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Online self-learning became widespread after the onset of the COVID-19 pandemic, and during this period, learners' self-leadership became an important measure of their competency. This study aims to verify the validity and reliability of the tool by translating the Abbreviated Self-Leadership Questionnaire (ASLQ) into Korean. Through web-based surveys, 286 nursing students from two university nursing colleges participated in the study. Cronbach's a, correlation, and confirmatory factor analyses were used to verify the nine-item ASLQ. The factor loading values ranged from 0.378 to 0.892. The ASLQ model fit had a comparative fit index of 0.944, root mean square error of approximation of 0.093, and standardized root mean residual of 0.069. The ASLQ showed a statistically significant positive correlation with the original self-leadership, emotional intelligence, and self-efficacy questionnaires. Additionally, structural, convergent, and criterion validity were also evident. The reliability of the ASLQ was 0.846 for Cronbach's a (the three sub-dimensions were 0.836, 0.732, and 0.734). This study verified the validity and reliability of the ASLQ and confirmed that it could be used to measure the self-leadership of nursing students at a time when self-leadership is crucial.

This study was conducted to confirm the feasibility of using yellow poplar, which is a fast-growing hardwood species in Korea, as a structural material. Lumber was produced, and the mechanical grading and the knot diameter ratio on the wide surface measurement were performed for each grade of lumber. It was confirmed that the majority mechanical grades of yellow poplar were E10, E11, and E12, and the size of knot in the surface increased as the mechanical grades decreased. A fitted distribution of tensile strength of the lumbers was the Weibull distribution. As a result of calculating the tensile allowable stress using the 5th percentile value calculated by the Weibull distribution and the non-parametric method according to the mechanical grade, all the experimental values were higher than the minimum allowable stresses presented in the Korean industrial standards. However, for the low grades, there was no significant difference from the standard values. This was thought to be due to the large size of knots in low-grade lumber. It was expected that the prospect of using yellow poplar structural member will be higher if additional research is conducted on the restriction of knot size according to the mechanical grade. [ABSTRACT FROM AUTHOR]

Background: The BENTLEY score (B-S), French thrombotic microangiopathy (TMA) Reference Center score (FTMA-S), and PLASMIC score (PLASMIC-S) have been developed for TMA diagnostic prediction. We retrospectively validated their predictive performances in patients with severe (<10%) disintegrin and metalloprotease with thrombospondin type 1 motif, member 13 (ADAMTS13) deficiency in terms of the risk of TMA and response to therapeutic plasma exchange (TPE). Methods: The predictive performances of the three scoring systems were compared in 145 patients with suspected TMA who underwent ADAMTS13 activity tests between January 2014 and September 2022. The response to TPE and mortality in TMA-positive patients were compared after risk stratification, using the Mann–Whitney U and Fisher’s exact tests. Results: The PLASMIC-S, FTMA-S, and B-S showed area under the curve values of 0.820, 0.636, and 0.513, respectively, for predicting TMA positivity in high-risk patients. The PLASMIC-S showed higher sensitivity (81.8%), negative predictive value (91.2%), positive predictive value (PPV; 66.7%), and accuracy (82.1%) than the FTMA-S (72.7%, 82.1%, 41.0%, and 60.0%, respectively) and B-S (4.6%, 70.2%, 50.0%, and 69.7%, respectively). The PLASMIC-S also showed higher specificity than the FTMA-S (82.2% vs. 54.5%). The modified PLASMIC-S, including lactate dehydrogenase/upper limit of normal ratios, increased the specificity, PPV, and accuracy to 97.0%, 92.3%, and 92.4%, respectively. In TMApositive patients, high risk assessed by the PLASMIC-S predicted higher platelet recovery rates and less TPE sessions required for recovery than for those assessed at low-to-intermediate risk. Conclusions: PLASMIC-S is the preferred scoring system for detecting patients with TMA positivity and for prognosis before confirmation of ADAMTS13 activity [ABSTRACT FROM AUTHOR]

This study purposed to analyze inter-influences among the administrators’ profiles of characteristics, their value systems, and their public policies in the situations of local governments in South Korea. The characteristic profiles are attributed to behavior, emotion, and cognition. The value systems are referred to as economics and job ethics. The public policies were divided into distribution and regulation. The research methods were based on a questionnaire that constructed items for the above three variables and requested Likert scales. The sample size was 1061, recruited from all eight Korean local governments. The results of the structure analysis suggested that the administrators’ decisions about their public policy were influenced by their value systems attributed to their characteristics profiles. Further studies required the application of this study’s paradigm to the diverse values and policies that were limited in this study and to the world’s nations, where the governmental processes are different in economic ideology and political culture from Korean structures. [ABSTRACT FROM AUTHOR]

The survival rate of children admitted in the neonatal intensive care unit (NICU) after birth is on the increase; hence, proper evaluation and care of their neurodevelopment has become an important issue. Neurodevelopmental assessments of individual domains regarding motor, language, cognition, and sensory perception are crucial in planning prompt interventions for neonates requiring immediate support and rehabilitation treatment. These assessments are essential for identifying areas of weakness and designing targeted interventions to improve future functional outcomes and the quality of lives for both the infants and their families. However, initial stratification of risk to select those who are in danger of neurodevelopmental disorders is also important in terms of cost-effectiveness. Efficient and robust functional evaluations to recognize early signs of developmental disorders will help NICU graduates receive interventions and enhance functional capabilities if needed. Several age-dependent, domain-specific neurodevelopmental assessment tools are available; therefore, this review summarizes the characteristics of these tools and aims to develop multidimensional, standardized, and regular follow-up plans for NICU graduates in Korea. [ABSTRACT FROM AUTHOR]

BACKGROUND: The purpose of this study was to analyze G test results according to the three-Factor eating Questionnaire (TFEQ), body composition, and physical fitness of fourth-grade air force cadets. this was done to identify the relationship between the TFEQ, body composition, and G resistance, in order to provide basic data for pilots and air force cadets to strengthen G tolerance. METHODS: From the Republic of Korea air Force academy (ROKAFA), 138 fourth-year cadets were assessed using the TFEQ and for body composition and physical fitness. Based on these measurement results, a G test result analysis and a correlation analysis were conducted. RESULT: The TFEQ showed statistically significant differences in several areas when comparing the G test pass group (GP group) to the G test fail group (GF group). Three-km running time was significantly faster in the GP group than in the GF group. Physical activity levels were higher in the GP group compared to the GF group. CONCLUSION: The TFEQ demonstrated utility in predicting whether cadets will pass or fail G-LOC testing. G test success for any cadet will require improvement in continuous eating behavior and physical fitness management. if variables affecting the G test are analyzed and applied to physical education and training through continuous research over the next two to three years, it is expected to have a greater effect on the success of the G test for every cadet. [ABSTRACT FROM AUTHOR]

Purpose: The purpose of this study is to confirm how the income level of the family caregivers for recipients in long-term care (LTC) facilities are related to family caregivers’ willingness to pay out-ofpocket payments for better LTC services. Methods: This study used the 2021 survey data on cost sharing in LTC facilities, which surveyed 1,111 family caregivers of recipients. To analyze the effect of the income level of family caregivers on the willingness to pay out-of-pocket payments for better LTC services, a chi-square test, a Cochran-Mantel-Haenszel test, and a logistic regression analysis were performed. Results: We found that 39.0% of respondents were willing to pay out-of-pocket payments if better services were available to recipients. Adjusted for recipient’s and family caregivers’ variables, characteristics of out-of-pocket payment, and LTC service use, the willingness to pay in the monthly household income level of 5 million won and more was 3.28 times higher than those in the monthly household income level of less than 1 million won (95% confidence level=1.93~5.55, p<.001). As monthly household income rises, the odds ratio of willingness to pay tended to increase (p<.001). Conclusion: Family caregivers who bear the out-of-pocket payments of LTC facilities are willing to pay more for better LTC services. In addition, the higher the income level of family caregivers, the higher their willingness to pay. A full-scale review of the system reform is needed to prevent out-ofpocket payments from becoming an economic barrier to service users and to contribute to service quality improvement and financial stability. [ABSTRACT FROM AUTHOR]

Background: The transition of dialysis modalities from continuous renal replacement therapy (CRRT) to intermittent hemodialysis (iHD) is frequently conducted during the recovery phase of critically ill patients with acute kidney injury. Herein, we addressed the occurrence of intradialytic hypotension (IDH) after this transition, and its association with the mortality risk. Methods: A total of 541 patients with acute kidney injury who attempted to transition from CRRT to iHD at Seoul National University Hospital, Korea from 2010 to 2020 were retrospectively collected. IDH was defined as a discontinuation of dialysis because of hemodynamic instability plus a nadir systolic blood pressure <90 mm Hg or a decrease in systolic blood pressure =30 mm Hg during the first session of iHD. Odds ratios (ORs) of outcomes, such as in-hospital mortality and weaning from RRT, were measured using a logistic regression model after adjusting for multiple variables. Results: IDH occurred in 197 patients (36%), and their mortality rate (44%) was higher than that of those without IDH (19%; OR, 2.64; 95% confidence interval [CI], 1.70-4.08). For patients exhibiting IDH, the iHD sessions delayed successful weaning from RRT (OR, 0.62; 95% CI, 0.43-0.90) compared with sessions on those without IDH. Factors such as low blood pressure, high pulse rate, low urine output, use of mechanical ventilations and vasopressors, and hypoalbuminemia were associated with IDH risk. Conclusions: IDH occurrence following the transition from CRRT to iHD is associated with high mortality and delayed weaning from RRT. [ABSTRACT FROM AUTHOR]

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Background: Pulmonary embolism is associated with reduced survival and considerable economic burden worldwide. In Korea, the incidence of pulmonary embolism has been gradually increasing. Older individuals are at an increased risk for pulmonary embolism and anticoagulation-related bleeding events. Typically, heparin and vitamin K antagonists are employed to treat pulmonary embolism; however, these agents present numerous limitations. Hence, novel anticoagulants with improved safety and efficacy profiles are urgently needed. Current Concepts: Direct oral anticoagulants (DOACs), including direct thrombin (coagulation factor II) inhibitors and selective inhibitors of coagulation factor Xa, have emerged as alternative agents. Phase III, large-scale clinical trials have revealed that DOACs are non-inferior to standard therapy during initial and long-term treatment of pulmonary embolism, considering the safety profile. Evidence-based clinical guidelines recommend that primary care clinicians employ DOACs over warfarin to achieve anticoagulation. Discussion and Conclusion: For over 70 years, the standard therapy for most patients with pulmonary embolism has involved heparin administration, overlapped and followed by a vitamin K antagonist. Recently developed DOACs against coagulation factor Xa or thrombin might overcome limitations of standard therapy, including the need for injection and regular dose adjustment with laboratory monitoring. These limitations hinder the management of patients with pulmonary embolism and negatively impact the patient's quality of life. Four DOACs, including apixaban, dabigatran, edoxaban, and rivaroxaban, are currently available for treating pulmonary embolism in Korea, which could simplify the therapeutic strategy. [ABSTRACT FROM AUTHOR]

Purpose: Lower urinary tract symptoms (LUTS) affect over half of the adults' population worldwide, with an increasing prevalence among the older age groups. Therefore, with the increasing elderly population, LUTS is an important disease, highlighting the need for accurate data on its prevalence. This present study aimed to investigate the prevalence of LUTS in South Korea. Methods: The study targeted individuals aged at least 19 years nationwide. We conducted computer-assisted telephone interviews, 80% mobile random digital dialing (RDD) sampling frame, and 20% landline RDD sampling frame between April and May 2020. Questionnaires included The International Prostate Symptom Score (IPSS), the overactive bladder symptom score (OABSS), and the characteristics of respondents. Current International Continence Society definitions were used for individual LUTS and OAB. Results: There were 2,000 respondents, 1,009 (50.4%) were women and 546 (27.3%) were aged =60 years. Based on our IPSS questionnaire survey results, 77.9% of the respondents had LUTS; 63.7% had mild symptoms (1-7), 11.7% had moderate symptoms (8-19), and 2.4% had severe symptoms (20-35). The prevalence and severity of LUTS increased with age with 22.1% of respondents aged 60 years and above complaining of moderate or severe LUTS. According to the survey through OABSS, the prevalence of OAB was 9.6%, males were 10.3% and females were 9.0%. Conclusions: Based on our survey results, 77.9% of the Korean adult population (over the age of 19) experienced at least one LUTS, and the severity increased with age. The prevalence and severity of OAB increased with age, especially after 40 years; the prevalence of OAB was 9.6%, and 13.4% of them were over 60 years old. [ABSTRACT FROM AUTHOR]

Electronic cigarette (e-cigarette) or vaping product use-associated lung injury (EVALI) has emerged as a social issue as e-cigarette use is rapidly increasing worldwide and is related to many deaths in the United States. To our knowledge, this is the first case report of EVALI in South Korea of a 24-year-old man with acute respiratory symptoms and a history of e-cigarette use. Chest CT revealed diffuse bilateral ground-glass opacities with subpleural sparing, airspace consolidation, and centrilobular micronodules as typical patterns of EVALI with organizing pneumonia and diffuse alveolar damage. Infection was excluded with meticulous laboratory examinations, and the patients’ illnesses were not attributed to other causes. EVALI was diagnosed by meeting the diagnostic criteria with consistent clinico-radiologic findings through a multidisciplinary approach. Radiologists should have good knowledge of EVALI radiologic findings and play a cardinal role in the proper diagnosis and management of EVALI. [ABSTRACT FROM AUTHOR]

BACKGROUND: The use of high-flow nasal cannula (HFNC) is rapidly increasing without clear indications, creating the potential for overuse or misuse and the accompanying risk of adverse events. The purpose of this study was to determine the factors associated with HFNC failure by examining the current clinical practice of HFNC. METHODS: From July 1, 2017, to June 30, 2018, in 5 university-affiliated hospitals in the Republic of Korea, a total of 1,161 admitted adult subjects who had HFNC administered were retrospectively enrolled and their medical records were reviewed. RESULTS: Pulmonary diseases including pneumonia (n = 757, 65.2%) were the most common reason for use of HFNC. Subjects with do-not-resuscitate (DNR) or do-not-intubate (DNI) orders comprised 33.8% of the study population (n = 392); 563 subjects (48.5%) were escalated directly to HFNC from low-flow devices without applying reservoir or other high-flow devices. In the non-DNR/DNI subjects, arterial blood gas was not monitored in 15.2% and 14.8% of subjects before and after HFNC application, respectively, and it was not monitored in 28.0% just before HFNC weaning. The HFNC failure rate was 27.0% in non-DNR/DNI subjects, and the HFNC failure was significantly associated with the decision by residents to apply HFNC (odds ratio [OR] 2.03, 95% CI 1.29-3.18, P = .002), high breathing frequency (OR 1.07, 95% CI 1.04-1.10, P < .001) ≤ 6 h before HFNC application, low S... (OR 0.92, 95% CI 0.89-0.95, P < .001) ≤ 6 h before HFNC application, low S... (OR 0.95, 95% CI 0.93--0.98, P < .001) ≤ 6 h before HFNC application, and the ratio of S.../F... to breathing frequency (ROX index) ≤ 6 h after HFNC application (OR 0.88, 95% CI 0.84-0.92, P < .001). CONCLUSIONS: HFNC was practiced without applying reservoir or other high-flow devices before application and without appropriate arterial blood gas monitoring during HFNC therapy. HFNC failure was significantly associated with the decision by the resident to use HFNC, breathing frequency, S..., and S... ≤ 6 h before HFNC application, and with the ROX index ≤ 6 h after HFNC application. [ABSTRACT FROM AUTHOR]

Background/Objectives: This study was conducted to investigate the effectiveness of mobile-based healthcare program on indicators of chronic disease. Method/Statistical Analysis: This study was conducted on 149 participants from the A company employees who had a Health Check-up at S hospital Health Screening Center (Yong-in, Korea) in 2017 then found to be exceeding the prediabetes standard (Fasting Glucose≥100 mg/dL). 109 participants completed the 12 weeks mobile healthcare program. The final data were analyzed from these participants. Participants are divided into two groups; General care group (HbA1c<6.4%, n=62) and intensive care group (HbA1c≥6.5%, n=47). Findings: After 12 weeks, participants' average HbA1c was decreased to 0.38 ± 0.65% (p<0.001). HbA1c of the intensive care group was decreased to 0.78 ± 0.79%, which was more effective than the 0.08 ± 0.25% reduction of HbA1c from the general care group. In addition, with adjustment of the age, body mass index, glucose, the improvement of HbA1c of intensive care group was even more effective than another group (Odds ratio [OR]=4.385, 95% CI 1.043-18.440). Improvements/Applications: The mobile healthcare program provided to pre-diabetes and diabetes patients was found to be effective in enhancing the indicators of chronical diseases. In particular, the program is more effective to the intensive care group than the general care group. [ABSTRACT FROM AUTHOR]

Background: Healthcare workers (HCWs) have a high risk of tuberculosis (TB) infection. Since August 2017, Korea has mandated the testing of latent TB infection (LTBI) and recommended treatment from HCWs at medical institutions. However, the acceptance/ completion rate and adverse events of LTBI treatment have not been analyzed. M a te r ia ls an d M e tho d s . From February to August 2017, we conducted a retrospective study at a referral university hospital in Korea, to screen the interferon-gamma release assay (IGRA) tests conducted for all HCWs for detecting and treating LTBI. HCWs diagnosed with LTBI were offered a 9-month isoniazid (9H), 3-month isoniazid/rifampin (3HR), or 4-month rifampin regimen. We investigated the acceptance/completion rate, adverse events, and causes of discontinuation or change in LTBI medication. A major adverse event was one wherein a patient had any adverse event >grade 3 causing LTBI treatment interruption. Results Of the 1,538 HCWs, 1,379 underwent IGRA testing for LTBI. Among them, 13.6% (187/1,379) tested positive and 73.3% (137/187) received treatment. The overall completion rate was 97.8% (134/137). HCWs were significantly more likely to complete first-line therapy with 3HR than with 9H (91.4% vs. 76.7%, P = 0.02). The most common major adverse event was hepatotoxicity (n = 7), followed by thrombocytopenia (n = 1) and anaphylactic shock (n = 1). Hepatotoxicity and hepatotoxicity (> grade 2) were more frequent in 9H than in 3HR (39.5% vs. 17.2%, P = 0.006 and 18.6% vs. 3.7%, P = 0.005, respectively). The median time to hepatotoxicity was 96 days (interquartile range, 20-103 days). Conclusion Completion of first-line therapy for LTBI is more likely with 3HR than with 9H. This might be related to the development of hepatotoxicity after around 3 months of treatment. Anaphylactic shock and platelet count should be carefully monitored in those receiving rifampin-containing regimens. [ABSTRACT FROM AUTHOR]

Background: Thyroid disease and metabolic syndrome are both associated with cardiovascular disease. The aim of this study was to investigate the correlation between thyroid hormones and obesity sub-phenotypes using nationwide data from Korea, a country known to be iodine replete. Methods: This study was based on data obtained from the sixth Korea National Health and Nutrition Examination Survey, administered from 2013 to 2015. A total of 13,873 participants aged ≥19 years were included, and classified into four groups: metabolically healthy non-obesity (MHNO), metabolically healthy obesity (MHO), metabolically unhealthy non-obesity (MUNO), and metabolically unhealthy obesity (MUO) by body fat on the basis of body mass index and metabolic health. Results: At baseline, serum free thyroxine (fT4) values were significantly higher in the MHNO phenotype (MHNO, 1.27±0.01 ng/dL; MHO, 1.25±0.01 ng/dL; MUNO, 1.24±0.01 ng/dL; MUO, 1.24±0.01 ng/dL, P<0.001) in total study population. However, this significant association no longer remained after adjustment for age, urine iodine concentration, and smoking (P=0.085). After adjustment for confounders, statistically significant association was observed between lower thyroid stimulating hormone (TSH) and MHNO phenotype (P=0.044). In men participants (not women), higher fT4 values were significantly associated with MHNO phenotype (P<0.001). However, no significant association was observed between thyroid function (TSH or fT4) and obesity phenotypes in groups classified by age (cutoff age of 55 years). Conclusion: Although there was a difference by age and sex, we found that the decrease of TSH and the increase of fT4 values were associated with MHNO. [ABSTRACT FROM AUTHOR]

Background: von Willebrand disease (VWD), characterized by quantitative or qualitative defects of von Willebrand factor (VWF), is the most common inheritable bleeding disorder. Data regarding the genetic background of VWD in Korean patients is limited. To our knowledge, this is the first comprehensive molecular genetic investigation of Korean patients with VWD. Methods: Twenty-two unrelated patients with VWD were recruited from August 2014 to December 2017 (age range 28 months-64 years; male:female ratio 1.2:1). Fifteen patients had type 1, six had type 2, and one had type 3 VWD. Blood samples were collected for coagulation analyses and molecular genetic analyses from each patient. Direct sequencing of all exons, flanking intronic sequences, and the promoter of VWF was performed. In patients without sequence variants, multiplex ligation-dependent probe amplification (MLPA) was performed to detect dosage variants. We adapted the American College of Medical Genetics and Genomics guidelines for variant interpretation and considered variants of uncertain significance, likely pathogenic variants, and pathogenic variants as putative disease-causing variants. Results: VWF variants were identified in 15 patients (68%): 14 patients with a single heterozygous variant and one patient with two heterozygous variants. The variants consisted of 13 missense variants, one small insertion, and one splicing variant. Four variants were novel: p.S764Efs*16, p.C889R, p.C1130Y, and p.W2193C. MLPA analysis in seven patients without reportable variants revealed no dosage variants. Conclusions: This study revealed the spectrum of VWF variants, including novel ones, and limited diagnostic utility of MLPA analyses in Korean patients with VWD. [ABSTRACT FROM AUTHOR]

Background: Next-generation sequencing is increasingly used for taxonomic identification of pathogenic bacterial isolates. We evaluated the performance of a newly introduced whole genome-based bacterial identification system, TrueBac ID (ChunLab Inc., Seoul, Korea), using clinical isolates that were not identified by three matrix-assisted laser desorption/ ionization time-of-flight mass spectrometry (MALDI-TOF MS) systems and 16S rRNA gene sequencing. Methods: Thirty-six bacterial isolates were selected from a university-affiliated hospital and a commercial clinical laboratory. Species was identified by three MALDI-TOF MS systems: Bruker Biotyper MS (Bruker Daltonics, Billerica, MA, USA), VITEK MS (bioMérieux, Marcy l'Étoile, France), and ASTA MicroIDSys (ASTA Inc., Suwon, Korea). Whole genome sequencing was conducted using the Illumina MiSeq system (Illumina, San Diego, CA, USA), and genome-based identification was performed using the TrueBac ID cloud system (www.truebacid.com). Results: TrueBac ID assigned 94% (34/36) of the isolates to known (N=25) or novel (N=4) species, genomospecies (N=3), or species group (N=2). The remaining two were identified at the genus level. Conclusions: TrueBac ID successfully identified the majority of isolates that MALDI-TOF MS failed to identify. Genome-based identification can be a useful tool in clinical laboratories, with its superior accuracy and database-driven operations. [ABSTRACT FROM AUTHOR]

This paper reports the Smart Call from the Sky (SCSky) Can Satellite (CanSat) platform developed by Chosun University, South Korea, with a focus on a smart material of shape memory alloy actuator applications. The primary objective of this study is to verify the effectiveness of a remote screen touch system using shape memory alloy wires. The system is currently being utilized to operate the on-board smartphone of a CanSat by telecommands from a ground station. It provides real-time streaming video showing the internal and external states of CanSat through video calls during actual flight. The secondary objective of the mission is to acquire a wide-scan image from the on-board USB cameras, whose elevation angles are actuated using shape memory alloy springs. The effectiveness of the design proposed was validated experimentally through actual flight tests using model rockets. [ABSTRACT FROM AUTHOR]

Purpose Dexrazoxane has been used as an effective cardioprotector against anthracycline cardiotoxicity. This study intended to analyze cardioprotective efficacy and secondary malignancy development, and elucidate risk factors for secondary malignancies in dexrazoxane-treated pediatric patients. Materials and Methods Data was collected from 15 hospitals in Korea. Patients who received any anthracyclines, and completed treatment without stem cell transplantation were included. For efficacy evaluation, the incidence of cardiac events and cardiac event-free survival rates were compared. Data about risk factors of secondary malignancies were collected. Results Data of total 1,453 cases were analyzed,dexrazoxane with every anthracyclines group (D group, 1,035 patients) and no dexrazoxane group (non-D group, 418 patients). Incidence of the reported cardiac events was not statistically different between two groups,however, the cardiac event-free survival rate of patients with more than 400 mg/m2 of anthracyclines was significantly higher in D group (91.2% vs. 80.1%, p=0.04). The 6-year cumulative incidence of secondary malignancy was not different between both groups after considering follow-up duration difference (non-D, 0.52%±0.37%,D, 0.60%±0.28%,p=0.55). The most influential risk factor for secondary malignancy was the duration of anthracycline administration according to multivariate analysis. Conclusion Dexrazoxane had an efficacy in lowering cardiac event-free survival rates in patients with higher cumulative anthracyclines. As a result of multivariate analysis for assessing risk factors of secondary malignancy, the occurrence of secondary malignancy was not related to dexrazoxane administration. [ABSTRACT FROM AUTHOR]

Background: Contrast-induced acute kidney injury (CI-AKI) is one of the most common causes of iatrogenic kidney injury and, therefore, its prevention is an important issue. However, whether the administration of 0.9% saline is the optimal prophylaxis method remains uncertain due to its supra-physiologic chloride component. In particular, recent studies suggest that chloride-restricted solutions showed superiority over 0.9% saline in several clinical settings.Methods/design: The investigators designed a multicenter randomized controlled trial to compare the efficacy of a balanced salt solution and 0.9% saline in CI-AKI prophylaxis. This study will recruit patients who are scheduled for contrast-enhanced computed tomography (CT) scans with CI-AKI prophylaxis. In this study, participants will be randomized into two study arms; the study group will receive a balanced salt solution, and the control group will receive 0.9% saline. Fluids will be administered as designated in the protocol before and after the CT scan, and an evaluation of baseline clinical status will be performed by obtaining blood and urine samples. During the follow-up visits, the incidence of CI-AKI and long-term outcomes, including the start of renal replacement therapy or all-cause mortality, will be assessed.Discussion: To our knowledge, this study will be the first study assessing the preventive value of a balanced salt solution over 0.9% saline for CI-AKI. If the trial shows that the balanced salt solution is as effective for CI-AKI prophylaxis as 0.9% saline, the use of the balanced salt solution could be promoted due to the reduced possibility of consequent metabolic acidosis compared to 0.9% saline.Trials Registration: ClinicalTrials.gov, ID: NCT02799368 . Registered on 14 June 2016. [ABSTRACT FROM AUTHOR]

Macrophytes play a major role in the structuring of aquatic environments, and create diverse microhabitats. Therefore, these plants represent an important factor regulating the zooplankton biomass, taxonomic composition, and distribution in freshwater ecosystems. In the current study, we examined the effects of the structural heterogeneity provided by various macrophytes. We identified four habitat types in this study: (1) open water (without macrophytes), (2) the helophyte zone, (3) the pleustophyte zone, and (4) the mixed vegetation zone (containing pleustophytes, nymphaeids, and elodeids). We tested the hypothesis that complex habitat structures support large zooplankton assemblages. Specifically, we collected zooplankton samples from a total of 119 sampling points in the Upo Wetlands, South Korea, during the spring and autumn of 2009. The largest zooplankton assemblage was found in the mixed macrophyte zone, followed by the helophyte and pleustophyte zones. The pleustophyte zone supported larger zooplankton assemblages during autumn compared to spring. Differences in zooplankton assemblages were considered to be strongly related to seasonal variation in the development and growth of pleustophytes. However, two-way ANOVA revealed that seasons had no significant influence on the zooplankton density and diversity. Instead, different habitat types substantially determined zooplankton characteristics. In conclusion, we demonstrated that wetland areas with high macrophyte species diversity contribute toward higher zooplankton diversity. [ABSTRACT FROM AUTHOR]

Study Question: Are mRNAs for specific aquaporins (AQPs) expressed in human luteinized granulosa cells (GCs) and are their expression levels correlated with in vitro fertilization (IVF) outcomes?Summary Answer: The mRNAs of AQP1-7, 9, 11, and 12 were expressed in human luteinized GCs; the level of AQP1 mRNA was negatively associated with retrieved oocyte number and the level of AQP7 mRNA was positively associated with fertilization rate.What Is Known Already: mRNAs of AQP1-4 and AQP9 have been detected in human GCs.Study Design, Size, Duration: Prospective observational study involving 111 women undergoing a stimulated IVF cycle.Participants/materials, Setting, Methods: In a preliminary experiment on 27 women, the mRNA expression of AQP0-12 in GCs was explored by RT-PCR. In the main experiment, luteinized GCs were obtained from 111 women at the time of oocyte retrieval of whom 102 had an embryo replacement. Real-time quantitative RT-PCR (qRT-PCR) was performed to quantify the mRNA level of AQP1-7, 9, 11, and 12. The mRNA for luteinizing hormone receptor (LHR) and steroidogenic acute regulatory protein (StAR) were also quantified by qRT-PCR.Main Results and the Role Of Chance: mRNAs for AQP0, 8 and 10 were not detected in the preliminary experiment. In samples from 111 women, retrieved oocyte number was negatively associated with the mRNA levels of AQP1, 4, 6, and 11 and LHR (r = -0.311, r = -0.233, r = -0.203, r = -0.194, and r = -0.202, respectively, P < 0.05 for each), however, after adjustment for woman's age and serum anti-Müllerian hormone (AMH) levels, only correlation with AQP1 was found (r = -0.299, P < 0.05). BMI was negatively associated (after adjustment for age) with the mRNA level of AQP7 (r = -0.259, P < 0.05). Fertilization rate was positively associated with the mRNA level of AQP7 (r = 0.269, P < 0.05). The number or quality of embryos or clinical pregnancy was not associated with the mRNA levels of any of ten AQP subtypes. The mRNA levels for the ten AQP subtypes were correlated positively with LHR expression but negatively with StAR expression. Amongst high responders (oocyte number ≥14), the mRNA levels of AQP11 (1.4 ± 0.7 versus 1.7 ± 0.6) and LHR (1.3 ± 0.7 versus 1.7 ± 0.7) were significantly lower in the group with PCOS than in the non-PCOS group.Limitations, Reasons For Caution: A relative small number of subjects in PCOS group is the main limitation of our study. P-values were not corrected for multiple comparisons.Wider Implication Of the Findings: AQP1 may be one of the factors that modulate individual ovarian response to exogenous gonadotrophin. The mRNA level of AQP7 was positively associated with fertilization rate, which is a surrogate marker of oocyte competence, thus expression of AQP7 could be a marker for adequate folliculogenesis and healthy oocytes.Study Funding/competing Interests: This work was supported by grant no. A120043 from the Korea Health Care Technology R&D Project, Ministry of Health and Welfare, Korea. None of the authors has any conflict of interest to declare. [ABSTRACT FROM AUTHOR]

Background: Two clinical scoring systems, the status epilepticus severity score (STESS) and the epidemiology-based mortality score in status epilepticus (EMSE), are used to predict mortality in patients with status epilepticus (SE). The aim of this study was to compare the outcome-prediction function of the two scoring systems regarding in-hospital mortality using a multicenter large cohort of adult patients with SE. Moreover, we studied the potential role of these two scoring systems in predicting the functional outcome in patients with SE.Methods: The SE cohort consisted of patients from the epilepsy centers of eight academic tertiary medical centers in South Korea. The clinical and electroencephalography data for all adult patients with SE from January 2013 to December 2014 were derived from a prospective SE database. The primary outcome variable was defined as in-hospital death. The secondary outcome variable was defined as a poor functional outcome, i.e., a score of 1-3 on the Glasgow Outcome Scale, at discharge.Results: Among the 120 non-hypoxic patients with SE recruited into the study, 16 (13.3%) died in the hospital and 64 (53.3%) were discharged with a poor functional outcome. The receiver-operating characteristic (ROC) curve for prediction of in-hospital death based on the STESS had an area under the curve of 0.673 with an optimal cutoff value for discrimination (best match for both sensitivity (0.56) and specificity (0.70)) that was ≥ 4 points. The two combinations of elements of the EMSE system (EMSE-ALDEg and EMSE-ECLEg) predicted not only in-hospital mortality with the best match for sensitivity (more than 0.6) and specificity (more than 0.6), but also a poor functional outcome with the best match for both sensitivity (>0.7) and specificity (>0.6). STESS did not predict a poor functional outcome (area under the ROC, 0.581; P = 0.23).Conclusion: Although the EMSE is a clinical scoring system that focuses on individual mortality, we did not find differences between the EMSE and STESS in the prediction of in-hospital death. The EMSE was useful in predicting poor functional outcome, as it was significantly better than STESS. [ABSTRACT FROM AUTHOR]

The article examines the influence of anthropogenic factors on the record hot spring season in South Korea in March-May 2014. Topics covered include average daily maximum temperature, the findings that human influence has increased the likelihood of extreme hot springs in South Korea and the observation that surface air temperature long-term trend is outside of the probability density functions of modeled climate simulations.

Background: Since avian-origin H3N2 canine influenza virus (CIV) was first identified in South Korea in 2008, the novel influenza virus has been reported in several countries in Asia. Reverse zoonotic transmission of pandemic H1N1 (2009) influenza virus (pH1N1) has been observed in a broad range of animal species. Viral dominance and characterization of the reassortants of both viruses was undertaken in the present study. Findings: Here we describe the viral dominance of 23 CIV reassortants between pH1N1 and canine H3N2 influenza viruses from a naturally co-infected dog. These results indicate that the M gene of pandemic H1N1 and the HA gene of canine H3N2 are predominant in the reassortants. Furthermore, unlike the original canine H3N2 virus, some reassortants showed high pathogenicity in mice. Conclusions: This study suggests that continuous monitoring of influenza infection in companion animals may be necessary to investigate the potential of the emergence of novel influenza viruses. [ABSTRACT FROM AUTHOR]

The article focuses on human influence on the heat wave recorded in South Korea in summer 2013, when the country experienced its hottest summer days with the average daily maximum temperature reached 29.9 degrees Celsius. Topics discussed include the simulation approach used to estimate anthropogenic influence on the heat wave, the relationship between sea surface temperature (SST) patterns and the heat wave in South Korea and the impact of human activity on SST warming.

Background: The role of adiposity in the relationship between serum vitamin D levels and insulin resistance has not yet been fully studied. This aim of this study is to clarify the role of adiposity in the relationship between serum vitamin D level and insulin resistance among middle-aged and elderly Korean adults. Methods: We used data from 2,710 individuals aged ≥50 years based on national data from a representative sample of the fourth Korea National Health and Nutrition Examination Survey IV-2 in 2008. Results: After adjustment for potential confounders, body mass index (BMI) was significantly associated with 25(OH) vitamin D (P=0.008). However, waist circumference was not significantly associated with 25(OH) vitamin D. In the stratified analyses, 25(OH) vitamin D was found to be negatively associated with fasting insulin and homeostasis model assessment estimate of insulin resistance (HOMA-IR) in participants with BMIs ≥ 25 kg/m² (P=0.003 for both insulin and HOMR-IR) but was not found to be associated in those with BMIs <23 kg/m ². However, we observed a significant inverse in the association of 25(OH) vitamin D with fasting insulin and HOMA-IR in both the normal (P=0.001 and P<0.001 and the abdominally obese group (P=0.010 and P=0.009) in the stratified analyses according to abdominal obesity. Conclusion: Our results support that the idea that endogenously-produced vitamin D might be stored in subcutaneous fat deposits. In addition, the association of vitamin D with insulin resistance in middle-aged and elderly Korean adults was stronger when it was stratified by BMI than when abdominal obesity status. [ABSTRACT FROM AUTHOR]

Background: Clinical research on moyamoya disease (MMD) has focused on symptomatic outcome such as transient ischemic attacks. Neurocognitive function in children critically affects social outcome and is closely related to quality of life. This study is the first to analyze the neurocognitive profiles of children with MMD before and after surgery. Methods: Sixty-five patients were selected out of 137 who underwent surgery for MMD between 2006 and 2008. The preoperative and postoperative neurocognitive function was tested using the Korean version of the Wechsler Intelligence Scale for Children-Revised (KEDI-WISC-R) and the Bender Gestalt Test (BGT). Pre- and postoperative profiles of patients with or without major infarctions were compared. Patients with borderzone infarctions were analyzed as well. Results: Preoperatively, patients had age-appropriate full-scale intelligence quotient (FSIQ) and verbal IQ (VIQ) scores, which were maintained after surgery. There was significant improvement in performance IQ (PIQ) (p = 0.01) and BGT scores postoperatively (p < 0.01). Among the subtests, Coding showed significant improvement postoperatively (p < 0.01). Preoperatively, patients with major infarctions had significantly lower FSIQ (p < 0.01), VIQ (p = 0.01) and PIQ (p < 0.01) scores compared with those without infarctions. The pre- and postoperative neurocognitive profiles of the patients with borderzone infarctions fell between those of patients with absolutely no infarctions and those of patients with major infarctions. Conclusions: Considering the natural history of MMD, which leads to a drastic decline in neurocognitive functions, the present findings indicate a role for early active surgery to save the intellectual abilities of children with MMD. Copyright © 2010 S. Karger AG, Basel [ABSTRACT FROM AUTHOR]

The interaction between heavy metals and river sediment is very important because river sediment is the sink for heavy metals introduced into a river and it can be a potential source of pollutants when environmental conditions change. The Kumho River, the main tributaries of the Nakdong River in Korea, can be one of the interesting research targets in this respect, because it runs through different geologic terrains with different land use characteristics in spite of its short length. Various approaches were used, including mineralogical, geochemical, and statistical analyses to investigate the distribution and behavior of heavy metals in the sediments and their sources. The effect of geological factor on the distribution of these metals was also studied. No noticeable changes in the species or relative amounts of minerals were observed by quantitative X-ray diffraction in the sediments at different stations along the river. Only illite showed a significant correlation with concentrations of heavy metals in the sediments. Based on an average heavy metal concentration (the average concentrations of Cd, Co, Cr, Cu, Ni, Pb, and Zn were 1.67, 20.9, 99.7, 125, 97.6, 149, 298 ppm, respectively), the sediments of the Kumho River were classified as heavily polluted according to EPA guidelines. The concentrations of heavy metals in the sediments were as follows: Zn > Pb > Cu > Ni > Cr > Co > Cd. In contrast, contamination levels based on the average Igeo (index of geoaccumulation) values were as follows: Pb > Cd > Zn > Cu > Co = Cr > Ni. The concentrations of heavy metals increased downstream (with the exception of Cd and Pb) and were highest near the industrial area, indicating that industrial activity is the main factor in increasing the concentrations of most heavy metals at downstream stations. Sequential extraction results, which showed increased heavy metal fractions bound to Fe/Mn oxides at the downstream stations, confirmed anthropogenic pollution. The toxicity of heavy metals such as Ni, Cu, and Zn, represented by the exchangeable fraction and the fraction bound to carbonate, also increased at the downstream stations near the industrial complexes. Statistical analysis showed that Pb and Cd, the concentrations of which were relatively high at upstream stations, were not correlated with other heavy metals, indicating other possible sources such as mining activity. [ABSTRACT FROM AUTHOR]

Wetting depth in a slope is an important indicator to properly evaluate the rainfall-induced slope instability. This rainfall infiltration has potential to induce shallow slope failures. It is necessary to characterize the field infiltration and movement of the wetting front due to a natural rainfall. To monitor important infiltration characteristics of a field slope, a compacted roadside slope in an express highway (South Korea) was instrumented to measure variations of matric suction and water content. The monitored variations of matric suction and water content in vegetated and nonvegetated areas are discussed. The pattern of field infiltration by severe rainfall storms is also compared with the estimation results obtained by widely used 1D infiltration models. The Chu model, by considering the ponding and run-off at each time interval, showed a good agreement with the field measurements. [ABSTRACT FROM AUTHOR]

Examines the patterns of family support and the quality of life of the elderly in South Korea. Us of the exchange theory; Four types of elderly parent-child relationships; Effect of support exchanges on the psychological well-being of the elderly.

Background: Continuous renal replacement therapy (CRRT) is essential in the management of critically ill patients with acute kidney injury (AKI). However, the optimal timing for initiating CRRT remains controversial, especially in elderly patients. Therefore, we investigated the outcomes of early CRRT initiation in elderly patients with AKI.Methods: A total of 607 patients ≥65 years of age who started CRRT due to AKI between August 2009 and December 2013 were prospectively enrolled. They were divided into two groups based on the median 6-hour urine output immediately before CRRT initiation. Propensity score matching was used to compare the overall survival rate, CRRT duration, and hospitalization duration.Results: The median age of both groups was 73.0 years, and 60 % of the patients were male. The most common cause of AKI was sepsis. In the early CRRT group, the mean arterial pressure was higher, but the prothrombin time and total bilirubin, aspartate aminotransferase, and alanine aminotransferase levels were lower. The overall cumulative survival rate was higher in the early CRRT group (log-rank P < 0.01). Late CRRT initiation was associated with a higher mortality rate than early initiation after adjusting for age, sex, the Charlson comorbidity index, systolic arterial pressure, prothrombin time, the total bilirubin, aspartate aminotransferase, and alanine aminotransferase levels, cumulative fluid balance and diuretic use (hazard ratio, 1.35; 95 % confidence interval 1.06, 1.71, P = 0.02). Following propensity score matching, patient survival was significantly better in the early CRRT group than in the late CRRT group (P < 0.01). The total duration of hospitalization from the start of CRRT was shorter among the survivors when CRRT was started earlier (26.7 versus 39.1 days, P = 0.04).Conclusion: A better prognosis can be expected if CRRT is applied early in the course of AKI in critically ill, elderly patients. [ABSTRACT FROM AUTHOR]

This study investigated the effect of Sinetrol-XPur on weight and body fat reduction in overweight or obese Korean participants. Among 100 overweight or obese participants enrolled in a 12-week randomized, double-blinded, controlled study, 86 participants completed the trial. Participants took either two Sinetrol-XPur tablets (450 mg per tablet) or two placebo tablets once a day. Bodyweight, body fat percentage, body mass index (BMI), body fat mass, waist circumference, and various safety parameters were measured. After the 12-week intervention, a significant reduction was observed in the body fat mass (P = .030) by dual-energy X-ray absorptiometry (DEXA), body weight (P = .002), and BMI (P = .002) compared to the placebo. Body fat percentage (P = .007) by DEXA showed a significant reduction in the Sinetrol-XPur group, but no difference compared to the control group. Abdominal metabolic risks by computed tomography and blood biochemistry analysis were significantly decreased in the Sinetrol-XPur group, but there were no differences between the Sinetrol-XPur and placebo groups. Safety profiles were not different between the two groups. These results suggested that Sinetrol-XPur significantly reduced body weight, body fat mass, and BMI in obese Korean subjects, which confirms the antiobesity effect of Sinetrol-XPur in the Korean population. [ABSTRACT FROM AUTHOR]

The 'Seolbaek' is an early-maturing low amylose variety developed from a cross between 'Suweon460' and 'Geuroobyeo' by the rice breeding team of National Institute of Crop Science, Rural Development Administration (RDA) in 2000. The 'Seolbaek' has about 100 days duration from seeding to heading in middle plain, mid-northern inland plain, southern alpine and north-eastern coastal areas. It has about 60 cm in culm length with semi-erect plant type and good canopy architecture. This variety has 13 tillers per hill and 81 spikelets per panicle. Its 1,000 grain-weight of brown rice is 20.7 g whereas less than that of 'Odaebyeo' (26.3 g). The milled kernels look like dull because amylose content of this variety is about 10.0%. This variety shows strong resistance to cold treatment, lodging, and wilting. The 'Seolbaek' shows resistant to blast disease but susceptible to bacterial blight, stripe virus and insect pests. The milled rice yield performance of this variety is about 4.96 MT/ha by ordinary culture in local adaptability test for three years. This variety may be highly adaptable to the middle plain area, mid-northern inland plain area, southern alpine area and north-eastern coastal areas of Korea. [ABSTRACT FROM AUTHOR]

'Wolbaek' is an early-maturing, semi-transparent low amylose content variety developed from a cross between 'Milkyqueen' and 'Geuroobyeo' by the rice breeding team of National Institute of Crop Science, Rural Development Administration (RDA) in 2000. 'Wolbaek' has about 102 days duration from seeding to heading in middle plain, mid-northern inland plain, southern alpine and north-eastern coastal areas. It is about 67 cm in culm length with semi-erect plant type and good canopy architecture. 'Wolbaek' has 16 tillers per hill and 59 spikelets per panicle. Its 1,000 grain-weight of brown rice is 21.4 g which is less than that of 'Odaebyeo' (26.4 g). The milled kernels look like semi-transparent dull because amylose content of this variety is about 11.6%. This variety shows strong resistance to cold treatment, lodging and wilting. 'Wolbaek' shows resistant to blast disease but susceptible to bacterial blight, stripe virus and insect pests. The milled rice yield performance of this variety is about 5.13 MT/ha by ordinary culture in local adaptability test for three years. 'Wolbaek' may be highly adaptable to the middle plain area, mid-northern inland plain area, southern alpine area and north-eastern coastal areas of Korea. [ABSTRACT FROM AUTHOR]

Cheonga is a new japonica rice cultivar developed from a cross between Kinuhikari, Japanese japonica cultivar of good quality and clear external appearance of brown rice and Yangjuseonbal, a japonica line of good quality and ripened grain (or leaf) color, which was collected in the farmer's field by the rice breeding team of National Institute of Crop Science, RDA. Cheonga has about 126 days duration from seeding to heading in central lowland and mid-mountainous areas South Korea. It is about 87 cm in culm length and tolerant to lodging. It has relatively semi-erect pubescent leaf blade and slightly tough culm with good canopy architecture. This cultivar has 14 tillers per hill and 106 spikelets per panicle. It shows a little sensitivity to premature heading in the transplanting of 50 days' old seedling. It shows similar tolerance to both heading delay and spikelet sterility due to cold stress compared with Hwaseongbyeo. This cultivar shows slow leaf senescence and low viviparous germination during the ripening stage. This variety shows susceptibility to the diseases and insect of leaf blast, bacterial blight (K1, K2, K3). stripe virus, and brown planthopper. Milled rice of Cheonga has medium short grain with translucent and clear non-glutinous endosperm. It shows similar amylose content (19.6%), and gelatinization temperature compared with Hwaseongbyeo, but good palatability of cooked rice. The milled rice yield performance of this cultivar is about 5.56 MT/ha by ordinary culture in local adaptability test for three years. This cultivar may be highly adaptable to the central plain area, middle-Southern plain and middle-western coastal areas of South Korea. [ABSTRACT FROM AUTHOR]