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Accessory minerals in granitic rocks are unlikely significant radionuclide contributions to groundwater due to their remarkable durability. However, accessory minerals incorporating U and Th may suffer structural damages due to the radioactivity and become highly susceptible to alteration. This study investigates geochemistry coupled with textural analysis of the U–Th bearing accessory minerals using a field emission scanning electron microscope and an electron probe micro-analyzer. Altered zircons with numerous open structures related to the radioactive decay show higher contents of U and Th and low analytical totals. Some thorites show high contents of U and non-formula elements due to the hydrothermal alteration in the metamicted thorite. The cerianite including U occurs as micro-veinlet in fracture with trace of Fe and Mn oxides, which indicates secondary phase formation from the decomposed accessory minerals in an oxidizing environment. Some accessory minerals with the high content of U and Th have been found in Mesozoic granite terrain in South Korea, where high concentration levels of radionuclide in groundwater were also reported. The leaching of U may be more likely when the accessory minerals are highly metamicted or altered as found in our samples. The altered zircon and thorite of the study area could be major carriers of radioelement in Mesozoic granitic aquifers where the occurrence of soluble U-minerals has not been reported. [Display omitted] • High radionuclides concentration in groundwater poses a threat to human health. • Accessary minerals can enrich groundwater with radionuclides in granite aquifers. • Altered zircons contain high U and Th levels with open structures. • Thorites show elevated U levels and non-formula elements due to alteration. • Metamicted and/or altered accessory minerals increase uranium leaching potential. [ABSTRACT FROM AUTHOR]

[Display omitted] • Groundwater Deficit (GWD) highlights delayed response to precipitation decline. • GWD characterizes and quantifies groundwater drought, including spatial extent. • GWD identifies thirteen drought events over a two-decade span in South Korea. Although South Korea is frequently subjected to monsoons, the shortage of summer monsoons and relatively dry spring and winter seasons cause droughts in the Korean Peninsula. Since the late 1960s, severe droughts in South Korea have encouraged extensive groundwater development for agricultural and economic growth. Therefore, identifying and estimating the impact of droughts on the country's groundwater resources is crucial for establishing policies and regulations on groundwater exploitation and recharge. Current drought management of the country relies on a meteorological drought index. However, these estimates lack a comprehensive understanding of absolute drought severity and propagation. This study aims to develop a quantitative method for calculating the frequency and severity of groundwater droughts based on the Groundwater Deficit (GWD) derived from NASA's Gravity Recovery and Climate Experiment (GRACE) mission data. The estimated annual GWD in mass over the country ranges from -0.07 km3 to 0.04 km3, with a trend in the mass of -1.60×10−3 km3/year from 2002 to 2021. Thirteen groundwater drought events were identified based on GWD. Among those, the highest drought severities recorded in 2015 and 2019 were -34.27 km3 months and -55.38 km3 months, respectively. Monthly deficits define the quantity of water required to restore normal groundwater storage conditions. Hence, the minimum and average days to recover from groundwater droughts were estimated based on the strength of the storage-based approaches. The GWD approach aligns with meteorological drought databases with a time lag. It illustrates the transition from meteorological drought to groundwater drought, along with their onset, cessation, propagation, instantaneous severity, and peak magnitude. [ABSTRACT FROM AUTHOR]

Plastic particles of less than 5 mm size, referred as microplastics, have recently become a major environmental issue. While microplastics are well known in marine and lake systems, there have been less investigations in soils and groundwater. Here we review the origin, shape, impact, and mitigation strategies of soil and groundwater microplastics. We found that littering is the main origin of microplastics in global topsoils, while greenhouses are the main source of microplastics in South Korea. Fibers and pellets are dominant microplastic shapes in soil and groundwater. Microplastic contamination of soil and groundwater is detrimental to human health, plants, nematodes, earthworms, and soil properties. Remediation methods include pyrolysis, replacing plastics by biodegradable plastics, plastic filtration, and subsequent chemical or biological degradation. [ABSTRACT FROM AUTHOR]

This study was conducted to determine the optimal entomopathogenic fungus for the simultaneous control of the adults of two mosquito species, Aedes albopictus and Culex pipiens. The pathogenicity and virulence against the two species of mosquitoes were evaluated by using 30 isolates of Beauveria bassiana, an entomopathogenic fungus isolated from Korea that has high thermotolerance and UV-B tolerance. Regarding pathogenicity, 23 isolates were pathogenic to Ae. albopictus and 12 isolates were pathogenic to Cx. pipiens; Ae. albopictus adults were more susceptible to B. bassiana than Cx. pipiens adults. Among the isolates, 6 isolates that were simultaneously pathogenic to the two species of mosquitoes were used to evaluate virulence and conidia productivity. B. bassiana CN6T1W2 and JN5R1W1 had higher virulence than the other isolates, and they were more virulent in Ae. albopictus than inCx. pipiens. The conidia productivity of B. bassiana JN5R1W1 on millet grain medium was higher than that of B. bassiana CN6T1W2. Based on these results, B. bassiana JN5R1W1 was selected as the most efficient isolate for the simultaneous control of the two mosquito species. B. bassiana JN5R1W1 can be used effectively in the development of fungal insecticides to simultaneously control Ae. albopictus and Cx. pipiens adults with similar distribution areas. [ABSTRACT FROM AUTHOR]

Background and Aim: Alcoholic hepatitis (AH) ranks among the most costly diseases in South Korea. However, accurate hospitalization incidence rates, mortality rates, and contributing factors have not been investigated in South Korea. This study aimed to provide the nationwide incidence of hospitalization, inhospital mortality, and readmission rates for South Korean patients with AH. Methods: Using the Korean Health Insurance Review and Assessment service database, a total of 39 800 inpatient cases from 2008 to 2012 were identified based on the International Classification of Diseases, 10th Revision diagnosis code for AH (K70.1). Standardized hospitalization incidence and mortality rates were calculated, and logistic regression analysis was performed to identify risk factors for inhospital mortality and readmission. Follow‐up data for those admitted in 2008 were collected to assess readmissions. Results: The standardized incidence rate for AH hospitalization per 105 person/year decreased from 19 in 2008 to 14 in 2012 (P = 0.001). The annual inhospital mortality rate ranged from 0.2% to 0.5%. Inhospital mortality was significantly higher in older patients (odds ratio [OR], 1.36) and those with cirrhosis (OR, 4.40). The readmission rate for patients admitted in 2008 was 34.0%. Male sex (OR, 1.21) and low economic status (OR, 2.35) were significantly associated with readmission, whereas older age (OR, 0.96), cirrhosis (OR, 0.77), and urban residency (OR, 0.68) were inversely associated with readmission. Conclusions: This study captured a 5‐year epidemiologic period in South Korea of patients with AH to reflect the real burden of AH and to provide valuable information to policy‐makers assessing public health priorities. [ABSTRACT FROM AUTHOR]

We present a review of groundwater studies over the past 50 years (1968-2017) in Korea. With economic and agricultural growth, water demand has been expanding, and groundwater development is gradually increasing. Initially, groundwater studies were largely focused on using pumping and slug tests to understand aquifers in Korea. However, the interest has expanded to groundwater monitoring and data analyses, as many national and local networks for monitoring groundwater quantity and quality have been implemented. Frequent severe droughts in recent decades have led to research on the design and pilot tests for managed aquifer recharge, especially on the volcanic island of Jeju and agricultural areas. As groundwater development and its use has increased, groundwater contamination is becoming a public grievance. Thus, effective investigation of contaminated groundwater and its efficient remediation are big issues in the Research and Development (R & D) sector. The recent Gyeongju earthquake posed an additional challenge for Korean groundwater scientists to develop a method to predict earthquakes using groundwater monitoring. Furthermore, changes in precipitation patterns caused by the changing climate aggravate groundwater recharge conditions. The country has seen many academic and technical achievements in groundwater science, but many issues remain to be resolved in the near future. [ABSTRACT FROM AUTHOR]

Background: Stevens-Johnson syndrome (SJS) and toxic epidermal necrolysis (TEN) are life-threatening diseases; however, it is hard to estimate their incidence due to the rarity of these diseases. We evaluated the incidence of SJS and TEN using a nationwide administrative database. Methods: We used a national medical insurance review system (Health Insurance Review and Assessment) database which contained the claim data of the entire nation from 2009 to 2013 to estimate the accurate incidence of SJS and TEN in Korea. The diagnostic codes of L511 (SJS) or L512 (TEN) from the International Classification of Diseases-10th revision were used to define the target study population. We also retrospectively followed up a 2011 SJS and TEN cohort for 24 months in order to assess the in-hospital mortality, related complications and total claims cost due to SJS and TEN. Results: A total of 1,167 (938 SJS and 229 TEN) cases were newly diagnosed from 2010 to 2013. The age- and sex-standardized annual incidences estimated in this study were 3.96 to 5.03 in SJS and 0.94 to 1.45 in TEN per million. There was no significant change in annual incidence throughout the study periods. When analyzed by 10-year age groups, the annual incidence was the lowest in group 20–29 years and the highest in group 70 for both SJS and TEN. Based on the 2011 cohort analysis, the in-hospital mortality were 5.7 and 15.1% for SJS and TEN, respectively. The mortality increased with age, particularly, after 40 years of age. Among the complications related with SJS or TEN, ocular sequelae was the most common (43.1 and 43.4% of SJS and TEN patients, respectively) followed by urethral sequelae (5.7 and 9.4% of SJS and TEN patients, respectively). Conclusion: Overall, our data suggest that SJS, and TEN are infrequent but constantly arise throughout the years. [ABSTRACT FROM AUTHOR]

Objective: This study aimed to identify private clinics that have a potential to perform the role of primary care providers (PCPs) in a primary care setting in Korea where private specialists are dominant. Methods: The 2013 National Patient Sample claim data of Health Insurance Review and Assessment Service in Korea was used. Two-step cluster analysis was performed using characteristics of private clinics, and patient and utilization characteristics of 27,797 private clinics. External validation of clusters was performed by assessing the association among clusters and outcomes of care provided by private clinics. Stability of clusters was cross-validated using discriminant analysis. Results: The result classified more than a half of private clinics into a potential PCP cluster. These were private clinics with specialties considered to be those of primary care physicians and were more likely to be located in non-metropolitan areas than specialized PCPs were. Compared to specialized PCPs, they had a higher percentage of pediatric and geriatric patients, patients with greater disease severity, a higher percentage of patients with complex comorbidities or with simple or minor disease groups, a higher number of patients and visits, and the same or higher quality of primary care. The most important factor in explaining variations between PCP clusters was the number of simple or minor disease groups per patient. Conclusion: This study identified potential PCPs and suggested the identifying criteria for PCPs. It will provide useful information for formulation of a primary care strengthening policy to policy makers in Korea as well as other countries with similar specialist-dominant primary care settings. [ABSTRACT FROM AUTHOR]

There is limited quantitative evidence to investigate short-term suicide rates although the risk of suicide in psychiatric patients is exceptionally high in the early post-discharge period. This study aimed to explore the trends of the 30 days suicide rate after discharge using population-based data from Korea. This study was conducted on psychiatric patients aged 15 years or older discharged between 2010 and 2018. Patients were extracted from the National Health Insurance Claim Database (NHICD) and information on suicide was obtained from the National Statistical Office. Age-standardized suicide rate (ASR) and Standardized Mortality Ratio (SMR) within 30 days after discharge was estimated and tested using joinpoint regression. Of the 1,576,028 patients discharged from hospitals from 2010 to 2018, 53.9 % were male and 47.9 % were aged between 40 and 59 years. The 30 days ASRs for psychiatric patients after discharge varied from 174.9 to 218.0 per 100,000 patients with no clear trend excluding patients with schizophrenia and anxiety disorder. The SMR for suicide within 30 days after discharge was 66.8 in 2016–2018, and patients aged 20 to 39, female, and patients with depression had high SMRs compared to other groups. Factors that may impact the suicide were not considered in this study. Since the NHICD data is collected for payment of medical expenses, there may be scope for inaccuracies. The 30 days suicide rate after psychiatric discharge has failed to decrease between 2010 and 2018. This study recommends early interventions after discharge and intensive interventions for patient groups who may be vulnerable to suicide. • The annual age-standardized suicide rates varied from 174.9 to 218.0 per 100,000 patients and there were no significant decrease between 2010 and 2018 in Korea • The standardized mortality ratio for suicide indicated a steady decline over time. • Patients aged 20 to 59, female, and patients with depression had high standardized mortality ratios compared to other groups. [ABSTRACT FROM AUTHOR]

We examined groundwater and stream water interaction in the Inbuk stream, Korea, using various approaches including hydrologic, thermal, hydrochemical, and isotopic methods. For this purpose, we installed four piezometers (IYHW1-4) in the streambed at 10 m interval across the stream and at depths of 0.90 to 1.54 m. We monitored water levels and water temperatures every hour using automatic transducers at the piezometers and in the stream (IYSW1) from September 2013 to April 2014. We also analyzed chemical and isotopic compositions for the hyporheic waters, stream water, and nearby groundwater in early September and late November in 2013. The water levels and hydraulic gradients revealed that three (IYHW1, 2, and 4) of the piezometers were in upwelling conditions for most of the monitoring period, except for the earliest short period (considered to be the wet season), whereas one piezometer (IYHW3) showed a reverse behavior, indicating that the gaining was dominant in the dry period. The mean calculated influx to the stream was 3.04 × 10 cm/sec. Observed temperatures of stream water, hyporheic waters, and groundwater also revealed that stream water was downwelling in the early monitoring period (wet season), whereas the groundwater was generally upwelling in most of the resting period, which is consistent with the water level interpretation. Chemical composition analysis indicated that most of the waters were Ca-HCO type for both seasons. However, no distinctive difference between chemical compositions of water without substantial seasonal variation negated any inference on the flow conditions. The mixing ratios computed from oxygen and hydrogen isotopic compositions indicated that losing conditions were dominant in the wet season, whereas gaining conditions prevailed in the dry season. The interpretations of stream water and groundwater interactions based on these different methods are relatively consistent for this study area, indicating that such combined methods will be very useful in enhancing understanding of groundwater and stream water interaction. [ABSTRACT FROM AUTHOR]

With a growing demand for fresh water, mainly due to the rapidly developing economy, their interests focus on securing plentiful groundwater resources for drinking, domestic, agricultural and industrial purposes. In addition, remediation of contaminated groundwater has become another main interest. Hence, many environmental tracers, such as CFCs, Ra, Rn, CH, δO, δD, H, He, δC, δCl, and applied tracers, such as Cl, Br and rhodamine WT, have been widely used in the country for groundwater studies with different purposes. The main purposes include estimations of submarine groundwater discharge pathways and their quantification in coastal regions, especially in Jeju (volcanic island), as well as examinations of groundwater origin and mixing with stream water, groundwater age dating, tracing (apportioning) the contamination sources of chlorinated solvents (e.g., TCE, PCE) in industrial areas, and identification of reservoir (large dam) leakage. This paper reviews the use of environmental and applied tracers in Korean groundwater studies and provides perspectives on their use. [ABSTRACT FROM AUTHOR]

Based on water chemistry data, a rockfill dam in South Korea was investigated to identify major parts of substantial dam water leakage. Sinkholes in the dam crest and abnormal water leakage through the dam were observed since the first impounding of the dam. Previous investigations, including observational drillings, hydraulic tests, geophysical surveys, and tracer tests, revealed the development of a high permeability zone in the clay core and an abnormally high phreatic line zone in the left embankment. Sequential tracer tests provided further evidence of locations of preference and rapid water leakage pathways. In this study, we examined the usefulness of water chemistry data to confirm previous findings of water leakage. Factor analysis of the water chemistry data revealed major processes controlling the chemical composition, which include the wash-out and successive dissolution of fill materials in the dam interior, interaction between percolating water and dam core materials, and contamination of seeping water by grouting materials and previous tracer tests. Distinct spatial distribution of similar chemical groups was illustrated by cluster analysis and confirmed the location of major water leakage at the left abutment adjoining the spillway. [ABSTRACT FROM AUTHOR]

Summary: The occurrence of submarine groundwater discharge (SGD) as well as its supply of many nutrients and metals to coastal seawaters is now generally known. However, previous studies have focused on the chemical and radiological analysis of groundwater, surface seawater, shallow marine sediments and their pore waters, as well as the measurement of upward flow through the marine sediments, as end members of the discharge process. In this study, chemical and isotopic analysis results of marine subsurface waters are reported. These were obtained from deep boreholes of an undersea liquefied petroleum gas (LPG) storage cavern, located about 8km off the western coast of Korea. The cavern is about 130–150m below the sea bottom, which is covered by a 4.8–19.5m silty clay stratum. An isotopic composition (δ2H and δ18O) of the marine subsurface waters falls on a mixing line between terrestrial groundwater and seawater. Vertical EC profiling at the cavern boreholes revealed the existence of a fresh water zone. An increase in the contents of ferrous iron and manganese and a decrease in levels of nitrate, bicarbonate and cavern seepage were recorded in August 2006, indicating a decreased submarine groundwater flux originating from land, mainly caused by an elevated cavern gas pressure. It is suggested in this study that the main source of fresh waters in the man-made undersea cavern is the submarine groundwater discharge mainly originating from the land. [Copyright &y& Elsevier]

Autism spectrum disorder is considered a vulnerability for many diseases including coronavirus disease 2019. This study investigated trends in coronavirus disease 2019 among children and adolescents with and without autism spectrum disorder and to evaluate whether there are differences in the prevalence, severity, and case fatality rate. We used data from the National Health Insurance Service for all people ⩽19 years of age. Among 9,187,211 children and adolescents ⩽19 years of age, 402,499 (4.4%) were coronavirus disease 2019–positive. Of the total population, 63,054 (0.7%) were diagnosed with autism spectrum disorder, among whom 2557 (4.1%) were coronavirus disease 2019–positive. The coronavirus disease 2019 prevalence was lower among children and adolescents with autism spectrum disorder, with 4055 per 100,000 versus 4383 per 100,000 without autism spectrum disorder (p < 0.001). However, children and adolescents with autism spectrum disorder exhibited a higher proportion of hospitalization (24.8% vs 21.5%) and severe disease (0.2% vs 0.01%) than those without autism spectrum disorder (p < 0.001); the length of hospital stay among inpatients was not different between the two groups (9.5 vs 9.4 days, respectively; p = 0.48). There were six deaths in total, with no deaths among children and adolescents with autism spectrum disorder. The quarantine policies have played a great role in sustaining low prevalence and higher hospitalization rates among children and adolescents with autism spectrum disorder. It is more difficult to prevent coronavirus disease 2019 in children and adolescents with autism spectrum disorder, as they have trouble communicating and adjusting to their new daily lives like wearing masks and social distancing. However, there have not been many studies that focused on coronavirus disease 2019 among children and adolescents with autism spectrum disorder. We included all Korean citizens under the age of 19 as our study subjects. Among them, we found out the prevalence, severity, and case fatality of coronavirus disease 2019 in children and adolescents with and without autism spectrum disorder. The prevalence of coronavirus disease 2019 among children and adolescents with autism spectrum disorder was lower than that of those without autism spectrum disorder. For severity, children and adolescents with autism spectrum disorder were more likely to enter severe stages of disease and had higher hospitalization rates than those without autism spectrum disorder. There were no deaths among children and adolescents with autism spectrum disorder, while a few died among children and adolescents without autism spectrum disorder. However, due to the small number of deaths, it was difficult to determine whether there was a link between autism spectrum disorder and coronavirus disease 2019 deaths. We found that the appropriate quarantine policies have played a great role in sustaining overall low prevalence and higher hospitalization rates among children and adolescents with autism spectrum disorder than those without autism spectrum disorder. Furthermore, because Korea has fewer schools and facilities (i.e. personal care, social training, and skilled nursing facility) for children and adolescents with autism spectrum disorder than other countries, those with autism spectrum disorder have fewer social contacts than even before the COVID-19 pandemic. [ABSTRACT FROM AUTHOR]

This study evaluated temporal and spatial variability of groundwater and stream water fluxes using multiple temperature time series. The study area is located in Inbuk stream, Gangwon Province, Republic of Korea. Total annual precipitation was 698.5 mm in 2014 (1210.5 mm, over the last 30 years). For the study, temperature loggers were installed at depths of 0.1, 0.2, 0.3, 0.4, and 0.5 m at five points with at 10 m intervals (IST1, IST2, IST5, and IST6) in the streambed. Temperature data was continuously measured every two-hours from June 1 to November 30, 2014. Vertical fluid flow (seepage flux) were calculated using the VFLUX program, which uses temperature time series data measured at different depths by temperature loggers in the hyporheic zone. The results of flux calculations Inbuk stream show that vertical flux rates at four locations are generally upwelling condition in the dry season and downwelling condition in the wet season. This research was supported by the National Research Foundation of Korea (NRF) grant funded by the Korea government (MSIT) (No. NRF-2015R1A4A1041105). [ABSTRACT FROM AUTHOR]

The objective of this study is to examine groundwater responses before and after the November 15, 2017 Pohang earthquake (Mw=5.4) in a coastal area of Korea. The earthquake caused devastating damages to many buildings in the city. For this study, groundwater monitoring data (water level, electrical conductivity, water temperature) were obtained for January 2016 to February 2018 from the national groundwater monitoring stations, the rural groundwater monitoring wells, and the seawater intrusion monitoring wells and they are located within 25 km from the epicenter. There are eight national groundwater monitoring stations (PSG, PYI-D, PYI-S, PGB-D, PGB-S, PJH, PDH, PGR), five rural groundwater monitoring wells (PH1, PH2, PH3, PH4, PH5) and four seawater intrusion monitoring wells (GG1, GG2, YI1, YI2). Six of the monitored wells showed groundwater level decreases of 9–81 cm and two of them exhibited a recovery to the previous level within three days while the remaining wells did not. And six monitoring wells showed EC changes to the earthquake with -1,274–161 μS/cm. In addition, three wells showed discernible groundwater temperature fluctuations of -0.2–0.3oC. Here, we found the magnitude of groundwater level change is decreasing with distance of the monitoring wells from the epicenter. Some detailed analyses on the relationship between the responses and a variety of hydrogeological parameters deserve a further study. This work was supported by the Energy Efficiency & Resources of the Korea Institute of Energy Technology Evaluation and Planning (KETEP) grant funded by the Korea government Ministry of Trade, Industry and Energy (No. 20183010111860) and by the National Research Foundation of Korea (NRF) grant funded by the Korea government (MSIT) (No. NRF-2015R1A4A1041105). [ABSTRACT FROM AUTHOR]

Seasonal fluctuation in groundwater level (below the ground surface) and water quality variables are mainly attributed to climatic conditions, soil characteristic, drainage method, and management practices. Groundwater degradations and high nitrate values have taken considerable attention in the Republic of Korea. Water management practices needs to be based on results of monitoring of groundwater level and water quality variables. We studied spatial variations based on temporal fluctuations of groundwater level (GWL), and water quality parameters including pH, electrical conductivity (EC), and nitrate (NO3). These contents were monitored from year 2011 to 2014 in 70 groundwater wells of an agricultural region in Korea. The monitoring of contents was done in field and collected data after laboratory analysis, was analyzed by using geostatistical modeling and mapping techniques. Seasonal variations in GWL during the period of four years of monitoring were ranged 2.91–5.17 m and 2.80–4.08 m in wet and dry seasons, respectively. The variations in pH value for the same period ranged 6.55–7.50 and 6.69–7.82 in wet and dry seasons, respectively. The fluctuations in EC values ranged 125–604 μg/cm and 80–272 μg/cm in wet and dry seasons, respectively. The values for NO3 in groundwater ranged 12.87–34.40 mg/L and 9.46–38.80 mg/L during the wet and dry seasons. The GWL shows strong spatial dependence, while pH and EC show strong to weak spatial dependence. The groundwater NO3 shows partial spatial dependence with decreased values in 2014 compared to the values in 2011. This finding is attributed to improved agricultural practices and change in land use pattern from white radish and cabbage to orchards and ginseng fields. This work was supported by the National Research Foundation of Korea (NRF) grant, funded by the Korean government (MSIT) (NRF-2015R1A4A1041105) and Basic Science Research Program through the National Research Foundation of Korea (NRF) funded by the Ministry of Education (NRF-2018R1D1A1B07047200). [ABSTRACT FROM AUTHOR]

Water is an essential element for all organism, including human. There are anaerobic organisms in nature, but no organisms hate water. As time goes on, the interest and need for such water management is increasing worldwide. Seawater is the most abundant on the Earth's water and accounts for more than 95% of the total. But this is the salty water that humans can not drink. So, even if most of the water is seawater, it is important to manage the fresh water that humans can drink. Uses in which water is used in human life are various such as agriculture and living water. Therefore, the purpose of this study is to contribute to the management of groundwater used in everyday life. Groundwater can be largely divided into quantity and water chemistry. Of these, interest in this study is related to water chemistry and is water temperature. Groundwater chemistry can be changed by temperature change. So, we want to predict changes in the future by analyzing past groundwater temperature changes. Box plot was used as the study method. This makes it is easy to see the yearly change visually. In this box, displays 25% to 75% of the total data distribution. Also, values outside the minimum (25% – 1.5 × IQR) and maximum (75% + 1.5 × IQR) range are designated and excluded as outliers. The line in the box represents the median, which is not necessarily located in the middle of the box. This study used water chemistry data from 2011 to 2015. The result of this study suggests that groundwater temperatures have risen over the past five years, and that this can increase in the future. This research was supported by the National Research Foundation of Korea (NRF) grant funded by the Korea government (MSIT) (No. NRF-2015R1A4A1041105). [ABSTRACT FROM AUTHOR]

The skyrocketing single-plastic demand during the coronavirus disease 2019 (COVID-19) pandemic proved the limitation of top-down environmental policies in accomplishing sustainable consumption and waste management. Nevertheless, 'smart consumers' can make smart choices for sustainable development. However, a review of the South Korean environmental education curriculum reveals that the current structure heavily leans towards the elementary level and does not enlighten the public on 'what' and 'how' to live sustainably. This study uses a quick survey to suggest that the effectiveness of environmental education may be enhanced if: (1) guidance on how to live with the natural environment in harmony for collective cooperation towards resilient and sustainable community building is incorporated with a clear purpose, (2) environment-friendly culture-building activities are enforced to institutionalise a new paradigm of sustainability to replace today's consumerism, and (3) contents are updated regularly to include Earth and environmental science knowledge in the state of art. [ABSTRACT FROM AUTHOR]

Risk perception research, targeting the general public, necessitates the study of the multi-faceted aspects of perceived risk through a holistic approach. This study aimed to investigate the association between the two dimensions of risk perception of COVID-19, i.e., risk as a feeling and analysis, trust in the current government, political ideologies, and socio-demographic factors in South Korea. This study used a year-long repeated cross-sectional design, in which a national sample (n = 23,018) participated in 23 consecutive telephone surveys from February 2020 to February 2021. Most factors differed in the magnitude and direction of their relationships with the two dimensions of risk perception. However, trust in the current government, alone, delineated an association in the same direction for both dimensions, i.e., those with a lower level of trust exhibited higher levels of cognitive and affective risk perception. Although these results did not change significantly during the one-year observation period, they are related to the political interpretation of risk. This study revealed that affective and cognitive risk perceptions addressed different dimensions of risk perception. These findings could help governments and health authorities better understand the nature and mechanisms of public risk perception when implementing countermeasures and policies in response to the COVID-19 pandemic and other public health emergencies. [ABSTRACT FROM AUTHOR]

Microplastic (MPs) contamination in groundwater has received massive attention since plastic waste has been released directly into the environment. This study investigates MPs contamination in groundwater on the Jeju volcanic Island, Korea. To the best of our knowledge, this is the first study to identify MPs in groundwater from volcanic islands. A total of 21 sites were sampled for groundwater wells and springs in July and September (2021). Sampling was performed without cross-contamination through quality assurance and quality control. The results showed that MPs abundance ranged from 0.006 to 0.192 particles/L in groundwater samples. Additionally, MPs were detected in deep groundwater wells where the groundwater level was 143 m below ground surface. Eight MPs polymer types, including polypropylene, polyethylene, polyethylene terephthalate, polyvinyl chloride, polystyrene, polyamide, acrylonitrile butadiene styrene, and polyurethane, were detected using Micro-Fourier Transform Infrared Spectroscopy (μ-FT-IR). Most of the detected MPs size ranged from 20 to 100 μm, accounting for 95% of the total. Fragments and fiber shaped MPs were detected, with the majority of them being fragmented in groundwater samples. The concentrations of MPs and major ions in groundwater showed a positive correlation. A negative correlation was observed between MPs concentration and topographic elevation (r = −0.59, p = 0.01). The source of MPs contamination is most likely attributed to agricultural activities, such as plastic mulching and greenhouses, which account for most of the land use in the study area. In this study, MPs entered the aquifer through the soil at the surface and seeped through cracks in fractured rock on basalt with sealed groundwater wells. This study takes 500 L of samples to prevent sample bias, reveal plastic contamination in groundwater, and indicating the characteristics and sources of contaminated plastics. [Display omitted] • Most MPs detected in groundwater were smaller than 50 μm. • Eight polymers were identified, with PP and PE being dominant types in groundwater. • Predominant shapes of MPs in groundwater were fragments. • MPs abundance and groundwater levels have a negative correlation. [ABSTRACT FROM AUTHOR]

Objectives To estimate the loss in quality-adjusted life-years (QALYs) in Korean adults due to 13 noncommunicable diseases (NCDs) in 2010 and predict changes in QALY loss through to the year 2040. Methods Thirteen NCDs (hypertension, diabetes mellitus, hyperlipidemia, stroke, myocardial infarction, angina, arthritis, osteoporosis, asthma, allergic rhinitis, atopic dermatitis, cataract, and depression) were selected from the Korean Community Health Survey 2010. The EuroQol five-dimensional questionnaire index from the Korean Community Health Survey 2010 and the Korean valuation set were used to estimate utility weights according to sex, age, and disease. Morbidity data were also obtained from the Korean Community Health Survey 2010. Mortality data according to disease and life expectancy were retrieved from the Korean Statistical Information Service. To predict future QALY loss, future population projection data from the Korean Statistical Information Service were used as substitutes for 2010 population size. Results Among the assessed 13 NCDs, the largest total QALY loss was for hypertension (513,113 QALYs; units are omitted hereafter), followed by arthritis (509,317) and stroke (431,049). The largest QALY loss due to mortality was stroke (306,733), whereas the largest QALY loss due to morbidity was arthritis (502,513). By applying the middle estimate of future population, the largest increase in total QALY loss between 2010 and 2040 was for hypertension (840,582), followed by stroke (719,076) and diabetes mellitus (474,607). Conclusions Hypertension, arthritis, and stroke are important in terms of total QALY loss, which will continuous to increase because of aging. These results could be used to develop cost-effective interventions that reduce the burden of NCDs. [ABSTRACT FROM AUTHOR]

The epidemiological characteristics of women living with human immunodeficiency virus (HIV) infection have gained little attention as the numbers are small compared with men living with HIV in the Republic of Korea. However, these data are important to achieve effective HIV infection control and to consider the influence of socioeconomic status on HIV transmission. This study utilized the claims database of the Korean National Health Insurance system to analyze women with a newly diagnosed HIV infection during the period 2009–2016. Adherence to antiretroviral agents was calculated using the medication possession ratio. Among 677 women with a newly diagnosed HIV infection, 219 (32.4%) were over 50 years of age; 291 (43.0%) were identified as having acquired immune deficiency syndrome (AIDS). A total of 99 women (14.6%) were National Medical Aid beneficiaries. Optimal medical adherence >95% was found in 62.2% of subjects. Teenage years (odds ratio(OR) 14.9, 95% confidence interval (95CI) 4.9-44.8), AIDS (OR 1.7, 95CI 1.2-2.3), and low economic status requiring National Medical Aid (OR 3.0, 95CI 2.0-4.6) were associated to adherence. Diagnosis prior to 2012 was also associated with poor adherence. In women, particularly young patients with low economic status, extra attention is required to enhance adherence to prescribed medication. [ABSTRACT FROM AUTHOR]

Background: Healthcare quality assessment is being conducted in many countries. Although improving health equity is one of the major objectives of medical quality assessment, it is not clear whether different socio-economic statuses show the same health outcomes even in the same medical quality hospitals. No study has directly compared the health outcomes of different socio-economic statuses in the same hospitals nationwide.Objective: To determine whether the mortality rate of acute stroke patients differs according to socioeconomic status.Methods: This study was a retrospective, observational study of patients who were subject to acute stroke quality assessment in 2013. A total of 10 399 stroke cases were included in the study. When evaluating the mortality rate, the researchers analysed 10 228 cases, after excluding 171 cases that were measured twice for the same person. The levels of socio-economic status were divided according to the use of medical benefits, either National Health Insurance (NHI) for general population or Medical Aid (MA) for the vulnerable. The primary outcomes measured according to socio-economic status were in-hospital mortality rate and 1-year follow-up mortality rate of stroke patients. The secondary outcome was the composite performance score.Results: MA recipients had a higher in-hospital mortality rate (12.5 vs. 8.3%, P < 0.001) and 1-year follow-up mortality rate (14.9 vs. 10.8%, P < 0.001) than NHI subscribers. MA recipients had slightly lower scores than NHI subscribers (83.2 vs. 84.4, P = 0.02). In hospitals of the same grade, MA recipients had lower performance scores than NHI subscribers, although the difference was not statistically significant.Conclusions: There is a difference in mortality and healthcare performance according to socio-economic status in stroke patients in Korea. Efforts to improve equity are needed, including the development and monitoring of equality indicators and developing policies for healthcare equity. [ABSTRACT FROM AUTHOR]

Background: The epidemiology of the association between psoriasis and inflammatory bowel disease is poorly defined and remains controversial.Aim: To evaluate the prevalence of inflammatory bowel disease in patients with psoriasis compared with the general population.Methods: We searched the nationwide health claims database between 2011 and 2015 and evaluated the prevalence of inflammatory bowel disease, including Crohn's disease and ulcerative colitis.Results: Prevalence of inflammatory bowel disease, Crohn's disease and ulcerative colitis in patients with psoriasis vs the general population in 2011 were 0.16, 0.05 and 0.12% vs 0.08, 0.03 and 0.06%, respectively, which increased significantly with time between 2011 and 2015. Patients with psoriasis consistently revealed higher standardized prevalence (age and sex adjusted) of inflammatory bowel disease, Crohn's disease and ulcerative colitis compared with the general population. Subgroup analysis revealed the highest risk of prevalent inflammatory bowel disease in patients younger than 19 years (crude odds ratio 5.33, 95% confidence interval 3.74-7.59). Severe psoriasis demonstrated higher odds of inflammatory bowel disease (odds ratio 2.96, 95% confidence interval 2.54-3.45) than mild psoriasis (odds ratio 1.68, 95% confidence interval 1.51-1.88).Limitations: Limited data for doing adjustment and cross-sectional study design.Conclusions: Psoriasis patients revealed higher risk of inflammatory bowel disease. In particular, young patients and those with severe psoriasis may require closer monitoring and comprehensive management. [ABSTRACT FROM AUTHOR]

To investigate the prevalence and incidence of Parkinson's disease (PD) and provide evidence for preventive strategy of vertebral, hip, and femoral fractures (VF, HF, and FF) in PD patients. Retrospective cohort study. Using a nationwide medical service utility database from 2009 to 2014, we enrolled PD patients with diagnosis of G20 as per ICD-10 who used medical services. Overall, the number of PD patients was 97,311, 106,072, 115,762, 127,647, 137,782, and 144,757 through 2009-2014, respectively. We followed 35,663 patients diagnosed with PD in 2010 without prior fracture. We estimated the annual PD prevalence and incidence and used Cox proportional hazards model to estimate the hazards ratio (HR) for factures based on demographic characteristics, underlying disease, and socioeconomic status according to fracture type (osteoporosis-related fracture, VF, HF/FF). Furthermore, we investigated the cumulative incidence of those fractures by month during the 5-year follow-up. The standardized PD prevalence increased from 238 to 279 between 2009 and 2014, and its incidence decreased from 86 to 72 between 2010 and 2014 per 100,000 population based on 2015 census data. We followed 35,663 PD patients: women, 20,732 (58.1%); aged ≥60 years, 29,264 (82.1%); with osteoporosis, 6542 (18.3%); VF experience, 4242 (11.9%); and HF/FF experience, 2112 (5.9%). Osteoporosis was a significant risk factor for VF [HR 1.75, 95% confidence interval (CI) 1.64-1.87] and HF/FF (HR 1.37, 95% CI 1.24-1.51). The cumulative incidence of VF and HF/FF was the highest at 6 months and increased more than half in the coming 2 years after PD diagnosis. VF and HF/FF are common among PD patients. VF and HF/FF risks were high for female PD patients aged ≥60 years with osteoporosis. Fracture prevention strategies should be focused on older, women, and osteoporosis patients within 3 years of PD diagnosis. [ABSTRACT FROM AUTHOR]

The international lack of water is publicly known. Over time, interest in groundwater and surface waters has increased for domestic use as drinking water and agricultural water. Due to the impacts of climate change, floods, landslides, droughts and other disasters related to water are becoming more and more important, and the need for water resources planning and management is emphasized. This study was aimed to assess the trend of groundwater quality in Korea. We also investigated the main drivers behind the trend and are attributed to rock-type and land use. Data was collected for 10 years from groundwater quality monitoring in Korea. Twelve water quality parameters were analyzed year by year. The collected data was statistically analyzed using a nonparametric method (Mann-Kendall trend test, M-K trend test). In addition, normality was analyzed by histogram (K-S test / Kolmogorov-Smirnov test or S-W test / Shapiro-Wilk test) and box plot. The Mann-Kendall trend test used the data for more than 5 years to identify the trends. The results were displayed on the map of the whole country, showing trends by regions. All of the water quality parameters were not statistically normal as a result of verifying the normality of the whole data through P-value in the histogram. Also, it was not normally distributed as a result of verifying the normality of yearly collected data through box plot. As a result of testing the normality of the M-K trend test using P-value, the T and HCO3- increased nationwide, and the pH, Eh and NO3- decreased nationwide. While, Cl-, Mg2+ and SO42- increased in the central area and decreased in the south. Potassium decreased markedly in the south, and EC and Ca2+ showed no regional trends. The reason for the regional difference was thought to be the influence of the rock type of the area where the irrigation had been installed, and it was affected by the land use. This work was supported by the National Research Foundation of Korea (NRF) grant funded by the Korea government (MSIT) (No. NRF-2015R1A4A1041105). [ABSTRACT FROM AUTHOR]

Background: Low socioeconomic status can increase the risk of adverse pregnancy outcomes, but it remains unclear whether this negative association is attributed to inadequate prenatal care. Korea has been adopting a universal healthcare system. All Korean citizens must be enrolled National Health Insurance (NHI) or be recipient of Medical Aid (MA). In addition, Korean government launched a financial support system for antenatal care for all pregnant women in 2008. Therefore, in theory, there is no financial barrier to receive prenatal cares regardless of someone's social class. However, it is still unclear whether adverse pregnancy outcomes observed in low-income women are attributable to low SES or to economic barriers specific to the utilization of medical services. The purpose of this study was to investigate whether socioeconomic status affects pregnancy outcomes after the introduction of this support system, which allows all pregnant women to receive adequate prenatal care regardless of socioeconomic status. Methods: Using the National Health Insurance database in Korea, we selected women who gave birth between January 1, 2010 and December 31, 2010. As a proxy indicator reflecting socioeconomic status, we classified subjects as MA recipient ("low" SES) or a NHI beneficiary ("middle/high" SES). Results: In the MA group, 29.4% women received inadequate prenatal care, compared to 11.4% in the NHI group. Mothers in the MA group were more likely to have an abortion (30.1%), rather than deliver a baby, than those in the NHI group (20.7%, P < 0.001). Mothers in the MA group were also more likely to undergo a Caesarean delivery (45.8%; NHI group: 39.6%, P < 0.001), and have preeclampsia (1.5%; NHI group: 0.6%, P < 0.001), obstetric hemorrhage (4.7%; NHI group: 3.9%, P = 0.017), and a preterm delivery (2.1%; NHI group: 1.4%, P < 0.001) than those in the NHI group. Conclusions: Women in the MA group tended to show higher rates of abortion, Caesarean delivery, preeclampsia, preterm delivery, and obstetrical hemorrhage than those in the NHI group Therefore, health authorities should consider investigating what kind of barriers exist or what factors may affect these inequitable outcomes. [ABSTRACT FROM AUTHOR]

Study Design: A cross-national study.Objective: To determine the prevalence and incidence of osteoporosis (OP) and osteoporotic vertebral fracture (OVF) in Korea and to investigate if socioeconomic status has an effect.Summary Of Background Data: As life expectancy increases, OP and related fragility fractures are also increasing. This presents a serious challenge, not only for health authorities but also for individuals, their families, and society overall. Determining the prevalence and incidence of OP and related fragility fractures is the first step in developing strategies to reduce their increasing disease burdens. Concurrently, we need to confirm whether people with low socioeconomic status are more susceptible to these diseases.Methods: Using the Health Insurance Review and Assessment Service (HIRA) database from 2008 to 2012, we estimated the annual prevalence and incidence of OP and OVF and investigated the differences according to socioeconomic status by National Health Insurance (NHI) beneficiaries and Medical Aid (MA) recipients.Results: In 2012, the standardized prevalence of OP in the NHI and MA groups was 3968 and 6927 per 100,000, respectively (odds ratio, 3.83). The standardized incidence of OP in the MA group was significantly higher than in the NHI group in 2011 and 2012 (odds ratios, 2.34 and 2.19, respectively). In addition, the standardized incidence of OVF in the MA group in 2011 and 2012 was 408 and 389 per 100,000, respectively, and the incidence in the MA group was significantly higher than in the NHI group (odds ratios, 4.13 and 4.12, respectively; P < 0.001).Conclusion: We confirmed that the prevalence and incidence of OP and OVF in the MA group were higher than those in the NHI group. It showed that low income might be a significant factor related to OP and OVF.Level Of Evidence: 3. [ABSTRACT FROM AUTHOR]

Abstract: Ethnopharmacological relevance: The fruits of Vitex rotundifolia L. have long been used for the treatment of inflammation of the respiratory tract in East Asia. Aim: To determine if casticin, one of the constituents of Vitex rotundifolia L., has anti-allergic and anti-inflammatory effects in asthma. Materials and methods: The in vitro anti-inflammatory activity of casticin was studied in A549 human type II-like epithelial lung cells using an eotaxin inhibition assay. Additionally, its effects on eotaxin, regulated on activation normal T cell expressed and secreted (RANTES), vascular cell adhesion molecule (VCAM)-1, and inter-cellular adhesion molecule (ICAM)-1 expression were investigated by real time-polymerase chain reaction (real time-PCR). The inhibition of nuclear factor κB (NF-κB) activity in the presence of casticin was determined by analyzing confocal microscopy images of fluorescence immunocytochemical analysis while the suppression of inhibitory κB (IκB)-α phosphorylation was studied using Western blot analysis. Finally, the inhibitory effect of casticin on eosinophil migration toward prestimulated A549 cell media was measured using the human eosinophilic leukemia cell line. Results and discussion: Casticin significantly suppressed eotaxin production in cytokine activated A549 lung epithelial cells. Casticin also suppressed the mRNA expression levels of eotaxin, RANTES, VCAM-1, and ICAM-1, which subsequently contributed to the inhibition of eosinophil migration. Furthermore, casticin inhibited IκB-α phosphorylation and nuclear translocation of p65 in A549 cells. Conclusion: Casiticin inhibited the eosinophil migration and activity of chemokines and adhesion molecules involved in the inflammatory process of asthma by suppressing the NF-κB pathway. These results suggest that casticin has the potential for use in the treatment of allergic asthma. [Copyright &y& Elsevier]

Abstract: Ethnopharmacological relevance: Patrinia scabiosaefolia Fisch is used in folk medicines to treat intestinal abscesses, acute appendicitis, and dysentery in Asia. Although recent reports indicate that Patrinia scabiosaefolia has sedative and anti-tumor effects, its effects on ulcerative colitis have not been previously explored. Aim of the study: To determine the effects and the mode of action of the methanol extract of the roots of Patrinia scabiosaefolia (PME) on a model of colitis in mice induced by dextran sulfate sodium (DSS). Materials and methods: We induced colitis using DSS in 5-week-ICR mice over 7 days and estimated disease activity index (DAI), which took into account body weight, stool consistency, gross bleeding, and tissue myeloperoxidase (MPO) accumulation. Colon lengths and spleen weights were measured. Histological changes were observed by H&E staining. Pro-inflammatory mediators, namely, nitric oxide (NO), tumor necrosis factor-α (TNF-α), interleukin-1β (IL-1β), and interleukin-6 (IL-6), were determined using Griess assays, immunoassays, and by quantitative real-time reverse-transcriptase polymerase chain reaction (qRT-PCR), respectively. Results: PME significantly attenuated DSS-induced DAI scores and tissue MPO accumulation, which implied that it suppressed weight loss, diarrhea, gross bleeding, and the infiltrations of immune cells. PME administration also effectively and dose-dependently prevented shortening of colon length and enlargement of spleen size. Histological examinations indicated that PME suppressed edema, mucosal damage, and the loss of crypts induced by DSS. Furthermore, PME inhibited the abnormal secretions and mRNA expressions of pro-inflammatory cytokines, such as, TNF-α, IL-1β, and IL-6. Conclusion: These results suggest that PME has an anti-inflammatory effect at colorectal sites that is due to the down-regulations of the productions and expressions of inflammatory mediators, and that it may have therapeutic value in the setting of inflammatory bowel disease (IBD). [Copyright &y& Elsevier]

Abstract: Hydrogeologic and hydrochemical data for subway tunnel seepage waters in Seoul (Republic of Korea) were examined to understand the effect of underground tunnels on the degradation of urban groundwater. A very large quantity of groundwater (up to 63 million m3 year−1) is discharged into subway tunnels with a total length of 287 km, resulting in a significant drop of the local groundwater table and the abandonment of groundwater wells. For the tunnel seepage water samples (n =72) collected from 43 subway stations, at least one parameter among pathogenic microbes (total coliform, heterotrophic bacteria), dissolved Mn and Fe, NH4 +, NO3 −, turbidity, and color exceeded the Korean Drinking Water Standards. Locally, tunnel seepage water was enriched in dissolved Mn (avg. 0.70 mg L−1, max. 5.58 mg L−1), in addition to dissolved Fe, NH4 +, and pathogenic microbes, likely due to significant inflow of sewage water from broken or leaking sewer pipes. Geochemical modeling of redox reactions was conducted to simulate the characteristic hydrochemistry of subway tunnel seepage. The results show that variations in the reducing conditions occur in urban groundwater, dependent upon the amount of organic matter-rich municipal sewage contaminating the aquifer. The organic matter facilitates the reduction and dissolution of Mn- and Fe-bearing solids in aquifers and/or tunnel construction materials, resulting in the successive increase of dissolved Mn and Fe. The present study clearly demonstrates that locally significant deterioration of urban groundwater is caused by a series of interlinked hydrogeologic and hydrochemical changes induced by underground tunnels. [Copyright &y& Elsevier]

Aim: A prospective, non-comparative study was conducted to evaluate the efficacy and efficiency of a starting dose of 100 IU recombinant follicle stimulating hormone (rhFSH, Puregon®) in women undergoing ovarian stimulation prior to in vitro fertilization (IVF). Methods: A total of 40 women were down-regulated with gonadotropin releasing hormone agonist (long protocol), then treated with a fixed dose of 100 IU rhFSH for the first 4 days, and the dose of gonadotropin administration was adjusted according to patient's response thereafter. A maximum number of 3 embryos were transferred in 32 patients. Results: Nine patients were treated with intracytoplasmic sperm injection, and 24 with conventional IVE The duration of stimulation was 10.8 ± 1.8 days, serum estradiol concentration on human chorionic gonadotropin day was 1693.0 ± 1651.2 pg/mL, and 1480 ± 450 IU rhFSH was used. A mean number of 8.4 ± 5.7 oocytes were retrieved, 4.9 ± 4.3 embryos obtained, 2.4 ± 0.9 embryos transferred, and 3.5 ± 3.2 embryos cryopreserved. The proportion of mature oocytes was 71.6%, and the fertilization rate was 86.4%. Clinical pregnancy was achieved in 8 patients (25.0%), and all of these pregnancies are ongoing or delivered. There were 3 cases of twin gestations (37.5%). The implantation rate was 13.1% (11/84). There was one case of moderate ovarian hyperstimulation syndrome, however, the patient recovered within 7 days without any complications. Conclusion: The starting dose of 100 IU rhFSH has a good safety profile, and is adequate in controlled ovarian hyperstimulation for IVF with a small amount of gonadotropin administered. [ABSTRACT FROM AUTHOR]

Background: Autism spectrum disorder (ASD) is characterized by continuous impairment in communication and social interaction and by limited and repetitive behaviors, interests, or activities. Behavioral, educational, and pharmaceutical interventions have been shown to reduce behavioral disabilities, improve verbal/non-verbal communication, and help patients acquire self-reliance skills. However, there has been a lack of systematic verification and consensus regarding the treatment of the core symptoms of ASD because of its unclear etiology. Ukgansangajinpibanha (UGSJB), a legitimately prescribed herbal medicine for nervousness, insomnia, night crying, and malnutrition in South Korea and Japan, has been used for angry, sensitive, nervous, and unsettled children with ASD.Methods/design: This trial is a prospective, multicenter, randomized, double-blinded, placebo-controlled, parallel-group, clinical trial. The 4- to 6-year-old children with ASD will be randomly assigned to following groups: 1. A UGSJB granule with acupuncture, twice daily (n = 120) 2. A placebo group with acupuncture, twice daily (n = 120). The following outcome measures will be used: behavior by the Childhood Autism Rating Scale, Autism Behavior Checklist, and Aberrant Behavior Checklist; social maturity by the Social Maturity Scale; quality of life by the Child Health Questionnaire and EuroQoL Five-dimension Five-level Youth; and parental stress by the Parenting Stress Index at baseline and at 6, 12, and 24 weeks after the beginning of treatment. In addition, to evaluate safety, we will investigate the adverse reactions that may be caused by UGSJB granule. Finally, we will make an economic evaluation of UGSJB for the treatment of ASD.Discussion: We prepared a well-designed clinical trial to investigate the safety and effectiveness of UGSJB on ASD symptoms compared with placebo treatment. The results from this study will provide clinical evidence on the safety, effectiveness, and economic value of UGSJB combined with acupuncture in children with ASD.Trial Registration: Clinical Research Information Service: KCT0003007 (registered on April 5, 2018). [ABSTRACT FROM AUTHOR]