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  • 1
    Online Resource
    Online Resource
    Comparison of Dose Distribution in Regional Lymph Nodes in Whole-Breast Radiotherapy vs. Whole-Breast Plus Regional Lymph Node Irradiation: An In Silico Planning Study in Participating Institutions of the Phase III Randomized Trial (KROG 1701)
    MDPI AG ; 2020
    In:  Cancers Vol. 12, No. 11 ( 2020-11-04), p. 3261-
    Details
    In: Cancers, MDPI AG, Vol. 12, No. 11 ( 2020-11-04), p. 3261-
    Abstract: The purpose of the current in silico planning study is to compare radiation doses of whole-breast irradiation (WBI) and whole-breast plus regional lymph node irradiation (WBI+RNI) administered to the regional lymph nodes (RLN) in pN1 breast cancer. Twenty-four participating institutions were asked to create plans of WBI and WBI+RNI for two dummy cases. To compare target coverage between the participants, an isodose line equal to 90% of the prescribed dose was converted to an isodose contour (contour90% iso). The relative nodal dose (RND) was obtained using the ratio of RLN dose to the target dose. The Fleiss’s kappa values which represent inter-observer agreement of contour90% iso were over 0.68. For RNI, 6 institutions included axillary lymph node (ALN), supraclavicular lymph node (SCN), and internal mammary lymph node (IMN), while 18 hospitals included only ALN and SCN. The median RND between the WBI and WBI+RNI were as follows: 0.64 vs. 1.05 (ALN level I), 0.27 vs. 1.08 (ALN level II), 0.02 vs. 1.12 (ALN level III), 0.01 vs. 1.12 (SCN), and 0.54 vs. 0.82 (IMN). In all nodal regions, the RND was significantly lower in WBI than in WBI+RNI (p 〈 0.01). In this study, we could identify the nodal dose difference between WBI and WBI+RNI.
    Type of Medium: Online Resource
    ISSN: 2072-6694
    URL: Article
    DOI: 10.3390/cancers12113261
    Language: English
    Publisher: MDPI AG
    Publication Date: 2020
    detail.hit.zdb_id: 2527080-1
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  • 2
    Online Resource
    Online Resource
    Factors Controlling the Spatial Distribution and Temporal Trend of Nationwide Groundwater Quality in Korea
    MDPI AG ; 2020
    In:  Sustainability Vol. 12, No. 23 ( 2020-11-28), p. 9971-
    Details
    In: Sustainability, MDPI AG, Vol. 12, No. 23 ( 2020-11-28), p. 9971-
    Abstract: Factors controlling the spatial distribution and temporal trend of groundwater quality at a national scale are important to investigate for sustaining livelihood and ecological balance. This study evaluated groundwater quality data for 12 parameters (n = 6405 for each parameter), collected from 97 groundwater monitoring stations (=289 monitoring wells) for ten years. Spatial distribution of groundwater quality parameters varied through the regional scale. Six parameters: T, EC, Ca2+, Mg2+, HCO3−, and Cl− were having dominant increasing trend, remaining pH, Eh, Na+, K+, SO42−, and NO3− showed a dominant decreasing trend over time. Among land use types, the upland fields had the highest mean of groundwater NO3− (22.2 mg/L), confirming plenty of application of fertilizers (5–10 kg/a more than standard) to upland fields. Means of groundwater Cl− and Na+ (705.3 and 298.4 mg/L, respectively) in the residential areas are greater than those in other land use types by 408–685.9, 154.3–274.2 mg/L, respectively. Agricultural activities were the main controlling factor of groundwater NO3− contamination in rural areas, domestic activities were responsible for groundwater Cl− and Na+ in urban areas, and seawater intrusion was controlling groundwater Cl− in coastal areas (within 10 km from sea). Groundwater hydrochemistry was controlled by the mechanism of geogenic rock and evaporation dominance. The rock dominance mechanism indicated that groundwater was interacting with rocks and resulted in groundwater chemistry. The findings of this study showed that groundwater was mainly contaminated by anthropogenic factors in some rural and residential areas. Effective measures by government authorities are needed to improve the groundwater quality.
    Type of Medium: Online Resource
    ISSN: 2071-1050
    URL: Article
    DOI: 10.3390/su12239971
    Language: English
    Publisher: MDPI AG
    Publication Date: 2020
    detail.hit.zdb_id: 2518383-7
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  • 3
    Online Resource
    Online Resource
    Lessons Learned from an Experience with Vancomycin-Intermediate Staphylococcus aureus Outbreak in a Newly Built Secondary Hospital in Korea
    MDPI AG ; 2021
    In:  Pathogens Vol. 10, No. 5 ( 2021-05-06), p. 564-
    Details
    In: Pathogens, MDPI AG, Vol. 10, No. 5 ( 2021-05-06), p. 564-
    Abstract: A vancomycin-intermediate Staphylococcus aureus (VISA) outbreak occurred in an intensive care unit (ICU) in South Korea. We aimed to investigate the condition that led to the VISA outbreak and seek measures to prevent further spread of the multidrug-resistant organism. A total of three VISA isolates were obtained from two patients and a health care worker (HCW) in a newly built 450-bed secondary hospital. Extensive screening of close contacts for VISA in terms of space sharing and physical contact, irrespective of contact time, was performed. Furthermore, multilocus sequence type, staphylococcal cassette chromosome mec type, and spa type profiles were determined for all VISA isolates. The relationship between vancomycin use and the minimum inhibitory concentration (MIC) of S. aureus was also investigated. Molecular typing showed that the strains of the three VISA isolates were identical, indicating horizontal hospital transmission. We assumed that VISA colonised in the HCW could have transmitted to the two patients, which resulted in one infection and one colonisation. The affected HCW was excused from work and was decolonised with mupirocin. Five weeks after the interventions, no additional VISA isolates were identified. No relationship between vancomycin use and MIC of S. aureus was identified. Extensive screening of contacts in addition to decolonisation is crucial in preventing the further spread of VISA.
    Type of Medium: Online Resource
    ISSN: 2076-0817
    URL: Article
    DOI: 10.3390/pathogens10050564
    Language: English
    Publisher: MDPI AG
    Publication Date: 2021
    detail.hit.zdb_id: 2695572-6
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  • 4
    Online Resource
    Online Resource
    Countrywide Groundwater Quality Trend and Suitability for Use in Key Sectors of Korea
    MDPI AG ; 2020
    In:  Water Vol. 12, No. 4 ( 2020-04-22), p. 1193-
    Details
    In: Water, MDPI AG, Vol. 12, No. 4 ( 2020-04-22), p. 1193-
    Abstract: Under changing climate, increasing groundwater use has risen the concern for groundwater quality variations over recent years, to maintain a healthy ecosystem. The objectives were to identify trend of temporal variations in groundwater quality and its suitability for different uses in Republic of Korea. Water quality data were collected from 198 monitoring stations of Groundwater Quality Monitoring Network (GQMN), annually for the period of ten years (2008–2017). Non-parametric trend analysis of a Mann–Kendall test and Theil–Sen’s slope was done on groundwater physico-chemical data of ten years. Groundwater suitability evaluation was done for use in main sectors including domestic (drinking) and agriculture (irrigation). For drinking suitability analysis, results were compared with World Health Organization (WHO) and Korean Ministry of Environment (KME) established guidelines. For irrigation suitability evaluation, electrical conductivity (EC), Sodium Adsorption Ratio (SAR), percent of Na+, Residual Sodium Carbonate (RSC), US Salinity Laboratory (USSL), and Wilcox diagram were used. Most significantly, water type belongs to Ca-HCO3 and Ca-SO4 types, but a small proportion belongs to Na-CO3 and Na-Cl types. Approximately, 96% and 93% of groundwater samples are suitable for drinking, based on WHO and KME guidelines, respectively. Around 98% and 83% of groundwater samples are in suitable range for irrigation use, based on USSL and Wilcox diagrams, respectively.
    Type of Medium: Online Resource
    ISSN: 2073-4441
    URL: Article
    DOI: 10.3390/w12041193
    Language: English
    Publisher: MDPI AG
    Publication Date: 2020
    detail.hit.zdb_id: 2521238-2
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  • 5
    Online Resource
    Online Resource
    Development of Prediction Models for Acute Myocardial Infarction at Prehospital Stage with Machine Learning Based on a Nationwide Database
    MDPI AG ; 2022
    In:  Journal of Cardiovascular Development and Disease Vol. 9, No. 12 ( 2022-12-02), p. 430-
    Details
    In: Journal of Cardiovascular Development and Disease, MDPI AG, Vol. 9, No. 12 ( 2022-12-02), p. 430-
    Abstract: Models for predicting acute myocardial infarction (AMI) at the prehospital stage were developed and their efficacy compared, based on variables identified from a nationwide systematic emergency medical service (EMS) registry using conventional statistical methods and machine learning algorithms. Patients in the EMS cardiovascular registry aged 〉 15 years who were transferred from the public EMS to emergency departments in Korea from January 2016 to December 2018 were enrolled. Two datasets were constructed according to the hierarchical structure of the registry. A total of 184,577 patients (Dataset 1) were included in the final analysis. Among them, 72,439 patients (Dataset 2) were suspected to have AMI at prehospital stage. Between the models derived using the conventional logistic regression method, the B-type model incorporated AMI-specific variables from the A-type model and exhibited a superior discriminative ability (p = 0.02). The models that used extreme gradient boosting and a multilayer perceptron yielded a higher predictive performance than the conventional logistic regression-based models for analyses that used both datasets. Each machine learning algorithm yielded different classification lists of the 10 most important features. Therefore, prediction models that use nationwide prehospital data and are developed with appropriate structures can improve the identification of patients who require timely AMI management.
    Type of Medium: Online Resource
    ISSN: 2308-3425
    URL: Article
    DOI: 10.3390/jcdd9120430
    Language: English
    Publisher: MDPI AG
    Publication Date: 2022
    detail.hit.zdb_id: 2777082-5
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  • 6
    Online Resource
    Online Resource
    Video Capsule Endoscopy Optimal Timing in Overt Obscure Gastrointestinal Bleeding
    MDPI AG ; 2022
    In:  Diagnostics Vol. 12, No. 1 ( 2022-01-09), p. 154-
    Details
    In: Diagnostics, MDPI AG, Vol. 12, No. 1 ( 2022-01-09), p. 154-
    Abstract: Video capsule endoscopy (VCE) has become the noninvasive diagnostic standard in the investigation of overt obscure gastrointestinal bleeding (OGIB), with a high positive and negative predictive value. However, the diagnostic yield of the VCE is thought to depend on when it was performed. We evaluate the optimal timing performing VCE relative to overt OGIB to improve the diagnostic yield. A total 271 patients had admitted and underwent VCE for overt OGIB between 2007 and 2016 in Samsung Medical Center, Seoul, Korea. To evaluate the diagnostic yield of VCE for overt OGIB with respect to timing of the intervention, diagnostic yield was analyzed according to the times after latest bleeding. The finding of VCE was classified into P0 or P1 (no potential for bleeding or uncertain hemorrhagic potential) and P2 (high potential for bleeding, such as active bleeding, typical angiodysplasia, large ulcerations or tumors). The P2 lesion was found in 106 patients and diagnostic yield of was 39.1% for overt OGIB. Diagnostic yield of VCE to detect P2 lesion was higher when it is performed closer to the time of latest bleeding (timing of VCE between the VCE and latest bleeding: 〈 24 h, 43/63 (68.3%); 1 days, 16/43 (34.9%); 2 days, 18/52 (34.6%); 3 days, 13/43 (30.2%); 4 days, 7/28 (25.0%); 5–7 days, 6/24 (25.0%), and ≥8 days, 4/18 (22.2%); ptrend 〈 0.001). The interval between the VCE and latest bleeding were categorized into 〈 24 h (n = 63), 1–2 days (n = 95), 3–7 days (n = 95) and ≥8 days (n = 18). Multivariable analyses showed the odds ratio for P2 lesion detection was 4.99 (95% confidence interval, 1.47–16.89) in 〈 24 h group, compared with ≥8 days group (p 〈 0.010). The overall re-bleeding rate for those with P2 lesion was higher than for those with P0 or P1 lesion at the end of mean follow up of 2.5 years. The proportion of patients who underwent therapeutic intervention including surgery, endoscopic intervention and embolization was higher when VCE is performed closer to the time of latest bleeding (p = 0.010). Early deployment of VCE within 24 h of the latest GI bleeding results in a higher diagnostic yield for patients with overt OGIB and consequently resulted in a higher therapeutic intervention rate
    Type of Medium: Online Resource
    ISSN: 2075-4418
    URL: Article
    DOI: 10.3390/diagnostics12010154
    Language: English
    Publisher: MDPI AG
    Publication Date: 2022
    detail.hit.zdb_id: 2662336-5
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  • 7
    Online Resource
    Online Resource
    The Effects of Group Art Therapy on the Primary Family Caregivers of Hospitalized Patients with Brain Injuries in South Korea
    MDPI AG ; 2021
    In:  International Journal of Environmental Research and Public Health Vol. 18, No. 9 ( 2021-05-09), p. 5000-
    Details
    In: International Journal of Environmental Research and Public Health, MDPI AG, Vol. 18, No. 9 ( 2021-05-09), p. 5000-
    Abstract: This study examined the effects of group art therapy on depression, burden, and self-efficacy in primary family caregivers of patients with brain injuries. This was a quasi-experimental, nonequivalent control group and a pre- and post-test design. This study was carried out in one national rehabilitation hospital targeting 41 primary family caregivers of patients with brain injuries. Group art therapy intervention was carried out three days per week comprising 12 sessions over four consecutive weeks. The experimental group (n = 20) received group art therapy, whereas the control group (n = 21) did not. We used a time difference method to minimize the risk of contaminating the control group by sampling sequentially. For depression, although there was a significant difference after the intervention (t = 3.296, p = 0.004), the mean difference score was not statistically significant between the experimental group and the control group (t = 0.861, p = 0.395). The experimental group showed a significantly greater decrease in burden (t = 2.462, p = 0.020) and significantly greater improvement in self-efficacy (t = −6.270, p 〈 0.001) than the control group. Group art therapy may be an effective nursing intervention for primary family caregivers of patients with brain injuries.
    Type of Medium: Online Resource
    ISSN: 1660-4601
    URL: Article
    DOI: 10.3390/ijerph18095000
    Language: English
    Publisher: MDPI AG
    Publication Date: 2021
    detail.hit.zdb_id: 2175195-X
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  • 8
    Online Resource
    Online Resource
    Analysis of Major Bacteria and Diversity of Surface Soil to Discover Biomarkers Related to Soil Health
    MDPI AG ; 2022
    In:  Toxics Vol. 10, No. 3 ( 2022-03-01), p. 117-
    Details
    In: Toxics, MDPI AG, Vol. 10, No. 3 ( 2022-03-01), p. 117-
    Abstract: The discovery of biomarkers for assessing soil health requires the exploration of organisms that can explain the core functions of soil and identification of species with major roles in these functions. However, identifying specific keystone markers within the soil microbiota is challenging. Next-generation sequencing (NGS)-based molecular-biological methods have revealed information on soil biodiversity; however, whether this biodiversity is related to soil health remains unclear. In this study, we performed NGS on grassland surface soil to compare the prokaryotic and eukaryotic genetic diversity to determine the chemical soil quality and examined markers associated with soil health. Microorganisms associated with the nitrogen cycle, bioremediation, plant pathogenicity, antibiotic production, and material degradation showed potential for use as markers. To propose a framework for soil health assessment, we not only used traditional indicators, such as chemical and physical measures, but also assessed metagenomics data of soil by land use to identify the major factors influencing the microbial structure in soil. Moreover, major keystone species were identified. Furthermore, the microbial genetic diversity of generally healthy surface soil, such as forests, farmland, and parks, was determined. These findings provide basic data for exploring soil health-related biomarkers.
    Type of Medium: Online Resource
    ISSN: 2305-6304
    URL: Article
    DOI: 10.3390/toxics10030117
    Language: English
    Publisher: MDPI AG
    Publication Date: 2022
    detail.hit.zdb_id: 2733883-6
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  • 9
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    Online Resource
    Impact of Media Coverage on Influenza Vaccine Coverage in Elderly Individuals from 2020 to 2021 in the Republic of Korea
    MDPI AG ; 2021
    In:  Vaccines Vol. 9, No. 4 ( 2021-04-10), p. 367-
    Details
    In: Vaccines, MDPI AG, Vol. 9, No. 4 ( 2021-04-10), p. 367-
    Abstract: Increased awareness of adverse events following immunization (AEFI) can disrupt vaccination programs. In South Korea, a report of alleged influenza vaccine-related deaths attracted significant media attention in 2020. We retrieved the vaccination coverage and AEFI data to determine their association with media coverage. Between 2015 and 2019, the vaccination coverage rate ranged between 80.5% and 83.3%; however, the vaccination coverage rate declined significantly from 2020 to 2021 to 73.6% (p 〈 0.0001). During the 43rd week of 2020, following a large amount of media coverage on vaccine safety issues, the number of cases with AEFI reached 60. Between 2015 and 2020, the mortality rate ratios for influenza vaccines and non-vaccines ranged between 0.1296 (95% confidence interval (CI), 0.1262–0.1331, p 〈 0.0001) and 0.1608 (95% CI, 0.1572–0.1644, p 〈 0.0001). Vaccine safety surveillance should be continued in conjunction with investigation and transparent risk communication to maintain public trust in vaccines and vaccinations.
    Type of Medium: Online Resource
    ISSN: 2076-393X
    URL: Article
    DOI: 10.3390/vaccines9040367
    Language: English
    Publisher: MDPI AG
    Publication Date: 2021
    detail.hit.zdb_id: 2703319-3
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  • 10
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    Online Resource
    Age-Standardized Breast Cancer Detection Rates of Breast Cancer Screening Program by Age Group in Korea; Comparison with Age-Standardized Incidence Rates from the Korea Central Cancer Registry
    MDPI AG ; 2020
    In:  Healthcare Vol. 8, No. 2 ( 2020-05-11), p. 132-
    Details
    In: Healthcare, MDPI AG, Vol. 8, No. 2 ( 2020-05-11), p. 132-
    Abstract: To compare the epidemiological characteristics of a breast cancer screening program of patients between 40–69 years of age and ≥70 years of age, we calculated the age-standardized detection rate of the breast cancer screening program and compared it with the age-standardized incidence rate from the Korea Central Cancer Registry. The data of the breast cancer screening program from January 2009 to December 2016 and the data of the health insurance claims from January 2006 to August 2017 were used. In the 40–69 year age group, the age-standardized detection rate of breast cancer increased annually from 106.1 in 2009 to 158.6 in 2015 and did not differ from the age-standardized incidence rate. In the ≥70 year age group, the age-standardized detection rate of breast cancer increased annually from 65.7 in 2009 to 120.3 in 2015 and was 1.9 to 2.7 fold of the age-standardized incidence rate. It shows that the early detection effect of breast cancer screening was greater for patients over 70 years old. Further studies are needed to evaluate the effect of breast cancer detection in the ≥70 year age group on all-cause mortality or breast cancer mortality.
    Type of Medium: Online Resource
    ISSN: 2227-9032
    URL: Article
    DOI: 10.3390/healthcare8020132
    Language: English
    Publisher: MDPI AG
    Publication Date: 2020
    detail.hit.zdb_id: 2721009-1
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