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Smectite- and zeolite-dominated assemblages occur at different depths within the same volcanic tuff sequence at the study site, indicating variability in post-depositional alteration conditions. The present study investigated the geological and environmental factors associated with the vertical mineralogical differences using outcrop and core samples from Pohang, South Korea. Mineralogical, geochemical, thermal, spectroscopic, and microbial analyses were conducted on representative samples. The outcrop samples contain Ca-smectite, cristobalite, and amorphous aluminosilicates, whereas the core samples contain zeolite (clinoptilolite and mordenite), quartz, and feldspar. (Na,Ca)-smectite occurs only at specific depths within the core. Major- and trace-element geochemistry indicates that the outcrop and core samples were derived from rhyolitic and andesitic precursors, respectively. Chondrite-normalized rare earth element patterns show no evidence of hydrothermal enrichment or depletion, suggesting diagenesis as the dominant alteration process. Bacterial community compositions, used as environmental indicators, indicate contrasting formation environments: the outcrop samples represent anaerobic, freshwater conditions, whereas the core samples reflect aerobic and saline conditions. Mössbauer spectra independently support these redox differences, showing structurally bound Fe within smectite in the outcrop sample and hematite-magnetite assemblages in the core samples. These results indicate that variations in precursor composition, salinity, and redox conditions were closely associated with the development of contrasting smectite- and zeolite-bearing assemblages within the same volcanic sequence.
Objectives: Neonatal intensive care unit (NICU) admits premature babies and neonates with acute illness who are under high infection risk due to immature immune response system. Infections caused by carbapenem- resistant Enterobacterales (CRE) is a serious threat to such patient population. A single case of CRE infection occurred in 36-bed NICU on July 2023. Infection control measures were put in place to prevent further CRE infection within the NICU. Methods: A neonate delivered at gestational age of 23 weeks and 6 days with birth weight of 650g was under mechanical ventilator care. On 35th day of life, CRE (Escherichia coli, New Delhi metallo-beta- lactamase-1 positive) was isolated from this neonate’s endotracheal suction material. After discussion with infection control physician, the bacterial culture was determined to have been resulted from colonization or localized infection, rather than invasive infection. Five measures were taken to prevent additional infection within the NICU. One, contact precaution was issued for CRE-infected baby, and an isolation ward and a designated nurse was assigned for the baby to prevent cross infection. Two, adherence to hand hygiene and personal protective equipment (PPE) application was monitored for medical personnel and visitors entering the NICU. Three, a checklist was designed specifically for disinfection of NICU isolation ward, and the designated cleaner and assistants were educated on the checklist. Four, testing with fluorescent markers was performed to validate cleaning. Five, the infectious disease specialist and the pharmacy analyzed the prescription pattern of broad-spectrum antibiotic among patients in NICU for systematic antibiotic regulation. Results: The following results were obtained after 2 weeks of infection control measures. 57 subjects underwent hand hygiene monitoring, on which 15.8%(9 case) of the subjects unadequately passed. Immediate feedback was provided upon these detections. Cleaning validation detected a single cases of inadequate disinfection (door to isolation ward), for which re-cleaning and education was performed. An increasing trend in consumption of 3rd generation cephalosporin (8.96% in April 2023 to 21.21% in June 2023) was found, and the neonatology department was advised to be more selective in prescription of broad- spectrum antibiotics. Conclusions: There was no CRE infection for 6 months following infection control measures. This case was determined to be an isolated case of CRE infection, and no further surveillance culture was obtained. Proactive infection control measures, including contact isolation, hand hygiene, environment cleaning, and regulation of broad-spectrum antibiotics, are necessary to prevent secondary infections that may follow an index CRE infection in the NICU.
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.
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.
In this review, we introduce our recent applications of deep learning to solar and space weather data. We have successfully applied novel deep learning methods to the following applications: (1) generation of solar farside/backside magnetograms and global field extrapolation based on them, (2) generation of solar UV/EUV images from other UV/EUV images and magnetograms, (3) denoising solar magnetograms using supervised learning, (4) generation of UV/EUV images and magnetograms from Galileo sunspot drawings, (5) improvement of global IRI TEC maps using IGS TEC ones, (6) one-day forecasting of global TEC maps through image translation, (7) generation of high-resolution magnetograms from Ca II K images, (8) super-resolution of solar magnetograms, (9) flare classification by CNN and visual explanation by attribution methods, and (10) forecasting GOES solar X-ray profiles. We present major results and discuss them. We also present future plans for integrated space weather models based on deep learning.
We compared the pregnancy and live birth rates following transfer of early-stage embryos or blastocysts produced by somatic cell nuclear transfer using in vitro-matured oocytes. In total 102 ovaries were collected from dromedary camels at a local abattoir; from these 1048 cumulus–oocytes complexes (COCs) were aspirated and cultured for 42 h in a commercial maturation medium. Metaphase II oocytes were subjected to nuclear transfer. Somatic cell nuclear transfer-derived embryos were cultured in a commercial embryo medium for 2 or 7 days. Next, 71 early-stage embryos were surgically transferred to the left fallopian tube of 28 recipients and 47 blastocysts were transferred to the left uterine horn of 26 recipients. Early pregnancy was detected by serum progesterone (P4), and pregnancy was confirmed using ultrasonography on days 30 and 90 after embryo transfer. Pregnancy rate based on P4 level was 17.86% (5/28) and 11.54% (3/26) for early-stage embryo and blastocyst transfer, respectively. In the early-stage embryo group, out of five recipients, one recipient had lost the pregnancy by the first ultrasonography on day 30; two other recipients aborted at 14 and 24 weeks, and two recipients gave live births. In the blastocyst group, out of three recipients, one lost the pregnancy at an early stage and two recipients gave live births. Therefore, for dromedary camels, we recommend transvaginal blastocyst transfer from the standpoint of the pregnancy and live birth rate, ease of the transfer procedure, and comfort and safety of the recipients.
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.
Background: Recently, healthcare-associated infections (HAIs) in long-term care hospitals (LTCHs) have markedly increased, but no infection control policy has been established in South Korea. We investigated the current HAI surveillance system and executed a point-prevalence pilot study in LTCHs. Methods: HAIs were defined by newly established surveillance manual based on McGeer criteria revised in 2012. Three LTCHs in Seoul and Gyeonggi province were voluntarily recruited, and data were collected from up to 50 patients who were hospitalized on August 1. The medical records from September to November 2018 were retrospectively reviewed by a charge nurse for infection control per each hospitals after 1 day of training specific for LTCH surveillance. All data were reviewed by a senior researcher visiting onsite. Results: The participating hospitals had 272.33 ± 111.01 beds. Only 1 hospital had an onsite microbiological laboratory. In total, 156 patients were enrolled and 5 HAIs were detected, for a prevalence rate of 3.2%. The average patient age was 79.04 ± 9.92 years. The HAIs included 2 urinary tract infections, skin and soft-tissue infection, low respiratory infection, and conjunctivitis. Conclusions: This is the first survey of HAI in LTCHs in South Korea. The 3.2% prevalence rate is lower than those from previous reports from the European Union or the United States. This study supports the development of a national HAI surveillance and infection control system in LTCHs, although implementation may be limited due to the lack of laboratory support and infection control infrastructure in Korea.
We report our experience with an emergency room (ER) shutdown related to an accidental exposure to a patient with coronavirus disease 2019 (COVID-19) who had not been isolated.
Setting:
A 635-bed, tertiary-care hospital in Daegu, South Korea.
Methods:
To prevent nosocomial transmission of the disease, we subsequently isolated patients with suspected symptoms, relevant radiographic findings, or epidemiology. Severe acute respiratory coronavirus 2 (SARS-CoV-2) reverse-transcriptase polymerase chain reaction assays (RT-PCR) were performed for most patients requiring hospitalization. A universal mask policy and comprehensive use of personal protective equipment (PPE) were implemented. We analyzed effects of these interventions.
Results:
From the pre-shutdown period (February 10–25, 2020) to the post-shutdown period (February 28 to March 16, 2020), the mean hourly turnaround time decreased from 23:31 ±6:43 hours to 9:27 ±3:41 hours (P < .001). As a result, the proportion of the patients tested increased from 5.8% (N=1,037) to 64.6% (N=690) (P < .001) and the average number of tests per day increased from 3.8±4.3 to 24.7±5.0 (P < .001). All 23 patients with COVID-19 in the post-shutdown period were isolated in the ER without any problematic accidental exposure or nosocomial transmission. After the shutdown, several metrics increased. The median duration of stay in the ER among hospitalized patients increased from 4:30 hours (interquartile range [IQR], 2:17–9:48) to 14:33 hours (IQR, 6:55–24:50) (P < .001). Rates of intensive care unit admissions increased from 1.4% to 2.9% (P = .023), and mortality increased from 0.9% to 3.0% (P = .001).
Conclusions:
Problematic accidental exposure and nosocomial transmission of COVID-19 can be successfully prevented through active isolation and surveillance policies and comprehensive PPE use despite longer ER stays and the presence of more severely ill patients during a severe COVID-19 outbreak.
Despite their importance in the formation and evolution of stellar clusters and galaxies, the formation of high-mass stars remains poorly understood. We recently started a systematic observational study of the 22 GHz water and 44 GHz class I methanol masers in high-mass star-forming regions as a four-year KaVA large program. Our sample consists of 87 high-mass young stellar objects (HM-YSOs) in various evolutionary phases, many of which are associated with two or more different maser species. The primary scientific goals are to measure the spatial distributions and 3-dimensional velocity fields of multiple maser species, and understand the dynamical evolution of HM-YSOs and their circumstellar structures, in conjunction with follow-up observations with JVN/EAVN (6.7 GHz class II methanol masers), VERA, and ALMA. In this paper we present details of our KaVA large program, including the first-year results and observing/data analysis plans for the second year and beyond.
Objectives: The aim of this study was to predict the potential impact of the introduction of implantation of polyurethane scaffold for the treatment of partial meniscal lesions in the South Korean healthcare system.
Methods: The horizon scanning process was used to select a target technology and assess its potential impacts on patients and the Korean healthcare system. We identified and filtered research-phase health technologies that are not listed yet in Korean, but appear promising. After a process of prioritization, we chose the implantation of polyurethane scaffolds as a target technology. Then, through the procedures of assessment and peer review, we analyzed current evidence and its predicted potential impacts.
Results: There were eight studies included in the review: one prospective cohort and seven case-series studies. Six revealed significant improvements in function and pain relief. Of the six studies, which reported safety endpoints, four stated no major postoperative complications related to scaffold, and two reported adverse events and serious adverse events such as pain, joint swelling, et cetera. We also included the potential impact of this technology based on the experts’ consultation. They all agreed that it would satisfy the diverse needs of patients and fulfill clinical needs. However, the majority of related clinical studies were based on short-term follow-up observations without any validation process involving comparison with control groups.
Conclusions: Through a horizon scanning activity, we found that the implantation of polyurethane scaffolds is a promising technology to resolve articular cartilage defects; however, long-term evidence with comparison groups for safety and effectiveness is required.
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.
Methods:
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.
Results:
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).
Conclusions:
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.
Many transgenic domestic animals have been developed to produce therapeutic proteins in the mammary gland, and this approach is one of the most important methods for agricultural and biomedical applications. However, expression and secretion of a protein varies because transgenes are integrated at random sites in the genome. In addition, distal enhancers are very important for transcriptional gene regulation and tissue-specific gene expression. Development of a vector system regulated accurately in the genome is needed to improve production of therapeutic proteins. The objective of this study was to develop a knock-in system for expression of human fibroblast growth factor 2 (FGF2) in the bovine β-casein gene locus. The F2A sequence was fused to the human FGF2 gene and inserted into exon 3 of the β-casein gene. We detected expression of human FGF2 mRNA in the HC11 mouse mammary epithelial cells by RT-PCR and human FGF2 protein in the culture media using western blot analysis when the knock-in vector was introduced. We transfected the knock-in vector into bovine ear fibroblasts and produced knock-in fibroblasts using the clustered regularly interspaced short palindromic repeats (CRISPR)/Cas9 system. Moreover, the CRISPR/Cas9 system was more efficient than conventional methods. In addition, we produced knock-in blastocysts by somatic cell nuclear transfer using the knock-in fibroblasts. Our knock-in fibroblasts may help to create cloned embryos for development of transgenic dairy cattle expressing human FGF2 protein in the mammary gland via the expression system of the bovine β-casein gene.
A 44-year-old man developed sudden non-fluent aphasia and right hemiplegia due to left striatocapsular infarction (Figure). Neurologic examination revealed gaze deviation to the right with eyes closed, but not with eyes open (Video). There was no spontaneous or gaze-evoked nystagmus, even after elimination of visual fixation. Leftward pursuit was impaired in a craniotopic frame of reference, and horizontal saccades were hypometric in both directions. Head impulse test was normal in the horizontal plane and there were no visual field defects. The contralesional gaze deviation with eye closure persisted for ten days.
Social support programs for dementia caregivers were widely used in order to reduce care burden. We investigated which types of social supports can reduce psychological and non-psychological burdens of dementia caregivers, and explored the mechanism of those social supports.
Methods:
We evaluated 731 community-dwelling dementia patients and their caregivers from the National Survey of Dementia Care in South Korea. We investigated the five types of social supports (emotional support, informational support, tangible support, positive social interaction, affectionate support) using the Medical Outcomes Study Social Support Survey in each caregiver. The mechanisms of specific types of social support on psychological/non-psychological burden were examined using path analysis.
Results:
Positive social interaction and affectionate support reduced psychological burden via direct and indirect paths. Tangible support reduced the non-psychological burden via direct and indirect paths. Informational support and emotional support were not helpful for reducing psychological or non-psychological burden. A maximum of 20% of psychological burden could be relieved by positive social interaction and 10.3% of that could be reduced by affectionate support. Tangible support was associated with a 15.1% maximal improvement in non-psychological burden.
Conclusions:
In order to reduce caregiver burden in dementia effectively, psychosocial interventions should be tailored to target type of caregiver burden.
The hardness changes caused by formation of the metastable and stable phases were examined and correlated with the microstructural changes in grain interior and grain boundary during aging at 350 °C to clarify the age-hardening and softening mechanism of a low-gold Au-Cu-Ag-Pd dental alloy. Aging in this context refers to the time-delay that occurs wherein such alloys are kept at elevated temperatures for periods upto many hours to allow precipitation or ordering to take place. During the period of increasing hardness, the matrix was separated into the Ag-rich α1 and AuCu I phases through the metastable phases, forming block-like structure. The apparent hardening was attributed primarily to lattice strain due to the tetragonality of AuCu I′ [the primer (′) here indicates a metastable phase; likewise (I) and (I′) indicate stable AuCu I and metastable AuCu I′ phases, respectively] and AuCu I phases along the c-axis, secondarily to the coherency or semicoherency strain between the metastable α1′ and AuCu I′ phases and between the α0 and AuCu I phases along the a-axis. The apparent softening was caused primarily by growth and coarsening of the lamellar structure in the grain boundaries, secondarily by coarsening of the block-like structure in the grain interior.