• Korean Journal of Biological Psychiatry
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• v.28 no.1
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• pp.13-22
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• 2021

Objectives Despite growing attention to anxiety in bipolar disorder (BD), little research has assessed anxiety symptoms in the course of BD. The current prospective follow-up study examines the influence of subjectively and objectively measured anxiety symptoms on the course of BD. Methods A total of 49 patients with BD were followed-up prospectively for average of one year at an average of four months interval. The Korean version of the Beck Anxiety Inventory (K-BAI), the Hamilton Anxiety Rating Scale, heart rate variability (HRV) were used to measure anxiety subjectively, objectively and physiologically. Participants were divided into high and low anxiety groups based on their K-BAI scores. Kaplan-Meier survival analysis was performed to compare the recurrence of mood episode, suicide attempt, emergency room visit, and psychiatric hospitalization between two groups. Mediators were investigated with Cox proportional hazards models. Results Compared to the low anxiety group, the high anxiety group reported significantly higher impulsiveness (p = 0.016) and lower high frequency component on HRV (p = 0.007) after controlling for severity of BD. Regarding survival analysis, the high anxiety group showed hastened depressive episode recurrence (p = 0.048) and suicidal ideation was the mediator of the hazard ratio (HR) 1.089 (p = 0.029) in the Cox model. Moreover, the high anxiety group showed a tendency of accelerated suicide attempt (p = 0.12) and impulsivity was the risk factor of suicide attempt (HR = 1.089, p = 0.036). Conclusions This interim analysis of prospective study suggests that high anxiety level in BD may anticipate unfavorable course. Further studies are needed to understand the multifactorial mechanism of anxious bipolar patients.

• Journal of Digital Convergence
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• v.20 no.2
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• pp.463-477
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• 2022

The current study examined the mediating effect of self-efficacy (SE) in the relationship between work ability (WA) and work satisfaction (WS) perceived by reemployed workers who have experienced industrial accidents based on social cognitive career theory (SCCT), and investigated the effect of Industrial accident sequelae and workplace relationships (WR) on these variables. The data of 976 newly employed workers were selected from the data of the Panel Study of Worker's Compensation Insurance collected in 2018. The data were analyzed by Structural Equation Modeling through SPSS and AMOS programs. It was found that WA had a positive effect on WS through SE. In addition, it was found that the level of pain, the severity of the disability, and the activities of daily living had a negative effect on WS through WA and SE sequentially. Meanwhile, it was found that the WR was affected by the activities of daily living, and had a positive effect on WS through WE. These results emphasize that it is important to provide support to manage sequelae and increase SE in order to help victims of industrial accidents return to the job market and live satisfactorily. It also suggests that SCCT is useful in explaining WS of industrially injured workers.

• The Journal of The Korea Institute of Intelligent Transport Systems
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• v.21 no.5
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• pp.149-161
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• 2022

Because the speed limit affects moving speed, it is closely related to traffic accidents as well as traffic flow. The existing speed limit calculation methods consider various engineering factors such as lanes, intersection spacing, driveways, crosswalks, 85 percentile speed, land uses, and roadway geometric characteristics etc. However, it can be said that the engineering analysis is insufficient because the traffic impact analysis considering traffic volume is not carried out. In addition, only 85 percentile speed, which is the spot speed, does not reflect the characteristics of the traffic flow on the road. In this paper, the effect of the speed limit change on the moving speed and the travel speed was analyzed in detail accordinr to the variation of intersection spacing and traffic volume. And by using the results, we proposed a speed limit calculation method that maintains the same service level as before the speed limit change, thereby increasing the speed improvement effect and reducing the difference between moving speed and travel speed. In addition, a variable speed limit operation method according to the change in traffic volume was also suggested. This method is expected to be effective in terms of safety by reducing the speed difference, which affects the severity of traffic accidents, while securing the speed improvement effect, and increasing the speed limit compliance rate of drivers by operating the speed limit that reflects the speed change due to the variation of traffic volume.

• Journal of the Korean Society of Marine Environment & Safety
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• v.29 no.2
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• pp.238-247
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• 2023

Liquefied petroleum gas (LPG) is an attractive fuel for ships considering its current technology and economic viability. However, safety guidelines for LPG-fueled ships are still under development, and there have been no cases of applying LPG propulsion systems to small and medium-sized ships in Korea. The purpose of this study was to perform an objective risk assessment for the first marine LPG engine system and propose safe operational standards. First, hazard and operability (HAZOP) analysis was used to divide the engine system into five nodes, and 58 hazards were identified. To compensate for the subjectivity of qualitative evaluation using HAZOP analysis, fuzzy set theory was used, and additional risk factors, such as detectability and sensitivity, were included to compare the relative weights of the risk factors using a fuzzy analytical hierarchy process. As a result, among the five risk factors, those with a major impact on risk were determined to be the frequency and severity. Finally, the fuzzy technique for order of preference by similarity to ideal solution (TOPSIS) was applied to select the risk rank more precisely by considering the weights of the risk factors. The risk level was divided into 47 groups, and the major hazard during the operation of the engine system was found through the analysis to be gas leakage during maintenance of the LPG supply line. The technique proposed can be applied to various facilities, such as LPG supply systems, and can be utilized as a standard procedure for risk assessment in developing safety standards for LPG-powered ships.

• Journal of the Korean Society for Aeronautical & Space Sciences
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• v.50 no.4
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• pp.259-267
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• 2022

The existing method of deriving the fail-safe design requirements for the domestic developed rotary-wing aircraft system may miss the factors that cause critical system function failures, when being applied to the latest integrated avionics system. It is because the existing method analyzes the severity effect of the failures caused by a single item. To solve the issue, we present a systematic analysis procedure for deriving fail-safe design requirements of system architecture by utilizing functional hazard assessment and development assurance level analysis of SAE ARP4754A, international standard for complex system development. To demonstrate that our proposed procedure can be a solution for the aforementioned issue, we set up experimental environments that include common factors that can cause critical function failures of a system, and we conducted a cross-validation with the existing method. As a result, we showed that the proposed procedure can identify the potential critical common factors that the existing method have missed, and that the proposed procedure can derive fail-safe design requirements to control the common factors.

• The Journal of Korean Society for School & Community Health Education
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• v.24 no.1
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• pp.17-31
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• 2023

Objectives: The purpose of this study is to identify differences in fear of COVID-19 according to types of positive mental health in college students, and to verify the moderating effect of mental well-being in the relationship between mental disorders and fear of COVID-19. Methods: The results of 1,542 college students' responses to the COVID-19 Fear Scale, Korean Mental Disorder Scale, and Korean Mental Health Scale were analyzed. According to the presence of mental disorders and the level of mental well-being (high, medium, and low) of the participants which were assessed by the Korean Mental Disorder Scale and the Korean Mental Health Scale, participants were classified into five mental health groups. And the difference in fear of COVID-19 between groups was identified by one-way ANOVA. In addition, it was identified whether the moderating effect of mental well-being was significant in the relationship between mental disorders and fear of COVID-19 using hierarchical regression analysis. Results: When participants were classified by positive mental health types, the flourish group had significantly lower fear of COVID-19 than the moderate mental health group and the languishing group. The moderating effect of mental well-being was significant in the relationship between mental disorder and fear of COVID-19. Additionally, the reducing effect of mental well-being upon fear of COVID-19 was greater when the severity of mental disorder was lower. Conclusions: Basically, in the case of groups with mental disorders, efforts to reduce mental disorders should be given first and foremost. In contrast, for groups without mental disorders, psychological interventions to raise levels of mental well-being are likely to help reduce fear of COVID-19.

• Korean Journal of Culture and Social Issue
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• v.23 no.2
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• pp.215-237
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• 2017

Most research on medical accidents is related to medical disputes and malpractice of relief system. Therefore, there is a lack of research which explores the psychological experiences of patients injured by medical accidents. The purpose of this study was to investigate Post Traumatic Stress Disorder (PTSD) of patients harmed by medical accidents and to examine the moderating role of social support on the relationship between clinicians' explanation and attitude and PTSD symptoms. A total of 180 patients were drawn from a medical accident organization and online communities related to medical accidents. Results showed that 171 (95%) of the subjects experienced full PTSD symptoms and their severity of the PTSD Symptoms was as high as those who experienced other severe traumatic events. Though the main effect of clinician's explanation and attitude on PTSD symptoms was not significant, the moderating effect of social support was significant in the relationship between clinicians' explanation and attitude and PTSD symptoms. In other words, when the level of social support was low, the poorer the explanation and attitude of clinicians, the more severe the symptoms of PTSD. Drawing from these results, psychological, social, and institutional strategies were suggested to alleviate and prevent PTSD symptoms of patients injured by medical accidents. Finally, limitations of this study and suggestions for future research were discussed.

• Journal of Korean Neurosurgical Society
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• v.66 no.6
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• pp.681-689
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• 2023

Objective : Subarachnoid hemorrhage (SAH) is a condition characterized by bleeding in the subarachnoid space, often resulting from the rupture of a cerebral aneurysm. Delayed cerebral ischemia caused by vasospasm is a significant cause of mortality and morbidity in SAH patients, and inflammatory markers such as systemic inflammatory response index (SIRI), systemic inflammatory index (SII), neutrophil-to-lymphocyte ratio (NLR), and derived NLR (dNLR) have shown potential in predicting clinical vasospasm and outcomes in SAH patients. This article aims to investigate the relationship between inflammatory markers and cerebral vasospasm after aneurysmatic SAH (aSAH) and evaluate the predictive value of various indices, including SIRI, SII, NLR, and dNLR, in predicting clinical vasospasm. Methods : A retrospective analysis was performed on a cohort of 96 patients who met the inclusion criteria out of a total of 139 patients admitted Trakya University Hospital with a confirmed diagnosis of aSAH between January 2013 and December 2021. Diagnostic procedures, neurological examinations, and laboratory tests were performed to assess the patients' condition. The Student's t-test compared age variables, while the chi-square test compared categorical variables between the non-vasospasm (NVS) and vasospasm (VS) groups. Receiver operating characteristic (ROC) curve analyses were used to evaluate the diagnostic accuracy of laboratory parameters, calculating the area under the ROC curve, cut-off values, sensitivity, and specificity. A significance level of p<0.05 was considered statistically significant. Results : The study included 96 patients divided into two groups : NVS and VS. Various laboratory parameters, such as NLR, SII, and dNLR, were measured daily for 15 days, and statistically significant differences were found in NLR on 7 days, with specific cut-off values identified for each day. SII showed a significant difference on day 9, while dNLR had significant differences on days 2, 4, and 9. Graphs depicting the values of these markers for each day are provided. Conclusion : Neuroinflammatory biomarkers, when used alongside radiology and scoring scales, can aid in predicting prognosis, determining severity and treatment decisions for aSAH, and further studies with larger patient groups are needed to gain more insights.

• Pediatric Infection and Vaccine
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• v.31 no.1
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• pp.94-101
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• 2024

Purpose: Coronavirus disease 2019 (COVID-19) has posed a significant burden to infant and toddler's care globally, while the disease severity is generally mild in this age group. In this study, we aimed to assess epidemiological and clinical aspects of COVID-19 in infants and toddlers in Seoul, South Korea. Methods: We used Seoul Metropolitan Government's epidemiological investigation database to describe the epidemiological and clinical characteristics of COVID-19 in infants and toddlers, between March 2020 to December 2021. Results: A total of 5,025 infants and toddlers aged <5 years was diagnosed between the observed period. 2,720 (54.1%) had symptoms, and fever was the most common symptom in 1,941 (74.1%). Of the diagnosed cases, 96.4% did not have underlying diseases. In a district level, extended opening of childcare facility was associated with increased risk of COVID-19 in infants and toddlers. Conclusions: An efficient monitoring system, resembling routine clinical care, is crucial, considering the low rates of severe progression and fatality among infants and toddlers. Moreover, a well-grounded intervention based on scientific evidence, rather than unconditional closures, is necessary to establish a suitable childcare policy that ensures safety from infectious diseases while not overlooking the developmental aspects of social skills.

• Korean Journal of Radiology
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• v.23 no.4
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• pp.389-401
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• 2022

Objective: This study aimed to determine a factor for predicting suboptimal image quality of the hepatobiliary phase (HBP) of gadoxetic acid-enhanced MRI in patients with extrahepatic bile duct (EHD) cancer before MRI examination. Materials and Methods: We retrospectively evaluated 259 patients (mean age ± standard deviation: 68.0 ± 8.3 years; 162 male and 97 female) with EHD cancer who underwent gadoxetic acid-enhanced MRI between 2011 and 2017. Patients were divided into a primary analysis set (n = 184) and a validation set (n = 75) based on the diagnosis date of January 2014. Two reviewers assigned the functional liver imaging score (FLIS) to reflect the HBP image quality. The FLIS consists of the sum of three HBP features, each scored on a 0-2 scale: liver parenchymal enhancement, biliary excretion, and signal intensity of the portal vein. Patients were classified into low-FLIS (0-3) or high-FLIS (4-6) groups. Multivariable analysis was performed to determine a predictor of low FLIS using serum biochemical and imaging parameters of cholestasis severity. The optimal cutoff value for predicting low FLIS was obtained using receiver operating characteristic analysis, and validation was performed. Results: Of the 259 patients, 140 (54.0%) and 119 (46.0%) were classified into the low-FLIS and high-FLIS groups, respectively. In the primary analysis set, total bilirubin was an independent factor associated with low FLIS (adjusted odds ratio per 1-mg/dL increase, 1.62; 95% confidence interval [CI], 1.32-1.98). The optimal cutoff value of total bilirubin for predicting low FLIS was 2.1 mg/dL with a sensitivity of 95.1% (95% CI: 88.9-98.4) and a specificity of 89.0% (95% CI: 80.2-94.9). In the validation set, the total bilirubin cutoff showed a sensitivity of 92.1% (95% CI: 78.6-98.3) and a specificity of 83.8% (95% CI: 68.0-93.8). Conclusion: Serum total bilirubin before acquisition of gadoxetic acid-enhanced MRI may help predict suboptimal HBP image quality in patients with EHD cancer.