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Purpose: The purpose of this study is to analyze the accreditation standards items related to the decision of accreditation of medical schools by the Korea Institute of Medical Education and Evaluation (KIMEE).Methods: The subjects are medical schools in Korea that have received post-2nd cycle accreditation from the KIMEE between 2012 and 2016. Analyses were conducted for differences in accreditation decisions according to the characteristics of medical schools, sufficient ratios of basic standards items, and correlation between standards items related to accreditation decisions.Results: After examining differences in accreditation decisions by the medical school’s characteristics, there were no significant correlations between accreditation standard items and accreditation decisions. Second, according to the number of schools that sufficiently or insufficiently met each standard item, from the total of 97 standard items, 20 (20.6%) were sufficiently fulfilled by all medical schools. Standard item 2-5-2 demonstrated the highest insufficiency ratio. Third, with respect to the standard item that had an effect on accreditation decisions, standard item 1-5-1 showed the highest correlation with the sufficiency rate.Conclusion: The validity of accreditation standards items was assured as this study evaluated the post-2nd cycle accreditation standards items regardless of each medical school’s characteristics. The accreditation standards items were found to have a meaningful impact on the development of medical schools and qualitative improvement in medical education. The findings are expected to contribute to guaranteeing the validity and reliability of accreditation decisions and raising the quality of accreditation.

Background: Dietary Na+ or Na+/K+ ratio has been reported to be associated with bone mineral density (BMD). However, this remains unclear, and only a few studies have been reported on the Korean population. Therefore, this study aimed to determine the association between dietary Na+, K+, and Na+/K+ ratios and BMD in middle-aged Korean women.Methods: This study used data from the Korea National Health and Nutrition Examination Survey 2008–2011. A total of 3,690 women aged >50 years were included. Study participants were classified into quartiles (lowest quartile Q1–highest quartile Q4) according to dietary Na+, K+, and Na+/K+ ratio, and we examined the association of these parameters with BMD. Total femur and lumbar spine BMD were measured using dual-energy X-ray absorptiometry. Multiple linear regression analyses were performed using IBM SPSS ver. 19.0.Results: The mean age was 62 years, and a significant negative trend in the β-coefficient regarding dietary Na+ was only observed in the total femur BMD. However, the total femur and lumbar spine BMD decreased from Q1 to Q4 regarding the dietary Na+/K+ ratio (P-value for trend: 0.044 for total femur BMD and 0.002 for lumbar spine BMD).Conclusion: A significant negative trend in the β-coefficient for both total femur and lumbar spine BMD was observed regarding the Na+/K+ ratio. Therefore, based on the results of this study, a higher dietary Na+/K+ ratio may be associated with a lower BMD.

Podocyte damage and renal inflammation are the main features and pathogenesis of diabetic nephropathy (DN). Inhibition of lysophosphatidic acid (LPA) receptor 1 (LPAR1) suppresses glomerular inflammation and improves DN. Herein, we investigated LPA-induced podocyte damage and its underlying mechanisms in DN. We investigated the effects of AM095, a specific LPAR1 inhibitor, on podocytes from streptozotocin (STZ)-induced diabetic mice. E11 cells were treated with LPA in the presence or absence of AM095, and the expression of NLRP3 inflammasome factors and pyroptosis were measured. A chromatin immunoprecipitation assay and Western blotting were performed to elucidate underlying molecular mechanisms. Gene knockdown by transfecting small interfering RNA was used to determine the role of the transcription factor Egr1 (early growth response protein 1) and histone methyltransferase EzH2 (Enhancer of Zeste Homolog 2) in LPA-induced podocyte injury. AM095 administration inhibited podocyte loss, NLRP3 inflammasome factor expression, and cell death in STZ-induced diabetic mice. In E11 cells, LPA increased NLRP3 inflammasome activation and pyroptosis via LPAR1. Egr1 mediated NLRP3 inflammasome activation and pyroptosis in LPA-treated E11 cells. LPA decreased H3K27me3 enrichment at the Egr1 promoter in E11 cells by downregulating EzH2 expression. EzH2 knockdown further increased LPA-induced Egr1 expression. In podocytes from STZ-induced diabetic mice, AM095 suppressed Egr1 expression increase and EzH2/H3K27me3 expression reduction. Collectively, these results demonstrate that LPA induces NLRP3 inflammasome activation by downregulating EzH2/H3K27me3 and upregulating Egr1 expression, resulting in podocyte damage and pyroptosis, which may be a potential mechanism of DN progression.

The purpose of this study was to explore, using topic modeling, the social value of doctors and medicine demanded by society as reflected in published newspaper articles in Korea. Ultimately, this study aimed to reflect social needs in the process of developing the Patient-Centered Doctor’s Competency Framework in Korea. For this purpose, a total of 2,068 newspaper articles published from 2016 to 2020 were analyzed. Through topic modeling of these newspaper articles over the past 5 years, 18 topics were derived and divided into four categories. Focusing on the derived topics and keywords, the topics derived in specific years and the proportion of topics by year were analyzed. The results of this study make it possible to grasp the needs of society projected through the press for doctors and medicine. Due to the nature of the press, topics that frequently appeared in newspaper articles were mainly social phenomena related to requirements for doctors, particularly dealing with economic and legal aspects. In particular, it was confirmed that doctors are now required to have a wider range of competencies that go beyond their required medical knowledge and clinical skills. This study helped to establish doctor’s competencies by analyzing social needs for doctors through the latest research methods, and the findings could help to establish and improve doctor’s competencies through ongoing research in the future.

With increasing demands for medical care by society, the medical system, and general citizens and rapid changes in doctor’s awareness, the competencies required of doctors are also changing. The goal of this study was to develop a doctor’s competency framework from the patient’s perspective, and to make it the basis for the development of milestones and entrustable professional activities for each period of medical student education and resident training. To this end, a big data analysis using topic modeling was performed on domestic and international research papers (2011–2020), domestic newspaper articles (2016–2020), and domestic social networking service data (2016–2020) related to doctor’s competencies. Delphi surveys were conducted twice with 28 medical education experts. In addition, a survey was conducted on doctor’s competencies among 1,000 citizens, 407 nurses, 237 medical students, 361 majors, and 200 specialists. Through the above process, six core competencies, 16 sub-competencies, and 47 competencies were derived as subject-oriented doctor’s competencies. The core competencies were: (1) competency related to disease and health as an expert; (2) competency related to patients as a communicator; (3) competency related to colleagues as a collaborator; (4) competency related to society as a health care leader (5) competency related to oneself as a professional, and (6) competency related to academics as a scholar who contributes to the development of medicine.

Asthma is a chronic inflammatory condition that affects the lung airways. Chronic use of oral glucocorticoids in patients with severe asthma is associated with several adverse events (AEs). Biologics (omalizumab, benralizumab, mepolizumab, reslizumab, and dupilumab) have been developed as alternative therapies for the treatment of asthma. The aim of this study was to evaluate the risk of anaphylactic reactions associated with these five biologics based on a large global database. We utilized individual case reports from the Uppsala Monitoring Center from 1968 to December 29, 2019. A disproportionality analysis of all drugs and monoclonal antibodies. Anaphylactic reactions were defined according to the "anaphylactic reaction” of the standardized MedDRA queries. Contrary to dupilumab, omalizumab, benralizumab, and mepolizumab demonstrated positive signals related to anaphylactic reactions among all drugs and monoclonal antibodies. Reslizumab, which represented only 315 cases of all AEs, required more reports to determine its association with anaphylactic reactions. This was an important study since the majority (96.2%) of the cases of anaphylactic reactions were reported serious. In conclusion, the results indicate that omalizumab, benralizumab, and mepolizumab are associated with a high risk of anaphylactic reactions, and careful monitoring in the post-injection period is recommended.

Surface plasmon resonance (SPR) sensors are based on photon-excited surface charge density oscillations confined at metal-dielectric interfaces, which makes them highly sensitive to biological or chemical molecular bindings to functional metallic surfaces. Metal nanostructures further concentrate surface plasmons into a smaller area than the diffraction limit, thus strengthening photon-sample interactions. However, plasmonic sensors based on intensity detection provide limited resolution with long acquisition time owing to their high vulnerability to environmental and instrumental noises. Here, we demonstrate fast and precise detection of noble gas dynamics at single molecular resolution via frequency-comb-referenced plasmonic phase spectroscopy. The photon-sample interaction was enhanced by a factor of 3,600 than the physical sample thickness owing to plasmon resonance and thermophoresis-assisted optical confinement effects. By utilizing a sharp plasmonic phase slope and a high heterodyne information carrier, a small atomic-density modulation was clearly resolved at 5 Hz with a resolution of 0.06 Ar atoms per nano-hole (in 10− 11 RIU) in Allan deviation at 0.2 s; a faster motion up to 200 Hz was clearly resolved. This fast and precise sensing technique can enable the in-depth analysis of fast fluid dynamics with the utmost resolution for a better understanding of biomedical, chemical, and physical events and interactions.

Beyond physical pain, patients with coronavirus disease 2019 (COVID-19) experience psychological anxiety during and after quarantine, often facing negative perceptions when returning to their communities. This study evaluated a health consultation program in Korea for post-quarantine patients with COVID-19, designed to help them return to their communities. The program was conducted from 9 March to 5 June 2020, in Daegu, Korea. In total, 20 doctors and 504 recovered patients were surveyed via questionnaire. The survey, comprising open-ended questions rated on a five-point Likert scale, was based on the Context–Input–Process–Product program evaluation model. Reliability was assessed, and descriptive statistics were obtained. A regression analysis was performed on factors affecting product (output) areas. As a main result, both doctors and recovered patients evaluated the program positively. The mean program effectiveness score was 4.00 in the doctors’ evaluations and 3.95 in the patients’ evaluations. Moreover, the input and process variables affected the product. This first-of-its-kind health consultation program proved to be an effective practical intervention for patients returning to the community after an infectious disease; it also highlights aspects that could increase satisfaction in systemized subsequent programs, with input and process areas for patients and doctors.

Acanthopanax leucorrhizus is an endemic medicinal plant growing abundantly in the northwest region of China. The roots and stem barks have been widely used to treat rheumatism, numbness, contracture, quadriplegia, hemiplegia, traumatic injury, edema, and itchy skin, although the anti-inflammatory effects of the extracts of A. leucorrhizus have not been assessed until now. To investigate the anti-inflammatory effects on macrophages of various extracts from A. leucorrhizus stems, alterations in the inducible nitric oxide synthase (iNOS)-mediated cyclooxygenase-2 (COX-2) expression and inflammatory cytokine production were measured in lipopolysaccharide (LPS)-activated RAW264.7 cells. Briefly, the dichloromethane extract prepared from stems of A. leucorrhizus (ALSDC) effectively inhibited NO production in LPS-stimulated cells and significantly reduced the production of pro-inflammatory cytokines IL-6 and TNF-α at a dose of 40 µg/mL. We also confirmed a dose-dependent and significant inhibition of iNOS and COX-2 protein expression. In conclusion, ALSDC exerted strong inhibitory effect on the expression of iNOS and COX-2 protein in LPS-induced RAW 264.7 macrophages and these results provide strong evidence to suggest that ALSDC may be considered as an important candidate for the treatment of inflammatory-related diseases in the future.

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The first massive outbreak of coronavirus disease 2019 (COVID-19) in Korea was controlled by fast diagnosis, isolation and triage systems The development of therapeutic agents and vaccinations are going on, but many studies clarified the nature of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) In this review, we will discuss the characteristics and spreading of SARS-CoV-2, and prognostic factors and diagnosis of COVID-19

The world’s premier metropolitan areas (‘global cities’) are key nodes in international business networks and function as important international innovation hubs. They are prominent spaces for knowledge exchange and collaboration on innovation yet their specific and changing role in global innovation networks has not received due attention. This chapter contributes an analysis of the changing role of global cities in global collaborative innovation networks, 2000–2014, by examining co-invention linkages across 125 global cities in forty-six countries. The international linkages of global cities have increased substantially over the period. Growth has been most pronounced in a number of Asian cities that rank among the top cities in the world in the most recent period. The patterns attest to the growing importance of international collaboration for innovation and the premier position of global cities as spaces facilitating such collaboration.

Background and Objective: In 2020, during the coronavirus disease (COVID-19) pandemic, medical students were placed in a learning environment that exposed them to unsafe clinical settings. In this study, using a phenomenological approach, we analyze the experiences of fourth-year students in the Daegu area of South Korea, a region that experienced a high concentration of COVID-19 infections. Methods: The essays of 80 students from four medical schools who agreed to participate in the study were utilized in the final data analysis. The data were analyzed using the proposed phenomenological analysis. Results: Forty-seven condensed meaning units, twelve subthemes, and three essential themes were identified. The main theme includes the following: 1) confusion and stress due to sudden changes in the learning situation 2) learned the medical professionalism of physicians 3) reflection and internal change regarding what it means to be a physician. Conclusions: The COVID-19 pandemic had a significant impact on students who participated in clinical clerkships. This study can provide baseline data for planning educational strategies and establishing a support system for students in response to the changes that they may experience in the event of the reoccurrence of a novel infectious disease in the future. doi: https://doi.org/10.12669/pjms.38.3.5031 How to cite this:Park KH, Yune SJ, Jung MK, Kim Y, Lee GH, Kim SY. Impact of the COVID-19 pandemic on medical students of clinical clerkship in South Korea: A qualitative study exploring medical students’ experiences. Pak J Med Sci. 2022;38(3):---------. doi: https://doi.org/10.12669/pjms.38.3.5031 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Acanthopanax gracilistylus W.W.Smith (AGS) is an traditional Chinese medicine and its leaves that have rich biological activities has been long used as a fresh vegetable in Chinese folk. There are two lupane-type triterpenoids, 3α,11α-dihydroxy-23-oxo-lup-20(29)-en-28-oic acid (1) and 3α,11α,23-trihydroxy-lup-20(29)-en-28-oic acid (2), were isolated as the active constituents from leaves of AGS. However, the anti-inflammatory effects and potential mechanisms of 1 and 2 on LPS-induced RAW264.7 Macrophages have not been evaluated. In this study, the results shown that compounds 1 and 2 reduced the levels of early pro-inflammatory cytokines TNF-α, IL-1β, the secretion of late pro-inflammatory cytokine HMGB1, as well as the activation of transcription factor NF-κB in RAW 264.7 macrophages induced by LPS. In conclusion, two lupane-type triterpenes (1 and 2) have anti-inflammatory activities in LPS-induced RAW264.7 cells through inhibiting expression of proinflammatory cytokines and NF‐κB activation and could be potentially used in treatment of inflammatory-related diseases in the future.

The epithelial–mesenchymal transition (EMT) is a differentiation process associated with fibrogenesis in diabetic nephropathy (DN). Lysophosphatidic acid (LPA) is a small, naturally occurring glycerophospholipid implicated in the pathogenesis of DN. In this study, we investigated the role of LPA/LPAR1 signaling in the EMT of tubular cells as well as the underlying mechanisms. We observed a decrease in E-cadherin and an increase in vimentin expression levels in the kidney tubules of diabetic db/db mice, and treatment with ki16425 (LPAR1/3 inhibitor) inhibited the expression of these EMT markers. Ki16425 treatment also decreased the expression levels of the fibrotic factors fibronectin and alpha-smooth muscle actin (α-SMA) in db/db mice. Similarly, we found that LPA decreased E-cadherin expression and increased vimentin expression in HK-2 cells, which was reversed by treatment with ki16425 or AM095 (LPAR1 inhibitor). In addition, the expression levels of fibronectin and α-SMA were increased by LPA, and this effect was reversed by treatment with ki16425 and AM095 or by LPAR1 knockdown. Moreover, LPA induced the expression of the transcription factor, Krüppel-like factor 5 (KLF5), which was decreased by AM095 treatment or LPAR1 knockdown. The expression levels of EMT markers and fibrotic factors induced by LPA were decreased upon KLF5 knockdown in HK-2 cells. Inhibition of the extracellular signal-regulated kinase (ERK), c-Jun N-terminal kinase (JNK), and serine-threonine kinase (AKT) pathways decreased LPA-induced expression of KLF5 and EMT markers. In conclusion, these data suggest that LPA contributes to the pathogenesis of diabetic nephropathy by inducing EMT and renal tubular fibrosis via regulation of KLF5 through the LPAR1.

Background: This study assessed the psychological impact of the outbreak of coronavirus disease 2019 (COVID-19) on university hospital nurses. It provides an assessment of mental health issues, including depression, anxiety, distress, and burnout of nurses dealing directly and indirectly with COVID-19. Methods: In a web-based, cross-sectional study, 111 nurses from Daegu Catholic University Hospital in Korea were enrolled from August 4 to August 9, 2020. Patient Health Questionnaire-9, Generalized Anxiety Disorder-7, Impact of Event Scale-Revised, and Maslach Burnout Inventory were used to assess the psychological symptoms of depression, anxiety, psychological distress, and burnout among the study participants. Results: Of 111 nurses, 35 (31.5%), nine (8.1%), 26 (23.4%), and 49 (44.1%) experienced depression, anxiety, distress, and burnout, respectively. Nurses who performed COVID-19–related tasks were more likely to have moderate depression (related vs. unrelated, 52.0% vs. 25.6%; p=0.037). There were no differences in anxiety, distress, and burnout between nurses with and without COVID-19–related tasks. More than 50% of the participants showed receptive and positive attitudes toward caring for COVID-19 patients. Conclusion: Nurses who performed COVID-19–related tasks had a higher risk of depression. There were no significant differences in anxiety, distress, and burnout between the two groups. Since nurses who perform COVID-19–related tasks are more prone to psychological distress, continued psychiatric interventions are required for infectious disease outbreaks with a high mortality rate for healthcare workers who are emotionally vulnerable.

Background We evaluated the effects of socioeconomic factors and psychosocial factors, both individually and combined, on all-cause mortality risk (mortality risk). Methods We conducted an 8-year (2006-2014) longitudinal analysis of 10,247 individuals who took part in the Korean Longitudinal Study of Aging, a nationwide survey of people aged 45-79 years. Socioeconomic vulnerability (SEV) was assessed with factors such as education, household income, commercial health insurance, and residential area. Mental health (MH) was assessed with factors such as depression, social engagement, and life satisfaction. The covariates were age, gender, marital status, cohabiting, number of chronic diseases, and health behaviors such as regular exercise, smoking, and alcohol intake. We used a Cox proportional hazard analysis to investigate the effects of SEV and MH on mortality risk and also to analyze the superimposed effects of SEV-MH on mortality risk. Results After the controlling for the covariates, high SEV and negative MH were found to be strong predictors of all-cause mortality. The highest quartile of SEV (vs. lowest) had a 1.70 times greater mortality risk (hazard ratio [HR], 1.70; 95% confidence interval [CI], 1.24-2.33) and the highest quartile of MH (vs. lowest) had a 2.13 times greater mortality risk (HR, 2.13; 95% CI, 1.72-2.64). Being in the highest quartile for both SEV and MH (vs. lowest) increased mortality risk more than 3 times (HR, 3.11; 95% CI, 2.20-4.40). Conclusion High SEV and negative MH were independently associated with increased mortality risk, and their superimposed effects were associated with an increased risk of mortality.

During the Coronavirus Infection Disease-19 (COVID-19) pandemic, the number of patients released from quarantine is exceeding the number of newly diagnosed cases. This study is a retrospective cohort study in which consultation data were collected from a COVID-19 follow-up health consultation program. The studied population was selected from patients who recovered after quarantine and treatment for COVID-19 in Daegu City and in Gyeongsangbukdo province, Korea, from March to June 2020. The healthcare providers comprised 20 family-medicine specialists who consulted and educated the patients through phone calls in accordance with structured guidelines. Physical and mental status before and after recovery were compared among patients who received a single consultation and those who received two or more consultations. A total of 1604 subjects were selected for the final analysis. Of these, 1145 (71.4%) had one consultation and 459 (28.6%) had two or more. The group that had two or more consultations reported significantly more physical symptoms, more psychological symptoms (including depression), and more psychological stress. Multivariate forward selection logistic regression analysis showed that re-confirmed cases of COVID-19, physical symptoms after quarantine, feelings of depression, and psychological stress had a significant effect on the number of consultations received. In conclusion, COVID-19 has various physical and mental sequelae after discharge from quarantine. Therefore, a well-structured follow-up program is needed after recovery.

Background The coronavirus pandemic has increased reliance on the internet as a tool for disseminating information; however, information is useful only when it can be understood. Prior research has shown that web-based health information is not always easy to understand. It is not yet known whether the Korean-language COVID-19 information from the internet is easy for the general public to understand. Objective We aimed to evaluate the readability of Korean-language COVID-19 information intended for the general public from the national COVID-19 portal of South Korea. Methods A total of 122 publicly available COVID-19 information documents written in Korean were obtained from the South Korean national COVID-19 portal. We determined the level of readability (at or below ninth grade, 10th to 12th grade, college, or professional) of each document using a readability tool for Korean-language text. We measured the reading time, character count, word count, sentence count, and paragraph count for each document. We also evaluated the characteristics of difficult-to-read documents to modify the readability from difficult to easy. Results The median readability level was at a professional level; 90.2% (110/122) of the information was difficult to read. In all 4 topics, few documents were easy to read (overview: 5/12, 41.7%; prevention: 6/97, 6.2%; test: 0/5, 0%; treatment: 1/8, 12.5%; P=.006), with a median 11th-grade readability level for overview, a median professional readability level for prevention, and median college readability levels for test and treatment. Difficult-to-read information had the following characteristics in common: literacy style, medical jargon, and unnecessary detail. Conclusions In all 4 topics, most of the Korean-language COVID-19 web-based information intended for the general public provided by the national COVID-19 portal of South Korea was difficult to read; the median readability levels exceeded the recommended ninth-grade level. Readability should be a key consideration in developing public health documents, which play an important role in disease prevention and health promotion.

BACKGROUND The coronavirus pandemic has increased reliance on the internet as a tool for disseminating information; however, information is useful only when it can be understood. Prior research has shown that web-based health information is not always easy to understand. It is not yet known whether the Korean-language COVID-19 information from the internet is easy for the general public to understand. OBJECTIVE We aimed to evaluate the readability of Korean-language COVID-19 information intended for the general public from the national COVID-19 portal of South Korea. METHODS A total of 122 publicly available COVID-19 information documents written in Korean were obtained from the South Korean national COVID-19 portal. We determined the level of readability (at or below ninth grade, 10th to 12th grade, college, or professional) of each document using a readability tool for Korean-language text. We measured the reading time, character count, word count, sentence count, and paragraph count for each document. We also evaluated the characteristics of difficult-to-read documents to modify the readability from difficult to easy. RESULTS The median readability level was at a professional level; 90.2% (110/122) of the information was difficult to read. In all 4 topics, few documents were easy to read (overview: 5/12, 41.7%; prevention: 6/97, 6.2%; test: 0/5, 0%; treatment: 1/8, 12.5%; P=.006), with a median 11th-grade readability level for overview, a median professional readability level for prevention, and median college readability levels for test and treatment. Difficult-to-read information had the following characteristics in common: literacy style, medical jargon, and unnecessary detail. CONCLUSIONS In all 4 topics, most of the Korean-language COVID-19 web-based information intended for the general public provided by the national COVID-19 portal of South Korea was difficult to read; the median readability levels exceeded the recommended ninth-grade level. Readability should be a key consideration in developing public health documents, which play an important role in disease prevention and health promotion.

BACKGROUND In South Korea, the number of coronavirus disease (COVID-19) cases has declined rapidly and much sooner than in other countries. South Korea is one of the most digitalized countries in the world, and YouTube may have served as a rapid delivery mechanism for increasing public awareness of COVID-19. Thus, the platform may have helped the South Korean public fight the spread of the disease. OBJECTIVE The aim of this study is to compare the reliability, overall quality, title–content consistency, and content coverage of Korean-language YouTube videos on COVID-19, which have been uploaded by different sources. METHODS A total of 200 of the most viewed YouTube videos from January 1, 2020, to April 30, 2020, were screened, searching in Korean for the terms “Coronavirus,” “COVID,” “Corona,” “Wuhan virus,” and “Wuhan pneumonia.” Non-Korean videos and videos that were duplicated, irrelevant, or livestreamed were excluded. Source and video metrics were collected. The videos were scored based on the following criteria: modified DISCERN index, Journal of the American Medical Association Score (JAMAS) benchmark criteria, global quality score (GQS), title–content consistency index (TCCI), and medical information and content index (MICI). RESULTS Of the 105 total videos, 37.14% (39/105) contained misleading information; independent user–generated videos showed the highest proportion of misleading information at 68.09% (32/47), while all of the government-generated videos were useful. Government agency–generated videos achieved the highest median score of DISCERN (5.0, IQR 5.0-5.0), JAMAS (4.0, IQR 4.0-4.0), GQS (4.0, IQR 3.0-4.5), and TCCI (5.0, IQR 5.0-5.0), while independent user–generated videos achieved the lowest median score of DISCERN (2.0, IQR 1.0-3.0), JAMAS (2.0, IQR 1.5-2.0), GQS (2.0, IQR 1.5-2.0), and TCCI (3.0, IQR 3.0-4.0). However, the total MICI was not significantly different among sources. “Transmission and precautionary measures” were the most commonly covered content by government agencies, news agencies, and independent users. In contrast, the most mentioned content by news agencies was “prevalence,” followed by “transmission and precautionary measures.” CONCLUSIONS Misleading videos had more likes, fewer comments, and longer running times than useful videos. Korean-language YouTube videos on COVID-19 uploaded by different sources varied significantly in terms of reliability, overall quality, and title–content consistency, but the content coverage was not significantly different. Government-generated videos had higher reliability, overall quality, and title–content consistency than independent user–generated videos.

Background In South Korea, the number of coronavirus disease (COVID-19) cases has declined rapidly and much sooner than in other countries. South Korea is one of the most digitalized countries in the world, and YouTube may have served as a rapid delivery mechanism for increasing public awareness of COVID-19. Thus, the platform may have helped the South Korean public fight the spread of the disease. Objective The aim of this study is to compare the reliability, overall quality, title–content consistency, and content coverage of Korean-language YouTube videos on COVID-19, which have been uploaded by different sources. Methods A total of 200 of the most viewed YouTube videos from January 1, 2020, to April 30, 2020, were screened, searching in Korean for the terms “Coronavirus,” “COVID,” “Corona,” “Wuhan virus,” and “Wuhan pneumonia.” Non-Korean videos and videos that were duplicated, irrelevant, or livestreamed were excluded. Source and video metrics were collected. The videos were scored based on the following criteria: modified DISCERN index, Journal of the American Medical Association Score (JAMAS) benchmark criteria, global quality score (GQS), title–content consistency index (TCCI), and medical information and content index (MICI). Results Of the 105 total videos, 37.14% (39/105) contained misleading information; independent user–generated videos showed the highest proportion of misleading information at 68.09% (32/47), while all of the government-generated videos were useful. Government agency–generated videos achieved the highest median score of DISCERN (5.0, IQR 5.0-5.0), JAMAS (4.0, IQR 4.0-4.0), GQS (4.0, IQR 3.0-4.5), and TCCI (5.0, IQR 5.0-5.0), while independent user–generated videos achieved the lowest median score of DISCERN (2.0, IQR 1.0-3.0), JAMAS (2.0, IQR 1.5-2.0), GQS (2.0, IQR 1.5-2.0), and TCCI (3.0, IQR 3.0-4.0). However, the total MICI was not significantly different among sources. “Transmission and precautionary measures” were the most commonly covered content by government agencies, news agencies, and independent users. In contrast, the most mentioned content by news agencies was “prevalence,” followed by “transmission and precautionary measures.” Conclusions Misleading videos had more likes, fewer comments, and longer running times than useful videos. Korean-language YouTube videos on COVID-19 uploaded by different sources varied significantly in terms of reliability, overall quality, and title–content consistency, but the content coverage was not significantly different. Government-generated videos had higher reliability, overall quality, and title–content consistency than independent user–generated videos.

We are currently experiencing the disaster of the COVID-19 pandemic. Since the first case of Coronavirus disease 2019 (COVID-19) was confirmed in South Korea on January 20, the number of COVID-19 cases in South Korea has been rapidly increasing until early March due to a local spread in Daegu, which is one of the eight metropolitan cities in South Korea with a population of 2.5 million. As the medical academy has social accountability as professionals, Daegu-Gyeongbuk branch of the Korean Academy of Family Medicine (Daegu-Gyeongbuk branch) developed the health counseling program for discharged COVID-19 patients. The Daegu-Gyeongbuk branch communicated with Daegu Medical Association and Daegu city for this program and incorporated available resources and capabilities as a leader of this program. This newly developed counseling program consists of medical consultations, sending healthcare brochures and medical supplies, and the appraisal at the end of the program. Not only COVID-19 related symptoms but also other psychological problems are also dealt with during consultations. This program started on March 18, and over 1,700 recovered patients have been receiving counseling as of April 28. Communication and cooperation between the medical academy, medical association, and government are essential to overcome the COVID-19 pandemic. Besides, we expect to apply this health counseling program and our model of setting this program cooperating with medical association and government to different infectious pandemic crisis.

The aim of this study was to identify the association of NLRP3 inflammasome-induced inflammation with disease activity and damage in Sjögren's syndrome.A total of 33 female patients with Sjögren's syndrome and 34 sex- and age-matched, healthy controls were consecutively enrolled. The mRNA expression levels of NLRP3, ASC, caspase-1, interleukin-1β (IL-1β), and IL-18 in peripheral blood mononuclear cells (PBMCs) were measured, as well as serum IL-1β and IL-18 protein expression levels. Protein levels for mature IL-1β (p17) and caspase-1 (p20) were analyzed by western blotting. The EULAR Sjögren's Syndrome Disease Activity Index (ESSDAI) and Sjögren's Syndrome Disease Damage Index (SSDDI) were also evaluated.Patients with Sjögren's syndrome group showed higher expression of mRNA IL-1β and IL-1β at the protein level than controls (p0.001 of both). Enhanced expression of mature IL-1β (p17) and caspase-1 (p20) proteins in Sjögren's syndrome were noted, compared to controls. The mRNA levels of caspase-1 and ASC were significantly increased in patients with Sjögren's syndrome compared to controls (p=0.001 and p=0.002, respectively). Based on the SSDDI scores, patients with damage (SSDDI≥1) had higher IL-1β mRNA expression compared to patients without damage (SSDDI=0) (p=0.034). SSDDI scores were closely related with IL-18 protein levels (r=0.357, p=0.041). The levels of IL-1β mRNA and IL-1β protein were correlated with the mRNA level of NLRP3 (r=0.597, p0.001 and r=0.502, p=0.003, respectively). IL-1β mRNA expression was responsible for the presence of damage for Sjögren's syndrome (p=0.034).This study confirmed that NLRP3 inflammasome-mediated inflammation might be implicated in the pathogenesis of Sjögren's syndrome.

weight, blood test, personal habits questionnaire, and echocardiographic indices were obtained. We analyzed the echocardiographic indices of left ventricular diastolic function with BMI and WC. Results: The left ventricle (LV) mass index (P = 0.007), LV dimension (P < 0.01), A (P < 0.01), Aʹ (P = 0.030), and E/Eʹ (P = 0.006) were higher, and E (P = 0.003), Eʹ (P < 0.01), E/A (P < 0.01) were lower in the overweight and obese groups than in the normal group. On multiple linear regression analysis, E/Eʹ correlated positively with age, gender, BMI and systolic blood pressure. In men, E/Eʹ correlated positively with age and BMI or WC. In women, only age had a positive correlation with E/Eʹ. Conclusion: In men, increased BMI or waist circumference are associated with an increase in E/Eʹ, which surrogates left ventricular diastolic dysfunction. In women, obesity and abdominal obesity have no correlation with E/Eʹ.

A combination of genetic and environmental factors determines age of menarche. In Korea, there has been a trend for a younger age of menarche as the country has undergone industrialization and adopted a westernized diet. Previous studies have indicated that the incidence of obesity and metabolic syndrome, as well as cardiovascular mortality, is higher in women who undergo menarche at a younger age. This study was conducted to examine the relationship between age of menarche and metabolic syndrome in premenopausal women in Korea. Data for 1464 women were collected from the Sixth Korea National Health and Nutrition Examination Survey (KNHANES VI). The modified NCEP-ATP III criteria were used to define metabolic syndrome. Considering the unit of data extraction (investigation district), stratification variables, and weighted value, a complex sample design extraction method was applied for statistical analysis. After dividing the subjects by age of menarche, the risk of metabolic syndrome was assessed using multiple logistic regression analysis adjusting for age, smoking, drinking, exercise, education level, household income, and marital status. When the subjects were grouped by age of menarche ( 16 years), a statistically significant increase in the average age of the group was observed (23.8 ± 0.8, 29.6 ± 0.4, 35.8 ± 0.4, and 39.8 ± 0.7, respectively; p 16 years. Age of menarche is associated with the risk of metabolic syndrome in premenopausal women in Korea.

The evaluation of the performance of aged structures is essential in the oil and gas industry, where inaccurate predictions of structural performance may lead to significant hazardous consequences. Elbows are critical structures subject to continuous corrosion that can lead to a burst or collapse. It is important to be able to predict both burst strength in continually corroding structures and the behaviour of the structures after critical corrosion takes place. Structural failures due to a significant reduction in wall thickness make it very complicated for pipeline operators to maintain pipeline serviceability. This paper discusses the plastic limit pressure of elbows without defects and with several local thinned areas. Finite element analysis (FEA) and the Goodall formula were used to evaluate the new formula. The results of the FEA show that the limit load of elbows under internal pressure differs with position and depth of damage. An empirical formula for the limit load of elbows with local ...

Evaluation of the performance of aging structures is essential in the oil and gas industry, where the inaccurate prediction of structural performance can have significantly hazardous consequences. The effects of structure failure due to the significant reduction in wall thickness, which determines the burst strength, make it very complicated for pipeline operators to maintain pipeline serviceability. In other words, the serviceability of gas pipelines and elbows needs to be predicted and assessed to ensure that the burst or collapse strength capacities of the structures remain less than the maximum allowable operation pressure. In this study, several positions of the corrosion in a subsea elbow made of API X42 steel were evaluated using both design formulas and numerical analysis. The most hazardous corrosion position of the aging elbow was then determined to assess its serviceability. The results of this study are applicable to the operational and elbow serviceability needs of subsea pipelines and can help predict more accurate replacement or repair times.

The purpose of this study is to investigate domestic and international research trends in studies of medical students’ characteristics by using the scoping review methods. This study adopted the scoping review to assess papers on the characteristics of medical students. The procedure of research was carried out according to the five steps of the scoping review. The full texts of 100 papers are obtained and are read closely, after which suitable 88 papers are extracted by us for this research. The review is mapped by the year of the study, source, location, author, research design, research subject, objective, and key results. The frequency is analyzed by using Microsoft Excel and SPSS. We found 70 papers (79.5%) on a single medical school, 15 (17.0%) on multiple medical schools, and three (3.4%) on mixed schools, including medical and nonmedical schools. Sixty-nine (79.5%) were cross-sectional studies and 18 (20.5%) were longitudinal studies. Eighty-two papers (93.2%) adopted questionnaire surveys. We summarized research trends of studies on medical students in Korea and overseas by topic, and mapped them into physical health, mental health, psychological characteristics, cognitive characteristics, social characteristics, and career. This study provides insights into the future directions of research for the characteristics of medical students.

Background γδ T cells are implicated in immunoregulation. However, little is known about the characteristics of γδ T cells in gastric cancer. In this study, we assessed the incidence of γδ T cells and lymphocyte subsets in the peripheral blood of gastric cancer patients. Methods We enrolled 48 patients and 49 healthy controls. The γδ T cells, lymphocyte subsets were analyzed with flow cytometry. Results The mean percentage of γδ T cells in patients with gastric cancer was 5.0 ± 3.4% and for controls 2.3 ± 1.6%. Twenty (41.7%) of the 48 patients with gastric cancer had a high percentage (more than 5%) of peripheral blood γδ T cells, while 4 (8.2%) of the 49 controls did. The percentage of CD3 + T cells were elevated in gastric cancer compared to controls ( P = 0.007). The CD4/CD8 ratio increased in gastric cancer ( P = 0.311). The percentage of CD3 + CD4 − CD8 − T cells increased in gastric cancer compared to controls ( P = 0.004). Conclusion The proportion of γδ T cells in the peripheral blood of gastric cancer patients was significantly higher in comparison to that in the healthy controls. Our findings suggest that increased proportion of peripheral γδ T cells may explain anti-tumor immunity against gastric cancer partly.

The compressor’s efficiency affects on the fuel consumption of the vehicle because the compressors for car air-conditioning system are operated by engine-driven. Especially, the refrigerant is being changed recently from R134a to substitution refrigerant to protect environment pollution that people concerned about. However, that leads to lower efficiency of the car air- conditioning system and worse fuel consumption of the vehicle. Thus, this paper is focused on the methods for improvement of the compressor’s efficiency that affects on the fuel consumption of the vehicle by numerical analysis for compressor’s performance and the measurement of cylinder volume and pressure when the compressor is being operated.Keywords:Compressor(압축기), Performance(성능), Simulation(압축기 이론 해석), Substitution refrigerant(대체 냉매), R1234yf †Corresponding author Tel.: +82-31-670-7096; fax: +82-31-670-7352 E-mail address: tjlee@doowonhi.com 기 호 설 명 A ：면적 [m 2 ] A 0 ：밸브 포트 단면적 [m 2 ]A e ：유효 유로 면적 [m 2 ]A