• Health Policy and Management
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• v.34 no.1
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• pp.48-58
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• 2024

Background: The purpose of this study was to investigate the association between external medical service use and the characteristics of Chungcheongnam-do patients. We aimed to provide evidence of external medical service use enhance the healthcare delivery system in Chungcheongnam-do. Methods: We used the Health Insurance Cohort DB 2.0 of 2016-2019, and 2,570,439 patients were included in the study. Multivariate logistic regression and multinomial logistic regression were used to identify the association between external medical service use and each patient characteristic. Generalized linear model was used to identify the association between medical costs and external medical service use area. Results: During the study period, 32.2% of inpatients and 12.5% of outpatients had external medical service use in Chungcheongnam-do. In comparison to patients living in Cheonan and Asan, the odds ratio (OR) for external medical services use was higher across all regions. Specifically, hospitalized patients from Gyeryong, Nonsan, and Geumsan (OR, 116.817) and Gongju, Buyeo, and Cheongyang (OR, 72.931) demonstrated extremely high likelihood of external medical service use in the Daejeon area. Furthermore, compared to medical expenses incurred within Chungcheongnam-do, patients with external medical service use in the capitol area (outpatient=17.01%, inpatients=22.11%) and Daejeon area (outpatient=16.63%, inpatients=15.41%) spent more on healthcare services. Conclusion: This study found the evidence of external medical service use among Chungcheongnam-do patients. Further study should be conducted taking into account variables including satisfaction of local medical services, different types of patient diseases, and others. The study's findings may serve as a foundation for policy proposals aimed at ensuring the financial stability of our health insurance system, ensuring the efficient delivery of medical care, and localization of medical care.

• Health Policy and Management
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• v.34 no.1
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• pp.78-86
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• 2024

Background: The purpose of this study was to determine the effectiveness of the specialty hospital system by comparing the medical use of inpatients who had artificial joint replacement surgery in specialty hospitals and non-specialty hospitals. Methods: This study utilized 2021-2022 healthcare benefit claims data provided by the Health Insurance Review and Assessment Service. The dependent variable is inpatient medical use which is measured in terms of charges per case and length of stay. The independent variable was whether the hospital was designated as a specialty hospital, and the control variables were patient-level variables (age, gender, insurer type, surgery type, and Charlson comorbidity index) and medical institution-level variables (establishment type, classification, location, number of orthopedic surgeons, and number of nurses). Results: The results of the multiple regression analysis between charges per case and whether a hospital is designated as a specialty hospital showed a statistically significant negative relationship between charges per case and whether a hospital is designated as a specialty hospital. This suggests a significant low in charges per case when a hospital is designated as a specialty hospital compared to a non-specialty hospital, indicating that there is a difference in medical use outcomes between specialty hospitals and non-specialty hospitals inpatients. Conclusion: The practical implications of this study are as follows. First, the criteria for designating specialty hospitals should be alleviated. In our study, the results show that specialty hospitals have significantly lower per-case costs than non-specialty hospitals. Despite the cost-effectiveness of specialty hospitals, the high barriers to be designated for specialty hospitals have gathered the specialty hospitals in metropolitan and major cities. To address the regional imbalance of specialty hospitals, it is believed that ease the criteria for designating specialty hospitals in non-metropolitan areas, such as introducing "semi-specialty hospitals (tentative name)," will lead to a reduction in health disparities between regions and reduce medical costs. Second, it is necessary to determine the appropriateness of the size of hospitals' medical staff. The study found that the number of orthopedic surgeons and nurses varied in charges per case. Therefore, it is believed that appropriately allocating hospital medical staff can maximize the cost-effectiveness of medical services and ultimately reduce medical costs.

• Journal of Korean Elementary Science Education
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• v.43 no.1
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• pp.122-135
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• 2024

The purpose of this study was to analyze the examples presented in the "Separation of Mixtures" section of the 2015 revised science authorized textbook introduced in elementary schools in 2022 and to see how the teachers and students understand the concept. To do that, 96 keywords were extracted through three cleansing processes to separate the elements of the mixture presented in the textbook. In order to analyze the teachers' perceptions, 32 teachers at elementary schools in Gyeonggi-do received responses to a survey, and a survey of 92 fourth graders who learned the separation of the mixture with an authorized textbook in 2022 was used for the analysis. As a result, as for the solids, 54 out of 96 separations (56.3%) showed the highest ratio, and the largest number of cases were presented according to the characteristics of the development stage of students. It was followed by living things, liquids, other objects and substances, and gasses. By analyzing the mixture, the structure and the interrelationships between the 96 extracted keywords were systematized through the network analysis, and the connection between the keywords, which were a part of the mixture was analyzed. The teachers partially responded to the separation of the complex mixture presented in the textbook, but most of the students did not recognize it. Because the analysis of the teachers' and students' perceptions of the seven separate categories presented in the survey was not based on a clear conceptual perception of the separation of the mixture, but rather they tended to respond differently for each characteristic of each individual category, it was decided that it was necessary to present clearer examples of the separation of the mixture, so that the students could better understand the concept of separation of mixtures that could be somewhat abstract.

• Pediatric Infection and Vaccine
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• v.31 no.1
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• pp.37-45
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• 2024

Purpose: This study aimed to examine the clinical features and determinants of macrolide-unresponsive Mycoplasma pneumoniae pneumonia (MUMP) and to assess the differences in the time to fever resolution between doxycycline (DXC), tosufloxacin (TFX) and corticosteroid (CST) as second-line treatment. Methods: We retrospectively analyzed the medical records of patients under the age of 18 who were admitted to Nowon Eulji University Hospital between July 2018 and February 2020, diagnosed with mycoplasma pneumonia. Macrolide resistance was confirmed by detecting point mutations in the 23S rRNA gene. MUMP was clinically defined by persistent fever (≥38.0℃) lasting for 72 hours or more after the initiation of macrolide treatment. In cases of MUMP, patients were treated with an addition of CST, or the initial macrolide was replaced either DXC or TFX. Results: Out of 157 cases of mycoplasma pneumonia, 83 cases (52.9%) did not respond to macrolides. Patients with MUMP exhibited significantly higher C-reactive protein (CRP) levels (3.2±3.0 vs. 2.4±2.2 mg/dL, P=0.047), more frequent lobar/segmental infiltrations or pleural effusions (56.6% vs. 27.0%, P<0.001; 6.0% vs. 0.0%, P=0.032), and a higher prevalence of 23S rRNA gene mutations (96.4% vs. 64.6%, P<0.001) when compared to those with macrolide-susceptible M. pneumoniae pneumonia. In terms of second-line treatment, 15 patients (18.1%) responded to CST, 30 (36.1%) to DXC, and 38 (45.8%) to TFX. The time to defervescence (TTD) after initiation second-line treatment was significantly shorter in the CST group compared to the DXC (10.3±12.7 vs. 19.4±17.2 hours, P=0.003) and TFX groups (10.3±12.7 vs. 25.0±20.1 hours, P=0.043), with no significant difference observed between the DXC and TFX groups (19.4±17.2 vs. 25.0±20.1 hours, P=0.262). Conclusions: High CRP levels, the presence of positive 23S rRNA gene mutation, lobar or segmental lung infiltration, and pleural effusion observed in chest X-ray findings were significant factors associated with macrolide unresponsiveness. In this study, CST demonstrated a shorter TTD compared to DXC or TFX. Further, larger-scale prospective studies are needed to determine the optimal second-line treatment for MUMP.

• Korean Journal of Ichthyology
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• v.35 no.4
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• pp.224-235
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• 2023

South Korea is the only divided nation globally, marked by a military demarcation line establishing demilitarized and civilian control zones, ensuring national security. Consequently, these areas exhibit relatively minimal ecological disruption compared to other regions. However, the threat to safety persists due to the presence of unexploded ordnances and landmines, imposing significant constraints on ecological research. To address this, we conducted a comparative study utilizing eDNA analysis as a supplementary and alternative approach within three points of the "Road of Peace" - Inje, Yanggu, and Hwacheon courses, located within the civilian control zone. Direct surveys and indirect eDNA sampling were carried out in May, July, and September of 2022. Genetic material obtained from the samples underwent amplification, library preparation, MiSeq sequencing, and subsequent ASV generation for indirect analysis. These results were then compared with the findings of direct surveys. Our findings revealed the detection of eDNA for both observed species at the Yanggu-1 point, and for two out of four species at Yanggu-2. Hwacheon-1 displayed the detection of eDNA for one out of one observed species, whereas Hwacheon-2 yielded seven out of twelve, Hwacheon-3 showed four out of six, and all one observed species at Hwacheon-4 exhibited eDNA detection. Consequently, approximately 69% of the fish species identified through direct surveys were confirmed by indirect eDNA analysis. It is necessary to verify if certain fish species, such as the continental trout and catfish, have genetic information registered in the NCBI database. Additionally, it is believed that further marker development research utilizing different genetic sequences is essential. Given the limitations imposed by the hazardous nature of the surveyed civilian control zone, eDNA analysis proves to be a suitable supplement for fish research in the area.

• Journal of the Korean Association of Geographic Information Studies
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• v.27 no.2
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• pp.78-95
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• 2024

For the establishment and comparison of environmental plans across various domains, considering climate change and urban issues, it is crucial to build spatial data at the regional scale classified with consistent criteria. This study mapping the Local Climate Zone (LCZ) of Changwon City, where active climate and environmental research is being conducted, using the protocol suggested by the World Urban Database and Access Portal Tools (WUDAPT). Additionally, to address the fragmentation issue where some grids are classified with different climate characteristics despite being in regions with homogeneous climate traits, a filtering technique was applied, and the LCZ classification characteristics were compared according to the filtering radius. Using satellite images, ground reference data, and the supervised classification machine learning technique Random Forest, classification maps without filtering and with filtering radii of 1, 2, and 3 were produced, and their accuracies were compared. Furthermore, to compare the LCZ classification characteristics according to building types in urban areas, an urban form index used in GIS-based classification methodology was created and compared with the ranges suggested in previous studies. As a result, the overall accuracy was highest when the filtering radius was 1. When comparing the urban form index, the differences between LCZ types were minimal, and most satisfied the ranges of previous studies. However, the study identified a limitation in reflecting the height information of buildings, and it is believed that adding data to complement this would yield results with higher accuracy. The findings of this study can be used as reference material for creating fundamental spatial data for environmental research related to urban climates in South Korea.

• The Sea:JOURNAL OF THE KOREAN SOCIETY OF OCEANOGRAPHY
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• v.14 no.2
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• pp.69-79
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• 2009

Major and trace elements were analyzed in three core sediments to investigate geochemical characteristics of East Sea sediments and provenance changes during late Quaternary in Ulleung Basin. Comparing with Yellow and South Sea sediments, contents of major elements were generally similar while contents of trace elements were significantly different. Furthermore, within this basin, there were some variabilities in trace element compositions. In the western slope sediments (WS), Mo was enriched over 6 times as much as other sites. On the other hand, Zr, Nb, Hf and Ta were enriched in basin sediments (Basin), and Ca and Cs were enriched in southern slope sediments (SS). After excluding elements derived from biogenic, authigenic and diagenetic origins, the lithogenic elements (K, Ti, Cs, Zr, Nb, Hf and Ta) could be classified into three groups from the comparison of element/Al ratios among cores. The first group consisted of elements (K and Ti) that showed the nearly similar element/Al ratios among three cores. The second group contained Cs which showed significant difference between two slope sediments. The third group elements (Zr, Nb, Hf and Ta) showed highly enriched in basin relative to both slope areas. The depth profiles of metal/Al ratios in basin sediments provided the following interpretation for the compositions of sediment and their variation. From 10,000 yr B.P. to 7,000 yr B.P. two lithogenic components (volcanic ashes and western slope sediments) were mixed and deposited in the basin. After 7,000 yr B.P., however, southern slope sediments were mixed with volcanic ashes and deposited in basin area. This event of source change is nearly close to inflow period of the Tsushima Warm Current to Ulleung Basin. Thus, it might be suggested that element geochemistry in Ulleung basin sediment indicate the change of current system in the study area.

• The Sea:JOURNAL OF THE KOREAN SOCIETY OF OCEANOGRAPHY
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• v.13 no.3
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• pp.168-177
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• 2008

Trafficablility of a miner and potential environmental impacts due to mining activities should be considered in the selection of a commercial manganese nodule mining site. These two factors can be evaluated comparatively with physical properties and shear strength of sea-bed sediments. For the qualitative comparison of potential minig sites in terms of these two factors, physical properties such as water contents, void ratios, porosities, and grain densities, and shear strengths of surface sediments were determined for the three potential manganese nodule mining sites(KR1, KR2, and KR5) in the Korean manganese nodule contract area, northeast Pacific. For the study, sediment samples were collected from 107 stations from 2004 to 2006. The physical properties of surface sediments showed more significant differences between northern(KR1, KR2) and southern(KR5) blocks than between northern blocks(KR1 vs. KR2). Water content, void ratio, and porosity of sediments from KR5 were relatively higher than those from KR1 and KR2. Grain density of sediments from KR5 was relatively lower than those from KR1 and KR2. Shear strengths of the top 10cm sediments were higher in KR1 and KR2, whereas those of the deeper part were highest in KR5 block. Generally, sediments of high water contents are less suspendible than those of the low water contents by benthic disturbances, thus less disturbance is expected in the sediments of high water content by mining activities. In terms of trafficability, the shear strength of sediment below 10 cm deep is more important than shallower part because miner will disturb at least top 10 cm interval of the surface sediments. Base on these results, we conclude that KR5 area will be the best site for commercial mining among three investigated sites in this study.

• Journal of The Korean Association For Science Education
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• v.29 no.2
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• pp.179-192
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• 2009

The purpose of this study was to examine the effects of Small-Scale Chemistry (below SSC) Lab Program with respect to students' extroversions and introversions. For this study, an SSC Lab Program was developed on the basis of analyzing the chemistry part of the high school science textbook in the 7th curriculum. The experimental group received SSC experiment lessons, and the comparison group received traditional experiment lessons based on textbook for 5 class periods. Afterwards, students were grouped into extrovert and introvert according to their personality test scores, the differences between the two groups were investigated using 2-way ANCOVA. Prior to the instructions, three test regarding the scientific attitude and academic self-efficacy were administered. After the instructions, the scientific attitude, academic self-efficacy, and students' perceptions on SSC Lab Program were examined. The scores in mid-term and end-of-term science exams were used as pre-test and post-test science achievement scores, respectively. Two-way ANCOVA results revealed that there were effects in the score of the academic achievement score, but there was no interactive effect between extroversion/introversion and treatment. In addition, a significant interactive effect was found in the scientific attitude, but there was no significant main effect. It was interpreted that extrovert students had many opportunities in SSC experiment classes and were able to experiment with initiative, but introverts would feel the responsibility and the pressure owing to the small group experiment. There were no main and interactive effects in the score of the academic self-efficacy test. Survey of students' perceptions on SSC Lab Program revealed that both over 90% extrovert and introvert students showed very positive perceptions in 'three-membered small group composition,' 'understanding,' and 'convenience' items. It was found to be a very different perception between extrovert and introvert students in 'comparing result with other students' item.

• Clean Technology
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• v.30 no.2
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• pp.123-133
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• 2024

Zeolite template carbon (ZTC) was synthesized as an adsorbent to remove low-concentration CH₄ from the atmosphere. The synthesis of ZTC was performed using CH₄ and C₂H₂ as carbon precursors and their impact on adsorption was investigated. ZTC was also synthesized using Y zeolite ion-exchanged with CaCl₂ and LiCl as templates to investigate the effect of using metals in ion exchange. The comparison of the carbon precursors revealed that C₂H₂ had a higher carbon yield than CH₄. The synthesized ZTC exhibited developed micropores due to carbon deposition deep inside the micropores of the zeolite template. The kinetic diameter of C₂H₂ (0.33 nm) is smaller than that of CH₄ (0.38 nm), which allowed for its deposition. The study compared metal precursors used for ion exchange and confirmed that the CaCl₂-based ZTC developed more micropores compared to the LiCl-based ZTC. The ion-exchanged Ca inhibited pore blocking by the carbon precursor, allowing it to enter the pores. The ability of synthesized ZTC to adsorb N₂ and CH₄ at 298 K was investigated. The results showed that CH₄ had a higher overall adsorption amount than N₂. The sample synthesized using C₂H₂ and CaY exhibited the highest N₂ and CH₄ adsorption capacity. However, the sample synthesized with CH₄ had the highest CH₄/N₂ gas uptake ratio, which is a crucial factor in designing an adsorption process. The observed difference was likely caused by the underdevelopment of ultrafine pores that are associated with N₂ adsorption. This resulted in a reduction of N₂ adsorption, leading to an increase in CH₄/N₂ separation.