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INTRODUCTION We used a simulation model to assess the feasibility of reaching the tobacco endgame target (reducing the smoking prevalence to below 5% by 2050) and explored potential implementation strategies. METHODS The impact of strengthened tobacco-control policies on smoking prevalence was analyzed using Korea SimSmoke, a discrete-time Markov process. We considered the effects of various scenarios from 2023 and predictions were conducted until 2050. To confirm the stability of the results, deterministic and probabilistic sensitivity analyses were carried out by increasing and decreasing parameter estimates. RESULTS The implementation of tobacco-control policies in accordance with the WHO MPOWER (Monitor tobacco use and prevention policies; Protect people from tobacco smoke; Offer help to quit tobacco smoking; Warn of the dangers of tobacco; Enforce bans on tobacco advertising, promotion, and sponsorship; Raise taxes on tobacco) measures were insufficient to achieve the tobacco endgame objective of 5% by 2050. The overall predicted smoking prevalence in 2050 is 4.7% if all policies are fully implemented in accordance with the FCTC guidelines together with a complete ban on the sale of cigarettes to people born after 2003 and annual 10% increases in price. Sensitivity analyses using the varying policy effect assumptions demonstrated the robustness of the simulation results. CONCLUSIONS For a substantive reduction in smoking prevalence, it is essential to strongly implement the MPOWER strategy. Beyond this foundational step, the eradication of smoking requires a paradigm shift in the perception of conventional tobacco-control policies, including a tobacco-free generation strategy and radical increases in the price of tobacco products. [ABSTRACT FROM AUTHOR]

Purpose: Diagnostic classification models (DCMs) were developed to identify the mastery or non-mastery of the attributes required for solving test items, but their application has been limited to very low-level attributes, and the accuracy and consistency of high-level attributes using DCMs have rarely been reported compared with classical test theory (CTT) and item response theory models. This paper compared the accuracy of high-level attribute mastery between deterministic inputs, noisy "and" gate (DINA) and Rasch models, along with sub-scores based on CTT. Methods: First, a simulation study explored the effects of attribute length (number of items per attribute) and the correlations among attributes with respect to the accuracy of mastery. Second, a real-data study examined model and item fit and investigated the consistency of mastery for each attribute among the 3 models using the 2017 Korean Medical Licensing Examination with 360 items. Results: Accuracy of mastery increased with a higher number of items measuring each attribute across all conditions. The DINA model was more accurate than the CTT and Rasch models for attributes with high correlations (>0.5) and few items. In the real-data analysis, the DINA and Rasch models generally showed better item fits and appropriate model fit. The consistency of mastery between the Rasch and DINA models ranged from 0.541 to 0.633 and the correlations of person attribute scores between the Rasch and DINA models ranged from 0.579 to 0.786. Conclusion: Although all 3 models provide a mastery decision for each examinee, the individual mastery profile using the DINA model provides more accurate decisions for attributes with high correlations than the CTT and Rasch models. The DINA model can also be directly applied to tests with complex structures, unlike the CTT and Rasch models, and it provides different diagnostic information from the CTT and Rasch models. [ABSTRACT FROM AUTHOR]

This paper presents two data-driven virtual sensors to estimate the time-series of the probability of high-concentration occurrence of naturally occurring radioactive materials (NORMs; 238U and 222Rn) in groundwater based on the in-situ groundwater quality monitoring data and geological information. The random forest was applied to estimate the NORM concentration based on the actual in-situ groundwater quality data, rock type, and the aquifer depth. Additionally, this study proposes three data sampling techniques (i.e., under-sampling, synthetic minority over-sampling, and a complex sampling) to improve the model applicability and accuracy. The developed models were validated using the actual data acquired from 201 locations in South Korea. The models for 238U and 222Rn showed estimation accuracies of 85% and 80%, respectively; the models with over-sampling showed better performance. All the results verified the usefulness of the developed models as virtual sensors for providing immediate information on the in-situ presence of NORMs in groundwater. [Display omitted] • Naturally occurring radioactive material (NORMs) in groundwater can be problematic. • Virtual sensor for in-situ estimating the probability of high-concentration of NORMs. • Major geochemical factors for NORMs were evaluated using statistical analyses. • Methods for solving data imbalance problem in training virtual sensor were proposed. • Major factors for the estimation were consistent with the statistical analysis result. [ABSTRACT FROM AUTHOR]

INTRODUCTION Relatively few, mainly cross-sectional, studies have examined the relationship between smoking cessation and metabolic syndrome (MetS). In particular, information on smoking cessation after MetS is limited. This study aimed to investigate the probability of smoking cessation after the onset of MetS. METHODS In this study we used cohort data from a rural area of Korea and extracted the data of 1054 smokers who were identifiable at baseline and were followed up. Of these, 1041 individuals were selected. Descriptive statistical analyses were performed to identify the basic characteristics of smokers. Multiple logistic regression was performed to determine the association between changes in MetS and smoking cessation. RESULTS The probability of smoking cessation was 1.84 times higher in the newly developed MetS cohort than in the reference group (without MetS at any time point), and it was 1.61 times higher in the persistent MetS cohort than in the reference group, with both probabilities being significant. CONCLUSIONS We found that patients with MetS were more likely to quit smoking than those without MetS. However, intervention is still needed, as numerous patients with MetS continued to smoke. Interventions that actively involve medical institutions or organizations are among the most effective approaches to promote smoking cessation in patients with MetS. In particular, women, farmers and current drinkers should be prioritized. [ABSTRACT FROM AUTHOR]

A hidden Markov model (HMM) is a useful tool for modeling dependent heterogeneous phenomena. It can be used to find factors that affect real-world events, even when those factors cannot be directly observed. HMMs differ from traditional methods by using state variables and mixture distributions to model the hidden states. This allows HMMs to find relationships between variables even when the variables cannot be directly observed. HMM can be extended, allowing the transition probabilities to depend on covariates. This makes HMMs more flexible and powerful, as they can be used to model a wider range of sequential data. Modeling covariates in a hidden Markov model is particularly difficult when the dimension of the state variable is large. To avoid these difficulties, Markovian properties are achieved by implanting the previous state variables to the logistic regression model. We apply the proposed method to find the factors that affect the hidden state of matsutake mushroom growth, in which it is hard to find covariates that directly affect matsutake mushroom growth in Korea. We believe that this method can be used to identify factors that are difficult to find using traditional methods. [ABSTRACT FROM AUTHOR]

Teaching evaluation is a comprehensive judgment of teachers' teaching effect and students' learning outcomes. It is an essential basis for comprehensive curriculum reform. There are many teaching evaluation systems for Korean majors, generally based on teachers' behavior discrimination and ignoring students' learning process and effect. The existing teaching evaluation system has problems such as heavy workload, slow calculation speed, and intense subjectivity. Based on the characteristics of Korean courses, this study constructs a teaching rating system for Korean courses in universities centered on language learning through data collection, correlation analysis, association rules, and other methods to optimize the student teaching evaluation index. At the same time, the machine learning algorithm is introduced into the teaching evaluation process to construct the teaching evaluation model and realize the automation of the teaching evaluation process. The weighted Bayesian incremental learning method is used to solve the cumulative problem of data acquisition samples. The experimental results show that the accuracy rate of classification using the weighted naive Bayesian algorithm to construct the model can reach 75%. Obviously, due to the traditional Bayesian algorithm and BP neural network algorithm, it is suitable for the teaching evaluation model of Korean majors. It provides a theoretical basis for the development of language education informatization. [ABSTRACT FROM AUTHOR]

Crack control for slabs and beams in current design practices in Korea are based on the Frosch's model, which is adapted in ACI 318. It is more difficult to have consistent quality control in underground construction sites, such as the RC box culverts used for electric power distribution built below the ground level. There are more discrepancies between the as-built dimensions and the design dimensions provided in drawings in these structures. Due to this variability in construction error, the crack widths measured in such structures have higher potential to have more differences than the calculated values. Although crack control is a serviceability concern, if the owner chooses to have a target crack width that needs better control, crack width estimations can be improved by considering such construction variability. The probability-based crack width model suggested in this study will allow minimizing the discrepancies between the measured and calculated crack widths and provide reliable estimations of crack widths. Typical size of slabs and beams ranging between 300 mm (12 in.) to 500 mm (20 in.) used in underground RC box culverts in Korea were tested under the four-point bending test program. The thicker specimens had smaller bar spacings which created more cracks with smaller crack widths. However, with smaller crack widths generated in these specimens, there were more errors between the measurements and calculated values. From site investigations in Korea, the thickness of slabs in underground box culverts varied the most among all parameters. As a result, the bottom concrete covers had the highest variability. Bottom concrete covers and bar spacings are the two most important parameters in concrete crack control. A probability-based crack width estimation model for flexural members was developed in this study to consider this construction variability. Monte Carlo simulations were performed to evaluate the probabilistic characteristics of the design surface crack widths with a target width of either 0.3 mm (12 mils) or 0.5 mm (20 mils). The probabilistic models of design variables included in the crack width estimation model were generated based on field-collected information from construction sites in Korea. Because the surface crack widths in RC flexural members are sensitive to the construction errors of concrete cover depths, and since there are differences between the assumed and actual stress distribution closer to the reinforcing bars, the probability of having surface cracks of 0.3 mm width (12 mils) is found to be quite high, such as 89% at the positive moment region (mid-span, bottom surface) of the top slab in RC box culverts and 45% for the negative moment region (support area, top surface) of the top slab with current design practice. In order to ensure crack widths to be smaller than the design target width, probability-based crack width factors are recommended in this study to improve estimations depending on the selected target reliability levels. [ABSTRACT FROM AUTHOR]

Background: The health of migrant workers is becoming an important public health issue. Although there are an increasing number of migrant workers in Korea, the health status in migrant populations remains unknown. The aims of this study were (1) to evaluate the association between income and self-rated oral health (SROH), and (2) to assess the role of health insurance and self-perceived discrimination in the association between income and SROH among Indonesian migrant workers in Korea. Methods: Information about self-reported income, SROH, coverage/utilization of health insurance (HI), living difficulties related to oral health (LDROH), oral health literacy (OHL), and discrimination were obtained from Indonesian migrant workers in Korea (n = 248). The main explanatory variable was income, and SROH was an outcome variable. Logistic regression analyses were performed controlling for age, gender, HI, LDROH, OHL, and discrimination. The paths from income to SROH were analyzed using the Partial Least Square-Structural Equation Model (PLS-SEM). Results: Among Indonesian migrant workers, the lower income group had the highest probability of a poor SROH compared to the higher income group. The variables showing a high explanatory power were discrimination among the low income group and HI among the middle income group. In PLS-SEM, the variables such as HI, LDROH, OHL, and discrimination contributed 11% to explaining the association between income and SROH. Conclusion: A monotonic gradient was revealed among migrant workers according to the association between income and SROH. Discrimination and HI contributed to oral health inequalities. [ABSTRACT FROM AUTHOR]

Purpose: The percent Angoff (PA) method has been recommended as a reliable method to set the cutoff score instead of a fixed cut point of 60% in the Korean Medical Licensing Examination (KMLE). The yes/no Angoff (YNA) method, which is easy for panelists to judge, can be considered as an alternative because the KMLE has many items to evaluate. This study aimed to compare the cutoff score and the reliability depending on whether the PA or the YNA standard-setting method was used in the KMLE. Methods: The materials were the open-access PA data of the KMLE. The PA data were converted to YNA data in 5 categories, in which the probabilities for a "yes" decision by panelists were 50%, 60%, 70%, 80%, and 90%. SPSS for descriptive analysis and G-string for generalizability theory were used to present the results. Results: The PA method and the YNA method counting 60% as "yes," estimated similar cutoff scores. Those cutoff scores were deemed acceptable based on the results of the Hofstee method. The highest reliability coefficients estimated by the generalizability test were from the PA method and the YNA method, with probabilities of 70%, 80%, 60%, and 50% for deciding "yes," in descending order. The panelist's specialty was the main cause of the error variance. The error size was similar regardless of the standard-setting method. Conclusion: The above results showed that the PA method was more reliable than the YNA method in estimating the cutoff score of the KMLE. However, the YNA method with a 60% probability for deciding "yes" also can be used as a substitute for the PA method in estimating the cutoff score of the KMLE. [ABSTRACT FROM AUTHOR]

Purpose: The aim of this study was to explore the effects of A-solution on halitosis and oral status in preoperative NPO patients. Methods: A nonequivalent control group, non-synchronized pretest-posttest design was used in this study. The participants in this study were 66 patients who were admitted for gynecologic surgery. The experimental treatment was to give oral gargling with A-solution, blended essential oils and diluted with distilled water. To identify the experimental treatment effects, halitosis, salivary pH, and oral status were measured by a portable halitosis detector, visual analogue scale, Bromo Thymol Blue (BTB), Bromo Cresol Purple (BCP) test paper and oral assessment guide. Data were analyzed using X²-test, t-test with PASW 18.0 version. Results: Participants were homogeneous before experimental treatment. Objective halitosis in the experimental group, measured by a portable halitosis detector (t= -8.34, p<.001) was significantly lower than the control group. Subjective halitosis was significantly lower in the experimental group (t= -9.29, p<.001). Salivary pH was significantly different between two groups (t=8.81, p<.001). Oral status was significantly better in the experimental group (t= -13.31, p<.001). Conclusion: These findings indicate that oral gargling using A-solution is effective in reducing patient halitosis, and improving oral status. [ABSTRACT FROM AUTHOR]

Purpose: Cost-benefit analysis is one of the most commonly used economic evaluation methods, which helps to inform the economic value of a program to decision makers. However, the selection of a correct benefit estimation method remains critical for accurate cost-benefit analysis. This paper compared benefit estimations among three different benefit estimation models. Methods: Data from community-based chronic hypertension management programs in a city in South Korea were used. Three different benefit estimation methods were compared. The first was a standard deterministic estimation model; second, a repeated-measures deterministic estimation model; and third, a transitional probability estimation model. Results: The estimated net benefit of the three different methods were $1,273.01, $-3,749.42, and $-5,122.55 respectively. Conclusion: The transitional probability estimation model showed the most correct and realistic benefit estimation, as it traced possible paths of changing status between time points and it accounted for both positive and negative benefits. [ABSTRACT FROM AUTHOR]

Global warming, one of the most serious aspects of climate change, can be expected to cause rising sea levels. These have in turn been linked to unprecedentedly large typhoons that can cause flooding of low-lying land, coastal invasion, seawater flows into rivers and groundwater, rising river levels, and aberrant tides. To prevent typhoon-related loss of life and property damage, it is crucial to accurately estimate storm-surge risk. This study therefore develops a statistical model for estimating such surges' probability based on surge data pertaining to Typhoon Maemi, which struck South Korea in 2003. Specifically, estimation of non-exceedance probability models of the typhoon-related storm surge was achieved via clustered separated peaks-over-threshold simulation, while various distribution models were fitted to the empirical data for investigating the risk of storm surges reaching particular heights. To explore the non-exceedance probability of extreme storm surges caused by typhoons, a threshold algorithm with clustering methodology was applied. To enhance the accuracy of such non-exceedance probability, the surge data were separated into three different components: predicted water level, observed water level, and surge. Sea-level data from when Typhoon Maemi struck were collected from a tidal-gauge station in the city of Busan, which is vulnerable to typhoon-related disasters due to its geographical characteristics. Fréchet, gamma, log-normal, generalized Pareto, and Weibull distributions were fitted to the empirical surge data, and the researchers compared each one's performance at explaining the non-exceedance probability. This established that Weibull distribution was better than any of the other distributions for modelling Typhoon Maemi's peak total water level. Although this research was limited to one city on the Korean Peninsula and one extreme weather event, its approach could be used to reliably estimate non-exceedance probabilities in other regions where tidal-gauge data are available. In practical terms, the findings of this study and future ones adopting its methodology will provide a useful reference for designers of coastal infrastructure. [ABSTRACT FROM AUTHOR]

The aim of this study is to evaluate and compare the performances of 5 machine learning (ML) techniques for predicting the spatial probability of landslide at Atsuma, Japan, and Mt. Umyeon, Korea. 5 ML models used are Naïve Bayes (NB), ensemble learning (random forest (RF) and adaboost (AB)), and deep learning (multilayer perceptron (MLP) and convolutional neural network (CNN)) models. Real landslide events at the study areas are randomly separated to the training set for landslide mapping and the validation set for assessing performance. To assess the performance of the used models, the resulting models are validated using receiver operating characteristic (ROC) curve. The success rate curves show that the areas under the curve (AUC) for the NB, RF, AB, MLP, and CNN are 85.1, 88.8, 88.6, 87.5, and 95.0%, respectively, at Atsuma and 68.7, 85.6, 90.5, 81.6, and 92.0%, respectively, at Mt. Umyeon. Similarly, the validation results show that the areas under the curve for the NB, RF, AB, MLP, and CNN are 84.3, 87.1, 87.1, 86.7, and 89.7%, respectively, at Atsuma and 64.9, 85.5, 83.9, 84.7, and 90.5%, respectively, at Mt. Umyeon. In addition, statistical tests such as Chi-square test and difference of proportions test show that all classified landslide susceptibility maps have statistical significance and the significant difference in classified landslide susceptibility maps from different ML models. The comparison results among 5 ML models show that the CNN model had the best performance and NB model had the worst performance in both study areas. [ABSTRACT FROM AUTHOR]

Background: This study examines the effects of a shift in medical coverage, from National Health Insurance (NHI) to Medical Aid (MA), on health care utilization (measured by the number of outpatient visits and length of stay; LOS) and out-of-pocket medical expenses.Methods: Data were collected from the Korean Welfare Panel Study (2010-2016). A total of 888 MA Type I beneficiaries and 221 MA Type II beneficiaries who shifted from the NHI were included as the case group and 2664 and 663 consecutive NHI holders (1:3 propensity score-matched) were included as the control group, respectively. We used the 'difference-in-differences' (DiD) analysis approach to assess changes in health care utilization and medical spending by the group members.Results: Differential average changes in outpatient visits in the MA Type I panel between the pre- and post-shift periods were significant, but differential changes in LOS were not found. Those who shifted from NHI to MA Type I had increased number of outpatient visits without changes in out-of-pocket spending, compared to consecutive NHI holder who had similar characteristics. However, this was not found for MA Type II beneficiaries.Conclusion: Our research provides evidence that the shift in medical coverage from NHI to MA Type I increased the number of outpatient visits without increasing the out-of-pocket spending. Considering the problem of excess medical utilization by Korean MA Type I beneficiaries, further researches are required to have in-depth discussions on the appropriateness of the current cost-sharing level on MA beneficiaries. [ABSTRACT FROM AUTHOR]

Purpose. To determine the incidence of keratoconus and to determine its possible association with common systemic diseases using a nationwide cohort. Methods. This retrospective nationwide cohort study included 1,025,340 subjects from the Korean National Health Insurance Service-National Sample Cohort database from 2004 to 2013. Estimates for incidence rates of keratoconus were identified. After 1 : 5 matching using propensity scores, associations between keratoconus and certain systemic comorbidities were determined using multivariate logistic regression analysis. Results. The incidence during the same period was 15.1 cases per 100,000 person-years. Adjusted logistic regression analysis after propensity score matching revealed significant associations between keratoconus and allergic rhinitis (odds ratio (OR): 1.86; 95% confidence interval (CI): 1.63–2.13; p < 0.001), asthma (OR: 1.20; 95% CI: 1.06–1.36; p < 0.001), atopic dermatitis (OR: 1.33; 95% CI: 1.13–1.56; p < 0.001), and diabetes mellitus (DM) (OR: 1.35; 95% CI: 1.15–1.58; p < 0.001). Conclusion. Estimates of the incidence of keratoconus may help in the planning of eye-care policies, and the results of this study determined the associations between allergic diseases and keratoconus. Conflicting results regarding the association between keratoconus and DM should be further evaluated. [ABSTRACT FROM AUTHOR]

Background: To evaluate the effect of different adjustments of the refractive outcome of the first eye according to corneal power (K) in order to improve the intraocular lens (IOL) power calculation of the second eye in the SRK/T formula.Methods: One hundred thirty-four patients who underwent uncomplicated bilateral, sequential phacoemulsification with AcrySof IQ implantation were enrolled. The optimal partial adjustment of the refractive outcome of the first eye according to K was retrospectively analyzed using a regression formula.Results: In all patients, the optimal partial adjustment of the refractive outcome of the first eye was calculated as 56%. For K values between 42.8 D and 44.6 D, the optimal partial adjustment was calculated as 30%; however, this adjustment of the first eye did not significantly improve the refractive outcome in the second eye of the subgroup with K values between 42.8 D and 44.6 D. For K values greater than 44.6 D or less than 42.8 D, the optimal partial adjustments were calculated as 69% and 81%, respectively. According to these results, the adjustment of the first eye significantly improved the refractive outcome in the second eye from 0.36 to 0.26 D (P < 0.001) in the entire data set. This result was significantly lower than that using a single partial adjustment (56%) (0.28 D; P = 0.027).Conclusions: For K values greater than 44.6 D or less than 42.8 D, an approximately 70-80% adjustment of the first eye error should be considered. In contrast, for K values between 42.8 D and 44.6 D, a 30% or less adjustment should be considered in the SRK/T formula. [ABSTRACT FROM AUTHOR]

Background: Obesity has been reported to be associated with iron deficiency. However, few studies have investigated iron status in low adiposity. To investigate whether body adiposity was associated with altered hepatic iron status, we compared liver iron levels and markers involved in inflammation and iron absorption in obese, control, and mildly calorie restricted mice. Methods: Seven week old C57BL/6 mice were fed control (10% kcal fat, Control) or high fat (60% kcal fat, HFD) diets, or reduced amount of control diet to achieve 15% calorie restriction (CR) for 16 weeks. Hepatic non-heme iron content and ferritin protein level, and hematocrit and hemoglobin levels were determined to assess iron status. Hepatic expression of Mcp-1 and Tnf-α were measured as hepatic inflammatory markers. Hepatic hepcidin (Hamp) and Bmp6, and duodenal Dmt1, Dcyt1b, hephaestin (Heph) and ferroportin mRNA levels were measured as factors involved in regulation of iron absorption. Results: Hepatic non-heme iron and ferritin protein levels were significantly higher in the CR group compared with the Control group, and significantly lower in the HFD group. These two iron status markers showed significantly negative correlations with the amount of white adipose tissue (r = -0.689 for hepatic non-heme iron and r = -0.740 for ferritin). Hepatic Mcp-1 and Tnf-α mRNA levels were significantly lower in the CR compared with the HFD (74 and 47% lower) and showed significantly negative correlations with hepatic non-heme iron levels (Mcp-1: r = -0.557, P < 0.05; Tnf-α: r = -0.464, P < 0.05). Hepatic Hamp mRNA levels were lower in the HFD and higher in the CR groups compared with the Control group, which could be a response to maintain iron homeostasis. Duodenal Dcyt1b mRNA levels were higher in the CR group compared with the HFD group and duodenal Heph mRNA levels were higher in the CR group than the Control group. Conclusion: We showed that body adiposity was inversely correlated with liver iron status. Low inflammation levels in hepatic milieu and enhanced expression of duodenal oxidoreductases induced by calorie restriction could have contributed to higher iron status. [ABSTRACT FROM AUTHOR]

Background: Zea mays L. (Z mays) has been used for human consumption in the various forms of meal, cooking oil, thickener in sauces and puddings, sweetener in processed food and beverage products, bio-disel. However, especially, in case of husk extract of Z mays, little is known about its anti-inflammatory effects. Therefore, in this study, the anti-inflammatory effects of Z mays husk extract (ZMHE) and its mechanisms of action were investigated. Methods: The husks of Z Mays were harvested in kangwondo, Korea. To assess the anti-inflammatory activities of ZMHE, we examined effects of ZMHE on nitric oxide (NO) production, and release of soluble intercellular adhesion molecule-1 (sICAM-1) and eotaxin-1. The expression level of inducible nitric oxide synthase (iNOS) gene was also determined by Western blot and luciferase reporter assays. To determine its mechanisms of action, a luciferase reporter assay for nuclear factor kappa B (NF-κB) and activator protein-1 (AP-1) was introduced. Results: ZMHE inhibited lipopolysaccharide (LPS)-induced production of NO in RAW264.7 cells. In addition, expression of iNOS gene was reduced, as confirmed by Western blot and luciferase reporter assays. Effects of ZMHE on the AP-1 and NF-κB promoters were examined to elucidate the mechanism of its anti-inflammatory activity. Activation of AP-1 and NF-κB promoters induced by LPS was significantly reduced by ZMHE treatment. In addition, LPS-induced production of sICAM-1 and IL-4-induced production of eotaxin-1 were all reduced by ZMHE. Conclusions: Our results indicate that ZMHE has anti-inflammatory effects by downregulating the expression of iNOS gene and its downregulation is mediated by inhibiting NF-κB and AP-1 signaling. [ABSTRACT FROM AUTHOR]

Background: The ethanol extract of KOTMIN13, composed of Flowers, Semen, Inula japonica Trichosanthes kirilowii Peucedanum praeruptorum Radix, and Bulbs, was investigated for its anti-asthmatic and Allium macrostemon anti-allergic activities. Methods: The anti-asthmatic effects of KOTMIN13 were evaluated on ovalbumin (OVA)-induced murine asthma model. Anti-allergic properties of KOTMIN13 in bone-marrow derived mast cells (BMMC) and passive cutaneous anaphylaxis (PCA) in vivo were also examined. Results: In asthma model, KOTMIN13 effectively suppressed airway hyperresponsiveness induced by aerosolized methacholine when compared to the levels of OVA-induced mice. KOTMIN13 treatment reduced the total leukocytes, eosinophil percentage, and Th2 cytokines in the bronchoalveolar lavage fluids in OVA-induced mice. The increased levels of eotaxin and Th2 cytokines in the lung as well as serum IgE were decreased by KOTMIN13. The histological analysis shows that the increased inflammatory cell infiltration and mucus secretion were also reduced. In addition, the degranulation and leukotriene C4 production were inhibited in BMMC with IC50 values of 3.9 µg/ml and 1.7 µg/ml, respectively. Furthermore, KOTMIN13 treatment attenuated mast-mediated PCA reaction. Conclusions: These results demonstrate that KOTMIN13 has anti-asthmatic and anti-allergic effects in vivo and in vitro models. [ABSTRACT FROM AUTHOR]

Research on the effect of low-fat intake on hearing is limited. This study aimed to elucidate the relationship between fat, carbohydrate and protein intake and the presence of hearing discomfort among the elderly. The Korean National Health and Nutrition Examination Survey was conducted from 2009 through to 2012. A total of 4615 participants ranging in age from 60 to 80 years underwent a pure-tone audiometric evaluation, a physical examination and a nutritional survey. The associations between the participants’ hearing thresholds and their protein/fat/carbohydrate intake/total energy intake were analysed using simple and multiple regression models with complex sampling adjusted for confounding factors, such as BMI, income level, smoking status and a history of hypertension, hyperlipidaemia and diabetes. Low fat and protein intakes were associated with hearing discomfort (OR 0·82, 95 % CI 0·71, 0·96, P=0·011; OR 0·81, 95 % CI 0·67, 0·96, P=0·017, respectively). This study revealed that low fat and protein intakes are associated with hearing discomfort in the elderly Korean population. [ABSTRACT FROM PUBLISHER]

Background: The purpose of this randomised phase III trial was to evaluate whether the addition of simvastatin, a synthetic 3-hydroxy-3methyglutaryl coenzyme A reductase inhibitor, to XELIRI/FOLFIRI chemotherapy regimens confers a clinical benefit to patients with previously treated metastatic colorectal cancer.Methods: We undertook a double-blind, placebo-controlled phase III trial of 269 patients previously treated for metastatic colorectal cancer and enrolled in 5 centres in South Korea. Patients were randomly assigned (1:1) to one of the following groups: FOLFIRI/XELIRI plus simvastatin (40 mg) or FOLFIRI/XELIRI plus placebo. The FOLFIRI regimen consisted of irinotecan at 180 mg m(-2) as a 90-min infusion, leucovorin at 200 mg m(-2) as a 2-h infusion, and a bolus injection of 5-FU 400 mg m(-2) followed by a 46-h continuous infusion of 5-FU at 2400 mg m(-2). The XELIRI regimen consisted of irinotecan at 250 mg m(-2) as a 90-min infusion with capecitabine 1000 mg m(-2) twice daily for 14 days. The primary end point was progression-free survival (PFS). Secondary end points included response rate, duration of response, overall survival (OS), time to progression, and toxicity.Results: Between April 2010 and July 2013, 269 patients were enrolled and assigned to treatment groups (134 simvastatin, 135 placebo). The median PFS was 5.9 months (95% CI, 4.5-7.3) in the XELIRI/FOLFIRI plus simvastatin group and 7.0 months (95% CI, 5.4-8.6) in the XELIRI/FOLFIRI plus placebo group (P=0.937). No significant difference was observed between the two groups with respect to OS (median, 15.9 months (simvastatin) vs 19.9 months (placebo), P=0.826). Grade⩾3 nausea and anorexia were noted slightly more often in patients in the simvastatin arm compared with with the placebo arm (4.5% vs 0.7%, 3.0% vs 0%, respectively).Conclusions: The addition of 40 mg simvastatin to the XELIRI/FOLFIRI regimens did not improve PFS in patients with previously treated metastatic colorectal cancer nor did it increase toxicity. [ABSTRACT FROM AUTHOR]

Study design:Experimental study.Objectives:To study the role of surface temperature as an adjunct to motor evoked potentials (MEPs) in rabbit spinal cord injury (SCI) model.Setting:Department of Orthopedics, Korea University Guro Hospital, Seoul, Korea.Methods:Rabbits (n=18) were divided into Complete (n=9) and Incomplete (n=9) SCI groups. Complete SCI was defined as being non-responsive to a wake-up test with loss of MEPs after transection of spinal cord. Incomplete SCI was defined as being responsive to a wake-up test with significant attenuation (⩾80%) of MEPs after impaction on spinal cord. Surface temperature of upper and lower extremities, core temperature and MEPs signals were checked before, during and after SCI for 20 min. A wake-up test was conducted and spinal cord was histologicaly evaluated.Results:Experimental conditions between the two groups were statistically similar (P>0.005 for all values). After SCI, upper extremity temperatures did not change in either group (P>0.005); however, the surface temperature of the lower extremities in the Complete SCI Group elevated to 1.7±0.5 °C in comparison to 0.5±0.1 °C in the Incomplete SCI Group (P<0.001). The scores of wake-up test in the Incomplete SCI Group were significantly different from that of the Complete SCI Group (P<0.001), while white and gray matter damage was variable on histology.Conclusions:Monitoring of changes of body surface temperature of the lower extremities can be potentially used to identify the completeness of SCI in a rabbit model. [ABSTRACT FROM AUTHOR]

Background: Intraoperative dexmedetomidine may decrease postoperative emergence agitation in elderly patients due to its sedative effect. In this study, we evaluated the effect of adjuvant dexmedetomidine on smooth emergence from anaesthesia after orthopaedic surgery in elderly patients. Methods: A total 115 patients (ASA I-II, aged over 65 years) were randomly allocated into four groups. Anaesthesia was maintained with either sevoflurane or total intravenous anaesthesia (TIVA) comprising propofol and remifentanil. Patients were also administered either dexmedetomidine (0.4 µg kg-1 hr-1; SD and TD) intraoperatively or normal saline (SN or TN) as a control. The bispectral index (BIS) score was maintained from 40-60 intraoperatively. All anaesthetics and dexmedetomidine were discontinued at surgical conclusion, and the recovery times (durations to a BIS = 60, 70, and 80; eye opening; and extubation) were measured. The mean arterial pressure, heart rate, Ricker's agitation-sedation scale (RSAS), visual analogue scale (VAS) for pain, and incidences of emergence agitation and postoperative nausea and vomiting (PONV) were measured in the recovery room. Results: Dexmedetomidine significantly decreased the RSAS score in the SD and TD groups, and a calm state postoperatively occurred more frequently in these groups than in the control groups. The heart rate and incidence of emergence agitation were lower in the dexmedetomidine groups. Recovery time was higher in the SD group than in the SN group, and no significant differences occurred between the TN and TD groups. The VAS score was lower in the SD group than in the SN group, and the PONV did not differ regardless of the use of dexmedetomidine. Conclusions: Dexmedetomidine may be an effective intraoperative adjuvant for a reducing emergence agitation and smooth emergence from anaesthesia after orthopaedic surgery in elderly patients. [ABSTRACT FROM AUTHOR]

Background: Dementia induced by β-amyloid accumulation impairs peripheral glucose homeostasis, but red pepper extract improves glucose homeostasis. We therefore evaluated whether long-term oral consumption of different red pepper extracts improves cognitive dysfunction and glucose homeostasis in type 2 diabetic rats with β-amyloid-induced dementia. Methods: Male diabetic rats received hippocampal CA1 infusions of β-amyloid (25-35) (AD) or β-amyloid (35-25, non-plaque forming), at a rate of 3.6 nmol/day for 14 days (Non-AD). AD rats were divided into four dietary groups receiving either 1% lyophilized 70% ethanol extracts of either low, moderate and severe pungency red peppers (AD-LP, AD-MP, and AD-SP) or 1% dextrin (AD-CON) in Western diets (43% energy as fat). Results: The ascending order of control < LSP < MSP and SSP potentiated the phosphorylation of CREB and GSK and inhibited Tau phosphorylation in the hippocampus which in turn inhibited β-amyloid accumulation. The inhibition by MP and SP reduced the memory deficit measured by passive avoidance test and water maze test. Furthermore, the accumulation of β-amyloid induced glucose intolerance, although serum insulin levels were elevated during the late phase of oral glucose tolerance test (OGTT). All of the red pepper extracts prevented the glucose intolerance in AD rats. Consistent with OGTT results, during euglycemic hyperinulinemic clamp glucose infusion rates were lower in AD-CON than Non-AD-CON with no difference in whole body glucose uptake. Hepatic glucose output at the hyperinsulinemic state was increased in AD-CON. β-amyloid accumulation exacerbated hepatic insulin resistance, but all red pepper extract treatments reversed the insulin resistance in AD rats. Conclusions: The extracts of moderate and severe red peppers were found to prevent the memory deficit and exacerbation of insulin resistance by blocking tau phosphorylation and β-amyloid accumulation in diabetic rats with experimentally induced Alzheimer's-like dementia. These results suggest that red pepper consumption might be an effective intervention for preventing age-related memory deficit. [ABSTRACT FROM AUTHOR]

Background Internet addiction (IA) is considered as one of behavioral addictions. Although common neurobiological mechanisms have been suggested to underlie behavioral addiction and substance dependence, few studies have directly compared IA with substance dependence, such as alcohol dependence (AD). Methods We compared patients with IA, AD, and healthy controls (HC) in terms of the Five Factor Model of personality and with regard to impulsiveness, anger expression, and mood to explore psychological factors that are linked to aggression. All patients were treatment-seeking and had moderate-to-severe symptoms. Results The IA and AD groups showed a lower level of agreeableness and higher levels of neuroticism, impulsivity, and anger expression compared with the HC group, which are characteristics related to aggression. The addiction groups showed lower levels of extraversion, openness to experience, and conscientiousness and were more depressive and anxious than the HCs, and the severity of IA and AD symptoms was positively correlated with these types of psychopathology. Conclusions IA and AD are similar in terms of personality, temperament, and emotion, and they share common characteristics that may lead to aggression. Our findings suggest that strategies to reduce aggression in patients with IA are necessary and that IA and AD are closely related and should be dealt with as having a close nosological relationship. [ABSTRACT FROM AUTHOR]

This study evaluated a method to maintain the optimal image quality in clinical practice for image quality management in a picture archiving and communication system (PACS) that uses typical technology for digital medical images. This study conducted a survey of 25 hospitals in Seoul and metropolitan areas that had installed PACS to examine the reality of image quality management. Sixteen diagnostic monitors were used as calibration tools to compare and analyze the external illuminance uniformity and grayscale standard display function (GSDF) values at each frequency. According to the survey results, most of the hospitals did not have any particular rules or standardized methods for image quality control. In a PACS, the calibration frequency was examined within the allowable limits of error for each week and month. The calibration was not affected by the difference in brightness of the environment for reading an image. The GSDF measurement values were quite different from the standard values. In conclusion, to improve the image quality of the digital system, it is important to make good use of the system and maintain the image quality. Therefore, it is critical to capitalize on the method suggested in this study and maintain the optimal image quality to guarantee a high level of observer satisfaction. [ABSTRACT FROM AUTHOR]

The objective of this study was to examine the effects of a hypertension management program provided by a primary health care post located in a distant rural area in South Korea on the level of knowledge of hypertension. The panel data consisted of a total of 319 people or the entire population aged above 40 years of five villages located in Goseong-gun, Gangwon province, South Korea. Preliminary interviews were conducted with all the residents prior to their enrollment in the health care post’s hypertension management program. After 5 years of program operation, follow-up interviews were carried out with the same population. A total of 207 participants who completed both interviews were used in the final analysis. First, only the hypertensive group who participated in the program exhibited a significant difference in the level of knowledge. Second, educational level was associated with the level of knowledge in the entire group. Third, the effects of the program differed by gender, with men demonstrating more significant variations in knowledge upon participating in the program. For effective use of resources, considering that the effects of a hypertension education programs worked differently for groups, more customized hypertension management programs need to be targeted at each group to improve the effectiveness of hypertension education programs. [ABSTRACT FROM PUBLISHER]

Objectives: Consultation difficulty occurs in hospitals located in many countries, and it is understood that strategies to improve the emergency department (ED) consultation process are needed. The authors constructed a computerized consultation management system in the ED of a tertiary care teaching hospital to improve the consultation process and evaluate the influence of the consultation management system on ED length of stay (LOS) and the throughput process. Methods: Consultation management system software was developed and integrated into the hospital information system. The development process took place between June 2008 and May 2009. Before the development of the consultation system, ED personnel contacted on-call physicians of the specialty department, who are usually residents, by cellular phones. After the system had been developed, ED personnel selected the department and on-call physician in the specialty department using the consultation management software and activated the automatic consultation process when specialty consultation was necessary. If the treatment plan had not been registered for 3 hours, all of the residents in the specific department are notified of the delay in the treatment plan with a short message service (SMS) message. If an admission or discharge order had not been made in 6 hours, all of the residents and faculty staff in the specific department receive SMS messages stating the delay in disposition. ED patient data were collected from the hospital information system for 40 days before the system was developed (June 1, 2008, to July 10, 2008) and 40 days after the system was implemented (June 1, 2009, to July 10, 2009). Results: The median ED LOS decreased significantly, from 417.5 minutes (interquartile range [IQR] = 178.8-1,247.5 minutes) in the presystem period to 311.0 minutes (IQR = 128.0-817.3 minutes) in the postsystem period (p < 0.001). Also, the median time to disposition order decreased significantly, from 336.0 minutes (IQR = 145.0-943.0 minutes) to 235.0 minutes (IQR = 103.0-21.5; p = 0.001). No significant reduction was observed in the interval between the time of disposition decision and the time when the patients left the ED. Significant reductions of ED LOS were observed after implementing the system (p < 0.001) regardless of whether the visit occurred during the weekday daytime (09:00-17:00 hours), holiday and weekend daytime (09:00-17:00 hours), or nighttime (17:00-09:00 hours next day). Conclusions: This study found decreased ED LOS by implementation of a computerized consultation management system in a tertiary care teaching hospital. The automated consultation and monitoring process formalized communication between physicians providing ED patient care in the academic ED with high consultation and admission rates. [ABSTRACT FROM AUTHOR]

The rise of the Internet sparked an intense debate on the democratic potential of information and communication technologies (ICTs). This research illustrates how web technologies enable ordinary citizens to articulate their interests in policy processes and enhance the organizational intelligence of local governments. The two South Korean cities introduced in this article adopted internet applications that allowed citizens to contact public officials or city mayors directly, resulting in dramatic increases in online civic input into local governance. Citizens' political efficacy was encouraged both by government feedback and by the system that enabled their evaluation of the feedback. Despite the substantive contributions of the applications to local governance, formalistic responses from some public officials indicate challenges in building citizens' trust in government through the use of ICTs. To address the challenges, it is necessary to cultivate the innovative leadership of senior public mangers and develop the institutional mechanisms encouraging public officials' sincere responses to citizens' online requests. [ABSTRACT FROM AUTHOR]

Bayesian changepoint analysis is applied to detect a change point in the 30-year (1976–2005) time series of the area-averaged annual maximum precipitation (A3MP) for the six accumulated time periods (1, 3, 6, 12, 24, and 48 h) over South Korea. Using noninformative priors, Bayesian model selection is performed by posterior probability through the Bayes factor, and the exact Bayes estimators of the parameters and unknown change point for the selected change model are obtained. To investigate the significance of the mean differences in the six A3MP between before and after the change point, posterior probability and 90% highest posterior density credible intervals are examined. The results show that a single change occurred around 1997 in the A3MP without regard to the accumulated time periods over South Korea. This is strongly consistent with the abrupt increases in the intensity and frequency of heavy precipitation after 1997. The A3MP after the change point (1997) significantly increased more than 15% compared with the A3MP before the change point. The intensification of A3MP resulted in a great increase of the annual total precipitation (about +18%), especially a greater increase of the heavy precipitation amount (+51%) and frequency (+48%) over South Korea. [ABSTRACT FROM AUTHOR]

The vulnerability of the water supply capacity of a dam is defined as the expected deficit volume from a typical water deficit event. In this study, a water deficit event was assumed to be a rectangle composed of the deficit duration and deficit intensity whose occurrence probability was then estimated by the bivariate frequency analysis based on the copula method. This approach is different from the conventional one based on the assumption of the same occurrence probability for all events. This proposed method was applied to the Namgang dam in Korea as an example and the resulting estimate of the vulnerability was compared with the conventional method. First, the 'OR' concept was found to be better than the 'AND' concept in the calculation of the occurrence probability. Additionally, based on the consideration of multicollinearity, it could be concluded that the occurrence probability should be estimated by considering the water deficit intensity and duration. For the Namgang dam, the vulnerability was determined to be 9.11 × 106 m3, which is about 3% of the total storage capacity. This estimated vulnerability is also about 70% of the amount estimated by applying the conventional method with the same occurrence probability for all water deficit events. [ABSTRACT FROM AUTHOR]