Effects of stress, depression, and spousal and familial support on maternal identity in pregnant women

Purpose The objective of this study was to identify the factors influencing maternal identity in pregnant women. Methods Using a descriptive research design, a cross-sectional survey was conducted. In total, 127 pregnant women were recruited from a tertiary hospital in Korea from January to April 2019. Measurements included maternal identity, stress, depression, spousal and familial support, and demographic and obstetric characteristics. Data were analyzed by descriptive statistics, the independent t-test, one-way ANOVA, Pearson correlation coefficients, and stepwise multiple regression using SPSS version 25.0. Results The mean score for maternal identity was 131.15 out of 160, and the mean scores for stress, depression, and spousal and familial support were 14.59 (out of 40), 6.82 (out of 30), and 109.04 (out of 132), respectively. Stress (r=–.38, p<.001), depression (r=–.37, p<.001), and spousal and familial support (r=.37, p<.001) were significantly correlated with maternal identity. In multiple regression analysis, stress (β=–0.27, p=.005) and spousal and familial support (β=0.23, p=.014) were found to be significant factors influencing maternal identity in pregnant women (F=14.19, p<.001). Conclusion It is necessary to develop effective strategies to mitigate stress and to encourage spousal and familial support in pregnant women. Such strategies could further enable pregnant women to enhance their maternal identity

Impact of successful restoration of sinus rhythm in patients with atrial fibrillation and acute heart failure: Results from the Korean Acute Heart Failure registry

Background: Restoring and maintaining sinus rhythm (SR) in patients with atrial fibrillation (AF) failed to show superior outcomes over rate control strategies in prior randomized trials. However, there is sparse data on their outcomes in patients with acute heart failure (AHF).Methods: From December 2010 to February 2014, 5,625 patients with AHF from 10 tertiary hospitals were enrolled in the Korean Acute Heart Failure registry, including 1,961 patients whose initial electrocardiogram showed AF. Clinical outcomes of patients who restored SR by pharmacological or electrical cardioversion (SR conversion group, n = 212) were compared to those of patients who showed a persistent AF rhythm (AF persistent group, n = 1,662).Results: All-cause mortality both in-hospital and during the follow-up (median 2.5 years) were significantly lower in the SR conversion group than in the AF persistent group after adjustment for risk factors (adjusted hazard ratio [HR]; 95% confidence interval [CI] = 0.26 [0.08–0.88], p = 0.031 and 0.59 [0.43–0.82], p = 0.002, for mortality in-hospital and during follow-up, respectively). After 1:3 propensity score matching (SR conversion group = 167, AF persistent group = 501), successful restoration of SR was associated with lower all-cause mortality (HR [95% CI] = 0.68 [0.49–0.93], p = 0.015), heart failure rehospitalization (HR [95% CI] = 0.66 [0.45–0.97], p = 0.032), and composite of death and heart failure rehospitalization (HR [95% CI] = 0.66 [0.51–0.86], p = 0.002).Conclusions: Patients with AHF and AF had significantly lower mortality in-hospital and during follow-up if rhythm treatment for AF was successful, underscoring the importance of restoring SR in patients with AHF

Holocene environmental changes in Dicksonfjorden, west Spitsbergen, Svalbard

Multi-proxy analyses of two sediment cores from Dicksonfjorden were performed to reconstruct Holocene environmental conditions in this northern branch of Isfjorden, the largest fjord system in Svalbard. Factors affecting the depositional processes include shifts in sources of sediments, ice rafting and regional glacio-isostatic rebound. Sediments were derived from Palaeozoic siliciclastics and carbonates occurring at the fjord head and sides, respectively. Their relative contributions were controlled by falling relative sea level and the resulting progradation of the major stream and delta systems closer to the core sites. Deposition of clasts from sea-ice rafting persisted throughout most of the Holocene. Following a period of low, but continuous, clast fluxes (ca. 11 000–7000 calibrated years before the present), ice rafting was most intensive between ca. 7000 and 3000 calibrated years before the present. It can be related to extensive seasonal sea-ice formation caused by regional cooling. The prograding deltas also provided coarse sediments. Reduced ice rafting from ca. 3000 calibrated years before the present suggests enhanced formation of shorefast and/or permanent sea ice, suppressing sea-ice rafting in the fjord, in response to the cool climate and reduced heat flux from Atlantic Water. Episodic inflow of Atlantic Water and low turbidity of surface water can, however, account for a larger amount of marine organic matter produced in the outer fjord. The sedimentary record in Dicksonfjorden, where tidewater glaciers are absent, reflects similar climate and oceanographic variations as reconstructed in fjords on western Spitsbergen that are influenced by tidewater glaciers

Impact of transvenous cardiac implantable electronic devices in chronic hemodialysis patients: a single-center, observational comparative study

Abstract Background We investigated the impact of a transvenous cardiac implantable electronic device (CIED) placement on outcomes and arteriovenous vascular access (VA) patency among chronic hemodialysis patients. Methods This is a single-center, observational comparative study between chronic hemodialysis patients with ipsilateral and contralateral CIED and VA. Forty-two consecutive patients who underwent both CIED placement and upper-extremity VA for hemodialysis, regardless of the sequence and time interval between these 2 procedures, were identified between January 2001 and December 2017. Patients with ipsilateral (n = 22, 52%, the ipsilateral group) and contralateral (n = 20, 48%, the contralateral group) CIED and VA were compared retrospectively; the primary outcome was any-cause mortality and cardiac mortality or the composite of any systemic complications, defined as central venous stenosis or occlusion, any device infections or tricuspid regurgitation; the secondary outcome was CIED or VA malfunction. Results During the median follow-up period of 101 months, primary outcome incidence was significantly higher in the ipsilateral group than the contralateral group (73% vs 40%, P = 0.03), although the incidences of any-cause mortality (P = 0.28) and cardiac mortality (P > 0.99) were similar between the groups. Secondary outcome incidence did not differ significantly between the 2 groups (55% vs 30%, P = 0.36). Kaplan–Meier survival analysis revealed similar primary and secondary VA patency rates in both groups. On subgroup analysis, patients with upper arm VA had similar primary and secondary patency to those with forearm VA. Conclusions Despite some notable limitations of the study, the retrospective study design and small sample size, we found that the any-cause mortality incidence and VA patency did not differ between the 2 groups, but primary outcome incidence was significantly higher among patients with ipsilateral CIED and VA

Patency rates of arteriovenous fistulas created before versus after hemodialysis initiation.

In an incident hemodialysis (HD) population, we aimed to investigate whether arteriovenous fistula (AVF) creation before HD initiation was associated with improved AVF patency compared with AVF creation from a central venous catheter (CVC), and also to compare patient survival between these patients. Between January 2011 and December 2013, 524 incident HD patients with identified first predialysis vascular access with an AVF (pre-HD group, n = 191) or an AVF from a CVC (on-HD group, n = 333) were included and analyzed retrospectively. The study outcome was defined as AVF patency and all-cause mortality (time to death). On Kaplan-Meier survival analysis, primary and secondary AVF patency rates did not differ significantly between the two groups (P = 0.812 and P = 0.586, respectively), although the overall survival rate was significantly higher in the pre-HD group compared with the on-HD group (P = 0.013). On multivariate analysis, well-known patient factors were associated with decreased primary (older age and diabetes mellitus [DM]) and secondary (DM and peripheral arterial occlusive disease) AVF patency, whereas use of a CVC as the initial predialysis access (hazard ratios, 1.84; 95% confidence intervals, 1.20-2.75; P = 0.005) was significantly associated with worse survival in addition to well-known patient factors (older age, diabetes mellitus, and peripheral arterial occlusive disease). Worse survival in the on-HD group was likely confounded by selection bias because of the retrospective nature of our study. Therefore, the observed lower mortality associated with AVF creation before HD initiation is not fully attributable to CVC use, but rather, affected by other patient-level prognostic factors. There were no CVC-related complications in the pre-HD group, whereas 10.2% of CVC-related complications were noted in the on-HD group. In conclusion, among incident HD patients, compared with patients who underwent creation of an AVF from a CVC, initial AVF creation showed similar primary and secondary AVF patency rates, but lower mortality risk. We also observed that an initial CVC use was an independent risk factor associated with worse survival. A fistula-first strategy might be the best option for incident HD patients who are good candidates for AVF creation

Epitaxially grown copper phosphide (Cu3P) nanosheets nanoarchitecture compared with film morphology for energy applications

Fabrication of 3D nanoarchitecture is one of the effective ways to improve performance of energy applications because it has advantages such as buffer space accommodating volume expansion or high surface area leading to higher efficiency. However, the fabrication of such nanoarchitectures is generally complex involving several steps including patterning, etching and growth of intermediate materials. Herein, we report a facile process to form a nanoarchitecture of copper phosphide (Cu3P) nanosheets directly on copper foil by epitaxially growing Cu3P sheets of controlled thickness on a suitably engineered Cu foil. The growth of Cu3P nanosheets and their epitaxial relationship with the Cu foil were studied by X-ray diffraction (XRD) and transmission electron microscopy (TEM). To show the advantages of nanoarchitecture, we tested both nanoarchitecture and film-like morphology of Cu3P as an anode in lithium-ion battery (LIB) and an electrocatalyst in hydrogen evolution reaction (HER). We found that the nanoarchitecture enabled significant improvements in both capacity and rate capability of the LIB. In the case of HER, however, the higher electrocatalytic efficiency of the nanoarchitectured electrode was maintained only in the initial cycles due to morphology reconstruction of Cu3P during HER. This result provides a new facile route to fabricate nanoarchitecture and shows superior performance of the nanoarchitecture in energy applications

Simultaneous Extraction of the Grain Size, Single-Crystalline Grain Sheet Resistance, and Grain Boundary Resistivity of Polycrystalline Monolayer Graphene

The electrical properties of polycrystalline graphene grown by chemical vapor deposition (CVD) are determined by grain-related parameters&mdash;average grain size, single-crystalline grain sheet resistance, and grain boundary (GB) resistivity. However, extracting these parameters still remains challenging because of the difficulty in observing graphene GBs and decoupling the grain sheet resistance and GB resistivity. In this work, we developed an electrical characterization method that can extract the average grain size, single-crystalline grain sheet resistance, and GB resistivity simultaneously. We observed that the material property, graphene sheet resistance, could depend on the device dimension and developed an analytical resistance model based on the cumulative distribution function of the gamma distribution, explaining the effect of the GB density and distribution in the graphene channel. We applied this model to CVD-grown monolayer graphene by characterizing transmission-line model patterns and simultaneously extracted the average grain size (~5.95 &mu;m), single-crystalline grain sheet resistance (~321 &Omega;/sq), and GB resistivity (~18.16 k&Omega;-&mu;m) of the CVD-graphene layer. The extracted values agreed well with those obtained from scanning electron microscopy images of ultraviolet/ozone-treated GBs and the electrical characterization of graphene devices with sub-micrometer channel lengths