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Edited by
Dharti Patel, Mount Sinai West and Morningside Hospitals, New York,Sang J. Kim, Hospital for Special Surgery, New York,Himani V. Bhatt, Mount Sinai West and Morningside Hospitals, New York,Alopi M. Patel, Rutgers Robert Wood Johnson Medical School, New Jersey
As astroviral infection rapidly increased in the summer of 2022 in Korea, this study aimed to determine the cause and genotype of astroviruses during this period. From January to December 2022, we tested 43,312 stool samples from patients with acute gastroenteritis utilizing multiplex PCR to detect HAstV. For the HAstV-positive samples, we determined the genotypes of the HAstVs by PCR and sequencing. The monthly positive rate from 2015 to 2022 showed a notable and abrupt increase of HAstV infection between June and August 2022, peaking at 9.8% in July 2022. The annual positivity rate of HAstV remained at 2–3% between 2015 and 2019, and then decreased to 0.5% in 2020, followed by an increase to 1.5% in 2021 and 3.6% in 2022.The genotyped astroviruses in 2022 were all identified as HAstV-1 type, and the nucleotide identity% among them was >99%. The GenBank accession number for the strain genetically closest to the strains identified in our study was ON571597.1, which was HAstV-1 isolated from Pingtan in 2019. Our results provide recent epidemiological data on HAstVs in Korea. The decline and surge in astrovirus positivity in recent years may be related to the COVID-19 pandemic.
Breast cancer is a major global health issue, especially among women. Previous research has indicated a possible association between psychiatric conditions, particularly schizophrenia, and an increased risk of breast cancer. However, the specific risk of breast cancer in women with schizophrenia, compared with those with other psychiatric disorders and the general population, remains controversial and needs further clarification.
Aims
To estimate the risk of breast cancer among people with schizophrenia compared with people with other psychiatric disorders and people in the general population.
Method
We utilised medical claims data of women aged 18 to 80 years in the Korean National Health Information Database from 2007 to 2018. Individuals with schizophrenia were defined as women with ICD-10 codes F20 or F25 (n = 224 612). The control groups were defined as women with other psychiatric disorders (n = 224 612) and women in the general Korean population (n = 449 224). Cases and controls were matched by index date and age, in a 1:1:2 ratio. We estimated the hazard of breast cancer using the Cox proportional hazards model, adjusting for insurance premiums and medical comorbidities. Among the people with schizophrenia, we used the landmark method to estimate the association between duration of antipsychotic medication use and the incidence of breast cancer.
Results
In multivariable Cox regression models, the hazard rate of breast cancer was 1.26 times higher in the people with schizophrenia than in the general population (95% CI: 1.20–1.32). In comparison with the psychiatric patient group, the hazard ratio was 1.17 (95% CI: 1.11–1.28). Among women with schizophrenia, the hazard of breast cancer was greater among those who took antipsychotic medications for 1 year or more compared with those who took antipsychotics for less than 6 months.
Conclusions
Women with schizophrenia have an elevated risk of breast cancer, and long-term use of antipsychotics is associated with an increased risk of breast cancer.
Recent studies have suggested an increased incidence of myocarditis and pericarditis following mRNA vaccination or COVID-19. However, the potential interaction effect between vaccine type and COVID-19 on heart disease risk remains uncertain. Our study aimed to examine the impact of COVID-19 status and vaccine type following the first dose on acute heart disease in the Korean population, using data from the National Health Insurance Service COVID-19 database (October 2018–March 2022). We sought to provide insights for public health policies and clinical decisions pertaining to COVID-19 vaccination strategies. We analysed heart disease risk, including acute cardiac injury, acute myocarditis, acute pericarditis, cardiac arrest, and cardiac arrhythmia, in relation to vaccine type and COVID-19 within 21 days after the first vaccination date, employing Cox proportional hazards models with time-varying covariates. This study included 3,350,855 participants. The results revealed higher heart disease risk in individuals receiving mRNA vaccines than other types (adjusted HR, 1.48; 95% CI, 1.35–1.62). Individuals infected by SARS-CoV-2 also exhibited significantly higher heart disease risk than those uninfected (adjusted HR, 3.56; 95% CI, 1.15–11.04). We found no significant interaction effect between vaccine type and COVID-19 status on the risk of acute heart disease. Notably, however, younger individuals who received mRNA vaccines had a higher heart disease risk compared to older individuals. These results may suggest the need to consider alternative vaccine options for the younger population. Further research is needed to understand underlying mechanisms and guide vaccination strategies effectively.
The purpose of this study was investigating the differences in temperament, personality, and cognitive function among athletes and non-athletes, as well as differences within athlete groups participating in different-paced sports like baseball and basketball.
Methods
A total of 57 professional basketball players, 51 professional baseball players, and 44 non-athletes subjected to temperament and characteristics inventory assessments and computerized neurocognitive function test. One-way analysis of variance (ANOVA) was employed to analyze the average differences in demographic characteristics, temperament, personality traits, and cognitive functions among the three groups, followed by Bonferroni post hoc tests. Comparisons between starters and non-starters within the athlete groups were conducted using the Mann–Whitney U test.
Results
In the analysis of temperament, the basketball and baseball player groups exhibited higher reward dependence and persistence compared with the control group. Additionally, in the assessment of personality traits, both basketball and baseball player groups scored higher in self-directedness and cooperativeness compared with the control group, whereas self-transcendence scores were lower. In cognitive ability assessments, baseball and basketball players outperformed the control group in emotional perception tests. Both baseball and basketball players showed lower card movement counts compared with the control group.
Conclusion
This study compared the differences in temperament, personality, and cognitive abilities between professional basketball and baseball players and non-athletes. These results provide valuable insights into the temperament, personality, and cognitive abilities of professional athletes, contributing important information for athlete development and coaching goals in the future.
In 2019, the National Evidence-based Healthcare Collaborating Agency (NECA) in Korea established a health technology reassessment (HTR) system to manage the life cycle of health technologies and develop operational measures promoting the efficient use of healthcare resources. The purpose of this study is to introduce the detailed implementation process and practical functional methods of the HTR implemented by NECA.
The HTR is a structured multidisciplinary method for analyzing health technologies currently used in the healthcare system based on the latest information on parameters, such as clinical safety, effectiveness, and cost-effectiveness of optimizing the use of healthcare resources as well as social and ethical issues. All decision-making stages of the HTR are carefully reviewed and transparently managed. The HTR committee makes significant decisions, and the subcommittee decides the details related to the assessment process.
Since the pilot began in 2018, 262 cases have been reassessed, of which, 126 cases (48.1 percent) were health services not covered by the National Health Insurance (NHI). Over the past 5 years, approximately 130 recommendations for the in-use technologies were determined by the HTR committee. In the near future, it will be necessary to officially develop and establish a Korean HTR system and a legal foundation to optimize the NHI system.
Our study investigates the influence of the Korean National Pension Fund's equity ownership on voting premiums, revealing a statistically significant reduction. In particular, we establish the liquidity pathway as the primary factor among the three channels previously suggested in the literature. Analysis of the COVID-19 era and the VKospi index underscores this predominance. These findings enrich the literature on public pension funds and capital markets, providing policymakers in emerging economies with a deeper understanding of the dynamics involved in establishing pension investment institutions.
Climate change poses a major threat to marine ecosystems, with its effects felt worldwide. A major effect of climate change on marine ecosystems is the rise in water temperature, leading to a northward expansion of habitats for marine organisms. Herdmania momus, a species of ascidians (sea squirts), originally found in tropical and subtropical regions, was introduced to the Korean Peninsula. In this study, we examined the habitat of H. momus along the southeastern coast of the Korean Peninsula between 2016 and 2022. We found that H. momus settlements were observed across the entire survey area, with confirmed habitation in Busan in 2016, Ulsan in 2021, and Gyeongju (the northernmost location) in 2022. The observed habitation trend indicates a rapid geographical expansion, occurring approximately 79 years earlier than previously predicted. These observations demonstrate that marine organisms are undergoing a more rapid geographical expansion than previously projected. These unexpected findings should inform government policies related to proactive measures and strategies for managing the impact of climate change on marine ecosystems.
A new magnetic mirror machine named KAIMIR (KAIST mirror) has been designed and constructed at the Korea Advanced Institute of Science and Technology (KAIST) to study mirror plasma physics and simulate the boundary regions of magnetic fusion plasmas such as in a tokamak. The purpose of this paper is to introduce the characteristics and initial experimental results of KAIMIR. The cylindrical vacuum chamber has a length of 2.48 m and a diameter of 0.5 m and consists of three sub-chambers, namely the source, centre and expander chambers. A magnetic mirror configuration is achieved by electromagnetic coils with a maximum magnetic field strength of 0.4 T at the mirror nozzles and 0.1 T at the centre. The source plasma is generated by a plasma washer gun installed in the source chamber with a pulse forming network system. The typical discharge time is ~12 ms with a ~6 ms (1–7 ms) steady period. Initial results show that the on-axis electron density at the centre is 1019–20 m−3 and the electron temperature is 4–7 eV. Two parameters were varied in this initial phase, the source power and the mirror ratio, which is the ratio of highest to lowest magnetic field strength in the mirror-confined region. We observed that the increase of the electron density was mitigated for a source power above 0.2 MW. It was also found that the electron density increases almost linearly with the mirror ratio. Accordingly, the stored electron energy was also linearly proportional to the mirror ratio, similar to the scaling of the gas dynamic trap.
Although people who attempted suicide tend to repeat suicide attempts, there is a lack of evidence on the association between psychiatric service factors and suicide reattempt among them.
Methods:
We used a nationwide, population-based medical record database of South Korea to investigate the use of psychiatric services before and after the index suicide attempt and the association between psychiatric service factors after the index suicide attempt with the risk of suicide reattempt.
Results:
Among 5,874 people who had attempted suicide, the all-cause mortality within 3 months after the suicide attempt was 11.6%. Among all subjects who attempted suicide, 30.6% of them had used psychiatric services within 6 months before the suicide attempt; 43.7% of them had used psychiatric services within 3 months after the suicide attempt. Among individuals who had visited clinics following attempted suicide, the cumulative incidence of suicide reattempt over a mean follow-up period of 5.1 years was 3.4%. About half of suicide reattempts occurred within 1 year after the index suicide attempt. Referral to psychiatric services within 7 days was associated with a decreased risk of suicide reattempt (adjusted hazard ratio, 0.51; 95% confidence intervals, 0.29-0.89).
Conclusion:
An early psychiatric referral within 1 week after a suicide attempt was associated with a decreased risk of suicide reattempt.
North Korean defectors (NKDs) have often been exposed to traumatic events. However, there have been few studies of neural alterations in NKDs with post-traumatic stress disorder (PTSD) and complex PTSD (cPTSD).
Aims
To investigate neural alterations in NKDs with PTSD and cPTSD, with a specific focus on alterations in resting-state functional connectivity networks, including the default mode network (DMN).
Method
Resting-state functional connectivity was assessed using brain functional magnetic resonance imaging in three groups of NKDs: without PTSD, with PTSD and with cPTSD. Statistical tests were performed, including region of interest (ROI)-to-ROI and ROI-to-voxel analysis, followed by post hoc correlation analysis.
Results
In the ROI-to-ROI analysis, differences in functional connectivity were found among the components of the DMN, as well as in the thalamus and the basal ganglia. Right hippocampus–left pallidum and right amygdala–left lingual gyrus connectivity differed between groups in the ROI-to-voxel analysis, as did connectivity involving the basal ganglia. The post hoc analysis revealed negative correlations between Coping and Adaptation Processing Scale (CAPS) score and left posterior cingulate cortex–right pallidum connectivity and between CAPS score and right putamen–left angular gyrus connectivity in the control group, which were not observed in other groups.
Conclusions
The results suggest that there are alterations in the functional connectivity of the DMN and the limbic system in NKDs with PTSD and cPTSD, and that these alterations involve the basal ganglia. The lower correlations of CAPS score with right basal ganglia–DMN functional connectivity in patients compared with controls further implies that these connectivities are potential targets for treatment of PTSD and cPTSD.
Depression is a risk factor for dementia and weight change can appear as a symptom of depression. However, the association between weight change after the diagnosis of depression and the risk of dementia is poorly established. This study aimed to investigate the association between weight change before and after a diagnosis of depression with the subsequent risk of dementia.
Methods
The National Health Insurance Sharing Service database was used. 1 308 730 patients aged ⩾40 years diagnosed with depression were identified to be eligible. Weight changes after their depression diagnosis were categorized and subsequent incidence of dementia was followed up.
Results
During an average follow-up period of 5.2 years (s.d., 2.0 years), 69 373 subjects were newly diagnosed with all-cause dementia (56 351 were Alzheimer's disease and 6877 were vascular dementia). Regarding all outcomes, compared to those with a minimal weight change (−5 to 5%), all groups with weight gain or loss showed increased risks of dementia after adjusting potential risk factors for dementia, in all analysis models with a dose–response relationship, showing a U-shaped association.
Conclusions
Weight change as a symptom of depression could be a predictor for the future development of dementia.
Waterproofing treatment is important for the preservation of smectite-rich rocks because of their shrinking and swelling properties. The effects of water repellents on the smectite structure and the water sorption of untreated and treated smectites were studied using X-ray diffraction. The hydrophobic Wacker BS 290 (around 100% silane/siloxane) does not prevent water from sorbing on the interlayer surface of smectite because the hydrophobic silane/siloxane is not intercalated into the interlayer space, but adsorbed onto the external surface of smectite. However, the hydrophilic Wacker BS 1001 (water-soluble emulsified silane/siloxane) prevents water from sorbing onto the interlayer surface beyond 33.3 wt.% because the hydrophobic part of the intercalated surfactant has a poor affinity for water. These results imply that water repellent containing a surfactant is suitable for smectite-rich rocks, but the expansion of smectite by intercalation of the surfactant is likely to influence volume change in smectite-rich rocks. This study notes that smectite within a rock can be one of the most important factors influencing the effectiveness of waterproof treatment. This study proposes that an intensive preliminary examination should be performed before applying water repellents to rocks, and furthermore, encourages development of new chemical reagents suitable for protecting smectite-rich rocks from moisture.
The immobilization of antimicrobial drugs can be used to expand the application of antibacterial properties to consumer products. The purpose of this study was to stabilize an antimicrobial agent, levofloxacin (LVX), for sustained antibacterial activity by immobilizing the drug molecules in a layered double hydroxide (LDH) and embedded in a polyurethane substrate. As-prepared MgAl-LDH was calcined at 400°C and reconstructed with LVX for intercalation. The X-ray diffraction patterns and cross-sectional transmission electron microscopy images showed lattice expansion along the crystallographic c axis upon LVX intercalation, suggesting successful loading of the drug. Fourier-transform infrared spectra revealed that the structure of LVX was well preserved between LDH layers. Elemental analysis indicated that the loading capacity of LVX in the hybrid was 41.7%. Bacterial-colony forming inhibitory assay on Bacillus subtilis exhibited ~100% antibacterial activity of both LVX alone and LVX-LDH hybrid (LL). To determine sustainability of antibacterial activity by the hybrid, either LVX alone or LL hybrid was loaded in the polyurethane (PU) substrate for which antibacterial activity was evaluated before and after immersion in a phosphate-buffered saline for 3 days. The LVX-composited PU showed a dramatic decrease in antibacterial activity, down to 0% after buffer treatment; LL-composited PU still contained antibacterial activity (~34% of colony suppression) after phosphate-buffered saline immersion.
The application of ceramic membranes is limited by the high cost of raw materials and the sintering process at high temperatures. To overcome these drawbacks, the present study investigated both the preparation of ceramic membranes using cost-effective raw materials and the possibility of recycling the membranes for the treatment of oily wastewater. Ceramic membranes with a pore size of 0.29–0.67 μm were prepared successfully at temperatures as low as 1000–1100°C by a simple pressing route using lowcost base materials including diatomite, kaolin, bentonite, talc, sodium borate, and barium carbonate. The typical steady-state flux, fouling resistance, and oil-rejection rate of the low-cost virgin membranes sintered at 1000°C were 2.5 × 10−5 m3m−2s−1 at 303 kPa, 63.5%, and 84.1%, respectively, with a feed oil concentration of 600 mg/L. A simple burn-out process of the used membranes at 600°C in air resulted in >95% recovery of the specific surface area (SSA) of the virgin membranes, a significantly increased steady-state flux, decreased fouling resistance, and increased oil-rejection rate. The typical steady-state flux, fouling resistance, and oil-rejection rate of the low-cost ceramic membrane sintered at 1000°C and subsequently heat treated at 600°C for 1 h in air after the first filtration were 5.4 × 10−5 m3m−2s−1 at 303 kPa, 27.1%, and 92.9%, respectively, with a feed oil concentration of 600 mg/L. The present results suggest that the low-cost ceramic membranes used for oily wastewater filtration can be recycled by simple heat-treatment at 600°C in air. As the fouling resistance of the low-cost ceramic membranes decreased with a decrease in pore size, the preferred pore size of the membranes for oily wastewater filtration is <0.4 μm.
The locus coeruleus (LC) innervates the cerebrovasculature and plays a crucial role in optimal regulation of cerebral blood flow. However, no human studies to date have examined links between these systems with widely available neuroimaging methods. We quantified associations between LC structural integrity and regional cortical perfusion and probed whether varying levels of plasma Alzheimer’s disease (AD) biomarkers (Aß42/40 ratio and ptau181) moderated these relationships.
Participants and Methods:
64 dementia-free community-dwelling older adults (ages 55-87) recruited across two studies underwent structural and functional neuroimaging on the same MRI scanner. 3D-pCASL MRI measured regional cerebral blood flow in limbic and frontal cortical regions, while T1-FSE MRI quantified rostral LC-MRI contrast, a well-established proxy measure of LC structural integrity. A subset of participants underwent fasting blood draw to measure plasma AD biomarker concentrations (Aß42/40 ratio and ptau181). Multiple linear regression models examined associations between perfusion and LC integrity, with rostral LC-MRI contrast as predictor, regional CBF as outcome, and age and study as covariates. Moderation analyses included additional terms for plasma AD biomarker concentration and plasma x LC interaction.
Results:
Greater rostral LC-MRI contrast was linked to lower regional perfusion in limbic regions, such as the amygdala (ß = -0.25, p = 0.049) and entorhinal cortex (ß = -0.20, p = 0.042), but was linked to higher regional perfusion in frontal cortical regions, such as the lateral (ß = 0.28, p = 0.003) and medial (ß = 0.24, p = 0.05) orbitofrontal (OFC) cortices. Plasma amyloid levels moderated the relationship between rostral LC and amygdala CBF (Aß42/40 ratio x rostral LC interaction term ß = -0.31, p = 0.021), such that as plasma Aß42/40 ratio decreased (i.e., greater pathology), the strength of the negative relationship between rostral LC integrity and amygdala perfusion decreased. Plasma ptau181levels moderated the relationship between rostral LC and entorhinal CBF (ptau181 x rostral LC interaction term ß = 0.64, p = 0.001), such that as ptau181 increased (i.e., greater pathology), the strength of the negative relationship between rostral LC integrity and entorhinal perfusion decreased. For frontal cortical regions, ptau181 levels moderated the relationship between rostral LC and lateral OFC perfusion (ptau181 x rostral LC interaction term ß = -0.54, p = .004), as well as between rostral LC and medial OFC perfusion (ptau181 x rostral LC interaction term ß = -0.53, p = .005), such that as ptau181 increased (i.e., greater pathology), the strength of the positive relationship between rostral LC integrity and frontal perfusion decreased.
Conclusions:
LC integrity is linked to regional cortical perfusion in non-demented older adults, and these relationships are moderated by plasma AD biomarker concentrations. Variable directionality of the associations between the LC and frontal versus limbic perfusion, as well as the differential moderating effects of plasma AD biomarkers, may signify a compensatory mechanism and a shifting pattern of hyperemia in the presence of aggregating AD pathology. Linking LC integrity and cerebrovascular regulation may represent an important understudied pathway of dementia risk and may help to bridge competing theories of dementia progression in preclinical AD studies.
South Korea has introduced conditionality to coverage decisions for certain difficult or high-risk procedures. The transcatheter aortic valve implantation (TAVI) was included in the coverage with evidence development (CED) in 2014. This study reviewed the results of reassessment for the TAVI using real world data (RWD) and suggested its implications.
Methods
Healthcare providers authorized to use the promising technologies are required to collect the RWD for suitability evaluation, safety monitoring, and cost-effectiveness, differing from the general reassessment process. In 2021, 45 healthcare providers collected clinical information for TAVI patients. Their registries were linked with the national health insurance claims, which provided data on 19 items to assess safety and effectiveness such as overall mortality, reoperation rates, hospital readmission rates, and degree of functional improvement.
Results
According to the Society of Thoracic Surgeons’ predicted risk of mortality (STS), 988 TAVI patients were classified into three groups; high (STS >8 percent, n=347), intermediate (STS 4-8 percent, n=272), and low (STS <4 percent, n=369); We compared main outcomes and estimated survival probabilities between subgroups. Within 30 days, the overall mortality rates were 4.9 percent (high), 2.6 percent (intermediate), and 1.4 percent (low); major bleeding rates were 7.6 percent (high), 6.2 percent (intermediate),and 1.4 percent (low); incidence of new atrial fibrillation were 6.8 percent (high), 4.2 percent (intermediate), and 3.2 percent (low). Based on the quantitative results using RWD and systematic review for the safety and effectiveness, TAVI is reported to have essential benefits for high-risk group and elderly patients (>80 years). Whereas, intermediate and low-risk groups have out-of-pocket payment rates of 50 percent and 80 percent, respectively.
Conclusions
The reassessment system through RWD accumulation enabled the evidence-based evaluation for the TAVI. Based on the transition to CED for essential benefits, a systematic framework such as RWD collection from treatment commencement should be introduced to broaden RWD use for benefit management of medical technologies with uncertain levels of evidence. Therefore, this ensures overall quality of care and effective coverage in health.
The stability and postcritical behaviour of a horizontal flag undergoing gravity-induced deformation and periodic contact with a nearby horizontal rigid wall are experimentally investigated. The results elucidate the combined effects of gravity and contact on flutter, and reveal design principles for application to triboelectric energy harvesting. By varying the free-stream velocity, flag thickness and distance between the flagpole and the wall, the dynamics of the flag are classified into quasistatic equilibrium, flutter, partial contact and saturated contact modes. Considering the significance of gravitational effects, a new dimensionless flow velocity is proposed to identify the distribution of the dynamic modes, and its definition varies according to whether the wall is placed above or below the flag. The critical conditions for transitions between the dynamic modes are determined from the balance of fluid dynamic and gravitational effects. The distance from the flagpole to the wall is found to be more critical for transitions in the lower-wall configuration than in the upper-wall configuration. The peak contact force as well as the oscillation amplitude and frequency at postequilibrium exhibits remarkably different trends depending on the location of the wall. The peak contact force imposed on the wall by the fluttering flag weakens as the distance to the wall increases in the case of an upper wall, whereas it becomes stronger in the case of a lower wall.
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.
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.