• The korean journal of orthodontics
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• v.49 no.1
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• pp.41-48
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• 2019

Objective: This in-vivo study aimed to compare landmark identification errors in anteroposterior (AP) and posteroanterior (PA) cephalograms generated from cone-beam computed tomography (CBCT) scan data in order to examine the feasibility of using AP cephalograms in clinical settings. Methods: AP and PA cephalograms were generated from CBCT scans obtained from 25 adults. Four experienced and four inexperienced examiners were selected depending on their experience levels in analyzing frontal cephalograms. They identified six cephalometric landmarks on AP and PA cephalograms. The errors incurred in positioning the cephalometric landmarks on the AP and PA cephalograms were calculated by using the straight-line distance and the horizontal and vertical components as parameters. Results: Comparison of the landmark identification errors in CBCT-generated frontal cephalograms revealed that landmark-dependent differences were greater than experienceor projection-dependent differences. Comparisons of landmark identification errors in the horizontal and vertical directions revealed larger errors in identification of the crista galli and anterior nasal spine in the vertical direction and the menton in the horizontal direction, in comparison with the other landmarks. Comparison of landmark identification errors between the AP and PA projections in CBCT-generated images revealed a slightly higher error rate in the AP projections, with no inter-examiner differences. Statistical testing of the differences in landmark identification errors between AP and PA cephalograms showed no statistically significant differences for all landmarks. Conclusions: The reproducibility of CBCT-generated AP cephalograms is comparable to that of PA cephalograms; therefore, AP cephalograms can be generated reliably from CBCT scan data in clinical settings.

• Progress in Medical Physics
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• v.29 no.4
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• pp.150-156
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• 2018

This study aims to develop an improved Feldkamp-Davis-Kress (FDK) reconstruction algorithm using anisotropic total variation (ATV) minimization to enhance the image quality of low-dose cone-beam computed tomography (CBCT). The algorithm first applies a filter that integrates the Shepp-Logan filter into a cosine window function on all projections for impulse noise removal. A total variation objective function with anisotropic penalty is then minimized to enhance the difference between the real structure and noise using the steepest gradient descent optimization with adaptive step sizes. The preserving parameter to adjust the separation between the noise-free and noisy areas is determined by calculating the cumulative distribution function of the gradient magnitude of the filtered image obtained by the application of the filtering operation on each projection. With these minimized ATV projections, voxel-driven backprojection is finally performed to generate the reconstructed images. The performance of the proposed algorithm was evaluated with the catphan503 phantom dataset acquired with the use of a low-dose protocol. Qualitative and quantitative analyses showed that the proposed ATV minimization provides enhanced CBCT reconstruction images compared with those generated by the conventional FDK algorithm, with a higher contrast-to-noise ratio (CNR), lower root-mean-square-error, and higher correlation. The proposed algorithm not only leads to a potential imaging dose reduction in repeated CBCT scans via lower mA levels, but also elicits high CNR values by removing noisy corrupted areas and by avoiding the heavy penalization of striking features.

• Health Policy and Management
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• v.32 no.1
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• pp.73-93
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• 2022

Background: Appropriate physician workforce projection through reasonable discussions and decisions with a broad view on supply and demand of the workforce, thus, is very important for high-quality healthcare services. The study expects to provide preliminary research data on the workforce diagnosis standard model for Korean physician workforce policy decision through more flexible and objective physician workforce projection in reflection of diverse changes in healthcare policy and sociodemographic environments. Methods: A low flow rate through the causal map was developed, and an objective workforce demand projection from 2019 to 2040 was conducted. In addition, projections by scenarios under various situations were conducted with the low flow rate developed in the study. Lastly, the demand projection of the physician workforce by region of 17 cities and provinces was conducted. Results: First, demand of physicians in 2019 was 110,665, 113,450 in 2020, 129,496 in 2025, 146,837 in 2030, 163,719 in 2035, and 179,288 in 2040. Second, the scenario for the retirement of baby boomers led to a decrease in the growth rate due to time delay. Third, Seoul and Gyeonggi-do account for a high percentage of demand, a very high upward trend was identified in Gyeonggi-do, and as a result, the projection showed that the demand of the physician workforce in Gyeonggi-do would worsen over time. Conclusion: This study is meaningful in that rational and collective physician workforce supply and demand and its imbalance in workforce distribution were verified through various projections by scenarios and regions of Korea with System Dynamics.

• BMB Reports
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• v.55 no.6
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• pp.293-298
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• 2022

Antipsychotics have been widely accepted as a treatment of choice for psychiatric illnesses such as schizophrenia. While atypical antipsychotics such as aripiprazole are not associated with obesity and diabetes, olanzapine is still widely used based on the anticipation that it is more effective in treating severe schizophrenia than aripiprazole, despite its metabolic side effects. To address metabolic problems, metformin is widely prescribed. Hypothalamic proopiomelanocortin (POMC) neurons have been identified as the main regulator of metabolism and energy expenditure. Although the relation between POMC neurons and metabolic disorders is well established, little is known about the effects of olanzapine and metformin on hypothalamic POMC neurons. In the present study, we investigated the effect of olanzapine and metformin on the hypothalamic POMC neurons in female mice. Olanzapine administration for 5 days significantly decreased Pomc mRNA expression, POMC neuron numbers, POMC projections, and induced leptin resistance before the onset of obesity. It was also observed that coadministration of metformin with olanzapine not only increased POMC neuron numbers and projections but also improved the leptin response of POMC neurons in the olanzapine-treated female mice. These findings suggest that olanzapine-induced hypothalamic POMC neuron abnormality and leptin resistance, which can be ameliorated by metformin administration, are the possible causes of subsequent hyperphagia.

• Proceedings of the Korea Water Resources Association Conference
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• 2023.05a
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• pp.162-162
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• 2023

Climate change is a complex phenomenon having its impact on diverse sectors. Temperature and precipitation are two of the most fundamental variables used to characterize climate, and changes in these variables can have significant impacts on ecosystems, agriculture, and human societies. This study evaluated the historical (1981-2010) and future (2011-2100) climatic trends in the Seti-Gandaki basin of Nepal based on 5 km resolution Multi Model Ensemble (MME) of 18 Global Climate Models (GCMs) from the Coupled Model Intercomparison Project Phase 6 (CMIP6) for SSP1-2.6, SSP2-4.5 and SSP5-85 scenarios. For this study, ERA5 reanalysis dataset is used for historical reference dataset instead of observation dataset due to a lack of good observation data in the study area. Results show that the basin has experienced continuous warming and an increased precipitation pattern in the historical period, and this rising trend is projected to be more prominent in the future. The Seti basin hosts 13 operational hydropower projects of different sizes, with 10 more planned by the government. Consequently, the findings of this study could be leveraged to design adaptation measures for existing hydropower schemes and provide a framework for policymakers to formulate climate change policies in the region. Furthermore, the methodology employed in this research could be replicated in other parts of the country to generate precise climate projections and offer guidance to policymakers in devising sustainable development plans for sectors like irrigation and hydropower.

• Archives of Plastic Surgery
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• v.50 no.4
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• pp.340-347
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• 2023

Background Though in facial plastic surgery, the ideal nasal characteristics are defined by average European-American facial features known as neoclassical cannons, many ethnicities do not perceive these characteristics as suitable. Methods To investigate the preferences for nasofrontal angle, nasolabial angle, dorsal height, alar width, and nasal tip projection, manipulated pictures of one male and one female model were shown to 203 volunteer patients from a tertiary university hospital's facial plastic clinic. Results The most aesthetically preferred nasofrontal angles were 137.64 ± 4.20 degrees for males and 133.55 ± 4.53 degrees for females. Acute nasofrontal angles were more desirable in participants aged 25 to 44. The most preferred nasolabial angles were 107.56 ± 5.20 degrees and 98.92 ± 4.88 degrees, respectively. Volunteers aged 19 to 24 preferred more acute male nasolabial angles. A straight dorsum was the most desirable in both genders (0.03 ± 0.78 and 0.26 ± 0.75 mm, respectively). The ideal male and female alar widths were -0.51 ± 2.26 and -1.09 ± 2.18 mm, respectively. More 45- to 64-year-old volunteers preferred alar widths equal to intercanthal distance. The ideal female and male tip projections were 0.57 ± 0.01 and 0.56 ± 0.01, respectively. Conclusion Results indicate that the general Iranian patients prefer thinner female noses with wider nasofrontal angles for both genders. However, the ideal nasolabial angles, dorsal heights, and tip projections were consistent with the neoclassical cannons. Besides ethnic differences, the trend of nasal beauty is also affected by gender, age, and prior history of aesthetic surgery.

• Journal of Radiation Protection and Research
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• v.48 no.1
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• pp.9-14
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• 2023

Background: The detectors of both computed radiography (CR) and direct digital radiography (DR) have a wide dynamic range that could tolerate high values of exposure factors without an adverse effect on image quality. Therefore, this study aims to assess patient radiation dose and proposes institutional diagnostic reference levels (DRLs) for two teaching hospitals in Ghana. Materials and Methods: CR and DR systems were utilized in this study from two teaching hospitals. The CR system was manufactured by Philips Medical Systems DMC GmbH, while the DR system was manufactured by General Electric. The entrance skin doses (ESDs) were calculated using the standard equation and the tube output measurements. Free-in-air kerma (µGy) was measured using a calibrated radiation dosimeter. The proposed institutional DRLs were estimated using 75^th percentiles values of the estimated ESDs for nine radiographic projections. Results and Discussion: The calculated DRLs were 0.4, 1.6, 3.4, 0.5, 0.4, 1.1, 1.0, 1.2, and 1.7 mGy for chest posteroanterior (PA), lumbar spine anteroposterior (AP), lumbar spine lateral (LAT), cervical spine AP, cervical spine LAT, skull PA, pelvis AP, and abdomen AP, respectively in CR system. In the DR system, the values were 0.3, 1.6, 3.1, 0.4, 0.3, 0.7, 0.6, 0.9, and 1.3 for chest PA, lumbar spine AP, lumbar spine LAT, cervical spine AP, cervical spine LAT, skull PA, pelvis AP, and abdomen AP, respectively. Conclusion: Institutional DRLs in nine radiographic projections have been proposed for two teaching hospitals in Ghana for the first time. The proposed DRLs will serve as baseline data for establishing local DRLs in the hospitals and will be a valuable tool in optimizing patient doses.

• Advances in Energy Research
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• v.8 no.1
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• pp.73-93
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• 2022

Focus on climate change and extreme weather conditions has received considerable attention in recent years. Civil engineers are now focusing on designing buildings that are more eco-friendly in the face of climate change. This paper describes the research conducted to assess the impact of future climate change on energy usage and carbon emissions in a typical supermarket at multiple locations across the UK. Locations that were included in the study were London, Manchester, and Southampton. These three cities were compared against their building performance based on their respective climatic conditions. Based on the UK Climatic Projections (UKCP09), a series of energy modelling simulations which were provided by the Chartered Institute of Building Service Engineers (CIBSE) were conducted on future weather years for this investigation. This investigation ascertains and quantifies the annual energy consumption, carbon emissions, cooling, and heating demand of the selected supermarkets at the three locations under various climatic projections and emission scenarios, which further validates annual temperature rise as a result of climatic variation. The data showed a trend of increasing variations across the UK as one moves southwards, with London and Southampton at the higher side of the spectrum followed by Manchester which has the least variability amongst these three cities. This is the first study which investigates impact of the climate change on the UK supermarkets across different regions by using the real case scenarios.

• Journal of Veterinary Science
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• v.24 no.5
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• pp.49.1-49.15
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• 2023

Background: Hystricomorpha rodents display a similar placentation model to humans. The present study was carried out considering the scarcity of information concerning the placental development in agouti. Objective: Describe the microscopy of the placenta, subplacenta and yolk sac of agoutis in early pregnancy and report on the inversion of the yolk sac. Methods: Fifteen females between the 14^th-32^nd day of gestation were used following euthanasia. Gestational buttons were collected, fixed, processed, stained to optical microscopy or immunohistochemistry. Results: Chorioallantoic placenta (CP) ranged from conical to a half-sphere, as follows: from the 14^th to 17^th day, the CP displays an inverted "V" shape, predominantly formed by cytotrophoblasts; from 20 to 22 days, formed almost entirely by cytotrophoblasts; at 28 days, a half sphere, with distinct lobes and interlobular area, numerous maternal gaps delimited by syncytiotrophoblasts and trophoblast giant cells; at 32 days, globose and undergoing the maturation process. Subplacenta, located between decidua and CP, initially presents septa consisting of simple columnar epithelium and after 17 days, comprising stratified epithelium. Visceral yolk sac (VYS) is attached to two CP projections between 14 and 17 days, formed by a simple cubic epithelium and inverted. Between 20 and 22 days, the epithelium displays apical villous projections with cytoplasmic vacuoles and a vascularized mesoderm. After the 24^th day, the VYS near the placenta is pleated, very vascularized and villous, with decreased villi sizes further away from the placenta. Conclusion: The agouti CP displays similar characteristics to other hystricomorpha, including placenta lobulation, a subplacenta and an inverted vitelline placenta.

• Korean Circulation Journal
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• v.54 no.1
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• pp.1-12
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• 2024

Background and Objectives: The objective of this study was to estimate the supply and demand for cardiologists in Korea and provide evidence for healthcare policy to ensure a stable and adequate workforce for optimal cardiovascular disease management. Methods: Past trends of inflow and outflow of cardiologists were used to make crude projections, which were then adjusted based on demands of services to obtain final projections. Inflow of cardiologists was estimated using second-order polynomial regression and demand for cardiology care was estimated using linear regression. Results: There were 1,139 active cardiologists who were under the age of 65 in clinical practice in Korea. The estimated number of cardiologists from 2022 to 2040 showed that the number of cardiologists would peak at 1,344 in 2032 and gradually decrease thereafter. We also estimated an increase of 947,811 cases of heart-related procedures annually from 2023 to 2032. The number of heart-related procedures per cardiologist would increase 1.4 times from 12,964 in 2023 to 17,862 in 2032. The estimated number of emergency patients per cardiologist under 50 years old would almost double from 544 in 2022 to 987 in 2032. Conclusions: We expect significant shortage of cardiologists in Korea within the next 10 years. The number of emergency patients per cardiologist will increase by nearly 50%, leading to high individual workload for cardiologists. To prevent this imbalance between supply and demand, an organized and collective approach by the specialty of cardiology is imperative to produce a balanced workforce.