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Although improvements in acute care for traumatic brain injury (TBI) have increased the patient survival rate, many survivors often suffer from neuropsychiatric sequelae such as depression. This study investigated the influence of TBI on the risk of depression using South Korean nationwide data. Data were extracted from the National Health Insurance Service database for patients who experienced TBI from 2010 to 2017 (

The search for improved CO₂ capture solvents can be accelerated by deploying computer-aided molecular and process design (CAMPD) techniques to explore large molecular and process domains systematically. However, the direct solution of the integrated molecular-process design problem is very challenging as nonlinear interactions between physical properties and process performance render a large proportion of the search space infeasible. We develop a methodology that enables the direct and reliable solution of CAMPD for absorption–desorption processes, using the state-of-the-art SAFT-γ Mie group contribution approach to predict phase and chemical equilibria. We develop new feasibility tests and show them to be highly efficient at reducing the search space, integrating them in an outer-approximation algorithm. The framework is applied to design an aqueous solvent and CO₂ chemical absorption–desorption process, with 150 CAMPD instances across three case studies solved successfully. The optimal solvents are more promising than those obtained with sequential molecular design approaches.

Objectives: To investigate the effect of the number of cohabitating household members on falls among an disabled aging Korean population. Methods: We used data from the first to the fourth waves of the Korea Longitudinal Study of Aging. Using the first wave at baseline, data included 1414 individuals aged 45 years and older who needed assistance for performance of activities of daily living (ADL) or instrumental activities of daily living (IADL). We classified falls as overall falls, falls requiring medical treatment, and hip fractures caused by falls. The number of cohabitating family members was classified as none (living alone), one, two, or more. A generalized estimating equation with logit link was used to examine the association between the number of cohabitating household members with overall falls and injuries caused by falls. Results: Compared to living with two or more household members, living alone was associated with higher odds of overall falls, falls needing medical treatment, and hip fractures caused by falls (odds ratio (OR) 2.13, 95% confidence interval [CI] 1.36–3.34; OR 2.13, 95% CI 1.28–3.53; OR 1.93, 95% CI 1.01–3.69, respectively). These associations were particularly strong in individuals with cognitive decline. Conclusions Living alone is associated with higher odds of overall falls, falls needing medical treatment, and hip fractures caused by falls, particularly for those with cognitive decline. Conclusions: Intervention programs to prevent falls in disabled, aging adults, especially those living alone and those with declined cognitive function, need to provide home care services and promote the use of safety equipment.

This study was a cost-effectiveness analysis of intensive blood pressure (BP) control among hypertensive patients in Korea. We constructed a Markov model comparing intensive versus standard BP control treatment and calculated the incremental cost-effectiveness ratio. The study population consisted of hypertensive patients over 50 years old with systolic blood pressures (SBPs) exceeding 140 mmHg and at high risk of cardiovascular disease. Treatment alternatives included lowering the SBP below 120 mmHg (intensive) and 140 mmHg (standard) for target BP. We assumed five scenarios with different medication adherence. The effectiveness variable was quality-adjusted life years (QALYs), and costs included medical costs related to hypertension (HT), complications, and nonmedical costs. In addition, we performed a sensitivity analysis to confirm the robustness of the results of this study. Scenario 5, with 100% medication adherence, showed the lowest incremental cost-effectiveness ratio (ICER) of $1,373 USD, followed by scenario 1 (first 15 years: 62.5%, 16-30 years: 65.2%, after 30 years: 59.5%), scenario 2 (first five years: 62.5% decrease by 5% every five years), and scenario 3 (first 10 years: 62.5% decrease by 10% every 10 years). The ICERs in all scenarios were lower than the willingness to pay (WTP) threshold of $9,492-$32,907 USD in Korea. Tornado analysis showed that the ICERs were changed greatly according to stroke incidence. Intensive treatment of HT prevents cardiovascular disease (CVD); therefore, intensive treatment is more cost-effective than standard treatment despite the consumption of more health resources. ICERs are considerably changed according to medication adherence, confirming the importance of patient adherence to treatment.

Background: Dental health is an important factor in daily life routines and is closely associated with maintaining a health-related quality of life. This study examined denture procedure changes after implementation of the National Health Insurance (NHI) Coverage of Dentures for the elderly. Methods: We used the “Korean Community Health Survey (KCHS)” developed by the Korea Centers for Diseases Control and Prevention. We analyzed the association between policy implementation and dental health-related outcomes using difference-in-differences (DID) analysis to compare patients aged ≥75 with those 65–74 years before and after coverage. Results: A comparison of age groups and coverage periods showed that patients aged ≥75 years had higher (OR: 1.038, 95% CI: 1.021–1.055) procedure rates after coverage. In particular, elderly patients on medical aid had significantly higher denture procedure rates, while those without oral health screening were more likely to have denture procedures. Conclusions: This study determined the impact of the NHI Coverage of Denture procedure policy for the elderly and found increased denture treatments in the elderly. This policy appeared to positively affect older patients by increasing denture procedures for low-income and medical aid beneficiaries. Hence, the government needs to increase oral health examination and dental health policies for the elderly.

In the field of Computer-Aided Molecular and Process Design (CAMPD), a variety of solution methods have been developed to handle the complexities associated with the non-convexity and non-linearity of molecular structure-property and process models. However, mostalgorithms are prone to failing to generate feasible solutions when the integrated solvent-process model renders a significant portion of the search space infeasible. In this work, we propose a solution approach for the integrated design of an optimal chemical absorption process in which tailored feasibility tests are incorporated into a process optimisation problem. The solution approach allows the exploration of a design space without unnecessary difficulties by recognising infeasibilities. The effectiveness of the approach is demonstrated on an aqueous amine solvent-based CO2 capture process.

Traumatic brain injury (TBI), a global public health concern, may lead to death and major disability. While various short-term, small-sample, and cross-sectional studies on TBI have been conducted in South Korea, there is a lack of clarity on the nationwide longitudinal TBI trends in the country. This retrospective study investigated the epidemiological TBI trends in South Korea, using a population-based dataset of the National Health Insurance (2008&ndash, 2017). The crude and age adjusted TBI incidence and mortality values were calculated and stratified by age, sex, and TBI diagnosis. The age-adjusted incidence per 100,000 people increased until 2010 and showed a decreasing trend (475.8 cases in 2017) thereafter, however, a continuously decreasing age-adjusted mortality trend was observed (42.9 cases in 2008, 11.3 in 2017). The crude incidence rate increased continually in those aged &gt, 70 years across all the TBI diagnostic categories. The mortality per 100,000 people was significantly higher among participants aged &ge, 70 years than in the other age groups. We observed changing trends in the TBI incidence, with a continuously decreasing overall incidence and a rapidly increasing incidence and high mortality values in older adults. Our findings highlight the importance of active TBI prevention in elderly people.

The need to consider multiple objectives in molecular design, whether based on techno-economic, environmental or health and safety metrics is increasingly recognized. There is, however, limited understanding of the suitability of different multi-objective optimization algorithm for the solution of such design problems. In this work, we present a systematic comparison of the performance of five mixed-integer non-linear programming (MINLP) multi-objective optimization algorithms on the selection of computer-aided molecular design (CAMD) and computer-aided molecular and process design (CAMPD) problems. The five methods are designed to address the discrete and nonlinear nature of the problem, with the aim of generating an accurate approximation of the Pareto front. They include: a weighted sum approach without global search phases (SWS), a weighted sum approach with simulated annealing (SA), a weighted sum approach with multi level single linkage (MLSL), the sandwich algorithm with MLSL and the non dominated sorting genetic algorithm-II (NSGA-II). The algorithms are compared systematically in two steps. The effectiveness of the global search methods is evaluated with SWS, WSSA and WSML. WSML is found to be most effective and a comparative analysis of WSML, SDML and NSGA-II is then undertaken. As a test set of these optimization techniques, two of CAMD and one CAMPD problems of varying dimensionality are formulated as case studies. The results show that the sandwich algorithm with MLSL provides the most efficient generation of a diverse set of Pareto points, leading to the construction of an approximate Pareto front close to exact Pareto front.

Background To assess whether the type of primary caregiver is a risk factor of the incidence of fracture among older adults who have survived a stroke. Methods Data from 4282 stroke survivors in the National Health Insurance Service—Senior Cohort (2002-2013) were used in this study. We categorized type of primary caregiver as none, spouse/family caregiver, and formal caregiver. The incidence of fracture within the year postdischarge was used as the outcome variable. These data were subjected to a survival analysis using the Cox proportional hazard model. Results Of the 4282 stroke survivors, 308 (7.2%) experienced a fracture during the 1-year follow-up period. According to type of primary caregiver, the adjusted hazard ratio (HR) of fracture was lower among those whose caregiver was a spouse (HR = .68, 95% confidence interval [CI], .48-.96] and those with a formal caregiver (HR = .59, 95% CI, .36-.97) compared to stroke survivors with no caregiver. In particular, those with a family or formal caregiver who were being cared for in nursing facilities were less likely to be associated with fracture than those with no caregiver. Conclusions The adjusted HR of fracture among stroke survivors was lower among those with primary caregivers compared to those without them. Thus, the government should monitor and allocate the appropriate attention to stroke survivors after discharge in order to ensure that they obtain the needed health care, especially for stroke survivors who are without a primary caregiver.

For the hospital administration, 1 major responsibility is to prevent the outflow of existing patients and minimize losses because of the failure of patients with cancer to attend appointments. We analyzed the association between no-show rates and characteristics of patients with cancer at a tertiary hospital in Seoul using patient affair data. Among the 680 190 patients, no-show rates were 4.39% and 3.37% for males and females, respectively. Male patients with colon and rectum, pancreas, and liver cancer had higher no-show rates (5.81%, 5.8%, and 5.1%). Among females, pancreas, colon and rectum, and liver cancer were associated with high no-show rates (5.65%, 5.44%, and 4.92%). For both males and females, liver (males: OR = 2.02; 95% CI: 1.68-2.44; females: OR = 1.91; 95% CI: 1.60-2.28) and pancreas (males: OR = 1.98; 95% CI: 1.57-2.50; females: OR = 1.97; 95% CI: 1.61-2.42) cancer were associated with high no-show rates. To reduce the rate of no-shows, hospitals should establish and enforce "missed appointment" policies as well as its effect upon health outcome.

In this work, we present a systematic comparison of the performance of five mixed-integer non-linear programming (MINLP) multiobjective optimisation algorithms on a computer-aided solvent design problem. The five methods are designed to address the nonconvexity of the problem, with the aim of generating an accurate and complete approximation of the Pareto front. The approaches includes: a weighted sum approach with simulated annealing (SA), a weighted sum approach with multi level single linkage (MLSL), the sandwich algorithm with SA, the sandwich algorithm with MLSL and the non dominated sorting genetic algorithm-II. These five combinations of optimisation techniques are applied to the design of a solvent for chemical absorption of carbon dioxide (CO2). The results shows that the sandwich algorithm with MLSL can efficiently generate diverse Pareto points leading to a construction of more complete Pareto front.

Industrial accidents cost a huge amount of money, but they also have negative consequences in many respects. We analyzed the data of the first to fourth panel study of workers&rsquo, compensation insurance (PSWCI). Repeated measures ANOVA was used to compare the annual income before and after the industrial accident, and a general linear model was used to identify changes in income due to disability ratings and participation in economic activities. The wages before the industrial accident and the annual income varied among the disabilities ratings. In addition, for affected workers, the average income during four years post-accident was lower than the average income before the accident. Regression analysis to see changes in income after the industrial accident showed that the group with a disability rating of 11&ndash, 14 and no injuries had a suffered a greater income decrease than those with a disability rating of 1&ndash, 3, and the unemployment group saw a greater decrease in income than the employment group. Workers who were affected by industrial accidents received lower incomes than before the accident, and even considering different disability ratings, there was a greater decrease in income among the unemployed group than in the working group.

Household food insecurity limits families’ access to sufficient and varied safe foods, which may result in problems such as insufficient food intake and nutritional imbalance. This may lead to health issues such as obesity, chronic illness, mental health problems, and even poor quality of life. Breakfast skipping is a risk factor for eating disorders which is related to diseases such as metabolic disorder and depressive symptoms. This study examined household food insecurity and breakfast skipping and their association with depressive symptoms. In this study, we used data from the 2015 Korean Community Health Survey. Study participants were a total of 225,965 people aged 18 years or older who answered questions related to eating habits. Multiple logistic regression analyses were used to identify factors associated with depressive symptoms. Those in households with low food security and very low food security were more likely to experience depressive symptoms. Individuals that skip breakfast 2 days or more per week were more likely to experience depressive symptoms. Our study suggests that those living in households with lower food security and who skip breakfast often should pay more attention to their mental health.

In the course of a study for the development of functional foods utilizing Woosul (Achyranthis radix), the components and various biological activities of Korean Woosul (AJN: Achyranthes japonica Nakai) and Chinese Woosul (ABB: Achyranthes bidentata Blume) were compared. Woosul in Korea, including AJN and ABB, are regulated and part of the Korean Pharmacopoeia. From AJN and ABB, ethanol extracts and their subsequent organic solvent fractions were prepared and their in-vitro antimicrobial, antioxidant and anti-diabetes activities were evaluated. Although AJN and ABB have no clear distinction in terms of usage in Korea, our results suggest that AJN has higher quantities of lipid-soluble components and lower amounts of water-soluble sugars than does ABB. ABB also appears to possess greater amounts of flavonoid and polyphenol substances than AJN. Analyses of biological activities showed that the fractions of AJN were more active as antibacterial agents, and possessed more pronounced -glucosidase inhibitory activities than those of the ABB fractions. However, the antioxidant activities of the ABB fractions, as determined by DPPH anion-, ABTS cation-, nitrite-scavenging activity and reducing power, were higher than those of the AJN fractions. Our results suggest that the components and bioactivity of the extracts and subsequent fractions of AJN and ABB are different. Therefore, usage of either AJN or ABB should be carefully considered, as regards their individual properties, when the active fractions of Woosul are employed in the development of functional foods or novel plant-derived medicines.

Background: This study researched related causes that make scheduled surgeries canceled not to be conducted and based on the research it is to derive issues in order to reduce surgery cancellation. Methods: We analyzed the association of surgery cancellation with patient characteristics, surgical characteristics and surgery schedule related characteristics, using electronic medical record (EMR) data on surgeries conducted at a university hospital in Korea over 10 years. Additionally, we examined the reasons for surgery cancellation based on patient and hospital characteristics. We used chi-square tests to analyze the distribution of various characteristics according to reasons for surgery cancellation. Multivariate logistic regression analyses were conducted to evaluate the factors associated with surgery cancellation. Results: Among 60,333 cases, surgery cancellation rate was 8.0%. The results of the logistic regression indicated a high probability of surgery cancellation when the patient was too old (odds ratio [OR]: 1.35, 95% confidence interval [CI]: 1.14&ndash, 1.59), when it was a neurosurgery case (OR: 1.39, 95% CI: 1.21&ndash, 1.59), when local anesthesia was used (OR: 1.15, 95% CI: 1.07&ndash, 1.24) or when it was a planned surgery (OR: 2.45, 95% CI: 2.21&ndash, 2.73). The surgery cancellation rate was lower when the patient was female (OR: 0.87, 95% CI: 0.82&ndash, 0.93) or when the surgery was related to Obstetrics &amp, Gynecology (OR: 0.53, 95% CI: 0.46&ndash, 0.60) or Ophthalmology (OR: 0.66, 95% CI: 0.56&ndash, 0.79). Among the canceled 4834 cases, the surgery cancellation rate for the reasons of patients was 93.2% and the surgery cancellation rate for the reasons of a hospital was 6.8%. Conclusions: This study found that there are related various causes to cancel operations, including patient characteristics, surgery related characteristics and surgery schedule related characteristics and it means that it would be possible for some reasons to be prevented. Every medical institution should consider the operation cancellation as an important issue and systematic monitoring should be needed.