• Neonatal Medicine
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• v.28 no.3
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• pp.124-132
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• 2021

Purpose: Neonatal near miss (NNM) allows for the detection of risk factors associated with serious newborn complications and death, the prevention of which could reduce neonatal mortality. This study was conducted with the objective of identifying predictors for NNM in a tertiary hospital in Bangalore city. Methods: This was an unmatched case-control study involving 120 NNM cases and 120 controls. NNM was determined using Pileggi-Castro's pragmatic and management criteria. Data was collected from in-patient hospital records and interviews of postpartum mothers. Multiple logistic regression of exposure variables was performed to calculate adjusted odds ratio (AOR) with 95% confidence interval (CI). Results: Significant predictors were maternal age ≥30 years (AOR, 5.32; 95% CI, 1.12 to 9.29; P=0.041), inadequate antenatal care (ANC) (AOR, 8.35; 95% CI, 1.98 to 51.12; P=0.032), <3 ultrasound scans during pregnancy (AOR, 12.5; 95% CI, 1.60 to 97.27; P=0.016), maternal anaemia (AOR, 18.96; 95% CI, 3.10 to 116.02; P=0.001), and any one obstetric complication (hypertensive disorder in pregnancy, diabetes in pregnancy, preterm premature rupture of membranes, prolonged labour, obstructed labour, malpresentation) (AOR, 4.34; 95% CI, 1.26 to 14.95; P=0.02). Conclusion: The predictors of NNM identified has important implications for public health policy and practice whose modifications can improve NNM. These include expanding essential ANC package to include ultrasound scans, ensuring World Health Organization recommendations of eight ANC visits, capacity building at all levels of health care to strengthen routine ANC and obstetric care for effective screening, referral and management of obstetric complications.

• Journal of Environmental Health Sciences
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• v.44 no.6
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• pp.539-547
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• 2018

Objectives: Ozone ($O_3$) advisories are issued by provincial/prefectural and city governments in Korea and Japan when oxidant concentrations exceed the criteria of the related country. Advisories issued only after exposure to high $O_3$ concentrations cannot be considered ideal measures. Forecasts of $O_3$ would be more beneficial to citizens' health and daily life than real-time advisories. The present study was undertaken to present a simplified forecasting model that can predict surface $O_3$ concentrations for the afternoon of the day of the forecast. Methods: For the construction of a simple and practical model, a multivariate regression model was applied. The monitored data on gases and climate variables from Japan's air quality networks that were recorded over nearly one year starting from April 2016 were applied as the subject for our model. Results: A well-known inverse correlation between $NO_2$ and $O_3$ was confirmed by the monitored data for Iksan, Korea and Fukuoka, Japan. Typical time fluctuations for $O_3$ and $NO_x$ were also found. Our model suggests that insolation is the most influential factor in determining the concentration of $O_3$. $CH_4$ also plays a major role in our model. It was possible to visually check for the fit of a theoretical distribution to the observed data by examining the probability-probability (P-P) scatter plot. The goodness of fit of the model in this study was also successfully validated through a comparison (r=0.8, p<0.05) of the measured and predicted $O_3$ concentrations. Conclusions: The advantage of our model is that it is capable of immediate forecasting of surface $O_3$ for the afternoon of the day from the routinely measured values of the precursor and meteorological parameters. Although a comparison to other approaches for $O_3$ forecasting was not carried out, the model suggested in this study would be very helpful for the citizens of Korea and Japan, especially during the $O_3$ season from May to June.

• Journal of Neurogastroenterology and Motility
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• v.24 no.4
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• pp.577-583
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• 2018

Background/Aims Potassium-competitive acid blockers are expected to be the next generation of drugs for the treatment of diseases caused by gastric acid. In 2015, vonoprazan fumarate, a novel potassium-competitive acid blocker, was approved by the Japanese health insurance system. Since its approval, patients refractory to vonoprazan can be encountered in clinical settings. We designed this study to clarify the pathophysiology of gastroesophageal reflux disease refractory to vonoprazan. Methods In this retrospective study, we involved patients who had refractory symptoms after administration of standard-dose proton pump inhibitors or vonoprazan and underwent diagnostic testing with esophageal high-resolution manometry and 24-hour multichannel intraluminal impedance and pH monitoring while using proton pump inhibitors or vonoprazan. Patients were diagnosed based on the Rome IV criteria for functional gastrointestinal disorders and diagnostic test results. Results Twenty-seven patients were analyzed during this study. Gastric pH ${\geq}4$ was sustained for a longer period of time, and the esophageal acid exposure time and number of acid reflux events were shorter in the vonoprazan group than in the proton pump inhibitor group. The percentage of patients diagnosed with acidic gastroesophageal reflux disease in the vonoprazan group was lower than that in the proton pump inhibitor group. Conclusions Intra-gastric pH and acid reflux were strongly suppressed by 20-mg vonoprazan. When patients with gastroesophageal reflux disease present symptoms after administration of 20-mg vonoprazan, the possibility of pathophysiologies other than acid reflux should be considered.

• Journal of the Korean Society of Radiology
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• v.16 no.3
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• pp.303-308
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• 2022

Mammography using X-rays is currently the most used for early diagnosis of breast cancer. As the frequency of use of X-ray devices increases, interest in radiation hazards caused by mammography is increasing. Therefore, in this study, in order to measure the exposure dose of the mammary gland in X-ray mammography that requires high contrast and high resolution, the international Atomic Energy Agency (IAEA) stipulates the international standards presented by IEC 62220-1-2: 2015. Based on the beam quality criteria of the recommendation, we tried to present a guideline for evaluating the average mammary gland dose. As a result, the average streamline dose value of the 4.5 cm PMMA phantom was 2.3 mGy at the maximum within the 30 kV range, and was evaluated to be 1.19 mGy based on 28 kV.

• Journal of Environmental Health Sciences
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• v.48 no.5
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• pp.255-265
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• 2022

Background: Research in environmental health (EH) is of crucial strategic importance for contemporary society. It is becoming even more critical in light of the increasingly rapid pace of environmental changes, opportunities, and threats. Objectives: This study aimed to identify trends and the prospective of environmental health research using SWOT analysis. Methods: The trends in environmental health research were reviewed in previous studies and reports. Reviewed manuscripts were searched for using the keywords of 'environmental health' and 'environmental hygiene' in the KCI (Korean Journal of Citation Index), KISS (Korean Academic Information), PubMed, and Google Scholar. Results: It is essential to center the EH research agenda around key priorities focusing on technological innovation, job creation, and the increasingly prominent role of the private sector. Given the rapidly evolving global sustainability agenda, greater clarity on the ever-increasing sources of complexity and growing expectations of the public might be needed. This requires the identification of criteria to identify EH research priorities with the ultimate goal of maximizing societal benefit. Public health relevance, such as extent and severity of health impact, level of exposure, and inequalities of effects, could be included. Conclusions: Considering the recent interest in and importance of environmental health, a comprehensive approach to environmental health research should be required through the application of the latest science and technology, citizen participation, and environmental health surveillance systems.

• IEMEK Journal of Embedded Systems and Applications
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• v.17 no.1
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• pp.9-17
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• 2022

As the COVID-19 pandemic situation worsens, the time spent indoors increases, and the exposure to indoor environmental pollution such as indoor air pollution and noise also increases, causing problems such as deterioration of human health, stress, and discord between neighbors. This paper designs and implements a system that measures and monitors indoor air quality and noise, which are representative evaluation criteria of the indoor environment. The system proposed in this paper consists of a particulate matter measurement subsystem that measures and corrects the concentration of particulate matters to monitor indoor air quality, and a noise measurement subsystem that detects changes in sound and converts it to a sound pressure level. The concentration of indoor particulate matters is measured using a laser-based light scattering method, and an error caused by temperature and humidity is compensated in this paper. For indoor noise measurement, the voltage measured through a microphone is basically measured, Fourier transform is performed to classify it by frequency, and then A-weighting is performed to correct loudness equality. Then, the RMS value is obtained, high-frequency noise is removed by performing time-weighting, and then SPL is obtained. Finally, the equivalent noise level for 1 minute and 5 minutes are calculated to show the indoor noise level. In order to classify noise into direct impact sound and air transmission noise, a piezo vibration sensors is mounted to determine the presence or absence of direct impact transmitted through the wall. For performance evaluation, the error of particulate matter measurement is analyzed through TSI's AM510 instrument. and compare the noise error with CEM's noise measurement system.

• Journal of Korean Biological Nursing Science
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• v.24 no.1
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• pp.1-16
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• 2022

Purpose: Recently, oxytocin has been introduced experimentally as a pharmacological treatment for post-traumatic stress disorder (PTSD). This study attempted to investigate the possibility of oxytocin as a treatment option for patients with PTSD by examining its dose, interval, and effectiveness in patients with PTSD. Methods: A systematic review was done on articles published from 1967 to 2020 using the PubMed, PsycINFO, and Cochrane databases. Our inclusion criteria were 1) subjects 18 years of age or older diagnosed with PTSD or exposed to a traumatic event that met criterion A of the Diagnostic and Statistical Manual of Mental Disorders (DSM) for PTSD, 2) oxytocin was administered at least once, 3) clinical trials, and 4) studies published in Korean or English. Two independent researchers reviewed 22 articles and recorded the contents. The risk of bias was evaluated to determine the quality of the reviewed article. Results: The parameters for evaluating the effectiveness of oxytocin were identified as socio-behavioral measures in 11 articles, neuronal imaging in 9, and biomarkers in 4. In 5 papers, oxytocin was administered multiple times. Socio-behavioral measures were improved in 3 out of 5 studies in which oxytocin was administered multiple times. In 2 studies in which prolonged exposure treatment and nasal oxytocin administration were combined for 10 weeks, patient symptoms were decreased compared to the control group. Conclusion: The possibility of oxytocin as an adjuvant treatment for PTSD psychotherapy was confirmed. Further studies are necessary to evaluate the long term effectiveness of administering oxytocin multiple times combined with psychotherapy.

• Clinical and Experimental Pediatrics
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• v.65 no.2
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• pp.85-89
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• 2022

Background: There is evidence of a relationship between prenatal excess androgen exposure and central nervous developmental problems and attention-deficit/hyperactivity disorder (ADHD) in the offspring of mothers with polycystic ovary syndrome (PCOS). Purpose: Here we aimed to use a meta-analysis to investigate whether the offspring of mothers with PCOS are at an increased chance of developing ADHD. Methods: Three main English databases were searched for articles published through December 2020. The Newcastle-Ottawa Scale was used to assess study quality. Study heterogeneity was determined using I² statistics and publication bias was assessed using Begg and Egger tests. The results are presented as odds ratio (OR) and relative ratio (RR) estimates with 95% confidence intervals (CIs) using a random-effects model. Results: Six articles (3 cohort and 3 case-control studies; 401,413 total ADHD cases) met the study criteria. Maternal PCOS was associated with an increased risk of ADHD in the offspring based on OR and RR (OR, 1.42; 95% CI, 1.27-1.57) and (RR, 1.43; 95% CI, 1.35-1.51), respectively. There was no heterogeneity among the included articles based on OR (I²=0.0%, P=0.588) and RR (I²=0.0%, P=0.878). Conclusion: Our study showed that maternal PCOS is a risk factor for ADHD. Therefore, screening their offspring for ADHD should be considered part of the comprehensive clinical care of women with PCOS.

• Archives of Plastic Surgery
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• v.49 no.6
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• pp.729-739
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• 2022

Cranioplasties are common procedures in plastic surgery. The use of tissue expansion (TE) in staged cranioplasties is less common. We present two cases of cranioplasties with TE and systematically review literature describing the use of TE in staged cranioplasties and postoperative outcomes. A systematic review was performed by querying multiple databases. Eligible articles include published case series, retrospective reviews, and systematic reviews that described use of TE for staged bony cranioplasty. Data regarding study size, patient demographics, preoperative characteristics, staged procedure characteristics, and postoperative outcomes were collected. Of 755 identified publications, 26 met inclusion criteria. 85 patients underwent a staged cranioplasty with TE. Average defect size was 122 cm², and 30.9% of patients received a previous reconstruction. Average expansion period was 14.2 weeks. The most common soft tissue closures were performed with skin expansion only (75.3%), free/pedicled flap (20.1%), and skin graft (4.7%). The mean postoperative follow-up time was 23.9 months. Overall infection and local complication rates were 3.53 and 9.41%, respectively. The most common complications were cerebrospinal fluid leak (7.1%), hematoma (7.1%), implant exposure (3.5%), and infection (3.5%). Factors associated with higher complication rates include the following: use of alloplastic calvarial implants and defects of congenital etiology (p = 0.023 and 0.035, respectively). This is the first comprehensive review to describe current practices and outcomes in staged cranioplasty with TE. Adequate soft tissue coverage contributes to successful cranioplasties and TE can play a safe and effective role in selected cases.

• Journal of Biomedical Engineering Research
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• v.44 no.3
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• pp.190-203
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• 2023

The purpose of this study is to provide basic data to ensure the safety and essential performance of a Lower Extremity robotic assisted gait training system and to provide advanced technology and technical basis to the industry handling the system. Based on IEC 60601-1:2012/AMD2:2020 (Medical Electrical Equipment - General requirements for basic safety and essential performance of medical electrical equipment), IEC 62366-1:2015/AMD1:2020 (Medical devices - Part 1: Application of usability engineering to medical devices) and EN ISO 14971:2019 (Medical devices - Application of risk management to medical devices), the requirements for ensuring the safety and essential performance of the Lower Extremity robotic assisted gait training system were derived. Through the Delphi survey method and scenario analysis, which reflects the opinions and knowledge of experts in the fields of development, testing and review of technical documents, and quality assurance of medical devices, validity and reliability were conducted and obtained results with adequate content validity ratio (CVR; 0.7≤) and excellent reliability (Cronbach's α; 0.9≤). As a result, it was confirmed that the reliability and validity of the risk management process to ensure the safety and essential performance of the Lower Extremity robotic assisted gait training system are required a model can be established to provide measures to reduce risks according to the level of risk exposure caused by usage.