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This study aimed to investigate the impact of parenting attitudes on the suicide risk of adolescents in South Korea, and to verify the moderating effect of out-of-school youth status. Utilizing data from the Mental Health Survey of Korean Adolescents (2021), conducted by the National Youth Policy Institute, 5,937 school youths (SYs) and 752 out-of-school youths (OSYs) were selected for this study. Multiple regression analysis was used to analyze the relationship between parenting attitudes and the impact on the suicide risk of adolescents along with the moderating effect of OSY status. Parenting attitudes consist of a total of six sub-types: warmth, autonomy support, structure, rejection, coercion and chaos. The results showed that the parenting attitude of warmth, autonomy support and rejection had a significant effect on the risk of suicide among adolescents. The study also confirmed that OSY had a moderating effect related to the parenting attitude types of structure, rejection and chaos. The result of this study filled the gap in prior research which overlooked the moderating factor of OSY related to parent attitudes and the suicide risk of adolescents. Some useful insights for practical and policy measures to reduce the suicide risk of adolescents are suggested.
Physical activities are widely implemented for non-pharmacological intervention to alleviate depressive symptoms. However, there is little evidence supporting their genotype-specific effectiveness in reducing the risk of self-harm in patients with depression.
Aims
To assess the associations between physical activity and self-harm behaviour and determine the recommended level of physical activity across the genotypes.
Method
We developed the bidirectional analytical model to investigate the genotype-specific effectiveness on UK Biobank. After the genetic stratification of the depression phenotype cohort using hierarchical clustering, multivariable logistic regression models and Cox proportional hazards models were built to investigate the associations between physical activity and the risk of self-harm behaviour.
Results
A total of 28 923 subjects with depression phenotypes were included in the study. In retrospective cohort analysis, the moderate and highly active groups were at lower risk of self-harm behaviour. In the followed prospective cohort analysis, light-intensity physical activity was associated with a lower risk of hospitalisations due to self-harm behaviour in one genetic cluster (adjusted hazard ratio, 0.28 [95% CI, 0.08–0.96]), which was distinguished by three genetic variants: rs1432639, rs4543289 and rs11209948. Compliance with the guideline-level moderate-to-vigorous physical activities was not significantly related to the risk of self-harm behaviour.
Conclusions
A genotype-specific dose of light-intensity physical activity reduces the risk of self-harm by around a fourth in depressive patients.
This study aimed to utilise graph theory to explore the functional brain networks in individuals with tic disorders and to investigate resting-state functional connectivity changes in critical brain regions associated with tic disorders.
Methods:
Participants comprised individuals with tic disorders and age-matched healthy controls, ranging from 6 to 18 years old, all recruited from Korea University Guro Hospital. We ensured a medication-naïve cohort by excluding participants exposed to psychotropic medications for at least three weeks prior to the study. Data included structural and resting-state functional MRI scans, analysed with the CONN-fMRI Functional Connectivity toolbox v20b. The analysis included 22 patients (18 males, 4 females) and 26 controls (14 males, 12 females).
Results:
Significantly increased global efficiency was observed in the left inferior frontal gyrus pars opercularis among tic disorder patients compared to controls. Furthermore, this region displayed enhanced resting-state functional connectivity with its right counterpart in patients versus controls.
Conclusion:
The inferior frontal gyrus pars opercularis, known for its inhibitory role, may reflect adaptive functional adjustments in response to tic symptoms. Increased hubness of the inferior frontal gyrus pars opercularis possibly represents functional adjustments in response to tic symptoms. The identified brain region with increased efficiency and connectivity presents a promising avenue for further research into tic expression and control mechanisms.
In this paper, we study the positivity property of the tangent bundle $T_X$ of a Fano threefold X with Picard number $2$. We determine the bigness of the tangent bundle of the whole $36$ deformation types. Our result shows that $T_X$ is big if and only if $(-K_X)^3\ge 34$. As a corollary, we prove that the tangent bundle is not big when X has a standard conic bundle structure with non-empty discriminant. Our main methods are to produce irreducible effective divisors on ${\mathbb {P}}(T_X)$ constructed from the total dual VMRT associated to a family of rational curves. Additionally, we present some criteria to determine the bigness of $T_X$.
This study presents the first Korean records of two subtropical fish species, Pseudojuloides paradiseus and Diplogrammus xenicus, collected around Jeju-do Island, as well as one boreal fish species, Erilepis zonifer, collected in Busan (approximately 200 km away from Jeju-do Island). In this study, we discuss the implications of the species’ habitat range expansion. Previously, P. paradiseus was known as an endemic species of Japan, while D. xenicus was known to inhabit the Eastern Indian Ocean and the Pacific Ocean excluding around the equator, and E. zonifer was only known to inhabit the Pacific Ocean between eastern Japan and the western USA. Their habitat range expansions might be attributed to the expansion of the Tsushima Warm Current at the surface layer and/or the North Korean Cold Current at the bottom layer. Our findings may suggest that habitat of marine fish is being changed continuously by climate change or oceanic currents. Therefore, it needs to conduct integrated and systematic monitoring of fish fauna to response changing marine biodiversity.
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.
Majority of international guidelines for bipolar disorders are based on evidences from clinical trials. In contrast, the Korean Medication Algorithm Project for Bipolar Disorder (KMAP-BP) was developed to adopt an expert-consensus paradigm which was more practical and specific to the atmosphere in Korea.
Objectives
In this study, preferred medication strategies for acute mania over six consecutively published KMAP-BP (2002, 2006, 2010, 2014, 2018, and 2022) were investigated.
Methods
A written survey using a nine-point scale was asked to Korean experts about the appropriateness of various treatment strategies and treatment agents. A written survey asked about the appropriateness of various treatment strategies and treatment agents commonly used by clinicians as the first-line.
Results
The most preferred option for the initial treatment of mania was a combination of a mood stabilizer (MS) and an atypical antipsychotic (AAP) in every edition. Preference for combined treatment for euphoric mania increased, peaked in KMAP-BP 2010, and declined slightly. Either MS or AAP monotherapy was also considered a first-line strategy for mania, but not for all types of episodes, including mixed/psychotic mania. Among MSs, lithium and valproate are almost equally preferred except in the mixed subtype where valproate is the most recommended MS. The preference of valproate showed reverse U-shaped curve. This preference change of valproate may indicate the concern about teratotoxicity in women. Quetiapine, aripiprazole, and olanzapine were the preferred AAP for acute mania since 2014. This change might depend on the recent evidences and safety profile. In cases of unsatisfactory response to initial medications, switching or adding another first-line agent was recommended. The most notable changes over time included the increasing preference for AAPs.
Conclusions
The Korean experts have been increasingly convinced of the effectiveness of a combination therapy for acute mania. There have been evident preference changes: increased for AAP and decreased for carbamazepine.
Bipolar disorder (BD) shows heterogeneous illness presentation both cross-sectionally and longitudinally. This phenotypic heterogeneity might reflect underlying genetic heterogeneity. At the same time, overlapping characteristics between BD and other psychiatric illnesses are observed at clinical and biomarker levels, which implies a shared biological mechanism between them. Incorporating these two issues in a single study design, this study investigated whether phenotypically heterogeneous subtypes of BD have a distinct polygenic basis shared with other psychiatric illnesses.
Methods
Six lifetime phenotype dimensions of BD identified in our previous study were used as target phenotypes. Associations between these phenotype dimensions and polygenic risk scores (PRSs) of major psychiatric illnesses from East Asian (EA) and other available populations were analyzed.
Results
Each phenotype dimension showed a different association pattern with PRSs of mental illnesses. PRS for EA schizophrenia showed a significant negative association with the cyclicity dimension (p = 0.044) but a significant positive association with the psychotic/irritable mania dimension (p = 0.001). PRS of EA major depressive disorder demonstrated a significant negative association with the elation dimension (p = 0.003) but a significant positive association with the comorbidity dimension (p = 0.028).
Conclusion
This study demonstrates that well-defined phenotype dimensions of lifetime-basis in BD have distinct genetic risks shared with other major mental illnesses. This finding supports genetic heterogeneity in BD and suggests a pleiotropy among BD subtypes and other psychiatric disorders beyond BD. Further genomic analyses adopting deep phenotyping across mental illnesses in ancestrally diverse populations are warranted to clarify intra-diagnosis heterogeneity and inter-diagnoses commonality issues in psychiatry.
While unemployment is known to increase the risk of suicide, its cumulative effect remains underexplored. This study investigates how unemployment affects suicide mortality and whether the effect varies based on the number of unemployment spells using two years of nationwide data.
Methods
Using the data from the National Statistical Office and Employment Insurance Database for 2018 and 2019, we identified an average of 2365 cases of suicide over two years among 7.76 million workers aged 25–64 years who had been employed within one year before their suicide. The number of unemployment spells was counted using the employment history of the past five years. We calculated crude suicide mortality rates per 100 000 population, age- and sex- standardized mortality rates (SMRs), and proportionate mortality rates (PMRs) for suicide.
Results
Over the two years, the crude suicide rate was 30.0 per 100 000 among the general population and 30.5 among workers. Workers with no unemployment spells in the past five years had a significantly lower SMR (0.44; 0.42–0.46), while those with four or more unemployment spells had a significantly higher SMR (3.13; 2.92–3.35) than the general population. These findings were consistent across all sex and age groups. Additionally, workers with four or more unemployment spells had a significantly higher PMR than the general population.
Conclusion
The impact of unemployment on suicide mortality intensifies as the number of unemployment spells increases. These results underscore the necessity for additional social and psychological support along with economic assistance for individuals facing recurrent unemployment.
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.
Comorbid depression substantially affects the management of glycemia and diabetes-related complications among patients with type 2 diabetes mellitus. In this study, we sought to determine the association between weight change over 4 years and depression risk among patients with type 2 diabetes mellitus.
Methods
This population-based retrospective cohort study from the National Health Insurance Services of Korea included 1 111 345 patients with type 2 diabetes who were divided into groups according to body weight change over 4 years. Body weight changes were compared with the preceding 4-year period (2005–2008). Depression was defined according to the International Classification of Diseases 10th revision code for depression (F32 and F33) on one or more inpatient or outpatient claims.
Results
During a median follow-up of 7.4 years, 244 081 cases of depression were identified. We observed a U-shaped association between body weight change and depression risk with a higher risk among both groups of weight loss (hazard ratio (HR) 1.17, 95% CI 1.15–1.19 for ⩾ −10%; HR 1.07, 95% CI 1.06–1.08 for −10 to −5%) and weight gain (HR 1.06, 95% CI 1.04–1.08 for ⩾10%; HR 1.02, 95% CI 1.01–1.04 for 5–10%) compared with the stable weight group (−5 to 5%).
Conclusions
A U-shaped association between body weight change and depression risk was observed in this large nationwide cohort study. Our study suggests that patients with type 2 diabetes and weight change, either gain or loss, could be considered a high-risk group for depression.
While driver telematics has gained attention for risk classification in auto insurance, scarcity of observations with telematics features has been problematic, which could be owing to either privacy concerns or favorable selection compared to the data points with traditional features.
To handle this issue, we apply a data integration technique based on calibration weights for usage-based insurance with multiple sources of data. It is shown that the proposed framework can efficiently integrate traditional data and telematics data and can also deal with possible favorable selection issues related to telematics data availability. Our findings are supported by a simulation study and empirical analysis in a synthetic telematics dataset.
Lamothe and colleagues view the nonprofit sector as being intentionally engineered or designed by government to create specific behaviors in the economy. This chapter examines the ways in which government and legal structures envision desirable outcomes in the broad economy and develop laws and policies intended to yield specific institutional state-sanctioned outcomes in the private market. Drawing on the Korean context as an example, the authors explore what government design of the social sector says about not only the strong-state context present in the global East, but also how this lens helps us to reinterpret our understanding of the legal underpinnings of the nonprofit sector elsewhere.
This study aimed to complement the previous studies conducted within a short period of time by examining the long-term trends in depression levels of older adults through a longitudinal study that includes the period following the onset of COVID-19. For analysis, this study used the data from the 12th (2017) through 16th (2021) Korea Welfare Panel Study, and 2,716 data of older adults 65 years and older were included. Variables included gender, age, equalized annual income (USD $), education background, residential area, living alone and disability status. As a result, two types of changes in depression were identified: the ‘rapidly rising’ type and the ‘steadily increasing’. We found that the lower the equalized annual income, women, the lower the education, living in urban and living alone showed a higher likelihood of belonging to the ‘rapidly rising’ type. The result suggests that those at risk of depression are at much higher risk during and after the COVID-19 pandemic. It is also necessary to provide timely and effective guidelines to prevent depression in older adults when implementing policies in response to an outbreak of infectious diseases, such as COVID-19.
In a subgroup analysis for an actuarial problem, the goal is for the investigator to classify the policyholders into unique groups, where the claims experience within each group are made as homogenous as possible. In this paper, we illustrate how the alternating direction method of multipliers (ADMM) approach for subgroup analysis can be modified so that it can be more easily incorporated into an insurance claims analysis. We present an approach to penalize adjacent coefficients only and show how the algorithm can be implemented for fast estimation of the parameters. We present three different cases of the model, depending on the level of dependence among the different coverage groups within the data. In addition, we provide an interpretation of the credibility problem using both random effects and fixed effects, where the fixed effects approach corresponds to the ADMM approach to subgroup analysis, while the random effects approach represents the classic Bayesian approach. In an empirical study, we demonstrate how these approaches can be applied to real data using the Wisconsin Local Government Property Insurance Fund data. Our results show that the presented approach to subgroup analysis could provide a classification of the policyholders that improves the prediction accuracy of the claim frequencies in case other classifying variables are unavailable in the data.
Despite the increasing demand for diverse Centella asiatica (L.) Urb. species in Korea, studies on related topics are limited, with the majority of studies focusing on functional evaluations, rather than genetic diversity. Therefore, in this study, we explored the genetic diversity of C. asiatica, a valuable medicinal plant collected from six island regions in Korea, using genotyping-by-sequencing analysis. Specifically, we aimed to understand plant genetic variations, population structure and the potential for conservation and genetic improvement. The results indicated relatively high genetic diversity among the samples collected from the six island regions but low genetic differentiation among their populations. Two distinct genetic clusters were identified; however, even within these clusters, genetic differentiation was minimal. The lack of significant isolation-by-distance patterns and evidence of potential clonal spread suggested that some individuals that adapted to colder Korean conditions achieved dominance. This study highlights the importance of assessing the genetic diversity of native C. asiatica in Korea and explores the possibility of conducting follow-up studies to understand the phytochemical content and bioactivity variations among the individuals. This information can aid in the selection of superior resources and effective utilization of plant genetic resources for cultivar development and other applications.
Cancer is a life-changing experience, and side effects from treatment can make it difficult for survivors to return to their pre-cancer “normal life.” We explored the “new normal” and barriers to achieving it among lung cancer survivors who underwent surgery.
Methods
Semi-structured interviews were conducted with 32 recurrence-free non–small cell lung cancer survivors. We asked survivors how life had changed; how they defined the “new normal”; barriers that prevent them from achieving a “normal” life; and unmet needs or support for normalcy. Thematic analysis was performed.
Results
Defining “new normal” subjectively depends on an individual’s expectation of recovery: (1) being able to do what they want without pain or discomfort; (2) being able to do activities they could accomplish before their surgery; and (3) being able to work, earn money, and support their family. We found that (1) persistent symptoms, (2) fear of cancer recurrence, (3) high expectations in recovery, and (4) psychosocial stress and guilty feelings were barriers to achieving a “new normal.” The needs and support for normalcy were information on expected trajectories, postoperative management, and support from family and society.
Significance of results
Survivors defined the “new normal” differently, depending on their expectations for recovery. Informing survivors about the “new normal” so they could expect possible changes and set realistic goals for their life after cancer. Health professionals need to communicate with survivors about expectations for “normality” from the beginning of treatment, and it should be included in comprehensive survivorship care.
In this article, we explore whether hierarchy and linearity conspire to affect agreement. The data come from an experimental study of honorific agreement between verbal si and coordinate subjects in Korean. We focus on computing the mismatch driven by honorifically mixed conjuncts. Unlike South Slavic gender agreement, Korean has neither Resolved Agreement nor First Conjunct Agreement. Only Last Conjunct Agreement is attested in Korean honorification. We show that honorific agreement within coordinate subjects is triggered only when the honorific verbal si appears, which is substantially different from the case with the honorific nominal nim. We also show that acceptability significantly decreases when the last conjunct of coordinate subjects is incongruous with an honorific verb. We thus argue that verbal honorific agreement with Korean coordinate subjects is sensitive to linear order, mimicking South Slavic gender agreement.
The aim of this study was to evaluate the impact of coronavirus disease 2019 (COVID-19) on treatment outcomes in critically ill patients with carbapenem-resistant Acinetobacter baumannii (CRAB) bloodstream infection (BSI). This single-centre, retrospective cohort study was conducted in a 1,048-bed university-affiliated tertiary hospital in the Republic of Korea from January 2021 to March 2022. The study participants included consecutive hospitalised adult patients (aged ≥18 years) in the intensive care unit with CRAB monomicrobial BSI. During the study period, a total of 70 patients were included in our study, and 24 (34.3%) were diagnosed with COVID-19. The 28-day mortality rate was 64.3%. In the multivariate Cox proportional hazard regression analysis, diagnosis of COVID-19 (hazard ratio (HR), 2.91; 95% confidence interval (CI): 1.45–5.87), neutropenia (HR, 2.76; 95% CI: 1.04–7.29), Pitt bacteraemia score (per point; HR, 1.30; 95% CI: 1.19–1.41), and appropriate definite antibiotic therapy (HR, 0.31; 95% CI: 0.15–0.62) were independent predictors of 28-day mortality in patients with CRAB BSI. In conclusion, our findings suggested that COVID-19 has a negative prognostic impact on patients with CRAB BSI. Further study is needed to investigate the specific mechanisms of how COVID-19 worsens the prognosis of CRAB infection.
The menopause transition is a vulnerable period that can be associated with changes in mood and cognition. The present study aimed to investigate whether a symptomatic menopausal transition increases the risks of depression, anxiety, and sleep disorders.
Methods
This population-based, retrospective cohort study analysed data from five electronic health record databases in South Korea. Women aged 45–64 years with and without symptomatic menopausal transition were matched 1:1 using propensity-score matching. Subgroup analyses were conducted according to age and use of hormone replacement therapy (HRT). A primary analysis of 5-year follow-up data was conducted, and an intention-to-treat analysis was performed to identify different risk windows over 5 or 10 years. The primary outcome was first-time diagnosis of depression, anxiety, and sleep disorder. We used Cox proportional hazard models and a meta-analysis to calculate the summary hazard ratio (HR) estimates across the databases.
Results
Propensity-score matching resulted in a sample of 17,098 women. Summary HRs for depression (2.10; 95% confidence interval [CI] 1.63–2.71), anxiety (1.64; 95% CI 1.01–2.66), and sleep disorders (1.47; 95% CI 1.16–1.88) were higher in the symptomatic menopausal transition group. In the subgroup analysis, the use of HRT was associated with an increased risk of depression (2.21; 95% CI 1.07–4.55) and sleep disorders (2.51; 95% CI 1.25–5.04) when compared with non-use of HRT.
Conclusions
Our findings suggest that women with symptomatic menopausal transition exhibit an increased risk of developing depression, anxiety, and sleep disorders. Therefore, women experiencing a symptomatic menopausal transition should be monitored closely so that interventions can be applied early.