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Background/Aims: Chronic hepatitis C (CHC) is the second leading cause of liver-related mortality and is more prevalent in the elderly population in Korea. Decisions to initiate treatment and selection of proper antiviral agents may be challenging among elderly patients due to relevant comorbidities, comedications, and drug-drug interaction (DDI). It may be helpful to understand the current demographic status and comorbidities of CHC patients in the country.Methods: Patients aged ≥ 18 years and diagnosed with CHC (KCD-7 code B18.2) were extracted from the Korean Health Insurance Review & Assessment Service database in 2018. Data on comorbidities and comedications were assessed and potential DDIs were analyzed.Results: A total of 50,476 patients with CHC, with a mean age of 60.3 years and 46.7% male patients were identified. The proportion of patients with cirrhosis, hepatocellular carcinoma, and liver transplantation was 6.0%, 4.1%, and 0.3%, respectively and 37.2% of patients were more than 65 years of age. The three most common comorbidities were diseases of the digestive system (83.7%), respiratory system (58.2%), and musculoskeletal system and connective tissue (57.6%). The three most common comedications were analgesics (91.6%), gastrointestinal agents (85%), and antibacterials (80.3%). Lipid-lowering agents and anticonvulsants were prescribed in 28.5% and 14.8% of patients. Rate of potential DDI for contraindication was 2.2%, 13.1%, and 15.6% with sofosbuvir/velpatasvir, ledipasvir/sofosbuvir, and glecaprevir/pibrentasvir.Conclusions: With the increasing age of patients with CHC, comorbidity, comedication, and potential DDI should be considered when choosing antivirals in Korea. Sofosbuvir-based regimens showed favorable DDI profiles among Korean patients.

Background/Aims: For patients hospitalized with coronavirus disease 2019 (COVID-19) who require supplemental oxygen, the evidence of the optimal duration of corticosteroid is limited. This study aims to identify whether long-term use of corticosteroids is associated with decreased mortality.Methods: Between February 10, 2020 and October 31, 2021, we analyzed consecutive hospitalized patients with COVID-19 with severe hypoxemia. The patients were divided into short-term (≤ 14 days) and long-term (> 14 days) corticosteroid users. The primary outcome was 60-day mortality. We performed propensity score (PS) analysis to mitigate the effect of confounders and conducted Kaplan-Meier curve analysis.Results: There were 141 (52%) short-term users and 130 (48%) long-term corticosteroid users. The median age was 68 years and the median PaO2/FiO2 at admission was 158. Of the patients, 40.6% required high-flow nasal cannula, 48.3% required mechanical ventilation, and 11.1% required extracorporeal membrane oxygenation. The overall 60-day mortality rate was 23.2%, and that of patients with hospital-acquired pneumonia (HAP) was 22.9%. The Kaplan-Meier curve for 60- day survival in the PS-matched cohort showed that corticosteroid for > 14 days was associated with decreased mortality (p = 0.0033). There were no significant differences in bacteremia and HAP between the groups. An adjusted odds ratio for the risk of 60-day mortality in short-term users was 5.53 (95% confidence interval, 1.90–18.26; p = 0.003).Conclusions: For patients with severe COVID-19, long-term use of corticosteroids was associated with decreased mortality, with no increase in nosocomial complications. Corticosteroid use for > 14 days can benefit patients with severe COVID-19.

Cisplatin is one of the most potent cytotoxic drugs used to treat cancer, but clinical use is linked to testicular and liver damage. According to a number of studies, antioxidant supplementation may have an impact on the toxicity caused by cisplatin. The purpose of the current investigation was to determine how vitamin-E supplementation protected rats from cisplatin-induced damage. Thirty laboratory adult male albino rats were divided into three groups: Group I received saline orally, once daily for 21 days. Group II received cisplatin on day 0, 7, 14 and were sacrificed on day 21. Group III received cisplatin on day 0, 7, 14 and received orally vitamin E daily, starting 5 days before the first dose of cisplatin until day 21. Liver and both testes were obtained and fixed. Sections from the liver and both testes were stained by H&E and Trichrome stain, and then examined under light microscope. Alterations included a significant increase in malondialdehyde (MDA) level in the cisplatin group compared with the other groups (p value for comparing between control and each other group, statistically significant at p ≤ 0.05). Histopathologically, cisplatin induced signs of hepatic injury; it also showed signs of testicular degeneration in all rats. However, the cisplatin induced disturbances significantly improved by treatment with Vitamin E. Statistical analysis showed a significant difference among the three groups in all signs of injury (p

The purpose of this study is to develop and implement a general education course called ‘Future Society and Government’ as a competency-based curriculum and to evaluate its effectiveness. For this, a formative research method called ‘Development Study’ was used. Thereafter, in the phase of the development of the course, expert consulting was conducted, and in the phase of implementation, the learning outcomes and other data were collected and analyzed to evaluate its effectiveness. Furthermore, since this course set higher-order thinking, communication, and information & technology utilization as target competencies, performance tasks, evaluation criteria, and rubrics have been developed to improve and evaluate these competencies effectively. Teaching activities and feedback have also been provided around these competencies. As a result, the course resulted in a clear positive change in the students’ core competencies and target behaviors. This is because it showed that students' achievement and competency levels actually improved in the four sub-tasks, which became increasingly difficult as the task progressed. Also, students perceived significant growth in their competency levels, as shown by pre- and post-test results comparison, course evaluation scores, and student feedback comments. Finally, this study comprehensively examined the process and results of this course, derived opinions for future improvement, and summarized the significance and limitations of the research.

Lamin A (LMNA)-related congenital muscular dystrophy usually presents with hypotonia and severe axial muscle weakness in early infancy. We report a patient who initially presented with torticollis but was finally diagnosed with LMNA-related congenital muscular dystrophy. A 7-month-old infant presented to the outpatient clinic with a chief complaint of torticollis. During a thorough physical examination, axial muscle weakness and gross motor delay were noted, and she was admitted to the pediatric rehabilitation department for further evaluation. The serum creatine kinase level was elevated, and electromyography demonstrated the possibility of hereditary myopathy or a motor neuron disorder. A gene study was conducted, and it showed a c.745C>T (p.Arg249Trp) mutation in the LMNA gene, which is known to cause congenital muscular dystrophy in rare cases. Since there are few reports describing nerve conduction and electromyography studies in patients with LMNA-related congenital muscular dystrophy, this case is meaningful.

This article discusses the ways in which the practical benefit of poetry, as a source of healing power to reduce distress, is enhanced through incorporating a detailed analysis of literary texts and their sources that relate to the author's depiction of the human predicament and suggestions for liberation from it. This article focuses on two Romantic poems as case studies, Percy Bysshe Shelley's “Mutability” (1816) and John Keats's “Ode on Melancholy” (1820), to highlight an effective way of inspiring students to recognize the poets’ representations of anxiety and their poems’ therapeutic effects. By pointing out the limitations of recent studies promoting the curative power of poetry, the article examines precise literary aspects of the two works, which facilitate the relief from inner affliction for readers as they discuss in detail the concept of affliction in its association with the realities of instability and depression. It suggests a method of providing poetry education that reveals the paradox of suffering and self-remedy and thereby reinforces comprehension.

Background: T50 is a novel serum-based marker that assesses the propensity for calcification in serum. A shorter T50 indicates a greater propensity to calcify and has been associated with cardiovascular disease and mortality among patients with chronic kidney disease. The factors associated with T50 and the correlation between T50 and bone mineral density (BMD) are unknown in hemodialysis (HD) patients. Methods: This cross-sectional study included 184 patients undergoing HD. Individuals were grouped into tertiles of T50 to compare the demographic and disease indicators of the tertiles. Linear regression was used to evaluate the association between T50 and hip and spinal BMD in a multivariate model. Results: Mineral and inflammatory parameters, including serum phosphate (r = –0.156, p = 0.04), albumin (r = 0.289, p < 0.001), and high-sensitivity C-reactive protein (r = –0.224, p = 0.003) levels, were associated with T50. We found a weak association between T50 and BMD in the total hip area in the unadjusted model (β = 0.030, p = 0.04) but did not find a statistically significant association with the total hip (β = 0.017, p = 0.12), femoral neck (β = –0.001, p = 0.96), or spinal BMD (β = 0.019, p = 0.33) in multivariable-adjusted models. Conclusion: T50 was moderately associated with mineral and inflammatory parameters but did not conclusively establish an association with BMD in HD patients. Broad-scale future studies should determine whether T50 can provide insights into BMD beyond traditional risk factors in this population.

Rope entanglement injury is a rare entity. Previous reported studies mainly consisted of finger-related injuries. We describe three cases of rope entanglement injury of the lower leg. In the first patient, a belowthe- knee amputation was performed as the primary treatment for unilateral amputated lower limb. In the second patient, a below-the-knee amputation and perineal wound management were simultaneously performed. The third patient had vascular injury combined with internal soft tissue injury without related bone fracture. He suffered serious sequelae from a delay in transfer from a local hospital. Rope entanglement injuries of the lower leg do not present in a consistent manner, and the treatment of accompanying injuries should be considered from an early stage. Care should be taken to ensure that there are no internal injuries missed because the exterior appears to be stable.

[Purpose] We compared and analyzed energy consumption and excess post-exercise oxygen consumption (EPOC) following Taekwondo Taegeuk Poomsae performances.[Methods] Forty-two healthy men who could perform Taegeuk Poomsae 1–8 Jangs were enrolled in this study. To reduce the impact of Poomsae, a random cross-design was used. The washout time was set to at least three days. Oxygen consumption (VO2) was monitored after performing each Poomsae until a reference line was resumed. Each Taegeuk Poomsae was performed at a speed of 60 bpm.[Results] There was no significant difference in VO2, carbon dioxide excretion, and heart rate after performing the Taegeuk Poomsae once; however, all variables increased significantly in combined results of EPOC metabolism (Fp2p2

Whether diabetes mellitus (DM) increases tuberculosis (TB) recurrence risk is debatable. We determined the effect of DM on TB recurrence.This retrospective nationwide cohort study included patients with TB who successfully completed TB treatment during 2011-2017 and were followed up for TB recurrence until August 2020. We performed subdistribution hazard model analyses stratified by sex to assess DM risk related to TB recurrence after successful treatment.Of 199,571 participants who had received successful TB treatment, 47,952 (24%) had DM. There were more men (64.4%), positive acid-fast bacilli smears (35.9%), and positive cultures (49.5%) in the DM group. There were 6208 (3.1%) TB recurrences during 5.1 years of follow-up: 38.9% and 26.6% occurred 1 and 1-2 years after treatment completion, respectively. The recurrence rate was higher in the DM group (3.8%) than in the non-DM group (2.9%, P0.0001). DM was associated with a higher TB recurrence risk, especially in men (adjusted hazard ratio 1.23, 95% confidence interval 1.15-1.32) but not in women (adjusted hazard ratio 0.96, 95% confidence interval 0.85-1.09).The TB recurrence rate after successful treatment was higher in patients with DM than in patients without DM. DM is associated with TB recurrence in men.

Evaluation indicators of general education represent the value and identity of general education. University members can clearly understand general education through evaluation indicators. Evaluation indicators serve as standards for establishing and implementing educational policies. Universities support general education according to the evaluation indicators. From this point of view, this study conducted a questionnaire survey to diagnose problems with the general education evaluation indicators of the Basic Competency Assessment for Universities. A survey was conducted targeting 127 universities that joined the Korean Council for University General Education. The total number of respondents was 51. The summary of the survey results is as follows. First, 70% of respondents said that it was reasonable to evaluate general education as ‘operation and improvement of curriculum’. But about 50% of the respondents were negative about evaluating the general curriculum as ‘core competency’ as a diagnostic factor. Second, more than 70% of respondents said that the standard of the general education standard model of the Korea National Institute for General Education, which was established theoretically and academically, was not applied to the current evaluation indicators. So it is necessary to improve the inclusiveness of general education evaluation indicators. Third, about 50% of the respondents were negative about the relevance of the evaluation indicators as a driving force for improving the quality of general education. Fourth, 70% of the respondents thought that the basis for applying core competencies as evaluation indicators for general education was not sufficient. Therefore, they think that evaluation criteria should be designed according to the essential characteristics of general education. Finally, many respondents said that the essential components of the evaluation indicators should include the organization and operation of the general education curriculum, the operating system for improving general education, and the organization and manpower necessary for supporting general education. This study examined the validity of competency-based general education, focusing on general education experts. As a result, it provided clear evidence for developing and designing evaluation indicators for the development and improvement of practical general education in universities. In particular, the Ministry of Education should go through a public deliberation process to improve the acceptance of evaluation results. Therefore, we proposed that the concept of competency should be established first and then the validity of competency-based general education should be reviewed.

The purpose of this study is to develop the performance tasks and evaluation tools for competency-based personality education in general education of college. For this, first of all, we reviewed the literature on competency-based education (CBE) and character education (CE), and then selected the subject as a mandatory course for personality education. Then, under the consulting of experts on competency modeling and CBE, the essential learning elements of the subject were analyzed into knowledge, skills, and attitudes, while the behavioral indicators for the competencies were defined and developed, along with the performance tasks and evaluation tools reflecting these behavioral indicators. Lastly, the evaluation methods and tools were validated through Delphi Research by 6 experts. As a result, firstly, 6 core competencies to be cultivated (self-esteem, morality, responsibility, self-expression, understanding others and empathy, coordination and collaboration) were selected for this course, 63 learning elements, and 13 behavioral indicators were drawn as the criterion for competency evaluation. Secondly, 4 core performance tasks, and learning activities were designed to combine learning elements and to demonstrate competencies in complex contexts or interpersonal situations, like discussion worksheets, and team projects activities, personality growth reports, reflection journals, etc. Thirdly, evaluation tools for 20 evaluation criteria for 5 evaluation methods for all tasks and activities were developed and revised through Delphi research. Lastly, the significance and limitations of this study were discussed.

In Kenya, the ‘Linda Mama Program’, a free care program for pregnant women, is being implemented, but as of 2017, maternal deaths per 100,000 live births reached 342, and the infection rate such as AIDS, hepatitis B, and syphilis is high. Diagnosis is being made centering on a quick simple test (rapid diagnosis), but the reliability is low, so an accurate and quick diagnosis method is needed. Through the Innovative Technology Program (CTS) of Korea International Cooperation Agency (KOICA), we developed a multi-immune diagnostic device and multi-diagnostic kit that can diagnose AIDS, hepatitis B, and syphilis, which can be tested with minimal education at schools and local public health centers in addition to hospitals. The sensitivity and specificity of the diagnostic kit were each 90% or more, which was improved by more than 20% compared to the rapid diagnostic kits. The supply of cost-competitive diagnostic devices and test kits will enable continuous monitoring of AIDS, hepatitis B, and syphilis infections among women of childbearing age between the ages of 15 and 49, thereby contributing to the improvement of maternal and child health.

Purpose: This study aimed to investigate the physicochemical and biological activity of ethanol extracted from the insect Jeotgal based on the fermentation period and extract concentration.Methods: Tenebrio molitor and Gryllus bimaculatus were crushed and then mixed with salt. Each sample was fermented at 15℃ for 180 days, and their physicochemical properties, such as salinity, brix, pH, color value and apparent viscosity were analyzed. The total polyphenol content, 2,2-diphenyl- 1-picrylhydrazyl (DPPH) scavenging ability, 2,2′-azinobis-(3-ethylbenzothiazoline- 6-sulfonic acid (ABTS) scavenging ability and α-glucosidase inhibitory activity were measured as antioxidant activity.Results: Salinity measurement results showed no significant difference in the fermentation period, but pH and viscosity were analyzed and found to continuously decrease with the increase of the fermentation period. Based on biological activity analysis, the total polyphenol content, DPPH scavenging activity, and ABTS radical scavenging activity increased with the increase of the fermentation period, and the effect was particularly remarkable at high concentrations. The results of the α-glucosidase inhibition activity showed that the effect was small at low concentrations but sufficient at high concentrations.Conclusion: The physiological activity of ethanol extract of salted fish using insects has been confirmed, and this finding may be used as a basic data for applying insect food to fermented food.

Objective: This study seeks to identify a more sensitive smear microscopy method for the detection of Mycobacterium tuberculosis in low-resource centers. Materials and methods: One hundred and forty sputum specimens were collected and direct smears were prepared as the specimen was submitted. The specimens were afterward digested/decontaminated using the modified Petroff’s method. Both smear methods were stained by the Ziehl-Neelsen technique and examined. All specimens (direct and concentrated) were cultured on a Lowenstein-Jensen medium and results were considered the gold standard to calculate sensitivity. Results: Out of 140 specimens, 27 (19%) and 34 (24%) were positive by direct and concentrated methods respectively. The number of culture positives by the direct and concentrated method was 26 (19%) and 31(22%) respectively. The sensitivity of direct and concentrated methods was 92.3% and 100% respectively. The negative culture and contamination rate was minimum with the concentrated method. The diagnostic accuracy of direct and concentrated methods was 88.6% and 97.1%. Conclusion: In summary, results showed concentrated techniques were able to detect more true positive Mycobacterium tuberculosis than the direct smear method. Therefore, the study region with AFB smear microscopy can utilize the concentrated smear method for AFB smear microscopy to improve the case-finding strategy.

Background: The contribution of sex as an independent risk factor for cardiovascular disease still remains controversial. The present study investigated the impact of sex on long-term clinical outcomes in Korean acute myocardial infarction (AMI) patients with a history of current smoking on admission after drug-eluting stents (DESs). Methods: A total of 12,565 AMI patients (male: n = 11767 vs. female: n = 798) were enrolled. Major adverse cardiac events (MACEs) comprising all-cause death, recurrent myocardial infarction (Re-MI), and any repeat revascularization were the primary outcomes that were compared between the two groups. Probable or definite stent thrombosis (ST) was the secondary outcome. Results: After adjustment, the early (30 days) cumulative incidences of MACEs (adjusted hazard ratio [aHR]: 1.457; 95% confidence interval [CI]: 1.021–2.216; p = 0.035) and all-cause death (aHR: 1.699; 95% CI: 1.074–2.687; p = 0.023) were significantly higher in the female group than in the male group. At 2 years, the cumulative incidences of all-cause death (aHR: 1.561; 95% CI: 1.103–2.210; p = 0.012) and Re-MI (aHR: 1.880; 95% CI: 1.089–2.974; p = 0.022) were significantly higher in the female group than in the male group. However, the cumulative incidences of ST were similar between the two groups (aHR: 1.207; 95% CI: 0.583–2.497; p = 0.613). Conclusions: The female group showed worse short-term and long-term clinical outcomes compared with the male group comprised of Korean AMI patients with a history of current smoking after successful DES implantation. However, further studies are required to confirm these results.