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Introduction:C-reactive protein-to-albumin ratio (CAR) is a prognostic marker in various diseases that represents patients’ inflammation and nutritional status. Here, we aimed to investigate the prognostic value of CAR in critically ill patients with severe acute kidney injury requiring continuous renal replacement therapy (CRRT). Methods:We retrospectively collected data from eight tertiary hospitals in Korea from 2006–2021. The patients were divided into quartiles according to CAR levels at the time of CRRT initiation. Cox regression analyses were performed to investigate the effect of CAR on in-hospital mortality. The mortality prediction performance of CAR was evaluated using the area under the curve (AUC), net reclassification improvement (NRI), and integrated discrimination improvement (IDI). Results:In total, 3,995 patients who underwent CRRT were included, and the in-hospital mortality rate was 67.3% during the follow-up period. The 7-day, 30-day, and in-hospital mortality rates increased toward higher CAR quartiles (all p 0.001). After adjusting for confounding variables, the higher quartile groups had an increased risk of in-hospital mortality (quartile 3: adjusted hazard ratio [aHR], 1.26, 95% confidence interval [CI], 1.10–1.43, p 0.001; quartile 4: aHR, 1.22, 95% CI, 1.07–1.40, p= 0.003). CAR combined with Acute Physiology and Chronic Health Evaluation II or Sequential Organ Failure Assessment scores significantly increased the predictive power compared to each severity score alone for AUC, NRI, and IDI (all p 0.05). Conclusions:A high CAR is associated with increased in-hospital mortality in critically ill patients requiring CRRT. The combined use of CAR and severity scores provides better predictive performance for mortality than the severity score alone. The mortality rate of critically ill patients with severe acute kidney injury (AKI) requiring continuous renal replacement therapy (CRRT) remains high. In addition, predicting the prognosis of these patients, which is crucial for determining the appropriate treatment level and timing, is difficult. Herein, we evaluated the C-reactive protein-to-albumin ratio (CAR) as a prognostic factor and compared its predictive performance with those of traditional severity scores. Our study demonstrated that high CAR was associated with increased in-hospital mortality. In particular, the addition of CAR to the APACHE II and SOFA scores was superior to traditional severity scores alone in predicting mortality. Consequently, CAR can be used to enhance the accuracy of predicting mortality in patients with severe AKI who require CRRT.

Background: The relationship between self-rated health (SRH) and the development of incident chronic kidney disease (CKD) has not been explored in the general population. Methods: We reviewed the data of 7027 participants in the Ansung-Ansan cohort study. SRH was categorized as poor, fair, or good, and the outcome was the development of CKD, defined as the first event of an estimated glomerular filtration rate < 60 mL/min/1.73 m2, at least twice during the follow-up period. Hazard ratios (HRs) and confidence intervals (CIs) were calculated using Cox proportional hazards regression analysis. Results: Over a mean follow-up duration of 11.9 years, 951 participants (13.5%) developed CKD. Compared with poor self-rated health, the HR (95% CI) of fair self-rated health for incident CKD development was 0.771 (0.657–0.905; P= 0.001), whereas that of good self-rated health was 0.795 (0.676–0.935; P= 0.006). However, the renal hazard of good self-rated health did not differ from that of fair self-rated health. In the fully adjusted model, the HR (95% CI) of poor self-rated health compared to non-poor self-rated health for incident CKD was 1.278 (1.114–1.465, P< 0.001). Old age, smoking, cardiovascular disease, diabetes, hypertension, impaired sleep, and high levels of C-reactive protein and white blood cell counts were associated with increased odds of poor self-rated health, whereas male sex, college graduate level of education, and alcohol consumption were associated with decreased odds of poor self-rated health. Conclusion: Poor self-rated health is independently associated with CKD development. Therefore, the early detection of potential CKD patients through a brief questionnaire assessment may help control the incidence of CKD.

Optimal blood pressure (BP) control is a major therapeutic strategy in the management of chronic kidney disease (CKD). We studied the association between BP and adverse kidney outcomes within a diverse cohort of Koreans with CKD.

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The role of logistics service provider (LSP) is essential for efficient logistics service quality (LSQ) and supply chain management, especially in multimodal transport. Multimodal transport routes that use the Trans-Siberian Railway (TSR) play an important role in the supply chains of Northeast Asia. This paper aims to identify current conditions of TSR LSQ and propose improvements to enhance the competitiveness of traditional routes. Therefore, this study sheds light on and provides recommendations for various managerial strategies to LSPs in the context of the TSR. This study utilizes Importance-Performance Analysis (IPA) to measure levels of importance and performance of the logistics service of LSPs that provide multimodal transport services via the TSR from South Korea to Europe. This study identifies capabilities on the basis of five criteria (price, timeliness, reliability, equipment systems, and customer service) from a customers’ perspective. The results of the research indicate that operational improvements should be considered to activate TSR multimodal transport for northern logistics routes from the perspective of Korean shippers. Specific findings show that balanced development strategies are needed for logistics routes that have not yet been significantly activated, while implying that logistics costs could be reduced initially to satisfy shippers. This study presents an operational strategy for LSPs using the TSR in northern logistics through IPA methods. Furthermore, this research can help policymakers propose specific policies to revitalize the northern logistics of Korean logistics companies and to provide incentive supports for shippers.

Purpose: This paper aims to identify the factors that experts consider important for the effective operation of multimodal transport using the Trans-Siberian Railway (TSR) in the Russian Far East and to also establish operational strategies that enable Korean logistics companies to use TSR efficiently for multimodal transportation. Design/methodology/approach: A total of 65 questionnaires were distributed to predominantly Korean logistics companies/shippers with experience in TSR and 19 replies were received. The majority of the respondents are senior executives with at least 10 years of work experience. To identify the factors and present strategies, this study applied the strengths, weaknesses, threats and opportunities -fuzzy analytic hierarchy process (FAHP) method, which is based on complex multiple-criteria decision-making (MCDM) that facilitates decision-makers in considering an operational strategy by calculating the importance of input factors. Findings: Results from the FAHP indicate that the Strengths is the main factor affecting TSR multimodal transport decisions, followed by the Threats, Opportunities and Weakness factors. In terms of rank, reduction of transportation distance and time are determined as the most crucial factor from the perspective of Korean logistics companies, followed by the northern logistics development plan, the Russian Government's willingness to the development plan, political instability and possible linkages with the Korean ports. Originality/value: Through a hybrid MCDM analysis of Korean logistics companies, three operational strategies were proposed: foreign direct and small investments in the Russian Far East, Korean logistics companies implementing a cold-chain logistics service in the fishery industry and a government-led “Block Train Integration System” to secure the minimum threshold volume of cargo for small and medium-sized companies.

This study aims to analyze information on vessel traffic between the two Koreas with a probability distribution for each route/vessel type. The study will then conduct an estimate for maritime transport patterns of inter-Korean trade in the future. To analyze the flow of inter-Korean coastal shipping, this study conducted visualization analysis of shipping status between North and South Korea by year, ship type, and port using navigation data of three years from Port Logistics Information System (Port-MIS) sources during 2006 to 2008, which saw the most active exchanges between the two governments. Also, this study analyzes shipping status between the two governments as a probability distribution for each port and provides the prospects for future maritime transport for inter-Korean trade by means of Bayesian Networks and simulation. The results of the analysis are as follows: i) when North-South routes are reopened, the import volume for sand from North Korea will be increased; ii) investment in the modernization of ports in North Korea is required so that shipping companies can generate profit through economies of scale; iii) the number of the operating vessels including container ships between the two governments is expected to increase like when the tensions and conflict on the Korean Peninsula was release, especially between Busan port in South Korea and Nampo port in North Korea; and iv) among container ships, transshipment containers imported and exported through Busan Port will be shipped to North Korea by feeder transportation.

The ascomycete fungi Cylindrocarpon destructans(Cd) and Fusarium solani(Fs) cause ginseng root rot and significantly reduce the quality and yield of ginseng. Cd produces the secondary metabolite radicicol, which targets the molecular chaperone Hsp90. Fs is resistant to radicicol, whereas other fungal genera associated with ginseng disease are sensitive to it. Radicicol resistance mechanisms have not yet been elucidated.

This paper presents a light detection and ranging (LIDAR) system using electromagnetically actuated two-axis scanning micromirror. The distance measurement with the LIDAR is based on the indirect time-of-flight method using the relative ratio of the accumulated charges in capacitors connected to photodiode pixels, which is determined by the time difference between the transmitted and reflected light pulse. The micromirror has double gimbaled structure for two-axis actuation and circular reflection plate with the diameter of 3 mm. The horizontal scan angle of 49.13° was obtained by the resonant actuation at 28 kHz, and the vertical scan of 29.23° was achieved by the sinusoidal forced actuation at 60 Hz. The distance to multiple targets could be measured at once by laser scanning using the micromirror, and the distance profile LIDAR image was constructed by the measurement results.

This paper aims to identify research topics about the theme of port based on a corpus of articles published in Korean and international academic journals after the 2000s through a comprehensive literature review. Scanning the literature on port enables the authors to list up common research topics by comparing each journal paper. The scope of literature survey for this paper is limited to articles appeared in international journals in the category of seaport in science citation index (SCI) and Korea Citation Index (KCI) level journals. This study applies the topic modeling approach on collected texts and completes mapping of research trends and patterns of the existing literature by inferring key topics. This paper contributes to the literature of port research by comparing the research trends of Korean and international journals, illuminating crucial gaps that the previous studies have not addressed. Also, results in this study show that future research should focus on port cooperation and the environmental issues for the sustainable development of ports. Valuable insight from observations of this study is that the gap between recent challenges of port and topics of port studies in Korean journals needs to be bridged. This study could inspire some new discussions on port research and potential directions.

Purpose: The purpose of this paper is to analyze maritime logistics connectivity of ports and shipping networks in the East Sea Economic Rim (ESER) to promote international trade in the context of China’s Belt and Road Initiative (BRI), considering centrality, primary flow and clustering interaction. Design/methodology/approach: The paper applies a complex network model, using a big data system consisting of an automated identification system, electronic data interchange and distributive and complex data. Three perspectives, including connectivity in trading ports and regions, centralities in the realm of complex network and potential marketing and regional impacts, and sixteen criteria are considered for this analysis. A visual approach has been also applied to highlight port connectivity and ship flows for the reader’s convenience. Findings: The paper shows that port connectivity and maritime logistics are enablers to promote Korean international trade in Northeast China through the ESER, and 25 major ports are well connected to promote international trade in the region with visual data of ship flows by ship type and by flag. Research limitations/implications: Owing to the lack of port management information systems among the countries in the ESER except Korea and Japan, this paper could not capture cargo types and amounts on board. Port connectivity analysis shows links of the ports in the ESER to major ports in southeast Asia along the Twenty-first Century Maritime Silk Road (MSR). These results contribute to drawing policy implications to promote the ESER and provide suggestions for promoting Korean international trade by enhancing maritime logistics connectivity. Originality/value: Unlike the existing literature showing descriptive and policy-oriented research related to ESER, this paper applied a vigorous method with a big amount of data to analyze port connectivity and ship flows in the ESER, considering China’s BRI affecting the global supply chain system, maritime transportation, and logistics. In addition, the paper shows how the seaports in the ESER are connected along the MSR.

Developing a material with a new morphology is very important for improving the functional performance and finding new applications. Monoclinic samarium oxysulfate (Sm2O2SO4) nanoplates were first prepared using a hydrothermal process followed by a post‐annealing treatment of an as‐synthesized Sm2(OH)4SO4·2H2Oplate at 450 °C. The fundamental physicochemical properties were examined by scanning electron microscopy, high‐resolution transmission electron microscopy, Rietveld X‐ray diffraction crystallographic data analysis, thermogravimetric analysis/differential scanning calorimetry, Fourier transform‐infrared spectroscopy, Raman spectroscopy, ultraviolet–visible‐NIRabsorption, and X‐ray photoelectron spectroscopy. Samarium oxysulfate Sm2O2SO4plates were prepared by the post‐annealing treatment of hydrothermally synthesized Sm2(OH)4SO4· 2H2O.

AbstractA life-threatening cardiopulmonary resuscitation (CPR)-related injury can cause recurrent arrest after return of circulation. Such injuries are difficult to identify during resuscitation, and their contribution to failed resuscitation can be missed given the limitations of conventional CPR. Extracorporeal cardiopulmonary resuscitation (ECPR), increasingly being considered for selected patients with potentially reversible etiology of arrest, may identify previously occult CPR-related injuries by restoring arterial pressure and flow. Herein, we describe two cases of severe CPR-related injuries contributing to recurrent arrest. Each case had ECPR implemented within 60 minutes of the start of CPR. After the presumed cardiac etiology had been addressed with percutaneous coronary intervention, life-threatening cardiovascular injuries with recurrent arrest were noted, and resuscitative thoracotomy was performed under ECPR. One patient survived to hospital discharge.ECPR may provide an opportunity to identify and correct severe resuscitation-related injuries causing recurrent arrest. Chest compression depth >6 cm, especially in older women, may contribute to these injuries.

Since the previous paper of us (Song & Lee, 2007), Korean ports, like others in the region and world, have experienced a number of challenges, which have driven the ports to make either a slight adjustment or a substantial re-organisation in terms of their governance structure. This paper aims to examine such drivers and subsequent changes taken place in Korea since 2007. This line of analysis will give an insight into an evolutionary development and movement in the area of port governance as an exemplar to those stakeholders who might consider a similar type of measurement now and future. This paper will utilise the same lenses adopted in the previous research for a coherent and consistent comparison to discuss the evolution of administrative and ownership structures.

AbstractBackground/Aims:Patients with minimal change disease (MCD) have a high relapse rate, which results in many complications. Identifying the risk factors for relapse is crucial, but little is known about these factors. Therefore, we performed the current study to determine the factors related to relapse in this patient population. Methods:We retrospectively analyzed 51 adult patients with biopsy-proven primary MCD treated between 2003 and 2013. The demographic, physiologic, laboratory and therapeutic data were gathered from the electronic medical records database. Lesions of the glomerulus, tubulointerstitium and vasculature were analyzed for associations with relapse. Results:During a median 50.9 months, 96.1 (49 of 51) of patients had achieved complete remission, and the rest ultimately achieved at least partial remission. A total of 56.9 (29 of 51) patients experienced at least 1 episode of relapse after the first remission. Patients with relapse had a higher rate of glomerular hypertrophy (GH; 34.5) than those without relapse (9.1; p < 0.05). After adjusting for confounders, GH was associated with increased odds of relapse (OR 15.992; 95 CI 1.537-166.362; p = 0.02). In a subgroup analysis according to median age, sex and tubulointerstitial (TI) lesions, the association between GH and relapse was evident only in men and in the group with TI lesions. Conclusion:GH is associated with relapse in adult patients with MCD, particularly in men and in those with TI lesions. Frequent monitoring and early intervention are needed in these groups. Future large prospective cohort studies are needed to confirm the study results.© 2015 S. Karger AG, Basel

Global warming and climate change haves brought a new issue in the Arctic sea. Therefore, we can now explore new shipping routes through the Arctic Ocean instead of the existing commercial route. In particular, the Northern Sea Route (NSR) is one of the feasible shipping routes and, has provided tremendous shipping benefits. If the NSR becomes commercialized, we will be able to save about 5,000 nautical miles in distance and sailing time. In this study, we will emphasize some of the important results on the possibility of commercializing the shipping route in the Arctic. The NSR may bring positive economic effects in terms of shipping distance and time. For example, when utilizing the NSR, the maximum cargo traffic between Asia and Europe is expected to be around 46 million TEU. However, we also need to consider an expensive passage fee that is currently imposed by Russia. In conclusion, we maintain our efforts to protect the environment in the Arctic, in terms of logistics, and we need to explore every possible avenue to bring possible economic benefits to the North Pacific countries.

ObjectivesContinuous blood gas monitoring is frequently necessary in critically ill patients. Our aim was to assess the accuracy of transcutaneous CO2tension (PtcCO2) monitoring in the emergency department (ED) assessment of hypotensive patients by comparing it with the gold standard of arterial blood gas analysis (ABGA).MethodsAll patients receiving PtcCO2monitoring in the ED were included. We excluded paediatric patients, patients with no ABGA results during a hypotensive event, patients whose ABGA was not performed simultaneously with PtcCO2monitoring, and patients who received sodium bicarbonate for resuscitation. The included patients were classified into hypotensive patients and normotensive patients. A hypotensive patient was defined as a patient showing a mean arterial pressure under 60 mm Hg. The agreement in measurement between PaCO2tension (PaCO2) and PtcCO2were investigated in both groups.ResultsThe mean difference between PaCO2and PtcCO2was 2.1 mm Hg, and the Bland–Altman limits of agreement (bias±1.96 SD) ranged from −15.6 to 19.7 mm Hg in the 28 normotensive patients. The mean difference between PaCO2and PtcCO2was 1.1 mm Hg, and the Bland–Altman limits of agreement (bias±1.96 SD) ranged from −19.5 to 21.7 mm Hg in the 26 hypotensive patients. The weighted κ values were 0.64 in the normotensive patients and 0.60 in the hypotensive patients.ConclusionsPtcCO2monitoring showed wider limits of agreement with PaCO2in urgent situations in the ED environment. However, acutely developed hypotension does not affect the accuracy of PtcCO2monitoring.

IntroductionUnerring radiological interpretation is essential in discharged minor trauma patients without follow-up visits based on the rapid decision of emergency physicians (EPs). Misinterpretation may raise issues concerning patient care, reimbursement and lawsuits. The authors investigated the discrepancies and associated factors in radiological interpretation for discharged trauma patients between EPs and radiologists.MethodsThe authors included trauma patients who visited the emergency department, from 1 August 2009 to 31 July 2010, and searched for cases showing discrepancy using the ‘modified quality assurance model for radiological interpretation’. The overall/clinically significant discrepancy (CSD)/clinically insignificant discrepancy (CinSD) rates were calculated. The authors also looked at the relationship between discrepancies and several factors including age and time of visit.Results10 243 cases were related to minor trauma, in which the radiological images were interpreted as normal by EPs. The overall discrepancy, the CSD and CinSD rates were 0.77% (n=79), 0.47% (n=48) and 0.3% (n=31), respectively. No discrepancy was shown to be related to the day or time of visit. The discrepancy rate turned out to be relatively higher with increasing age, and for injuries of the extremities. No associated factors were found between the CSD and CinSD groups.ConclusionsDespite a relatively low CSD rate, careful interpretation is recommended considering age and body areas imaged. A modified model would be needed as a supportive tool for training and improving the quality of care. A further development of the modified system for efficient use of resources will be needed to focus on quality improvement and education in each hospital.

In comparison to concrete or steel bridge decks, glass-fibre-reinforced polymer (GFRP) compos ite bridge deck is highly economical, since its lightweight property reduces initial construction cost for the foundation, and the high durability decreases the life-cycle cost for the bridges. Furthermore, the duration of construction is reduced significantly because of the short installation time of the lightweight GFRP composite decks.Korea is one of the leading countries in the construction of composite-deck bridges in recent years. In Korea, 13 road bridges (deck area = 15 917 m2) have been constructed and six more road bridges (deck area = 9747 m2) will be constructed in the near future. Furthermore, 19 footbridges (deck area = 14 921 m2) have been constructed to date and six more footbridges (deck area = 14 204 m2) will be constructed in the near future. Among them, there are two remarkable projects: the Noolcha Bridge in Busan Newport which was constructed with the world's largest composite-deck panel, which is 300 m long and 35 m wide, and the existing 1,7 km-long walkway of the Hangang Bridge in Seoul which was expanded from a width of 2,5 to 5 m by replacing the existing concrete decks with composite decks.

In comparison to concrete or steel bridge decks, glass-fibre-reinforced polymer (GFRP) compos ite bridge deck is highly economical, since its lightweight property reduces initial construction cost for the foundation, and the high durability decreases the life-cycle cost for the bridges. Furthermore, the duration of construction is reduced significantly because of the short installation time of the lightweight GFRP composite decks.Korea is one of the leading countries in the construction of composite-deck bridges in recent years. In Korea, 13 road bridges (deck area = 15 917 m2) have been constructed and six more road bridges (deck area = 9747 m2) will be constructed in the near future. Furthermore, 19 footbridges (deck area = 14 921 m2) have been constructed to date and six more footbridges (deck area = 14 204 m2) will be constructed in the near future. Among them, there are two remarkable projects: the Noolcha Bridge in Busan Newport which was constructed with the world's largest composite-deck panel, which is 300 m long and 35 m wide, and the existing 1,7 km-long walkway of the Hangang Bridge in Seoul which was expanded from a width of 2,5 to 5 m by replacing the existing concrete decks with composite decks.

In comparison to concrete or steel bridge decks, glass-fibre-reinforced polymer (GFRP) compos ite bridge deck is highly economical, since its lightweight property reduces initial construction cost for the foundation, and the high durability decreases the life-cycle cost for the bridges. Furthermore, the duration of construction is reduced significantly because of the short installation time of the lightweight GFRP composite decks. Korea is one of the leading countries in the construction of composite-deck bridges in recent years. In Korea, 13 road bridges (deck area = 15 917 m2) have been constructed and six more road bridges (deck area = 9747 m2) will be constructed in the near future. Furthermore, 19 footbridges (deck area = 14 921 m2) have been constructed to date and six more footbridges (deck area = 14 204 m2) will be constructed in the near future. Among them, there are two remarkable projects: the Noolcha Bridge in Busan Newport which was constructed with the world's largest composite-deck panel, which is 300 m long and 35 m wide, and the existing 1,7 km-long walkway of the Hangang Bridge in Seoul which was expanded from a width of 2,5 to 5 m by replacing the existing concrete decks with composite decks.

PURPOSE: To determine the diagnostic performance of bedside assessment of end-tidal alveolar dead space fraction (ADSF) for pulmonary embolism (PE) and whether the use of additional ADSF assessment following D-dimer assay can improve the diagnostic accuracy in suspected PE patients in the emergency department. METHODS: A prospective observational study of 112 consecutive adult patients suspected of PE of whom 102 were eligible for analysis. ADSF was calculated using arterial carbon dioxide and end-tidal carbon dioxide. An ADSF less than 0.2 was considered normal. RESULTS: PE was confirmed in 11 (10.8%) of 102 patients. D-dimer assay alone as a reference standard test for PE had a sensitivity of 100%, specificity of 38.5% and false negativity of 0%. Area under the receiver-operator characteristic curve for the diagnosis of PE using ADSF values alone was 0.894, Sensitivity, specificity and false negativity for the combined results of a positive D-dimer test and abnormal ADSF were 100%, 78.0% and 0% for the presence of PE, respectively. Of 65 patients with a low or intermediate clinical probability and a positive D-dimer assay, 36 (55.4%) patients displayed normal ADSF and had no PE. CONCLUSIONS: By itself ADSF assessment performed well in diagnosis of PE. The combined result of a positive D-dimer and abnormal ADSF increased the specificity for diagnosing PE compared with the D-dimer test alone. The use of additional bedside ADSF assessment following a positive D-dimer test may reduce the need for further imaging studies to detect PE in patients with a low or intermediate clinical probability.

Restrospective case series.

Although facioscapulohumeral muscular dystrophy (FSHD) is the third most common inherited myopathy, cases of infantile or early-childhood onset have rarely been reported. The purpose of this study was to describe a case of early-onset FSHD with lumbar hyperlordosis, which shows the significance of the dynamic component of sagittal spinal imbalance. An 11-year-old girl presented with progressive gait disturbance and lumbar hyperlordosis. The motor power of her pelvic extensor muscles was grade 3. Pelvic tilt and hip flexion were markedly increased as determined by gait analysis. The most important factor in the development of hyperlordosis is the weakness of the pelvic extensor muscles, and the results of gait analysis exquisitely explain the pathophysiology. The patient stands with her spine hyperextended to maintain upright posture by a compensatory mechanism of relatively strong back extensor muscles. Corrective surgery for lumbar hyperlordosis was not considered because it could have eliminated the compensatory lumbar hyperextension, thus making the spine of the patient stoop forward through her hip joint during walking by the weakness of her pelvic extensor muscles. This FSHD case is an impressive example of a patient showing the concept that weak pelvic extensor muscles cannot keep the spine upright and balanced.

It is important for preventing hyperventilation so as to improve the outcomes of patients with severe traumatic brain injuries. End-tidal CO2(Petco2) reflects arterial CO2(Paco2), noninvasively and continuously. The aim of this study is to examine the concordance between Paco2and Petco2among adults presenting to the emergency department with severe traumatic brain injury and to elucidate the patient groups who had discordance.

Ever since the 1960s, every 10 to 15 years, the size of ships has been upgraded by 1,000 TEU. This trend of upgrading has been maintained due to advances in ship manufacturer's technologies, and in the carriers' strategy. It is likely that this strategy will accelerate the trend for carriers to operate VLCSs far earlier than was previously expected. The main aims of using larger containerships are to reduce costs with economies of scale, to maintain the monopoly of the major carriers, and to achieve a high rate of growth.

Port competition at both the regional and global scales results in port concentration and deconcentration, respectively. Whereas a number of recent studies interpret such phenomena as the effects of global forces such as containerization, few researchers have investigated local forces, such as the evolving relationships between urban policy and port growth. This study compares how two global hub port cities in the Asia-Pacific region, Hong Kong and Singapore, have sustained their port functions while transforming into major economic centers. Entropy indexes are calculated by district based on service industries related to port activities between 1993 and 2004. The results show the influences of port competition, lack of space, and congestion on changes in port-related activities. We conclude that cross-border integration is a main differentiating factor in the evolution of these hub port cities.

The recycling of magnesium chloride brines via a multi-step chemical reaction and precipitation process has been studied in waste bittern from a salt purification plant. In this study, the rates of particle (magnesium hydroxide) growth, the effects of initial concentration of reactants and optimum condition of reaction to make high purity magnesium hydroxide were investigated. Produced magnesium hydroxide was separated and washed using carboxy methyl cellulose as sedimentation agent, and used sodium stearate to prevent particle from aggregating. The mean particle size of obtained high quality magnesium hydroxide are 5 μm and concentration is 99.5%.

In the 1990s, following the challenges imposed by globalisation, the liner shipping industry experienced profound changes, leading major carriers to create ad-hoc logistics business-units. Nevertheless the vertical integration of shipping lines along the transport chain faced important entry barriers in various regions.This paper aims at analysing the impact of such barriers on carriers’ pathways of expansion in the logistics business. It mainly focuses on the East-Asian market, as a relevant empirical case in which important institutional and socio-political obstacles are still in force .Main results disclose sui-generis paths of expansion achieved by major carriers, in contrast with linear constructs of time and space proposed by classical TNC theories. In such respect, port operations reveal to be the most critical stage of the chain. The ‘sidestep’ of the port phase, leading to investments in other on-shore activities (warehousing, inland terminals, etc.) as well as the implementation of aggressive financial campaigns (acquisitions and takeovers), reveal the unfaltering will of top shipping lines: the quick achievement of a successful vertical and horizontal expansion despite environmental obstacles.

The basic concept, design and performance of a novel needle-based x-ray system for medical applications are reported. The main principle of the system is based on a two-stage production of x-rays. The system comprises a conventional x-ray tube with an Ag anode, any known type of conditioning optics and a 2.2 mm diameter hollow needle with an interchangeable Mo target. The target can be moved along the needle axis and rotated around the needle axis. The needle x-ray device allows for adjustment in energy and flux intensity of the x-rays emitted by the target. The depth dependence of the intensity, dose rate as well as spatial and energy distribution of the radiation emitted by the target have been experimentally measured. The depth dose rate results have been compared with theoretical calculations using a Monte Carlo simulation of the x-ray production process. These studies have experimentally confirmed that the concept of this x-ray system is correct. Further improvement of the device can increase the dose rate up to the levels required for clinical applications.

A newly designed pressure-scanning slit viscometer is developed to combine an optical device without refraction while measuring blood viscosity over a range of shear rates. The capillary tube in a previously designed capillary viscometer was replaced with a transparent slit, which is affordable to mount optical measurement of flowing blood cells. Using a pressure transducer, we measured the change of pressure in a collecting chamber with respect to the time, p(t), from which the viscosity and shear rate were mathematically calculated. For water, standard oil and whole blood, excellent agreement was found between the results from the pressure-scanning slit viscometer and those from a commercially available rotating viscometer. This new viscometer overcomes the drawbacks of the previously designed capillary viscometer in the measuring whole blood viscosity. First, the pressure-scanning slit viscometer can combine an optical instrument such as a microscope. Second, this design is low cost and simple (i.e., ease of operation, no moving parts, and disposable).

A newly designed pressure-scanning slit viscometer is developed to combine an optical device without refraction while measuring blood viscosity over a range of shear rates. The capillary tube in a previously designed capillary viscometer was replaced with a transparent slit, which is affordable to mount optical measurement of flowing blood cells. Using a pressure transducer, we measured the change of pressure in a collecting chamber with respect to the time, p(t), from which the viscosity and shear rate were mathematically calculated. For water, standard oil and whole blood, excellent agreement was found between the results from the pressure-scanning slit viscometer and those from a commercially available rotating viscometer. This new viscometer overcomes the drawbacks of the previously designed capillary viscometer in the measuring whole blood viscosity. First, the pressure-scanning slit viscometer can combine an optical instrument such as a microscope. Second, this design is low cost and simple (i.e., ease of operation, no moving parts, and disposable).

Electron backscattering is a prominent secondary effect in beta dosimetry, and is closely correlated with factors such as the geometries of the source and the scattering material, as well as the composition of the scattering material. Previous results were varied depending on the experimental setup and detector resolution, and were generally performed for monoenergetic electron beams, which makes direct application of these factors to beta sources difficult. In this work, backscattering factors were calculated with MCNP 4C for selected beta sources currently in use (³²P and ⁹⁰Sr/⁹⁰Y) as well as for sources of potential therapeutic use (⁴⁵Ca, ¹⁴²Pr and ¹⁸⁵W). Specifically, the calculations used beta spectra generated by the SADDE MOD2 code. The factors were calculated as a function of the distance from the interface between water and scatterers. The scatterers include source surroundings, source supporting materials and contrast agents commonly used for imaging purposes in brachytherapy. The results were fit by a simple function for future incorporation into a dose point kernel code. Due to the high-Z material content (iodine, Z = 53) in the contrast agent, a significant dose backscatter was observed near the water interface. Different cross-section algorithms in the MCNP code (inherent and ITS 3.0) affect the factor calculations. The results generated by the ITS 3.0 algorithm closely matched the EGS4 calculations for ³²P. The dependence of backscatter factors on log(Z + 1) (Baily 1980 Med. Phys. 7 514–9) was observed for all the beta sources with a high correlation coefficient, R (>0.95). The overall results indicate that the backscattering effect is significant at short distances from the surface of the interface between water and the scattering material. This model can also aid in choosing a source support or mixing materials for beta brachytherapy sources.

Background:Although tongue coating and periodontal conditions have been reported to be major halitosis‐inducing factors, the relationship between volatile sulfur compounds (VSC) and these 2 major factors is not yet fully understood. The aim of this study was to investigate the relationship of VSC concentrations to tongue coating and periodontal health. Methods:Forty subjects (mean age 33.3 years, range 14 to 64 years) were enrolled in this study. Gas chromatography was performed to analyze each VSC component from the mouth air sampled prior to tongue scraping, after tongue scraping, and after a subsequent prophylaxis on the interdental spaces. Results:CH3SH was the most malodorous component among the 3 major VSC from the mouth air. The high CH3SH group showed a significantly higher organoleptic rating (P<0.01), gingival index (P<0.01), bleeding index (P<0.01), probing depth (P<0.05), and VSC concentrations prior to tongue scraping (P<0.01), except for the amount of tongue coating, compared to the low CH3SH group. All VSC concentrations were vastly reduced by tongue scraping in both groups, and the remaining contents were nearly all removed by the subsequent prophylaxis. The VSC contents produced by the tongue coating played a major role [H2S: 76%; CH3SH: 52%; (CH3)2S: 55%] in the low CH3SH group. In the high CH3SH group which had poor periodontal health, the tongue coating still played a major role [H2S: 67%; CH3SH: 59%; (CH3)2S: 48%], but the interdental spaces also contributed to VSC production [H2S: 26%; CH3SH: 32%; (CH3)2S; 36%]. Conclusions:The tongue coating was demonstrated to be a primary halitosis‐inducing factor. Periodontal health was also shown to contribute to VSC production. J Periodontol 2003;74:32‐37.

Objective.The aim of this study was to investigate oral manifestations and salivary changes in patients with end-stage renal disease undergoing hemodialysis. Study Design.Eighty-two patients undergoing hemodialysis for renal insufficiency were examined; 22 of these patients were randomly selected for salivary tests. Unstimulated whole saliva and stimulated parotid saliva were collected, and flow rate, pH, and buffer capacity were examined. Twenty-two healthy volunteers were included as controls. Results.Uremic odor, dry mouth, and taste change were common symptoms. Petechia and/or ecchymosis and increase of tongue coating were major signs. The flow rates of unstimulated whole and stimulated parotid saliva were decreased in the patient group. The pH and buffer capacity of unstimulated whole saliva were increased in the patient group, but stimulated parotid saliva did not show any significant differences. Conclusions.Patients with end-stage renal disease undergoing hemodialysis showed apparent oral and salivary changes. The results help us understand the relationship between oral changes and renal insufficiency. (Oral Surg Oral Med Oral Pathol Oral Radiol Endod 1999;88:316-9)

We report on high-efficiency and low-threshold operation of the pump reflection configuration using an additional mirror in the noncollinear phase matching optical parametric oscillator (OPO). Beta-barium borate (β-BBO) cut for type I phase matching is pumped by the second harmonics of a Q-switched Nd:YAG laser. The maximum output efficiency of 22.9% with a slope efficiency of 26.9% was obtained at the wavelength of 756 nm. The threshold energy of 4.9 mJ was obtained. In this scheme, the linewidth was measured to be 1.5 nm.

In this paper, a method for the efficient implementation of the control network for a distributed control system (DCS) is proposed. The proposed method focuses on the real-time property and the low networking cost of a control network. It suggests a new network architecture combining the IEEE 802.4 token-passing bus access method and the IEEE 802.3 physical layer. For this purpose, a new interface, a physical layer service translator is introduced. A control network using this method is implemented and applied to a DCS.