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High school students need more comprehensive scientific inquiry learning instruction through research ethics education. Yet, this topic is often overlooked in the science curriculum. To collect basic data to guide research ethics education for high school students, this study documents the kinds of research misconduct students commit, the contexts in which they do so, and the factors that influence such misconduct. Data were collected via questionnaires from 223 gifted high school students at science academies in Korea. The results showed that high school students engaged in the most research misconduct in experiment-based classes rather than in mentorship programmes and science fair competitions. The largest number of data fabrication and falsification instances were seen in experiment-based classes. A regression analysis on the effect of influencing factors on each research misconduct type showed that falsification and plagiarism can be reduced by increasing education and regulation and lowering desire and neglect, whereas duplicate publications can be reduced by decreasing desire and neglect levels.

Neutropenic sepsis (NS) is one of the leading causes of death among patients with hematologic malignancies. Identifying its predictive factors is fundamental for early detection. Few studies have evaluated the predictive factors in relation to microbial infection confirmation, which is clinically important for initiating sepsis treatment. This study aimed to determine whether selected biomarkers (i.e., body temperature, C-reactive protein, albumin, procalcitonin), treatment-related characteristics (i.e., diagnosis, duration of neutropenia, treatment modality), and infection-related characteristics (i.e., infection source, causative organisms) can predict NS in patients with hematologic malignancies. We also aimed to identify the optimal predictive cutoff points for these parameters. This retrospective case–control study used the data from a total of 163 patients (58 in the sepsis group and 105 in the non-sepsis group). We collected data with reference to the day of specimen collection, with which microbial infection was confirmed. Multiple logistic regression was used to determine predictive risk factors and the area under the curve (AUC) of the receiver operating characteristic for the optimal predictive cutoff points. The independent predictors of NS were average body temperature during a fever episode and procalcitonin level. The odds for NS rose by 9.97 times with every 1°C rise in average body temperature (95% confidence interval, CI [1.33, 75.05]) and by 2.09 times with every 1 ng/mL rise in the procalcitonin level (95% CI [1.08, 4.04]). Average body temperature (AUC = 0.77, 95% CI [0.68, 0.87]) and procalcitonin levels (AUC = 0.71, 95% CI [0.59, 0.84]) have fair accuracy for predicting NS, with the optimal cutoff points of 37.9°C and 0.55 ng/mL, respectively. This study found that average body temperature during a fever episode and procalcitonin are useful in predicting NS. Thus, nurses should carefully monitor body temperature and procalcitonin levels in patients with hematologic malignancies to detect the onset of NS. [ABSTRACT FROM AUTHOR]

The scientific integrity, perceptions of scientific misconduct, and students' needs in the research ethics education of Korean and Japanese gifted students were analyzed to address three questions. First, how well do students practice research ethics in their research? Second, how do students perceive scientists' misconduct? Third, do students want to learn research ethics and what aspects do they want to learn? Participants comprised 397 Korean and 370 Japanese science gifted high school students. Survey results showed that 48.92% of Korean students and 14.86% of Japanese students experienced scientific misconduct regarding their research. However, 90.61% of Korean students and 87.54% of Japanese students could identify these behaviors are scientific misconducts. Only 32.94% of Korean students and 19.63% of Japanese students expressed a desire to learn about research ethics concepts and practical issues during research. Although professing knowledge about scientific integrity, their scientific misconduct demonstrates a lack of authentic understanding. Thus, there is a need to accurately present students with the training they need.

Background: Despite a well-known relation between smoking tobacco and the tuberculosis epidemic, the factors associated with smoking cessation in tuberculosis patients are unclear. This study aims to examine the cascade of smoking cessation and the factors associated with persistent smoking among tuberculosis patients. Methods: We conducted a prospective cohort study enrolling adult patients with pulmonary tuberculosis between 2016 and 2019 in the Republic of Korea. We examined the smoking status at baseline, followed the current smokers, re-examined their smoking status after 6 months of anti-tuberculosis treatment, and identified the factors associated with persistent smoking. Results: Of the 419 enrolled patients, 109 (26.0%) were current smokers at baseline. Of the 79 current smokers who completed the 6-month survey, 24 (30.4%) succeeded in quitting smoking after 6 months of treatment. The adjusted odds ratio for persistent smoking was 6.57 (95% confidence interval [CI], 1.76–27.83) for drinking and 0.15 (95% CI, 0.03–0.68) for diabetes comorbidity. Conclusion: Drinking alcohol and diabetes comorbidity were important factors in smoking cessation. Only one third of the tuberculosis patients in our study cohort succeeded in quitting smoking during the 6-month treatment period. More aggressive interventions for smoking cessation should be adopted within the national anti-tuberculosis program. [ABSTRACT FROM AUTHOR]

Melton demonstrated a surprising disappearance using total internal reflection. When he put a Florence flask filled with marbles into a water tank and looked straight down from directly above the flask, he was only able to see marbles above a certain water level. When he added more water into the tank above the top line of the marbles, all of the marbles disappeared. He explained this phenomenon as due to a combination of both refraction and total internal reflection. Here, we wanted to develop this surprising idea to create more surprises. However, in our case, we only took the refraction effect from Melton's idea to demonstrate our magic. This idea is supported by various perspectives. For instance, Viss and Sikkema demonstrated the critical angle without using total internal reflection, and James showed the novel optical properties of a submerged light bulb.

The social distancing policy is an effective way to prevent the spread of infectious diseases in the initial phase of their outbreak when medical evidence to support a particular course of treatment is deficient. While studies on the coronavirus disease 2019 (COVID-19) have mainly focused on the effects of specific measures (e.g., school and workplace closures and restrictions on movement), few investigated the characteristics of epidemic trends in response to the intensity of the policy and the amount of time required for policy measures to take effect. This study employs the SIRD (susceptible, infected, recovered, and deceased) model to analyze the COVID-19 epidemic trend according to the intensity of the social distancing policy in South Korea. The model reveals that the reproduction number began at 5.58 and fluctuated between 0.14 and 1.72 during the study period in accordance with different policy intensities. At the beginning of the social distancing policy, restrictions on public facility use were likely to have been effective in preventing the spread of COVID-19. When the intervention was relaxed, the transmission potential increased significantly. According to the reproduction number, social distancing policies prove to be effective after 13–19 days of implementation; however, as the pandemic progressed, this period extended from 13–14 to 18–19 days for the same effect. This suggests that governments need to consider not only the intensity of the social distancing policy, but also people's low responsiveness as the pandemic remains prevalent over time. It is also recommended they take preemptive action to ensure sufficient time for the policy to achieve its stated goal. [ABSTRACT FROM AUTHOR]

Introduction: SB4 is the first approved biosimilar of etanercept, a biologic tumor necrosis factor inhibitor, to treat various autoimmune diseases including axial spondylarthritis (axSpA), rheumatoid arthritis (RA), psoriatic arthritis (PsA), and plaque psoriasis (PsO). This post-marketing surveillance (PMS) study of SB4 investigated safety and effectiveness in routine clinical practice and is part of the drug approval process in Korea. Methods: This prospective, multi-center, open-label, observational, phase IV PMS study was designed to enroll patients with axSpA, RA, PsA, and PsO in Korea from September 2015 to September 2019. Both etanercept-naïve patients or patients switched from reference etanercept were included. SB4 was administered weekly via subcutaneous injections using pre-filled syringes. Safety was assessed by the incidence of adverse events (AEs), adverse drug reactions (ADRs) and serious adverse events (SAE). Effectiveness was assessed by the change from baseline of investigator-rated Bath Ankylosing Spondylitis Disease Activity Index (BASDAI) in patients with ankylosing spondylitis (AS) and disease activity score-28 (DAS28) in patients with RA. Results: Among 316 enrolled patients, 314 were included in the safety analysis (176 with AS and 138 with RA). The overall incidence of AEs, ADRs and serious AEs were 17.8, 9.9, and 1.3%, respectively. Most AEs were mild (66.7%) or moderate (31.1%) and not related to SB4 (58.9%). Most common AEs were injection site pruritus (1.9%) and injection site rash (1.3%). At week 24, mean disease activity scores significantly decreased compared to baseline in naïve patients with AS and RA (BASDAI 2.7 vs. 6.2, p < 0.0001; DAS28 3.8 vs. 5.7, p < 0.0001) and in switched patients with AS and RA (BASDAI 1.0 vs. 1.3, p = 0.0018; DAS28 2.4 vs. 2.9, p = 0.0893). Conclusion: This first real-world evidence of SB4 from a phase IV PMS study in Korea shows comparable effectiveness to historical SB4 real-world evidence without any new significant safety signals. [ABSTRACT FROM AUTHOR]

Simulation is a learner-centered practice that helps develop and maintain knowledge, skills, and competencies. This study evaluated the effect of neonatal resuscitation simulation-based education for medical students in the fifth year (part of the regular clinical clerkship program) on the perceived performance of their technical and non-technical skills. In addition, we analyzed the difference between instructor's and learners' evaluations of technical skills after the simulation. A one-group pretest-posttest design was adopted. The simulation-based education of the neonatal resuscitation program (NRP) was conducted for 40 medical students from July to November 2020 at a medical school in South Korea. The simulation-based education comprised 5 minutes of pre-briefing, 10 minutes of running the simulation, and 30 minutes of debriefing (using a recorded video). The perceived performance of students' technical and non-technical skills before and after the simulation was compared by collecting and analyzing the pre- and post-questionnaires. The perceived performance of technical (p =.001) and non-technical skills (p <.001) was found to have significantly increased after the simulation. Particularly, the performance of technical skills, such as diagnostic (p =.007) and therapeutic actions (p <.001) and non-technical skills, such as leadership (p <.001), teamwork (p =.001), and task management (p =.020) improved significantly. There was no significant difference in the evaluations of the technical performance of the instructor and learners after the simulation (p =.953). Simulation-based education can improve technical skills, such as diagnostic and therapeutic actions for neonatal resuscitation. It is also effective in enhancing non-technical skills, such as leadership, teamwork, and task management. Further, after the simulation-based education, students can fully self-evaluate through objective reflection and improve their clinical competency. [ABSTRACT FROM AUTHOR]

As ageing population is growing faster, traffic accidents involving elderly drivers become a serious social problem in South Korea. The present study aims to examine the impact of environmental characteristics on the injury severity of accidents involving elderly drivers in Seoul, South Korea. To achieve the purpose, the study divided elderly drivers into the following two groups: young-elderly drivers aged 65–69 years and middle- and old-aged drivers over 69 years old. The study also analysed non-elderly drivers aged 30 to 64 years as the comparative group. The study used the generalised ordered logit model, which is widely used to analyse data with ordinal scales. The findings from the study draw attention to the fact that (1) the characteristics of traffic accidents by injury severity considerably differed by age group. (2) risk of accident severity involving elderly drivers increase in areas with heavy traffic volumes and facilities that may create a complex driving condition to elderly drivers, (3) since elderly drivers tend to require longer response time with impaired vision under complex driving environment, it increased the risk of traffic accidents that older drivers face a higher risk of fatal injuries than younger counterparts. Thus, in order to reduce traffic accidents involving elderly drivers, the traffic safety policies should take environmental characteristics as well as the human factor concerning elderly drivers' difficulties because of ageing and longer cognitive response time. This study contributes to the research in traffic accidents involving elderly drivers in that not only the accident characteristics (human factors, road condition, weather), mostly used for traffic accident analysis, but also environmental factors concerning the urban characteristics of Seoul Metropolitan City were analysed to compare the risk of traffic accidents and accident severity by age groups. [ABSTRACT FROM AUTHOR]

Background: Obesity affects health-related quality of life (QoL); however, their relationship among elderly Asians is not well known. Aims: Relationship of domain-specific QoL with body mass index (BMI) and waist circumference and the sex differences were investigated using a nationally representative sample of elderly Korean population. Methods: In the Korea National Health and Nutrition Examination Survey phase VII (2016–2018), 3659 adults aged ≥ 65 years (1551 men and 2108 women) participated. BMI and waist circumference were classified according to Asian- and Korean-specific criteria. QoL was evaluated using the European Quality of Life Scale-Five Dimensions (EQ-5D). Multivariable logistic regressions were used to examine the relationship of QoL with BMI and waist circumference. Results: Men with BMI < 18.5 kg/m2 and ≥ 25.0 kg/m2 had a significant association with poor QoL in mobility and self-care, but no relationship was found with the other domains. Women with BMI ≥ 25.0 kg/m2 had poor QoL in mobility and self-care, and those with BMI ≥ 30.0 kg/m2 had poor QoL in usual activities and pain/discomfort. There was no significant association with anxiety/depression. Both elderly men and women with abdominal obesity had a significant association with poor QoL in mobility, self-care, usual activities, and pain/discomfort; however, there was no significant relationship with waist circumference and anxiety/depression. Conclusions: The association between QoL and BMI was different according to sex and the domains of QoL. Domain-specific QoL should be considered in the management of body weight of the elderly. [ABSTRACT FROM AUTHOR]

To increase the specificity in paternal influence as the importance caregiving context on mothers and children, we aimed to test 1) whether the mediation effect of maternal parenting stress at age 3 on children's social skills at age 9 via home learning stimulation at age 5 was significant; 2) whether this mediation effect varied according to paternal involvement and depression at age 3; and 3) whether this proposed path was culturally generalizable. To examine causal pathways and compare differences between two cultures, we analyzed the proposed moderated mediation models using nationally representative longitudinal data from the U.S. (the Fragile Families and Child Wellbeing Study) and Korea (the Panel Study on Korean Children) using SPSS 25 and PROCESS. We found that in both countries, higher maternal parenting stress at age 3 hindered the development of school-aged children's social skills through lower levels of home-learning stimulation. We also found cultural differences: paternal involvement significantly buffered the negative effects of maternal parenting stress in Korea, while paternal mental health (i.e., non-depression) played that buffering role in the U.S. This study illustrates both the cross-cultural generalizability and culture-specific aspects of family processes, then discusses some theoretical implications and potential practices that would better support families in promoting their children's social development. [ABSTRACT FROM AUTHOR]

Background: For successful lighted stylet intubation, bending the lighted stylet with an appropriate angle is a prerequisite. The purpose of this study was to compare three different bend angles of 70, 80, and 90 degrees for lighted stylet intubation. Methods: The patient trachea was intubated with a lighted stylet bent at 70, 80, or 90 degrees according to the randomly allocated groups (group I, II, and III, respectively). A lighted stylet combined with a tracheal tube was prepared with a bend angle of 70, 80, or 90 degrees according to the assigned group. We checked the success rate at the first attempt and overall success rate for the two attempts. Additionally, we measured search time, which was time from insertion of the bent union into the patient mouth to the start of advancing the tracheal tube while separating it from the lighted stylet, and evaluated postoperative sore throat (POST) at 2, 4, and 24 h after the recovery from anesthesia. Results: There was no statistically significant difference between group I, II, and III for success rate at first attempt (73.9 %, 88.2 %, and 94.7 %, respectively, p = 0.178), even though there was a trend of increasing success rate with increasing bend angles. For overall success rate, there was similar result to that in the first attempt between the groups I, II, and III (82.6 %, 94.1 %, and 100 %, respectively, p = 0.141). However, search time took significantly longer in group I than groups II and III (p < 0.001). When group II and III were compared for POST with numeric rating scale (0–10), it was significantly lower in group II than III at 2, 4 h after the recovery (0.5 vs. 2.3, p = 0.016, and 0.4 vs. 1.8, p = 0.011, respectively). Conclusions: The bend angle of the lighted stylet affected the time required for tracheal intubation and POST in our study. 80 and 90 degrees as a bend angle seem to be acceptable for clinicians in regard to success rate of lighted stylet intubation. Considering the success rate of lighted stylet intubation and POST, the bend angle of 80 degrees might be better than 70 and 90 degrees. Trial registration: ClinicalTrials.gov Identifier NCT03693235, registered on 30 September 2018. [ABSTRACT FROM AUTHOR]

Background: Children with nephrotic syndrome (NS) are at an increased risk of acute kidney injury (AKI) and the incidence of AKI in this population is reportedly increasing. This study aimed to investigate the incidence, clinical profiles, and risk factors of AKI in hospitalized children with NS through a nationwide study. Methods: This retrospective multicenter study included 14 pediatric nephrology centers in Korea. From 2013 to 2017, a total of 814 patients with idiopathic NS were cared for at participating centers. Among them, 363 patients were hospitalized for NS and investigated in this study. Results: A total of 363 children with NS were hospitalized 574 times. AKI occurred in 93 admissions (16.2%) of 89 patients: 30 (32.3%) stage 1; 24 (25.8%) stage 2; and 39 (41.9%) stage 3. Multivariate logistic regression analysis showed that longer disease duration, lower albumin level, and methylprednisolone pulse treatment were significantly associated with AKI development in hospitalized children with NS. AKI was associated with a longer hospital stay than non-AKI (median 10 vs. 7 days, P = 0.001). Among 93 admissions, 85 (91.4%) episodes recovered from AKI without complication, whereas 6 (6.5%) progressed to advanced chronic kidney disease (CKD). Conclusions: AKI is not uncommon in hospitalized children with NS, and its incidence in this nationwide study was 16.2%. Risk factors for AKI in hospitalized children with NS include longer disease duration, lower albumin level, and methylprednisolone pulse therapy. Pediatric NS patients with these characteristics should be under more strict scrutiny for the occurrence of AKI. [ABSTRACT FROM AUTHOR]

Microcephaly is a prevalent phenotype in patients with neurodevelopmental problems, often with genetic causes. We comprehensively investigated the clinical phenotypes and genetic background of microcephaly in 40 Korean patients. We analyzed their clinical phenotypes and radiologic images and conducted whole exome sequencing (WES) and analysis of copy number variation (CNV). Infantile hypotonia and developmental delay were present in all patients. Thirty-four patients (85%) showed primary microcephaly. The diagnostic yield from the WES and CNV analyses was 47.5%. With WES, we detected pathogenic or likely pathogenic variants that were previously associated with microcephaly in 12 patients (30%); nine of these were de novo variants with autosomal dominant inheritance. Two unrelated patients had mutations in the KMT2A gene. In 10 other patients, we found mutations in the GNB1, GNAO1, TCF4, ASXL1, SMC1A, VPS13B, ACTG1, EP300 , and KMT2D genes. Seven patients (17.5%) were diagnosed with pathogenic CNVs. Korean patients with microcephaly show a genetic spectrum that is different from that of patients with microcephaly of other ethnicities. WES along with CNV analysis represents an effective approach for diagnosis of the underlying causes of microcephaly. [ABSTRACT FROM AUTHOR]

Purpose: Pheochromocytoma (PCC) and paraganglioma (PGL) (PPGL) are rare neuroendocrine tumors, and data on managing these conditions in children and adolescents are lacking. The objective of this study was to demonstrate the clinical presentation and treatment outcomes in children and adolescents with PPGL in a single tertiary care center in Korea. Methods: This retrospective study included 23 patients diagnosed with PCC (n = 14) and PGL (n = 9) before the age of 21 at Samsung Medical Center (from June 1994 to June 2019). We describe age, gender, family history, clinical characteristics, laboratory findings, pathologic findings, therapeutic approaches, and treatment outcomes. Results: Of the 23 patients, 14 had PCC and nine had PGL. The median age at diagnosis was 16.8 years (range, 6.8–20.8 years). The common presenting symptoms were hypertension (n = 10), headache (n = 9), palpitation (n = 4), and sweating (n = 4). The plasma or 24-hour urine catecholamine and/or metabolite concentrations were markedly elevated in 22 patients with PPGL, but were normal in one patient with carotid body PGL. All tumors were visualized on computed tomography. Genetic tests were performed in 15 patients, and seven patients showed mutations in RET (n = 3), SDHB (n = 3), and VHL (n = 1). All patients underwent surgery, and complete excision was performed successfully. Three patients with metastasis underwent postoperative adjuvant therapy. Conclusion: This study suggests that pediatric PPGL tends to be extra-adrenal and bilateral and shows a higher potential for genetic mutations. Considering the hereditary predisposition of pediatric PPGL, genetic screening tests are strongly recommended, and lifelong follow-up is needed to detect recurrence and metastasis. Further research with a larger sample size and routine genetic screening is needed to better understand the genetic conditions and long-term prognosis of PPGL. [ABSTRACT FROM AUTHOR]

Talent development in science is a national investment as it is key to enhancing national competitiveness. However, even after undergoing a 3-year training in a science gifted academy, 8.5% of South Korea's gifted students choose to enter medical school rather than pursuing a science or technology major. By conducting in-depth interviews with five participants, this study determines why talented students who are trained to become scientists at high schools and universities change their major to medicine. The participants were high school graduates gifted in science selected by purposive sampling according to the following criteria: Individuals entered medical school immediately after graduation, majored in a STEM at university and then entered a graduate school of medicine, and have a master's or doctoral degree in a STEM major but changed their major to becoming a doctor. This study investigates students who have lost motivation for a pure STEM career to reflect on the educational and social driving forces that would have enabled them to continue on their path to become scientists. In addition, as it examines the current controversy over these individuals' career choices, the study has implications for the development of talent development goals from a macro perspective. [ABSTRACT FROM AUTHOR]

Due to the rapid ageing of the population, the number of traffic accidents involving elderly drivers has dramatically increased in Northeast Asia countries including South Korea. In order to ensure the mobility of elderly drivers and prevent the risk of accidents, it is necessary to consider various factors, which may affect elderly drivers while driving in urban areas. The primary goal of this study is to examine the characteristics of elderly drivers' traffic accidents in urban areas using spatial econometrics models. The study reveals that the highly populated areas (e.g. commercial areas, employment centres, and subway station catchment areas) have a higher risk of accidents involving elderly drivers. Also, due to an increase in cognitive response time and physical ageing of the elderly, the factors which represent complex driving condition for elderly drivers (e.g. traffic islands, intersections, and school zones) are found to be positively associated with the risk of accidents. [ABSTRACT FROM AUTHOR]

Aim: The awareness for the need for end‐of‐life care has increased among noncancer patients. However, studies on the topic have rarely targeted the needs of noncancer patients who want to die at home. This study assessed the end‐of‐life care needs of noncancer patients who were receiving care and wanted to die at home. Methods: A cross‐sectional study design was used and involved 200 participants who were diagnosed as noncancer patients and receiving home care nursing. Data were collected on demographics, disease, Palliative Performance Scale (PPS) scores, and end‐of‐life care needs, in April and May, 2016. Results: Among the six areas of care, "supporting fundamental needs" of patients required the most care, followed by "coordination among family or relatives." Multivariate analysis revealed that the duration of home care nursing held a significant association with end‐of‐life care needs. Conclusion: By reflecting on the comprehensive care needs of patients with chronic illnesses and including them in the care process, it will be possible to provide better quality palliative care to patients at home in the end‐of‐life stages. SUMMARY STATEMENT: What is already known about this topic? Noncancer patients at the end‐of‐life stage have complex needs and problems that are difficult to solve, compared with cancer patients.Noncancer patients need to receive effective symptom management or sufficient support for satisfactory care.End‐of‐life care is still mainly focused on cancer patients and attention to noncancer patients is lacking. What this paper adds? Among the six areas of care, "supporting fundamental needs" of patients required the most care, followed by "coordination among family or relatives."Duration of home care nursing and an income level were significantly associated with higher end‐of‐life care needs. The implications of this paper: Home care nurses must clearly assess the care needs of noncancer patients at the end‐of‐life stage and subsequently provide comprehensive patient‐centered care based on this assessment.It is important to adjust the care direction between patient, family, and medical staff from early on for patients who want to die at home.The results highlight needs for the development of interventions that focus on the duration of home care nursing of patients. [ABSTRACT FROM AUTHOR]

A deep recurrent neural network system based on a long short-term memory (LSTM) model was developed for daily PM 10 and PM 2.5 predictions in South Korea. The structural and learnable parameters of the newly developed system were optimized from iterative model training. Independent variables were obtained from ground-based observations over 2.3 years. The performance of the particulate matter (PM) prediction LSTM was then evaluated by comparisons with ground PM observations and with the PM concentrations predicted from two sets of 3-D chemistry-transport model (CTM) simulations (with and without data assimilation for initial conditions). The comparisons showed, in general, better performance with the LSTM than with the 3-D CTM simulations. For example, in terms of IOAs (index of agreements), the PM prediction IOAs were enhanced from 0.36–0.78 with the 3-D CTM simulations to 0.62–0.79 with the LSTM-based model. The deep LSTM-based PM prediction system developed at observation sites is expected to be further integrated with 3-D CTM-based prediction systems in the future. In addition to this, further possible applications of the deep LSTM-based system are discussed, together with some limitations of the current system. [ABSTRACT FROM AUTHOR]

The aim of this study was to gain an understanding of the experiences of families who care for older adults with non-cancer diseases at the end of their lives. The data accrued through in-depth interviews, analyzed using Giorgi's phenomenological method: caregiving burden; situational responsibility; consolation by support; and mourning for the deceased. In Korean culture, adult children had the responsibility of caring for their aged parents as a burden of caregiving and as a main motive for caregiving. Educational and psychological support programs for caregivers should aim to boost confidence, rather than merely focusing on their burden. [ABSTRACT FROM AUTHOR]

Background Decline in neurocognitive function is a reported complication in children with chronic illness. Concerns have been increasing that exposure to a major surgery or trauma may negatively affect cognitive performance in children. This study evaluated cognitive function in 43 Korean children who received organ transplantation (Tx), and sought to identify associated clinical factors. Methods Pediatric recipients of kidney ( KT) or liver Tx ( LT) from 1999 to 2011 were recruited for cognitive tests. Cognitive function was evaluated using intelligence quotient ( IQ), social quotient ( SQ), and Continuous Performance Test using Advanced Test for Attention scores, which reflect attention ability. Intellectual delay was graded as intellectual disability ( ID; IQ <70) or low intelligence ( LI; IQ<85). Diagnosis for attention-deficit-hyperactivity disorder ( ADHD) was made by pediatric psychiatrists. Results The subjects consisted of 43 pediatric recipients of 28 LT and 15 KT. There were 20 boys (46.5%). Median age was 3.1 years (range, 0.5-15.3 years) at Tx. Median age at cognitive evaluation was 12.9 years (range, 3.4-18.4 years). Median pre-Tx duration of illness was 1.6 years (range, 0-13.5 years). The prevalence of ID, LI, and ADHD was 11.6%, 32.5%, and 32.5%, respectively. On multivariate analysis, longer pre-Tx duration of illness was a significant factor for LI ( OR, 1.263; 95% CI: 1.033-1.544, P = 0.023). Conclusion Longer pre-Tx duration may negatively affect intellectual ability in Korean children. Pre-Tx duration was more significant than the age at Tx or total disease duration per se. Early Tx may be beneficial for cognitive function in children. [ABSTRACT FROM AUTHOR]

Background: This study protocol evaluates the effectiveness of adjuvant electroacupuncture (EA) for urinary retention in poststroke patients undergoing conventional treatments, in comparison with that of a sham control.Methods/design: A multicenter, blinded, randomized controlled trial will be conducted in three hospitals in the Republic of Korea. We are recruiting 54 stroke survivors (aged >19 years), who were diagnosed with urinary retention based on the results of two consecutive post-void residual (PVR) tests, and dividing them randomly into two arms: the EA and Park-sham control groups. They will receive ten sessions of EA or sham treatment for 2 weeks. The participants will be blinded with non-penetrating needles and fake sounds of EA stimulators. The daily PVR ratio will be primarily measured at baseline and at the end of the study to statistically test the effectiveness of EA for poststroke urinary retention. Then, the Korean version of the Qualiveen Questionnaire, the Korean version of the International Prostate Symptom Score, and the blinding index will be assessed. After each EA session or sham EA, adverse events will be reported to evaluate the safety of EA. Results will be analyzed by using the independent t-test or Mann-Whitney U test, based on both intention-to-treat and per-protocol principles.Discussion: The findings will provide clinical evidence for the effectiveness of EA treatment to improve urinary retention in stroke survivors.Trial Registration: This study protocol was registered in ClinicalTrials.gov (NCT02472288) on 10 June 2015. [ABSTRACT FROM AUTHOR]

Adopting an evolutionary perspective, we introduce an alternative approach to the opportunism in strategic alliance where the accumulated risks during alliance operation lead to opportunism in alliance. To examine this process, a total of 358 employees from South Korean firms in the high technology sector completed a survey on opportunism in strategic alliance, measuring each firm's perceived risks on the relational and operational issues in alliance and their antecedents and outcomes. Key results show that perceived risks on the relationship between alliance partners cause a passive type of opportunism, whereas perceived risks both on the relationship between alliance partners and on the achievement of alliance objectives cause an active type of opportunism. Specifically, cultural difference showed the largest influence on relational risks, whereas issues in equity involvement showed the largest influence on performance risk. Based on the findings, theoretical and practical implications on the opportunism management in strategic alliance are discussed. [ABSTRACT FROM PUBLISHER]

Background: Hepatorenal fibrocystic diseases (HRFCDs) are a group of monogenic disorders characterized by developmental abnormalities involving the liver and kidney. In this study, we performed genotype and phenotype analyses of children with HRFCDs to determine the distribution of underlying diseases. Methods: A total of 36 children with HRFCDs were recruited, with genetic tests being performed in 22 patients and 14 patients diagnosed clinically as having autosomal recessive polycystic kidney disease (ARPKD). Results: In children with HRFCDs, ARPKD was the most common disease, found in 16/36 (44.4 %), followed by nephronophthisis 13 (NPHP13) in 11/36 (30.6 %) and Meckel-Gruber syndrome type 3 (MKS3) in 4/36 (11.1 %). Renal function deteriorated faster in children with NPHP13. The main hepatic pathology was Caroli disease in the NPHP13 patients, while most other patients had Caroli syndrome or congenital hepatic fibrosis. Of note, three of four MKS3 patients had an accompanying choledochal cyst. No ARPKD patient had other organ involvement, while several NPHP13 patients had ocular and/or neurodevelopmental involvement. In contrast, all MKS3 patients had severe ocular and neurodevelopmental involvement. Conclusions: NPHP13 is a major disease in the HRFCD category, and thorough evaluation of its clinical features, including kidney, liver and other organ involvement, may aid in the differential diagnosis of HRFCD. [ABSTRACT FROM AUTHOR]

Background: Nephronophthisis 13 (NPHP 13) is associated with mutations in the WDR19 gene, which encodes for a protein in the intraflagellar transport complex. Herein, we describe six additional cases accompanied by Caroli syndrome or disease. Methods: Targeted exome sequencing covering 96 ciliopathy-related genes was performed for 48 unrelated Korean patients with a clinical suspicion of NPHP. Mutations were confirmed by Sanger sequencing. We evaluated the expression of WDR19 in the biopsied kidney by immunohistochemistry in patients and controls. Results: We detected three (3/48, 6.3 %) unrelated index cases with WDR19 mutations. One of the cases involved two siblings with the same mutation. Later, we detected an additional index case with a similar phenotype of kidney and liver involvement by Sanger sequencing of WDR19. The p.R1178Q mutation was common in all patients. All of the six affected patients from four families progressed to chronic kidney disease. Of note, all six patients had Caroli syndrome or disease. Immunohistochemistry for WDR19 showed localized expression along the luminal borders of the renal tubular epithelium in controls, whereas it showed diffuse cytoplasmic staining in the affected patients. Conclusions: Caroli disease is a major extra-renal phenotype associated with mutations in WDR19 in the Korean population. In this study, we visually validated the expression pattern of mutant WDR19 protein in the kidneys of NPHP 13 patients. More data are needed to identify the true frequency of p.R1178Q. Functional studies including transfection assay will provide solid grounds for the pathogenicity of each mutation. [ABSTRACT FROM AUTHOR]

Background Atypical hemolytic uremic syndrome ( aHUS) is a rare disease with a genetic predisposition. Few studies have evaluated the disease in the Asian population. We studied a Korean pediatric cohort to delineate the clinical characteristics and genotypes. Methods A multicenter cohort of 51 Korean children with aHUS was screened for mutations using targeted exome sequencing covering 46 complement related genes. Anti-complement-factor- H autoantibody (anti- CFH) titers were measured. Multiplex ligation-dependent probe amplification assay was performed to detect deletions in the complement factor- H related protein genes ( CFHR) in the patients as well as in 100 healthy Korean controls. We grouped the patients according to etiology and compared the clinical features using Mann-Whitney U-test and chi-squared test. Results Fifteen patients (group A, 29.7%) had anti- CFH, and mutations were detected in 11 (group B, 21.6%), including one with combined mutations. The remaining 25 (group C, 49.0%) were negative for both. The prevalence of anti- CFH was higher than the worldwide level. Group A had a higher onset age than group B, although the difference was not significant. Group B had the worst renal outcome. Gene frequencies of homozygous CFHR1 deletion were 73.3%, 2.7% and 1% in group A, group B + C and the control, respectively. Conclusions The incidence of anti- CFH in the present Korean aHUS cohort was high. Clinical outcomes largely conformed to the previous reports. Although the sample size was limited, this cohort provides a reassessment of clinicogenetic features of aHUS in Korean children. [ABSTRACT FROM AUTHOR]

In Korea, non-point source emissions have been investigated since the early 1980s, and the proportion of non-point source sources as a source unit for each land use has been evaluated based on actual measurement data following the implementation of the Total Water Pollution Control System. Recently, a lot of research has been done on the application of LID(low impact development) technology that can effectively manage nonpoint pollution and rainfall runoff. The ratio SA/CA (surface area/catchment area) is one of the design factors for LID facilities. In this study, the major objective is to analyse relationship between the SA/CA ratio and efficiencies of runoff reduction and pollutant removal. To do this, long-term monitoring has been conducted for three - years at LID facilities installed at a domestic LID pilot project complex. The type of LID facilities analyzed in this study are grassed swale, vegetative filter strip, tree filter box, planter box, and bioretention. As a result of logarithmic relation analysis, efficiencies of pollutants removal tended to increase with increasing SA/CA ratio. Among the pollutants, TP(total phosphorus) had the highest correlation with R value of 0.9365. When SA/CA is under consideration as a design factor, this research data can be used as input for the designer for calculating the specific criteria and scope. • Runoff reduction and pollutant removal were analyzed through long-term monitoring at five vegetation type LID facilities • Correlation analysis runoff reduction and pollutant removal with SA/CA was performed on the analyzed data. • Nutrients were found to have a relatively high correlation with SA/CA, but organics had a relatively low correlation with that. • When designing a LID facility, it is reasonable to consider the SA/CA as a design factor to determine the size of facility [ABSTRACT FROM AUTHOR]

In this paper, we propose a new temperature prediction model based on deep learning by using real observed weather data. To this end, a huge amount of model training data is needed, but these data should not be defective. However, there is a limitation in collecting weather data since it is not possible to measure data that have been missed. Thus, the collected data are apt to be incomplete, with random or extended gaps. Therefore, the proposed temperature prediction model is used to refine missing data in order to restore missed weather data. In addition, since temperature is seasonal, the proposed model utilizes a long short-term memory (LSTM) neural network, which is a kind of recurrent neural network known to be suitable for time-series data modeling. Furthermore, different configurations of LSTMs are investigated so that the proposed LSTM-based model can reflect the time-series traits of the temperature data. In particular, when a part of the data is detected as missing, it is restored by using the proposed model's refinement function. After all the missing data are refined, the LSTM-based model is retrained using the refined data. Finally, the proposed LSTM-based temperature prediction model can predict the temperature through three time steps: 6, 12, and 24 h. Furthermore, the model is extended to predict 7 and 14 day future temperatures. The performance of the proposed model is measured by its root-mean-squared error (RMSE) and compared with the RMSEs of a feedforward deep neural network, a conventional LSTM neural network without any refinement function, and a mathematical model currently used by the meteorological office in Korea. Consequently, it is shown that the proposed LSTM-based model employing LSTM-refinement achieves the lowest RMSEs for 6, 12, and 24 h temperature prediction as well as for 7 and 14 day temperature prediction, compared to other DNN-based and LSTM-based models with either no refinement or linear interpolation. Moreover, the prediction accuracy of the proposed model is higher than that of the Unified Model (UM) Local Data Assimilation and Prediction System (LDAPS) for 24 h temperature predictions. [ABSTRACT FROM AUTHOR]

Background: As the population ages, the prevalence of various chronic diseases increases. Palliative care for patients at the end of life with a noncancer diagnosis is currently limited because of the difficulties of demarcating the boundaries of the end-of-life care period and of determining the various care needs of patients at the end of life. Purpose: This study aimed to investigate the levels of importance and difficulty of the multidimensional care needs for patients with a noncancer diagnosis during various end-of-life stages. Methods: This study is a retrospective survey. Home healthcarenurse specialists (HHNS) reviewed medical and nursing records and responded to a structured questionnaire. The caring experiences of HHNS with 115 patients, who were 40 years or older, had received home care nursing throughout the stable (between the onset of the end-of-life stage and 1 week before death) and near-death (1 week before death) stages at Seoul St. Mary's Hospital in Korea, and had died between September 1, 2014, and December 31, 2015, were analyzed. Results: The care needs of "coordination among family or relatives" and "support for fundamental needs" were more important in the stable stage than in the near-death stage. The care need of "loss, grief care" was more important in the near-death stage than in the stable stage. The care need of "physical symptoms management" was the most difficult to meet in both stages. Lower Palliative Performance Scale score was associated with a higher level of care need, particularly in the "management of physical symptoms" and "psychological support" realms in the stable stage and in the "coordination among family or relatives" realm in both stages. Conclusions: End-of-life stage and initial score on the Palliative Performance Scale were found to have a significant influence on the multidimensional care needs of patients with a noncancer diagnosis. Thus, healthcare professionals should assess patient care needs according to disease trajectory to provide continuous and holistic care. [ABSTRACT FROM AUTHOR]

The soil vulnerability index (SVI) classifies vulnerability to cropland pollutant transport by surface runoff and leaching, helping to categorize areas with a high contribution of pollutant loads. This study aims to 1) adopt the SVI classification scheme in South Korea and 2) suggest a modified SVI classification scheme for surface runoff to anticipate climate change impacts. The precipitation amount was considered in an original scheme to make a modified scheme. The results with an original SVI classification scheme predicted that the SVI surface runoff vulnerability was relatively greater in areas with a steep slope than in those with a plain topography, and a high level of the SVI leaching vulnerability was frequently observed in plain areas. When a modified SVI classification scheme was applied, "High" vulnerability class increased from 44.0% to 57.4% and the greater increase rate was observed in the regions susceptible to heavy precipitation defined as a day with more than 80 mm precipitation. When compared with observational suspended solids, the results with a modified SVI classification scheme were more consistent with observations than those with an original SVI classification scheme. Relative to the baseline period, the SVI surface runoff vulnerability of "High" class increased by 47.1–88.7% during the climate change period. When the number of vulnerability classes was increased, the differences on "Very extremely high" class between the baseline and projection periods were clear with the increase rate of 16.4–343%. The results with an original SVI classification scheme matched well with the topographic characteristics, and a modified SVI classification scheme captured the impacts of regional precipitation patterns and climate change impacts. As a first approach to adopting the SVI classification system to South Korea, increasing the number of classifications in regions with excessive rainfall amounts can improve identifying those most vulnerable areas. • The SVI was developed to classify soil vulnerability classes to cropland pollutant. • The SVI classification scheme was tested on croplands across South Korea. • The SVI classification results agreed well with topographic characteristics. • An original classification scheme was modified to consider precipitation amount. • A modified classification scheme showed enhanced SVI classification results. [ABSTRACT FROM AUTHOR]

The Republic of Korea is one of the largest producers of farm-raised olive flounder (Paralichthys olivaceus), accounting for nearly half of the global production. However, global warming has affected the aquaculture industry worldwide as it impacts survival, growth, and immunity and accelerates increases in pathogen load. In this study, we identified thermal stress-related genes in olive flounder using a genome-wide association study (GWAS) to provide a basis for marker-assisted selection and the development of temperature-resistant olive flounder in response to global warming. In total, 768 healthy olive flounder (weight of 159 ± 29.9 g and length of 25.42 ± 1.63 cm) were subjected to thermal stress (19.4–32.5 °C), and dead fish (537) were collected every 30 min. The fin tissues were isolated from all dead and surviving fish (231) and used for gDNA extraction. A high-quality 70 K SNP chip was used for genotyping, and 58,920 SNPs were obtained from 726 individuals after quality filtering. The GWAS identified 216 statistically significant SNPs at the Bonferroni cutoff (8.5 × 10−7). All significant SNPs were located on chromosome (chr) 18 (39 SNPs), chr 19 (176 SNPs), and contig 28 (AGQT02031776.1). After the SNP annotation, 13, 67, and 135 SNPs were identified in exons, introns, and intergenic regions, respectively. Gene and functional annotations revealed that almost all significant SNPs were directly or indirectly associated with the thermal stress response. Annotated genes were further categorized into the following functional groups: metabolic, neural and neuroendocrine, molecular and cellular, and physiological and behavioral responses. The significant SNP-harboring genes identified in this study could be used for marker-assisted genomic selection in future breeding programs. • Genome-wide association study was conducted for thermal response in olive flounders. • The selected thermal tolerance traits were highly heritable. • A total of 216 significant SNPs were associated with the thermal response. • These significant SNPs can be used for marker-assisted selection in the future. [ABSTRACT FROM AUTHOR]