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This study analyzed the risk factors for heel pressure injury in cardiovascular intensive care unit patients with the aim of laying the groundwork for preventive nursing interventions. We conducted a retrospective case-control study of 92 patients who were admitted to the cardiovascular surgical or medical intensive care unit of a university hospital in South Korea between January and December 2017. Of these patients, 31 and 61 were included to the heel pressure injury group and the non-heel pressure injury group, respectively. Data on their demographic, disease-related, and intensive care unit treatment characteristics, as well as the degree of pressure injury, were collected from the hospital's electronic medical records using a standardized form. Cardiac surgery (P

This study aimed to investigate the applicability of deep learning algorithms to (monthly) surface water quality forecasting. A comparison was made between the performance of an autoregressive integrated moving average (ARIMA) model and four deep learning models. All prediction algorithms, except for the ARIMA model working on a single variable, were tested with univariate inputs consisting of one of two dependent variables as well as multivariate inputs containing both dependent and independent variables. We found that deep learning models (6.31–18.78%, in terms of the mean absolute percentage error) showed better performance than the ARIMA model (27.32–404.54%) in univariate data sets, regardless of dependent variables. However, the accuracy of prediction was not improved for all dependent variables in the presence of other associated water quality variables. In addition, changes in the number of input variables, sliding window size (i.e., input and output time steps), and relevant variables (e.g., meteorological and discharge parameters) resulted in wide variation of the predictive accuracy of deep learning models, reaching as high as 377.97%. Therefore, a refined search identifying the optimal values on such influencing factors is recommended to achieve the best performance of any deep learning model in given multivariate data sets.

Purpose This study aimed to identify the risk factors for diabetic foot ulceration (DFU) to develop and evaluate the performance of a DFU prediction model and nomogram among people with diabetes mellitus (DM). Methods This unmatched case-control study was conducted with 379 adult patients (118 patients with DM and 261 controls) from four general hospitals in South Korea. Data were collected through a structured questionnaire, foot examination, and review of patients' electronic health records. Multiple logistic regression analysis was performed to build the DFU prediction model and nomogram. Further, their performance was analyzed using the Lemeshow-Hosmer test, concordance statistic (C-statistic), and sensitivity/specificity analyses in training and test samples. Results The prediction model was based on risk factors including previous foot ulcer or amputation, peripheral vascular disease, peripheral neuropathy, current smoking, and chronic kidney disease. The calibration of the DFU nomogram was appropriate (χ² = 5.85, p = .321). The C-statistic of the DFU nomogram was .95 (95% confidence interval .93~.97) for both the training and test samples. For clinical usefulness, the sensitivity and specificity obtained were 88.5% and 85.7%, respectively at 110 points in the training sample. The performance of the nomogram was better in male patients or those having DM for more than 10 years. Conclusion The nomogram of the DFU prediction model shows good performance, and is thereby recommended for monitoring the risk of DFU and preventing the occurrence of DFU in people with DM.

It is fundamental task to reveal the mechanism of the dispersion and the diffusion on solute transport in open channel flow. In this study, the dispersion and the diffusion coefficients were observed and compared with each other based on the tracer tests at a prototype channel in the Andong experimental site, South Korea. The channel has sinuosity of 1.2 and can control the flow rate. For each experimental condition, measurements of average velocity by wading and the turbulence intensity were performed with a fixed device. The dispersion and diffusion coefficients were calculated using a dissolved tracer (Rhodamine WT) and a surface particle tracer (GPS floater), respectively. For each channel section, based on the tracer experiments, the transverse dispersion coefficient and transverse diffusion coefficient were calculated. The observed diffusion and dispersion coefficients were laid on the reliable ranges. The relation between dispersion and diffusion was analyzed by comparing the transverse diffusion coefficient, calculated by the diffusion of surface particles, and the transverse dispersion coefficient, determined by the surface flow velocity, which was calculated using the vertical distribution equation. Based on the analysis, the results that the turbulent diffusion coefficient is proportional to the turbulence intensity, and the transverse turbulence intensity is proportional to the transverse flow velocity. Also, the transverse flow velocity is relative to the transverse dispersion coefficient. Thus, the correlation between dispersion and diffusion is confirmed by the experimental results, and a formula that could be converted based on the relation is proposed.

For sustainable and effective innovation, who should own an academic patent obtained as a result of funded research? The issue of ownership can influence the motivation of academic researchers. In this paper, we address this issue from the perspective of engineering graduate students who have experience of RD and patent ownership policies within university. In this paper, we carried out classification tree analyses of preferred ownership categories, using various factors related to ‘researchers and the environment for R&D,’ ‘technology,’ ‘patenting activities,’ ‘sponsors,’ ‘currently existing ownership policy,’ and ‘compensation policy’. Our findings can help design an effective ownership policy that promotes innovation by incorporating the views of students who will be important asset for future innovation.

Nuclear factor of activated T cells 5 (NFAT5) has been implicated in the pathogenesis of various human diseases, including cancer and arthritis. However, therapeutic agents inhibiting NFAT5 activity are currently unavailable. To discover NFAT5 inhibitors, a library of > 40,000 chemicals was screened for the suppression of nitric oxide, a direct target regulated by NFAT5 activity, through high-throughput screening. We validated the anti-NFAT5 activity of 198 primary hit compounds using an NFAT5-dependent reporter assay and identified the novel NFAT5 suppressor KRN2, 13-(2-fluoro)-benzylberberine, and its derivative KRN5. KRN2 inhibited NFAT5 upregulation in macrophages stimulated with lipopolysaccharide and repressed the formation of NF-κB p65-DNA complexes in the NFAT5 promoter region. Interestingly, KRN2 selectively suppressed the expression of pro-inflammatory genes, including Nos2 and Il6, without hampering high-salt-induced NFAT5 and its target gene expressions. Moreover, KRN2 and KRN5, the latter of which exhibits high oral bioavailability and metabolic stability, ameliorated experimentally induced arthritis in mice without serious adverse effects, decreasing pro-inflammatory cytokine production. Particularly, orally administered KRN5 was stronger in suppressing arthritis than methotrexate, a commonly used anti-rheumatic drug, displaying better potency and safety than its original compound, berberine. Therefore, KRN2 and KRN5 can be potential therapeutic agents in the treatment of chronic arthritis., Highlights • We identify a novel NFAT5 suppressor KRN2, 13-(2-fluoro)-benzylberberine, and its derivative KRN5 to inhibit NFAT5 activity. • KRN2 inhibits the transcriptional activation of NFAT5 and the pro-inflammatory responses. • KRN2 and KRN5 suppress experimentally induced arthritis in mice. NFAT5 has been implicated in the pathogenesis of arthritis. However, therapeutic agents specifically inhibiting NFAT5 activity are currently unavailable. To discover NFAT5 inhibitors, a library of > 40,000 chemicals was screened, leading to the discovery of novel berberine-based NFAT5 suppressors, KRN2 and its oral derivative KRN5. KRN2 inhibited the transcriptional activation of NFAT5 by blocking NF-κB binding to the NFAT5 promoter region, thereby reducing the expression of pro-inflammatory genes. Moreover, KRN2 and KRN5 ameliorated experimentally induced arthritis in mice without serious adverse effects. Therefore, we propose that KRN2 and KRN5 may be potential therapeutic agents in the treatment of chronic arthritis.

In recent years, many technologies are converging with information and communication technology (ICT) while several of them are being standardized. In this study, we identify technological convergence in standards related to ICT. We apply the concepts of entropy and gravity, social network analysis, and association rule analysis to the International Patent Classification (IPC) codes of patents that have been declared as essential in the European Telecommunications Standards Institute. Results from our study show the technology fields that have played a major role in technological convergence in standards. In addition, other technology fields that are linked with these important technology fields are identified. During the period 2010–2014, services or facilities specially adapted for wireless communication networks had the highest entropy value and the highest binding force; and visible signaling systems were associated with several technology fields having a high potential to converge with other technology fields. Our findings can contribute to R&D planning for essential patents by suggesting potential technology fields that play a crucial role in technological convergence in related standards and other technological fields that are linked with these potential fields.

Understanding technology convergence became crucial for pursuing innovation and economic growth. This paper attempts to predict the pattern of technology convergence by jointly applying the Association Rule and Link Prediction to entire IPCs related to triadic patents filed during the period from 1955 to 2011. We further use a topic model to discover emerging areas of the predicted technology convergence. The results show that the medical area is in the center of convergence, and we predict that technologies for treating respiratory system/blood/sense disorders are associated with the technologies of genetic engineering/peptide/heterocyclic compounds. After eliminating the majority of convergence, we found the convergence pattern among activating catalysts, printing, advanced networking, controlling devices, secured communication with in-memory system, television system with pattern recognition, and image processing and analyzing technologies. The results of our study are expected to contribute to firms that seek new innovative technological domain.

Recently, many countries have shown considerable interest in gas hydrates as an alternative energy source and have conducted many studies for exploring, drilling, and producing gas hydrates. In this paper, we investigate international RD Japan, a country that leads in technological development; and China, which has enormous resources of gas hydrates. This study delineates these countries' expertise and changing R&D trends in gas hydrates. Our findings can provide insights for academic research and technical development regarding gas hydrates.

To improve healing of pressure ulcer wounds, it is important to optimize the conditions of the area surrounding the wound. Negative pressure wound therapy (NPWT) promotes wound healing, however, the removal of NPWT can cause pain or focal bleeding, delaying wound healing or causing infection. In this study, we reviewed the efficacy of the lipidocolloid non-adherent dressing (Urgotul&reg, ) as a wound contact layer. A total of 38 patients from the same facility who applied NPWT from April 2016 to October 2019 were included and divided into two groups, NPWT with the lipidocolloid non-adherent dressing (group 1, experimental group, 19 patients) and NPWT only (group 2, control group, 19 patients). The condition of the wound was examined prior to NPWT application, at one week, and again at three weeks after application. No significant differences were found between groups for general characteristics, bacterial culture or photo analysis. However, when comparing groups based on the time of examination, there was a significant reduction of the wound size in group 1 (p = 0.001) but not in group 2 (p = 0.082). Therefore, the current study finds that using the lipidocolloid non-adherent dressing as a wound contact layer in NPWT stimulates healing by shrinking the size of the pressure ulcer wound.

Governments and also local councils create and enforce their own regional public health care plans for the problem of overweight and obesity in the population. Public sports facilities can help these plans. In this paper, we investigated the contribution of public sports facilities to the reduction of the obesity of local residents. We used the data obtained from the Fifth Korea National Health and Nutrition Examination Surveys; and measured the degree of obesity using body mass index (BMI). We conducted various spatial regression analyses including the global Moran’s I test and local indicators of spatial autocorrelation analysis finding that there exists spatial dependence in the error term of spatial regression model for BMI. However, we also observed that the number of local public sports facilities is not significantly related to local BMI. This result can be caused by the low utilization ratio and an unbalanced spatial distribution of local public sports facilities. Based on our findings, we suggest that local councils need to improve the quality of public sports facilities encouraging the establishment of preferred types of pubic sports facilities.

Firms in industries that pose environmental hazards are striving to acquire new technologies to meet tightened environmental regulations. Typically such firms have three main alternatives for obtaining technologies complying with the regulations: in-house development, purchasing a license, or merger and acquisition (M&A). In this paper, a new cost of ownership model that can assist selecting the best option to meet the regulation over the product lifetime is proposed. In order to forecast the demand for new products complying with environmental regulations, we apply Norton and Bass model. Our proposed evaluation model is applied to a case of heavy-duty diesel engine (HDDE) technology. According to our findings, purchasing a license is the most profitable alternative, while M&A and in-house development are sensitive to product lifetime and the expected lead-time for success, respectively. Our study is expected to support a firm's decision making process for selecting the best alternative for cleaner production.

ObjectiveaaPanic disorder (PD) is a common psychiatric disorder with a complex etiology, and several studies have suggested that it has a genetic component. Brain-derived neurotrophic factor (BDNF) is the most abundant of the neurotrophins in the brain and is recognized for its important role in the survival, differentiation and growth of neurons. Several lines of research have suggested possible as sociations between the BDNF gene and PD. In this study, we investigated the BDNF 196G/A (rs6265), 11757G/C (rs16917204), and 270C/T (rs56164415) single nucleotide polymorphisms (SNPs) in order to determine an association with PD. We also identified the ge netic sequence associations with PD via haplotype analysis. MethodsaaParticipants in this study included 136 PD patients and 263 healthy controls. Male and female subjects were analyzed separately. The genotype and allele frequencies of the PD patients and controls were analyzed using χ 2 statistics. Frequencies and haplotype reconstructions were calculated using the SNP analyzer 2.0. ResultsaaWe found no significant statistical differences in the genotype distributions or allele frequencies of the three tested polymor phisms between the PD and control groups. In addition, no differences were found between PD patients and the controls in either male or female subgroups. However, we found that, the frequency of the G-C haplotype for 196G/A and 11757G/C was significantly higher in PD patients than in the controls. ConclusionaaOur result suggest that patients with the G-C haplotype for 196G/A and 11757G/C may be more susceptible to the development of PD. Further studies are needed to replicate the associations that we observed. Psychiatry Investig 2015;12(1):112-117 Key Wordsaa Panic disorder, Brain-derived neurotrophic factor, Polymorphism.

Assessing the value of a patent is crucial not only at the licensing stage but also during the resolution of a patent infringement lawsuit. In this study, we use text mining to identify important factors associated with patent value as represented by its survival period. The variables retrieved from text mining were the Euclidian distance of patent claims between a patent and its backward cited patents, or forward cited patents, and the singular value decompositions (SVDs) of patent claims. After applying Weibull regression to 3D printing patents, the following factors were found to have significant associations with the survival time of a patent: the Euclidian distance of claims between a patent and its forward cited patents, the average number of forward citations, whether Germany is included among the family patent countries, whether the patent is transferred to another, and the presence of five SVDs. Our study is expected to contribute to enhancing patent valuation in consideration of patent infringement risk.

Makers of heavy-duty diesel engines (HDDEs) need to reduce their inventory of old-generation products in preparation for the demand for next-generation products that satisfy new emission regulations. In this paper, a new demand forecasting model is proposed to reflect special conditions raised by the technological generational shift owing to new emission regulation enforcement. In addition, sensitivity analyses are conducted to better accommodate uncertainty involved at the time of prediction. Our proposed model can help support manufacturers’ production and sales management for a series of products in response to new emission regulations.

NFAT5 (nuclear factor of activated T cells), a well-known osmoprotective factor, can be activated by isotonic stimuli such as Toll-like receptor (TLR) triggering. However, it is unclear how NFAT5 discriminates between isotonic and hypertonic stimuli to produce different functional and molecular outcomes. Here, we identified a novel XO-ROS-p38 MAPK-NFAT5 pathway (XO is xanthine oxidase, ROS is reactive oxygen species) that is activated in RAW 264.7 macrophages upon isotonic TLR stimulation. Unlike what is seen under hypertonic conditions, XO-derived ROS were selectively required for the TLR-induced NFAT5 activation and NFAT5 binding to the IL-6 promoter in RAW 264.7 macrophages under isotonic conditions. In mouse peritoneal macrophages and human macrophages, TLR ligation also induced NFAT5 activation, which was dependent on XO and p38 kinase. The involvement of XO in NFAT5 activation by TLR was confirmed in RAW 264.7 macrophages implanted in BALB/c mice. Moreover, allopurinol, an XO inhibitor, suppressed arthritis severity and decreased the expression of NFAT5 and IL-6 in splenic macrophages in C57BL/6 mice. Collectively, these data support a novel function of the XO-NFAT5 axis in macrophage activation and TLR-induced arthritis, and suggest that XO inhibitor(s) could serve as a therapeutic agent for chronic inflammatory arthritis.

Background/ContextResearch on Chinese immigrant parents tends to focus on their high levels of educational involvement and its positive impact on their children's exceptional educational performances. Relatively little research has been conducted to understand the challenges Chinese immigrant parents face in helping their children with school and the resulting influence on parent-child relations and children's adaptation.Focus of StudyIn this paper, we examined how immigration reshapes parental involvement in these Chinese immigrant families and its subsequent influence on parent-child relations.SettingThe research was conducted in the metropolitan area of a northeastern city in the United States.ParticipantsOur participants were 72 Chinese immigrant children and their parents.Research DesignOur study utilizes longitudinal interview data with open-ended questions. Open, axial, and selective coding procedures were used in qualitative data analysis.Findings/ResultsOur findings suggest that when parents face multiple challenges in their adaptation after migration, they often experience a feeling of powerlessness especially in dealing with their children's schooling. This then forces the children to be precociously independent. This dynamic puts strain on parent-child relations and has a negative impact on children's adaptation.Conclusions/RecommendationsIt is important for schools and other social institutions working with Chinese immigrant families to reach out to parents by providing them with more information and resources to be more involved in their children's education. Immigrant and local communities can also help by offering parent and youth programs to help improve parental involvement and parent-child relations in Chinese and other immigrant families.

Gonadotropin-releasing hormone (GnRH) agonist has been used in the treatment of a wide variety of sex-hormone-related diseases, as the administration of GnRH agonist can alter the secretion of gonadotropin and sex hormones. Recently, we found that the long-acting GnRH agonist aggravated hyperthyroidism and induced painless thyroiditis. This is the first report to demonstrate the association of thyroid dysfunction with GnRH agonist injection in Korea. Here, we report three cases and emphasize the clinical importance of this aggravating factor in autoimmune thyroid disease.

Bacteriocin KU24 produced by Lactococcus lactis KU24 exhibited an inhibitory effect against methicillin-resistant Staphylococcus aureus (MRSA). Bacteriocin KU24 was inactivated by protease XIV, showing that it has a proteinaceous nature on S. aureus ATCC 33591. Also, bacteriocin KU24 exhibited a strong heat stability (121 °C for 15 min) and pH stability (pH 3 to 9). The mode of inhibition was determined for S. aureus ATCC 33591 by treatment of 0, 250, and 500 AU/mL of bacteriocin KU24. S. aureus ATCC 33591 was inhibited by added bacteriocin KU24, while control was increased. The cell membranes of S. aureus ATCC 33591 were damaged with treatment of 500 AU/mL of bacteriocin KU24. Also, bacteriocin KU24 inhibited the occurrence of mecA gene, the methicillin resistance gene in S. aureus ATCC 33591. Bacteriocin KU24 was purified by C18 Sep-Pack column, cation exchange chromatography, and gel filtration chromatography, and molecular mass is approximately 6.5 kDa by sodium dodecyl sulphate-polyacrylamide gel electrophoresis. These results demonstrate that bacteriocin KU24 can be used as an alternative antimicrobial agent for the treatment of infection of MRSA in the food industry.

This study examines short-term and longitudinal associations between school-based discrimination and mental health, (i.e., self-esteem and depression) and the moderating roles of “preference for American culture” and positive school experiences, for 684 Filipino American adolescents drawn from the Children of Immigrants Longitudinal Study (CILS). Our findings suggest that school-based discrimination predicted increased levels of depression and lower levels of self-esteem in short-term but not in long-term. The shortterm negative associations between discrimination and mental health were not moderated by levels of preference for American culture, and positive school experiences decrease the negative association between discrimination and self-esteem. Implications from this study are discussed.

Children have become the target of intense and specialized food advertising efforts. This study examines the content of TV food advertising and discussed possible concerns from the perspective of children. A total of 102 ads were collected from two cable networks aimed at children. Most of the food ads used emotional appeals and did not provide information clues such as nutrition values. Ads with high sales pressure and celebrity endorsements appeared frequently and the ads for snack foods and high-carbohydrate bakery products were dominant. Understanding food ads can be a significant indicator to establish the orientation of consumer ad education and build educational programs appropriate for children. The issue that appears conspicuous in child targeted advertising and marketing is the childhood obesity and food advertising relation; subsequently, there is a need to evolve advertising that targets children into a positive educational information source.

An antimicrobial peptide produced by Bacillussubtilis KU25, KU43, and KU44 was isolated from traditional Korean fermented foods and characterized. It was named as subtilin KU25, KU43, and KU44. Subtilin KU25, KU43, and KU44 were sensitive against α-chymotrypsin, protease XIII, and various proteinase enzymes, respectively. B. subtilis KU43 was selected as the producer with the broadest antimicrobial spectrum. Subtilin KU43 was stable at a pH range of 3 to 9 for 4 h, and withstood exposure to temperatures of 50–90°C for 30 min. The mode of inhibition against Listeria monocytogenes ATCC 15313 involved a bactericidal effect by a reduction in the cell numbers and breakage of the indicator cell membranes. The molecular mass of subtilin KU43 was measured at approximately 3.5 kDa. These results demonstrate the development of novel strains from traditional Korean fermented foods, and illustrate the possibility that some of these strains might generate a natural preservative compound.

Objective.To investigate the expression of Gremlin 1 (GREM1), an antagonist of bone morphogenetic protein, in rheumatoid arthritis (RA) synovia and its involvement in the hyperplasia and invasiveness of fibroblast-like synoviocytes of RA (RA-FLS).Methods.Computational analysis was introduced to identify FLS-predominant regulators. GREM1 expression was examined by immunohistochemistry, real-time PCR, and ELISA. FLS proliferation and apoptosis were determined using tetrazolium-based colorimetric assay and APOPercentage assay, respectively. FLS migration and invasion were evaluated by wound migration and Matrigel invasion assay, respectively. Expressions of Bax, Bcl2, pErk1/2, and pAkt were detected by Western blot analysis.Results.Through global transcriptome profiling, we identified aGREM1gene predominantly expressed in RA-FLS. Indeed, the GREM1 expression was higher in synovia, synovial fluids, and FLS of patients with RA than in those of patients with osteoarthritis, and its levels correlated well with proinflammatory cytokine concentrations. Knockdown of GREM1 transcripts using short interfering RNA (siRNA) reduced the proliferation and survival of RA-FLS along with downregulation of pErk1/2, pAkt, and Bcl2 expressions, whereas it induced Bax expression. Conversely, the addition of recombinant GREM1 to RA-FLS showed the opposite results. Moreover, GREM1 siRNA decreased the migratory and invasive capacity of RA-FLS, whereas exogenous GREM1 increased it. The GREM1-induced FLS survival, migration, and invasion were completely blocked by neutralizing antibodies to ανβ3integrin on RA-FLS, suggesting that ανβ3integrin mediates the antiapoptotic and promigratory effects of GREM1.Conclusion.GREM1 is highly expressed in RA joints, and functions as a regulator of survival, proliferation, migration, and invasion of RA-FLS.

SummaryObjective Overt and subclinical hypothyroidism are risk factors for atherosclerosis and cardiovascular diseases. It is unclear whether thyroid hormone levels within the normal range are also associated with atherosclerosis measured by coronary artery calcium (CAC). Context This study aimed to examine the relationship between normal variations in thyroid function and changes in CAC. Measurements We conducted a 4-year retrospective study of 2173 apparently healthy men and women with normal thyroid hormone levels. Their free thyroxin (FT4), free triiodothyronin (FT3) and thyroid-stimulating hormone (TSH) levels were measured by electrochemiluminescent immunoassay. The CAC score (CACS) of each subject was measured by multidetector computed tomography in both 2010 and 2014. Progression of CAC was defined as a CACS change over 4 years > 0. Results The mean CACS changes over 4 years by quartiles of baseline FT4 level (lowest to highest) were 12·9, 8·43, 7·82 and 7·81 (P = 0·028). CAC progression was not significantly associated with either the baseline FT3 or TSH levels. The odds ratios (OR) for CAC progression over 4 years (highest vs lowest quartile for baseline FT4) were 0·647 (95% confidence interval (CI) 0·472–0·886) after adjustment for confounding factor, which were attenuated with further adjustment for lipid profiles, homoeostasis model assessment of insulin resistance, high-sensitivity C-reactive protein and hypertension [0·747 (95% CI 0·537–1·038)]. Quartiles of baseline FT3 or TSH level did not show any increased OR for CAC progression after adjustment for confounding factors. Conclusions In this cohort of euthyroid men and women, a low baseline FT4 level was associated with a high risk of CACS progression over 4 years.

While patents do have many advantages, their disadvantages include requiring disclosure of technical information and imposing the burden of patenting and litigation costs. In this study, we investigate the relationship between a firm’s negative perception on patents, technology management strategies, and subsequent performance. For this purpose, we use a categorical canonical correlation analysis of the top 200, large, R&D-intensive firms in Korea. We find that negative perceptions such as burdensome transaction costs, non-patenting culture, and uncertainty of the outcome of patent litigation are associated with firms’ technology management strategies, such as purchase of licenses, and subsequent performance, such as an increase in the number of inventions from the cross-fertilization of different technologies. The results of this study are expected to contribute to a better understanding of firms’ negative attitudes toward the effects of patents, their subsequent technology management strategies, and resulting performance.