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We investigate whether firm-level political connections affect the allocation of exemptions from tariffs imposed on $US 550 billion of Chinese goods imported to the United States annually beginning in 2018. Evidence points to politicians not only rewarding supporters but also punishing opponents: Past campaign contributions to the party controlling (in opposition to) the executive branch increase (decrease) approval likelihood. Our findings point to quid pro quo arrangements between politicians and firms, as opposed to the “information” channel linking political access to regulatory outcomes.
Hybrid procedure of hypoplastic left heart syndrome, comprising ductus arteriosus stenting and bilateral pulmonary artery banding, is a good surgical option for initial palliative procedure for high-risk patients for Norwood procedure. However, ductal stenting may cause retrograde aortic blood flow obstruction. Furthermore, complete removal of stent while performing the Norwood procedure make the operation more difficult. We report a case that overcame these problems using a novel surgical technique.
Functional extended redundancy analysis (FERA) was recently developed to integrate data reduction into functional linear models. This technique extracts a component from each of multiple sets of predictor data in such a way that the component accounts for the maximum variance of response data. Moreover, it permits predictor and/or response data to be functional. FERA can be of use in describing overall characteristics of each set of predictor data and in summarizing the relationships between predictor and response data. In this paper, we extend FERA into the framework of generalized linear models (GLM), so that it can deal with response data generated from a variety of distributions. Specifically, the proposed method reduces each set of predictor functions to a component and uses the component for explaining exponential-family responses. As in GLM, we specify the random, systematic, and link function parts of the proposed method. We develop an iterative algorithm to maximize a penalized log-likelihood criterion that is derived in combination with a basis function expansion approach. We conduct two simulation studies to investigate the performance of the proposed method based on synthetic data. In addition, we apply the proposed method to two examples to demonstrate its empirical usefulness.
We propose a functional version of extended redundancy analysis that examines directional relationships among several sets of multivariate variables. As in extended redundancy analysis, the proposed method posits that a weighed composite of each set of exogenous variables influences a set of endogenous variables. It further considers endogenous and/or exogenous variables functional, varying over time, space, or other continua. Computationally, the method reduces to minimizing a penalized least-squares criterion through the adoption of a basis function expansion approach to approximating functions. We develop an alternating regularized least-squares algorithm to minimize this criterion. We apply the proposed method to real datasets to illustrate the empirical feasibility of the proposed method.
This study aimed to identify the roles of community pharmacists (CPs) during the coronavirus disease 2019 (COVID-19) pandemic, the differences in their role performance compared with their perceived importance, and limiting factors.
Methods:
A cross-sectional online survey of CPs was conducted. The CPs self-measured the importance and performance of each role during the pandemic using a 5-point Likert scale. A paired t-test was used to compare each role’s importance and performance scores. A logistic regression analysis of the roles with low performance scores, despite their level of importance, was conducted to determine the factors affecting performance. The limiting factors were also surveyed.
Results:
The 436 responses to the questionnaire were analyzed. The performance scores were significantly lower than the perceived importance scores for 15 of the 17 roles. The source and update frequency of COVID-19 information and participation in outreach pharmaceutical services were associated with low performance scores. Insufficient economic compensation, the lack of communication channels, and legal limitations were the limiting factors in performing the CPs’ roles.
Conclusions:
The participation in outreach pharmaceutical services, economic compensation, and communication channel should be improved to motivate the CPs in performing their roles.
A 65-day-old girl presented to the emergency room with lethargy, requiring emergency venoarterial extracorporeal membrane oxygenation for refractory cardiogenic shock. Initially, hypoplastic left heart syndrome was suspected. However, cor triatriatum with a pinpoint opening on the membrane was diagnosed based on a detailed echocardiographic examination. After membrane resection, the left heart size was restored. However, follow-up echocardiography performed 4 months later showed occlusion of both upper pulmonary veins and stenosis in both lower pulmonary veins. Hybrid balloon angioplasty was performed in all pulmonary veins, and stents were inserted into the right upper and lower pulmonary veins. Despite repeated balloon angioplasty, all pulmonary vein stenosis progressed over 6 months and the patient expired while waiting for a heart-lung transplant. Even after successful repair of cor triatriatum, short-term close follow-up is required for detecting the development of pulmonary vein stenosis.
The “Fast track” protocol is an early extubation strategy to reduce ventilator-associated complications and induce early recovery after open-heart surgery. This study compared clinical outcomes between operating room extubation and ICU extubation after open-heart surgery in patients with CHD.
Methods:
We retrospectively reviewed 215 patients who underwent open-heart surgery for CHDs under the scheduled “Fast track” protocol between September 2016 and April 2022. The clinical endpoints were post-operative complications, including bleeding, respiratory and neurological complications, and hospital/ICU stays.
Results:
The patients were divided into operating room extubation (group O, n = 124) and ICU extubation (group I, n=91) groups. The most frequently performed procedures were patch closures of the atrial septal (107/215, 49.8%) and ventricular septal (89/215, 41.4%) defects. There were no significant differences in major post-operative complications or ICU and hospital stay duration between the two groups; however, patients in group I showed longer mechanical ventilatory support (0.0 min vs. 59.0 min (interquartile range: 17.0–169.0), p < 0.001). Patients in Group O showed higher initial lactate levels (3.2 ± 1.7 mg/dL versus 2.5 ± 2.0 mg/dL, p = 0.007) and more frequently used additional sedatives and opioid analgesics (33.1% versus 19.8%, p = 0.031).
Conclusions:
Extubation in the operating room was not beneficial for patients during post-operative ICU or hospital stay. Early extubation in the ICU resulted in more stable hemodynamics in the immediate post-operative period and required less use of sedatives and analgesics.
In this observational study conducted in 2022, 12.3% of patients who shared a room with a patient positive for severe acute respiratory coronavirus virus 2 (SARS-CoV-2) also had a positive polymerase chain reaction (PCR) test, either at initial screening or during a 5-day quarantine. Therefore, screening and quarantine are still necessary within hospitals for close-contact inpatients during the SARS-CoV-2 omicron-variant dominant period.
Age is a risk factor for numerous diseases. Although the development of modern medicine has greatly extended the human lifespan, the duration of relatively healthy old age, or ‘healthspan’, has not increased. Targeting the detrimental processes that can occur before the onset of age-related diseases can greatly improve health and lifespan. Healthspan is significantly affected by what, when and how much one eats. Dietary restriction, including calorie restriction, fasting or fasting-mimicking diets, to extend both lifespan and healthspan has recently attracted much attention. However, direct scientific evidence that consuming specific foods extends the lifespan and healthspan seems lacking. Here, we synthesized the results of recent studies on the lifespan and healthspan extension properties of foods and their phytochemicals in various organisms to confirm how far the scientific research on the effect of food on the lifespan has reached.
Coping is critical for adaptation across the lifespan. However, our knowledge of how it develops is limited by the fact that most coping theories concentrate on particular life stages. The purpose of this review is to examine similarities in theories across the lifespan to identify overlapping issues that could inform a lifespan theory of coping. Generally, individuals develop more positive and efficacious ways of coping as they age, with noted individual differences. Individuals may revert back to earlier strategies when facing new traumas or transitions. Coping is embedded within social contexts. In childhood, coping is scaffolded by parents, caregivers, and teachers, transitioning to peer influence in adolescence. In adulthood, dyadic coping within couples becomes central, although its influences on coping trajectories is largely unknown. A lifespan theory of coping should address plasticity, individual differences, social contextual, and increases in situational specificity and coping efficacy for better energy and resource management.
This study aimed to explore perceptions of the meaning of life among Korean patients living with advanced cancer.
Method
The study employed a mixed-methods design, and 16 participants were included in the analysis. Qualitative data gathered from in-depth interviews were analyzed using Colaizzi's phenomenological method. Quantitative survey data were analyzed using descriptive statistics, the Mann–Whitney U test, the Kruskal–Wallis test, and Spearman's ρ correlation.
Results
Participants experienced both the existence of meaning and the will to find meaning in terms of four categories: “interpersonal relationships based on attachment and cohesion” (three themes — family as the core meaning of one's life, supportive and dependent interconnectedness with significant others, and existential responsibility embedded in familism), “therapeutic relationships based on trust” (one theme — communication and trust between the patient and medical staff), “optimism” (two themes — positivity embodied through past experiences and a positive attitude toward the current situation), and “a sense of purpose with advanced cancer” (two themes — the will to survive and expectations for the near future). The meaning in life questionnaire (MLQ) and the purpose in life scale (PIL) showed a significant positive correlation tendency with the functional assessment of chronic illness therapy-spiritual well-being scale (FACIT-Sp). The patient health questionnaire (PHQ-9) showed significant negative correlation tendency with both the MLQ-presence of meaning (MLQ-PM) and PIL-Initiative (PIL-I) questionnaires.
Significance of results
Finding meaning in life helps advanced cancer patients realize their will to live. It also acts as a coping mechanism that palliates negative experiences in the fight against the disease. In particular, among advanced cancer patients in the Korean culture, the dynamics of relationships with family and medical staff was a key axis that instilled optimism and will to live. These results suggest that considering the meaning of life in advanced cancer patients by reflecting Korean culture in the treatment process improves the quality of care.
Accurate prognostication is important for patients and their families to prepare for the end of life. Objective Prognostic Score (OPS) is an easy-to-use tool that does not require the clinicians’ prediction of survival (CPS), whereas Palliative Prognostic Score (PaP) needs CPS. Thus, inexperienced clinicians may hesitate to use PaP. We aimed to evaluate the accuracy of OPS compared with PaP in inpatients in palliative care units (PCUs) in three East Asian countries.
Method
This study was a secondary analysis of a cross-cultural, multicenter cohort study. We enrolled inpatients with far-advanced cancer in PCUs in Japan, Korea, and Taiwan from 2017 to 2018. We calculated the area under the receiver operating characteristics (AUROC) curve to compare the accuracy of OPS and PaP.
Results
A total of 1,628 inpatients in 33 PCUs in Japan and Korea were analyzed. OPS and PaP were calculated in 71.7% of the Japanese patients and 80.0% of the Korean patients. In Taiwan, PaP was calculated for 81.6% of the patients. The AUROC for 3-week survival was 0.74 for OPS in Japan, 0.68 for OPS in Korea, 0.80 for PaP in Japan, and 0.73 for PaP in Korea. The AUROC for 30-day survival was 0.70 for OPS in Japan, 0.71 for OPS in Korea, 0.79 for PaP in Japan, and 0.74 for PaP in Korea.
Significance of results
Both OPS and PaP showed good performance in Japan and Korea. Compared with PaP, OPS could be more useful for inexperienced physicians who hesitate to estimate CPS.
Mental illness among survivors of coronavirus disease 2019 (COVID-2019) during the post-illness period is an emerging and important health issue.
Aims
We aimed to investigate the prevalence of mental illness and the associated factors for its development among COVID-2019 survivors.
Method
From 1 January to 4 June 2020, data were extracted from the National Health Insurance Service COVID-19 database in South Korea. Patients with COVID-19 were defined as those whose test results indicated that they had contracted the infection, regardless of disease severity. COVID-19 survivors were defined as those who recovered from the infection. The primary end-point was the development of mental illness, which was evaluated between 1 January and 1 December 2020.
Results
A total 260 883 individuals were included in this study, and 2.36% (6148) were COVID-19 survivors. The COVID-19 survivors showed higher prevalence of mental illness than the control group (12.0% in the COVID-19 survivors v. 7.7% in the control group; odds ratio (OR) = 2.40, 95% CI 2.21–2.61, P < 0.001). Additionally, compared with the control group, the no specific treatment for COVID-19 group (OR = 2.23, 95% CI 2.03–2.45, P < 0.001) and specific treatment for COVID-19 group (OR = 3.27, 95% CI 2.77–3.87, P < 0.001) showed higher prevalence of mental illness among survivors.
Conclusions
In South Korea, COVID-19 survivors had a higher risk of developing mental illness compared with the rest of the populations. Moreover, this trend was more evident in COVID-19 survivors who experienced specific treatment in the hospital.
Oxidative stress causes several diseases and dysfunctions in cells, including oocytes. Clearly, oxidative stress influences oocyte quality during in vitro maturation and fertilization. Here we tested the ability of coenzyme Q10 (CoQ10) to reduce reactive oxygen species (ROS) and improve mouse oocyte quality during in vitro culture. Treatment with 50 μM CoQ10 efficiently reduced ROS levels in oocytes cultured in vitro. The fertilizable form of an oocyte usually contains a cortical granule-free domain (CGFD). CoQ10 enhanced the ratio of CGFD–oocytes from 35% to 45%. However, the hardening of the zona pellucida in oocytes was not affected by CoQ10 treatment. The in vitro maturation capacity of oocytes, which was determined by the first polar body extrusion, was enhanced from 48.9% to 75.7% by the addition of CoQ10 to the culture medium. During the parthenogenesis process, the number of two-cell embryos was increased by CoQ10 from 43.5% to 67.3%. Additionally, treatment with CoQ10 increased the expression of Bcl2 and Sirt1 in cumulus cells. These results suggested that CoQ10 had a positive effect on ROS reduction, maturation rate and two-cell embryo formation in mouse oocyte culture.
Background: The purpose of this study was to find out the relationship between appropriateness of antibiotic prescription and clinical outcomes in patients with community-acquired acute pyelonephritis (CA-APN). Methods: A multicenter prospective cohort study was performed in 8 Korean hospitals from September 2017 to August 2018. All hospitalized patients aged ≥19 years diagnosed with CA-APN at admission were recruited. Pregnant women and patients with insufficient data were excluded. In addition, patients with prolonged hospitalization due to medical problems that were not associated with APN treatment were excluded. The appropriateness of empirical and definitive antibiotics was divided into “optimal,” “suboptimal,” and “inappropriate,” and optimal and suboptimal were regarded as appropriate antibiotic use. The standard for the classification of empirical antibiotics was defined reflecting the Korean national guideline for the antibiotic use in urinary tract infection 2018. The standards for the classification of definitive antibiotics were defined according to the result of in vitro susceptibility tests of causative organisms. Clinical outcomes including clinical failure (mortality or recurrence) rate, hospitalization days, and medical costs were compared between patients who were prescribed antibiotics appropriately and those who were prescribed them inappropriately. Results: In total, 397 and 318 patients were eligible for the analysis of the appropriateness of empirical and definitive antibiotics, respectively. Of these, 10 (2.5%) and 18 (5.7%) were inappropriately prescribed empirical and definitive antibiotics, respectively, and 28 (8.8%) were prescribed either empirical or definitive antibiotics inappropriately. Patients who were prescribed empirical antibiotics appropriately showed a lower mortality rate (0 vs 10%; P = .025), shorter hospitalization days (9 vs 12.5 days; P = .014), and lower medical costs (US$2,333 vs US$4,531; P = .007) compared to those who were prescribed empirical antibiotics “inappropriately.” In comparison, we detected no significant differences in clinical outcomes between patients who were prescribed definitive antibiotics appropriately and those who were prescribed definitive antibiotics inappropriately. Patients who were prescribed both empirical and definitive antibiotics appropriately showed a lower clinical failure rate (0.3 vs 7.1%; P = .021) and shorter hospitalization days (9 vs 10.5 days; P = .041) compared to those who were prescribed either empirical or definitive antibiotics inappropriately. Conclusions: Appropriate use of antibiotics leads patients with CA-APN to better clinical outcomes including fewer hospitalization days and lower medical costs.
To evaluate the impact of a vancomycin-resistant Enterococcus (VRE) screening policy change on the incidence of healthcare-associated (HA)-VRE bacteremia in an endemic hospital setting.
Design:
A quasi-experimental before-and-after study.
Setting:
A 1,989-bed tertiary-care referral center in Seoul, Republic of Korea.
Methods:
Since May 2010, our hospital has diminished VRE screening for admitted patients transferred from other healthcare facilities. We assessed the impact of this policy change on the incidence of HA-VRE bacteremia using segmented autoregression analysis of interrupted time series from January 2006 to December 2014 at the hospital and unit levels. In addition, we compared the molecular characteristics of VRE blood isolates collected before and after the screening policy change using multilocus sequence typing and pulsed-field gel electrophoresis.
Results:
After the VRE screening policy change, the incidence of hospital-wide HA-VRE bacteremia increased, although no significant changes of level or slope were observed. In addition, a significant slope change in the incidence of HA-VRE bacteremia (change in slope, 0.007; 95% CI, 0.001–0.013; P = .02) was observed in the hemato-oncology department. Molecular analysis revealed that various VRE sequence types appeared after the policy change and that clonally related strains became more predominant (increasing from 26.1% to 59.3%).
Conclusions:
The incidence of HA-VRE bacteremia increased significantly after VRE screening policy change, and this increase was mainly driven by high-risk patient populations. When planning VRE control programs in hospitals, different approaches that consider risk for severe VRE infection in patients may be required.
The explosive outbreak of COVID-19 led to a shortage of medical resources, including isolation rooms in hospitals, healthcare workers (HCWs) and personal protective equipment. Here, we constructed a new model, non-contact community treatment centres to monitor and quarantine asymptomatic and mildly symptomatic COVID-19 patients who recorded their own vital signs using a smartphone application. This new model in Korea is useful to overcome shortages of medical resources and to minimise the risk of infection transmission to HCWs.
Argument-based validity has evolved in response to the needs of language testing researchers for a systematic approach to investigating validity of the language tests. Based on a collection of 51 recent books, articles, and research reports in language assessment, this chapter describes the fundamental characteristics of an argument-based approach to validity, which has been operationalized in various ways in language assessment. These characteristics demonstrate how argument-based validity operationalizes the ideals for validation presented by Messick (1989) and accepted by most language testers: that a validity argument should be unitary, but multifacted means for integrating a variety of evidence in an ongoing validation process. The chapter describes how validity arguments serve the multiple functions that language testers demand of their validation tools, and takes into account the concepts that are important in language testing. It distinguishes between two formulations of argument-based validity that appear in language testing to introduce the conventions used throughout the papers in the volume.
Is economic development a prerequisite for concern over environmental issues? The existing literature has yet to reach an empirical consensus on this question. To revisit this important topic, we offer new experimental evidence by conducting online survey experiments in one developed country (the United States) and one developing country (India). We investigate how providing information on the negative environmental costs of foreign direct investment (FDI) affects people’s support of FDI, and how these effects differ between residents of the United States and India. The results of our experiment show that among residents of the United States, being presented with information about the environmental costs of FDI sharply reduces support for FDI, while a substantially weaker effect of the environmental costs of FDI was observed among residents of India. Also, respondents from the United States are more concerned about environmental damage caused by FDI in their own city than in a distant location, while this pattern is not observed among respondents from India. These results are consistent with the claim that economic prosperity and wealth are prerequisites for environmental concern.
When forming opinions, mass publics may implicitly or explicitly value some people’s well-being more than others. Here we examine how two forms of this phenomenon—ethnocentric valuation and moral exclusion—affect attitudes toward international trade. We hypothesize that attitudes toward competition and believing that trade is a competition moderate the extent of ethnocentric valuation and moral exclusion; although all citizens value their co-nationals’ livelihoods systematically more than those of people in trading partner countries, greater ethnocentric valuation and moral exclusion occur when trade is seen as a competition and when individuals hold more positive attitudes toward competition.
Using two survey experiments conducted on representative samples of both Americans and Canadians, we examine how differential valuation of in-country and out-country job gains and losses influences trade policy preferences. We test a series of hypotheses using multiple variables tied to competitive attitudes across two countries that differ in their attitudes toward competition.