducting Rubrene Single Crystal.

Epitaxial crystallization of thin poly(vinylidene fluoride-co-trifluoroethylene) (PVDF-TrFE) films is important for the full utilization of their ferroelectric properties. Epitaxy can offer a route for maximizing the degree of crystallinity with the effective orientation of the crystals with respect to the electric field. Despite various approaches for the epitaxial control of the crystalline structure of PVDF-TrFE, its epitaxy on a semiconductor is yet to be accomplished. Herein, the epitaxial growth of PVDF-TrFE crystals on a single-crystalline organic semiconductor rubrene grown via physical vapor deposition is presented. The epitaxy results in polymer crystals globally ordered with specific crystal orientations dictated by the epitaxial relation between the polymer and rubrene crystal. The lattice matching between the c-axis of PVDF-TrFE crystals and the (210) plane of orthorhombic rubrene crystals develops two degenerate crystal orientations of the PVDF-TrFE crystalline lamellae aligned nearly perpendicular to each other. Thin PVDF-TrFE films with epitaxially grown crystals are incorporated into metal/ferroelectric polymer/metal and metal/ferroelectric polymer/semiconductor/metal capacitors, which exhibit excellent nonvolatile polarization and capacitance behavior, respectively. Furthermore, combined with a printing technique for micropatterning rubrene single crystals, the epitaxy of a PVDF-TrFE film is formed selectively on the patterned rubrene with characteristic epitaxial crystal orientation over a large area.

Experience of advance directives in a hospice center.

To protect patient autonomy when confronting death, the importance of advance directives (ADs) has recently became an issue and gradually accepted in Korea. However, in real practice, ADs were not completed by patients but their families in most cases. To analyze the current situation of performing ADs, we reviewed medical charts of 214 terminal cancer patients admitted to the hospice center from October 2012 to September 2013. Seventy-six (35.5%) patients completed ADs. All ADs were completed by patients themselves. The most common reason for not completing ADs was poor physical and/or mental condition. As a proxy, the majority of patients preferred their spouses (55.3%). Few patients wanted life sustaining treatment (1.3%), however palliative sedation was accepted in 89.5%. The median timing of ADs after admission was three (0-90) days, and duration of survival since ADs was 22 (1-340) days. In conclusion, approximately one third of terminal cancer patients completed ADs by themselves. Considering that patient's poor condition is the main reason for not completing ADs, earlier discussion regarding ADs is necessary to enhance patients' participation.

Compression of cross-linked poly(vinylidene fluoride-co-trifluoro ethylene) films for facile ferroelectric polarization.

In this study, we demonstrated a facile route for enhancing the ferroelectric polarization of a chemically cross-linked poly(vinylidene fluoride-co-trifluoro ethylene) (PVDF-TrFE) film. Our method is based on thermally induced cross-linking of a PVDF-TrFE film with a 2,2,4-trimethyl-1,6-hexanediamine (THDA) agent under compression. The remanent polarization (P(r)) of a metal/ferroelectric/metal capacitor containing a cross-linked PVDF-TrFE film increased with pressure up to a certain value, whereas no change in the P(r) value was observed in the absence of THDA. A film cross-linked with 10 wt % THDA with respect to PVDF-TrFE under a pressure of 100 kPa exhibited a P(r) of approximately 5.61 µC/cm(2), which is 1.6 times higher than that in the absence of pressure. The enhanced ferroelectric polarization was attributed to highly ordered 20-nm-thick edge-on crystalline lamellae whose c-axes are aligned parallel to the substrate. The lamellae were effective for ferroelectric switching of the PVDF-TrFE when a cross-linked film was recrystallized under pressure. Furthermore, compression of a PVDF-TrFE film with a topographically prepatterned poly(dimethyl siloxane) mold gave rise to a chemically cross-linked micropattern in which edge-on crystalline lamellae were globally oriented over a very large area.

Chemically cross-linked thin poly(vinylidene fluoride-co-trifluoroethylene)films for nonvolatile ferroelectric polymer memory.

Both chemically and electrically robust ferroelectric poly(vinylidene fluoride-co-trifluoro ethylene) (PVDF-TrFE) films were developed by spin-coating and subsequent thermal annealing with the thermal cross-linking agent 2,4,4-trimethyl-1,6-hexanediamine (THDA). Well-defined ferroelectric ß crystalline domains were developed with THDA up to approximately 50 wt %, with respect to polymer concentration, resulting in characteristic ferroelectric hysteresis polarization-voltage loops in metal/cross-linked ferroelectric layer/metal capacitors with remnant polarization of approximately 4 µC/cm(2). Our chemically networked film allowed for facile stacking of a solution-processable organic semiconductor on top of the film, leading to a bottom-gate ferroelectric field effect transistor (FeFET). A low-voltage operating FeFET was realized with a networked PVDF-TrFE film, which had significantly reduced gate leakage current between the drain and gate electrodes. A solution-processed single crystalline tri-isopropylsilylethynyl pentacene FeFET with a chemically cross-linked PVDF-TrFE film showed reliable I-V hysteresis with source-drain ON/OFF current bistablility of 1 × 10(3) at a sweeping gate voltage of ±20 V. Furthermore, both thermal micro/nanoimprinting and transfer printing techniques were conveniently combined for micro/nanopatterning of chemically resistant cross-linked PVDF-TrFE films.

Nonvolatile polymer memory with nanoconfinement of ferroelectric crystals.

We demonstrate significantly improved performance of a nonvolatile polymeric ferroelectric field effect transistor (FeFET) memory using nanoscopic confinement of poly(vinylidene fluoride-co-trifluoroethylene) (PVDF-TrFE) within self-assembled organosilicate (OS) lamellae. Periodic OS lamellae with 30 nm in width and 50 nm in periodicity were templated using block copolymer self-assembly. Confined crystallization of PVDF-TrFE not only significantly reduces gate leakage current but also facilitates ferroelectric polarization switching. These benefits are due to the elimination of structural defects and the development of an effective PVDF-TrFE crystal orientation through nanoconfinement. A bottom gate FeFET fabricated using a single-crystalline triisopropylsilylethynyl pentacene channel and PVDF-TrFE/OS hybrid gate insulator shows characteristic source-drain current hysteresis that is fully saturated at a programming voltage of ±8 V with an ON/OFF current ratio and a data retention time of approximately 10(2) and 2 h, respectively.

Evaluation of the Relationship between Circadian Blood Pressure Variation and Left Atrial Function Using Strain Imaging.

BACKGROUND: Non-dippers were reported as showing different left atrial function, compared to dippers, but no study to date investigated the changes in the left atrial function according to the diurnal blood pressure pattern, using tissue Doppler and strain imaging. METHODS: Forty never treated hypertensive patients between 30 and 80 years of age were enrolled in this study. Patients were classified as non-dippers when, during night time, they had a blood pressure decrease of less than 10%. Strain of the left atrium was measured during late systole, and peak strain rates of the left atrium were measured during systole, early and late diastolic periods. RESULTS: The left atrial expansion index, left atrial active emptying volume and left atrial active emptying fraction were all significantly increased in non-dippers. They also had increased values of mean peak left atrial strain (dippers = 21.26 ± 4.23% vs. non-dippers = 24.91 ± 5.20%, p = 0.02), strain rate during reservoir (dippers = 1.29 ± 0.23 s(-1) vs. non-dippers =1.52 ± 0.27 s(-1), p = 0.01) and contractile period (dippers = -1.38 ± 0.24 s(-1) vs. non-dippers = -1.68 ± 0.32 s(-1), p < 0.01). CONCLUSION: Strain and strain rate acquired from color Doppler tissue imaging demonstrate exaggerated reservoir and booster pump function in never-treated, non-dipper hypertensive patients. These methods are simple and sensitive for the early detection of subtle changes in the left atrial function.

Block copolymer micelles with near infrared metal phthalocyanine dyes for laser induced writing.

A route has been developed to disperse metal-containing phthalocyanine dyes in a non-polar medium based on amphiphilic block copolymer micelles of poly[styrene-block-(4-vinylpyridine)] (PS-b-P4VP) and poly[styrene-block-(acrylic acid)] (PS-b-PAA) copolymers. Polar P4VP and PAA efficiently encapsulate cobalt(II), manganese(II), and nickel(II) phthalocyanine dyes by axial coordination of nitrogen and µ-oxo bridged dimerization with the transition metals, respectively. Good dispersion of the dyes is confirmed by the linear enhancement of Q-bands in UV-vis absorption spectra with dye concentration. A thin monolayered PS-b-P4VP micelle film that contained a nickel(II) phthalocyanine dye which efficiently adsorbs a laser beam on a localized area to generate a local heat higher than the glass transition temperatures of both blocks. One-dimensional laser writing on the dye-containing film allows the fabrication of a few submicrometer wide line patterns in which the self-assembled nanostructure of the block copolymer is modified by the directional heat arising from laser scanning.

Implementation of a large-scale hospital information infrastructure for multi-unit health-care services.

With the increase in demand for high quality medical services, the need for an innovative hospital information system has become essential. An improved system has been implemented in all hospital units of the Yonsei University Health System. Interoperability between multi-units required appropriate hardware infrastructure and software architecture. This large-scale hospital information system encompassed PACS (Picture Archiving and Communications Systems), EMR (Electronic Medical Records) and ERP (Enterprise Resource Planning). It involved two tertiary hospitals and 50 community hospitals. The monthly data production rate by the integrated hospital information system is about 1.8 TByte and the total quantity of data produced so far is about 60 TByte. Large scale information exchange and sharing will be particularly useful for telemedicine applications.

Thin film fabrication of PMMA/MEH-PPV immiscible blends by corona discharge coating and its application to polymer light emitting diodes.

We introduce a new and facile process, corona discharge coating (CDC), to fabricate thin polymer films of the immiscible poly[2-methoxy-5-(2'-ethylhexyloxy)-p-phenylenevinylene] (MEH-PPV) and poly(methyl methacrylate) (PMMA) blends. The method is based on utilizing directional electric flow, known as electric wind, of the charged unipolar particles generated by corona discharge between a metallic needle and a bottom plate under high electric field (5-10 kV/cm). The electric flow rapidly spreads out the polymer solution on the bottom plate and subsequently forms a smooth and flat thin film over a large area within a few seconds. The method is found to be effective for fabricating uniform thin polymer films with areas larger than approximately 30 mm2. The thin films obtained by CDC exhibit unique microstructures where well-defined spherical and cylindrical domains of approximately 50 nm in diameter coexist. These nanosized domains are found to be much smaller than those in films made by conventional spin coating, which suggests that CDC is beneficial for fabricating phase-separated thin film structures with significantly increased interfacial areas. The effects of the applied voltage, tip-to-plate distance, and substrates on the film formation as well as the resulting microstructure are investigated. Furthermore, the light emitting performance of a device prepared by CDC is compared with one made by spin coating.

Activation of insulin-like growth factor II signaling by mutant type p53: physiological implications for potentiation of IGF-II signaling by p53 mutant 249.

The aim of the present study was to investigate the intracellular mediators of the third base mutant of codon 249 in p53 gene (p53mt249) mutation that potentiate IGF-II dependent IGF-I receptor (IGF-IR) signaling. p53mt249 enhanced IGF-II dependent IGF-IR signaling in p53 negative Hep3B hepatoma cells which were specifically prevented by IGF-IR antibody, alpha IR3 and lovastin. p53mt249 increased the number of IGF-II binding sites with no change in the affinity of IGF-IR. Enhanced levels of IGF-IR expression and transcription were identified in p53mt249 transfected Hep3B cells. Pre-transfection of cultured hepatoma cells with p53mt249 resulted in a three to fourfold increase in IGF-IR phosphorylation and downstream mediator IRS-I phosphorylation but, enhanced more than 15-fold after IGF-II treatment, which coincides well with the cell growth and thymidine uptake results. Our results showed that p53mt249 modulate IGF-II dependent IGF-IR signaling by upregulating IGF-IR and potentiating IGF-IRs where IGF-IRs became more sensitive on treatment with IGF-II. We concluded that p53mt249 stimulates IGF-II dependent IGF-IR signaling by upregulating the expression of both ligand (IGF-II) and receptor (IGF-IR) through an autocrine and/or paracrine loop and we outline the physiological significance of potentiation of IGF-IR by p53 mutation in the development of hepatocellular carcinoma (HCC).