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Timely access to innovative medical technologies driven by accelerated patient access pathways can substantially improve the health outcomes of patients who often have few therapeutic alternatives. We analyzed lead-times for the medical procedure reimbursement coverage process undertaken in South Korea from 2014 to 2017, which is considered one of the most important factors contributing to delays in patient access to new medical technologies.
This analysis was performed using the open datasets source of “Medical Procedure Expert Evaluation Committee (MPEEC)” meeting results and medical procedure coverage application information published on the Health Insurance Review and Assessment Service Web site.
From 2014 to 2017, 90 percent of all new coverage determinations took on average >250 days with almost 20 percent taking more than 2 years (>750 days), The average lead-time from the medical procedure coverage application to MPEEC meeting in 2015 was 435.0 ± 214.7 days (n = 26), which was significantly shorter than the average lead-time in 2014 (624.9 ± 290.3 days, n = 16) (p < .05). The average lead-time from application to official enforcement in 2015 was significantly shorter than that of 2014 (540.8 ± 217.4; n = 16 versus 734.1 ± 299.7 days; n = 26, respectively) (p < .05).
While this analysis showed a general trend of a reduction in the time taken to receive a positive coverage determination for a new medical technology, the average lead-time remains well over the government mandated 100 days. To continue this trend and further enhance the patient access pathway for medical procedure coverage determinations, some measures can be applied. In particular, the extended “One-Stop Service” program encompassing coverage determinations is one such recommendation that could be considered.
Cerebral white matter hyperintensities (WMH) are prevalent incident findings on brain MRI scans among elderly people and have been consistently implicated in cognitive dysfunction. However, differential roles of WMH by region in cognitive function are still unclear. The aim of this study was to ascertain the differential role of regional WMH in predicting progression from mild cognitive impairment (MCI) to different subtypes of dementia.
Participants were recruited from the Clinical Research Center for Dementia of South Korea (CREDOS) study. A total of 622 participants with MCI diagnoses at baseline and follow-up evaluations were included for the analysis. Initial MRI scans were rated for WMH on a visual rating scale developed for the CREDOS. Differential effects of regional WMH in predicting incident dementia were evaluated using the Cox proportional hazards model.
Of the 622 participants with MCI at baseline, 139 patients (22.3%) converted to all-cause dementia over a median of 14.3 (range 6.0–36.5) months. Severe periventricular WMH (PWMH) predicted incident all-cause dementia (Hazard ratio (HR) 2.22; 95% confidence interval (CI) 1.43–3.43) and Alzheimer's disease (AD) (HR 1.86; 95% CI 1.12–3.07). Subcortical vascular dementia (SVD) was predicted by both PWMH (HR 16.14; 95% CI 1.97–132.06) and DWMH (HR 8.77; 95% CI 1.77–43.49) in more severe form (≥ 10 mm).
WMH differentially predict dementia by region and severity. Our findings suggest that PWMH may play an independent role in the pathogenesis of dementia, especially in AD.
We present an overview of recent findings on the kinematics, age, and metallicity of globular cluster systems in nearby giant elliptical galaxies and their implications for understanding how giant elliptical galaxies formed and evolved.
The purpose of this study was to investigate whether there is any association between preeclampsia and eNOS, DDAH, and VEGF gene polymorphisms, and also to search for a possible association between haplotypes in eNOS, DDHA, and VEGF genes and the risk for preeclampsia. DNA was extracted from whole blood of 223 preeclampsia patients and 237 healthy pregnant women. The genotypes were analyzed by a single base primer extension assay using a SNaPShot assay kit. Results were analyzed with the Student's t-test, Chi-square test, and Logistic regression analysis. Haplotype analyses were performed using Haploview 3.2 version. There were no significant differences in genotype or allele frequencies of eNOS, DDAH, and VEGF gene polymorphisms between preeclampsia patients and controls. No increase in the risk of preeclampsia for those genes was observed under any model of inheritance and there were no statistically significant associations between any haplotypes and preeclampsia risk. Polymorphisms in eNOS, DDAH, and VEGF gene do not seem to be risk factors for preeclampsia.
In this study, we synthesized ZnO nanowires using Au catalytic particles formed on a ZnO seed layer. We modulated the microstructure of the ZnO seed layer by changing the sputtering power to investigate how the underlying ZnO film microstructure affects the distribution of ZnO nanowires. Examining the samples after each of the three key steps of the growth process (ZnO seed layer deposition, Au catalytic particle formation, and nanowire growth) using various characterization methods such as scanning electron microscopy, transmission electron microscopy, and x-ray diffraction helped us illuminate the profound impacts of the grain size of the seed layer on the nanowire density.
The diatoms are an ecologically important group of algae that have been extensively studied by ecologists and taxonomists. However, the large-scale patterns of diatom distribution and the factors underlying this distribution are largely unknown. The aims of this study were to identify the large-scale spatial patterns of benthic diatom assemblages in Korean streams and rivers, and to assess the importance of numerous environmental factors on diatom distribution. We classified 720 study sites based on diatom flora. Benthic diatoms, water chemistry, altitude, and riparian land cover and use were characterized by multivariate analyses, Monte Carlo permutation tests, and indicator species analysis. In total, we identified 531 diatom taxa. Diatom assemblages were mostly dominated by species of the genera Achnanthes, Navicula, Nitzschia, Cocconeis, Fragilaria (Synedra included), Cymbella, Gomphonema, and Melosira. Cluster analysis partitioned all 720 sites into eight groups based on diatom species composition. Canonical correspondence analysis indicated that altitude, land cover and use, current velocity, electrical conductivity, and nutrient levels explained a significant amount of the variation in the composition of assemblages of benthic diatoms. At the national scale, a downstream ecological gradient was apparent, from fast-flowing, mostly oligotrophic highland streams to slow-flowing, mostly eutrophic lowland rivers. Our data suggest that spatial factors explain some of the variation in diatom distribution. The present investigation of the spatial patterns of benthic diatoms, the ecological determinants of diatom occurrence, and the identification of diatom indicator species contributes to development of a program for assessing the biological integrity of lotic ecosystems in Korea.
SMART is a model to derive both star formation history and chemical evolution simultaneously from color-magnitude diagrams of resolved stars in a galaxy. We present current progress and discuss the prospects of SMART for the next decade.
The globular cluster system in M31 is an ideal laboratory for studying the formation and evolution of M31 as well as the globular clusters themselves. There have been numerous surveys and studies of the globular clusters in M31. However, only recently has the entire body of M31 been searched for globular clusters using wide-field CCD images by our group. A new era for the M31 globular cluster system has begun with the advent of wide-field CCD surveys of M31. We have discovered more than 100 new globular clusters in M31. Our catalog currently includes more than 500 globular clusters confirmed either based on spectra or HST images, many more than in the Milky Way. We present the structure, kinematics and chemical abundance of the M31 globular cluster system based on this large sample, and the implications for the formation and evolution of M31.
There has been a significant effort to create spiral sensors by changing either the periodic d-spacing of the structure or the dielectric constants of the materials by combining the multi-faceted environmental responsiveness of polymer hydrogels with dielectrical structures.1 Reversible spiral switches with dimensional functionalities that respond to chemical environment were constructed. When the spiral photonic actuator was swollen in hydrophilic acetic acid, right-handed spiral structures are formed, while the spiral photonic actuator was swollen in hydrophobic hexane, left-handed spiral structures are formed. All actuators returned back to the transparent planar state after deswelling processes. These reversible spiral photonic actuators can be applied in the application of mechanical actuators, electrical devices, and optical components.
In this study, we assess the neuropsychological profiles of both early
and late symptom-onset obsessive-compulsive disorder (OCD) patients. The
early and late-onset OCD patients are compared to the control group with a
series of neuropsychological measurements. The late-onset OCD patients
exhibited impaired performance on the immediate and the delayed recall
conditions of the Rey-Osterrieth Complex Figure Test (RCFT) and the letter
and category fluency of the Controlled Oral Word Association Test (COWA),
compared to the normal controls and the early-onset OCD patients. The
controls and early-onset OCD patients did not differ on any of the
neuropsychological measurements taken in this study. These results suggest
that different neurophysiological mechanisms are in play in early and
late-onset OCD patients, and age of onset can serve as a potential marker
for the subtyping of OCD. (JINS, 2007, 13,
We present a new numerical model of star formation history and chemical evolution using the color-magnitude diagrams of resolved stars in galaxies. Our model differs from previous models in that it generates the simulated color-magnitude diagrams with the metal enrichment law calculated from the galactic chemical evolution model. We present a case of applying our model to a resolved galaxy in the Local Group: the Sextans dwarf spheroidal galaxy. It is found the the primary origin of the radial gradient of stellar population in this galaxy is star formation followed by metallicity.
Planarization characteristics of ultra low diluted Ceria (CeO2) based slurry, especially a multi-layered Chemical Mechanical Polishing (CMP) process, have been studied. The multi-layer represents the polished film consists of more than two different materials, so that, more than two different materials are exposed to the polished surface. In this work, ultra low diluted ceria based slurry was introduced to minimize micro-dishing effect of the process such as a storage node contact and a bit line contact in 80nm feature sized DRAM device, which has multi-layer film surfaces. As a result, we can minimize micro dishing of silicon dioxide and polycrystalline silicon at memory cell area, and silicon dioxide dishing at peripheral area.
We report the discovery of three new star clusters in the halo of the Local Group dwarf irregular galaxy NGC 6822. These clusters were found in the deep images taken with the MegaPrime at the CFHT covering a total field of 2 deg $\times$ 2 deg. The most remote cluster is found to be located as far as 79 arcmin away from the center of NGC 6822. This distance is several times larger than the size of the region in NGC 6822 where star clusters were previously found. Morphological structures of the clusters and color-magnitude diagrams of the resolved stars in the clusters show that at least two of these clusters are proabably old globular clusters.
Bilayer structures consisting of ZrO2-3mol% Y2O3(TZ-3Y) and zirconia-alumina composites as inner (substrate) and outer (coating) layers, respectively, are fabricated using gel-casting for the inner layer and dip-coating for the outer layer in aqueous system. The relatively tough TZ-3Y is used as the inner layer for damage absorption due to its mechanical properties. The mixture ratio of alumina/zirconia slips for dip-coating is 1:9, 2:8, and 3:7 as mole ratio. The processing additives for gel casting, such as dispersant, monomer, dimer, and initiator, are adjusted and optimized by measuring viscosity. From which the solid loading of starting material (TZ-3Y) is determined. The optimum amount of dispersant (D-3019; anionic dispersant agent) for TZ-3Y is 0.7 wt%. The slip pH affects the electric double layer in sols, which causes the different rheological behaviors and solid loadings. The castable solid loading of TZ-3Y is 37 vol%, showing a pseudoplastic rheological behavior. The effect of slip type (different mixture ratio) on sintered body is investigated through hardness (Vickers indentation), microstructure (SEM), and strength (4-point bending tests). Strength of sintered bodies after dip-coating into the slips is higher than that before dip-coating, but hardness is not much different among cases. The effects of thickness in the outer layer on damage resistance and mechanical properties of the bilayer structures are discussed extensively.
We present a photometric study of the stars in ionizing star clusters embedded in several giant H II regions of M33 (CC93, IC 142, NGC 595, MA2, NGC 604 and NGC 588). Our photometry is based on the HST-WFPC2 images of these clusters. Color-magnitude diagrams and color-color diagrams of these clusters are obtained and are used for estimating the reddenings and ages of the clusters. The luminosity functions (LFs) and initial mass functions (IMFs) of the massive stars in these clusters are also derived. The slopes of the IMFs range from Γ = −0.5 to −2.1. Interestingly, it is found that the IMFs get steeper with increasing galactocentric distance and with decreasing [O/H] abundance.
Although a number of functional imaging studies are in agreement in suggesting orbitofrontal and subcortical hyperfunction in the pathophysiology of obsessive–compulsive disorder (OCD), the structural findings have been contradictory.
To investigate grey matter abnormalities in patients with OCD by employing a novel voxel-based analysis of magnetic resonance images.
Statistical parametric mapping was utilised to compare segmented grey matter images from 25 patients with OCD with those from 25 matched controls.
Increased regional grey matter density was found in multiple cortical areas, including the left orbitofrontal cortex, and in subcortical areas, including the thalamus. On the other hand, regions of reduction were confined to posterior parts of the brain, such as the left cuneus and the left cerebellum.
Increased grey matter density of frontal–subcortical circuits, consonant with the hypermetabolic findings from functional imaging studies, seems to exist in patients with OCD, and cerebellar dysfunction may be involved in the pathophysiology of OCD.
Strip-shaped diamond-tip field emitter array was fabricated by using the transfer mold technique. The sharp turn-on characteristic was observed from the current-voltage measurement of the fabricated diamond-tip field emitter array. The turn-on characteristic of the diamond-tip field emitter array was compared with that of a flat diamond film. High emission current density was obtained from the diamond-tip field emitter array. The threshold voltage of the diamond-tip field emitter array was lower than that of a flat diamond film.
We have investigated solid phase crystallization behavior of the MBE grown amorphous Si1-xGex (x=0 to 0.53) layers using x-ray diffractometry and transmission electron microscopy (TEM). It is found that the thermal budget of the solid phase crystallization of the film is significantly reduced as the Ge concentration in the film is increased. In addition, we find that the amorphous Si film crystallizes with a strong (111) texture while the Si1-xGex alloy film crystallizes with a (311) texture suggesting that the solid-phase crystallization mechanism is changed by the incorporation of Ge. TEM analysis of the crystallized film shows that the grain morphology of the pure Si is an elliptical or a dendrite shape with a high density of microtwins in the grains while that of the Si0.47 Ge0.53 alloy is more or less equiaxed shape with a much low density of crystalline defects in them.
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