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[This corrects the article DOI: 10.1371/journal.pone.0270808.].

Energy flux of Vertical Greening System (VGS) is crucial for understanding of heat exchange processes by optimizing the cooling performance in outdoor thermal comfort, thereby mitigating heat stress through the transpiration. To understand the potential cooling effect of VGS, we quantify the Mean Radiant Temperature (MRT) of VGS by analyzing radiation flux and evaluating cooling efficiency, defined as the ratio of the cooling effect provided by the VGS to the energy input necessary to achieve that effect to quantify the effectiveness of VGS. The VGS showed a decrease in net radiation by 120 W/ m2, resulting in a decline in MRT by 3.02 °C compared to the wall. Furthermore, we found that the cooling efficiency of transpiration in VGS was 7.38 times more effective than evaporation from soil without plants. These findings suggest that VGS has the potential to significantly reduce heat stress and serve as an efficient strategy in urban areas.

Abstract We aimed to examine whether metabolic syndrome (MetS) is associated with mobility in the older adults, using the timed up and go (TUG) test which is one of the most widely used tests for evaluating mobility. This is population-based study with the National Health Insurance Service–National Health Screening Cohort database of National Health Information Database. Participants included were those who completed the TUG as part of the National Screening Program for Transitional Ages. An abnormal TUG result was defined as a time ≥ 10 s. Multiple logistic regression models were used to assess the associations between MetS and TUG results. We constructed three models with different levels of adjustment. Furthermore, we conducted a stratified analysis according to the risk. Among the 40,767 participants included, 19,831 (48.6%) were women. Mean TUG value was 8.34 ± 3.07 s, and abnormal TUG test results were observed in 4,391 (10.8%) participants; 6,888 (16.9%) participants were categorised to have MetS. The worst TUG test results were obtained in participants with three or four MetS features, and a J-shaped relationship of each MetS feature, except triglyceride (TG) and high-density lipoprotein-cholesterol (HDL-C), with TUG test was found. Participants with MetS had 18% higher likelihood of showing abnormal TUG test results in a fully adjusted model (adjusted odds ratio 1.183, 95% confidence interval 1.115–1.254). The stratified analysis revealed that participants with central obesity, high blood pressure, and normal HDL-C and TG were more likely to have abnormal TUG times. Participants with MetS had a higher risk of exhibiting abnormal TUG results, and except for HDL-C and TG, all other MetS features had a J-shaped relationship with TUG. Preventive lifestyle such as lower carbohydrate and higher protein intake, and endurance exercise is needed.

Abstract Background Over 10% of adults aged ≥65 years have anemia, as defined by the World Health Organization (WHO). As the timed up and go (TUG) test is one of the most widely used tests of mobility, this study investigated whether anemia was associated with mobility capacity assessed using the TUG test in older adults. Methods Subjects belonging to the Korean National Health Insurance Service-National Health Screening Cohort of the National Health Information Database were reviewed. Subjects were included if they had completed the TUG test as part of the National Screening Program for Transitional Ages in Korea. An abnormal TUG test result was defined as a time of ≥10 s and anemia was defined according to the WHO criteria as a hemoglobin (Hb) concentration of

Abstract Background The timed up and go test (TUG) is one of the most widely used tests of mobility. We aimed to examine whether the TUG is associated with cardiovascular (CV) events, CV mortality, and all-cause mortality. Methods Subjects in the senior cohort database of the Korean National Health Insurance Service (2002–2013) who completed the TUG as part of the National Screening Program for Transitional Ages (NSPTA) during 2007–2008 were identified. An abnormal TUG result was defined as a time ≥ 10 s. Cox proportional hazard models were used to assess the associations between TUG results and CV events, CV mortality, and all-cause mortality. Results The mean follow-up period was 5.7 years. Incidence rates of CV events in the normal and abnormal TUG groups were 7.93 and 8.98 per 1000 person-years, while CV mortality rates were 0.96 and 1.51 per 1000 person-years, respectively. In a fully adjusted model, we found that abnormal TUG results were not associated with the incidences of CV events and CV mortality. However, abnormal TUG results (≥10 s) resulted in a 2.9-fold increase in CV mortality in women (adjusted hazard ratio 2.90, 95% confidence interval 1.15–7.30). Further, participants lacking certain CV risk factors, such as current cigarette smoking, obesity, or diabetes, had a higher CV mortality rate when TUG results were abnormal. Conclusions Abnormal TUG results in subjects aged 66 years were associated with future CV mortality in women and in subjects without obesity, diabetes, or cigarette smoking. In patient with mobility impairment, physicians should consider CV disease risk, especially in women.

Although previous studies examined the association between mobility and disability, they have used either subjective measure disability such as activity of daily living or instrumental activity of daily living or indirect measure such as long-term care service use with small size of participants. This study aimed to examine the association between timed up and go (TUG) test and disability incidence with national disability registration data in Korea longitudinally, by using a national representative sample. We used the National Health Insurance Service-National Health Screening Cohort (NHIS-HEALS) database of National Health Information Database. The NHIS-HEALS dataset includes disability information of National Screening Programme participants, including registration date and type of disability, which is merged from Korean National Disability Registry (KNDR). We used Cox proportional hazard models to evaluate the association between TUG and disability incidence. We constructed three models with different levels of adjustment; Model 3 was a fully adjusted model. We conducted subgroup analysis according to the risk factors for disability. The study population comprised 81,473 participants; 86 of them were newly registered to KNDR, which were observed during a mean follow-up of 4.1 ± 2.6 (maximum, 8.9) years. For 334,200.9 person-year (PY) follow-up, the disability incidence rate was 0.208 per 1,000 PY. Disability incidence was significantly higher in participants with abnormal TUG results than in those with normal TUG results. (adjusted hazard ratio [aHR] 1.600, 95% confidence interval [CI] 1.036-2.472). In subgroup analysis, the disability incidence increased in participants of normal cognition, without obesity or without cardiovascular (CV) disease. Increased incidence in disability was noted in participants with abnormal TUG results. The increase was more evident for participants with normal cognition, without obesity or CV disease.

Abstract Adherence to antihypertensive medication is a critical factor to control blood pressure and prevent complications. However, cognitive impairment can negatively affect medication adherence. In this study, we investigated the association between cognitive function and antihypertensive medication adherence among elderly hypertensive patients using the Korean National Health Insurance Service National Sample Cohort Data of the Elderly Cohort. The study included 20,071 elderly hypertensive patients and the prevalence of poor medication adherence to antihypertensive medications was 16.4%. A multivariate logistic regression analysis showed that lower cognitive function was associated with poor medication adherence (adjusted odds ratio 0.980, 95% confidence interval 0.961–0.999). Additionally, high income levels, living in metropolitan areas, and comorbidities (such as stroke, coronary heart disease, diabetes, and dyslipidemia) were positively associated with medication adherence, while patients diagnosed with cancers showed poor medication adherence. Our study demonstrated that cognitive impairment is a possible risk factor for poor antihypertensive medication adherence, even in patients without dementia. Thus, clinicians involved with geriatric care should monitor patients’ cognitive function and medication adherence. And if a patient shows cognitive impairment, clinicians need to educate patients and caregivers about the importance of proper adherence, and consider proper interventions to optimize the cognitive function of elderly patients.

Background : As the elderly population increases in number, prediction and prevention of functional decline in this population are of great importance. This study evaluated whether depression in an elderly population could predict functional decline in activities of daily living and the components of instrumental activities of daily living 2 years after baseline. Methods : Data from the Korean Longitudinal Study of Aging panel, a national, representative sample of aging Koreans, were used. The subjects were the elderly aged 65 years or older who had no disabilities that hindered them from performing activities of daily living at baseline. Depression was measured using the Short-form (10-item) Center for Epidemiological Studies Depression Scale. Multivariable logistic regression analysis was performed to evaluate the effect of functional impairment according to baseline depression. Results : Of the 3,477 participants, 166 (4.8%) showed at least 1 impairment in the 7 activities of daily living (ADL) categories after 2 years. The participants with depression (scored 15 or higher on the depression scale) were more likely to have functional decline 2 years later (odds ratio, 1.82; 95% confidence interval, 1.23-2.71). All the components of the ADL had an increased tendency to develop functional decline (all odds ratios>1.00). Furthermore, negative items were significantly associated with functional decline (all p-values adjusted for trend

Background: The objective of our study was to examine the clinical factors associated with bone microarchitecture in Koreans. To the best of our knowledge, only a few studies have investigated these factors. Methods: Data from patients who underwent a dual-energy X-ray absorptiometry scan at Seoul National University Hospital health promotion center between November 2014 and March 2015 were collected. The study population was divided into 2 groups, according to the patient's trabecular bone score (TBS) as follows: normal TBS ≥1.35 (n=700) and low TBS ＜1.35 (n=154). Intergroup comparison was carried out using the Student t-test and chi-square test. Logistic regression analysis, adjusted for age and body mass index (BMI), was applied to investigate the factors associated with TBS. Results: Data from 854 men and women were analyzed. Our results showed that TBS was inversely associated with age, BMI, waist circumference, serum phosphorus level (P), serum alkaline phosphatase level (ALP), serum C-terminal telopeptide (CTX), serum triglycerides (TG), serum C-reactive protein (CRP), erythrocyte sedimentation rate (ESR), and white blood count (WBC). Bone mineral density (BMD) was positively related to TBS. BMD, waist circumference, and serum ALP had an association with TBS in both men and women, after adjusting for age and BMI. Conclusion: Our findings suggest that obese patients (especially those with abdominal obesity) have worse bone microarchitecture. Serum P, ALP, CTX, TG, CRP, ESR, and WBC might have a negative association with TBS. Further studies are needed to clarify these findings.

Background. Several factors influence the choice of antihypertensive drugs. To facilitate the rational use of drugs it is important to assess their prescription patterns over time. This study aims to evaluate doctors’ prescribing patterns of antihypertensive drugs for drug-naïve patients in South Korea. Methods. The claims data of the Korean National Health Insurance Research Database from 1 January 2011 to 31 December 2015 were analyzed. The data virtually cover the entire South Korean population. Antihypertensive drugs were further subdivided into angiotensin receptor blockers (ARBs), angiotensin-converting enzyme inhibitors (ACEis), calcium channel blockers (CCBs), beta-blockers (BBs), and thiazide diuretics. The prescription pattern of antihypertensive drugs and associated factors were assessed according to the patients’ characteristics, including associated comorbidities. Results. A total of 2,919,162 subjects had started taking antihypertension medications during the study period. ARB was the most frequently prescribed drug (51.6%) followed by CCB (45.0%), BB (18.5%), diuretics (17.0%), and ACEi (11.7%). Most patients were prescribed with monotherapy (66.7%) rather than combination therapy (33.3%), and CCB was the most frequently prescribed monotherapy drug (25.7%). For combination therapy, ARB + CCB was the most frequently prescribed combination, and the prescription frequency was found to be increasing. In patients prescribed with combination therapy, most had been prescribed single-pill fixed-dose combination. Conclusion. We identified the physicians’ prescription patterns of antihypertensive drugs for treatment-naïve patients. The findings of this study can lead to a rational, evidence-based, and cost-effective improvement of prescription patterns in newly diagnosed hypertensive patients.

Background and challenges to implementation Accurate estimation of smoking prevalence is important in a smoking cessation policy. Previous study using the Korean National Health and Nutrition Examination Survey (KNHANES) data compared women's self-report and urinary cotinine, and found that smoking prevalence is underestimated by self-report suggesting smoking concealment by female smokers due to stigma and cultural influence. We aimed to investigate whether female smokers report their smoking status consistently and related it to their smoking patterns (daily vs. intermittent). Intervention or response A cross-sectional, online panel survey was conducted with 2,080 women aged 19 to 39. We first administered standard smoking status questions of KNHANES, and positioned unrelated health questions in between, and repeatedly asked about their smoking status and patterns. Then we cross-tabulated them to determine consistency of their self-report. Results and lessons learnt By initial self-reports, 366 (17.6%) were current smoker, 120 (5.8%) were former smoker, and 1594 (76.6%) were never smoker. At second question, 102 (6.3%) and 223 (14.0%) women initially declared themselves as non-smoker answered that they are current smoker and former smoker. Current and former smokers at first smokers consistently reported their status at second questions. Among 256 daily smoker at second questions, 251 (98.0%) reported they are smoker at first question. Among 210 intermittent smokers, only 115 (54.8%) reported they are smokers at first questions. Conclusions and key recommendations At least 22% of current smokers (102/468) reported they are not smoking at first standard KNHANES smoking status question. Most of them were intermittent smoker. Survey methods to reduce underestimation of female smoking prevalence are needed.

INTRODUCTION:Cerebral microbleed (CMB) is a potent risk factor for overt cerebrovascular disease. Although some studies indicated the possible role of renal dysfunction as a risk factor of CMB, the findings could not be generalized. This study aimed to investigate the association between renal dysfunction and cerebral microbleed (CMB) in neurologically healthy adults. MATERIALS AND METHODS:A total of 2,518 subjects who underwent brain MRI as part of health screening were involved in the study. CMBs were defined as well-demarcated focal areas of low signal intensity with associated blooming on the T2-weighted MRI measuring less than 5mm in diameter. The glomerular filtration rate (GFR) was estimated using the Modification of Diet in Renal Disease formula. Kidney function was classified as normal (≥90), mild (60 to 89.9), moderate (30 to 59.9), and severe (

[This corrects the article DOI: 10.1371/journal.pone.0172210.].

Research on robots that accompany humans is being continuously studied. The Pet-Bot provides walking-assistance and object-carrying services without any specific controls through interaction between the robot and the human in real time. However, with Pet-Bot, there is a limit to the number of robots a user can use. If this limit is overcome, the Pet-Bot can provide services in more areas. Therefore, in this study, we propose a swarm-driving middleware design adopting the concept of a swarm, which provides effective parallel movement to allow multiple human-accompanying robots to accomplish a common purpose. The functions of middleware divide into three parts: a sequence manager for swarm process, a messaging manager, and a relative-location identification manager. This middleware processes the sequence of swarm-process of robots in the swarm through message exchanging using radio frequency (RF) communication of an IEEE 802.15.4 MAC protocol and manages an infrared (IR) communication module identifying relative location with IR signal strength. The swarm in this study is composed of the master interacting with the user and the slaves having no interaction with the user. This composition is intended to control the overall swarm in synchronization with the user activity, which is difficult to predict. We evaluate the accuracy of the relative-location estimation using IR communication, the response time of the slaves to a change in user activity, and the time to organize a network according to the number of slaves.