BACKGROUND/OBJECTIVES: Several previous studies have investigated whether regular walnut consumption positively changes heart-health-related parameters. The aim of this study was to investigate the effects of daily walnut intake on metabolic syndrome (MetS) status and other metabolic parameters among subjects with MetS. SUBJECTS/METHODS: This study was a two-arm, randomized, controlled crossover study with 16 weeks of each intervention (45 g of walnuts or iso-caloric white bread) with a 6 week washout period between interventions. Korean adults with MetS (n = 119) were randomly assigned to one of two sequences; 84 subjects completed the trial. At each clinic visit (at 0, 16, 22, and 38 weeks), MetS components, metabolic parameters including lipid profile, hemoglobin A1c (HbA1c), adiponectin, leptin, and apolipoprotein B, as well as anthropometric and bioimpedance data were obtained. RESULTS: Daily walnut consumption for 16 weeks improved MetS status, resulting in 28.6%-52.8% reversion rates for individual MetS components and 51.2% of participants with MetS at baseline reverted to a normal status after the walnut intervention. Significant improvements after walnut intake, compared to control intervention, in high-density lipoprotein cholesterol (HDL-C) (P = 0.028), fasting glucose (P = 0.013), HbA1c (P = 0.021), and adiponectin (P = 0.019) were observed after adjustment for gender, age, body mass index, and sequence using a linear mixed model. CONCLUSION: A dietary supplement of 45 g of walnuts for 16 weeks favorably changed MetS status by increasing the concentration of HDL-C and decreasing fasting glucose level. Furthermore, consuming walnuts on a daily basis changed HbA1c and circulating adiponectin levels among the subjects with MetS. This trial is registered at ClinicalTrials.gov as NCT03267901.
LEE, GUAN-HONG;PARK, JAE-HUN;HA, HO KYUNG;KIM, DO WAN;LEE, WOOJOO;KIM, HONGTAE;SHIN, HYUN-JUNG
The Sea:JOURNAL OF THE KOREAN SOCIETY OF OCEANOGRAPHY
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v.23
no.4
/
pp.204-217
/
2018
This study proposes a cost-effective method to monitor coastal environments using e-Navigation-implemented domestic and international ferries, and to analyze big data of records such as wind, temperature, salinity, waves, and currents that are gathered through e-Navigation system. First, we present the concept and architecture of e-Navigation operation system based on the General Information Center on Maritime Safety and Security. Then, the marine observation system that can be applied to ferries operating in our nation's territory is discussed. Analytical methods, such as spatio-temporal mixed effects model, ensemble method, and meshfree method, in handling real-time big data obtained by the e-Navigation observing system are then explained in detail. This study will support the implementation of the Korean e-Navigation project that focuses on the safety of small vessels such as coasters and fishing vessels.
Purpose: The purpose of this study is to identify trends in research on cultural competency of nursing students and nurses in Korea and to provide suggestions for future studies. Methods: A literature search was conducted with 432 papers published between 1985 and 2016 from five electronic databases and other sources using such key words as 'cultural competency', 'cultural nursing', 'multi-cultural competency', 'nursing students', 'nurses', etc. Results: The research design of 86 nursing researches on the cultural competence of nurses and nursing students analyzed in this study was 90.7% in quantitative research, 9.3% in qualitative research, and 2.3% in mixed research. Cultural competence was the most measured concept. A total of 41 papers (47.7%) out of 86 papers were used to measure cultural competence. Ten different tools were used various instruments of cultural competency were used in 41 papers. In 11 experimental studies, new methods such as role playing, case study, four stage 3D puzzle model, newspaper reading, and writing reflection note were used other than traditional method of lecture. Conclusion: The overall findings of this study suggest that future research should include more well-designed experimental studies, qualitative studies and repeated studies to confirm the effects of findings from previous studies. Development of effective and highly diverse teaching methods is recommended to increase cultural competency. Supporting systems and funding are required to help activate research of nurses.
Lee, Sang Ah;Park, Eun-Cheol;Shin, Jaeyong;Ju, Yeong Jun;Lee, Hoo-Yeon
Health Policy and Management
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v.29
no.2
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pp.237-244
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2019
Background: Weekend admission is known for having association with increased mortality attributed by poor quality of care and severe patients. We investigated the association between hospital admission on weekends and the in-hospital mortality rates of patients with cardiovascular disease. Furthermore, we examined this association stratified by admission via emergency room or not. Methods: We analyzed claim data provided by the Health Insurance Review & Assessment in 2013. In total, 80,817 cardiovascular patients were included in this study, which treated in-hospital mortality (early and during total length of stay) as a dependent variable. A generalized linear mixed effects model was used. We conducted subgroup analyses stratified by admission via emergency room or not. Results: Patients who admitted on weekend showed higher in-hospital mortality both early (odds ratio [OR], 1.48; 95% confidence interval [CI], 1.23-1.78) and during total length of stay (OR, 1.17; 95% CI, 1.02-1.33) compared to those admitted on weekdays. Patients who were admitted to the hospital on a weekend by emergency room were more likely to experience early in-hospital mortality compared to those admitted on weekdays. Furthermore, we found that patients not admitted to the hospital through the emergency department were more likely to experience both early and total length of stay in-hospital mortality. Conclusion: Our study shows higher in-hospital mortality rates for cardiovascular patients admitted on weekends. Efforts to improve the quality of care on weekend are important to mitigate the 'weekend effect' and improve patient outcomes.
Purpose: This study was conducted to develop and test the effects of a program for practice application of intravenous infusion evidence based nursing practice (EBP) guidelines in small and medium-sized hospitals. Methods: A mixed method research design was used, combining non-equivalent control group pre-post test design with qualitative study analysis. The subjects consisted of 55 nurses. The practice application program was developed based on the Advancing Research and Clinical practice through close Collaboration (ARCC) model. Data were collected for analysis in the following areas: nurses' EBP organizational culture and readiness, EBP beliefs, EBP implementation, importance about intravenous infusion, and performance about intravenous infusion, with data assessed using valid and reliable instruments. Patient outcomes were collected from the hospital's medical records. Data were analyzed using t-test, χ2-test, and Shapiro-Wilk test, with qualitative content analysis used for interview data. Results: Following the intervention, nurses' EBP organizational culture and readiness, EBP beliefs, EBP implementation, and performance of intravenous infusion and perceptions of its importance showed significant improvement in the experimental group. Phlebitis rates decreased in the experimental group compared to the control group. Conclusion: This program is effective to improve nurse's perception and practice of evidence based nursing. Therefore we recommend to use this program at same levels of hospitals.
Objective: To evaluate the trueness and precision of full-arch scans acquired using five intraoral scanners and investigate the factors associated with the dimensional accuracy of the intraoral scan data. Methods: Nine adult participants (mean age, 34.3 ± 8.3 years) were recruited. Four zirconium spheres (Ø 6 mm) were bonded to the canines and the molars. Following acquisition of reference scans using an industrial-grade scanner, five intraoral scanners, namely i500, CS3600, Trios 3, iTero, and CEREC Omnicam, were used to scan the arches. Linear distances between the four reference spheres were automatically calculated, and linear mixed model analysis was performed to compare the trueness and precision of the intraoral scan data among the different scanners. Results: The absolute mean trueness and precision values for all intraoral scanners were 76.6 ± 79.3 and 56.6 ± 52.4 ㎛, respectively. The type of scanner and the measured linear distances had significant effects on the accuracy of the intraoral scan data. With regard to trueness, errors in the intermolar dimension and the distance from the canine to the contralateral molar were greater with Omnicam than with the other scanners. With regard to precision, the error in the linear distance from the canine to the molar in the same quadrant was greater with Omnicam and CS3600 than with the other scanners. Conclusions: The dimensional accuracy of intraoral scan data may differ significantly according to the type of scanner, with the amount of error in terms of trueness being clinically significant.
Kim, Myoung-Jin;Choi, Hye-Min;Nam, Won-Hee;Kim, Se-Jin;Son, Su-Mi;Kim, Jung-Ok
Journal of Physiology & Pathology in Korean Medicine
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v.35
no.6
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pp.235-241
/
2021
Sogunjung-tang (SGJT) is traditional herbal prescriptions used to treat abdominal pain. In this study, we evaluated the effect on inflammation and gastritis through SGJT formulation development. SGJT composition herbal medicine was boiled in water at 95~100℃ for 3 hours and then concentrated. Sogunjung-tang mix soft extract (STM) was prepared using pharmaceutical excipients such as purified water, sodium benzoate, β-cyclodextrin and CMC-Na. Anti-inflammatory experiment was conducted using STM and lipopolysaccharide (LPS) in RAW 264.7 cells. Cell survival was measured by MTT method. Nitric oxide (NO) was measured using griess reagents, and pro inflammatory cytokines were measured by enzyme-linked immunosorbent assay and RT-PCR. Also, we verified STM validity in acute gastritis using the ICR mouse. STM was administered oral for three days. And 150 mM HCl in 60% ethanol was oral administered 0.5 mL one hour after the last drug administration. Mice were sacrificed 1 hour after 150 mM HCl in 60% ethanol administration. The gastric mucosa was visually observed. STM were not toxic in RAW 264.7 cells. Treatment of STM inhibited the production of NO and inflammatory cytokine at the protein and mRNA levels. Also, in the acute gastritis model with the mouse, the treatment of STM improved gastric mucosal bleeding and edema. In summary, it was confirmed that the treatment of STM exerts anti-inflammatory and anti-gastritis effects. Therefore, we suggest that STM may provide a preclinical evidence for the prevention and treatment of inflammatory and gastritis diseases.
Disks around protostars are the birthplace of planets. The first step toward planet formation is grain growth from ㎛-sized grains to mm/cm-sized grains in a disk, particularly in dense regions. In order to study whether grains grow and segregate at the protostellar stage, we investigate the ALMA Band 3 (3.1 mm) and 7 (0.87 mm) dust continuum observations of the protostellar disk WL 17 in ρ Ophiuchus L1688 cloud. As reported in a previous study, the Band 3 image shows substructures: a narrow ring and a large central hole. On the other hand, the Band 7 image shows different substructures: a non-axisymmetric ring and an off-center hole. The two-band observations provide a mean spectral index of 2.3, which suggests the presence of mm/cm-sized large grains. Its non-axisymmetric distribution may imply dust segregation between small and large grains. We perform radiative transfer modeling to examine the size and spatial distributions of dust grains in the WL 17 disk. The best-fit model suggests that large grains (>1 cm) exist in the disk, settling down toward the midplane, whereas small grains (~10 ㎛) well mixed with gas are distributed off-center and non-axisymmetrically in a thick layer. The low spectral index and the modeling results suggest that grains rapidly grow at the protostellar stage and that grains differently distribute depending on sizes, resulting in substructures varying with observed wavelengths. To understand the differential grain distributions and substructures, we discuss the effects of the protoplanet(s) expected inside the large hole and the possibility of gravitational instability.
Nearly all Koreans are insured through National Health Insurance(NHI). While NHI coverage is nearly universal, it is not complete. Coverage is largely limited to minimal level of hospital and physician expenses, and copayments are required in each case. As a result, Korea's public insurance system covers roughly 50% of overall individual health expenditures, and the remaining 50% consists of copayments for basic services, spending on services that are either not covered or poorly covered by the public system. In response to these gaps in the public system, 64% of the Korean population has supplemental private health insurance. Expansion of private health insurance raises negative externality issue. Like public financing schemes in other countries, the Korean system imposes cost-sharing on patients as a strategy for controlling utilization. Because most insurance policies reimburse patients for their out-of-pocket payments, supplemental insurance is likely to negate the impact of the policy, raising both total and public sector health spending. So far, most empirical analysis of supplemental health insurance to date has focused on the US Medigap programme. It is found that those with supplements apparently consume more health care. Two reasons for higher health care consumption by those with supplements suggest themselves. One is the moral hazard effect: by eliminating copayments and deductibles, supplements reduce the marginal price of care and induce additional consumption. The other explanation is that supplements are purchased by those who anticipate high health expenditures - adverse effect. The main issue addressed has been the separation of the moral hazard effect from the adverse selection one. The general conclusion is that the evidence on adverse selection based on observable variables is mixed. This article investigates the extent to which private supplementary insurance affect use of health care services by public health insurance enrollees, using Korean administrative data and private supplements related data collected through all relevant private insurance companies. I applied a multivariate two-part model to analyze the effects of various types of supplements on the likelihood and level of public health insurance spending and estimated marginal effects of supplements. Separate models were estimated for inpatients and outpatients in public insurance spending. The first part of the model estimated the likelihood of positive spending using probit regression, and the second part estimated the log of spending for those with positive spending. Use of a detailed information of individuals' public health insurance from administration data and of private insurance status from insurance companies made it possible to control for health status, the types of supplemental insurance owned by theses individuals, and other factors that explain spending variations across supplemental insurance categories in isolating the effects of supplemental insurance. Data from 2004 to 2006 were used, and this study found that private insurance increased the probability of a physician visit by less than 1 percent and a hospital admission by about 1 percent. However, supplemental insurance was not found to be associated with a bigger health care service utilization. Two-part models of health care utilization and expenditures showed that those without supplemental insurance had higher inpatient and outpatient expenditures than those with supplements, even after controlling for observable differences.
Radiation therapy of human tissues, including bone tissue, is accompanied by side effects on normal tissues. It has a more lethal effect on stem cells, which play an essential role in tissue regeneration, including the basal cells constituting the tissue. In this study, the mouse parietal model, which implemented an artificial osteoradionecrosis model on the parietal region of the mouse, was artificially defected and then the bone regeneration was tested. In order to overcome the implemented osteoradionecrosis, a fibrin scaffold, widely used as a biomaterial, and stromal cell-derived factor-1 (SDF-1), which is used as a long-term treatment for damaged, were mixed to verify the osteoradionecrosis regeneration effect on the parietal of mouse. In order to expect a synergistic effect in the fibrin scaffolds, a fibrin scaffolds was prepared after maintaining the concentration of SDF-1 (1 ㎍/ml) in the fibrinogen solution. In this study, after artificially creating a osteoradionecrosis model in the parietal region of mouse, fibrin scaffolds were incorporated to analyze the effect of bone regeneration within 4 weeks, the initial stage of bone regeneration. In conclusion, the combined use of these two substances did not show a dramatic regenerative effect in inducing the regeneration of osteoradionecrosis in the parietal region of mouse. However, positive results were obtained that can be maintain the bone regeneration effect environment at the initial stage. Therefore, the combined use of the fibrin scaffold and SDF-1 is considered to be a suitable candidate for the effect of overcoming osteoradionecrosis.
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