• Physical Therapy Korea
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• v.31 no.1
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• pp.40-47
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• 2024

Background: Single-leg squat (SLS)s are commonly used as assessment tool and closed kinetic exercises are useful for assessing performance of the lower extremities. Pronated feet are associated with foot pressure distribution (FPD) during daily activities. Objects: To compare the FPD during SLSs between groups with pronated and normal feet. Methods: This cross-sectional study included 30 participants (15 each in the pronated foot and control groups) are recruited in this study. The foot posture index was used to distinguish between the pronated foot and control groups. The Zebris FDM (Zebris Medical GmbH) stance analysis system was used to measure the FPD on the dominant side during a SLS, which was divided into three phases. A two-way mixed-model ANOVA was used to identify significant differences in FPD between and within the two groups. Results: In the hallux, the results of the two-way mixed-model ANOVAs revealed a significant difference between the group and across different phases (p < 0.05). The hallux, and central forefoot were significantly different between the group (p < 0.05). Moreover, significant differences across different phases were observed in the hallux, medial forefoot, central forefoot, lateral forefoot, and rearfoot (p < 0.05). The post hoc t-tests were conducted for the hallux and forefoot central regions. In participants with pronated foot, the mean pressure was significantly greater in hallux and significantly lower, in the central forefoot during the descent and holding phases. Conclusion: SLSs are widely used as screening tests and exercises. These findings suggest that individuals with pronated feet should be cautious to avoid excessive pressure on the hallux during the descent-to-hold phase of a SLS.

• Journal of Yeungnam Medical Science
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• v.40 no.4
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• pp.381-387
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• 2023

Background: Frailty is defined as a condition of being weak and delicate, and it represents a state of high vulnerability to adverse health outcomes. Recent studies have suggested that the cingulate gyrus is associated with frailty in the elderly population. However, few imaging studies have explored the relationship between frailty and the cingulate gyrus in patients with end-stage renal disease (ESRD) undergoing hemodialysis. Methods: Eighteen right-handed patients with ESRD undergoing hemodialysis were enrolled in the study. We used the FreeSurfer software package to estimate the cortical thickness of the regions of interest, including the rostral anterior, caudal anterior, isthmus, and posterior cingulate gyri. The Beck Depression Inventory, Beck Anxiety Inventory, and laboratory tests were also conducted. Results: The cortical thickness of the right rostral anterior cingulate gyrus (ACG) was significantly correlated with the Fried frailty index, age, and creatinine level. Multiple regression analysis indicated that the cortical thickness of the right rostral ACG was associated with frailty after controlling for age and creatinine level. Conclusion: Our results indicate that the cortical thickness of the rostral ACG may be associated with frailty in patients with ESRD on hemodialysis and that the rostral ACG may play a role in the frailty mechanism of this population.

• Journal of Yeungnam Medical Science
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• v.40 no.4
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• pp.402-411
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• 2023

Background: We hypothesized that fatty liver disease (FLD) is associated with a high prevalence of hearing loss (HL) owing to metabolic disturbances. This study aimed to evaluate the association between FLD and HL in a large sample of the Korean population. Methods: We used a dataset of adults who underwent routine voluntary health checkups (n=21,316). Fatty liver index (FLI) was calculated using Bedogni's equation. The patients were divided into two groups: the non-FLD (NFLD) group (n=18,518, FLI <60) and the FLD group (n=2,798, FLI ≥60). Hearing thresholds were measured using an automatic audiometer. The average hearing threshold (AHT) was calculated as the pure-tone average at four frequencies (0.5, 1, 2, and 3 kHz). HL was defined as an AHT of >40 dB. Results: HL was observed in 1,370 (7.4%) and 238 patients (8.5%) in the NFLD and FLD groups, respectively (p=0.041). Compared with the NFLD group, the odds ratio for HL in the FLD group was 1.16 (p=0.040) and 1.46 (p<0.001) in univariate and multivariate logistic regression analyses, respectively. Linear regression analyses revealed that FLI was positively associated with AHT in both univariate and multivariate analyses. Analyses using a propensity score-matched cohort showed trends similar to those using the total cohort. Conclusion: FLD and FLI were associated with poor hearing thresholds and HL. Therefore, active monitoring of hearing impairment in patients with FLD may be helpful for early diagnosis and treatment of HL in the general population.

• Restorative Dentistry and Endodontics
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• v.49 no.1
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• pp.2.1-2.12
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• 2024

Objectives: This study aimed to determine the effects of 1-rooted mandibular second molar (MnSM) teeth on root canal anatomy complexities of the mandibular central incisor (MnCI), mandibular lateral incisor (MnLI), mandibular canine (MnCn), mandibular first premolar (MnFP), mandibular second premolar (MnSP), and mandibular first molar (MnFM) teeth. Materials and Methods: Cone-beam computed tomography images of 600 patients with full lower dentition were examined. Individuals with 1-rooted MnSMs were determined, and the complexity of root canal anatomy of other teeth was compared with individuals without 1-rooted MnSMs (Group-1; subjects with at least one 1-rooted MnSM, Group-2; subjects with more than a single root in both MnSMs). A second canal in MnCIs, MnLIs, MnCns, MnFPs, and MnSPs indicated a complicated root canal. The presence of a third root in MnFMs was recorded as complicated. Results: The prevalence of 1-rooted MnSMs was 12.2%, with the C-shaped root type being the most prevalent (9%). There were fewer complicated root canals in MnCIs (p = 0.02), MnLIs (p < 0.001), and MnFPs (p < 0.001) in Group 1. The other teeth showed no difference between the groups (p > 0.05). According to logistic regression analysis, 1-rooted right MnSMs had a negative effect on having complex canal systems of MnLIs and MnFPs. Left MnSMs were explanatory variables on left MnLIs and both MnFPs. Conclusions: In individuals with single-rooted MnSMs, a less complicated root canal system was observed in all teeth except the MnFMs.

• Korean Circulation Journal
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• v.53 no.7
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• pp.472-479
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• 2023

Background and Objectives: The association between bilirubin and atrial fibrillation (AF) has been evaluated previously in observational studies but with contradictory results. This study evaluated the causal association between serum bilirubin level and AF using Mendelian randomization (MR) analysis. Methods: This cross-sectional study includes 8,977 participants from the Dong-gu Study. In the observational analysis, multivariate logistic regression was performed to evaluate the association between bilirubin and prevalent AF. To evaluate the causal association between bilirubin and AF, MR analysis was conducted by using the UGT1A1 rs11891311 and rs4148323 polymorphisms as instrumental variables. Results: Elevated serum bilirubin levels were associated with an increased risk for AF in observational analysis (total bilirubin: odds ratio [OR], 1.31; 95% confidence interval [95% CI], 1.15-1.48 per 1 standard deviation [SD]; direct bilirubin: OR, 1.31; 95% CI, 1.18-1.46 per 1 SD), whereas the genetically predicted serum bilirubin levels in MR analysis did not show this association (total bilirubin: OR, 1.02; 95% CI, 0.67-1.53 per 1 SD; direct bilirubin: OR, 1.03; 95% CI, 0.61-1.73 per 1 SD). Conclusions: Genetically predicted bilirubin levels were not associated with prevalent AF. Thus, the observational association between serum bilirubin levels and AF may be noncausal and affected by reverse causality or unmeasured confounding.

• Clinical and Experimental Vaccine Research
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• v.12 no.3
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• pp.209-215
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• 2023

Purpose: The delay in acceptance or refusal to get vaccinated despite the availability of services is called vaccine hesitancy. The Global Polio Eradication Initiative in Pakistan faced consistent barriers preventing the eradication of the disease in the country. Similarly with the advent of the coronavirus disease 2019 (COVID-19) pandemic mass vaccination drives were initiated to a vaccine hesitant population. The aim of this study is to explore the prevalence and reasons for COVID-19 vaccine hesitancy in the Pakistani population. Materials and Methods: Cross-sectional study conducted during July to September 2021 using a snowball sampling technique targeting the adult population of Pakistan. The modified version of the vaccine hesitancy questionnaire related to the Strategic Advisory Group of Experts on Immunization Vaccine Hesitancy matrix was distributed online. Results: Out of 973 participants, 52.4% were immediately willing to take the vaccine and constituted the acceptance group whereas the remaining 47.6% who were still not sure formed the hesitant group. Support from leaders was found to be statistically significant for the difference between the hesitant and acceptance groups (p-value=0.027). Hesitant people were concerned about the effectiveness of the vaccine (60.9%) and potential side effects (57.9%) as it was not sufficiently tested prior to launch (44.7%). Age and education were significant factors affecting the acceptance of vaccination. The most trusted source of information regarding vaccination was health care workers (43.8%). Conclusion: A moderately high prevalence of vaccine hesitancy was reported in Pakistan. To overcome it, policymakers need to address the reasons for it. Leaders, celebrities, and healthcare workers can play an instrumental role in dispelling conspiracy theories regarding vaccines and making the vaccination drive a success.

• Quality Improvement in Health Care
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• v.30 no.1
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• pp.3-14
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• 2024

Purpose: We conducted this study with the aim of characterizing safety attitudes (SA) among medical staff in a disadvantaged area of Vietnam and examining associated factors with SA. Methods: A cross-sectional survey was conducted on 442 health staff members at four hospitals in Son La Province from June until August 2021. We used the Vietnamese shortened edition of the Safety Attitudes Questionnaire to measure the SA of study participations. We chose latent class analysis (LCA) to identifying the number of latent classes of SA among the study subjects. Multinomial logistic regression was used to examine factors associated with the identified SA classes. Results: The results of our LCA showed that there were three latent classes, namely high SA group (n=150, 33.9%), moderate SA group (n=236, 53.4%), and low SA group (n=56, 12.7%). The multinomial logistic regression analysis found that medical staff who had university education and above, who were nurses, and who served in non-clinical areas were more likely to be in the moderate SA group and in the high SA group than in the low SA group. Conclusion: Based on these results, several recommendations could be made to improve the SA of healthcare workers in disadvantaged areas. Further research with larger sample sizes and more diverse populations is needed to confirm these findings and to develop effective interventions to improve the SA of healthcare workers in disadvantaged areas.

• Structural Engineering and Mechanics
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• v.89 no.2
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• pp.181-197
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• 2024

A numerical method is presented in this paper, for buckling analysis of thin arbitrary stiffened composite cylindrical shells under axial compression. The stiffeners can be placed inside and outside of the shell. The shell and stiffeners are operated as discrete elements, and their interactions are taking place through the compatibility conditions along their intersecting lines. The governing equations of motion are obtained based on Koiter's theory and solved by utilizing the principle of the minimum potential energy. Then, the buckling load coefficient and the critical buckling load are computed by solving characteristic equations. In this formulation, the elastic and geometric stiffness matrices of a single curved strip of the shell and stiffeners can be located anywhere within the shell element and in any direction are provided. Moreover, five stiffened composite shell specimens are made and tested under axial compression loading. The reliability of the presented method is validated by comparing its numerical results with those of commercial software, experiments, and other published numerical results. In addition, by using the ANSYS code, a 3-D finite element model that takes the exact geometric arrangement and the properties of the stiffeners and the shell into consideration is built. Finally, the effects of Poisson's ratio, shell length-to-radius ratio, shell thickness, cross-sectional area, angle, eccentricity, torsional stiffness, numbers and geometric configuration of stiffeners on the buckling of stiffened composite shells with various end conditions are computed. The results gained can be used as a meaningful benchmark for researchers to validate their analytical and numerical methods.

• Korean Journal of Radiology
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• v.23 no.2
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• pp.237-245
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• 2022

Objective: Viscoelasticity is an essential feature of nerves, although little is known about their viscous properties. The discovery of shear wave dispersion (SWD) imaging has presented a new approach for the non-invasive evaluation of tissue viscosity. The present study investigated the feasibility of using SWD imaging to evaluate diabetic neuropathy using the sciatic nerve in a diabetic rat model. Materials and Methods: This study included 11 diabetic rats in the diabetic group and 12 healthy rats in the control group. Bilateral sciatic nerves were evaluated 3 months after treatment with streptozotocin. We measured the nerve cross-sectional area (CSA), nerve stiffness using shear wave elastography (SWE), and nerve viscosity using SWD imaging. The motor nerve conduction velocity (MNCV) was also measured. These four indicators and the histology of the sciatic nerves were then compared between the two groups. The performance of CSA, SWE, and SWD imaging in distinguishing the two groups was assessed using receiver operating characteristic (ROC) analysis. Results: Nerve CSA, stiffness, and viscosity in the diabetic group was significantly higher than those in the control group (all p < 0.05). The results also revealed a significantly lower MNCV in the diabetic group (p = 0.005). Additionally, the density of myelinated fibers was significantly lower in the diabetic group (p = 0.004). The average thickness of the myelin sheath was also lower in the diabetic group (p = 0.012). The area under the ROC curve for distinguishing the diabetic neuropathy group from the control group was 0.876 for SWD imaging, which was significantly greater than 0.677 for CSA (p = 0.030) and 0.705 for SWE (p = 0.035). Conclusion: Sciatic nerve viscosity measured using SWD imaging was significantly higher in diabetic rats. The viscosity measured using SWD imaging performed well in distinguishing the diabetic neuropathy group from the control group. Therefore, SWD imaging may be a promising method for the evaluation of diabetic neuropathy.

• Journal of Korean Society for Quality Management
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• v.52 no.1
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• pp.95-113
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• 2024

Purpose: This study focused on the societal changes associated with the entry into an ultra-aged society and the increase in single-person households. The core objective of this research is to investigate how social intelligent robots can bring about positive changes in the lives of individuals in single-person households and how such changes influence user satisfaction and the intention to use these robots. Methods: The study employed a cross-sectional analysis using a structural equation model. A survey designed to assess the impact of social intelligent robots' characteristics, such as perceived encouragement, empathy, presence, appearance, and attachment, on user satisfaction and usage intentions was conducted. Data were collected from a total of 335 users and analyzed using the structural equation model. Results: In the characteristics of social intelligent robots for single-person households, it was found that empathy, presence, and attachment significantly influenced satisfaction, while perceived encouragement, empathy, and attachment significantly influenced usage intentions. The research results indicate differences between enhancing user satisfaction and increasing the intention to use social intelligent robots. The findings suggest the essential need for a user-centric approach in the design and development of social intelligent robots. Additionally, it was observed that emotional support plays a crucial role in users' experiences with social intelligent robots. Conclusion: This study verified the impact of social intelligent robots on satisfaction and usage intentions based on users' experiences. It examined the influence of linguistic, visual, and personal characteristics of robots on user experiences, providing insights into how technological and human aspects of social intelligent robots interact to shape user satisfaction and usage intentions. Consequently, the study confirmed that social intelligent robots can bring positive changes to human life, emphasizing the necessity for the advancement of robot technology in a human-centric direction.