• Clinical Endoscopy
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• v.55 no.1
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• pp.33-40
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• 2022

Background/Aims: Multiple outbreaks of multidrug-resistant organisms have been reported worldwide due to contaminated duodenoscopes. In 2015, the United States Food and Drug Administration recommended the following supplemental enhanced surveillance and reprocessing techniques (ESRT) to improve duodenoscope disinfection: (1) microbiological culture, (2) ethylene oxide sterilization, (3) liquid chemical sterilant processing system, and (4) double high-level disinfection. A systematic review and meta-analysis was performed to assess the impact of ESRT on the contamination rates. Methods: A thorough and systematic search was performed across several databases and conference proceedings from inception until January 2021, and all studies reporting the effectiveness of various ESRTs were identified. The pooled contamination rates of post-ESRT duodenoscopes were estimated using the random effects model. Results: A total of seven studies using various ESRTs were incorporated in the analysis, which included a total of 9,084 post-ESRT duodenoscope cultures. The pooled contamination rate of the post-ESRT duodenoscope was 5% (95% confidence interval [CI]: 2.3%-10.8%, inconsistency index [I²]=97.97%). Pooled contamination rates for high-risk organisms were 0.8% (95% CI: 0.2%-2.7%, I²=94.96). Conclusions: While ESRT may improve the disinfection process, a post-ESRT contamination rate of 5% is not negligible. Ongoing efforts to mitigate the rate of contamination by improving disinfection techniques and innovations in duodenoscope design to improve safety are warranted.

• Journal of Preventive Medicine and Public Health
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• v.57 no.4
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• pp.388-398
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• 2024

Objectives: A substantial proportion of women experience mental health challenges during pregnancy or the postpartum period. Common mental disorders (CMDs), including depression, anxiety, and obsessive-compulsive disorder, are prevalent. Identifying causes and associated risk factors is imperative for early intervention and the prevention of mental health issues. Methods: This study utilized data from the 2018 Basic Health Research, which was conducted nationwide in Indonesia, using a cross-sectional approach. We focused on women aged 13-49 years who were currently or previously married, and had experienced pregnancy, including 8889 pregnant women and 77 012 women who had delivered between January 1, 2013 and August 31, 2018. The Self-Reporting Questionnaire-20 was employed to assess CMDs. Multivariate logistic regression was performed. Results: The prevalence of CMDs in pregnant women was 12.6%, while postpartum mothers exhibited a prevalence of 10.1%. Poor health status displayed the strongest impact on CMDs during both pregnancy (adjusted odds ratio [aOR], 12.23; 95% confidence interval [CI], 9.01 to 16.60) and the postpartum period (aOR, 16.72; 95% CI, 14.85 to 18.82). Additional significant factors for both group include young maternal age, lack of education, unemployment, history of hypertension, and smoking status. Among pregnant women, CMDs was also associated with first-trimester pregnancy, previous pregnancy complications, and small upper arm circumference. For postpartum mothers, significant factors include living in rural areas, history of abortion, unwanted pregnancy, pregnancy complications, lack of antenatal care, spontaneous delivery, postpartum complications and contraceptive use. Conclusions: CMDs can impact in pregnant and postpartum women. Early diagnosis and management must be seamlessly integrated into primary healthcare practices.

• International Journal of Heart Failure
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• v.6 no.1
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• pp.36-43
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• 2024

Background and Objectives: Atrial fibrillation is common in patients with cardiac amyloidosis. However, the optimal anticoagulation strategy to prevent thromboembolic events in patients with cardiac amyloidosis and atrial fibrillation is unknown. This systematic review and meta-analysis compares direct oral anticoagulants (DOACs) vs. vitamin K antagonists (VKAs) in patients with cardiac amyloidosis and atrial fibrillation. Methods: We performed a systematic literature review to identify clinical studies of anticoagulation therapies for patients with cardiac amyloidosis and atrial fibrillation. The primary outcomes of major bleeding and thrombotic events were reported using random effects risk ratios (RRs) with 95% confidence interval (CI). Results: Our search yielded 97 potential studies and evaluated 14 full-text articles based on title and abstract. We excluded 10 studies that were review articles or did not compare anticoagulation. We included 4 studies reporting on 1,579 patients. The pooled estimates are likely underpowered due to small sample sizes. There was no difference in bleeding events for patients with cardiac amyloidosis and atrial fibrillation treated with DOACs compared to VKAs with a RR of 0.64 (95% CI, 0.38-1.10; p=0.10). There were decreased thrombotic events for patients with cardiac amyloidosis and atrial fibrillation treated with DOACs compared to VKAs with a RR of 0.50 (95% CI, 0.32-0.79; p=0.003). Conclusions: This systematic review and meta-analysis suggests that DOACs are as safe and effective as VKAs in patients with cardiac amyloidosis and atrial fibrillation. However, more data are needed to investigate clinical differences in anticoagulation therapy in this patient population.

• Journal of The Korean Society of Integrative Medicine
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• v.12 no.3
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• pp.237-247
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• 2024

Purpose : This study aimed to systematically review the effectiveness of nursing interventions for patients receiving extracorporeal membrane oxygenation (ECMO). As the use of ECMO increases in critical care settings, it is important to understand how nursing interventions affect patient outcomes, survival, and complication rates. Methods : This systematic review followed the preferred reporting items for systematic reviews and meta-analysis guidelines. A literature search was performed using terms related to ECMO and nursing interventions in several international electronic databases including CINAHL, Embase, MEDLINE, and Web of Science. Studies were screened and selected according to predefined eligibility criteria, focusing on those that evaluated the impact of nursing interventions on adult. Data extraction and risk-of-bias assessment were independently performed by two researchers. Results : A total of 647 studies were identified, and seven met the inclusion criteria for qualitative analysis. The included studies demonstrated that high-quality nursing care significantly improves clinical outcomes and reduces complications in patients receiving ECMO. Effective nursing interventions included prone positioning combined with ECMO for patients with acute respiratory distress syndrome, meticulous infection control, comprehensive and continuous nursing protocols, skilled nursing, and multidisciplinary management. These interventions have been shown to improve oxygenation, reduce complications, such as bleeding, manage blood pressure, and enhance overall clinical outcomes. Conclusion : High-quality nursing interventions are critical to improve survival and reduce complications in patients receiving ECMO. Implementing a multidisciplinary approach and comprehensive nursing protocols, including infection control and psychological support, is essential for the effective management of these patients. The findings of this study provide a foundation for the development of practical guidelines and educational programs to improve the quality of care for patients undergoing ECMO, ultimately enhancing the effectiveness of ECMO treatment and patient outcomes.

• The Korean Journal of Air & Space Law and Policy
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• v.32 no.2
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• pp.101-127
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• 2017

Even with the most advanced aviation technology benefits, aircraft accidents are constantly occurring while air passenger transportation volume is expected to double in the next 15 years. Since it is not possible to secure aviation safety only by the post aircraft accident safety action of accident investigations, it has been recognized and consensus has been formed that proactive and predictive prevention measures are necessary. In this sense, the aviation safety management system (SMS) was introduced in 2008 and has been carried out in earnest since 2011. SMS is a proactive and predictive aircraft accident preventive measure, which is a mechanism to eliminate the fundamental risk factors by approaching organizational factors beyond technological factors and human factors related to aviation safety. The methodology is to collect hazards in all the sites required for aircraft operations, to build a database, to analyze the risks, and through managing risks, to keep the risks acceptable or below. Therefore, the improper implementation of SMS indicates that the aircraft accident prevention is insufficient and it is to be directly connected with the aircraft accident. Reports of duty performance related hazards including their own errors are essential and most important in SMS. Under the policy of just culture for voluntary reporting, the guarantee of information providers' anonymity, non-punishment and non-blame should be basically secured, but to this end, under-reporting is stagnant due to lack of trust in their own organizations. It is necessary for the accountable executive(CEO) and senior management to take a leading role to foster the safety culture initiating from just culture with the safety consciousness, balancing between safety and profit for the organization. Though a Ministry of Land, Infrastructure and Transport's order, "Guidance on SMS Implementation" states the training required for the accountable executive(CEO) and senior management, it is not legally binding. Thus it is suggested that the SMS training completion certificates of accountable executive(CEO) and senior management be included in SMS approval application form that is legally required by "Korea Aviation Safety Program" in addition to other required documents such as a copy of SMS manual. Also, SMS related items are missing in the aircraft accident investigation, so that organizational factors in association with safety culture and risk management are not being investigated. This hinders from preventing future accidents, as the root cause cannot be identified. The Aircraft Accident Investigation Manuals issued by ICAO contain the SMS investigation wheres it is not included in the final report form of Annex 13 to the Convention on International Civil Aviation. In addition, the US National Transportation Safety Board(NTSB) that has been a substantial example of the aircraft accident investigation for the other accident investigation agencies worldwide does not appear to expand the scope of investigation activities further to SMS. For these reasons, it is believed that investigation agencies conducting their investigations under Annex 13 do not include SMS in the investigation items, and the aircraft accident investigators are hardly exposed to SMS investigation methods or techniques. In this respect, it is necessary to include the SMS investigation in the organization and management information of the final report format of Annex 13. In Korea as well, in the same manner, SMS item should be added to the final report format of the Operating Regulation of the Aircraft and Railway Accident Investigation Board. If such legal and institutional improvement methods are complemented, SMS will serve the purpose of aircraft accident prevention effectively and contribute to the improvement of aviation safety in the future.

• Korean Journal of Radiology
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• v.22 no.12
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• pp.2094-2123
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• 2021

Incidental thyroid nodules are commonly detected on ultrasonography (US). This has contributed to the rapidly rising incidence of low-risk papillary thyroid carcinoma over the last 20 years. The appropriate diagnosis and management of these patients is based on the risk factors related to the patients as well as the thyroid nodules. The Korean Society of Thyroid Radiology (KSThR) published consensus recommendations for US-based management of thyroid nodules in 2011 and revised them in 2016. These guidelines have been used as the standard guidelines in Korea. However, recent advances in the diagnosis and management of thyroid nodules have necessitated the revision of the original recommendations. The task force of the KSThR has revised the Korean Thyroid Imaging Reporting and Data System and recommendations for US lexicon, biopsy criteria, US criteria of extrathyroidal extension, optimal thyroid computed tomography protocol, and US follow-up of thyroid nodules before and after biopsy. The biopsy criteria were revised to reduce unnecessary biopsies for benign nodules while maintaining an appropriate sensitivity for the detection of malignant tumors in small (1-2 cm) thyroid nodules. The goal of these recommendations is to provide the optimal scientific evidence and expert opinion consensus regarding US-based diagnosis and management of thyroid nodules.

• Journal of Intelligence and Information Systems
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• v.14 no.2
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• pp.179-192
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• 2008

This case study shows constructing the knowledge-based system using a rule-based approach for detecting illegal transactions regarding money laundering in the Korea Financial Intelligence Unit (KoFIU). To better manage the explosive increment of low risk suspicious transactions reporting from financial institutions, the adoption of a knowledge-based system in the KoFIU is essential. Also since different types of information from various organizations are converged into the KoFIU, constructing a knowledge-based system for practical use and data management regarding money laundering is definitely required. The success of the financial information system largely depends on how well we can build the knowledge-base for the context. Therefore we designed and constructed the knowledge-based system for anti-money laundering by committing domain experts of each specific financial industry co-worked with a knowledge engineer. The outcome of the knowledge base implementation, measured by the empirical ratio of Suspicious Transaction Reports (STRs) reported to law enforcements, shows that the knowledge-based system is filtering STRs in the primary analysis step efficiently, and so has made great contribution to improve efficiency and effectiveness of the analysis process. It can be said that establishing the foundation of the knowledge base under the entire framework of the knowledge-based system for consideration of knowledge creation and management is indeed valuable.

• The Journal of the Korea Contents Association
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• v.15 no.1
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• pp.357-365
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• 2015

Folk medicine is traditionally passed down to cure disease, and adverse events (AEs) of folk medicine are any unfavorable and unintended discomforts temporally associated with the use of folk medicine. The aim of this study was to analyze AEs types and risks of folk medicine through the internet news articles. Included in this analysis are all articles on the topic of folk medicine and AE reported in the top 3 online news websites (NAVER, DAUM and NATE) determined by InternetTrend$^{TM}$(www.internettrend.co.kr). It was searched in the last five years (between 1 January 2009 and 28 February 2014). In total, 18 AEs articles of 973 news articles met our inclusion criteria. A total of 27 people were experienced AEs associated with use of folk medicine. Age was from 4 months to 76 years old, and it was occurred in both men and women. Folk medicine that caused AEs in twice or more was therapy that patient taking the dictamnus or aconitum of toxic herbal medicines, vinegar therapy of external use to topical skin, and cupping or bee sting therapy by practitioners. Death as a kind of serious AEs was 11 people, and 10 people were died after treatment by unqualified practitioner. Folk medicine that is popular and widely used in Korea is actively interacted with information on the internet, so it apt to misuse and abuse without guidance of health professionals. Aspects of health care system, we point out that the need for government and medical society establish not only correct health information plan and promotion of risk but also system as reporting and monitoring of AEs by folk medicine.

• Journal of the Korea Convergence Society
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• v.13 no.5
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• pp.219-228
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• 2022

In order to improve audit quality, it is essential to understand the occurrence of disagreement between auditors and managers, and this study aims to analyze the impact of Business Strategies on audit risk and accounting audit delay. To this end, we conducted an empirical analysis using sample 2,910 firm-year data from 2018 to 2020 of KOSPI-listed and KOSDAQ-listed companies. The results of the empirical analysis of this study are as follows. First, compared to the companies of defender type, prospectors can expand audit procedures for new products, R&D costs, and intangible assets, and increase audit delays due to disagreement between managers and auditors. Second, compared to KOSPI-listed companies, the prospectors in KOSDAQ are more likely to have lower financial reporting quality, which further increases audit delays. The results of this study analyzed whether a company's Business Strategy affects the possibility of disagreement between an auditor and a company, and verified whether there is a difference in the audit report lag by stock market. The results of this study show that auditors' strong duty of care is needed for the companies of prospector type with high audit risk, and it is meaningful to present reinforced audit systems and specific guidelines for the companies of prospector type through the definition of prospector type. It also enables the expansion of research to identify the relationship between non-financial factors and audit risks that make up the companies of prospector type.

• Korean Journal of Forensic Psychology
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• v.12 no.3
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• pp.301-321
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• 2021

The Comprehensive Assessment of Psychopathic Personality(CAPP) is an emerging comprehensive approach that makes use of 99 items in 33 symptoms to well-represented psychopathic personality disorder, but cross-cultural generalizability of this potential model have not endured extensive validation to date. The current study sought to validate the recently published CAPP-Self-Report form(CAPP-SR). 311 participants were derived from eleven prisons by the systematic sampling. They were administered the CAPP-SR, Triarchic Psychopathy Measure(TriPM), Levenson's SRP(LSRP), Short Dark Tetrad(SD-4), and Korean Offender Risk Assessment-General(KORAS-G designed for predicting Korean offenders'recidivism. The results showed that the CAPP-SR total, domain, and symptom scores were generally associated with TriPM, LSRP, SD-4, and KORAS-G scores in a manner consistent with conceptual expectations. Also. the findings cross-culturally provide support for construct validity and incremental validity of the CAPP-SR in Korea as well as have clinical implications for the CAPP model more broadly, which are discussed.