To save content items to your account,
please confirm that you agree to abide by our usage policies.
If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your account.
Find out more about saving content to .
To save content items to your Kindle, first ensure email@example.com
is added to your Approved Personal Document E-mail List under your Personal Document Settings
on the Manage Your Content and Devices page of your Amazon account. Then enter the ‘name’ part
of your Kindle email address below.
Find out more about saving to your Kindle.
Note you can select to save to either the @free.kindle.com or @kindle.com variations.
‘@free.kindle.com’ emails are free but can only be saved to your device when it is connected to wi-fi.
‘@kindle.com’ emails can be delivered even when you are not connected to wi-fi, but note that service fees apply.
Identification of geographical areas with high burden of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) transmission in schools using spatial analyses has become an important tool to guide targeted interventions in educational setting. In this study, we aimed to explore the spatial distribution and determinants of coronavirus disease 2019 (COVID-19) among students aged 3–18 years in South Korea. We analysed the nationwide epidemiological data on laboratory-confirmed COVID-19 cases in schools and in the communities between January 2020 and October 2021 in South Korea. To explore the spatial distribution, the global Moran's I and Getis-Ord's G using incidence rates among the districts of aged 3–18 years and 30–59 years. Spatial regression analysis was performed to find sociodemographic predictors of the COVID-19 attack rate in schools and in the communities. The global spatial correlation estimated by Moran's I was 0.647 for the community population and 0.350 for the student population, suggesting that the students were spatially less correlated than the community-level outbreak of SARS-CoV-2. In schools, attack rate of adults aged 30–59 years in the community was associated with increased risk of transmission (P < 0.0001). Number of students per class (in kindergartens, primary schools, middle schools and high schools) did not show significant association with the school transmission of SARS-CoV-2. In South Korea, COVID-19 in students had spatial variations across the country. Statistically significant high hotspots of SARS-CoV-2 transmission among students were found in the capital area, with dense population level and high COVID-19 burden among adults aged 30–59 years. Our finding suggests that controlling community-level burden of COVID-19 can help in preventing SARS-CoV-2 infection in school-aged children.
The current research examined whether children’s expectations about labeling conventions can be influenced by limited exposure to a foreign language. Three- to four-year-old Korean children were presented with two speakers who each assigned a novel label either in Korean or Spanish to a novel object. Children were asked whether both labels were acceptable for the object. Children who had more exposure to a foreign language through live social interaction, but not through media, were more likely to accept both Korean and Spanish labels. These findings indicate the influence of social interaction in foreign language exposure on children’s understanding of different labeling conventions.
Mood disorders require consistent management of symptoms to prevent recurrences of mood episodes. Circadian rhythm (CR) disruption is a key symptom of mood disorders to be proactively managed to prevent mood episode recurrences. This study aims to predict impending mood episodes recurrences using digital phenotypes related to CR obtained from wearable devices and smartphones.
The study is a multicenter, nationwide, prospective, observational study with major depressive disorder, bipolar disorder I, and bipolar II disorder. A total of 495 patients were recruited from eight hospitals in South Korea. Patients were followed up for an average of 279.7 days (a total sample of 75 506 days) with wearable devices and smartphones and with clinical interviews conducted every 3 months. Algorithms predicting impending mood episodes were developed with machine learning. Algorithm-predicted mood episodes were then compared to those identified through face-to-face clinical interviews incorporating ecological momentary assessments of daily mood and energy.
Two hundred seventy mood episodes recurred in 135 subjects during the follow-up period. The prediction accuracies for impending major depressive episodes, manic episodes, and hypomanic episodes for the next 3 days were 90.1, 92.6, and 93.0%, with the area under the curve values of 0.937, 0.957, and 0.963, respectively.
We predicted the onset of mood episode recurrences exclusively using digital phenotypes. Specifically, phenotypes indicating CR misalignment contributed the most to the prediction of episodes recurrences. Our findings suggest that monitoring of CR using digital devices can be useful in preventing and treating mood disorders.
Low rates of bystander cardiopulmonary resuscitation (CPR) were identified as a shortcoming in the “chain of survival” for out-of-hospital cardiac arrest (OHCA) care in the Korean city of Ansan. This study sought to evaluate the effect of an initiative to increase bystander CPR and quality of out-of-hospital resuscitation on outcome from OHCA. The post-intervention data were used to determine the next quality improvement (QI) target as part of the “Plan-Do-Study-Act” (PDSA) model for QI.
The study hypothesis was that bystander CPR, return of spontaneous circulation (ROSC), and survival to discharge after OHCA would increase in the post-intervention period.
This was a retrospective pre/post study. The data from the pre-intervention period were abstracted from 2008–2011 and the post-intervention period from 2012–2013. The effect of the intervention on the odds of ROSC and survival to hospital discharge was determined using a generalized estimating equation to account for confounders and the effect of clustering within medical centers. The analysis was then used to identify other factors associated with outcomes to determine the next targets for intervention in the chain of survival for cardiac arrest in this community.
Rates of documented bystander CPR increased from 13% in the pre-intervention period to 37% in the post-intervention period. The overall rate of ROSC decreased from 18.4% to 14.3% (risk difference −4.1%; 95% CI, −7.1%–1.0%), whereas survival to hospital discharge increased from 3.9% to 5.0% (risk difference 1.1%; 95% CI, −1.8%–3.8%), and survival with good neurologic outcome increased from 0.8% to 1.6% (risk difference 0.8%; 95% CI, −0.8%–2.4%). In multivariable analyses, there was no association between the intervention and the rate of ROSC or survival to hospital discharge. The designated level of the treating hospital was a significant predictor of both survival and ROSC.
In this case study, there were no observed improvements in outcomes from OHCA after the targeted intervention to improve out-of-hospital CPR. However, utilizing the PDSA model for QI, the designated level of the treating hospital was found to be a significant predictor of survival in the post-period, identifying the next target for intervention.
Hyperlipidaemia is a major cause of atherosclerosis and related CVD and can be prevented with natural substances. Previously, we reported that a novel Bacillus-fermented green tea (FGT) exerts anti-obesity and hypolipidaemic effects. This study further investigated the hypotriglyceridaemic and anti-obesogenic effects of FGT and its underlying mechanisms. FGT effectively inhibited pancreatic lipase activity in vitro (IC50, 0·48 mg/ml) and ameliorated postprandial lipaemia in rats (26 % reduction with 500 mg/kg FGT). In hypertriglyceridaemic hamsters, FGT administration significantly reduced plasma TAG levels. In mice, FGT administration (500 mg/kg) for 2 weeks augmented energy expenditure by 22 % through the induction of plasma serotonin, a neurotransmitter that modulates energy expenditure and mRNA expressions of lipid metabolism genes in peripheral tissues. Analysis of the gut microbiota showed that FGT reduced the proportion of the phylum Firmicutes in hamsters, which could further contribute to its anti-obesity effects. Collectively, these data demonstrate that FGT decreases plasma TAG levels via multiple mechanisms including inhibition of pancreatic lipase, augmentation of energy expenditure, induction of serotonin secretion and alteration of gut microbiota. These results suggest that FGT may be a useful natural agent for preventing hypertriglyceridaemia and obesity.
Personality may predispose family caregivers to experience caregiving differently in similar situations and influence the outcomes of caregiving. A limited body of research has examined the role of some personality traits for health-related quality of life (HRQoL) among family caregivers of persons with dementia (PWD) in relation to burden and depression.
Data from a large clinic-based national study in South Korea, the Caregivers of Alzheimer's Disease Research (CARE), were analyzed (N = 476). Path analysis was performed to explore the association between family caregivers’ personality traits and HRQoL. With depression and burden as mediating factors, direct and indirect associations between five personality traits and HRQoL of family caregivers were examined.
Results demonstrated the mediating role of caregiver burden and depression in linking two personality traits (neuroticism and extraversion) and HRQoL. Neuroticism and extraversion directly and indirectly influenced the mental HRQoL of caregivers. Neuroticism and extraversion only indirectly influenced their physical HRQoL. Neuroticism increased the caregiver's depression, whereas extraversion decreased it. Neuroticism only was mediated by burden to influence depression and mental and physical HRQoL.
Personality traits can influence caregiving outcomes and be viewed as an individual resource of the caregiver. A family caregiver's personality characteristics need to be assessed for tailoring support programs to get the optimal benefits from caregiver interventions.
The Sewol ferry disaster is one of the most tragic events in Korea’s modern history. Among the 476 people on board, which included Danwon High School students (324) and teachers (14), 304 passengers died in the disaster (295 recovered corpses and 9 missing) and 172 survived. Of the rescued survivors, 72 were attending Danwon High School, located in Ansan City, and residing in a residence nearby. Because the students were young, emotionally susceptible adolescents, both the government and the parents requested the students be grouped together at a single hospital capable of appropriate psychiatric care. Korea University Ansan Hospital was the logical choice, as the only third-tier university-grade hospital with the necessary faculty and facilities within the residential area of the families of the students. We report the experiences and the lessons learned from the processes of preparing for and managing the surviving young students as a community-based hospital. (Disaster Med Public Health Preparedness. 2017;11:389–393)
A cylindrical-shaped micropillar array embedded microfluidic device was proposed to enhance the dispersion of cell clusters and the efficiency of single cell encapsulation in hydrogel. Different sizes of micropillar arrays act as a sieve to break Escherichia coli (E. coli) aggregates into single cells in polyethylene glycol diacrylate (PEGDA) solution. We applied the external force for the continuous breakup of cell clusters, resulting in the production of more than 70% of single cells into individual hydrogel particles. This proposed strategy and device will be a useful platform to utilize genetically modified microorganisms in practical applications.
Cancer is a leading cause of death, and the dietary pattern in Korea is changing rapidly from a traditional Korean diet to a Westernised diet. In the present study, we investigated the effects of dietary factors on cancer risk with a prospective cohort study. Among 26 815 individuals who participated in cancer screening examinations from September 2004 to December 2008, 8024 subjects who completed a self-administered questionnaire concerning demographic and lifestyle factors, and a 3 d food record were selected. As of September 2013, 387 cancer cases were identified from the National Cancer Registry System, and the remaining individuals were included in the control group. The hazard ratio (HR) of cancer for the subjects older than or equal to 50 years of age was higher (HR 1·80, 95 % CI 1·41, 2·31; P< 0·0001) than that for the other subjects. Red meat consumption, Na intake and obesity (BMI ≥ 25 kg/m2) were positively associated with overall cancer incidence in men (HR 1·41, 95 % CI 1·02, 1·94; P= 0·0382), gastric cancer (HR 2·34, 95 % CI 1·06, 5·19; P= 0·0365) and thyroid cancer (HR 1·56, 95 % CI 1·05, 2·31; P= 0·0270), respectively. Participants who had at least three dietary risk factors among the high intakes of red meat and Na, low intakes of vegetables and fruits, and obesity suggested by the World Cancer Research Fund/American Institute for Cancer Research at baseline tended to have a higher risk of cancer than the others (HR 1·26, 95 % CI 0·99, 1·60; P= 0·0653). In summary, high intakes of red meat and Na were significant risk factors of cancer among Koreans.
Objectives: The aim of this study was to systematically assess the long-term (≥ 6 months) benefits of epidural steroid injection therapies for patients with low back pain.
Methods: We identified randomized controlled trials by database searches up to October 2011 and by additional hand searches without language restrictions. Randomized controlled trials on the effects of epidurals for low back pain with follow-up for at least 6 months were included. Outcomes considered were pain relief, functional improvement in 6 to 12 months after epidural steroid injection treatment and the number of patients who underwent subsequent surgery. Meta-analysis was performed using a random-effects model.
Results: Twenty-nine articles were selected. The meta-analysis suggested that a significant treatment effect on pain was noted at 6 months of follow-up (weighted mean difference [WMD], −0.41; 95 percent confidence interval [CI], −0.66 to −0.16), but was no longer statistically significant after adjusting for the baseline pain score (WMD, −0.19; 95 percent CI, −0.61 to 0.24). Epidural steroid injection did not improve back-specific disability more than a placebo or other procedure. Epidural steroid injection did not significantly decrease the number of patients who underwent subsequent surgery compared with a placebo or other treatments (relative risk, 1.02; 95 percent CI, 0.83 to 1.24).
Conclusions: A long-term benefit of epidural steroid injections for low back pain was not suggested at 6 months or longer. Introduction of selection bias in the majority of injection studies seems apparent. Baseline adjustment is essential when we evaluate pain as a main outcome of injection therapy.
Conus medullaris syndrome (CMS) is a clinical neurologic syndrome caused by a conus medullaris lesion. CMS is a heterogeneous entity with various etiologies such as trauma or a space-occupying lesion. Multiple cases of CMS following spinal anesthesia have been reported, but CMS after radioisotope (RI) cisternography has not yet been reported.
We present four patients who developed CMS after RI cisternography.
All experienced neurological deficits such as paraparesis, sensory loss, and urinary incontinence three to four days after RI cisternography. Two showed abnormalities on lumbar magnetic resonance imaging, and three had complete symptom resolution within ten weeks.
The pathomechanism of the CMS is unclear, but we hypothesize that RI neurotoxicity might be responsible. It is possible that the use of low-dose 99mTc-DTPA or an alternative diagnostic tool such as magnetic resonance cisternography could help to prevent this complication.
Stream restoration is an important process affecting the ecological health of stream ecosystems. There have been numerous cases of restoration, dealing with either structural or biological changes. In Korea, most restoration projects have merely dealt with improving hydrological characteristics or water quality; however, in recent years the improvement of ecological characteristics has been an increasing focus for restoration projects. In this study, we utilized data collected from 5675 stream sites in May 2007 to discover general patterns of anthropogenic modification in Korean streams. The survey results after application of the stream modification index (SMI; presence or absence type; high scores indicate more disturbed) provided a general distribution of disturbed/undisturbed streams or rivers in the watershed. We then compared the level of modification with the socio-geographical patterns (population, land coverage, elevation, and slope) for the watershed. The results show that streams in highly populated areas suffered from human modification compared with other well-preserved stream sites. In metropolitan cities, urbanized areas had positive relationship as identified by a high SMI. On the other hand, agricultural land cover identified an SMI increase for lowland river area. In general, mountainous streams possessed a better status in stream morphology due to different land-cover patterns (i.e., mainly forested area); however, some mountainous areas were impacted by concentrated summer rainfall. We could distinguish the forcing variables (i.e., land use pattern) for the disturbed streams through a comparison between the SMI and geographical information; the SMI application was able to identify areas of high necessity for restoration.
Despite numerous previous studies, relationships between watershed land use and adjacent streams and rivers at various scales in Korea remain unclear. This study investigated the relationships between land uses and the physical, chemical, and biological characteristics of 720 sites of streams and rivers across the country. The land uses at two spatial scales, including a 1-km buffer and the base watershed management region (BWMR), were computed in a geographical information system (GIS) with a digital land use/land cover map. Characteristics of land uses at two spatial scales were then correlated with the monitored multidimensional characteristics of the streams and rivers. The results of this study indicate that land use types have significant effects on stream and river characteristics. Specifically, most characteristics were negatively correlated with the proportions of urban, rice paddy, agricultural, and bare soil areas and positively correlated with the amount of forest. The site-scale and BWMR-scale analyses suggest that BWMR land use patterns were more strongly related to ecological integrity than they were to site land use patterns. Improving our understanding of land use effects will largely depend on relating the results of site-specific studies that use similar response techniques and measures to evaluate ecological integrity. In addition, our results clearly indicate that the characteristics of streams and rivers are closely linked and that land use types differentially affect those characteristics. Thus, effective restoration and management for ecological integrity of lotic system should consider the physical, chemical, and biological factors in combination.
Modified embedded-atom method (MEAM) interatomic potentials for Nb-C, Nb-N, Fe-Nb-C, and Fe-Nb-N systems have been developed based on the previously developed MEAM potentials for lower order systems. The potentials reproduce various fundamental physical properties (structural properties, elastic properties, thermal properties, and surface properties) of NbC and NbN, and interfacial energy between bcc Fe and NbC or NbN, in generally good agreement with higher-level calculations or experimental information. The applicability of the present potentials to atomic-level investigations to the precipitation behavior of complex-carbonitrides (Nb,Ti)(C,N) as well as NbC and NbN, and their effects on the mechanical properties of steels are also discussed.
This article reports on low (below 800 °C) melting temperature characteristics of a Zr-Ti-Ni-Cu alloy system, designed by adding a small amount of Cu to a Zr-Ti-Ni eutectic alloy system in the Zr-rich corner of the Zr-Ti-Ni system. A series of Zr-Ti-Ni-Cu-based alloy buttons of varying Cu content was fabricated by an arc melting machine. The melting temperature ranges of the quaternary alloys were systematically examined by differential thermal analysis (DTA). As a result, a quaternary eutectic alloy of composition Zr54Ti22Ni16Cu8 with a low melting temperature range from 774 °C to 783 °C was found. In addition, structural and chemical analysis results for the slowly solidified, quaternary eutectic alloy sample revealed equivalent quaternary eutectic structure and phases to those of the ternary eutectic Zr50Ti26Ni24 alloy, except for a small amount of Cu dissolved in individual constituent phases. The wetting angle tested at 800 °C for 60 s on the commercially pure titanium was about 25°.
Unlike the dislocation-based plasticity in crystalline metals, which can be readily explained by their crystal structure and the presence of defects, the nature of the plasticity in amorphous alloys is not completely understood. Experiments have shown that the plasticity in amorphous alloys is strongly dependent on their atomic packing density. This study, based on the combination of experimental and computational techniques, examines the origin of the plasticity in amorphous alloys considering characteristics of the inherent atomic-scale structure as defined by short-range ordered (SRO) clusters. The role of various SRO atomic clusters in creating free volume during shear deformation is discussed. We report that the plasticity exhibited by amorphous alloys is very sensitive to the characteristics of the atomic packing state, which can be described by various SRO atomic structures and quantified by the effective activation energy for crystallization.
A mucin coat is deposited on rabbit embryos during passage through the oviduct; rabbit blastocysts cultured from the 1-cell stage in vitro have no mucin coat. When cultured blastocysts are transferred to recipients, the lack of mucin coat might account in part for subsequent failure of pregnancy. We have investigated the possibility that mucin coat deposition is induced following transfer of in vitro 72 h-cultured blastocysts to oviducts of asynchronous or synchronous recipients. One-cell embryos were collected by flushing oviducts 19–20 h post-coitus and were cultured in vitro for 72 h until they reached the blastocyst stage. The blastocysts were transferred to the oviducts of recipients that were synchronized either with the donors (synchronous) or 1 day later than the donors (asynchronous). They were recovered after 24–48 h and the mucin coat thickness and embryo degeneration rate were measured. The degeneration rate of blastocysts recovered from uteri of synchronous recipients was higher than that from asynchronous recipients (72.2% vs 40.0%). The mucin coats around embryos recovered from oviducts of asynchronous recipients after 48 h were thicker than those from synchronous recipients. More asynchronous recipients were pregnant and gave birth to more pups than synchronous recipients. These results indicate that the oviducts of asynchronous recipients secreted more mucin around the transferred embryos, causing higher rates of implantation of the in vitro-cultured blastocysts.
In order to decrease the silica content in 16% Cr ferritic stainless steel,
the phases present in deoxidized inclusions were predicted by the FACT model.
To decrease the amount of deoxidized inclusions and slag inclusions in the melt,
the capacity of alumina absorption was compared using different top slags. In trial tests,
the cleanliness of slabs was significantly improved in 16% Cr ferritic
stainless steel produced by AOD processes and the number of surface defects
of cold coils was also significantly reduced.
Based on a structure model of mixture of phases, the crystal structure analysis of (Ba1−xLax)[Mg(1+x)/3Nb(2−x)/3]O3 (BLMN) (x = 0.9 and 1.0) by Rietveld refinements was carried out. The pure La(Mg2/3Nb1/3)O3 (LMN) and BLMN (x=0.9) actually consist of a two-phase mixture rather a single phase. One is Fm-3m, which is cubic and 1:1 ordered and the other is P21/n, which is monoclinic and has both 1:1 ordering and the antiphase and inphase tilting of oxygen octahedra with a−a−c+. The weight fraction of the Fm-3m phase is 17.5% at x=0.9 and further decreases to 7.5% in pure LMN. Meanwhile, that of the P21/n phase is 82.5% at x =0.9 and further increases to 92.5% in pure LMN. The I4/m phase, which is present as a minor phase from x=0.3 to 0.7, disappeared when x≥0.9. The abrupt change of the x-ray diffraction pattern at x=0.9 is caused by a change of major phase from Fm-3m to P21/n phase in the matrix.