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In this study, the relationship between the environmental radiation dose rate and meteorological variables was investigated with multiple regression analysis and big data of those variables. The environmental radiation dose rate and 36 different meteorological variables were measured on Ulleung Island, Republic of Korea, from 2011 to 2015. Not all meteorological variables were used in the regression analysis because the different meteorological variables significantly affect the environmental radiation dose rate during different periods, and the degree of influence changes with time. By applying the Pearson correlation analysis and stepwise selection methods to the big dataset, the major meteorological variables influencing the environmental radiation dose rate were identified, which were then used as the independent variables for the regression model. Subsequently, multiple regression models for the monthly datasets and dataset of the entire period were developed.

Inevitable exposure to high-LET ionizing radiation (IR) present in galactic cosmic radiation (GCR) could enhance gastrointestinal (GI) cancer incidence among astronauts undertaking deep space exploration and GI-cancer mortality has been predicted to far exceed NASA’s limit of < 3% REID (Radiation exposure-induced death) from cancer. Therefore, the development of countermeasure agents against high-LET radiation-induced GI cancer is needed to safeguard astronauts during and after an outer space mission. The cyclooxygenase-2/prostaglandin E2 (COX2/PGE2) mediated activation of pro-inflammatory and oncogenic signaling has been reported to play an important role in persistent inflammation and GI-tumorigenesis after high-LET radiation exposure. Therefore, aspirin, a well-known inhibitor of the COX/PGE2 pathway, was evaluated as a potential countermeasure against (28)Si-induced PGE2 and tumorigenesis in Apc(1638N/+), a murine model of human GI-cancer. Animals were fed either standard or aspirin supplemented diet (75, 150, or 300 mg/day of human equivalent dose) starting at the age of 4 weeks and continued till the end of the study, while mice were exposed to (28)Si-ions (300 MeV/n; 69 keV/μm) at the age of 8 weeks. Serum PGE2 level, GI tumor size (>2mm(2)), number, and cluster (>5 adjoining tumors) were analyzed at 150 days post-exposure. Aspirin led to a significant reduction in PGE2 in a dose-dependent manner but did not reduce (28)Si-induced GI tumorigenesis even at the highest (300 mg/day) dose. In summary, this study suggests that aspirin could reduce high-LET IR-induced pro-inflammatory PGE2 levels, however, lacks the ability to reduce high-LET IR-induced GI tumorigenesis in Apc(1638N/+) mice.

BACKGROUND This study aimed to evaluate the prevalence of monosymotomatic nocturnal enuresis (MSNE) with reduced bladder capacity in children with primary nocturnal enuresis (NE) and to suggest treatment outcomes. METHODS This study retrospectively evaluated 54 children (30 males, 24 females; median age: 8; range: 5-14) who were newly diagnosed with primary NE from November 2017 to October 2019. Reduced bladder capacity in MSNE was defined when a patient's maximal voided volume (MVV) from his or her voiding diary was 75% or less than estimated functional bladder capacity ([age + 1] x 30 mL) for his or her age and there were no daytime lower urinary tract symptoms (LUTS) as assessed using history taking and questionnaires. RESULTS Nineteen (35.2%) of 54 children with newly diagnosed primary NE did not report daytime LUTS. Fifteen children (27.8%) had a reduced bladder capacity and were prescribed anticholinergic or beta-3 agonist. After three months of medication, MVV significantly increased from 117.5 mL to 183.3 mL (P = 0.010), but frequency showed no significant change from 5.7 to 4.9 times a day. Improvement in enuresis occurred completely and partially in 41.7% and 25% of participants, respectively. CONCLUSIONS The prevalence of reduced bladder capacity without daytime voiding symptoms was relatively high as 27.8% in children newly diagnosed with primary NE. In primary MSNE, reduced bladder capacity should be investigated using a frequency-volume chart in addition to thorough history taking or questionnaires. Anticholinergics or beta-3 agonists for MSNE with reduced bladder capacity are effective at increasing the bladder capacity of these patients.

Background: Actinic cheilitis, herpes labialis and lip cancer are relatively common conditions presenting on the lips associated with exposure to periods of sun exposure and thereby ultraviolet radiation. Objective: This systematic review aimed to determine the efficacy of the application of sunscreen-containing lip-protecting agents (LPA) in the prevention of actinic cheilitis (AC), recurrent herpes labialis (RHL) and lip cancer (LC). Methods: This review was conducted in accordance with the PRISMA guidelines and registered with the PROSPERO database. A literature search was conducted using SCOPUS, Google Scholar, Medline (Ovid), Pubmed, CINAHL, Cochrane Library databases and manual search using search terms actinic cheilitis (AC), recurrent herpes labialis (RHL) and lip cancer (LC) along with lip protecting agents and their variations as keywords. A total of 1,567 papers were yielded. Of them, nine studies were eligible for qualitative data synthesis. Results: Nine articles (3 AC, 5 RHL, 1 LC) were deemed eligible and thus selected for qualitative synthesis. Three studies on AC identified approximately 21.7% lower prevalence of lesions when some form of lip protection was used. Eighty percent of studies on RHL identified that the application of LPA is effective in preventing RHL. Subjects who applied LPA more than once daily only had half the risk of having LC compared to those who applied once daily. Conclusion: This review of randomised controlled trials (RCTs) and observational studies supports the use of LPA as an effective method in preventing lip-associated lesions. Further, RCTs and observational studies should aim at determining a definitive LPA application regime and optimal SPF strength to prevent lip-associated lesions. This systematic review was registered with the International Prospective Register of Systematic Reviews (PROSPERO): Registration Number - CRD42020177484. https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42020177484

There is growing interest in conservative treatment of Achilles tendon rupture. However, the majority of experimental studies of Achilles tendon have been performed by open tenotomy. More appropriate model of conservative treatment of Achilles tendon rupture is required. We performed experimental study to evaluate whether outcomes differ between open tenotomy and percutaneous tenotomy of the Achilles tendon in rats. The Achilles tendons of 48 rats were transected. The animals were divided into two groups according to surgical technique: open tenotomy or microscopy-assisted percutaneous tenotomy. After 1, 2, and 4 weeks, functional, biomechanical, and histological analyses were performed. Western blot was performed for quantitative molecular analysis at 1 week. The Achilles functional index was superior in the percutaneous tenotomy group, compared with the open tenotomy group, at 1 week. The cross-sectional area was significantly larger in the percutaneous tenotomy group than in the open tenotomy group at 4 weeks. Relative to the native tendons, load to failure and stiffness yielded comparable results at 2 weeks in the percutaneous tenotomy group and at 4 weeks in the open tenotomy group. The histological score was significantly better in the percutaneous tenotomy group than in the open tenotomy group at 1 week. At 1week, interleukin-1β expression in the open tenotomy group was higher than in the percutaneous tenotomy group. In summary, Achilles tendon healing was substantially affected by the tenotomy method. We presume that our percutaneous tenotomy method might constitute a useful experimental animal model for conservative treatment of Achilles tendon rupture. This article is protected by copyright. All rights reserved.

OBJECTIVES Recently, several studies have suggested that blade-type cephalomedullary nails (CMNs) have a higher risk of fixation failure than that of lag screws, but no clinical consensus exists. This study compared fixation failure between helical blade-type and lag screw-type CMNs with cut-out and cut-through rates as primary outcomes and degree of sliding length, time to union, and nonunion rate as secondary outcomes. DATA SOURCES MEDLINE, Embase, and Cochrane Library were systematically searched for studies published before March 4, 2020, using the PRISMA guidelines. STUDY SELECTION Studies were included if they directly compared helical blade and lag screw for treating hip fractures. Data could be extracted for CMN alone to avoid mixing CMN and extramedullary plate devices, such as the dynamic hip screw. DATA EXTRACTION Two board-certified orthopaedic surgeons specializing in hip surgery independently extracted data from the selected studies, and the data collected were compared to verify agreement. DATA SYNTHESIS All data were pooled using a random-effects model. For all comparisons, odds ratios (ORs) and 95% confidence intervals (CIs) were calculated as dichotomous data, whereas continuous data were analyzed using mean differences with 95% CIs. CONCLUSIONS Fixation failure (OR = 1.88, 95% CI: 1.09-3.23, P = 0.02), especially cut-through (OR = 5.33; 95% CI, 2.09-13.56; P < 0.01), was more common with helical blades than with lag screws, although the cut-out rate was not significantly different between both the 2 groups (OR = 0.87, 95% CI: 0.38-1.96, P = 0.73). Surgeons should carefully select a blade-type CMN when treating hip fractures. LEVEL OF EVIDENCE Therapeutic Level III. See Instructions for Authors for a complete description of levels of evidence.

Background: Neutrophil gelatinase-associated lipocalin (NGAL) has emerged as a valuable biomarker of urinary tract infection (UTI) in children.Purpose: This study aimed to compare the diagnostic accuracy of urinary NGAL (uNGAL) with those of serum C-reactive protein (CRP) and white blood cell (WBC) count for predicting UTI and acute pyelonephritis (APN) in febrile children.Methods: The medical charts of children undergoing uNGAL measurements between November 2017 and August 2019 were retrospectively reviewed. Patients with a suspected or diagnosed UTIs were included. The diagnostic accuracies of uNGAL, serum CRP, and WBC count for detecting UTI and APN were investigated. Independent predictors of UTI and APN were investigated using multivariable logistic regression analyses.Results: A total of 321 children were enrolled in this study. The uNGAL levels were higher in the UTI group (n=157) than in the non-UTI group (n=164) (P

Self-powered implantable devices have the potential to extend device operation time inside the body and reduce the necessity for high-risk repeated surgery. Without the technological innovation of in vivo energy harvesters driven by biomechanical energy, energy harvesters are insufficient and inconvenient to power titanium-packaged implantable medical devices. Here, we report on a commercial coin battery-sized high-performance inertia-driven triboelectric nanogenerator (I-TENG) based on body motion and gravity. We demonstrate that the enclosed five-stacked I-TENG converts mechanical energy into electricity at 4.9 μW/cm3 (root-mean-square output). In a preclinical test, we show that the device successfully harvests energy using real-time output voltage data monitored via Bluetooth and demonstrate the ability to charge a lithium-ion battery. Furthermore, we successfully integrate a cardiac pacemaker with the I-TENG, and confirm the ventricle pacing and sensing operation mode of the self-rechargeable cardiac pacemaker system. This proof-of-concept device may lead to the development of new self-rechargeable implantable medical devices., Self-powered implantable devices have the potential to extend device operation, though current energy harvesters are both insufficient and inconvenient. Here the authors report on a commercial coin battery-sized high-performance inertia-driven triboelectric nanogenerator based on body motion and gravity that can be used to charge a lithium-ion battery and integrated into a cardiac pacemaker.

This paper analyzed the primary concerns about radiation among the Korean public with a big data analysis of questions posted at the section of “Knowledge iN” on the portal site NAVER in Korea from January 2010 to August 2020. First, we extracted questions about radiation and categorized them into the three categories with TF-IDF analysis: “Medical,” “Career Counseling,” and “General Interest”. The “Medical” category includes questions about radiation diagnosis or treatment. The “Career Counseling” category includes questions about entering college and the prospect of finding jobs in radiation-related fields. The “General Interest” category includes questions about terminology and the basic knowledge of radiation or radioisotopes. Second, we extracted common questions for each category. Finally, we analyzed the temporal change in the numbers of questions for each category to confirm whether there is any correlation between radiation-related events and the number of questions. The analysis results demonstrate that major radiation-related events have little relevance to the number of questions except during March 2011.

Parkinson’s Disease (PD) is a neurodegenerative disorder affecting the substantia nigra, which leads to more than half of PD patients are considered to be at high risk of falling. Recently, Inertial Measurement Unit (IMU) sensors have shown great promise in the classification of activities of daily living (ADL) such as walking, standing, sitting, and laying down, considered to be normal movement in daily life. Measuring physical activity level from longitudinal ADL monitoring among PD patients could provide insights into their fall mechanisms. In this study, six PD patients (mean age=74.3±6.5 years) and six young healthy subjects (mean age=19.7±2.7 years) were recruited. All the subjects were asked to wear the single accelerometer, DynaPort MM+ (Motion Monitor+, McRoberts BV, The Hague, Netherlands), with a sampling frequency of 100 Hz located at the L5-S1 spinal area for 3 days. Subjects maintained a log of activities they performed and only removed the sensor while showering or performing other aquatic activities. The resultant acceleration was filtered using high and low pass Butterworth filters to determine dynamic and stationary activities. As a result, it was found that healthy young subjects performed significantly more dynamic activities (13.2%) when compared to PD subjects (7%), in contrast, PD subjects (92.9%) had significantly more stationary activities than young healthy subjects (86.8%).

In this study, we used square-type organic scintillating fibers and polymethyl methacrylate phantoms to develop an all-in-one phantom dosimeter measure the multidimensional dose distributions for a 60Co radiotherapy source. Multidimensional dose distributions, which include the transverse, depth, and surface dose distributions, can be obtained by measuring scintillating light simultaneously in real time. An additional phantom for quality assurance before radiotherapy is not required because square-type organic scintillating fibers are directly inserted into the polymethyl methacrylate phantom. Multidimensional dose distributions can also be measured simultaneously by changing the arrangement of one-dimensional phantom dosimeters, which are very thin and can be stacked, similar to books placed on a shelf. Therefore, the proposed dosimeter can be applied as an all-in-one phantom dosimeter with a variable structure that can respond to changes in various radiotherapy treatment environments. Through experiments, the multidimensional dose distributions for the 60Co radiotherapy unit were measured to evaluate the performance of the proposed all-in-one phantom dosimeter. The results were compared and evaluated using external beam therapy films and Monte Carlo simulations. Based on the results of this study, significant time is expected to be saved during dose measurements for quality assurance in radiotherapy, as simultaneous measurements can yield multidimensional data on the transverse, depth and surface dose distributions in real time.

This paper reviewed the temporal changes in the public opinions on nuclear energy in Korea with a big data analysis of nuclear energy-related articles and their comments posted on the portal site NAVER. All articles that included at least one of “nuclear energy,” “nuclear power plant (NPP),” “nuclear power phase-out,” or “anti-nuclear” in their titles or main text were extracted from those posted on NAVER in January 2010–December 2019. First, we performed annual word frequency analysis to identify what words had appeared most frequently in the articles. For that period, the most frequent words were “NPP,” “nuclear energy,” and “energy.” In addition, “safety” has remained in the upper ranks since the Fukushima NPP accident. Then, we performed sentiment analysis of the pre-processed articles. The sentiment analysis showed that positive-tone articles have been reported more frequently than negative-tone over the entire analysis period. Last, we performed sentiment analysis of the comments on the articles to examine the public’s intention regarding nuclear issues. The analysis showed that the number of negative comments to articles each month–irrespective of positive or negative tone–was always larger than that of positive comments over the entire analysis period.

Understanding of stand growth information is necessary for establishing forest management plans, but accurate models for estimating ingrowth are currently lacking in Korea. This research aims to develop an ingrowth estimation equation according to various forest types using nationwide forest monitoring data by the National Forest Inventory (NFI). A two-stage approach was developed based on the ingrowth database using permanent sample plots from the 5th (2006–2010) and 6th (2011–2015) NFI. In the first stage, the ingrowth probability was estimated using a logistic function. In the second stage, the ingrowth amount was estimated using a conditional function by regression analysis. In results, a logistic regression model based on the number of sampling plot which did not result in ingrowth (Model VI), was selected for an ingrowth probability estimation equation. After performing three types of statistical test to evaluate the ingrowth estimation equation suitability, three optimal models were selected based on their respective estimation ability: Coniferous Forest (Model IV), Broad-leaved Forest (Model VII), and Mixed Forest (Model VI). The estimation ability of the proposed estimation equation was statistically verified and showed no problems of suitability or applicability. If high-quality data are continuously accumulated for comparison and contrast with the present sampling plot data through the ongoing NFI system, this research can present a new direction in ingrowth modeling for Korean forests.

Several studies investigated the posttraumatic osteonecrosis of the femoral head (ONFH) after femoral neck fracture (FNF). However, no study has investigated the hidden ONFH after FNF, which is missed by simple radiographs, using magnetic resonance imaging (MRI). This retrospective study involved 58 consecutive patients who underwent implant removal surgery after internal fixation due to FNF. MRI was used to investigate the incidence of hidden ONFHs, which were not initially revealed on plain radiographs. The comparisons between hidden ONFH and other groups were performed for patent demographics and clinical variables including ONFH location, lesion size, the progression rate of ONFH collapse, and end-stage arthroplasty conversion rate. Of the 58 patients, 38 exhibited no evidence of ONFH on plain radiograph screening. However, 13 of the 38 patients were confirmed of hidden ONFH via MRI. The collapse progressed in four of the 13 patients, and one of them underwent total hip arthroplasty surgery. No significant differences were found between the hidden and definite ONFH groups in demographics and clinical variables. However, a significant difference exists between the hidden ONFH and the normally healed FNF groups in terms of the Garden type (P

This paper presents an overall optimization procedure and the electrical performances of 1.2 kV/10 A 4H-SiC junction barrier Schottky (JBS) diodes with high current density. To achieve high current density, the epi-layer, the design parameters for active region including p-grid width and cell pitch, and the field limiting ring for edge termination were optimized with analytic calculation to estimate forward electrical performances and with Silvaco atlas™ simulator to estimate reverse electrical performances. Based on the systematic design, the JBS diodes were fabricated and electrically characterized. The experimental results showed that the breakdown voltage (BV) of JBS diode was significantly sensitive to field limiting ring (FLR) space and that the JBS diode with the ratio of pure Schottky contact area to total active area of 0.75 and the FLR space of 1.25 μm had optimum electrical performances such as a forward current density of 370 A/cm2, a reverse leakage current below 20 μA at the reverse anode voltage of 1.2 kV, and the BV of 1400 V. These were in coincidence with the simulation results within 10% error.

Purpose: This study aimed to evaluate the outcomes of large angiomyolipoma (AML) treatment by selective arterial embolization (SAE) versus nephron-sparing surgery (NSS) using a robotic surgical system. Materials and Methods: Between January 2011 and June 2018, we retrospectively reviewed 25 patients who underwent robot-assisted partial nephrectomy (RAPN) or SAE for large AMLs. Ten patients underwent RAPN, and 15 underwent SAE. Patient demographics, AML characteristics, and operative and postoperative clinical outcomes were recorded and analyzed. Outcomes were compared between patients who underwent RAPN and patients who underwent SAE. Specifically, changes in renal function and size were evaluated after the treatment. Results: The mean age of the patients was 52.9 years, and 22 of 25 patients were female. The mean maximum AML diameter on computed tomography was 8.9 cm, and 8 patients had multiple masses. Twenty-two of 25 patients had moderate to high RENAL complexity. Patients who underwent SAE had more symptoms (p = 0.018) and higher RENAL complexity scores (p = 0.013) on average. On average, tumor size decreased by 99% among RAPN patients and by 58% among SAE patients (p = 0.001). Although the mean pretreatment estimated glomerular filtration rate (eGFR) was higher among RAPN patients (99.8 vs. 80.0 mL/min/1.73 m2, p = 0.043), there were no significant changes in eGFR in either group after the treatment. One patient in the RAPN group experienced complications, but the postoperative ileus resolved without intervention. Conclusions: Both RAPN and SAE were effective and feasible treatment options for large AMLs. The AML characteristics and the condition of the patient might be important in determining the appropriate treatment method.

The use of SiO2/4H–SiC metal-oxide-semiconductor field-effect transistors (MOSFETs) can be problematic due to high interface state density (Dit) and low field-effect mobility (μfe). Here, we present a tetra-ethyl-ortho-silicate (TEOS)-based low-pressure chemical vapor deposition (LPCVD) method for fabricating the gate oxide of 4H–SiC MOSFETs using nitric oxide post-deposition annealing. SiO2/4H–SiC MOS capacitors and MOSFETs were fabricated using conventional wet and TEOS oxides. The measured effective oxide charge density (Qeff) and Dit of the TEOS-based LPCVD SiO2/4H–SiC MOS capacitor with nitridation were 4.27 × 1011 cm−2 and 2.99 × 1011 cm−2eV−1, respectively. We propose that the oxide breakdown field and barrier height were dependent on the effective Qeff. The measured μfe values of the SiO2/4H–SiC MOSFETs with wet and TEOS oxides after nitridation were, respectively, 11.0 and 17.8 cm2/V due to the stable nitrided interface between SiO2 and 4H–SiC. The proposed gate stack is suitable for 4H–SiC power MOSFETs.

Although not as prevalent as in Caucasian rhinoplasty, correction of a hump nose also poses a significant problem for East Asian rhinoplasty. The hump noses in East Asians can be classified as generalized humps, isolated humps, and relative humps with a low tip. Appropriate management of the Asian hump nose demands a good understanding of the anatomical characteristics unique to East Asians. As the East Asians generally prefer to have a nose with a prominent tip and well-augmented nasal dorsum, the concept of redistribution is significant in managing convex dorsum of the East Asians. Hump reduction should be done in a conservative and incremental manner, including careful removal of the bony cap and cartilaginous hump. Tip augmentation using a septal extension graft is an essential maneuver to achieve an aesthetically pleasing tip height, which has a tremendous impact on the overall aesthetic outcome. Midvault reconstruction, dorsal augmentation, and camouflage are additional key elements for the success of the operation. Complications such as undercorrection and dorsal irregularities are not uncommon, requiring surgeons to take utmost care to address them.

In this study, we investigated whether there is a significant relationship between the natural radiation dose rate and the cancer incidences in Korea by using a big data analysis. The natural dose rate data for this analysis were the measurement data obtained from the 171 monitoring posts of the 113 administrative districts in Korea over the 10 years from 2007 to 2016. The relative cancer incidences for this analysis were the difference in the cancer patients per hundred thousand people year-on-year in the administrative districts with the five highest and the five lowest natural gamma dose rates each year over the same period. To analyze the correlation between the two variables, Spearman's rank correlation coefficient between the two rates was derived using R, a well-known big data analysis tool. The analysis showed that Spearman's rank correlation coefficient was more than 0.05 and that the correlation between the two variables was not statistically significant.

Background: Studies have reported that reduced autonomic nervous system activity could result in a suboptimal health condition and various diseases, further increasing the mortality rate. The present study aimed to determine the difference in risk factors for metabolic and cardiovascular diseases in patients with reduced or unstable autonomic activity according to heart rate variability test results.Methods: We recorded blood pressure, physical measurements (body mass index and waist circumference), fasting blood glucose, and blood lipid status. Indicators representative of autonomic nerve functionality (total power [TP], standard deviation of the normal-to-normal intervals [SDNN], low-frequency band [LF], high-frequency band [HF]) were measured using a 5-minute heart rate variability test. Each indicator was divided into quartiles.Results: In men, the risk of abdominal obesity was high in the group with a low TP. In the group with a low SDNN, TP, and LF, the risk of a blood pressure increase was high. When LH and HF were low, there was a high risk of increased fasting blood sugar, whereas when LH was low, there was a high risk of hypertriglyceridemia. Women with SDNN loss had higher odds ratios for abdominal obesity and low high-density lipoprotein cholesterolemia.Conclusions: These results indicate a higher risk of having risk factors for metabolic and cardiovascular diseases, such as abdominal obesity, elevated blood pressure, hyperglycemia, hypertriglyceridemia, and low high-density lipoprotein cholesterolemia in a group with reduced autonomic activity measured by heart rate variability. Women with a low SDNN had a 4.51-fold higher risk of abdominal obesity than women with a high SDNN, showing the greatest value of the heart rate variability indices.

Aims Changes in serotonergic sensory modulation associated with overexpression of 5-HT3 receptors in the central nervous system (CNS) have been implicated in the pathophysiology of neuropathic pain after peripheral nerve damage. 5-HT3 receptor antagonists such as ondansetron can potentially alleviate neuropathic pain, but have limited effectiveness, due potentially to limited CNS access. However, there is currently limited information on CNS disposition of systemically-administered 5-HT3 receptor antagonists. This study evaluated the cerebrospinal fluid (CSF) disposition of ondansetron, as a surrogate of CNS penetration. Methods Fifteen patients were given a single 16 mg intravenous 15 minute infusion of ondansetron, followed by serial blood and a single CSF sampling. Population pharmacokinetic (PK) modelling was implemented to describe the average and individual plasma and CSF profiles of ondansetron. A two-compartmental model was used to capture ondansetron plasma PK with a single CSF compartment to describe distribution to the CNS. Results The individual model-estimated CSF to plasma partition coefficients of ondansetron were between 0.09 and 0.20. These values were mirrored in the calculated CSF penetration ratios, ranging from 0.08 to 0.26. Conclusions After intravenous administration, CSF concentrations of ondansetron were approximately 7-fold lower than those observed in the plasma. A model could be developed to describe individual CSF concentration-time profiles of ondansetron based on a single CSF data point. The low CSF penetration of ondansetron may explain its limited analgesic effectiveness, and affords an opportunity to explore enhancing its CNS penetration for targeting conditions such as neuropathic pain.

Although the national radiological emergency response system has been improved by incorporating lessons from the Fukushima nuclear power plant accident and recent domestic natural disasters, it has not fully incorporated these lessons. In addition, it cannot deal with a variety of aftermath of the radiological disaster. Even for the same disaster, the national emergency response system should comply with multiple domestic laws in our country. Furthermore, there are a few discrepancies between the articles of the domestic laws that the national radiological emergency response system should address. Therefore, this study investigates the characteristics of radiological disasters, examines articles on the domestic laws related to the national radiological emergency response system, and analyses the Japanese government’s responses to the Fukushima nuclear power plant accident. Based on the results of the review, suggestions for the improvement of the national radiological emergency response system in terms of response organization and framework have been proposed in this study.

Background The primary objective of this study aims to test patient factors, with a focus on cardiometabolic disease, influencing the performance of the Cockcroft-Gault equation in estimating glomerular filtration rate. Methods A cohort study was performed using data from adult patients with both a 24-h urine creatinine collection and a serum creatinine available. Creatinine clearance was calculated for each patient using the Cockcroft-Gault, Modified Diet in Renal Disease, and Chronic Kidney Disease Epidemiology Collaboration equations and estimates were compared to the measured 24-h urine creatinine clearance. In addition, new prediction equations were developed. Results In the overall study population (n = 484), 44.2% of patients were obese, 44.0% had diabetes, and 30.8% had dyslipidemia. A multivariable model which incorporating patient characteristics performed the best in terms of correlation to measured 24-h urine creatinine clearance, accuracy, and error. The modified Cockcroft-Gault equation using lean body weight performed best in the overall population, the obese subgroup, and the dyslipidemia subgroup in terms of strength of correlation, mean bias, and accuracy. Conclusions Regardless of strategy used to calculate creatinine clearance, residual error was present suggesting novel methods for estimating glomerular filtration rate are urgently needed.

ObjectiveMany women with overactive bladder (OAB) do not seek medical care despite urinary symptoms. As the diagnosis and treatment of OAB are often late, there is a need to identify undiagnosed OAB patients and start effective treatment. Furthermore, an objective and appropriate screening biomarker for OAB is needed. This study aimed to investigate the relationship between serum neutrophil-to-lymphocyte ratio (NLR) and OAB in South Korean women.DesignCross-sectional, retrospective study.SettingJeju National University Hospital.ParticipantsThis study included a total of 4394 women (mean age=48.6 years) who underwent self-referred health screenings.InterventionsBlood tests were conducted and the NLR was calculated by dividing the number of neutrophils by the number of lymphocytes.Outcome measuresThe severity of OAB was evaluated using the OAB Symptom Score (OABSS).ResultsApproximately 9.8% of participants (n=432) were diagnosed with OAB. The association pattern between the NLR and urinary tract symptoms was variable; however, NLR was associated with OAB, by the OABSS and OAB severity (pConclusionsElevated NLR is associated with OAB; hence, NLR may be a cost-effective and readily available biomarker of OAB in women.

Typical Asian deformed nose has many different types: concave nasal dorsum, low nasal dorsum, wide nasal dorsum, deviated nose, convex nasal dorsum, saddle nose, short-nose deformity, and deformities involving irreversible damage of skin/soft tissue envelop are the most representative ones. The key concept in Asian rhinoplasty is augmentation in all different forms of nasal deformities. Augmentation of the nose consists of framework, tip, and dorsal augmentation. Septal extension grafting and tip grafting are 2 maneuvers with profound importance in augmentation of lower two-thirds of the Asian nose. Dorsal augmentation is central concept in beautifying all different types of deformed noses, even the hump nose.

In this research, we developed and characterized a phoswich radiation sensor (PHORS) to simultaneously measure the count rates and the energies of beta and gamma radiation. The proposed PHORS device comprises a sensing probe combining NaI(Tl) and CaF2(Eu) scintillators for simultaneous measurement of beta and gamma radiation, a multichannel analyzer to characterize the radiation energy, and a laptop computer for signal analysis. For its performance test, we employed a prototype PHORS to measure the energies and the count rates of beta and gamma radiation from three different radiation sources for separation distances from 2 to 10 cm. The count rates of the PHORS were consistent with expected rates, and the captured energy spectra showed classic radionuclide characteristics. Thus, the proposed PHORS system provides an effective and facile tool to detect beta and gamma radiation simultaneously and to identify radionuclides from the captured energy spectra.

Cognitive frailty — the coexistence of physical frailty and cognitive impairment—is a phenotype of frailty in the elderly. The coexistence of physical frailty and cognitive impairment, known as cognitive frailty, is one of the phenotypes of frailty in the elderly. Cognitive frailty predicts adverse health outcome more accurately than does physical frailty. In this study, we aim to determine whether the polypharmacy common among the elderly is linked with cognitive frailty. The elderly, aged between 70 and 84 years, who participated in the cross-sectional Korean Frailty and Aging Cohort Study were included in the present study. Polypharmacy and hyperpolypharmacy were defined as the use of at least five and ten medications, respectively. Physical frailty was assessed by the Korean version of the FRAIL scale, and cognitive status was measured by the Trail Making Test part A, word list recall test, the Korean version of the Frontal Assessment Battery, and the Digit Span Backward test. Among the 2,392 participants, 26.8% and 4.1% took more than five and ten prescribed medications, respectively. Polypharmacy and hyperpolypharmacy participants tend to have more cognitive impairment and physical frailty. Participants with cognitive frailty had the highest polypharmacy rate regardless of medication type. After controlling for the potential confounders including severity of comorbidities, frailty was found to be significantly related to polypharmacy, as defined by prescribed as well as total medications, including non-prescribed medications. However, cognitive impairment only showed a linkage to polypharmacy of prescribed medications, which—according to the results of multivariable analysis— could increase cognitive frailty, with an odds ratio of 2.70. Although the elderly tend to depend on various medications, they should seriously consider the risk of polypharmacy for better health outcomes.

This study aims to suggest marketing implications for the success of the luxury brands in the market. Questionnaire was conducted for 360 consumers interested in purchasing luxury goods. The collected data were verified for the appropriateness of the structural equation model and the causation of each concept. luxury brands should put more effort to improve the quality and type of products through various consumer characteristics analysis, and build a pricing strategy to match consumer characteristics with various pricing systems and payment methods. In addition, it is necessary to pay more attention to setting the service system worthy of their luxury images so that the service system can also take the luxury image. What's more, since most luxury consumers are those who value their personality and image rather than cost, so they should do their best at each step so as not to give the negative image of the company to the eyes of the consumers until the end. And it needs to continue their research for enhanced quality of the products and manage the image to sustain the image of the company over time, and make efforts to understand the way of expressing the changing images in step with the changing times and read the cultural trend.

PURPOSE: Maternal Fetal Intensive Care Unit (MFICU), which provides intensive care to high-risk mothers with increasing maternal age and high-risk newborns, has become a new field of nursing work in South Korea. The present study was conducted to identify the educational needs and self-assessing clinical competence of nurses in MFICU. METHODS: The education needs and competencies of MFICU nurses were measured through prepared questionnaires by researchers based on the previous studies on job analysis of nurses in MFICU. Data were collected from January 2019 to March 2019. The study involved 168 nurses working in MFICUs at 12 hospitals nationwide as study subjects. The data were analyzed using the SPSS WIN 23.0 program. RESULTS: The education needs of nurses in MFICU had an average of 4.21 points (±0.50) and their nursing competence was average 3.38 points (±0.60). The items reported as high education needs but low competency by nurses in MFICU were as following: ‘postpartum hemorrhage and shock,’ ‘cardiopulmonary resuscitation (CPR) for neonate,’ ‘CPR during pregnancy,’ ‘disseminated intravascular coagulation,’ ‘sepsis,’ and ‘mechanical ventilation during pregnancy.’ CONCLUSION: Based on these results, it is proposed that a comprehensive education program for nurses in MFICU should be developed by considering low capabilities among MFICU nurses as a priority factor.

Renal disease is a worldwide health issue. Besides transplantation, current therapies revolve around dialysis, which only delays disease progression but cannot replace other renal functions, such as synthesizing erythropoietin. To address these limitations, cell-based approaches have been proposed to restore damaged kidneys as an alternative to current therapies. Recent studies have shown that stem cell-derived secretomes can enhance tissue regeneration. However, many growth factors undergo rapid degradation when they are injected into the body in a soluble form. Efficient delivery and controlled release of secreting factors at the sites of injury would improve the efficacy in tissue regeneration. Herein, we developed a gel-based delivery system for controlled delivery of trophic factors in the conditioned medium (CM) secreted from human placental stem cells (HPSCs) and evaluated the effect of trophic factors on renal regeneration. CM treatment significantly enhanced cell proliferation and survival in vitro. Platelet-rich plasma (PRP) was used as a delivery vehicle for CM. Analysis of the release kinetics demonstrated that CM delivery through the PRP gel resulted in a controlled release of the factors both in vitro and in vivo. In an acute kidney injury model in rats, functional and structural analysis showed that CM delivery using the PRP gel system into the injured kidney minimized renal tissue damage, leading to a more rapid functional recovery when compared with saline, CM, or vehicle only injection groups. These results suggest that controlled delivery of HPSC-derived trophic factors may provide efficient repair of renal tissue injury. Stem Cells Translational Medicine 2019;8:959–970

OBJECTIVES Patulous eustachian tube (ET) has been characterised by the visualisation of full-length ET on computed tomography (CT) results. We wanted to investigate the changes of visualised ET lengths by age in supine and sitting positions. DESIGN Retrospective study. SETTING Tertiary care academic referral centre. PARTICIPANTS One hundred subjects who underwent cone beam CT (CBCT) in a sitting position and conventional CT in a supine position for non-otitis-related or dental complaints. MAIN OUTCOME MEASURES Visualised ET lengths from the nasopharyngeal orifice measured by different positions and ages. RESULTS Subjects did not show visualisation of full-length ET throughout the study. The visualised ET lengths (9.0 ± 2.5 mm) of the CBCT group were significantly larger than those (6.8 ± 2.3 mm) of the conventional CT group (P

Background/aims Various alterations of microRNA (miRNA) expression have been reported in myelodysplastic syndrome (MDS). We aimed to investigate the unique patterns and prognostic significance of miRNA expression in Korean patients with MDS. Methods Bone marrow mononuclear cells were collected from eight healthy controls and 26 patients with MDS, and miRNAs were isolated and assessed via quantitative real-time polymerase chain reaction for selected miRNAs, including miR-21, miR-124a, miR-126, miR-146b-5p, miR-155, miR-182, miR-200c, miR-342-5p, miR-708, and Let-7a. Results MiR-124a, miR-155, miR-182, miR-200c, miR-342-5p, and Let-7a were significantly underexpressed in patients with MDS, compared to healthy controls. MiR-21, miR-126, 146b-5p, and miR-155 transcript levels were significantly lower in international prognostic scoring system lower (low and intermediate-1) risk MDS than in higher (intermediate-2 and high) risk MDS. Higher expression levels of miR-126 and miR-155 correlated with significantly shorter overall survival and leukemia-free survival. Higher miR-124a expression also tended to be related to shorter survivals. Conclusion Although our study was limited by the relatively small number of patients included, we identified several miRNAs associated with pathogenesis, leukemic transformation, and prognosis in MDS.

To achieve carbon neutrality by 2050, Korea has been expanding its investment in renewal energy distribution and technology development. However, with this rapid expansion of renewable energy, public concern about it has grown. This study developed and used a big data analysis-based procedure to analyze the questions registered on Naver, the largest portal site in Korea, from 2008 to 2020 to identify public concern over renewable energy. The big data analysis-based procedure consisted of two steps. The first was a frequency analysis to identify the most frequently registered words. The second was to classify questions using term frequency-inverse document frequency (TF-IDF) weight and cosine similarity based on word2vec. The analysis revealed the most frequently registered words related to renewable energy, such as “solar power,” “power generation,” “energy,” and “wind power.” It also revealed the most frequently registered questions, such as those related to solar panel installation, renewable energy generation methods, and certificates. To continue expanding renewable energy, it is becoming increasingly important to understand the public’s concerns and create a method to resolve their objections to renewable energy. It is expected that the procedure in this study may provide relevant insight for the method.

BACKGROUND Discrimination of nasal cavity mass lesions is a challenging work requiring extensive experience. A deep learning-based automated diagnostic system may help clinicians to classify nasal cavity mass lesions. We demonstrated the feasibility of a convolutional neural network (CNN)-based diagnosis system for automatic detection and classification of nasal polyps (NP) and inverted papillomas (IP). METHODS We developed a CNN-based algorithm using a transfer learning strategy and trained it on nasal endoscopic images. A total of 99 nasal endoscopic images with normal findings, 98 images with NP, and 100 images with IP were analyzed using the developed CNN. Six otolaryngologists participated in clinical visual assessment. Image-based classification performance was measured by calculating the accuracy and area under the receiver operating characteristic curve (AUC). The diagnostic performance was compared between the CNN and clinical visual assessment by human experts. RESULTS The algorithm achieved an overall accuracy of 0.742 ± 0.058 with the following class accuracies: normal, 0.81± 0.14; IP, 0.57 ± 0.07; and NP, 0.83 ± 0.21. The AUC values for normal, IP, and NP were 0.91 ± 0.06, 0.82 ± 0.09, and 0.84 ± 0.06, respectively. The overall accuracy of the CNN model was comparable with the average performance of human experts (0.742 vs. 0.749; p = 0.11). CONCLUSIONS The trained CNN model appears to reliably classify NP and IP of the nasal cavity from nasal endoscopic images; it also yields a reliable reference for diagnosing nasal cavity mass lesions during nasal endoscopy. However, further studies with more test data are warranted to improve the diagnostic accuracy of our CNN model.

Background We evaluated the treatment outcomes of ureteral stones according to energy intensity generated by extracorporeal shock wave lithotripsy (ESWL). Methods We retrospectively analyzed 150 patients who underwent ESWL for treatment of ureteral stones between September 2018 and February 2020. All stones were confirmed by a computed tomography examination, and the size, location, skin-to-stone distance, and Hounsfield units (HU) of the stones were assessed. In addition, patient characteristics including body mass index and estimated glomerular filtration rate, which can affect treatment outcome, were also evaluated. The success or failure of ESWL was confirmed according to the session, and the factors affecting the treatment outcome were analyzed using a logistic regression model. Results Of the 150 patients, 82 (54.7%) had stones in the proximal ureter, 5 (3.3%) in the mid, and 63 (42.0%) in the distal ureter. Patients underwent ESWL an average of 1.5 times, and the success rate according to session was 65.3% for the first, 83.3% for the second, and 90.0% for the third session. A multivariate analysis revealed that stone size [odds ratio (OR) 0.81, 95% confidence interval (CI), 0.66-0.99, P=0.049] and HU (OR 0.99, 95% CI, 0.98-0.99, P=0.001) were significant factors affecting the success rate after the first ESWL session; ESWL intensity was not related to success rate. Stone size (OR 0.78, 95% CI, 0.62-0.96, P=0.022) was the only significant factor affecting the success rate in the third session. Conclusions Stone size and HU affected the ESWL success rate. ESWL intensity was not significantly related to the success rate, so it should be adjusted according to patient pain and the degree of stone fragmentation.

BackgroundLower urinary tract symptoms (LUTS) including frequency, nocturia, urgency, and incontinence, are common in women and cause significant discomfort in daily life. However, diagnosis and treatment of LUTS are often delayed because many patients with such symptoms do not complain to the physician of discomfort and do not seek medical attention. LUTS are known to be associated with muscle weakness. We investigated the association between grip strength and LUTS in women of different ages.MethodsThis study included 4225 women (mean age 48.6 years) who underwent self-referred health screening between April 2015 and December 2019. LUTS were evaluated using a self-reported questionnaire, and the overactive bladder symptom score was used to screen for an overactive bladder. Low muscle strength was defined as a hand grip strength of ResultsWe observed decreased grip strength in 13.7% (n = 580) of the participants. Nocturia, urgency, incontinence, and overactive bladder were more common in women with decreased grip strength than in women with normal grip strength. After adjusting for age, comorbidities (hypertension, diabetes, hyperlipidemia), smoking status, alcohol consumption, regular exercise, and stress, nocturia (odds ratio [OR] 1.19, 95% confidence interval [CI] 1.01–1.52), urinary incontinence (OR 1.32, 95% CI 1.01–1.72), and an overactive bladder (OR 1.75, 95% CI 1.35–2.27) were significantly associated with decreased grip strength.ConclusionsThe findings suggest that LUTS, especially nocturia, incontinence, and an overactive bladder are associated with decreased grip strength in women. Therefore, physicians should be aware that patients may not seek help, even if they are uncomfortable, and it is important to obtain a detailed medical history and perform additional tests, even in the absence of complaints, in patients with low grip strength, who are at high risk of LUTS.