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Varicella (chickenpox) is an infectious disease caused by the highly contagious varicella zoster virus with a secondary attack rate greater than 90%. From this perspective, we aimed to establish the basis for a national varicella vaccine policy by reviewing vaccination programs and policies of countries that have introduced universal varicella vaccinations. As a result of the spread of varicella, an increasing number of countries are providing 2-dose vaccinations and universally expanding their use. In practice, the efficacy and effectiveness of vaccination differ among vaccines and vaccination programs. Optimized vaccination strategies based on each country’s local epidemiology and health resources are required. Accordingly, it is necessary to evaluate the effectiveness of varicella vaccines in different settings. Given the short-term and fragmented vaccine effectiveness evaluation in Korea, it is necessary to evaluate its effectiveness at the national level and determine its schedule based on the evidence generated through these studies.

Summary: Purpose: Patients undergoing cholecystectomy report experiencing stress related to the surgery, complaining of pain and poor sleep quality. Aromatherapy is known to have positive effects on these complaints. However, the effect of aromatherapy on cholecystectomy patients has yet to be determined. The aim of this study, therefore, was to investigate the effects of aromatherapy on laparoscopic cholecystectomy patients’ stress, pain, and sleep quality. Methods: This study was a randomized controlled trial involving 69 adults who underwent laparoscopic cholecystectomy. Essential oil therapy was given to an intervention group, and almond oil was given to a placebo group. The outcome variables were stress, pain, and sleep quality. Results: There were no differences between the groups in terms of demographic and clinical characteristics and pretreatment dependent variables. After the intervention, subjective stress (F = 7.43, p

Numerous varieties of life forms have filled the earth throughout evolution. Evolution consists of two processes: self-replication and interaction with the physical environment and other living things around it. Initiated by von Neumann et al. studies on self-replication in cellular automata have attracted much attention, which aim to explore the logical mechanism underlying the replication of living things. In nature, competition is a common and spontaneous resource to drive self-replications, whereas most cellular-automaton-based models merely focus on some self-protection mechanisms that may deprive the rights of other artificial life (loops) to live. Especially, Huang et al. designed a self-adaptive, self-replicating model using a greedy selection mechanism, which can increase the ability of loops to survive through an occasionally abandoning part of their own structural information, for the sake of adapting to the restricted environment. Though this passive adaptation can improve diversity, it is always limited by the loop’s original structure and is unable to evolve or mutate new genes in a way that is consistent with the adaptive evolution of natural life. Furthermore, it is essential to implement more complex self-adaptive evolutionary mechanisms not at the cost of increasing the complexity of cellular automata. To this end, this article proposes new self-adaptive mechanisms, which can change the information of structural genes and actively adapt to the environment when the arm of a self-replicating loop encounters obstacles, thereby increasing the chance of replication. Meanwhile, our mechanisms can also actively add a proper orientation to the current construction arm for the sake of breaking through the deadlock situation. Our new mechanisms enable active self-adaptations in comparison with the passive mechanism in the work of Huang et al. which is achieved by including a few rules without increasing the number of cell states as compared to the latter. Experiments demonstrate that this active self-adaptability can bring more diversity than the previous mechanism, whereby it may facilitate the emergence of various levels in self-replicating structures.

Objectives This study aims to evaluate the risk assessments of coronavirus 2019 (COVID-19) in the Korea Centers for Disease Control and Prevention (KCDC), from the point of detection to the provision of basic information to the relevant public health authorities. Methods To estimate the overall risk of specific public health events, probability, and impact at the country-level were evaluated using available information. To determine the probability of particular public health events, the risk of importation and risk of transmission were taken into consideration. KCDC used 5 levels (“very low,” “low,” “moderate,” “high,” and “very high”) for each category and overall risk was eventually decided. Results A total of 8 risk assessments were performed on 8 separate occasions between January 8th to February 28th, 2020, depending on the detection and report of COVID-19 cases in other countries. The overall risk of the situation in each assessment increased in severity over this period: “low” (first), “moderate” (second), “high” (third), “high” (fourth), “high” (fifth), “high” (sixth), “high” (seventh), and “very high” (eighth). Conclusion The KCDC’s 8 risk assessments were utilized to activate national emergency response mechanisms and eventually prepare for the pandemic to ensure the containment and mitigation of COVID-19 with non-pharmaceutical public health measures.

Density-based clustering methods have achieved many applications in data mining, whereas most of them still likely suffer poor performances on data sets with extremely uneven distributions, like the manifold or ring data. The paper proposes a novel method for clustering with local peaks in the symmetric neighborhood. Local peaks are points with maximum densities at the local level. During the searching of local peaks, all data, except those outliers, can be easily divided into a number of small clusters in accordance with the local peaks in each point's neighborhood. Especially, a graph-based scheme is adopted here to merge similar clusters based on their similarity in the symmetric neighborhood graph, followed by assigning each outlier to the closest cluster. A variety of artificial, real data sets and a real building data set have been tested for clustering by the proposed method and compared against other popular density-based methods and other algorithms.

Summary: Purpose: Mothers who give birth prematurely experience parenting stress after their babies are discharged and find it difficult to emotionally bond with them. Forming an emotional bond with a baby promotes the baby's growth and development, helps the mother cope with parenting stress after discharge, and is important for maintaining family functioning. This study aimed to identify the attachment experiences of mothers with low-birth-weight infants (LBWIs) in a follow-up program using early intervention. Methods: A phenomenological perspective was used for this qualitative research. Data were collected from in-depth interviews with twelve mothers who participated in a follow-up program using early intervention for mothers with LBWIs from September 2017 to December 2017. Colaizzi's method was used to analyze the data. Results: The experience of mothers' attachment was investigated on the basis of three categories: ‘beginning of changes in parenting methods,’ ‘forming an intimate mother–child bond,’ and ‘concerns and expectation about the child's development.’ Conclusion: The results indicate that the follow-up program using an early intervention designed to increase mothers' confidence in their parenting skills can promote mother’ attachment and the quality of life of families with LBWIs. Keywords: affect, early intervention, infant, low birth weight, qualitative research

The density peaks clustering (DPC) is a clustering method proposed by Rodriguez and Laio (Science, 2014), which sets up a decision graph to identify the cluster centers of data points. Because the improper selection of its parameter cut-off distance will lead to the wrong selection of initial cluster centers with no corrective actions in the subsequent assignment process, DPC may not identify cluster centers with different densities accurately. Especially, all cluster centers are settled as soon as they are detected, after which the DPC simply assigns each point to the same cluster as its nearest neighbor of higher density. This tends to cause the erroneous assignments of data and thus degrade the efficiency of clustering. In this paper, we propose a robust clustering method which establishes a symmetric neighborhood graph over all data points, based on the k -nearest neighbors and reverse k-nearest neighbors of each point. In order to distinguish the density peaks from all data points, local densities of each point are calculated using the reverse k-nearest neighbors. After that, initial centers for clusters are estimated over the peaks and similar clusters are aggregated on the symmetric neighborhood graph, which ends up with every point being successfully assigned to a cluster. To testify the efficiency of the new clustering method, numerical experiments and comparison works have been done on a variety of artificial and real data sets for clustering.

Abstract Background: The Asiatic pit vipers from the Trimeresurus complex are medically important venomous snakes. These pit vipers are often associated with snakebite that leads to fatal coagulopathy and tissue necrosis. The cytotoxic venoms of Trimeresurus spp.; however, hold great potential for the development of peptide-based anticancer drugs. Methods: This study investigated the cytotoxic effect of the venom from Trimeresurus purpureomaculatus, the mangrove pit viper (also known as shore pit viper) which is native in Malaysia, across a panel of human cancer cell lines from breast, lung, colon and prostate as well as the corresponding normal cell lines of each tissue. Results: The venom exhibited dose-dependent cytotoxic activities on all cell lines tested, with median inhibition concentrations (IC50) ranging from 0.42 to 6.98 µg/mL. The venom has a high selectivity index (SI = 14.54) on breast cancer cell line (MCF7), indicating that it is significantly more cytotoxic toward the cancer than to normal cell lines. Furthermore, the venom was fractionated using C18 reversed-phase high-performance liquid chromatography and the anticancer effect of each protein fraction was examined. Fraction 1 that contains a hydrophilic low molecular weight (approximately 7.5 kDa) protein was found to be the most cytotoxic and selective toward the breast cancer cell line (MCF7). The protein was identified using liquid chromatography-tandem mass spectrometry as a venom disintegrin, termed purpureomaculin in this study. Conclusion: Taken together, the findings revealed the potent and selective cytotoxicity of a disintegrin protein isolated from the Malaysian T. purpureomaculatus venom and suggested its anticancer potential in drug discovery.

Reusable, antibacterial, and photocatalytic isoporous through-hole air filtration membranes have been demonstrated based on hydrothermally grown ZnO nanorods (NRs). High-temperature (300~375 °C) stability of thermoset-based isoporous through-hole membranes has enabled concurrent control of porosity and seed formation via high-temperature annealing of the membranes. The following hydrothermal growth has led to densely populated ZnO NRs on both the membrane surface and pore sidewall. Thanks to the nanofibrous shape of the grown ZnO NRs on the pore sidewall, the membrane filters have shown a high (>97%) filtration efficiency for PM2.5 with a rather low-pressure (~80 Pa) drop. The membrane filters could easily be cleaned and reused many times by simple spray cleaning with a water/ethanol mixture solution. Further, the grown ZnO NRs have also endowed excellent bactericidal performance for both Gram-positive S. aureus and Gram-negative S. enteritidis bacteria. Owing to the wide bandgap semiconductor nature of ZnO NRs, organic decomposition by photocatalytic activity under UV illumination has been successfully demonstrated. The reusable, multifunctional membrane filters can find wide applications in air filtration and purification.

Classification of asynchronous elementary cellular automata (AECAs) was explored in the first place by Fates et al. (Complex Systems, 2004) who employed the asymptotic density of cells as a key metric to measure their robustness to stochastic transitions. Unfortunately, the asymptotic density seems unable to distinguish the robustnesses of all AECAs. In this paper, we put forward a method that goes one step further via adopting a metric entropy (Martin, Complex Systems, 2000), with the aim of measuring the asymptotic mean entropy of local pattern distribution in the cell space of any AECA. Numerical experiments demonstrate that such an entropy-based measure can actually facilitate a complete classification of the robustnesses of all AECA models, even when all local patterns are restricted to length 1. To gain more insights into the complexity concerning the forward evolution of all AECAs, we consider another entropy defined in the form of Kolmogorov–Sinai entropy and conduct preliminary experiments on classifying their uncertainties measured in terms of the proposed entropy. The results reveal that AECAs with low uncertainty tend to converge remarkably faster than models with high uncertainty.

Purpose: Current increase and complexity of medical tests and surgical procedures at outpatient department (OPD) require OPD nurses to have customer orientation focusing on various customers' interests and needs. The purpose of this study was to identify the factors associated with customer orientation in nurses working at OPD of hospitals. Methods: The study used a descriptive correlational design with cross-sectional survey. The study settings were four general hospitals in Seoul and its metropolitan area. Data were collected from 138 OPD nurses from general hospitals. Study variables were personal traits, emotional intelligence, internal marketing, service management and customer orientation. Results: Factors associated with customer orientation were identified as conscientiousness from personal traits (β = .37, p

Abstract Background The effect of nirmatrelvir/ritonavir on preventing post-COVID condition (PCC) in the BA4, BA5, and XBB Omicron predominant periods is not well understood. The purpose of this study was to assess how nirmatrelvir/ritonavir treatment affected both PCC and health-related quality of life. Methods This retrospective cohort study enrolled 2,524 adults aged 18 years and older who were eligible for nirmatrelvir/ritonavir between July 14 to November 14, 2022. All outcomes were observed from the patient’s first visit to the primary health clinic, 1 week, 1 month, 3 months, and 6 months after testing positive for COVID-19. The primary outcome was the presence of PCC. Secondary outcomes included the effects on health-related quality of life, such as walking, bathing and dressing, activities, cause adverse emotions or signs that prevent individuals from leading normal lives over a 180-day observation period. Results There were no significant differences observed between the nirmatrelvir/ritonavir and those not administered (control group) in terms of PCC symptoms at 3 months (OR 0.71 95% CI 0.31, 1.64) and 6 months (OR 1.30 95% CI 0.76, 2.21). At 3 months, the use of nirmatrelvir/ritonavir was associated with a 26% reduction in symptoms causing negative emotions (OR 0.74 95% CI 0.60, 0.92) and an increased likelihood of symptoms limiting walking (OR 1.58 95% CI 1.10, 2.27). However, there were no significant differences between the nirmatrelvir/ritonavir and the control group in terms of the impact of PCC on health-related quality of life at 6 months. Conclusions Our study indicates that the administration of nirmatrelvir/ritonavir does not significantly reduce PCC after 3 months and 6 months in a population with high vaccination coverage.

Small vertebrate carcasses represent critical resources for many terrestrial organisms, including burying beetles, which rely on carcasses for survival and breeding. Carcass attributes can influence the reproduction of burying beetles, yet most studies on their breeding ecology have used laboratory-reared carcasses of limited sizes. We conducted breeding and feeding experiments using a wide size range of lab (laboratory mice) and wild carcasses (wild mammals, birds and reptiles) to investigate how carcass size, source and taxon affect various breeding outcomes (e.g. clutch size, brood size and brood mass) of the burying beetle Nicrophorus nepalensis. Our results reveal a hump-shaped relationship between carcass size and breeding performance, with optimal breeding outcomes occurring on medium-sized carcasses. Furthermore, despite the variation in carcass tissue nutritional composition, breeding outcomes and larval growth did not differ between the two carcass sources or among the three wild carcass taxa. Finally, we found a larval quality–quantity trade-off across the range of carcasses examined, with carcass size shaping the larval life-history traits. Overall, these results elucidate how carcass resources may influence the breeding performance of burying beetles. Importantly, our study provides solid evidence validating decades of research using lab carcasses to study the reproductive ecology of burying beetles.

The purpose of this study was to explore the perspectives of lung cancer patients, their families, physicians and nurses on advance directives. Methods: The study employed a comparative descriptive design. A total of 124 participants from six general hospitals in Seoul and metropolitan area participated in this study from January 1, 2009 to November 15, 2009. Face-to-face interviews were conducted using a structured questionnaire. Results: The majority of participants were not aware of advance directives. Most participants desired the establishment of a reliable legal system and a specific legal protocol for the design and application of advance directives. The perspectives of patients, their families, physicians and nurses differed regarding end-of-life care decisions. The least preferred treatment by patients with lung cancer was intensive care, followed by cardiopulmonary resuscitation, tracheotomy and artificial ventilation, and radiotherapy. Conclusions: There were many differences in the perspectives of patients, families, physicians and nurses on advance directives. End-of-life care decisions should take the wishes of patients into account, and that such decisions should therefore be made before the patients lose the capacity to make them. To make well-informed decisions regarding future care, patients and families must be fully educated about advance directives and expected outcomes.

Middle aged women are exposed to high levels of psychologic distress due to various factors including health problems of family members, their own declining health, negative outlook towards menopause, loss of significant supportive relationships, and uncertainties regarding the future. The purpose of this study was to identify the factors associated with psychologic distress of middle-aged Korean women in the Seoul metropolitan area. Methods: The data were collected from 277 community-dwelling women between the ages of 40 and 60 years without any known severe illnesses from May 6, 2004 to May 31, 2004. The researcher or two research assistants visited the participants in person, handed out copies of the questionnaire after receiving study permission, and answered if they had any questions. Results: Hierarchical multiple regression analysis found that women with low scores of health promoting behaviors for self-actualization, nutrition, and interpersonal relation reported high levels of psychologic distress. In addition, women with low scores of marital satisfaction reported high psychologic distress. Conclusion: The study found cultural characteristics of middle-aged Korean women in psychologic distress. Health care providers should consider marital satisfaction, self-actualization, nutrition, and interpersonal relations, in particular, among Korean middle-aged women.

Abstract Background and objectives Nirmatrelvir/ritonavir was administered orally to manage mild to moderate symptoms of COVID-19 in adult patients. The objectives of this study were to (i) evaluate the cost-effectiveness of prescribing nirmatrelvir/ritonavir within 5 days of a COVID-19 illness in order to avert hospitalization within a 30-day period in the Malaysia setting; (ii) determine how variations in pricing and hospitalization rates will affect the cost-effectiveness of nirmatrelvir/ritonavir. Methods The 30-day hospitalization related to COVID-19 was determined using 1 to 1 propensity score-matched real-world data in Malaysia from 14 July 2022 to 14 November 2022. To determine the total per-person costs related to COVID-19, we added the cost of drug (nirmatrelvir/ritonavir or control), clinic visits and inpatient care. Incremental cost-effectiveness ratio (ICER) per hospitalization averted was calculated. Results Our cohort included 31,487 patients. The rate of hospitalization within 30 days was found to be 0.35% for the group treated with nirmatrelvir/ritonavir, and 0.52% for the control group. The nirmatrelvir/ritonavir group cost an additional MYR 1,625.72 (USD 358.88) per patient. This treatment also resulted in a reduction of 0.17% risk for hospitalization, which corresponded to an ICER of MYR 946,801.26 (USD 209,006.90) per hospitalization averted. Conclusion In Malaysia, where vaccination rates were high, nirmatrelvir/ritonavir has been shown to be beneficial in the outpatient treatment of adults with COVID-19 who have risk factors; however, it was only marginally cost effective against hospitalization for healthy adults during the Omicron period.

Mannheimia haemolytica is one of the bacterial agents responsible for bovine respiratory disease (BRD). The capability of M. haemolytica to form a biofilm may contribute to the development of chronic BRD infection by making the bacteria more resistant to host innate immunity and antibiotics. To improve therapy and prevent BRD, a greater understanding of the association between M. haemolytica surface components and biofilm formation is needed. M. haemolytica strain 619 (wild-type) made a poorly adherent, low-biomass biofilm. To examine the relationship between capsule and biofilm formation, a capsule-deficient mutant of wild-type M. haemolytica was obtained following mutagenesis with ethyl methanesulfonate to obtain mutant E09. Loss of capsular polysaccharide (CPS) in mutant E09 was supported by transmission electron microscopy and Maneval's staining. Mutant E09 attached to polyvinyl chloride plates more effectively, and produced a significantly denser and more uniform biofilm than the wild-type, as determined by crystal violet staining, scanning electron microscopy, and confocal laser scanning microscopy with COMSTAT analysis. The biofilm matrix of E09 contained predominately protein and significantly more eDNA than the wild-type, but not a distinct exopolysaccharide. Furthermore, treatment with DNase I significantly reduced the biofilm content of both the wild-type and E09 mutant. DNA sequencing of E09 showed that a point mutation occurred in the capsule biosynthesis gene wecB. The complementation of wecB in trans in mutant E09 successfully restored CPS production and reduced bacterial attachment/biofilm to levels similar to that of the wild-type. Fluorescence in-situ hybridization microscopy showed that M. haemolytica formed a poly-microbial biofilm with Histophilus somni and Pasteurella multocida. Overall, CPS production by M. haemolytica was inversely correlated with biofilm formation, the integrity of which required eDNA. A poly-microbial biofilm was readily formed between M. haemolytica, H. somni, and P. multocida, suggesting a mutualistic or synergistic interaction that may benefit bacterial colonization of the bovine respiratory tract.

Seaweed, in particular, brown seaweed, has gained research interest in the past few years due to its distinctive phenolic profile that has a multitude of bioactive properties. In order to obtain the maximum extraction efficiency of brown seaweed phenolic compounds, Response Surface Methodology was utilized to optimize the ultrasound-assisted extraction (UAE) conditions such as the amplitude, time, solvent:solid ratio, and NaOH concentration. Under optimal conditions, UAE had a higher extraction efficiency of free and bound phenolic compounds compared to conventional extraction (stirred 16 h at 4 °C). This led to higher antioxidant activity in the seaweed extract obtained under UAE conditions. The profiling of phenolic compounds using LC-ESI-QTOF-MS/MS identified a total of 25 phenolics with more phenolics extracted from the free phenolic extraction compared to the bound phenolic extracts. Among them, peonidin 3-O-diglucodise-5-O-glucoside and hesperidin 5,7-O-diglucuronide are unique compounds that were identified in P. comosa, E. radiata and D. potatorum, which are not reported in plants. Overall, our findings provided optimal phenolic extraction from brown seaweed for research into employing brown seaweed as a functional food.

The translation of discoveries on extracellular vesicle (EV) based cancer biomarkers to personalised precision oncology requires the development of robust, sensitive and specific assays that are amenable to adoption in the clinical laboratory. Whilst a variety of elegant approaches for EV liquid biopsy have been developed, most of them remain as research prototypes due to the requirement of a high level of microfabrication and/or sophisticated instruments. Hence, this study is set to develop a simple DNA aptamer‐enabled and fluorescence polarisation‐based homogenous assay that eliminates the need to separate unbound detection ligands from the bound species for EV detection. High specificity is achieved by immobilising EVs with one set of antibodies and subsequently detecting them with a DNA aptamer targeting a distinct EV biomarker. This two‐pronged strategy ensures the removal of most, if not all, non‐EV substances in the input biofluids, including soluble proteins, protein aggregates or non‐vesicular particles, prior to quantifying biomarker‐positive EVs. A limit of detection of 5.0 × 106 EVs/mL was achieved with a linear quantification range of 5.0 × 108 to 2.0 × 1010 EVs/mL. Facilitated by a multiple parametric analysis strategy, this aptamer‐guided fluorescence polarisation assay was capable of distinguishing EVs from three different types of solid cancer cells based on quantitative differences in the levels of the same sets of biomarkers on EVs. Given the simplicity of the method and its ease of implementation in automated clinical biochemistry analysers, this assay could be exploited for future EV‐based continuous and real‐time monitoring of the emergence of new macro‐ or micro‐metastasis, cancer progression as well as the response to treatment throughout different stages of cancer management in the clinic. [ABSTRACT FROM AUTHOR]