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Background and ObjectivesPeople with epilepsy (PWE) are at risk of premature death with considerable variability according to the study population. We aimed to estimate the risk and causes of death in PWE according to age, disease severity, disease course, comorbidities, and socioeconomic status in Korea.MethodsWe conducted a nationwide population-based retrospective cohort study using the National Health Insurance database linked with the national death register. Newly treated PWE from 2008 to 2016 who were identified by antiseizure medication (ASM) prescriptions and diagnostic codes for epilepsy/seizure were included and observed until 2017. We assessed all-cause and cause-specific crude mortality rates and standardized mortality ratios (SMRs).ResultsAmong 138,998 PWE, 20,095 deaths were identified, and the mean follow-up period was 4.79 years. The SMR was 2.25 in the overall group of PWE, with a higher value in the younger age group at diagnosis and a shorter time interval after diagnosis. The SMR in the monotherapy group was 1.56, while that in the group with 4 or more ASMs was 4.93. PWE without any comorbidities had an SMR of 1.61. PWE who were rural residents had a higher SMR than those who were urban residents (2.47 vs 2.03, respectively). The causes of death among PWE were cerebrovascular disease (18.9%, SMR 4.50), malignant neoplasms outside the CNS (15.7%, SMR 1.37), malignant neoplasms of the CNS (6.7%, SMR 46.95), pneumonia (6.0%, SMR 2.08), and external causes (7.2%, SMR 2.17), including suicide (2.6%, SMR 2.07). Epilepsy itself and status epilepticus accounted for 1.9% of the overall death. The excess mortality associated with pneumonia and external causes was persistently high, whereas the excess mortality associated with malignancy and cerebrovascular diseases tended to decrease with increasing time since diagnosis.DiscussionThis study showed excess mortality in PWE, even in those without comorbidities and those receiving monotherapy. Regional disparities and sustained risks of deaths from external causes over 10 years imply potential points of intervention. In addition to active control of seizures, education about injury prevention, monitoring for suicidal ideation, and efforts to improve accessibility to epilepsy care are all required to reduce mortality.

Korea's national health insurance authority introduced a drug utilization review modernization pilot project in which health professionals provided follow-up services to monitor adverse drug events. We aimed to evaluate the effects of the project on clinical and economic outcomes.We conducted difference-in-differences analysis using National Health Insurance claims data from the Health Insurance Review and Assessment Service. We calculated the number of adverse drug events and allergic reactions as a clinical indicator and medical costs incurred to manage these events as an economic indicator. Absolute difference in each outcome measure was defined as the value after the project minus the value before the project. Difference-in-differences was defined as a difference in absolute differences between the intervention group and the control group.Overall, difference-in-differences were -43 and -826 for the number of drug-related adverse events and allergic reactions and -$198,700 and $53,318 for medical costs in the inpatient and outpatient settings, respectively. For outpatients, the monthly number of adverse drug events and allergic reactions has grown higher for the control group than for the intervention group after implementation of the pilot project.Implementation of the pilot project lowered the number of adverse drug events and allergic reactions in the inpatient and outpatient setting. The project also lowered medical costs incurred to manage these events in the inpatient setting only. Based on our findings, we recommend that the pilot project be expanded on a nationwide level at least in the inpatient setting.

Upon withdrawal of propacetamol, an injectable formulation of the paracetamol prodrug, in Europe due to safety concerns, South Korea’s regulatory body requested a post-marketing surveillance study exploring its safety profile. We characterized regional disparities in adverse events (AE) associated with propacetamol between Asia and Europe using the World Health Organization’s pharmacovigilance database, VigiBase. We performed disproportionality analyses using reporting odds ratios (rOR) and information component (IC) to determine whether five AEs (anaphylaxis, Stevens–Johnson syndrome, thrombosis, contact dermatitis/eczema, injection site reaction [ISR]) were associated with propacetamol versus non-propacetamol injectable antipyretics in Asia and Europe, separately. In Asia, there was a high reporting ratio of propacetamol-related ISR (rOR 5.72, 95% CI 5.19–6.31; IC025 1.27), satisfying the signal criteria; there were no reports of thrombosis and contact dermatitis/eczema. Two signals were identified in Europe, with higher reporting ratios for thrombosis (rOR 7.45, 95% CI 5.19–10.71; IC025 1.92) and contact dermatitis/eczema (rOR 16.73, 95% CI 12.48–22.42; IC025 2.85). Reporting ratios of propacetamol-related anaphylaxis were low for Asia and Europe. While signals were found for thrombosis and contact dermatitis/eczema in Europe, these were not detected in Asia. These findings suggest potential ethnic differences in propacetamol-related AEs between Asia and Europe, which could serve as supportive data for future decision-making.

This study explored predictors of coronavirus disease 2019 (COVID-19) booster hesitancy among fully vaccinated young adults and parental COVID-19 vaccine hesitancy for their children.This cross-sectional study administered an online survey from December 2 to December 20, 2021. We enrolled participants aged 18-49 years, for whom ≥2 weeks had passed after their initial COVID-19 vaccination. We estimated odds ratios (ORs) with 95% confidence intervals (CIs) using multivariate logistic regression to evaluate factors associated with booster/vaccine hesitancy.Among the 2,993 participants, 48.8% showed hesitancy (wait and see: 40.2%; definitely not: 8.7%). Booster hesitancy was more common among women (OR, 1.25; 95% CI, 1.05 to 1.50), younger people (OR, 1.44; 95% CI, 1.17 to 1.77), those with a lower education level (OR, 2.05; 95% CI, 1.10 to 3.82), those who received the mRNA-1273 vaccine type (OR, 2.01; 95% CI, 1.65 to 2.45), and those who experienced serious adverse events following previous COVID-19 vaccination (OR, 2.03; 95% CI, 1.47 to 2.80). The main reasons for booster hesitancy were concerns about safety (54.1%) and doubts about efficacy (29.8%). Among the 1,020 respondents with children aged18 years, 65.8% were hesitant to vaccinate their children against COVID-19; hesitancy was associated with younger parental age, education level, the type of vaccine the parent received, and a history of COVID-19 infection.Concerns about the efficacy and safety of COVID-19 vaccines were the major barrier to booster acceptance. The initial COVID-19 vaccine type (mRNA-1273), young age, gender (women), a low education level, and adverse events after the first COVID-19 vaccine were key predictors of booster hesitancy.

To examine the extent of codeine prescriptions for children younger than 12 years in Korea and to investigate characteristics associated with pediatric codeine use.A retrospective observational study was conducted to examine codeine prescriptions and patients' characteristics.We used the Korea Health Insurance Review and Assessment Service National Patient Sample database. The study participants were patients younger than 12 years who were prescribed codeine as inpatients or outpatients between 2011 and 2016. Pediatric codeine use was defined as codeine prescribed at least once for a child younger than 12 years. The frequency and proportion of pediatric codeine users were analyzed by age group (0-2, 3-6, or 7-11 years), sex, year, region, diagnosis, type of medical institution, and coprescribed medication. Logistic regression analyses were performed to identify characteristics associated with pediatric codeine use.Of all patients younger than 12 years, 518,895 (55.8%) and 16,337 (1.7%) were treated with codeine in outpatient and inpatient settings, respectively. Odds of pediatric codeine prescriptions were highest for outpatients at clinics (adjusted odds ratio [OR], 1.19; 95% CI, 1.16-1.21) and public hospitals (adjusted OR, 1.56; 95% CI, 1.28-1.91) and for inpatients at public hospitals (adjusted OR, 8.38; 95% CI, 6.64-10.58).Codeine was frequently prescribed for pediatric outpatients in Korea, especially in primary care clinics. Efforts to limit codeine use in children are required to prevent the occurrence of codeine-related adverse events.

In order to study Sa-Ahm's underlying thoughts on the basis of Yin-Yang and the five-element theory, the 12 acupuncture meridian systems and eight extra meridian systems were investigated in detail. The clinical acupuncture points for Sa-Ahm's four-needle acupuncture technique were also reviewed. The forms of the combinations using the five Shu acupuncture points, which are based on the promotion and control cycles with tonification and sedation, were shown to connect to the acupuncture points, which represent the meridian system itself. However, not all of Sa-Ahm's clinical cases were fully explained by this doctrine, so the five correlations among the meridian systems and the acupuncture points that affect the clinical treatment and the occurrence of disease were determined. The mutual efficacies for Sa-Ahm's clinical cases can be analyzed and explained with correlativity diagrams that include five interrelations.

Daycare centers provide care for children, often infants, toddlers and some school age children. These centers provide opportunities for playing, eating and napping. As such, cleaning, disinfecting areas and indoor environment management is necessary to keep clean and safe for children; this is often required through regulations. Children breathe more air per pound of body weight than adults. Children are more vulnerable to environmental health risks than adults. Children are still developing, which means indoor pollutants exposure can affect them even more. Korea Indoor Air Quality Control in Public Use Facilities, Etc. Act says shall manage the facilities by satisfying the standards for maintenance of safe indoor air quality. However, Some daycare center are excluded from this act because their floor area is under by regulation, Maintenance and management of indoor air quality is very inadequate. So, the purpose of this study is to evaluate method of to improve and to apply control and management indoor air quality in uncontrolled daycare center. It selected 28 sites as uncontrolled daycare center and measured indoor air quality. The items of measurement as follow: carbon dioxide (), particle matter (), total volatile organic compounds (TVOC), formaldehyde (HCHO), total bacteria colony (TBC). Measurement site in day care center is classroom and living room where the children spent in activity and measurement time is in class. After appling technology, Two month later, it measured same mensuration. To determine which factors influence improvement indoor air quality, it analysed the measurement data by comparing before.

In this study, surface modification technology has been developed in order to improve toluene removal performance of volcanic ash which is used as an adsorptive building material. Furthermore, the performance of building materials with the addition of modified volcanic ash will be evaluated; and in turn, it will be used as fundamental information for the improvement of performance on functional building materials. In order to eliminate the toluene in the air, copper nitrate salts was impregnated on the surface of volcanic ash by one to two percent of its mass. To confirm its toluene adsorption performance, the modified volcanic ash was added for the purpose of Spray-painting composition production; and in turn, the performance evaluation on toluene adsorption was carried out. In the case of Toluene removal rate, all samples impregnated copper nitrate salts by 1 wt percent and 2 wt percent showed the rate equal to or higher than 90 percent. Spray-painting composition added by modified volcanic ash showed the adsorption rate of 67 percent on the first day and 60 percent on day 7. Spray-painting composition added by modified volcanic ash showed higher toluene adsorption performance than the one with natural volcanic ash. Therefore, in order to enhance the performance of indoor contaminants removal by functional building materials, various materials should be developed.

Aldehydes are of particularly interest due to their potential adverse impact on human health. Formaldehyde is one of the most abundant indoor pollutants. To improve indoor air quality, identifying and removing the major emission sources of formaldehyde would be desirable. The purposes of this study were to determine aldehyde concentrations in libraries and reading rooms and to identify emission sources of formaldehyde in private reading rooms. Indoor aldehyde concentrations were quantified at 66 facilities, including public libraries, children's libraries, public reading rooms, and private reading rooms, in the Seoul metropolitan area. Emission fluxes of formaldehyde from the surfaces of desks, chairs, floors, walls, and ceilings in 19 private reading rooms were measured using a passive emission colorimetric sensor. Indoor aldehyde (formaldehyde, acetaldehyde, propioaldehyde, benzaldehyde, and hexaldehyde) levels were significantly higher than outdoor levels. Indoor formaldehyde geometric mean concentrations in private reading rooms (119.3 μg m − 3 ) were significantly higher than in public libraries (29.2 μg m − 3 ), children's libraries (29.3 μg m − 3 ), and public reading rooms (40.8 μg m − 3 ). Indoor formaldehyde levels were associated with relative humidity. In private reading rooms, the emission rates from desks (255.5 ± 214.8 μg h − 1 ) and walls (231.7 ± 192.3 μg h − 1 ) were significantly higher than that from chairs (79.6 ± 88.5 μg h − 1 ). Desks (31%) and walls (29%) were the major emission sources of formaldehyde in 14 facilities in which measurements exceeded the indoor standard of 100 μg m − 3 . The age of interior materials was a significant factor for indoor formaldehyde emission flux. Controlling the emission rates of desks and walls is recommended to improve formaldehyde concentrations in private reading rooms.

Thermal comfort provide satisfaction of thermal environment and affects productivity of occupants in residential building. However, temperature control can not provide the thermal comfort at all the time. because thermal comfort is influenced by many environmental variables such as temperature, relative humidity, air velocity, radiation temperature, activity level and clothing insulation. The purpose of this study is that predicted mean vote(PMV) index is used as control. And, Thermal comfort is evaluated both PMV control and temperature control by simulation. Each other cases were compared, in which set-point temperatures of and and, set-point PMV index through the respective heating season in the simulation. The results show that PMV control is better to maintain comfort state and save energy than temperature control.

Prothrombin, a protein involved in blood coagulation, is a plasma glycoprotein composed of the Gla domain, two adjacent kringle domains, and a serine protease domain. Kringles are triple-disulfide-loop folding domains, which are found in several other blood proteins. In this study, we showed that recombinant human prothrombin kringle-1, -2. and -1-2 (rk-1, -2, -1-2) all have potent anti-angiogenic activities, which inhibit Lewis lung carcinoma (LLC) tumor growth and metastases. Recombinant human prothrombin kringles were expressed by an E. coli expression system and purified to apparent homogeneity from crude E. coli extracts. Purified rk-1, -2, -1-2 migrated with a molecular mass of 14, 19, and 31 kDa, respectively, on sodium dodecyl sulfate-polyacrylamide gel electrophoresis (SDS-PAGE) under reducing conditions. rk-1, -2, -1-2 exhibited potent inhibitory effects on bFGF-stimulated bovine capillary endothelial cell growth with half-maximal concentrations (ED50) of approximately 41, 55, and 156 nM, respectively. All of the recombinant human prothrombin kringles also inhibited angiogenesis in the chorioallantoic membrane (CAM) of chick embryos at a dose of 20 microg. Systemic administration of rk-1, -2, -1-2 at a dose of 0.5 mg/kg/day suppressed the growth of primary LLC and at dose of 0.5 and 1.0 mg/kg/day inhibited LLC metastases in C57BL6/J mice lungs through their anti-angiogenic effects.