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Background. Yin deficiency (YD) is a pathological condition characterized by emaciation, afternoon fever, dry mouth, and night sweats. The incidence of YD is 23.3%. A 27-item Yin Deficiency Scale (YDS) was developed to estimate the clinical severity of YD. This study aimed to develop three short-form YDS versions to reduce the burden of response time, using three item-reduction approaches: Rasch, equidiscriminatory item-total correlation (EITC), and factor-based analyses. Methods. Two datasets were analyzed from previous studies (169 outpatients from May to June 2009 and 237 healthy college students from January to April 2016). The optimal response category was examined using Rasch analysis. Items with higher item-total correlations were determined using the EITC. Using a factor-based approach, the items were reduced, while maintaining the original YDS construct. Reliability was estimated using the person separation index (PSI) and Cronbach's α values. The predictive accuracy was examined using the area under the curve (AUC). Finally, the relationship between YD and dysfunctional breathing (DB) was examined using factor scores from the YDS and the Korean version of the Nijmegen Questionnaire (KNQ). Results. We developed two 14-item YDS versions using the Rasch and EITC approaches, and a 16-item YDS version using a factor-based approach. Rasch analysis suggested an optimal response category of five points. The PSI of Rasch and Cronbach's α of the EITC and factor-based versions were 2.19, 0.855, and 0.827. The AUCs of the three short-form YDS were 0.812, 0.811, and 0.818. The sensitivity of the EITC-YDS was 0.632, which was lower than its specificity of 0.875. The fatigue-related scores of the factor-based YDS were fairly correlated with the factor scores of the KNQ estimating the DB (r = 0.349–0.499). Conclusion. The 14-item Rasch- and 16-item factor-based YDS may replace the original YDS during YD's primary screening, epidemiological surveys, and health checkups. [ABSTRACT FROM AUTHOR]

The 25-item Phlegm Pattern Questionnaire (PPQ) has been widely used to examine the relationship between the phlegm pattern (PP), quality of life, tongue colour, vocal qualities, and dysfunctional breathing. However, the concerns of response burden and differences in the respondent's abilities or item difficulty for the original version of the PPQ have not been sufficiently addressed. This study aimed to develop a short-form PPQ using Rasch analysis, an item response theory. Based on the retrospective data, the response order, differential item functioning (DIF), dimensionality, reliability, concurrent validity, and fitting errors were examined for 291 normal participants and 61 inpatients. The discriminative ability of the short-form PPQ was examined using receiver operating characteristic curve analysis. Along with Rasch analysis, another short-form PPQ was developed using equidiscriminative item-total correlation (EITC) analysis and the results between the two short-form PPQs were compared accordingly. Rasch analysis results suggested a 6-point response category for the PPQ, and finally, 8 items without fitting errors or DIF variability were selected for the PPQ (PPQ-8). The PPQ-8 had satisfactory reliability (person separation index = 2.23), unidimensionality (unexplained variance in the first contrast = 1.598), fitting levels (infit mean square, 0.80–1.39; outfit mean square, 0.79–1.34), sensitivity (70.5%), and specificity (76.5%). The PPQ-8 had a moderate discriminative ability of the PP (area under the curve = 0.759), and the cut-off point was 23. Although the 8-item PPQ developed using EITC analysis showed similar levels of reliability, validity, and discriminative ability of the PP to the PPQ-8, it could not present the information of item hierarchy and differences in the respondents' abilities. In conclusion, the PPQ-8 by Rasch analysis is recommended for future use to evaluate the clinical severity of PP. [ABSTRACT FROM AUTHOR]

Background: Sjogren's syndrome (SS) is a heterogenous disease with various phenotypes. We aimed to provide a relevant subclassification based on symptom-based clustering for patients with primary (p) SS.Methods: Data from patients in a prospective pSS cohort in Korea were analysed. Latent class analysis (LCA) was performed using patient reported outcomes, including pain, fatigue, dryness, and anxiety/depression. Clinical and laboratory differences between the classes were analysed. Latent transition analysis (LTA) was applied to the longitudinal data (annually for up to 5 years) to assess temporal stability of the classifications.Results: LCA identified three classes among 341 patients with pSS (i.e., 'high symptom burden', 'dryness dominant', 'low symptom burden'). Each group had distinct laboratory and clinical phenotypes. LTA revealed that class membership remained stable over time. Baseline class predicted future salivary gland function and damage accrual represented by a Sjogren's syndrome disease damage index.Conclusion: Symptom-based clustering of heterogenous patients with primary Sjogren's syndrome provided a relevant classification supported by temporal stability over time and distinct phenotypes between the classes. This clustering strategy may provide more homogenous groups of pSS patients for novel treatment development and predict future phenotypic evolvement. [ABSTRACT FROM AUTHOR]

Background: Deep spinal infection is a devastating complication after epidural injection. This study aimed to investigate the incidence of deep spinal infection primarily after outpatient single-shot epidural injection for pain. Secondarily, this study assessed the national trends of the procedure and risk factors for said infection.Methods: Using South Korea's National Health Insurance Service sample cohort database, the 10-yr national trend of single-shot epidural injections for pain and the incidence rate of deep spinal infection after the procedure with its risk factors were determined. New-onset deep spinal infections were defined as those occurring within 90 days of the most recent outpatient single-shot epidural injection for pain, needing hospitalization for at least 1 night, and receiving at least a 4-week course of antibiotics.Results: The number of outpatient single-shot epidural injections per 1,000 persons in pain practice doubled from 40.8 in 2006 to 84.4 in 2015 in South Korea. Among the 501,509 injections performed between 2007 and 2015, 52 cases of deep spinal infections were detected within 90 days postprocedurally (0.01% per injection). In multivariable analysis, age of 65 yr or more (odds ratio, 2.91; 95% CI, 1.62 to 5.5; P = 0.001), living in a rural area (odds ratio, 2.85; 95% CI, 1.57 to 5.0; P < 0.001), complicated diabetes (odds ratio, 3.18; 95% CI, 1.30 to 6.7; P = 0.005), multiple epidural injections (three times or more) within the previous 90 days (odds ratio, 2.34; 95% CI, 1.22 to 4.2; P = 0.007), and recent use of immunosuppressants (odds ratio, 2.90; 95% CI, 1.00 to 6.7; P = 0.025) were significant risk factors of the infection postprocedurally.Conclusions: The incidence of deep spinal infection after outpatient single-shot epidural injections for pain is very rare within 90 days of the procedure (0.01%). The data identify high-risk patients and procedure characteristics that may inform healthcare provider decision-making.Editor’s Perspective: [ABSTRACT FROM AUTHOR]

Dysfunctional breathing (DB) is characterized by abnormal breathing patterns and often results from psychogenic causes in the absence of organic diseases. Although acupuncture and herbal treatments have been suggested as alternative therapies for DB, few studies have addressed the relationship between DB and pathological patterns from a diagnostic perspective. We asked 237 college students (130 men aged 21.4 ± 1.9 years; 107 women aged 21.4 ± 3.0 years) to complete the Korean version of the General Health Questionnaire-30 (K-GHQ-30) and four validated pathological pattern questionnaires regarding qi and yin deficiencies, phlegm, and cold-heat patterns. The Korean version of the Nijmegen Questionnaire was used to classify participants into DB and non-DB groups. Effects of age, gender, and DB on pathological patterns were examined using simple regression and two-way MANCOVA models. Age had an effect on all pattern scores except heat pattern scores (β: 0.154–0.098). DB group showed a moderate main effect (η2 = 0.167) on pathological patterns, while gender showed a minimal main effect (η2 = 0.096); qi and yin deficiencies, phlegm, and cold-heat pattern scores in DB and female groups were higher than those in non-DB and male groups. The K-GHQ-30 scores showed significant positive correlations with the pathological pattern scores (r: 0.243–0.533), indicating that disruption of pathological patterns could be associated with patients' psychological disturbance. In conclusion, these questionnaires may help to identify pathological patterns related to DB and determine individually tailored alternative therapies. [ABSTRACT FROM AUTHOR]

This study aimed to evaluate the effect of acupuncture intervention and manipulation types on poststroke dysarthria. Electronic database, including PubMed, CENTRAL, Scopus, RISS, and CNKI, were searched for randomized controlled trials (RCT), treating dysarthria using acupuncture, speech-language therapy (SLT), and general management (GM), published before April 2019. The number, distribution, intensity, depth, and repetition of acupuncture and bleeding therapy on the sublingual veins were considered as manipulation types. Risk of bias of the included trials was evaluated, and their efficacy was assessed using risk ratio (RR) and the standard mean differences in the Frenchay Dysarthria Assessment and Speech Function Grading, with 95% confidence intervals (CIs).Fifteen RCT trials involving 1453 patients were isolated. Electroacupuncture plus SLT and manual acupuncture plus SLT were more effective than SLT only, respectively (RR = 1.520, 95% CI [1.183–1.952], RR = 1.380, 95% CI [1.281–1.488]). The clinical efficacy of acupuncture plus GM was higher than that of GM alone (RR = 1.165, 95% CI [1.050–1.293]). Meta-ANOVA showed that none of the manipulation types increased the clinical efficacy of acupuncture on dysarthria. The methodological quality was low. In conclusion, our study suggests that the effect of acupuncture on poststroke dysarthria may be maximized when manual acupuncture or electroacupuncture is combined with SLT, irrespective of manipulation types. [ABSTRACT FROM AUTHOR]

The effect of ZnO nanostructures on the light output power of 375 nm near-ultraviolet light-emitting diodes (NUV-LEDs) was investigated by comparing one-dimensional (1D) nanorods (NR-ZnO) with two-dimensional (2D) nanosheets (NS-ZnO). ZnO nanostructures were grown on a planar indium tin oxide (ITO) by solution based method at low temperature of 90°C without degradation of the forward voltage. At an injection current of 100 mA, the light output efficiency of NUV-LED with NR-ZnO was enhanced by around 30% compared to the conventional NUV-LEDs without ZnO nanostructures. This improvement is due to the formation of a surface texturing, resulting in a larger escape cone and a multiple scattering for the photons in the NUV-LED, whereas the light output efficiency of NUV-LED with NS-ZnO was lower than that of the conventional NUV-LEDs due to the internal reflection and light absorption in the defective sites of NS-ZnO. [ABSTRACT FROM AUTHOR]

The aggregation of zinc oxide nanoparticles leads to an increased absorbance in the ultraviolet-visible region by an induced light scattering effect. Herein, we demonstrate the inhibition of photoconversion activity in ZnO-graphene core-shell quantum dots (QD) (ZGQDs) agglomerated by 4-aminophenol (4-AP) used as a linker. The ZnO-graphene quantum dots (QD) aggregates (ZGAs) were synthesized using a facile solvothermal process. The ZGAs revealed an increased absorbance in the wavelengths between 350 and 750 nm as compared with the ZGQDs. Against expectation, the calculated average photoluminescence lifetime of ZGAs was 7.37 ns, which was 4.65 ns longer than that of ZGQDs and was mainly due to the high contribution of a slow (τ2, τ3) component by trapped carriers in the functional groups of graphene shells and 4-AP. The photoelectrochemical (PEC) cells and photodetectors (PDs) were fabricated to investigate the influence of ZGAs on the photoconversion activity. The photocurrent density of PEC cells with ZGAs was obtained as 0.04 mA/cm2 at 0.6 V, which was approximately 3.25 times lower than that of the ZGQDs. The rate constant value of the photodegradation value of rhodamine B was also decreased by around 1.4 times. Furthermore, the photoresponsivity of the PDs with ZGAs (1.54 μA·mW−1) was about 2.5 times as low as that of the PDs with ZGQDs (3.85 μA·mW−1). Consequently, it suggests that the device performances could be degraded by the inhibition phenomenon of the photoconversion activity in the ZGAs due to an increase of trap sites. [ABSTRACT FROM AUTHOR]

Symptomatic hyperventilation (SH) is a pathological condition that manifests with breathlessness, dyspnea, light-headedness, anxiety, and paresthesia. However, little is known about the prevalence of SH and its association with health-related quality of life (HRQoL) in a young population. The Nijmegen questionnaire (NQ), which measures severity of SH, had not previously been cross-culturally translated into Korean. In this study, the NQ was cross-culturally translated into Korean (KNQ), using translation and back-translation methods. To examine the reliability and validity levels of the KNQ, as well as its association with HRQoL, 237 college students (21.38 ± 2.45 years) were asked to complete the KNQ, the Korean version of the general health questionnaire (K-GHQ-30) and the short form-36 (K-SF-36). The KNQ showed satisfactory reliability (Cronbach’s α = 0.878). In the construct validity test, four factors (neuropsychological, respiratory, neurogastrointestinal, and neuromuscular) were extracted (% of total variance = 59.8). Using a KNQ cut-off score of 23 points, the prevalence of SH was 22.8%. Physical and mental HRQoL levels estimated by the K-GHQ-30 score and the 8 subscale scores of the K-SF-36 were lower in the SH group than in those of the non-SH group. It is concluded that the cross-culturally translated KNQ is reliable and valid, and management of SH may prevent a reduction in physical and mental HRQoL in a young population. [ABSTRACT FROM AUTHOR]

This paper provides two types of engineering J estimation equations for cylinders with finite internal axial surface cracks under internal pressure. The first type is the so-called GE/EPRI type J estimation equation based on Ramberg–Osgood (R–O) materials. Based on detailed 3-D FE results using deformation plasticity, plastic influence functions for fully plastic J components are tabulated for practical ranges of the mean radius-to-thickness ratio, the crack depth-to-length ratio, the crack depth-to-thickness ratio, the strain hardening index for the R–O material, and the location along the semi-elliptical crack front. Based on tabulated plastic influence functions, the GE/EPRI-type J estimation equation along the crack front is proposed and validated for R–O materials. For more general application, for instance, to general stress–strain laws, the developed GE/EPRI-type solutions are then re-formulated based on the reference stress concept. Such a re-formulation provides a simpler equation for J, which is then further extended to combined internal pressure and bending. The proposed reference stress based J estimation equation is compared with elastic–plastic 3-D FE results using actual stress–strain data for a Type 304 stainless steel. Good agreement between the FE results and the proposed reference stress based J estimation provides confidence in the use of the proposed method for elastic–plastic fracture mechanics of pressurised piping. [Copyright &y& Elsevier]

This paper proposes engineering estimation equations of elastic–plastic J and crack opening displacement (COD) for axial through-wall cracked pipes under internal pressure. On the basis of detailed 3D finite element (FE) results using deformation plasticity, the plastic influence functions for fully plastic J and COD solutions are tabulated as a function of the mean radius-to-thickness ratio, the normalised crack length, and the strain hardening. On the basis of these results, the GE/EPRI-type J and COD estimation equations are proposed and validated against 3D FE results based on deformation plasticity. For more general application to general stress–strain laws or to complex loading, the developed GE/EPRI-type solutions are re-formulated based on the reference stress (RS) concept. Such a re-formulation provides simpler equations for J and COD, which are then further extended to combined internal pressure and bending. The proposed RS based J and COD estimation equations are compared with elastic–plastic 3D FE results using actual stress–strain data for Type 316 stainless steels. The FE results for both internal pressure cases and combined internal pressure and bending cases compare very well with the proposed J and COD estimates. [Copyright &y& Elsevier]

An attempt to degrade volatile organic compounds (VOCs) and sterilize air simultaneously is highly desirable to improve indoor air quality. With the help of deep ultraviolet (UVC) lighting, harmful bacteria that exists in the air can be destroyed. Thus, a new photocatalytic substance that can break down VOCs under UVC irradiation is required. Here, we demonstrate the photocatalytic activity of β-Ga2O3 nanostructures, synthesized via the solvothermal method for removing formaldehyde (HCHO) under deep ultraviolet irradiation. The Raman and XRD results indicated that as-synthesized nanostructures showed β-crystalline phase with a monoclinic structure. The photoluminescence spectrum exhibited a broad and strong green emission peak at 510 nm, which was likely attributed to a considerable amount of oxygen and gallium vacancies formed during the calcinating process. The photocatalytic efficiency for decomposing HCHO at room temperature under deep ultraviolet irradiation (278 nm) of the synthesized β-Ga2O3 nanoparticles is higher than that of the β-Ga2O3 nanorods. Both nanoparticles and nanorods obeyed the pseudo-first-order Langmuir-Hinshelwood kinetic model with a degradation rate constant of 0.057 and 0.033 min−1, corresponding to the efficiency of 82% and 62% in the formaldehyde removal, respectively. [ABSTRACT FROM AUTHOR]

Although both III-N laser diodes (LDs) and LEDs employ electron blocking layers (EBLs) to reduce electron leakage from the active region, LDs typically operate at far higher current densities than LEDs. Shortcomings of the common rectangular EBL are discussed. Two alternative EBL designs have been systematically studied using numerical simulation: the inverse-tapered EBL and the inverse-tapered step-graded EBL. It is shown that the efficacy of each of these EBL designs depends strongly on the operational current density, suggesting that the EBL design considerations for III-N LDs and LEDs are fundamentally different. [ABSTRACT FROM AUTHOR]

Lateral hole injection into AlGaN-based ultraviolet (UV) vertical-cavity light-emitting lasers (VCSELs) has been studied via numerical simulation. For blue and violet vertical cavity light emitters, indium tin oxide (ITO) is most commonly used as a transparent current spreading layer to increase the overlap between the optical mode and the radial current profile. However, ITO has very high optical losses in the UV spectrum, so alternative schemes for lateral current spreading have been investigated for use in UV-VCSELs. A modulation doped short-period superlattice (MD-SPSL) has been proposed as a transparent lateral current spreading layer in UV-VCSELs. The narrow bandgap unintentionally doped (uid) material maintains a high mobility due to reduced impurity scattering and has a high free hole concentration due to modulation doping, thus forming highly conductive channels which aid lateral hole transport. This has been shown to partially mitigate current crowding around the current aperture. To account for imperfect modulation doping due to the magnesium memory effects and other factors, the effect of varying the hole mobility in the uid-narrow bandgap layer of the MD-SPSL from 13–300 cm2/($\text {V}\cdot \text {s}$) on the threshold current and slope efficiency has also been studied. Employing an MD-SPSL results in a significant reduction in the threshold current and slope efficiency compared to ITO, and the extent of the improvement depends on the hole mobility in the uid-AlGaN layer. [ABSTRACT FROM AUTHOR]

Tongue diagnosis is a technique used to determine cold-heat pathologic patterns (CHPPs). Herein, we reviewed electronic medical records of tongue temperature measured using infrared thermography (IRT), tongue color (luminance, green/red, and blue/yellow balance), cold-heat pattern questionnaires (CHPQ), and body temperature for 134 women with gynecological problems (age, 38.97 ± 11.49 years). The temperatures of seven tongue regions (root, center, tip, and both sides of the center and root) were determined, and the effects of age, regional differences, and their correlations with color parameters were examined. Factor analysis was conducted separately with the 10 cold pattern (CP) and 10 heat pattern (HP) items. Tongue temperature showed an age effect (β; -0.198 to -0.210) and regional differences (both sides of the root > center and root > tip). Tongue temperature was positively correlated with luminance (r: 0.236-0.246), indicating that a higher temperature was associated with a brighter color. The factor analysis extracted two factors (cold sensitivity-pain and discharge-complexion factors) from the CP items and three factors (heat sensation-pain, discharge-breath, and cold preference-thirst factors) from the HP items. Tongue temperature was negatively correlated with the discharge-complexion factor of CP and the discharge-breath factor of HP (r: -0.171 to -0.203), indicating that a lower tongue temperature may be a consequence of emission of excessive heat in HP and a lower blood perfusion in CP. Body temperature did not correlate with the CHPQ factor scores. In conclusion, tongue temperatures measured using IRT may be a partial indicator of CHPPs. [ABSTRACT FROM AUTHOR]

Background. Phlegm pattern questionnaire (PPQ) was developed to evaluate and diagnose phlegm pattern in Korean Medicine and Traditional Chinese Medicine, but it was based on a dataset from patients who visited the hospital to consult with a clinician regarding their health without any strict exclusion or inclusion. In this study, we reinvestigated the construct validity of PPQ with a new dataset and confirmed the feasibility of applying it to a healthy population. Methods. 286 healthy subjects were finally included and their responses to PPQ were acquired. Confirmatory factor analysis (CFA) was conducted and the model fit was discussed. We extracted a new factor structure by exploratory factor analysis (EFA) and compared the two factor structures. Results. In CFA results, the model fit indices are acceptable (RMSEA = 0.074) or slightly less than the good fit values (CFI = 0.839, TLI = 0.860). Many average variances extracted were smaller than the correlation coefficients of the factors, which shows the somewhat insufficient discriminant validity. Conclusions. Through the results from CFA and EFA, this study shows clinically acceptable model fits and suggests the feasibility of applying PPQ to a healthy population with relatively good construct validity and internal consistency. [ABSTRACT FROM AUTHOR]

If a small dc-link capacitor is used in the dc link fed by a single-phase ac source, then the dc-link voltage severely fluctuates at twice of the source frequency. To handle this fluctuation, the concept of “average voltage constraint” is proposed in this study. On the basis of this concept, a flux-weakening scheme, generating the d-axis current reference (ids^{r}^{\ast}) for the interior permanent-magnet synchronous machine, is devised. The q-axis current reference (iqs^{r}^{\ast}) is modified for the unity power factor operation in the viewpoint of an ac source without an additional sensor. The proposed scheme has been applied to the inverter-driven 1-kW compressor of an air conditioner. From the experimental results, it has been verified that the compressor operates well at the required operating condition, regardless of the severe fluctuation of dc-link voltage, because of the reduced dc-link capacitance. The frequency spectrum of the ac source current reveals that the harmonics of the source current meet the regulation of IEC 61000-3-2 Class A and that the overall power factor is above 96% without any additional circuit, such as an input filter and a power factor correction circuit. [ABSTRACT FROM PUBLISHER]

Extracting useful and meaningful patterns from large volumes of text data is of growing importance. In the present study we analyze vast amounts of prescription data, generated from the book of oriental medicine to identify the relationships between the symptoms and the associated medicines used to treat these symptoms. The oriental medicine book used in this study (called Bangyakhappyeon) contains a large number of prescriptions to treat about 54 categorized symptoms and lists the corresponding herbal materials. We used an association rule algorithm combined with network analysis and found useful and informative relationships between the symptoms and medicines. [ABSTRACT FROM AUTHOR]

There is an error in of in the TE01 optical mode profile. The error is due to the author forgetting to rescale the x-axis when plotting the optical mode profile on the right y-axis. This oversight occurred because the optical mesh is different from the electrical mesh, and the correct figure is shown below. We wish to emphasize that this was merely a plotting error, and hence all of the results and conclusions presented in the manuscript remain unchanged. We sincerely regret the error. [ABSTRACT FROM AUTHOR]