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Limited data are available regarding the effect of metabolic syndrome on heart failure (HF) development in young individuals. Utilizing data from the Korean National Health Insurance Service, we included a total of 1,958,284 subjects in their 40s who underwent health screening between January 2009 and December 2009 in Korea. Subjects were classified into three groups: normal, pre-metabolic syndrome (Pre-MetS), and metabolic syndrome (MetS). MetS was identified in 10.58% of males and 5.21% of females. The hazard ratio for HF in subjects with MetS was 1.968 (95% CI: 1.526–2.539) for males and 2.398 (95% CI: 1.466–3.923) for females. For those with Pre-MetS, the hazard ratio was 1.607 (95% CI: 1.293–1.997) in males and 1.893 (95% CI: 1.43–2.505) in females. Additionally, acute myocardial infarction and low hemoglobin levels were identified as significant risk factors for HF in both genders. MetS approximately doubled the risk of developing HF in individuals in their 40s. Pre-MetS was also a significant risk factor for HF in this population.

This study aimed to investigate the growth performance of far eastern catfish (Silurus asotus) on outdoor fish farms to obtain basic data for the domestic eastern catfish aquaculture industry. An outdoor fish farm was directly monitored from June 2018 to October 2019 to determine the farming conditions, growth performance, and water quality. The growth performance in 2017 was analyzed using data from the same fish farm. Three years of monitoring showed that the fish farm required approximately 5–6 months between stocking, harvesting, and selling an S. asotus batch. The growth parameters, namely, the weight gain rate (WGR), specific growth rate (SGR) for culture periods, SGR for feeding periods, and feed coefficient rate (FCR), were 4,664.7%, 1.27%, 2.43%, and 1.25 in 2017; 6,452.0%, 1.52%, 2.79%, and 1.42 in 2018; and 3,270.0%, 1.11%, 2.12%, and 1.38 in 2019, respectively. Moreover, the WGR was two-fold higher in 2018 than 2019, whereas the FCR was more effective in 2019 than 2018, presumably because of the stocking density. No mass mortality was observed during the water quality analysis. The results of this study provide basic data for the development of the catfish industry.

We investigated the reproductive strategies and embryonic development of Acheilognathus rhombeus (a bitterling species that spawns in autumn) within its freshwater mussel host in the Bongseo Stream, South Korea. By focusing on survival mechanisms during critical stages of embryonic development, the selective use of mussel gill demibranchs by the bitterlings and associated adaptive traits were observed over 1 year. A significant diapause phase occurs at developmental stage D, which lasts for approximately 7 months, allowing embryos to survive winter. Development resumes when the temperature exceeds 10 °C. Minute tubercles on the embryos (crucial for anchoring within the host gill demibranchs and preventing premature ejection) exhibit the largest height during diapause, and the height decreases when developmental stage E is reached, when growth resumes. Acheilognathus rhombeus embryos were observed in 30.5% of the mussels, mostly within the inner gills, thereby maximizing spatial use and oxygen access to enhance survival. These results highlight the intricate relationship between A. rhombeus and its mussel hosts, demonstrating the evolutionary adaptations that enhance reproductive success and survival. This study provides valuable insights into the ecological dynamics and conservation requirements of such symbiotic relationships.

ABSTRACTBackground Due to the prolonged period of COVID-19, the uncertainty related to COVID-19 is bound to increase for healthcare workers (HCWs) in tertiary medical institutions as much as for the HCWs in dedicated hospitals.Purpose To assess anxiety, depression, and uncertainty appraisal, and to determine the factors affecting uncertainty risk and opportunity appraisal experienced by HCWs at the forefront of COVID-19 treatment.Method This was a descriptive, cross-sectional study. The participants were HCWs at a tertiary medical center in Seoul. HCWs included medical (doctors, nurses) and non-medical (nutritionists, pathologists, radiologists, office workers, etc.) personnel. Self-reported structured questionnaires (patient health questionnaire, generalized anxiety disorder scale, and uncertainty appraisal) were obtained. Finally, responses from 1337 people were used to evaluate factors affecting uncertainty risk and opportunity appraisal using a quantile regression analysis.Results The average ages of medical and non-medical HCWs were 31.69 ± 7.87 and 38.66 ± 11.42 years, and the proportion of females was high. The rates of moderate to severe depression (23.23%) and anxiety (6.83%) were higher in medical HCWs. The uncertainty risk score was higher than the uncertainty opportunity score for all the HCWs. Factors that increased uncertainty opportunity were a decrease in depression in medical HCWs and a decrease in anxiety in non-medical HCWs. Increase in age was directly proportional to uncertainty opportunity in both groups.Conclusion There is a need to devise a strategy to reduce uncertainty among HCWs who inevitably face various infectious diseases that appear in the near future. In particular, since there are various types of non-medical as well as medical HCWs in medical institutions who can prepare an intervention plan that comprehensively considers the characteristics of each occupation and the distribution of risks and opportunities of uncertainty will be able to improve the quality of life of HCWs and further promote the health of the people.

Interest in aquaponics (AP) is increasing due to its ability to minimize sewage and maximize feed efficiency in fish farming. However, owing to limitations of intensive cultures and a lack of nutrients such as NO3 for growing crops, AP requires the use of artificial nutrients. Therefore, novel approaches are required to develop AP-intensive culturing methods. An AP system based on biofloc technology (BFT) called FLOCponics (FP) has been recommended. Here, the productivity of the weather loach (Misgurnus anguillicaudatus) in the FP system, BFT system, and flow-through systems (FTSs), as well as these systems’ effect on Caipira lettuce (Lactuca sativa) growth, was analyzed. To compare crop productivity, a hydroponic (HP) bed was installed. The growth rate of M. anguillicaudatus showed significant differences, at 51.1 ± 3.69% in the FP system, followed by 24.0 ± 4.16% in the BFT system and −14.3 ± 1.4% in the FTS. Its survival rates were better in the FP system (91.1 ± 2.64%) than in the BFT system (82.1 ± 10.98%) or the FTS (66.8 ± 2.75%) (p < 0.05). Total ammonia nitrogen and NO2−-N concentrations were stabilized in every plot during the experimental period. However, the NO3−-N concentration continuously increased in the BFT system but decreased in the FP system and was maintained. The shoot weight of the Caipira lettuce was 163.6 ± 8.65 g in the FP system and 149.6 ± 9.05 g in the HP system. In conclusion, FP system can provide a large amount of nutrients and improve the growth performance of both fish and crops in the FP system.

OBJECTIVES We estimated the population prevalence of antibodies to severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), including unreported infections, through a Korea Seroprevalence Study of Monitoring of SARS-CoV-2 Antibody Retention and Transmission (K-SEROSMART) in 258 communities throughout Korea. METHODS In August 2022, a survey was conducted among 10,000 household members aged 5 years and older, in households selected through two stage probability random sampling. During face-to-face household interviews, participants self-reported their health status, COVID-19 diagnosis and vaccination history, and general characteristics. Subsequently, participants visited a community health center or medical clinic for blood sampling. Blood samples were analyzed for the presence of antibodies to spike proteins (anti-S) and antibodies to nucleocapsid proteins (anti-N) SARS-CoV-2 proteins using an electrochemiluminescence immunoassay. To estimate the population prevalence, the PROC SURVEYMEANS statistical procedure was employed, with weighting to reflect demographic data from July 2022. RESULTS In total, 9,945 individuals from 5,041 households were surveyed across 258 communities, representing all basic local governments in Korea. The overall population-adjusted prevalence rates of anti-S and anti-N were 97.6% and 57.1%, respectively. Since the Korea Disease Control and Prevention Agency has reported a cumulative incidence of confirmed cases of 37.8% through July 31, 2022, the proportion of unreported infections among all COVID-19 infection was suggested to be 33.9%. CONCLUSIONS The K-SEROSMART represents the first nationwide, community-based seroepidemiologic survey of COVID-19, confirming that most individuals possess antibodies to SARS-CoV-2 and that a significant number of unreported cases existed. Furthermore, this study lays the foundation for a surveillance system to continuously monitor transmission at the community level and the response to COVID-19.

OBJECTIVES This study investigated whether Janus kinase inhibitors (JAKis) raise the risk of cardiovascular disease (CVD), venous thromboembolism (VTE), and cancer in patients with rheumatoid arthritis (RA). METHODS We conducted a real-world retrospective observational study using data obtained from the Korean National Health Insurance Service database. Two data sets were analyzed: tumor necrosis factor inhibitor (TNFi)/JAKi-naive RA patients (set 1) and all RA patients who used TNFis or JAKis (set 2). The incidence rate ratios (IRRs) and hazard ratios (HRs) for acute myocardial infarction (AMI), stroke, cardiovascular (CV)-related mortality, major adverse cardiovascular events (MACE), VTE, arterial thromboembolism (ATE), cancer, and all-cause mortality were compared between the JAKi and TNFi groups. RESULTS Set 1 included 1,596 RA patients (JAKi group: 645; TNFi group: 951), and set 2 included 11,765 RA patients (JAKi group: 2,498; TNFi group: 9,267). No adverse events (AEs) showed significantly higher IRRs in the JAKi groups than in the TNFi groups of sets 1 and 2. The HRs for MACE in the JAKi groups of sets 1 and 2 were 0.59 (95% confidence [CI], 0.35 to 0.99) and 0.80 (95% CI, 0.67 to 0.97), respectively. The JAKi group of set 2 showed a significantly higher risk of all-cause mortality (HR, 1.71; 95% CI, 1.32 to 2.20), but the other AEs did not demonstrate increased risks in the JAKi groups. CONCLUSIONS In this study, JAKis did not increase the risk of AMI, stroke, CV-related mortality, MACE, VTE, ATE, or cancer in Korean RA patients relative to TNFis.

Large epidemiological studies show U-shaped relationships between high-density lipoprotein cholesterol (HDL-C) levels and all-cause mortality in individuals without atherosclerotic cardiovascular diseases (ASCVD). Association in those with ASCVD by sex is unclear. We examined the association between HDL-C levels and 10-year all-cause mortality in subjects (≥40 years of age) with ASCVD using the 2010 National Health Insurance Service and the National Death Registry of Korea. We categorized HDL-C levels into three groups (low: 90 mg/dL) and 10 mg/dL intervals. We conducted a sex-stratified and adjusted Cox proportional hazards analysis. Out of 1,711,548 individuals (54% female, mean age 61.4 years), 10-year mortality was observed in 218,252 (12.8%). Males had a higher mortality rate than females (16.2% vs. 9.8%; p < 0.001). When adjusting for age, body mass index, LDL-cholesterol, triglycerides, hypertension, diabetes, smoking, and alcohol consumption, the low and extremely high HDL-C groups had significantly higher hazard ratios for 10-year mortality compared to the high HDL-C group in males [1.183 (1.166–1.199), 1.359 (1.288–1.434)] and in females [1.153 (1.138–1.169), 1.095 (1.029–1.167)]. The frequency distribution bars for the 10-year mortality rate showed sex-specific nadirs of 50–59 mg/dL in males and 70–79 mg/dL in females. In this ASCVD cohort, the extremely high HDL-C (>90 mg/dL) group had 35.9% and 9.5% higher 10-year mortality risks than the high HDL-C group for males and females, respectively. There was a slightly U-shaped relationship between baseline HDL-C levels and a 10-year mortality rate, with earlier inflection in males than in females.

OBJECTIVES Although an association is known to exist between metabolic syndrome (MetS) and heart failure (HF) risk, large longitudinal studies are limited. We investigated metabolic status as a risk factor for HF in middle-aged male and female and considered sex differences in various risk factors for HF using nationwide real-world data. METHODS Data obtained from the Korean National Health Insurance Service from 2009 to 2016 were analyzed. A total of 2,151,597 middle-aged subjects (between 50 and 59 years old) were enrolled. Subjects were divided into 3 groups (normal, pre-MetS, and MetS). Cox proportional hazard models were used to estimate the association between MetS and incident HF after adjusting for clinical risk factors. RESULTS At baseline, MetS existed in 23.77% of male and 10.58% of female. Pre-MetS and MetS increased the risk of HF: the hazard ratios of pre-MetS for incident HF were 1.508 (95% confidence interval [CI], 1.287 to 1.767) in male and 1.395 (95% CI, 1.158 to 1.681) in female, and those of MetS were 1.711 (95% CI, 1.433 to 2.044) in male and 2.144 (95% CI, 1.674 to 2.747) in female. Current smoking, a low hemoglobin level, underweight (body mass index

Aquaponics (AP) and biofloc technology (BFT) systems rely heavily on bacterial communities to break down organic matter and cycle nutrients that are essential for fish and plant growth. The functional roles of bacterial communities in aquaculture systems are critical to their sustainable operation. Currently, the research on the combination of BFT and AP systems called FLOCponics (FP) is lacking, thereby hindering our ability to optimize their performance. Here, several characteristics (productivity of fish and crops, physicochemical properties of water, and bacterial community) in FP systems cultivating Japanese eel (Anguilla japonica) and leaf lettuce Caipira (Lactuca sativa) were compared to those in the BFT system. Additionally, the effect of fish density on the FP system was investigated. The results indicated that the FP system was more productive than the BFT system. Fish growth rate was highest in the FP system (52.6%), and the average body weight of eels was 168.2 ± 26.8 g in the FP system compared to 140.3 ± 27.0 g in the control (BFT, 5 kg/m2). However, increasing fish density resulted in lower growth rates, with a growth rate of 20.6% observed in the high-density (20 kg/m2) experimental group. The bacterial composition was also significantly different between the systems and fish densities, suggesting that bacterial communities may be closely related to the performance of the aquaponics system.

Objective Ischaemic stroke incidence is on the decline globally, but the trend in South Korea is unknown. In this study, the 10-year incidence trends of first-ever ischaemic stroke in South Korea were evaluated.Design, setting and participants The National Health Insurance Services medical claim data were used to construct 10 annual cohorts of adults aged 20 years and older, who had not been diagnosed with stroke, to find out the incidence trends of first-ever ischaemic stroke from 2010 to 2019.Outcome measures The primary outcomes were crude and age-adjusted incidence rates for 10 years. Crude incidence rates of the age groups and incidence age statistics were calculated. For comparison among the income groups, age-adjusted incidence rates were used. Incidence rates in all the groups were analysed separately by sex.Results Age-standardised incidence rates of ischaemic stroke per 100 000 were 101.0 in men, and 67.6 in women in 2010; and 92.2 in men, and 55.0 in women in 2019. By age group, there was a decrease in women over 40 years of age, and men over 60 years of age. The relative difference in stroke incidence rates between medical aid beneficiaries and the highest income group increased from 1.5 to 1.87 over 10 years.Conclusions Age-standardised incidence rate of ischaemic stroke has decreased from 2010 to 2019 for both man and women. The incidence rate was stable in the younger age groups and decreased in the older age groups, and the disparities between income groups have widened over the past decade. Stroke prevention strategies are needed for the younger age group and the low-income group. Further research is needed to study the risk factors contributing to the incidence of ischaemic stroke in different groups.

Abstract This nationwide population-based cohort study aimed to investigate the impact of systemic anti-inflammatory treatment on the major adverse cardiovascular events (MACE) risk in patients with psoriasis from January 2006 to December 2018, using a database provided by the Korean National Health Insurance Service. Patients were grouped based on the following treatment modalities: biologics, phototherapy, methotrexate, cyclosporine, and mixed conventional systemic agents. Patients who had not received any systemic treatment were assigned to the control cohort. The incidence of MACE per 1000 person-year was 3.5, 9.3, 12.1, 28.4, 39.5, and 14.5 in the biologic, phototherapy, methotrexate, cyclosporine, mixed conventional systemic agents, and control cohorts, respectively. During the 36-month follow-up, the cumulative incidence of MACE in the phototherapy and biologic cohorts remained lower than that of other treatment modalities. Cyclosporine (hazard ratio (HR) = 2.11, 95% confidence interval (CI) = 1.64–2.71) and mixed conventional systemic agents (HR = 2.57, 95% CI = 2.05–3.22) treatments were associated with increased MACE risk. Methotrexate treatment was not associated with MACE. Our finding demonstrates that treatment modalities may affect cardiovascular comorbidities in patients with psoriasis. Thus, an appropriate combination of anti-psoriatic therapies should be considered to manage patients with high cardiovascular risk. IRB approval status: Waiver decision was obtained by the institutional review board, Konkuk University Hospital, Seoul, Republic of Korea (KUH1120107).

Background: Limited data is available between metabolic syndrome (MetS) and the development of peripheral arterial disease (PAD) or venous thromboembolism (VTE) in the Asian population. We investigated the incidence of PAD and VTE according to the prevalence of MetS and evaluated the impact of individual components in MetS on the development of PAD and VTE using Korean national data. Methods: Data obtained from national health screening examinations of the Korean National Health Insurance Service from January 1, to December 31, 2009. In total, 9,927,538 participants, 7,830,602 participants were included in this study and the incidence rate of PAD and VTE was investigated retrospectively during a 7-year follow-up. Using the National Cholesterol Education Program Adult Treatment Panel III criteria, patients were placed into one of three groups depending on MetS component numbers: 0 (normal), 1–2 (Pre-MetS), or 3–5 (MetS). Results: The incidence rates of PAD and VTE in MetS were 2.25% and 0.71%, respectively. After multivariable adjustment, the risk of PAD was significantly associated with MetS (hazard ratio (HR) 1.45, 95% confidence interval (CI) 1.42–1.49), the risk of VTE was not associated with MetS (HR 1.01, 95% CI 0.96–1.05). When subgroup analyses were conducted according to MetS components, elevated fasting glucose (HR 1.26, 95% CI 1.23–1.27), abdominal obesity (HR 1.15, 95% CI 1.12–1.17), and elevated blood pressure (HR 1.13, 95% CI 1.12–1.15) were the most related to PAD. Abdominal obesity (HR 1.104, 95% CI 1.064–1.146) was associated with an increased risk of VTE. Conclusions: MetS was significantly associated with an increased incidence rate of PAD among the general Korean population. On the other hand, MetS was not associated with the VTE incidence rate. Of the MetS components, only abdominal obesity was a significant predictor of VTE.

Background: A prehospital delay from symptom onset to hospital arrival resulted in stroke-related complications or in-hospital deaths in acute stroke patients. We aimed to investigate trends in prehospital visits as a cause of prehospital delay using data from the Korean Health Insurance Service. Methods: This nationwide, population-based, retrospective cohort study included 524,524 newly-diagnosed stroke patients admitted via the emergency departments of secondary and tertiary hospitals. We obtained the prehospital visits rate from 2010 to 2019 and identified the related characteristics. Results: Prehospital visits were observed in 111,465 patients (21.3%). The prehospital visits rate decreased from 25.1% in 2010 to 17.8% in 2019, but the number of patients increased from 11,255 cases in 2010 to 11,747 cases in 2019. Fortunately, the rate of delayed admission for more than one day decreased from 26.7% to 21.3%. However, 10.4% of patients were diagnosed more than two days later. Young, females, or patients with higher income status and living in low urbanization areas exhibited a higher rate of prehospital visits. Conclusions: Prehospital visits in Korean stroke patients decreased from 25.1% in 2010 to 17.8% in 2019. However, more than 10,000 patients still visited other medical institutions before admission to treatment.

A novel design method using unsigned input is proposed for a high-density and parallel synaptic string architecture capable of bit-wise operation and bit-counting utilizing NAND flash memory. Though the NAND flash memory has a cell string structure, unsigned binary input enables analogue and parallel bit-counting in NAND flash memory, while achieving high accuracy comparable to that of signed input. Adopting unsigned input allows using current sense amplifier as neuron circuit, which reduces burden of peripheral circuits. In addition, the operation scheme for convolution layers is proposed for parallel convolution operation utilizing NAND flash memory. We show that sufficiently low device variation of 7.2 % obtained by applying 1 erase or program pulse achieves accuracy of 98.12 % and 87.12 % for MNIST and CIFAR 10 patterns, respectively.

Abstract Objectives This study evaluated the incidence of colorectal cancer (CRC) according to the number of metabolic syndrome (MetS) components. Methods Using health checkup and insurance claims data of 6,365,409 subjects, the occurrence of CRC according to stage of MetS by sex was determined from the date of the health checkup in 2009 until December 31, 2018. Results Cumulative incidence rates (CIR) of CRC in men and women was 3.9 and 2.8 per 1000 (p < 0.001), respectively. CIR of CRC for the normal, pre-MetS, and MetS groups in men was 2.6, 3.9, and 5.5 per 1000 (p < 0.001) and CIR in women was 2.1, 2.9, and 4.5 per 1000 (p < 0.001), respectively. Compared with the normal group, the hazard ratio (HR) of CRC for the pre-MetS group was 1.25 (95% CI 1.17–1.33) in men and 1.09 (95% CI 1.02–1.17) in women, and the HR of CRC for the MetS group was 1.54 (95% CI 1.43–1.65) in men and 1.39 (95% CI 1.26–1.53) in women after adjustment. Conclusions We found that MetS is a risk factor for CRC in this study. Therefore, the prevention and active management of MetS would contribute to the prevention of CRC.

We propose a novel synaptic architecture based on a NAND flash memory for highly robust and high-density quantized neural networks (QNN) with 4-bit weight and binary neuron activation, for the first time. The proposed synaptic architecture is fully compatible with the conventional NAND flash memory architecture by adopting a differential sensing scheme and a binary neuron activation of (1, 0). A binary neuron enables using a 1-bit sense amplifier, which significantly reduces the burden of peripheral circuits and power consumption and enables bitwise communication between the layers of neural networks. Operating NAND cells in the saturation region eliminates the effect of metal wire resistance and serial resistance of the NAND cells. With a read-verify-write (RVW) scheme, low-variance conductance distribution is demonstrated for 8 levels. Vector-matrix multiplication (VMM) of a 4-bit weight and binary activation can be accomplished by only one input pulse, eliminating the need of a multiplier and an additional logic operation. In addition, quantization training can minimize the degradation of the inference accuracy compared to post-training quantization. Finally, the low-variance conductance distribution of the NAND cells achieves a higher inference accuracy compared to that of resistive random access memory (RRAM) devices by 2~7 % and 0.04~0.23 % for CIFAR 10 and MNIST datasets, respectively.

The Korean Demilitarized Zone (DMZ) was established in 1953 during the cessation of the Korean War, which divided the Korean Peninsula into North and South Korea. The DMZ is a representative biodiversity resource because it limits human activities. The current status of faunal diversity in adjacent areas of the DMZ was investigated in five regions at 91 sites from 2015 to 2019. A total of 19,562 individuals were collected and identified, including 81 species, 19 families, and 11 orders. Zacco koreanus was the most abundant fish species (relative abundance of 21.9%), while other key species were Zacco platypus (18.2%), Rhynchocypris oxycephalus (5.2%), Rhynchocypris steindachneri (4.9%), and Pungtungia herzi (3.7%). Notably, twenty-nige endemic and seven Red Data Book species were recorded, and three exotic species, Carassius cuvieri, Micropterus salmoides, and Lepomis macrochirus were found at five sites. Human activities and disturbances were found at 34.0% of all sampling sites, and the highest disturbance factors were river dredging and agricultural use (seven sites), sewage (five sites), and fisheries and development (two sites). We recommend that the governments of South and North Korea collaboratively manage the DMZ to protect ecological diversity and maintain its status as a symbol of peace.

The operation principle and near-linear potentiation mechanism of reconfigurable gated Schottky diodes (GSDs) are analyzed using calibrated device simulation. The reconfigurable GSD has two bottom gates and SiO2/Si3N4/SiO2 gate insulator stack. According to the polarity of the bottom gate bias, electrons, or holes are induced in the poly-Si active layer and the type of Schottky diodes is reconfigured. In the same manner, the reverse-biased current of GSD is modulated by applying bottom gate bias or storing charge in the Si3N4 charge storage layer. The reverse-biased current of GSD is exponentially proportional to the charge stored in the Si3N4 layer. By representing the amount of stored charge as a logarithmic relation to the number of potentiation pulses, the number of potentiation pulses, and the current of GSD has a power relation. It has been demonstrated that the GSD current exhibits near-linear potentiation characteristics when the exponent of the power relation is close to 1.

An inference system using gated Schottky diode (GSD) is proposed for highly reliable hardware-based neural networks (HNNs). We explain the characteristics of the GSD and present circuits that take into account the characteristics of the device. The reverse current of the GSD, which is the synaptic current, is saturated with respect to input voltage, which results in immunity of input and output noise and overcoming the IR drop problem in metal wire. In order to take advantages of this saturated I-V characteristics, pulse-width modulation (PWM) of input data instead of amplitude modulation is proposed. In addition, by applying identical pulses to the bottom gate, the synaptic current of the GSD increases linearly, which makes it easy to transfer the calculated weights to the conductance of GSDs. By considering these characteristics, electronic circuits for PWM, current sum, and activation function are designed. Through SPICE simulation, we evaluate the inference accuracy of a 2-layer neural network. The classification accuracy rate of 100 images of MNIST test sets is 94% accuracy obtained with software.

Introduction Inter-hospital transfer (IHT) and primary percutaneous coronary intervention (PCI) are preferred over onsite thrombolysis when provided expeditiously. On the other hand, its benefit has not been evaluated in a real-world situation. This study examined the effects of IHT on the short- and long-term mortality in patients with acute myocardial infarction (AMI) and compared the reperfusion treatments and resources between the referring and receiving hospitals. Methods Patients newly diagnosed with AMI and admitted to hospital were selected from the national health insurance database from 2004 to 2018. The 30-day and one-year mortality in the transferred and non-transferred patients were estimated and compared using stabilized inverse probability of treatment weighting to account for confounding bias. Results Of the 258,291 participants, 10,158 were transferred to one or more hospitals. IHT was more likely to occur to older or more comorbid people, patients in rural areas, and those whose insurance was medical aid. The 30-day and one-year mortality of the non-IHT group was 9.7% and 15.8%, respectively, whereas the figure was 11.4% and 20.5% in the IHT group. After balancing the baseline characteristics, the transferred patients were 1.12 (95% CI: 1.06–1.20) and 1.25 (95% CI: 1.20–1.31) times more likely to die during the subsequent 30 days and one year, respectively, than those treated solely at the presenting hospital. In ST-segment elevation myocardial infarction (STEMI), the hazard ratios of the 30-day and 1-year mortality were 1.14 (95% CI: 0.97–1.35) and 1.31 (95% CI: 1.15–1.49) in the transferred patients after balancing cardiogenic shock and cardiac arrest. On-site thrombolysis was rarely performed in the referring hospitals. Conclusion Patients transferred for the treatment of AMI experienced higher short- and long-term mortality. Therefore, onsite thrombolysis and the estimated time delay to PCI should be considered in regional hospitals to reduce mortality with the organization of STEMI treatment networks.

Liobagrus hyeongsanensis, Korean indigenous catfish, was reported as a new species in 2015. The complete mitochondrial DNA sequence of L. hyeongsanensis was sequenced by next-generation sequencing (NGS) analysis. The mitochondrial genome was assembled with 16,529 bp in length and encoded 13 protein-coding genes (PCGs), 22 tRNAs, two rRNAs, and one control region (D-loop). Also, the gene structures such as gene order and content were totally identical with the congeneric species. Molecular phylogenetic analysis determined the taxonomical position of L. hyeongsanensis in species level among the genus Liobagrus.

Hardware-based spiking neural networks (SNNs) inspired by a biological nervous system are regarded as an innovative computing system with very low power consumption and massively parallel operation. To train SNNs with supervision, we propose an efficient on-chip training scheme approximating backpropagation algorithm suitable for hardware implementation. We show that the accuracy of the proposed scheme for SNNs is close to that of conventional artificial neural networks (ANNs) by using the stochastic characteristics of neurons. In a hardware configuration, gated Schottky diodes (GSDs) are used as synaptic devices, which have a saturated current with respect to the input voltage. We design the SNN system by using the proposed on-chip training scheme with the GSDs, which can update their conductance in parallel to speed up the overall system. The performance of the on-chip training SNN system is validated through MNIST data set classification based on network size and total time step. The SNN systems achieve accuracy of 97.83% with 1 hidden layer and 98.44% with 4 hidden layers in fully connected neural networks. We then evaluate the effect of non-linearity and asymmetry of conductance response for long-term potentiation (LTP) and long-term depression (LTD) on the performance of the on-chip training SNN system. In addition, the impact of device variations on the performance of the on-chip training SNN system is evaluated.

Background : Continuous renal replacement therapy (CRRT) is an important treatment modality for severe acute kidney injury. As such, the epidemiology of CRRT in Korea needs further investigation. Methods : We conducted a nationwide, population-based study analyzing the claims data from National Health Insurance Service of Korea. All index intensive care unit admission cases of CRRT in government-designated tertiary referral hospitals in Korea from 2005 to 2016 were included. Patients with a history of renal replacement therapy or who were under 20 years old were not considered. In addition to baseline and treatment characteristics, patient outcomes, including all-cause mortality and renal survival rates, were investigated. We stratified the study patients according to 3-year time periods and major regions of the nation. Results : We included 37,337 patients who received CRRT in Korea. The overall use of CRRT increased over time, and more than 80% of cases of acute renal replacement therapy were CRRT after 2014. Seoul was the region in which the majority of CRRT (45.0%) was performed. The clinical characteristics of CRRT patients were significantly different among time-intervals and regions. Both all-cause mortality and renal survival rates after CRRT were prominently improved in the recent time periods (P ＜ 0.001). Conclusion : CRRT is a widely used treatment strategy for severe acute kidney injury in Korea. The prognosis of CRRT patients has improved compared to the past. This epidemiological study of CRRT in Korea revealed notable trends with regard to time period and geographic region.

Summary: Purpose: The purpose of this study was to evaluate the contributions and limitations of the cervical cancer screening test with accuracy in Korea. Methods: This was a retrospective observational study. The study population consisted of all participants who underwent cervical cancer screening test from 2009 to 2014. The data were obtained from National Health Information Database (NHID) which represents medical use records of most Koreans. As the indices for contributions and limitations of the screening test, crude detection rate, incidence rate of interval cancer, sensitivity, specificity, and positive predictive value were used. Results: The crude detection rate of screening test per 100,000 participants increased from 100.7 in 2009 to 102.1 in 2014. The incidence rate of interval cancer per 100,000 negatives decreased from 13.0 in 2009 to 10.2 in 2014. The sensitivities of screening test were 88.7% in 2009 and 91.2% in 2014, and the specificities were 98.5% in 2009 and 97.7% in 2014. The positive predictive value of screening decreased from 6.2% in 2009 to 4.3% in 2014. Conclusion: The Korean national cervical cancer screening program has improved in accuracy and has contributed to detection of early stage of cervical cancer over the years. Along with efforts to promote participation in cancer screening programs, quality control over the screening program should be enhanced. Keywords: carcinoma in situ, early detection of cancer, Papanicolaou test, sensitivity and specificity, uterine cervical neoplasms

Background. Whole-body vibration has been used to improve motor function in chronic stroke patients, but its effect on patients with subacute strokes remains unclear. Objectives. We explored the effect of whole-body vibration on patients with subacute strokes. Methods. Participants were randomly allocated to a whole-body vibration (WBV) group (n=30) or an upper- and lower-cycle (ULC) group (n=30). Both groups received occupational therapy after these interventions. All participants received treatment for 30 min/day, 5 days/week, for 4 weeks. Both groups received the same conventional physical therapy. Results. The manual function test (MFT) score and grip strength improved after both WBV (p=0.001 and p=0.001, respectively) and ULC (p=0.002 and p=0.001, respectively), but the improvement was more pronounced (MFT p=0.016; GS p=0.023) after WBV. Conclusions. These findings suggest that the use of WBV and ULC was effective as remedial treatments for improving upper extremity motor function and increasing grip strength for patients with subacute strokes. The improvement was more pronounced for the WBV treatment. This trial is registered with KCT0003246.

The causative agent of acute hepatopancreatic necrosis disease (AHPND) is the bacterium, Vibrio parahaemolyticus, which secretes toxins into the gastrointestinal tract of its host. Vibrio parahaemolyticus toxins A and B (PirAvp/PirBvp) have been implicated in the pathogenesis of this disease, and are, therefore, the focus of studies developing treatments for AHPND. We previously produced recombinant antibodies based on the hagfish variable lymphocyte receptor B (VLRB) capable of neutralizing some viruses, suggesting that this type of antibody may have a potential application for treatment of AHPND. Here, recombinant PirAvp/PirBvp, produced using a bacterial expression system, were used as antigens to screen a hagfish VLRB cDNA library to obtain PirAvp/PirBvp-specific antibodies. A cell line secreting these antibodies was established by screening and cloning the DNA extracted from hagfish B cells. Supernatants collected from cells secreting the PirAvp/PirBvp antibodies were collected and concentrated, and used to passively immunize shrimp to neutralize the toxins PirAvp or PirBvp associated with AHPND. Briefly, 10 μg of PirAvp and PirBvp antibodies, 7C12 and 9G10, respectively, were mixed with the shrimp feed, and fed to shrimp for three days consecutive days prior to experimentally infecting the shrimp with V. parahaemolyticus (containing toxins A and B), and resulting mortalities recorded for six days. Results showed significantly higher level of survival in shrimp fed with the PirBvp-9G10 antibody (60%) compared to the group fed the PirAvp-7C12 antibody (3%) and the control group (0%). This suggests that VLRB antibodies may be a suitable alternative to immunoglobulin-based antibodies, as passive immunization treatments for effective management of AHPND outbreaks within shrimp farms.

Background: The National Health Insurance Service (NHIS) conducted a screening test to detect chronic diseases such as hypertension and diabetes in Korea. This study evaluated the effects of health screening for DM on pharmacological treatment. Methods: The data from qualification and the General Health Screening in 2012, the insurance claims of medical institutions from Jan 2009 to Dec 2014, and the diabetic case management program extracted from the NHIS administrative system were used. Total 16068 subjects were included. Visiting rate to medical institution, medication possession ratio and the rate of medication adherence of study subjects were used as the indices. Results: The visiting rates to medical institutions were 39.7%. The percentage who received a prescription for a diabetes mellitus medication from a doctor was 80.9%, the medication possession ratio was 70.8%, and the rate of medication adherence was 57.8%. Conclusion: The visiting rate, medication possession ratio and rate of medication adherence for DM medication were not high. In order to increase the visiting rate, medication possession ratio and rate of medication adherence, NHIS should support environment in which medical institutions and DM patients can do the role of each part.

Purpose: We evaluated changes in and factors affecting second-hand smoke (SHS) exposure in a panel study of nonsmokers. Methods: This study was based on data from a larger study of tobacco use among a representative sample of adults of Korean descent residing in California. Participants included 846 males and 1,399 females who were nonsmokers at baseline (2005–2006) and at follow-up (2007–2009). Participants were selected by probability sampling and were interviewed by telephone. Results: At baseline, 50.0% were exposed to any SHS, and at follow-up 2 years later, 60.4% were exposed to any SHS (p < .001). SHS exposure at baseline was associated with acculturation, employment, spousal smoking, and having a friend who smoked (p < .001). Employment, spousal smoking, and other family members smoking were associated with SHS at follow-up (p < .001). The odds ratio of SHS in the employed group declined from 2.01 at baseline to 1.53 at follow-up, that of the group having a smoking spouse increased from 1.88 to 2.36, and that of the group having other family members smoking increased from 1.20 to 1.69. Conclusions: We showed that SHS exposure increased among Korean American nonsmokers in California, and the most important variables explaining the change in SHS exposure involved smoking among others with whom the subject is associated. These findings could be used as objective evidence for developing public health policies to reduce SHS exposure.

Purpose: We investigated the role of individual and community level factors on diabetes screening test behavior. Methods: We used individual-level data from 170,193 adults aged 30 years or older who were not diagnosed with diabetes and participated in the 2009 community health survey. Community-level data includes 253 communities and were collected from various national statistics. Multilevel logistic regression analysis was conducted. Results: The rate of diabetes screening within the year prior to this study was 53.2%. Community variance of Model I, Model II and Model III was 0.236, 0.252 and 0.238, respectively. The proportional change in variance of Model II and Model III was –6.8% and –1.2%. The odds ratio for participation of diabetic screening of areas with bottom financial independence compared to areas with top was 0.84 (95% confidence interval, 0.74–0.96); the odds ratio of areas with top internist compared to areas with bottom was 1.15 (95% confidence interval, 1.01–1.31). Conclusion: This study identified a contextual effect influencing the participation of Korean adults in diabetes screening. It is necessary to develop specific policies that consider not only individual factors, but also community factors relating to individual behaviors to increase the likelihood of diabetes screening.

Purpose: Longitudinal changes in the prevalence of self-reported physician-diagnosed allergic rhinitis (AR) in Korea and the association between the prevalence of AR and type of residence area among Korean males and females in 1998, 2001, 2005 and 2007–2009 were evaluated. Methods: Age-standardized prevalence was calculated using the Korea National Health and Nutrition Examination Survey (KNHANES) I–IV. Stratified factors of sex, age, and socioeconomic status were adjusted to compare the prevalence of AR in relation to residential area by multiple logistic analysis. Results: The prevalence of AR increased by tenfolds from 1.2 % in 1998 to 12.0 % in 2007–2009. The trends for prevalence of AR were also statistically significant (p

Objective: This study aims to investigate the implementation rate and influencing factors of confirmatory tests for women with abnormal cervical cytology results in the Korean nationwide cervical cancer screening program. Methods: The National Health Insurance Service (NHIS) database was utilized to identify all Korean women who have participated in the Korean nationwide cervical cancer screening program from January 2011 and December 2021 using the NHIS database. Multiple logistic regression analysis was performed to estimate the multivariate odds ratio and evaluate the patients' characteristics. Results: The rate of abnormal Papanicolaou (Pap) smears showed an initial increase from 2011 to 2015 and subsequently reached a plateau after 2016. When examining specific subcategories, cases of atypical squamous cells of undetermined significance (ASC-US) increased from 28,546 cases (1.1%) in 2011 to 62,850 cases (1.7%) in 2021. In contrast, cases of HSIL and SCC declined from 3,535 cases (0.14%) to 2,763 cases (0.07%) and from 383 cases (0.01%) to 179 cases (0.005%), respectively. Furthermore, the implementation rate of confirmatory tests for women with abnormal cytology increased from 8,865 cases (21.0%) in 2011 to 39,045 cases (51.2%) in 2021. Regarding the specific subcategory of ASC-US, the number of confirmatory tests exhibited a substantial increase from 4,101 cases (14.4%) in 2011 to 30,482 cases (48.5%) in 2021. For SCC, there was no significant change, with 216 cases (56.4%) in 2011 and 102 cases (57.0%) in 2021. The implementation rate of confirmatory tests was found to be significantly associated with results of abnormal Pap smear, age, and residence. Notably, economic status did not emerge as a significant factor affecting the likelihood of undergoing confirmatory tests. Conclusions: The severity of abnormal Pap smear results is a reliable indicator of the probability of undergoing a confirmatory test. Additional endeavors are required to improve the implementation rate among women who have received abnormal Pap smear results. [ABSTRACT FROM AUTHOR]