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Background: Conflicting results regarding sex-based differences in the outcomes of out-of-hospital cardiac arrest (OHCA) patients have been reported. Furthermore, no study has examined whether differences in in-hospital interventions and courses are driven by sex. This study evaluated the effect of sex on the in-hospital course as well as the survival rates and long-term neurological outcomes of OHCA patients treated with targeted temperature management.Methods: We retrospectively analyzed the Korean Hypothermia Network Prospective Registry composed of data collected from 22 hospitals in Korea between October 2015 and December 2018. To evaluate the effect of sex on patient outcomes, we created various multivariate logistic regression models. Regarding the difference in in-hospital courses, we compared daily total and SOFA sub-scores between the sexes and analyzed whether the decision regarding early cardiac interventions and limitations in in-hospital care were associated with sex.Results: The rate of good neurological outcomes after 6 months was higher in men (OR = 1.66, 95% CI: 1.26 2.17). However, when the results were adjusted using resuscitation variables and in-hospital variables were added, there was no significant difference between the two sexes (OR =1.22, 95% CI: 0.85 – 1.74; OR = 1.13, 95 CI: 0.76 – 1.68, respectively). There was no association between sex and outcome in patients of reproductive age and no interaction between age and sex. Regarding the in-hospital course, the daily total SOFA score was similar in both sexes whereas cardiovascular scores were higher in women on 2 and 3 days (on day 2, p = 0.006; on day 3, p = 0.017). The adjusted effect of sex was not associated with the clinician’s decision to perform early cardiac interventions except that men had more extracorporeal membrane oxygenation (ECMO) (OR=2.51, 95% CI: 1.11-5.66). The decision to discontinue life-sustaining treatment was determined by poor prognostic factors, not by sex. Conclusions: The findings suggested that men had more favorable 6-month neurological outcomes. However, after adjusting for confounders, there was no difference between the sexes. The results regarding in-hospital course were similar in men and women.

Purpose: The density ratio of gray matter (GM) to white matter (WM) on brain computed tomography (CT) (gray-to-white matter ratio, GWR) helps predict the prognosis of comatose patients after cardiac arrest. However, Hounsfield units (HU) are not an absolute value and can change based on imaging parameters and CT scanners. We compared the density of brain GM and WM and the GWR by using images scanned with different types of CT machines. Method: 102 patients with normal readings who were scanned using three types of CT scanners were included in the study. HU were measured at the basal ganglia level by two observers with circular regions of interest. Result: The difference in GM was 0.98–10.30 HU and WM was 1.05–7.55 HU. The mean value of measured HU and GWR were different for each CT group. The ANOVA test showed significant difference all variables. The post hoc test for GWR, which was used to compare the differences between each scanner, was statistically significant. Interclass correlation coefficients of measured GM and WM between the two observers were very high (Cronbach's α = 0.995 and 0.990, respectively) and GWR was showed good confidence level (0.798). Conclusion: In this study, the HU values of GM and WM in the normal adult brain differed up to 23% among scanners. Unfortunately, the GWR may not compensate for the HU difference between GM and WM occurring between scanners. Therefore, rather than applying consistent GWR cut-offs, the protocol or manufacturer differences between imaging scanners should be considered.

The gray-to-white matter ratio (GWR) has been used to identify brain damage in comatose patients after cardiac arrest. However, Hounsfield units (HUs), the measurement of brain density on computed tomography (CT) images, may vary depending on the machine type or parameter. Therefore, differences in CT scanners may affect the GWR in post-cardiac arrest patients. We performed a retrospective study on comatose post-cardiac arrest patients who visited the hospital from 2007 to 2017. Two CT, Lightspeed and SOMATOM, scanners were used. Two observers independently measured the HUs of the caudate nucleus, putamen, posterior internal capsule, and corpus callosum using regions of interest. We compared the GWR calculated from the HUs measured at different CT scanners. The analysis of different scanners showed statistically significant differences in the measured HUs and GWR. The HUs and GWR of Lightspeed were measured lower than SOMATOM. The difference between the two CT scanners was also evident in groups divided by neurological prognosis. The area under the curve of the receiver operating characteristic curve to predict poor outcomes of Lightspeed was 0.798, and the cut-off value for 100% specificity was 1.172. The SOMATOM was 0.855, and the cut-off value was 1.269. The difference in scanners affects measurements and performance characteristics of the GWR in post-cardiac arrest patients. Therefore, when applying the results of the GWR study to clinical practice, reference values for each device should be presented, and an integrated plan should be prepared.

Background Outcome prediction is crucial for out-of-hospital cardiac arrest (OHCA) survivors. Several attempts have been made to use the bispectral index (BIS) for this purpose. We aimed to investigate the prognostic power of the BIS during the early stage of targeted temperature management (TTM) after OHCA. Methods From Jan 2014 to Feb 2017, the BIS was determined in OHCA patients as soon as possible after the start of TTM. We injected a neuro-muscular blocking agent and recoded the BIS value and the time when the electromyographic (EMG) factor reached zero. The primary outcome was the cerebral performance category scale (CPC) score at 6 months, and a poor outcome was defined as a CPC score of 3, 4, or 5. The exclusion criteria were age under 18 years, traumatic cardiac arrest, and BIS data with a non-zero EMG factor. Results Sixty-five patients were included in this study. Good outcomes were observed for 16 patients (24.6%), and poor outcomes were observed for 49 patients (75.4%). The mean time of BIS recording was 2.3 ± 1.0 h after return of spontaneous circulation (ROSC). The mean BIS values of the good outcome and poor outcome groups were 35.6 ± 13.1 and 5.5 ± 9.2, respectively (p

Few studies on crew productivity has been conducted, although the data is significant for time and cost estimation. Crew productivity data was collected for over 9 months from a nuclear power plant and analysed in order to identify factors driving the productivity. It was revealed that the crew productivity of form work and rebar work was 45.64(), 2.93() on average respectively. The study also found that 'nightwork' and 'total work amount completed' were identified as drivers for the both works. Moreover, 'complexity of daywork' can lead to crew productivity deduction of about 77% for form-work and 81% for rebar-work. The productivity data collected and factors affecting the productivity will help managers to plan and control their similar works. This study will also be beneficial for those performing related studies.

Korea has been promoting green-roof related industry with a great efforts, which leads many researchers to study and develop technology of economical and lightweight green-roof system. In this study, the industrial waste of 'Bottom Ash' produced inevitably from thermal power generation was researched in order to examine the possibility of using it as material for lightweight vegetative block for an economical and lightweight green-roof system. A production manual of the block containing material selection and delivery, mixing, maintenance; and a construction manual of the system are also proposed. From a study of two test-beds of the system, it was revealed material cost as well as maintenance efforts could be saved. Moreover, the system is believed to be a very environment friendly since the system is utilizing industrial waste. Findings from the study will be a great interest of the industry. This study will also be beneficial for those performing related studies.

VE(Value Engineering) is believed to be a very powerful tool for quality improvement and schedule reduction of a project as well as for cost savings. However, little of small and medium size construction companies adopt the VE into their projects, particularly those in private sector. The main reason is that the VE is commonly misunderstood to be complex and sophisticated process, thus it is only applicable for large and difficult projects. VE applied into two small and medium scaled private projects from design phase to construction phase in order to verify advantages of the tool and find the most optimized process of it. As a result, a P university project experienced a considerable reduction on construction cost by changing a construction method of its ground works and sizes of H-beams. In addition, a H motor exhibition hall project also achieved time and cost savings. It was also revealed that, for better application of the VE on a small and medium size project, building trust between owner and contractor is prerequisite. VE skill can be taken full advantage by all the small and medium scale enterprises, which will surely lead to a huge progress of the construction business.

Green roof system is classified as intensive greening, extensive greening or mix of intensive-extensive greening. Recently, light-weigh green roof has been performed actively, because buildings have been considered loads, design and maintenance. This study was conducted to design soil depth for light-vegetation block with using bottom-ash. As a result, it was found that growth of plant had no direct effect on soil depth even it was less than 10cm. Soil depth having under 5cm could be integration of plant roots and vegetation blocks. It was also possible to grow organic vegetables through the experiment of planting. According to this experiment, as light-vegetation block with bottom-ash was used for planting, it makes design shallow soil depth. The results will help install green roof system conveniently not only new buildings but also used buildings.

Calcium sulfate scaling is a known issue with drainage water concentration systems. During preliminary pilot testing of a solar assisted agricultural drainage water salt concentration and recovery system, calcium sulfate dihydrate (gypsum) precipitated as a scale on the primary evaporator surface and on other water-side surfaces. The concentrator surface design may allow for recovery of gypsum as an additional product from the facility, in addition to the main product of sodium sulfate. Seeding with gypsum crystal was tested to reduce the scale growth and precipitate gypsum in suspension. The mechanical removal of gypsum from a flexible concentrator surface was also tested. As a result, the seeding process had influence on the scale formation and reduced calcium sulfate buildup on components of the evaporator system.