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Incidence and Associated Factors of Delirium after Orthopedic Surgery (정형외과 수술 후 발생한 섬망의 발생 빈도와 관련 인자)

  • Lee, Si-Wook;Cho, Chul-Hyun;Bae, Ki-Cheor;Lee, Kyung-Jae;Son, Eun-Seok;Um, Sang-Hyun
    • Journal of the Korean Orthopaedic Association
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    • v.54 no.2
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    • pp.157-163
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    • 2019
  • Purpose: To investigate the incidence and associated factors of delirium after orthopedic surgery. Materials and Methods: A total of 2,122 cases, who were older than 20 years and underwent orthopedic surgery at a single medical center during a one year period were included. Among them, 132 patients who were diagnosed with delirium after surgery under the Diagnostic and Statistical Manual of Mental Disorders-V criteria and medicated under the consultation of a psychiatrist were included in the study The differences in the incidence of delirium and several affecting factors were analyzed. Results: The overall incidence of delirium after surgery was 6.2% (132 in 2,122 cases). The mean age of the delirium group was 77.4 years (range, 54-92 years), which was higher than that of the non-delirium group (58.1 years). The percentage of women in the delirium group was 63.6% (84 in 132 cases), which was higher than that of the women in the non-delirium group (49.0%). The incidence of delirium after surgery was 9.3% (85 in 916 cases) due to trauma and 3.9% (47 in 1206 cases) due to disease. The incidence of postoperative delirium according to the surgical region was 29.2% (7 in 24 cases) in two or more regions, 13.7% (72 in 526 cases) in the hip, and 9.6% (14 in 146 cases) in the spine, 3.5% (20 in 577 cases) in the knee-lower leg, 2.5% (5 in 199 cases) in the foot-ankle, 2.4% (11 in 457 cases) in the shoulder-elbow, and 1.6% (3 in 189 cases) in the forearm-wrist-hand. Delirium occurred more rapidly in women and surgery due to disease, and the duration of delirium was longer in patients with dementia and major depressive disorders. Conclusion: The incidence of postoperative delirium was high in cases of surgery due to trauma and in cases of surgery in two or more sites. The incidence of postoperative delirium according to a single surgical region was higher in the order of the hip, spine, and knee. Active intervention is needed regarding the correctable risk factor.

MDP(Markov Decision Process) Model for Prediction of Survivor Behavior based on Topographic Information (지형정보 기반 조난자 행동예측을 위한 마코프 의사결정과정 모형)

  • Jinho Son;Suhwan Kim
    • Journal of Intelligence and Information Systems
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    • v.29 no.2
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    • pp.101-114
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    • 2023
  • In the wartime, aircraft carrying out a mission to strike the enemy deep in the depth are exposed to the risk of being shoot down. As a key combat force in mordern warfare, it takes a lot of time, effot and national budget to train military flight personnel who operate high-tech weapon systems. Therefore, this study studied the path problem of predicting the route of emergency escape from enemy territory to the target point to avoid obstacles, and through this, the possibility of safe recovery of emergency escape military flight personnel was increased. based problem, transforming the problem into a TSP, VRP, and Dijkstra algorithm, and approaching it with an optimization technique. However, if this problem is approached in a network problem, it is difficult to reflect the dynamic factors and uncertainties of the battlefield environment that military flight personnel in distress will face. So, MDP suitable for modeling dynamic environments was applied and studied. In addition, GIS was used to obtain topographic information data, and in the process of designing the reward structure of MDP, topographic information was reflected in more detail so that the model could be more realistic than previous studies. In this study, value iteration algorithms and deterministic methods were used to derive a path that allows the military flight personnel in distress to move to the shortest distance while making the most of the topographical advantages. In addition, it was intended to add the reality of the model by adding actual topographic information and obstacles that the military flight personnel in distress can meet in the process of escape and escape. Through this, it was possible to predict through which route the military flight personnel would escape and escape in the actual situation. The model presented in this study can be applied to various operational situations through redesign of the reward structure. In actual situations, decision support based on scientific techniques that reflect various factors in predicting the escape route of the military flight personnel in distress and conducting combat search and rescue operations will be possible.

A Comprehensive Review of Geological CO2 Sequestration in Basalt Formations (현무암 CO2 지중저장 해외 연구 사례 조사 및 타당성 분석)

  • Hyunjeong Jeon;Hyung Chul Shin;Tae Kwon Yun;Weon Shik Han;Jaehoon Jeong;Jaehwii Gwag
    • Economic and Environmental Geology
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    • v.56 no.3
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    • pp.311-330
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    • 2023
  • Development of Carbon Capture and Storage (CCS) technique is becoming increasingly important as a method to mitigate the strengthening effects of global warming, generated from the unprecedented increase in released anthropogenic CO2. In the recent years, the characteristics of basaltic rocks (i.e., large volume, high reactivity and surplus of cation components) have been recognized to be potentially favorable in facilitation of CCS; based on this, research on utilization of basaltic formations for underground CO2 storage is currently ongoing in various fields. This study investigated the feasibility of underground storage of CO2 in basalt, based on the examination of the CO2 storage mechanisms in subsurface, assessment of basalt characteristics, and review of the global research on basaltic CO2 storage. The global research examined were classified into experimental/modeling/field demonstration, based on the methods utilized. Experimental conditions used in research demonstrated temperatures ranging from 20 to 250 ℃, pressure ranging from 0.1 to 30 MPa, and the rock-fluid reaction time ranging from several hours to four years. Modeling research on basalt involved construction of models similar to the potential storage sites, with examination of changes in fluid dynamics and geochemical factors before and after CO2-fluid injection. The investigation demonstrated that basalt has large potential for CO2 storage, along with capacity for rapid mineralization reactions; these factors lessens the environmental constraints (i.e., temperature, pressure, and geological structures) generally required for CO2 storage. The success of major field demonstration projects, the CarbFix project and the Wallula project, indicate that basalt is promising geological formation to facilitate CCS. However, usage of basalt as storage formation requires additional conditions which must be carefully considered - mineralization mechanism can vary significantly depending on factors such as the basalt composition and injection zone properties: for instance, precipitation of carbonate and silicate minerals can reduce the injectivity into the formation. In addition, there is a risk of polluting the subsurface environment due to the combination of pressure increase and induced rock-CO2-fluid reactions upon injection. As dissolution of CO2 into fluids is required prior to injection, monitoring techniques different from conventional methods are needed. Hence, in order to facilitate efficient and stable underground storage of CO2 in basalt, it is necessary to select a suitable storage formation, accumulate various database of the field, and conduct systematic research utilizing experiments/modeling/field studies to develop comprehensive understanding of the potential storage site.

Suicide Method, the Recent Stressors, Psychiatric Diagnosis of Suicide Attempters and Suicide Completers (자살시도자와 자살 사망자의 자살 방법, 스트레스 요인 및 정신과적 진단)

  • Sea Hyun O;Jihye Ahn;Seo Jihyo;Hyerin Gu;Minjeong Kim;Hyeyeon Jang;Seog Ju Kim
    • Sleep Medicine and Psychophysiology
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    • v.29 no.1
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    • pp.15-20
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    • 2022
  • Objectives: Suicide is the major public mental health concerns all over the world. The comparison of suicide attempters and suicide completers could be the fundamental evidence for the suicide prevention. The aim of this study is to explore the differences between suicide attempters and suicide completers in terms of the stressors, suicide methods, and psychiatric diagnosis. Methods: Two types of secondary data were collected for the analyses. Data of the suicide attempters (n = 680) were gathered by intensive reviewing the medical records of Samsung Medical Center, Seoul, Republic of Korea. Data of suicide completers (n = 11,722) were collected by the psychological autopsy data which were gathered by Korean Foundation for Suicide Prevention. Suicidal methods, psychiatric disorders and stressors before suicidal attempt were compared between suicide attempter and completers. Results: Suicide completers were older and male predominant compared to suicidal attempt. Hanging or gas intoxication were more commonly used in the suicide completion, while wrist cutting or drug intoxication were more common in suicide attempters. All types of stressors were found to be high in suicide completers than suicide attempters. However, the proportion of economic and physical stress were greater in suicide completers, while the proportion of family stress were greater in suicide attempters. According to the recorded diagnoses, the rates of depressive disorders, sleep-wake disorders, substance-related disorders were higher in suicide completers, while the rates of anxiety disorders and trauma- and stressor-related disorders, bipolar and related disorders and somatic symptom disorders were higher in suicide attempters. However, after controlling the gender and age, there were no significant differences in diagnosis between suicide attempters and suicide completers. Conclusion: These findings implicate that suicide attempters and completers differed in suicide methods and type of stress. The results suggests that economic stressors, physical illness might raise the risk of suicide completion.

Revision of Nutrition Quotient for Korean adolescents 2021 (NQ-A 2021) (청소년 영양지수 (NQ-A 2021) 개정에 관한 연구)

  • Ki Nam Kim;Hyo-Jeong Hwang;Young-Suk Lim;Ji-Yun Hwang;Sehyug Kwon;Jung-Sug Lee;Hye-Young Kim
    • Journal of Nutrition and Health
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    • v.56 no.3
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    • pp.247-263
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    • 2023
  • Purpose: This study was conducted to update the Nutrition Quotient for Adolescents (NQ-A), which is used to assess the overall dietary quality and food behavior among Korean adolescents. Methods: The first 30 candidate items of the measurable eating behavior checklist were obtained based on a previous NQ-A checklist, the results of the seventh Korea National Health and Nutrition Examination Survey data, Korea Youth Risk Behavior Survey data, national nutrition policies and dietary guidelines, and literature reviews. A total of 100 middle and high school students residing in Seoul and Gyeonggi Province participated in a pilot study using the 25-item checklist. Factor analysis and frequency analysis were conducted to determine if the checklist items were organized properly and whether the responses to each item were distributed adequately, respectively. As a result, 22 checklist items were selected for the nationwide survey, which was applied to 1,000 adolescent subjects with stratified sampling from 6 metropolitan cities. The construct validity of the updated NQ-A 2021 was assessed using confirmatory factor analysis. Results: Twenty checklist items were determined for the final NQ-A 2021. The items were composed of three factors: balance (8 items), moderation (9 items), and practice (3 items). The standardized path coefficients were used as the weights of items to determine the nutrition quotients. NQ-A 2021 and 3-factor scores were calculated according to the weights of questionnaire items. The weight for each of the 3 factors was determined as follows: balance, 0.15; moderation, 0.30; and practice, 0.55. Conclusion: The updated NQ-A 2021 is a useful instrument for easily and quickly evaluating the dietary qualities and eating behaviors of Korean adolescents.

Does Sarcopenic Obesity Affect Physical Function and Physical Fitness of Korean Older Women? (근위축비만이 국내 여성고령자의 신체기능과 체력에 미치는 영향)

  • Hong, Seung-youn
    • 한국노년학
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    • v.30 no.3
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    • pp.831-842
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    • 2010
  • BACKGROUND: Sarcopenic obesity(SO), a condition of the reduction in muscle mass paired with an increased fat mass has been paid attention because of its association with disability in later life. A few evidence, however, has reported the association with these factors. PURPOSE: To explore the association among SO, physical function and fitness in older women. METHOD: 257 older women(age of 74) were recruited from Y city and 7 physical functions and 4 fitness tests were measured. Participants were classified into one of four groups based on their body fat and muscle mass: Normal group (GR-A), high fat(GR-B), sarcopenia(GR-C), and sarcopenic obese(GR-D). GLMand LSD-test were conducted with SPSS 12.0. RESULTS: Chair stand, arm-curl, back-scratch, 2-min steps of GR-A was higher than GR-C and GR-D(p<.05). One-leg stand of GR-A was higher than GR-D(p<.01) and of GR-C was higher than GR-D(p<.01).8ft-TUG of GR-D was lower than GR-A(p<.01). Grip strength, knee extension of GR-A was higher than that of GR-C and GR-D(p<.01) and knee flexion of GR-A was also higher than that of GR-C and GR-D(p<.01). CONCLUSION: Based on our findings, we conclude that SO is significantly associated with lower physical function and fitness in older Korean women, which alarm the risk of frailty induced by SO.

Prediction of Species Distribution Changes for Key Fish Species in Fishing Activity Protected Areas in Korea (국내 어업활동보호구역 주요 어종의 종분포 변화 예측)

  • Hyeong Ju Seok;Chang Hun Lee;Choul-Hee Hwang;Young Ryun Kim;Daesun Kim;Moon Suk Lee
    • Journal of the Korean Society of Marine Environment & Safety
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    • v.29 no.7
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    • pp.802-811
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    • 2023
  • Marine spatial planning (MSP) is a crucial element for rational allocation and sustainable use of marine areas. Particularly, Fishing Activity Protected Areas constitute essential zones accounting for 45.6% designated for sustainable fishing activities. However, the current assessment of these zones does not adequately consider future demands and potential values, necessitating appropriate evaluation methods and predictive tools for long-term planning. In this study, we selected key fish species (Scomber japonicus, Trichiurus lepturus, Engraulis japonicus, and Larimichthys polyactis) within the Fishing Activity Protected Area to predict their distribution and compare it with the current designated zones for evaluating the ability of the prediction tool. Employing the Intergovernmental Panel on Climate Change (IPCC) 6th Assessment Report scenarios (SSP1-2.6 and SSP5-8.5), we used species distribution models (such as MaxEnt) to assess the movement and distribution changes of these species owing to future variations. The results indicated a 30-50% increase in the distribution area of S. japonicus, T. lepturus, and L. polyactis, whereas the distribution area of E. japonicus decreased by approximately 6-11%. Based on these results, a species richness map for the four key species was created. Within the marine spatial planning boundaries, the overlap between areas rated "high" in species richness and the Fishing Activity Protected Area was approximately 15%, increasing to 21% under the RCP 2.6 scenario and 34% under the RCP 8.5 scenario. These findings can serve as scientific evidence for future evaluations of use zones or changes in reserve areas. The current and predicted distributions of species owing to climate change can address the limitations of current use zone evaluations and contribute to the development of plans for sustainable and beneficial use of marine resources.

The study of heavy rain warning in Gangwon State using threshold rainfall (침수유발 강우량을 이용한 강원특별자치도 호우특보 기준에 관한 연구)

  • Lee, Hyeonjia;Kang, Donghob;Lee, Iksangc;Kim, Byungsikd
    • Journal of Korea Water Resources Association
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    • v.56 no.11
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    • pp.751-764
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    • 2023
  • Gangwon State is centered on the Taebaek Mountains with very different climate characteristics depending on the region, and localized heavy rainfall is a frequent occurrence. Heavy rain disasters have a short duration and high spatial and temporal variability, causing many casualties and property damage. In the last 10 years (2012~2021), the number of heavy rain disasters in Gangwon State was 28, with an average cost of 45.6 billion won. To reduce heavy rain disasters, it is necessary to establish a disaster management plan at the local level. In particular, the current criteria for heavy rain warnings are uniform and do not consider local characteristics. Therefore, this study aims to propose a heavy rainfall warning criteria that considers the threshold rainfall for the advisory areas located in Gangwon State. As a result of analyzing the representative value of threshold rainfall by advisory area, the Mean value was similar to the criteria for issuing a heavy rain warning, and it was selected as the criteria for a heavy rain warning in this study. The rainfall events of Typhoon Mitag in 2019, Typhoons Maysak and Haishen in 2020, and Typhoon Khanun in 2023 were applied as rainfall events to review the criteria for heavy rainfall warnings, as a result of Hit Rate accuracy verification, this study reflects the actual warning well with 72% in Gangneung Plain and 98% in Wonju. The criteria for heavy rain warnings in this study are the same as the crisis warning stages (Attention, Caution, Alert, and Danger), which are considered to be possible for preemptive rain disaster response. The results of this study are expected to complement the uniform decision-making system for responding to heavy rain disasters in the future and can be used as a basis for heavy rain warnings that consider disaster risk by region.

Physiological and Psychological analysis of musculoskeletal symptoms (근골격계질환에 대한 물리적/심리적요인에 대한 연구)

  • Donghyun Park;Sung Kyu Bae
    • Korean Journal of Culture and Social Issue
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    • v.9 no.spc
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    • pp.107-122
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    • 2003
  • The object of this study is to evaluate the prevailing physical and psychosocial conditions regarding occupational low back injury. This study consists of two parts. In the first part of the study, analytic biomechanical model and NIOSH guidelines are applied to evaluate risk levels of low back injury for automobile assembly jobs. Total of 246 workers are analysed. There are 20 jobs having greater back compressive forces than 300kg at L5/S1. Also, there are 44 jobs over Action Limit with respect to 1981 NIOSH guidelines. The relationship between psychosocial factors and low back injury was examined in the second part of the study. A battery of questionnaires concerning the psychosocial stress based on PWI (Psychosocial Well-being Index) and musculoskeletal pain symptoms at low back was completed by 246 workers at the same plant. Results showed that 207 out 246 workers experienced the symptoms and 27 workers were diagnosed as patients. Two groups(low stressed, high stressed) based on PWI score had no significant relationships with both symptoms and results of diagnosis. The relationships between physical work load and psychosocial stress were also analysed. Specifically, some postural factors(vertical deviation angle of forearm, horizontal deviation angle of upperarm, vertical deviation angle of thigh, etc) were highly correlated with psychosocial stress. The results illustrated that PWI scores were associated with some physical workloads. However, psychosocial stress levels couldn't be well related with the pain symptom as well as the actual incidence of low back injury since pain or discomfort regarding low back injury were more complex than that of other musculoskeletal disorders.

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A Study on the Types and Characteristics of Tech Start-up Preparation of Middle-Aged Entrepreneurs (중장년 기술창업가의 창업 준비 유형 및 특성에 대한 연구)

  • Sungpyo, Hong;Minhee, Kim
    • Asia-Pacific Journal of Business Venturing and Entrepreneurship
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    • v.18 no.1
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    • pp.125-140
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    • 2023
  • Careful preparation for a start-up can lower the risk of failure and create a successful business model. However, there are still challenges for middle-aged entrepreneurs, as start-up services and policies are often not readily accessible or fully utilized. Despite active research on middle-aged start-ups, previous studies have not delved deeply into the demographics of start-up preparation and various preparation behaviors. In response to this, a study was conducted to identify which start-up support services middle-aged entrepreneurs use, and how start-up preparation can be classified based on this. Data from 324 middle-aged tech start-up owners, based in Seoul and who started their businesses within the past 7 years, was collected and analyzed. The results showed that middle-aged entrepreneurs had moderate start-up preparation, with the greatest focus on the preparation period and the least focus on start-up education. Latent Profile Analysis revealed three groups of start-up preparation types among middle-aged entrepreneurs: "Overall Tribal Type," "Lack of Start-up Education Type," and "Comprehensive Preparation Type." BCH was performed on start-up satisfaction, start-up competence, fear of failure, access to start-up services, and support needs for middle-aged entrepreneurs based on the preparation type. The results showed that "Overall Tribal Type" had statistically lower start-up satisfaction, competence, and service accessibility compared to the other groups. Meanwhile, "Comprehensive Preparation Type" had a statistically lower fear of failure than the other types. "Overall Tribal Type" also had lower accessibility to middle-aged start-up services. All types had a high recognition of the need for support for specialized middle-aged start-ups. The findings highlight the need for more comprehensive support for middle-aged entrepreneurs. This could include expanding support projects to enhance their level of preparation, providing customized support based on their level of preparation, and improving the visibility and accessibility of start-up support services for middle-aged individuals. Additionally, specialized education that addresses the characteristics of middle-aged individuals should be provided.

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