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Introduction: In this study we aimed to investigate the prognostic accuracy for predicting in-hospital mortality using respiratory Sequential Organ Failure Assessment (SOFA) scores by the conventional method of missing-value imputation with normal partial pressure of oxygen (PaO2)- and oxygen saturation (SpO2)-based estimation methods.Methods: This was a single-center, retrospective cohort study of patients with suspected infection in the emergency department. The primary outcome was in-hospital mortality. We compared the area under the receiver operating characteristics curve (AUROC) and calibration results of the conventional method (normal value imputation for missing PaO2) and six SpO2-based methods: using methods A, B, PaO2 is estimated by dividing SpO2 by a scale; with methods C and D, PaO2 was estimated by a mathematical model from a previous study; with methods E, F, respiratory SOFA scores was estimated by SpO2 thresholds and respiratory support use; with methods A, C, E are SpO2-based estimation for all PaO2 values, while methods B, D, F use such estimation only for missing PaO2 values.Results: Among the 15,119 patients included in the study, the in-hospital mortality rate was 4.9%. The missing PaO2was 56.0%. The calibration plots were similar among all methods. Each method yielded AUROCs that ranged from 0.735–0.772. The AUROC for the conventional method was 0.755 (95%confidence interval [CI] 0.736–0.773). The AUROC for method C (0.772; 95% CI 0.754–0.790) was higher than that of the conventional method, which was an SpO2-based estimation for all PaO2 values. The AUROC for total SOFA score from method E (0.815; 95% CI 0.800–0.831) was higher than that from the conventional method (0.806; 95% CI 0.790–0.822), in which respiratory SOFA was calculated by the predefined SpO2 cut-offs and oxygen support.Conclusion: In non-ICU settings, respiratory SOFA scores estimated by SpO2 might have acceptable prognostic accuracy for predicting in-hospital mortality. Our results suggest that SpO2-based respiratory SOFA score calculation might be an alternative for evaluating respiratory organ failure in the ED and clinical research settings.

We present trace gas vertical profiles observed by instruments on the NASA DC-8 and at a ground site during the Korea-US air quality study (KORUS) field campaign in May to June 2016. We focus on the region near the Seoul metropolitan area and its surroundings where both anthropogenic and natural emission sources play an important role in local photochemistry. Integrating ground and airborne observations is the major research goal of many atmospheric chemistry field campaigns. Although airborne platforms typically aim to sample from near surface to the free troposphere, it is difficult to fly very close to the surface especially in environments with complex terrain or a populated area. A detailed analysis integrating ground and airborne observations associated with specific concentration footprints indicates that reactive trace gases are quickly oxidized below an altitude of 700 m. The total OH reactivity profile has a rapid decay in the lower part of troposphere from surface to the lowest altitude (700 m) sampled by the NASA DC-8. The decay rate is close to that of very reactive biogenic volatile organic compounds such as monoterpenes. Therefore, we argue that photochemical processes in the bottom of the boundary layer, below the typical altitude of aircraft sampling, should be thoroughly investigated to properly assess ozone and secondary aerosol formation.

During the May-June 2016 International Cooperative Air Quality Field Study in Korea (KORUS-AQ), light synoptic meteorological forcing facilitated Seoul metropolitan pollution outflow to reach the remote Taehwa Research Forest (TRF) site and cause regulatory exceedances of ozone on 24 days. Two of these severe pollution events are thoroughly examined. The first, occurring on 17 May 2016, tracks transboundary pollution transport exiting eastern China and the Yellow Sea, traversing the Seoul Metropolitan Area (SMA), and then reaching TRF in the afternoon hours with severely polluted conditions. This case study indicates that although outflow from China and the Yellow Sea were elevated with respect to chemically unperturbed conditions, the regulatory exceedance at TRF was directly linked in time, space, and altitude to urban Seoul emissions. The second case studied, occurring on 09 June 2016, reveals that increased levels of biogenic emissions, in combination with amplified urban emissions, were associated with severe levels of pollutions and a regulatory exceedance at TRF. In summary, domestic emissions may be causing more pollution than by trans-boundary pathways, which have been historically believed to be the major source of air pollution in South Korea. The case studies are assessed with multiple aircraft, model (photochemical and meteorological) simulations, in-situ chemical sampling, and extensive ground-based profiling at TRF. These observations clearly identify TRF and the surrounding rural communities as receptor sites for severe pollution events associated with Seoul outflow, which will result in long-term negative effects to both human health and agriculture in the affected areas.

Nitryl chloride (ClNO2) is a radical reservoir species that releases chlorine radicals upon photolysis. An integrated analysis of the impact of ClNO2 on regional photochemistry in the Seoul metropolitan area (SMA) during the Korea-United States Air Quality Study (KORUS-AQ) 2016 field campaign is presented. Comprehensive multiplatform observations were conducted aboard the NASA DC-8 and at two ground sites (Olympic Park, OP; Taehwa Research Forest, TRF), representing an urbanized area and a forested suburban region, respectively. Positive correlations between daytime Cl2 and ClNO2 were observed at both sites, the slope of which was dependent on O3 levels. The possible mechanisms are explored through box model simulations constrained with observations. The overall diurnal variations in ClNO2 at both sites appeared similar but the nighttime variations were systematically different. For about half of the observation days at the OP site the level of ClNO2 increased at sunset but rapidly decreased at around midnight. On the other hand, high levels were observed throughout the night at the TRF site. Significant levels of ClNO2 were observed at both sites for 4-5 h after sunrise. Airborne observations, box model calculations, and back-trajectory analysis consistently show that these high levels of ClNO2 in the morning are likely from vertical or horizontal transport of air masses from the west. Box model results show that chlorine-radical-initiated chemistry can impact the regional photochemistry by elevating net chemical production rates of ozone by 25% in the morning.

Abstract. Nitryl chloride (ClNO2) is a radical reservoir species that releases chlorine radicals upon photolysis. An integrated analysis of the impact of ClNO2 on regional photochemistry in the Seoul Metropolitan Area (SMA) during the Korean-United States-Air Quality (KORUS-AQ) 2016 field campaign is presented. Comprehensive multiplatform observations were conducted aboard the NASA DC-8 and at two ground sites (Olympic Park, OP; Taehwa Research Forest, TRF), representing an urbanized area and a forested region downwind, respectively. The overall diurnal variations of ClNO2 in both sites appeared similar but the night time variation were systematically different. For about half of the observation days at the OP site the level of ClNO2 increased at sunset but rapidly decreased at around midnight. On the other hand, high levels were sustained throughout the night at the TRF site. Significant levels of ClNO2 were sustained at both sites for 4–5 hours after sunrise. Airborne observations, box model calculations, and back trajectory analysis consistently show that this high levels of ClNO2 in the morning is likely due to the transport of air masses within the boundary layer. Box model results show that chlorine radical initiated chemistry can impact the regional photochemistry by elevating net ozone production rate up to ~ 25 % in the morning.

We present the ambient ozone and relevant observed trace gas dataset in Seoul, South Korea, during the Megacity Air Pollution Studies (MAPS)-Seoul field campaign from May to June of 2015 (MAPS-Seoul 2015). We observed two distinctive periods, one with higher and the other with lower daytime ozone levels despite mostly clear conditions for both periods. The importance of peroxy radical contributions to excess ozone production is illustrated by the substantial differences in the Leighton constant (Φ) for the two periods. Moreover, higher levels of hydroxyl radical (OH) reactivity (s–1) were observed during the high ozone episode compared to the low ozone episode by as much as ~5 s–1. The contributions of nitrogen oxides (NOx) to OH reactivity become less important than those of volatile organic compounds (VOCs) during the high ozone episode, which suggests the NOx saturated ozone production regime. It was also notable that the biogenic VOC isoprene consistently contributed the most to OH reactivity from among the observed VOCs during the afternoon throughout the whole field campaign. Finally, we ran multiple box model scenarios to evaluate the ozone production rates of three different air mixtures: a high ozone mixture, a low ozone mixture, and a simulation of the regional air quality. The results indicate that the total OH reactivity levels and the relative contributions of VOCs to NOx play critical roles in ozone production rates. The simulated air quality mixture results in lower OH reactivity, causing lower ozone production rates than those calculated for the high ozone mixture, which clearly indicates the need for further improvements in the regional model to accurately simulate ozone precursors in the region. The results of this study suggest that a comprehensive trace gas dataset combined with observations of the OH reactivity enables us to properly diagnose the photochemistry behind ozone pollution, leading to effective ozone abatement policies.

SecDF is an important component of the Sec protein translocation machinery embedded in the bacterial membrane, which is associated with many functions, such as stabilizing other Sec translocon components within the membrane, maintaining the transmembrane (TM) potential, and facilitating the ATP-independent stage of the translocation mechanism. Related studies suggest that SecDF undergoes functionally important conformational changes that involve mainly its P1-head domain and that these changes are coupled with the proton motive force (Δp). However, there still is not a clear understanding of how SecDF functions, its exact role in the translocation machinery, and how its function is related to Δp. Here, using all-atom molecular dynamics simulations combined with umbrella sampling, we study the P1-head conformational change and how it is coupled to the proton motive force. We report potentials of mean force along a root-mean-square-distance-based reaction coordinate obtained in the presence and absence of the TM electrical potential. Our results show that the interaction of the P1 domain dipole moment with the TM electrical field considerably lowers the free-energy barrier in the direction of F-form to I-form transition.

South Korea has recently achieved developed country status with the second largest megacity in the world, the Seoul Metropolitan Area (SMA). This study provides insights into future changes in air quality for rapidly emerging megacities in the East Asian region. We present total OH reactivity observations in the SMA conducted at an urban Seoul site (May-June, 2015) and a suburban forest site (Sep, 2015). The total OH reactivity in an urban site during the daytime was observed at similar levels (∼15 s(-1)) to those previously reported from other East Asian megacity studies. Trace gas observations indicate that OH reactivity is largely accounted for by NOX (∼50%) followed by volatile organic compounds (VOCs) (∼35%). Isoprene accounts for a substantial fraction of OH reactivity among the comprehensive VOC observational dataset (25-47%). In general, observed total OH reactivity can be accounted for by the observed trace gas dataset. However, observed total OH reactivity in the suburban forest area cannot be largely accounted for (∼70%) by the trace gas measurements. The importance of biogenic VOC (BVOCs) emissions and oxidations used to evaluate the impacts of East Asian megacity outflows for the regional air quality and climate contexts are highlighted in this study.