Search

Background: Though composite grafting is an easy, simple treatment for fingertip amputation, it is known to have a low survival rate. To increase the likelihood of composite graft survival, various adjuvant therapies such as hyperbaric oxygen therapy, ice-cooling, or vasodilator agents have been used. In this study, we attempted to validate the hypothesis that topical normobaric oxygen therapy (tNBO) could improve composite graft survival in fingertip amputation.Methods: Patients who sustained fingertip amputations and who were treated with composite grafting between January 2015 and July 2020 were included. The patients (n=154) were divided into two groups: those who received tNBO (n=102) and those who had not (n=52). The effect of tNBO on graft survival, survival rate by level of amputation, and risk factors of graft survival (age, smoking, time to surgery, diabetes mellitus, and crush-avulsion injury type) were examined.Results: tNBO significantly increased composite graft survival (75.3% vs. 50%, P5 hours (odds ratio, 48.6; P=0.001) and crush-avulsion injury type (odds ratio, 10.1; P

Background: Cultured allogenic keratinocyte (CAK) and epidermal growth factor (EGF) are commonly used biological treatments for partial-thickness burn wounds. A comparative study was conducted on whether the combination therapy of CAK and EGF promotes partial-thickness burn wound healing.Methods: From January 2020 to March 2021, 73 patients who visited the hospital with partial-thickness burns were enrolled in the study. Patients were treated with CAK (Kaloderm) (n=20), EGF (Easyef) (n=17), and CAK+EGF (n=24). Wound healing rate, time to heal, factors affecting wound healing (age, sex, underlying disease, mode of injury, location of injury, initial wound size), and scarring were comparatively analyzed.Results: The wound healing rate for 20 days was 85% (17/20) in the CAK group, 88% (15/17) in the EGF group, and 92% (22/24) in the CAK+EGF group. The average healing time was 11.0±6.0 days, with the CAK group taking 12.6±5.5 days, EGF group taking 11.5±6.0 days, and CAK+EGF group taking 9.0±6.3 days. The patients who received CAK+EGF treatment had higher hazard than the patients without CAK+EGF treatment (hazard ratio, 2.078; 95% confidence interval, 1.021–4.228). Smaller wound size

Selective serotonin reuptake inhibitors (SSRIs) are used worldwide as the first-line pharmacological treatment for depression. Although SSRI use can increase the risk of suicide, fractures, and infertility, the nature of these relationships is controversial. This review reports confounding by indication and confounding by severity for SSRI side effects in previously published observational studies. The PubMed and Google Scholar databases were searched for English-language articles published from 2005 to 2022. SSRIs are often prescribed for depressive symptoms, and depression is associated with an increased risk of side effects. Therefore, confounding by indication, whereby patients are selected for a particular treatment depending on their diagnosis or severity of illness, may lead to erroneous treatment conclusions, resulting in an adverse outcome. The side effects of SSRIs that can be considered due to confounding by indication or severity include suicide, fractures, infertility, atrial fibrillation, stroke, autism spectrum disorder, and congenital malformation. When prescribing SSRIs for depression, physicians must consider confounding by indication and severity in the management of side effects. In addition, medication discontinuation should be carefully considered when side effects occur during the treatment.

Rechargeable aqueous Zn metal batteries (AZMBs) are desirable because of the advantages of metallic Zn and aqueous media. However, AZMBs suffer from limited cyclability and low Coulombic efficiency, originating from uncontrolled dendrite growth and side reactions such as hydrogen gas evolution and corrosion. A hierarchically porous poly(vinylidene difluoride) (PVDF) protection layer with ferroelectric β-phases is formed on the Zn metal using a simple electrospinning method. This suppresses Zn metal failure modes such as side reactions and dendrite growth and supports rapid electrolyte accessibility. The synergetic effect of hierarchically porous structures and ferroelectricity not only facilitates a supporting matrix to form uniform nucleation sites for Zn deposition but also inhibits corrosion, allowing dendrite-free Zn deposition. This multifunctional PVDF film significantly improves the cyclability of Zn symmetric cells, allowing for up to 850 h of repeated plating/stripping cycles. Moreover, it exhibits an excellent cycle life of 1000 cycles under harsh conditions and high current densities of 4.0-10.0 mA cm

This study analyzed the relationship between adult attachment, self-differentiation, and self-esteem in solving the fear of intimacy in interpersonal relationships experienced by adults. This study targeted people in the 20s to 50s age group, and data from 1,263 participants were analyzed using SPSS 23.0 and AMOS 23.0. The results are as follows. First, it was found that secure attachment had a negative relationship with the fear of intimacy, while the relationship between self-differentiation and self-esteem was positive. On the other hand, anxiety attachment and avoidance attachment were shown to have a positive relationship with the fear of intimacy, but a negative relationship was identified with self-differentiation and self-esteem. Second, it became evident that self-differentiation and self-esteem mediated the relationship between adult attachment and the fear of intimacy. Additionally, the findings indicated that self-differentiation and self-esteem had a dual mediating effect. The results of this study can be used as basic data for counseling and educational programs to solve the fear of intimacy in interpersonal relationships experienced by adults.

Objective Several previous studies have reported the negative psychological impact of the coronavirus disease (COVID-19) pandemic on medical students worldwide. This study investigated the sociodemographic and psychosocial factors associated with COVID-19–related post-traumatic stress disorder (PTSD) risk among medical students in Daegu, a region that experienced a high concentration of infections.Methods A total of 270 students completed the self-reported questionnaires including COVID-19 exposure, psychological measurement, and sociodemographic factors. We evaluated the COVID-19–related PTSD risk group using the Korean version of the Impact of Event Scale-Revised. Logistic regression analysis was performed to evaluate the odds ratio for the COVID-19–related PTSD risk group in sociodemographic and psychosocial factors.Results The prevalence of the COVID-19–related PTSD risk group was 10.4% in medical students. Among sociodemographic factors, lower grades (specially, first-year medical students) and current smokers were associated with the COVID-19–related PTSD risk. Indirect exposure to COVID-19 was also associated with this risk. Meanwhile, having higher resilience, self-esteem, and social support were less likely to be associated with COVID-19–related PTSD risk.Conclusion This study suggested that it is necessary to develop a system for the screening and managing of COVID-19–related PTSD risk group among medical students, especially high-risk groups during the COVID-19 pandemic.

On March 11, 2011, a magnitude 9.0 earthquake occurred in the Pacific Ocean off the Tohoku region, which greatly affected the crust of the Korean Peninsula. At the time of the Tohoku earthquake, the crust deformation of the Korean Peninsula moved about 30 mm in the eastward direction. This is the size corresponding to the annual average on the Korean Peninsula, and this displacement occurred in one day due to the earthquake. Therefore, in this study, the degree of impact of crustal movement on the Korean Peninsula before and after the Tohoku earthquake was analyzed using domestic and global GNSS observation data. The analysis was performed in two ways. The first was a time series analysis of the crustal movement on the Korean Peninsula based on the IGS observation station in order to globally observe the change in the crustal movement on the Korean Peninsula before and after the earthquake. Secondly, the movement of the inner crust of the Korean Peninsula was confirmed by analyzing the correlation of movement according to the distance from the epicenter. The analysis period is from January 1, 2005 to December 31, 2021. As a result, stations that moved in the southeast direction before the earthquake on the Korean Peninsula moved eastward after the earthquake. However, over time, it gradually moves in a southeasterly direction. The velocity was higher in the western region before the earthquake. At the time of the earthquake, the stations in the eastern area where closer to the epicenter moved more, but have since returned to a similar velocity to that before the earthquake. It seems to be recovering over time after the earthquake, but to be incompleted which means continuous monitoring is needed.

Regulating the morphology of lithium plating is the key to extending the cycle life of lithium metal batteries. Fatal dendritic growth is closely related to out-of-plane nucleation on the lithium metal surface. Herein, we report a nearly perfect lattice match between the lithium metal foil and lithium deposits by removing the native oxide layer using simple bromine-based acid-base chemistry. The naked lithium surface induces homo-epitaxial lithium plating with columnar morphologies and lower overpotentials. Using the naked lithium foil, the lithium-lithium symmetric cell maintains stable cycling at 10 mA cm−2 for more than 10,000 cycles, and the full-cell paired with LiFePO4 with high areal capacity of 3.3 mAh cm−2 and practical N/P ratio of 2.5 exhibits 86% capacity retention after 300 cycles. This study elucidates the usefulness of controlling the initial surface state to facilitate homo-epitaxial lithium plating for sustainable cycling of lithium metal batteries.

Recently, new types of base editors, C-to-G base editors (CGBEs), that enable cytosine transversions that are unachievable with cytosine base editors (CBEs) and adenosine base editors (ABEs), have been developed in human cells. However, despite their importance in crop genome editing, the efficacy of CGBEs has not yet been extensively evaluated. In our study, based on the previously reported plant-compatible CBE and human CGBE, we demonstrated that our monocot plant-compatible CGBEs (PcCGBEs) enable cytosine transversions (C-to-G) in rice protoplasts. For all targets tested, PcCGBEs (monocot plant-compatible CGBEs) appeared to have substantial levels of C-to-G editing activity. PcCGBE showed a much higher C-to-G base editing activity and C-to-G specificity among C-to-D conversions than the mini-version of PcCGBE. Our demonstration of PcCGBE could provide a platform for the further development of enhanced CGBEs for reliable application as a new crop breeding technology.

Background There have been few reports comparing image quality and radiation dose of aorta computed tomography angiography (CTA) between the high-pitch and the hybrid technique. Purpose To compare the image quality and radiation dose among non-electrocardiogram (ECG)-gated high-pitch CTA and hybrid ECG-gated CTA of the aorta using 512-slice CT. Material and Methods This retrospective study included 110 patients who underwent non-ECG-gated high-pitch CTA (group 1) or hybrid ECG-gated CTA (group 2) of the entire aorta. Interpretability, image noise, contrast-to-noise ratio (CNR), signal-to-noise ratio (SNR), and the mean effective radiation dose were compared. Results The mean image noise of the whole aorta was significantly lower (15.7 ± 1.8 HU vs. 16.5 ± 1.2 HU, P = 0.008) in group 1 than in group 2. The CNR (22.3 ± 4.7 vs. 20.0 ± 3.9, P Conclusion The non-ECG-gated high-pitch technique shows significantly improved CNR and SNR due to reduced noise with lower radiation exposure. The interpretability of the cardiac structure, ascending aorta, aortic valve, and both ostia did not differ significantly between the two groups.

Type I restriction-modification enzymes are oligomeric proteins composed of methylation (M), DNA sequence-recognition (S), and restriction (R) subunits. The different bipartite DNA sequences of 2-4 consecutive bases are recognized by two discerned target recognition domains (TRDs) located at the two-helix bundle of the two conserved regions (CRs). Two M-subunits and a single S-subunit form an oligomeric protein that functions as a methyltransferase (M

Aptamers are widely used as binders that interact with targets with high affinity or as inhibitors of the function of target molecules. However, they have also been used to modulate target protein function, which they achieve by activating the target or stabilizing its conformation. Here, we report a unique aptamer modulator of the insulin receptor (IR), IR-A62. Alone, IR-A62 acts as a biased agonist that preferentially induces Y1150 monophosphorylation of IR. However, when administered alongside insulin, IR-A62 shows variable binding cooperativity depending on the ligand concentration. At low concentrations, IR-A62 acts as a positive allosteric modulator (PAM) agonist that enhances insulin binding, but at high concentrations, it acts as a negative allosteric modulator (NAM) agonist that competes with insulin for IR. Moreover, the concentration of insulin affects the binding of IR-A62 to IR. Finally, the subcutaneous administration of IR-A62 to diabetic mice reduces blood glucose levels with a longer-lasting effect than insulin administration. These findings imply that aptamers can elicit various responses from receptors beyond those of a simple agonist or inhibitor. We expect further studies of IR-A62 to help reveal the mechanism of IR activation and greatly expand the range of therapeutic applications of aptamers.

The process of cellular senescence, which is characterized by stable cell cycle arrest, is strongly associated with dysfunctional cellular metabolism and circadian rhythmicity, both of which are reported to result from and also be causal to cellular senescence. As a result, modifying any of them - senescence, metabolism, or the circadian clock - may affect all three simultaneously. Obesity accelerates aging by disrupting the homeostasis of reactive oxygen species (ROS) via an increased mitochondrial burden of fatty acid oxidation. As a result, if senescence, metabolism, and circadian rhythm are all linked, anti-obesity treatments may improve metabolic regulation while also alleviating senescence and circadian rhythm. Vutiglabridin is a small molecule in clinical trials that improves obesity by enhancing mitochondrial function. We found that chronic treatment of senescent primary human dermal fibroblasts (HDFs) with vutiglabridin alleviates all investigated markers of cellular senescence (SA-β-gal,CDKN1A, CDKN2A) and dysfunctional cellular circadian rhythm (BMAL1), while remarkably preventing the alterations of mitochondrial function and structure that occur during the process of cellular senescence. Our results demonstrate the significant senescence-alleviating effects of vutiglabridin, specifically with the restoration of cellular circadian rhythmicity and metabolic regulation. These data support the potential development of vutiglabridin against aging-associated diseases and corroborate the intricate link between cellular senescence, metabolism, and the circadian clock.

We conducted spatiotemporal assessments of ozone in South Korea from 1990-2020 to evaluate trends and compare changes in compliance based on South Korean, US, and EU standards. Observational data from nationwide air-quality monitoring stations were collected and converted to the maximum daily 8 hr ozone average (MDA8O3). Seasonal ozone variations displayed an overall increase across most of South Korea and a noticeably high rate of 0.86 ppbv/yr in Seoul, with an even higher rate 1.2 ppbv/yr for the fourth-highest MDA8O3. Recent air-quality regulations to reduce NOx emissions have been estimated to weaken NO titration effects, leading to higher ozone levels for VOC-limited urban areas in South Korea while decreasing ozone concentrations elsewhere. In recent years, nearly all monitoring stations have exceeded the South Korean MDA8O3 standard, leading to debate regarding the adequacy of current standards for monitoring changes in nonattainment. Comparison with EU and US standards showed that implementing these could significantly lower nonattainment events due to the easing of target threshold values by either percentile or concentration values. Relative distances in nonattainment percentages between South Korean and other standards indicated that the EU ozone guideline was most suitable for tracing recent ozone changes not apparent when using the South Korean or US standards.

This letter presents a deep convolutional neural network (CNN) with attention module that improves the performance of the classification of various earthquake events. Addressing all possible earthquake events, including not only microearthquakes and artificial-earthquakes but also large-earthquakes, requires both suitable feature expression and a classifier that can effectively discriminate seismic waveforms under adverse conditions. To robustly classify earthquake events, a deep CNN with an attention module was proposed in raw seismic waveforms. Representative experimental results show that the proposed method provides an effective structure for earthquake events classification and, with the Korean peninsula earthquake database from 2016 to 2018, outperforms previous state-of-the-art methods.

Introduction: This study examined the relative timing in individuals with dysarthria secondary to amyotrophic lateral sclerosis (ALS). The aim was to examine whether the relative timing was influenced by severity of dysarthria and phonetic complexity of the speech being produced. Methods: Twenty-one adults with dysarthria secondary to ALS, who presented with a range of dysarthria severity, participated in the study. A group of nonimpaired, age-matched adults served as controls. All participants produced a single phrase, across which four measures of relative timing were calculated, and the phonetic composition (complexity) of each measure was considered. Both participant groups completed the Sentence Intelligibility Test, which provided measures of speech intelligibility and speaking rate. Results: Relative timing did not significantly differ between speaker groups across the four measures, regardless of phonetic complexity. Neither Sentence Intelligibility Test score nor speaking rate were significantly correlated with relative timing. Discussion: Relative timing of phrase-level speech appears to remain intact regardless of the phonetic complexity of speech among individuals with dysarthria secondary to ALS. The potential of an internal phonological system organizing speech gestures is discussed to explain why the consistency in relative timing occurs.

Two species of the marine harpacticoid family Pseudotachidiidae (Copepoda) are reported from subtidal sediments in the Southern Sea of Korea. Psammis wellsi sp. nov. (Danielsseniinae) is most closely related to P. longisetosa Sars, 1910 but differs from its European congener in the ventral ornamentation of the female genital double-somite, the dorsal ornamentation of the second abdominal somite in the male, the armature of the proximal endite of the maxillary syncoxa, the relative setal lengths and general shape of the female P5, and the relative length of the inner seta of the male P5 endopodal lobe and P6. The female of Pseudomesochra tatianae Drzycimski, 1968 is redescribed in detail, constituting the only other record of the species since its discovery at the type locality in western Norway. East Asian records of members of the four subfamilies currently recognized in the Pseudotachidiidae are summarized. Published and other records of the 23 described species in the Pseudomesochrinae are collated and their armature patterns of P1–P5 are tabulated and corrected where necessary. Pseudomesochra affinis (Sars, 1920) is removed from its synonymy with P. longifurcata T. Scott, 1902 and formally reinstated as a valid species. An updated female-based key to the 19 valid species of Pseudomesochra T. Scott, 1902 and four species of Keraia Willen & Dittmar, 2009 is presented.

There is an increasing number of youth having access to smartphones and technology, especially throughout the COVID-19 pandemic (McClain, 2022). Social media, such as TikTok, grew exponentially during the pandemic alongside increased postings of mental health content. As the majority of TikTok users are young people, this paper examines the question: “what factors have contributed most to the increase in the use of potentially misleading online mental health information among youth during the COVID-19 pandemic?”. Reviewing previous research, this paper mainly applies descriptive and evaluation analysis to study the factors that prompted youth to seek mental health information on TikTok. This paper argues that barriers to mental health care and isolation during the COVID-19 pandemic have led young people to turn to TikTok for mental health information, in turn leading to youth to be more exposed to misinformation. This paper calls for improvements in mental health care accessibility for youth and identifies the root causes of increased misinformation exposure on TikTok. The increased mental health discussions that took place through TikTok should continue but it is imperative to explore ways to prevent information from overflowing and being unreliable for the users.

Long noncoding RNAs (lncRNAs) act as transcriptional regulators in plants and animals. To date, they have been reported to regulate various biological processes, such as phosphate homeostasis, grain yield, and fertility in rice (Oryza sativa L.). However, the lncRNAs involved in abiotic stress responses remain poorly identified in rice. In this study, we analyzed the expression profiles of lncRNAs using public rice transcriptome datasets derived from abiotic stress-treated samples. We found that the expression of thousands of rice lncRNAs was significantly altered in the shoot and root tissues under different abiotic stresses (drought, high salinity, low temperature, and abscisic acid). We selected six novel drought-induced lncRNAs (DRILs, specifically DRIL1 to DRIL6) for further study. Real-time polymerase chain reaction analysis revealed the differential expression patterns of these DRILs under various stress conditions. The expression of abiotic stress-responsive genes was upregulated in the protoplasts by transiently overexpressed DRIL1 and DRIL4. Therefore, DRILs may be involved in the transcriptional regulation of abiotic stress-responsive genes in rice.

Bulbar dysfunction is a common presentation of amyotrophic lateral sclerosis (ALS) and significantly impacts quality of life of people with ALS (PALS). The current paper reviews measurements of dysarthria and dysphagia specific to ALS to identify efficient and valid assessment measures. Using such assessment measures will lead to improved management of bulbar dysfunction in ALS. Measures reviewed for dysarthria in PALS are organized into three categories: acoustic, kinematic, and strength. A set of criteria are used to evaluate the effectiveness of the measures' identification of speech impairments, measurement of functional verbal communication, and clinical applicability. Assessments reviewed for dysphagia in PALS are organized into six categories: patient reported outcomes, dietary intake, pulmonary function and airway defense capacity, bulbar function, dysphagia/aspiration screens, and instrumental evaluations. Measurements that have good potential for clinical use are highlighted in both topic areas. Additionally, areas of improvement for clinical practice and research are identified and discussed. In general, no single speech measure fulfilled all the criteria, although a few measures were identified as potential diagnostic tools. Similarly, few objective measures that were validated and replicated with large sample sizes were found for diagnosis of dysphagia in PALS. Importantly, clinical applicability was found to be limited; thus, a collaborative team focused on implementation science would be helpful to improve the clinical uptake of assessments. Overall, the review highlights the need for further development of clinically viable and efficient measurements that use a multidisciplinary approach.

This letter proposes an attention-based convolutional neural network architecture for multitasking learning to accurately classify not only the presence of an earthquake but also the event type of the earthquake. In particular, to improve the performance in earthquake-type classification, we develop an attention-based feature aggregation framework embedded in multitask learning architecture. Representative experimental results show that the proposed method provides an effective structure for an earthquake detection and event classification with an earthquake database of the Korean peninsula and the Circum-Pacific belt.

Transcription, in which RNA polymerases (RNAPs) produce RNA from DNA, is the first step of gene expression. As such, it is highly regulated either by trans-elements like protein factors and/or by cis-elements like specific sequences on the DNA. Lambdoid phage HK022 contains a cis-element, put, which suppresses pausing and termination during transcription of the early phage genes. The putRNA transcript solely performs the anti-pausing/termination activities by interacting directly with the E.coli RNAP elongation complex (EC) by an unknown structural mechanism. In this study, we reconstituted putRNA-associated ECs and determined the structures using cryo-electron microscopy. The determined structures of putRNA-associated EC, putRNA-absent EC, and σ70-bound EC suggest that the putRNA interaction with the EC counteracts swiveling, a conformational change previously identified to promote pausing and σ70 might modulate putRNA folding via σ70-dependent pausing during elongation.

With the aging of the population, the number of people with age-related memory complaints has also increased. The purpose of this study was to develop a cognitive rehabilitation program based on mnemonic skills and memory compensatory strategies (CRM) and to investigate the effects of CRM in community-dwelling older adults without dementia.This study was an open-label, single-arm, pilot study. We developed a CRM program comprising 8 weekly sessions. The study participants consisted of older adults with normal cognitive function and mild cognitive impairment (MCI). They were recruited from eight dementia counseling centers and one senior welfare center. To assess the effects of CRM, we administered the following tests at baseline and after completion of the program: Subjective Memory Complaints Questionnaire, the Short form of Geriatric Depression Scale, the Euro Quality of life-5 Dimension, and the Consortium to Establish a Registry for Alzheimer's Disease Neuropsychological Assessment Battery.Thirty-two participants completed the study. Among older adults with normal cognitive function, CRM showed significant improvement in verbal memory function. Among the older adults with MCI, CRM showed significant improvements in language ability, verbal recognition memory, nonverbal memory, attention, and processing speed.CRM improved cognitive function in two distinct populations, older adults with normal cognitive function and older adults with MCI. Additionally, our preliminary findings suggest that older adults with MCI show cognitive improvement in both the trained and non-trained cognitive domains.

Despite substantial progresses, in aqueous zinc ion batteries (AZIBs), developing zinc metal anodes with long-term reliable cycling capabilities is nontrivial because of dendritic growth and related parasitic reactions on the zinc surface. Here, we exploit the tip-blocking effect of a scandium (Sc

Patients with sleep disturbances have gastrointestinal symptoms. Breath hydrogen (H: This prospective study enrolled consecutive patients with OSA using polysomnography. Heart rate variability (HRV) was used as a measurement for the balance of autonomic nervous system during polysomnography. Glucose breath test (GBT) to evaluate breath HAmong 52 patients with OSA, 16 (30.8%) showed positivity to GBT. Although no significant difference was shown in GBT positivity between patients with healthy controls and patients with OSA (13.3% vs 30.8%, P = 0.109), breath H: Elevated breath H

The human-specific bacterial pathogen Group AStreptococcus(GAS) is a significant cause of morbidity and mortality. Macrophages are important to control GAS infection, but previous data indicate that GAS can persist in macrophages. In this study, we detail the molecular mechanisms by which GAS survives in THP-1 macrophages. Our fluorescence microscopy studies demonstrate that GAS are readily phagocytosed by macrophages, but persist within phagolysosomes. These phagolysosomes are not acidified, which is in agreement with our findings that GAS cannot survive in low pH environments. We find that the secreted pore-forming toxin Streptolysin O (SLO) perforates the phagolysosomal membrane, allowing leakage of not only protons, but large proteins including the lysosomal protease cathepsin B. Additionally, GAS blocks the activity of vacuolar ATPase (v-ATPase) to prevent acidification of the phagolysosome. Thus, while GAS does not inhibit fusion of the lysosome with the phagosome, it has multiple mechanisms to prevent proper phagolysosome function, allowing for persistence of the bacteria within the macrophage. This has important implications for not only the initial response but the overall functionality of the macrophages, which may lead to the resulting pathologies in GAS infection. Our data suggests that therapies aimed at improving macrophage function may positively impact patient outcomes in GAS infection.

Considering the weak role of public health insurance in South Korea, this study identified the impact of older consumers’ coping resources such as income and education, well-being (e. g., successful aging and quality of life), and psychological and economic aspects affecting potential stressors on their purchasing of private health insurance (PHI) based on proactive coping theory. From the sixth wave of the 2016 Korean Longitudinal Study of Aging (KLoSA), a sample of 1,224 Korean older adults aged above 65 years was used; binary logistic regression was conducted to identify the association of PHI and purchase decision factors, first separately for two groups (lower/higher use of health care services), and then for the total group. The results showed that older adults with higher levels of well-being, especially with a higher successful aging index and coping resources such as income are more likely to purchase PHI in all three groups.