Depression and anxiety one month after stroke

Depression and anxiety after stroke negatively affect patient outcomes; however, health care professionals may overlook poststroke depression and anxiety while they focus on the physical disabilities of patients soon after a stroke. The purpose of this study was to investigate the prevalence and predictors of depression, anxiety, or both concurrently at one month after stroke. We conducted a cross-sectional, descriptive study in a sample of 231 hospitalized patients with ischemic stroke in Korea. Data were collected by interviews using a series of structured questionnaires in addition to clinical data retrieved from patients’ medical records. More than 70% were identified as depressed, 45.9% experienced anxiety, and 43.7% had concurrent depression and anxiety. Using a multiple logistic regression analysis, we identified anxiety as a predictor of depression; depression as a predictor of anxiety; and female sex, headaches, and swallowing difficulty as predictors of the comorbidity of depression and anxiety. Periodical screenings for poststroke depression and anxiety from an early stage in a hospital to years after stroke in a community are recommended to provide better chances for early identification of patients at risk because depression and anxiety may manifest at any stage of recovery. Special attention should be given to individuals with culture-bound somatic symptoms in addition to female patients and those who have difficulty swallowing among Korean stroke patients

Facilitators of and barriers to emergency medical service use by acute ischemic stroke patients: A retrospective survey

Objective: The objective of the study was to identify facilitators and barriers to emergency medical service use among acute ischemic stroke patients in Korea. Methods: This paper presents a secondary analysis of a retrospective survey that collected data from questionnaires and medical records. Among 233 acute ischemic stroke patients enrolled in a large-scale study, 160 patients who had arrived at a hospital within 72 h after symptom onset were included in the data analysis. Results: Users of emergency medical services needed a shorter time than non-users to arrive at hospital (140 min vs. 625 min., p = 0.001) and were more likely to arrive at hospital within 3 h of symptom onset (51.9% vs. 31.5%, p = 0.013). For those who first contacted emergency medical service, the facilitators of emergency medical service use were the presence of hemiparesis (p = 0.003), bilateral paralysis (p = 0.040), and loss of balance (p = 0.021). The predominant barrier was the failure to recognize the urgency of symptoms (p = 0.006). Conclusions: The use of emergency medical services reduced prehospital delay and increased the likelihood of patient arrival at hospital within 3 h. Given that experiencing typical stroke symptoms was a facilitator of emergency medical service use yet failure to recognize the urgency of symptoms was a barrier, public awareness should be raised as regards stroke symptoms and the benefits of using emergency medical services. Keywords: Barrier, Emergency medical services, Facilitator, Social norms, Strok

Experimental Results of Underwater Acoustic Communication with Nonlinear Frequency Modulation Waveform

In this paper, we propose underwater acoustic (UWA) communications using a generalized sinusoidal frequency modulation (GSFM) waveform, which has a distinct ambiguity function (AF) and correlation function characteristic. For these reasons, it is more robust in multipath channels than the conventional chirp spread spectrum (CSS) with a linear frequency modulation (LFM) waveform. Four types of GSFM waveforms that are orthogonal to each other are applied for each symbol in the proposed method. To evaluate the performance of the proposed method, we compared the performances of the proposed method and conventional method by conducting diverse experiments: simulations, lake trials and sea trials. In the simulation results, the proposed method shows better performance than the conventional method. The lake trial was conducted with a distance of 300~400 m between the transmitter and receiver. As a result of the experiment, the average bit error rate (BER) of the proposed method is 3.52×10−2 and that of the conventional method is 3.52×10−1, which shows that the proposed method is superior to the conventional method. The sea trial was conducted at a distance of approximately 20 km between the transmitter and receiver at a depth of 1500 m, and the receiver was composed of 16 vertical line arrays (VLAs) with a hydrophone. The proposed method had a BER of 0.3×10−2 in one channel and was error free in the other

Long-Range Acoustic Communication Using Differential Chirp Spread Spectrum

Here, we propose a new modulation method using chirp spread spectrum (CSS) modulation to indicate the result of long-range acoustic communication (LRAC). CSS modulation had outstanding matched filter characteristics even though the channel was complex. The performance of the matched filter depends on the time–bandwidth product. We studied the method of using the same modulation method while increasing the amount of the time–bandwidth product. When differential encoding is applied, the de-modulation is made using the difference between the current symbol and the previous symbol. If the matched filter is applied using both the current and the previous symbol, such as the use of two symbols, the amount of the time–bandwidth product can be doubled, and this method can make the output of the matched filter larger. The proposed method was verified in lake and sea experiments, in which the experimental environment was analyzed and compared with the result using the channel impulse response (CIR) of the lake and sea. The lake experiment was conducted over a distance of about 100–300 m between the transmitter and receiver and at a depth of ~40 m. As a result of the communication, the conventional method’s bit error rate (BER) was 1.22×10−1, but the proposed method’s BER was 1.98×10−2. The sea experiment was conducted over a distance of ~90 km and at a depth of ~1 km, and the conventional method BER in this experiment was 1.83×10−4, while the proposed method’s BER was 0

Treatment outcomes and factors affecting treatment outcomes of new patients with tuberculosis in Busan, South Korea: a retrospective study of a citywide registry, 2014–2015

Abstract Background This study investigated the treatment outcomes, and factors affecting the outcomes, of new tuberculosis (TB) patients in Busan, South Korea. Methods We retrospectively analysed the citywide TB registry data (collected for the Korean National TB Surveillance System) of new TB patients registered in Busan from January 2014 to December 2015. Results A total of 4732 patients were included in this study (mean age, 52.5 ± 19.9 years; 58.4% male). The overall treatment success rate was 83.9% (cured, 20.2%; completed, 63.7%); 8.0% of patients died, and 3.6% were lost to follow-up. In multivariate analyses, a higher rate of loss to follow-up was associated with foreign nationality, registered as TB-positive at least twice, and being in Q4 (fourth quintile) or Q5 (fifth quintile) of the regional deprivation index. Conversely, a lower rate of loss to follow-up was associated with female gender, smear-positive for pulmonary TB (PTB), and the treatment outcome being reported by a public health centre. Higher mortality was associated with old age (≥ 75 years), smear-positive PTB, treatment outcome being reported by the hospital, and being registered as TB-positive twice. Lower mortality was associated with female gender, treatment outcome being reported by a public health centre or clinic, and Q5 of the regional deprivation index. Conclusions Treatment outcomes of new TB patients were sub-optimal in Busan. TB control programs should maintain close monitoring and provide greater socioeconomic support to patients at high risk of poor treatment outcomes