Background: Data on antimicrobial use at the national level is crucial to establish domestic antimicrobial stewardship policies and enable medical institutions to benchmark against each other. This study aimed to analyze antimicrobial use in Korean hospitals. Methods: We investigated the antimicrobials prescribed in Korean hospitals between 2018 and 2021, using data from the Health Insurance Review and Assessment. Primary care hospitals (PCHs), secondary care hospitals (SCHs), and tertiary care hospitals (TCHs) were included in this analysis. Antimicrobials were categorized according to the Korea National Antimicrobial Use Analysis System (KONAS) classification, which is suitable for measuring antimicrobial use in Korean hospitals. Results: Out of more than 1,900 hospitals, PCHs and TCHs represented the largest and lowest percentage of hospitals, respectively. The most frequently prescribed antimicrobial in 2021 was piperacillin/β-lactamase inhibitor (9.3%) in TCHs, ceftriaxone (11.0%) in SCHs, and cefazedone (18.9%) in PCHs. Between 2018 and 2021, the most used antimicrobial class according to the KONAS classification was ‘broad-spectrum antibacterial agents predominantly used for community-acquired infections’ in TCHs and SCHs, and 'narrow spectrum beta-lactam agents' in PCH. Total consumption of antimicrobials has decreased from 951.7 to 929.9 days of therapy (DOT)/1,000 patient-days in TCHs and from 817.8 to 752.2 DOT/1,000 patient-days in SCHs during study period, but not in PCHs (from 504.3 to 527.2 DOT/1,000 patient-days). Moreover, in 2021, while use of reserve antimicrobials has decreased from 13.6 to 10.7 DOT/1,000 patient-days in TCHs and from 4.6 to 3.3 DOT/1,000 patient-days in SCHs, it has increased from 0.7 to 0.8 DOT/1,000 patient-days in PCHs. Conclusion: This study confirms that antimicrobial use differs by hospital type in Korea. Recent increases of use of antimicrobials, including reserve antimicrobials, in PCHs reflect the challenges that must be addressed.

The intensity attenuation of a high-power laser is a frequent task in the measurements of optical science. Laser intensity can be attenuated by inserting an optical element, such as a partial reflector, polarizer or absorption filter. These devices are, however, not always easily applicable, especially in the case of ultra-high-power lasers, because they can alter the characteristics of a laser beam or become easily damaged. In this study, we demonstrated that the intensity of a laser beam could be effectively attenuated using a random pinhole attenuator (RPA), a device with randomly distributed pinholes, without changing the beam properties. With this device, a multi-PW laser beam was successfully attenuated and the focused beam profile was measured without any alterations of its characteristics. In addition, it was confirmed that the temporal profile of a laser pulse, including the spectral phase, was preserved. Consequently, the RPA possesses significant potential for a wide range of applications.

Collisionless charged particle motion and its transport in the two-wire model (TWM) with no axial magnetic fields is investigated numerically. The TWM configuration contains a magnetic X-point, and single particle motions in such a field have two conserved quantities: the total kinetic energy and the base field line value which is a quantity derived from the axial canonical momentum. As gyrating particles travel along the field lines, they may reach near the X-point region where the magnetic moment, the first adiabatic invariant, can be occasionally shifted due to a large gradient of the field. When the magnetic moment becomes large, resulting in a large Larmor radius, particles probabilistically cross the X-point to migrate to the opposite side of the TWM configuration. These phenomena are investigated with single particle simulations. We find that the statistical behaviour of the seemingly chaotic magnetic moment shifts are completely determined by the two aforementioned conserved quantities, and also that there exists a threshold energy, determined by the base field line value, allowing only particles with a higher energy to cross the separatrix and migrate. It is found that the crossing time is distributed exponentially, and that the migration confinement time, which is the average crossing time, is shorter for particles with a base field line closer to the separatrix and a higher energy. We provide an empirical expression, derived with the simulations, for estimating the collisionless migration confinement time.

This study aimed to characterize the association between paranoid ideation without psychosis (PIP) and suicide attempts in a general population. A total of 12,532 adults were randomly selected as the study sample through one-person-per-household method. Subjects completed a face-to-face interview. Among 12,532 subjects, 471 (3.76%) met criteria for the PIP group. The PIP group was younger with more divorced/widowed/separated and lower income than the non-PIP group. The PIP group showed more than fivefold higher lifetime suicide attempt (LSA) rates and ninefold multiple attempt rates than the non-PIP group. Among PIP symptoms, “spouse was being unfaithful” showed the strongest association with LSA (adjusted odds ratio [AOR], 4.49; 95% confidence interval, 2.95-6.85). Major depressive disorder (MDD) in combination with PIP was associated with a higher risk of LSA (AOR, 15.39; 95% confidence interval, 9.63-24.59) compared with subjects without MDD or PIP. In conclusion, PIP, especially “doubting spouse,” was significantly associated with LSA. PIP in combination with comorbid MDD showed higher risk of LSA than subjects without PIP or MDD.

Fe-rich smectite is ubiquitous in soil environments and closely linked to the fate and mobility of hazardous trace metals and particularly to the variations in the biogeochemical redox reactions of structural Fe that determine the sorption and desorption properties of clay minerals. The biotic/abiotic redox reactions of a Fe-rich smectite, nontronite (NAu-1), were performed at various reaction times using the Fe-reducing bacterium Shewanella oneidensis MR-1 at 30°C and Na-dithionite (Na2S2O4), respectively. The extent of biotic Fe-reduction of NAu-1 after 30 days of incubation reached up to 10.7% of total Fe and the range of abiotic Fe-reduction varied from 4.9–46.6% at reaction times of 5 min, 30 min, 1 h, and 4 h. The biotically and abiotically Fe-reduced NAu-1 samples were spiked with Pb concentrations of 0.07, 0.2, 0.5, and 1.0 mg/kg and incubated under aerobic or anaerobic conditions for 24 h.

The amounts of Pb in the supernatants were analyzed using an Inductively Coupled Plasma Mass Spectrometer (ICP-MS) and Multi-collector (MC)-ICP-MS. The amounts of Pb removed from the supernatants were negatively related to the extent of Fe(III) reduction in the abiotically Fe-reduced NAu-1 samples. In contrast, less Pb (~15%) was removed from the biotically Fe-reduced NAu-1 samples with a similar extent of Fe(III) reduction. Changes in the isotopic 208/204Pb ratio indicated that the lighter 204Pb isotope was preferentially adsorbed to the NAu-1 samples with less Fe reduction and indicated that variations in the net layer charge affected isotopic fractionation. Significant differences in the 208/204Pb ratios for NAu-1 samples that were biotically Fe-reduced under anaerobic conditions were measured and indicate that the reversibility of the structural/chemical modifications that occur under redox conditions can affect Pb removal and, thus, isotope fractionation. These results collectively infer that the biogeochemical properties of clay minerals should be considered in order to understand the fate of trace metals in natural environments.

Over the past several decades, clay minerals have been applied in various bio-fields such as drug and drug additives, animal medicine and feed additives, cosmetics, biosensors, etc. Among various research areas, however, the medical application of clay minerals is an emerging field not only in academia but also in industry. In particular, cationic and anionic clays have long been considered as drug delivery vehicles for developing advanced drug delivery systems (DDSs), which is the most important of the various research fields including new drugs and medicines, in vitro and in vivo diagnostics, implants, biocompatible materials, etc., in nanomedicine. These applications are obviously related to global issues such as improvements in welfare and quality of life with life expectancy increasing. Many scientists, therefore, in various disciplines, such as clay mineralogy, material chemistry, molecular biology, pharmacology, and medical science, have been endeavoring to find solutions to such global issues. One of the strategic approaches is probably to explore new drugs possessing intrinsic therapeutic effects or to develop advanced materials with theranostic functions. With this is mind, discussions of examples of cationic and anionic clays with bio- and medical applications based on nanomedicine are relevant. In this tutorial review, nanomedicine based on clay minerals are described in terms of synthetic strategies of clay nanohybrids, in vitro and in vivo toxicity, biocompatibility, oral and injectable medications, diagnostics, theranosis, etc.

The ongoing pandemic, COVID-19 (SARS-CoV-2), has afflicted millions of people around the world, necessitating that the scientific community work, diligently and promptly, on suitable medicaments. Although vaccination programs have been run globally, the new variants of COVID-19 make it difficult to restrict the spread of the virus by vaccination alone. The combination of vaccination with anti-viral drug formulation is an ideal strategy for tackling the current pandemic situation. Drugs approved by the United States Food and Drug Administration (FDA), such as Remdesivir, have been found to be of little or no benefit. On the other hand, re-purposing of FDA-approved drugs, such as niclosamide (NIC), has offered promise but its applicability is limited due to its poor aqueous solubility and, therefore, low bioavailability. With advanced nano-pharmaceutical approaches, re-purposing this drug in a suitable drug-carrier for a better outcome may be possible. In the current study, an attempt was made to explore the loading of NIC into exfoliated layered double hydroxide nanoparticles (X-LDH NPs); prepared NIC-X-LDH NPs were further modified with eudragit S100 (ES100), an enteric coating polymer, to make the final product, ES100-NIC-X-LDH NPs, to improve absorption by the gastro/intestinal tract (GIT). Furthermore, Tween 60 was added as a coating on ES100-NIC-X-LDH NPs, not just to enhance its in vitro and in vivo stability, but also to enhance its mucoadhesive property, and to obtain, ultimately, better in vivo pharmacokinetic (PK) parameters upon oral administration. Release of NIC from Tween 60-ES100-NIC-X-LDH NPs was found to be greater under gastro/intestinal solution within a shorter period of time than the uncoated samples. The in vivo analysis revealed that Tween 60-ES100-NIC-X-LDH NPs were able to maintain a therapeutically relevant NIC plasma concentration in terms of PK parameters compared to the commercially available Yomesan®, proving that the new formulation might prove to be an effective oral drug-delivery system to deal with the SARS-CoV-2 viral infections. Further studies are required to ensure their safety and anti-viral efficacy.

Clay minerals, such as layered double hydroxide (LDH) and montmorillonite (MMT), have attracted a great deal of attention for biological applications. Along with the rapid development of nanotechnology, public concern about the potential toxicity of nanoparticles is growing. In the present work, cytotoxicity of LDH and MMT was assessed in terms of inhibition of cell proliferation, generation of oxidative stress, and induction of inflammation response. Moreover, the biokinetics of LDH and MMT were evaluated; biokinetics provides information about in vivo absorption, distribution, and excretion kinetics. The results demonstrated that both LDH and MMT inhibited cell proliferation at relatively large concentrations and after long exposure time compared to other inorganic nanoparticles, although they generated reactive oxygen species (ROS). LDH induced pro-inflammatory cytokines in a size-dependent manner. Biokinetic study revealed that, after single-dose oral administration to mice, both LDH and MMT had extremely slow oral rates of absorption and did not accumulate in any specific organ. All the results suggest great potential of clay minerals for biological application at safe levels.

Focus here is placed on the pharmaceutical and biomedical applications of novel clay-drug hybrid materials categorized by methods of administration. Clay minerals have been used for many years as pharmaceutical and medicinal ingredients for therapeutic purposes. A number of studies have attempted to explore clay-drug hybrid materials for biomedical applications with desired functions, such as sustained release, increased solubility, enhanced adsorption, mucoadhesion, biocompatibility, targeting, etc. The present review attempts not only to summarize the state-of-the-art of clay-drug hybrid materials and their advantages, depending on the methods of administration, but also to deal with challenges and future perspectives of clay mineral-based hybrids for biomedical applications.

This study focuses on analysing the heights of 10,953 Korean men aged 20 to 40 years who were measured during the Joseon dynasty, the Japanese colonialisation period, and the contemporary period, the latter including both North and South Korea. This study thus provides rare long-term statistical evidence on how biological living standards have developed over several centuries, encompassing Confucianism, colonialism, capitalism, and communism. Using error bar analysis of heights for each historical sample period, this study confirms that heights rose as economic performance improved. For instance, economically poorer North Koreans were expectedly shorter, by about 6 cm, than their peers living in the developed South. Similarly, premodern inhabitants of present-day South Korea, who produced a gross domestic product (GDP) per capita below the world average, were about 4 cm shorter than contemporary South Koreans, who have a mean income above the world average. Along similar lines, North Koreans, who have a GDP per capita akin to that of the premodern Joseon dynasty, have not improved much in height. On the contrary, mean heights of North Koreans were even slightly below (by about 2.4 cm) heights of Joseon dynasty Koreans. All in all, the heights follow a U-shaped pattern across time, wherein heights were lowest during the colonial era. Heights bounced back to Joseon dynasty levels during the interwar period, a time period where South Korea benefitted from international aid, only to rise again and surpass even premodern levels under South Korea’s flourishing market economy.

Accurate and reliable disaster forecasting is vital for saving lives and property. Hence, effective disaster management is necessary to reduce the impact of natural disasters and to accelerate recovery and reconstruction. Typhoons are one of the major disasters related to heavy rainfall in Korea. As a typhoon develops in the far ocean, satellite observations are the only means to monitor them. Our study uses satellite observations to propose a deep-learning-based disaster monitoring model for short-term typhoon rainfall forecasting. For this, we consider two deep learning models: a video frame prediction model, Warp and Refine Network (WR-Net), to predict future satellite observations and an image-to-image translation model, geostationary rainfall product (GeorAIn) (based on the Pix2PixCC model), to generate rainfall maps from predicted satellite images. Typhoon Hinnamnor, the worst typhoon case in 2022 in Korea, is selected as a target case for model verification. The results show that the predicted satellite images can capture the structures and patterns of the typhoon. The rainfall maps generated from the GeorAIn model using predicted satellite images show a correlation coefficient of 0.81 for 3-hr and 0.56 for 7-hr predictions. The proposed disaster monitoring model can provide us with practical implications for disaster alerting systems and can be extended to flood-monitoring systems.

Blood carotenoid concentration measurement is considered the gold standard for fruit and vegetable (F&V) intake estimation; however, this method is invasive and expensive. Recently, skin carotenoid status (SCS) measured by optical sensors has been evaluated as a promising parameter for F&V intake estimation. In this cross-sectional study, we aimed to validate the utility of resonance Raman spectroscopy (RRS)-assessed SCS as a biomarker of F&V intake in Korean adults. We used data from 108 participants aged 20–69 years who completed SCS measurements, blood collection and 3-d dietary recordings. Serum carotenoid concentrations were quantified using HPLC, and dietary carotenoid and F&V intakes were estimated via 3-d dietary records using a carotenoid database for common Korean foods. The correlations of the SCS with serum carotenoid concentrations, dietary carotenoid intake and F&V intake were examined to assess SCS validity. SCS was positively correlated with total serum carotenoid concentration (r = 0·52, 95 % CI = 0·36, 0·64, P < 0·001), serum β-carotene concentration (r = 0·60, 95 % CI = 0·47, 0·71, P < 0·001), total carotenoid intake (r = 0·20, 95 % CI = 0·01, 0·37, P = 0·04), β-carotene intake (r = 0·30, 95 % CI = 0·11, 0·46, P = 0·002) and F&V intake (r = 0·40, 95 % CI = 0·23, 0·55, P < 0·001). These results suggest that SCS can be a valid biomarker of F&V intake in Korean adults.

Democratic accountability relies on voters to punish their representatives for policies they dislike. Yet, a separation-of-powers system can make it hard to know who is to blame, and partisan biases further distort voters’ evaluations. During the COVID-19 pandemic, precautionary policies were put into place sometimes by governors, sometimes by mayors, and sometimes by no one at all, allowing us to identify when voters hold out-party versus in-party politicians responsible for policies. With a survey spanning 48 states, we test our theory that attitudes toward policies and parties intersect to determine when selective attribution takes place. We find that as individuals increasingly oppose a policy, they are more likely to blame whichever level of government is led by the out-party. This is most pronounced among partisans with strong in-party biases. We provide important insight into the mechanisms that drive selective attribution and the conditions under which democratic accountability is at risk.

This study provides an econometric methodology to test a linear structural relationship among economic variables. We propose the so-called distance-difference (DD) test and show that it has omnibus power against arbitrary nonlinear structural relationships. If the DD-test rejects the linear model hypothesis, a sequential testing procedure assisted by the DD-test can consistently estimate the degree of a polynomial function that arbitrarily approximates the nonlinear structural equation. Using extensive Monte Carlo simulations, we confirm the DD-test’s finite sample properties and compare its performance with the sequential testing procedure assisted by the J-test and moment selection criteria. Finally, through investigation, we empirically illustrate the relationship between the value-added and its production factors using firm-level data from the United States. We demonstrate that the production function has exhibited a factor-biased technological change instead of Hicks-neutral technology presumed by the Cobb–Douglas production function.

Sarcopenic obesity is defined as the presence of high fat mass and low muscle mass combined with low physical function, and it is closely related with the onset of cardiovasular diseases (CVD). The existing anthropometric indices, which are being utilised in clinical practice as predictors of CVD, may also be used to screen sarcopenic obesity, but their feasibility remained unknown. Using cross-sectional data of 2031 participants aged 70–84 years (mean age, 75·9 ± 3·9 years; 49·2 % women) from the Korean Frailty and Aging Cohort Study, we analysed the association of anthropometric indices, including body mass index (BMI), waist circumference (WC), waist-to-height ratio (WHtR) and weight-adjusted waist index (WWI) with sarcopenic obesity. Body composition was measured using dual-energy X-ray absorptiometry. Higher WWI, WHtR and WC quartiles were associated with higher risk of sarcopenic obesity; the odds ratio (OR) of sarcopenic obesity were highest in the fourth quartile of the WWI (OR: 10·99, 95 % CI: 4·92–24·85, P for trend < 0·001). WWI provided the best diagnostic power for sarcopenic obesity in men (area under the receiver operating characteristic curve: 0·781, 95 % CI: 0·751–0·837). No anthropometric indices were significantly associated with sarcopenic obesity in women. WWI was the only index that was negatively correlated with physical function in both men and women. WWI showed the strongest association with sarcopenic obesity, defined by high fat mass and low muscle mass combined with low physical function only in older men. No anthropometric indices were associated with sarcopenic obesity in older women.

Nosocomial transmission of COVID-19 among immunocompromised hosts can have a serious impact on COVID-19 severity, underlying disease progression and SARS-CoV-2 transmission to other patients and healthcare workers within hospitals. We experienced a nosocomial outbreak of COVID-19 in the setting of a daycare unit for paediatric and young adult cancer patients. Between 9 and 18 November 2020, 473 individuals (181 patients, 247 caregivers/siblings and 45 staff members) were exposed to the index case, who was a nursing staff. Among them, three patients and four caregivers were infected. Two 5-year-old cancer patients with COVID-19 were not severely ill, but a 25-year-old cancer patient showed prolonged shedding of SARS-CoV-2 RNA for at least 12 weeks, which probably infected his mother at home approximately 7–8 weeks after the initial diagnosis. Except for this case, no secondary transmission was observed from the confirmed cases in either the hospital or the community. To conclude, in the day care setting of immunocompromised children and young adults, the rate of in-hospital transmission of SARS-CoV-2 was 1.6% when applying the stringent policy of infection prevention and control, including universal mask application and rapid and extensive contact investigation. Severely immunocompromised children/young adults with COVID-19 would have to be carefully managed after the mandatory isolation period while keeping the possibility of prolonged shedding of live virus in mind.