Search Results (5,511)

Background/Objectives: Pressure injuries are a significant concern among older adults, particularly in community-based long-term care settings where prolonged immobility is prevalent. This study aimed to identify factors influencing sacral interface pressure in community-dwelling older adults, with an emphasis on support surface usage and clinical risk indicators. Methods: A total of 210 participants aged 65 years and older, all receiving long-term care services in South Korea, were enrolled in this study. Sacral interface pressure was measured in the supine position using a portable pressure mapping device (Palm Q7). General characteristics, Braden Scale scores, Huhn Scale scores, and mattress usage were assessed. Data were analyzed using descriptive statistics, t-tests, chi-square tests, and logistic regression. Results: Mattress non-use was identified as the strongest predictor of elevated sacral interface pressure (OR = 6.71, p < 0.001), followed by Braden Scale scores indicating moderate risk (OR = 4.8, p = 0.006). Huhn Scale scores were not significantly associated with interface pressure. These results suggest that support surface quality and skin condition have a stronger impact on interface pressure than mobility-related risk factors. Conclusions: The findings highlight the importance of providing high-quality pressure-relieving mattresses and implementing standardized nursing assessments to reduce the risk of pressure injuries. Integrating smart technologies and expanding access to advanced support surfaces may aid in developing tailored preventive strategies for vulnerable older adults. Full article

Background and Objectives: Hysterectomy is a common non-obstetric procedure. Minimally invasive techniques, such as laparoscopy and robot-assisted surgery, have replaced open surgery for benign gynecologic conditions. Robotic surgery offers reduced blood loss and shorter hospital stays but is limited by high costs. Articulating laparoscopic instruments aim to replicate robotic dexterity cost-effectively. However, comparative data on these two approaches in hysterectomy are limited. Materials and Methods: This multicenter study analyzed the outcomes of hysterectomies for benign gynecological diseases using articulating laparoscopic instruments (prospectively recruited) and robot-assisted surgery (retrospectively reviewed). The surgeries were performed by minimally invasive gynecological surgeons in South Korea, Japan, and Taiwan. The baseline characteristics, operative details, and outcomes, including operative time, blood loss, complications, and hospital stay, were compared. Statistical significance was set at p < 0.05. Results: A total of 151 patients were analyzed, including 67 in the articulating laparoscopy group and 84 in the robot-assisted group. The operating times were comparable (114.9 vs. 119.9 min, p = 0.22). The articulating group primarily underwent dual-port surgery (79.1%), whereas the robot-assisted group required four or more ports in 71.4% of the cases (p < 0.001). Postoperative complications occurred in both groups, without a significant difference (9.0% vs. 3.6%, p = 0.17). No severe complications or significant differences in the 30-day readmission rates were observed. Conclusions: Articulating laparoscopic instruments provide outcomes comparable to robot-assisted surgery in hysterectomy while reducing the number of ports required. Further studies are needed to explore the learning curve and long-term impact on surgical outcomes. Full article

Background/Objectives: The expansion of National Health Insurance (NHI) coverage for dental implants in South Korea has substantially increased implant placements among older adults. While implants offer functional and esthetic benefits, their lack of periodontal ligaments alters occlusal force distribution, potentially increasing biomechanical stress on adjacent or opposing teeth. This study aimed to investigate the association between the increased number of dental implants and the incidence of cracked teeth following the introduction of implant insurance. Methods: A retrospective analysis was conducted using the Clinical Data Warehouse of Seoul St. Mary’s Dental Hospital. Patients who underwent molar crown restorations between 2014 and 2022 were included. The incidence and clinical features of cracked teeth were compared before (2014–2015) and after (2016–2022) the introduction of implant insurance. Statistical analyses assessed differences in symptom presentation, pulp status, and treatment outcomes. Results: Among 5044 molars restored with crowns, 1692 were diagnosed with cracks. The incidence of cracked teeth significantly increased after NHI coverage for implants (25.5% vs. 32.6%, p < 0.001). Cases after insurance implementation showed fewer signs and symptoms at initial presentation (67.4% vs. 50.0%, p < 0.001), reduced irreversible pulpitis (37.2% vs. 25.8%, p < 0.001), and increased preservation of pulp vitality (46.9% vs. 57.8%, p < 0.001). These shifts may reflect changes in occlusal adjustment practices and earlier clinical intervention. Conclusions: The findings suggest a temporal link between increased implant placement and the rising incidence of cracked teeth. Implant-induced occlusal changes may contribute to this trend. Careful occlusal evaluation and follow-up are essential after implant placement, and further prospective studies are warranted to confirm causality and refine prevention strategies. Full article

In South Korea, securing ground space for installing hydrogen refueling stations in urban areas is challenging due to limited ground space and high-density development. Safety concerns for hydrogen systems in enclosed urban environments also require careful consideration. To address this issue, this study explored a method of undergrounding hydrogen infrastructure as a solution for urban hydrogen charging stations. This study examined the characteristics of hydrogen diffusion and concentration reduction under leakage conditions within a confined hydrogen infrastructure, focusing on key safety systems, including emergency shut-off valves (ESVs) and ventilation fans. We discovered that the ESV reduced hydrogen concentration by over 80%. Installing two or more ventilation fans arranged horizontally improves airflow and enhances ventilation efficiency. Moreover, increasing the number of fans reduces stagnant zones within the space, effectively lowering the average hydrogen concentration. Full article

This study presents an integrated geospatial framework for assessing the risk to high-speed railway (HSR) infrastructure, combining a persistent scatterer interferometric synthetic aperture radar (PS-InSAR) analysis with multi-criteria decision-making in a geographic information system (GIS) environment. Focusing on the Honam HSR corridor in South Korea, the model incorporates both maximum ground deformation and subsidence velocity to construct a dynamic hazard index. Social vulnerability is quantified using five demographic and infrastructural indicators, and a two-stage analytic hierarchy process (AHP) is applied with dependency correction to mitigate inter-variable redundancy. The resulting high-resolution risk maps highlight spatial mismatches between geotechnical hazards and social exposure, revealing vulnerable segments in Gongju and Iksan that require prioritized maintenance and mitigation. The framework also addresses data limitations by interpolating groundwater levels and estimating train speed using spatial techniques. Designed to be scalable and transferable, this methodology offers a practical decision-support tool for infrastructure managers and policymakers aiming to enhance the resilience of linear transport systems. Full article

This study empirically evaluates the energy and carbon reduction effects of an envelope retrofit applied to an aging public building in South Korea. Unlike previous studies that primarily relied on simulation-based analyses, this work fills the empirical research gap by using actual utility billing data collected over one pre-retrofit year (2019) and two post-retrofit years (2023–2024). The retrofit included improvements to exterior walls, roofs, and windows, aiming to enhance thermal insulation and airtightness. The analysis revealed that monthly electricity consumption was reduced by 14.7% in 2023 and 8.0% in 2024 compared to that in the baseline year, with corresponding decreases in electricity costs and carbon dioxide emissions. Seasonal variations were evident: energy savings were significant in the winter due to reduced heating demand, while cooling energy use slightly increased in the summer, likely due to diminished solar heat gains resulting from improved insulation. By addressing both heating and cooling impacts, this study offers practical insights into the trade-offs of envelope retrofitting. The findings contribute to the body of knowledge by demonstrating the real-world performance of retrofit technologies and providing data-driven evidence that can inform policies and strategies for improving energy efficiency in public buildings. Full article

This paper examines the changing role of emissions trading systems (ETSs) within the macro-financial framework of energy markets, emphasizing price dynamics and systemic spillovers. Utilizing monthly data from seven ETS jurisdictions spanning January 2021 to December 2024 (N = 287 observations after log transformation and first differencing), which includes four auction-based markets (United States, Canada, United Kingdom, South Korea), two secondary markets (China, New Zealand), and a government-set fixed-price scheme (Germany), this research estimates a panel vector autoregression (PVAR) employing a Common Correlated Effects (CCE) model and augments it with machine learning analysis utilizing XGBoost and explainable AI methodologies. The PVAR-CEE reveals numerous unexpected findings related to carbon markets: ETS returns exhibit persistence with an autoregressive coefficient of −0.137 after a four-month lag, while increasing inflation results in rising ETS after the same period. Furthermore, ETSs generate spillover effects in the real economy, as elevated ETSs today forecast a 0.125-point reduction in unemployment one month later and a 0.0173 increase in inflation after two months. Impulse response analysis indicates that exogenous shocks, including Brent oil prices, policy uncertainty, and financial volatility, are swiftly assimilated by ETS pricing, with effects dissipating completely within three to eight months. XGBoost models ascertain that policy uncertainty and Brent oil prices are the most significant predictors of one-month-ahead ETSs, whereas ESG factors are relevant only beyond certain thresholds and in conditions of low policy uncertainty. These findings establish ETS markets as dynamic transmitters of macroeconomic signals, influencing energy management, labor changes, and sustainable finance under carbon pricing frameworks. Full article

As ad-supported subscription models proliferate across over-the-top (OTT) media platforms, understanding the psychological mechanisms and perceptual factors that underlie consumers’ transition decisions becomes increasingly consequential. This study integrates the Uses and Gratifications framework with a contemporary motivation-based perspective to examine how users’ media consumption motivations and advertising attitudes predict intentions to adopt ad-supported OTT plans. Data were collected via a nationally representative online survey in South Korea (N = 813). The sample included both premium subscribers (n = 708) and non-subscribers (n = 105). The findings reveal distinct segmentation in decision-making patterns. Among premium subscribers, switching intentions were predominantly driven by intrinsic motivations—particularly identity alignment with content—and by the perceived informational value of advertisements. These individuals are more likely to consider ad-supported plans when ad content is personally relevant and cognitively enriching. Conversely, non-subscribers exhibited greater sensitivity to extrinsic cues such as the entertainment value of ads and the presence of tangible incentives (e.g., discounts), suggesting a hedonic-reward orientation. By advancing a dual-pathway explanatory model, this study contributes to the theoretical discourse on digital subscription behavior and offers actionable insights for OTT service providers. The results underscore the necessity of segment-specific advertising strategies: premium subscribers may be engaged through informative and identity-consistent advertising, while non-subscribers respond more favorably to enjoyable and benefit-laden ad experiences. These insights inform platform monetization efforts amid the evolving dynamics of consumer attention and subscription fatigue. Full article

In today’s volatile supply chain environment, organizations require flexible and collaborative procurement strategies. Swap contracts, originally developed as financial instruments, have recently been adopted to address inventory imbalances—such as the 2021 COVID-19 vaccine swap between South Korea and Israel. Despite its increasing adoption in the real world, theoretical studies on swap-based procurement remain limited. This study proposes an integrated model that combines buyer-to-buyer swap agreements with long-term wholesale contracts under demand uncertainty. The model quantifies the expected swap quantity between parties and embeds it into the profit function to derive optimal order quantities. Numerical experiments are conducted to compare the performance of the proposed strategy with that of a baseline wholesale contract. Sensitivity analyses are performed on key parameters, including demand asymmetry and swap prices. The numerical analysis indicates that the swap-integrated procurement strategy consistently outperforms procurement based on long-term wholesale contracts. Moreover, the results reveal that under the swap-integrated strategy, the optimal order quantity must be adjusted—either increased or decreased—depending on the demand scale of the counterpart and the specified swap price, deviating from the optimal quantity under traditional long-term contracts. These findings highlight the potential of swap-integrated procurement strategies as practical coordination mechanisms across both private and public sectors, offering strategic value in contexts such as vaccine distribution, fresh produce, and other critical products. Full article

Background/Objectives: This study evaluated the real-world effectiveness of prophylactic Human Papillomavirus (HPV) vaccination in Korean women aged over 26 years, focusing on its impact on persistent HPV infection and disease progression. Methods: This multicenter prospective study analyzed data from the Korea HPV Cohort (2010–2021). After applying exclusion criteria, the final analytical cohort included 1,231 women aged ≥ 27 years with cytologic findings of atypical squamous cells of undetermined significance/low-grade squamous intraepithelial lesions and HPV infection. Propensity score matching was used to compare vaccinated (n = 340) and unvaccinated (n = 891) participants. After matching, 273 vaccinated and 273 unvaccinated individuals were included in the final analysis. The primary outcomes were persistent HPV infection and progression to biopsy-confirmed cervical intraepithelial neoplasia grade 2 or worse (CIN2+). Logistic and Cox regression models were employed, with additional age-stratified analyses. Results: Among women aged 27–39 years, vaccination was significantly associated with a 54% reduction in the odds of persistent HPV infection (odds ratio = 0.46; 95% CI: 0.22–0.96; p = 0.040). In the full cohort, vaccinated participants had a 62% lower risk of progression to CIN2+ compared with unvaccinated participants (hazard ratio = 0.38; 95% CI: 0.18–0.81; p = 0.011). Body mass index had a notable impact on HPV persistence in HPV 16/18 genotype groups. Conclusions: HPV vaccination effectively reduced persistent infection and progression to CIN2+ in Korean women, particularly those vaccinated before age 40. These findings support the age-extended HPV vaccination policies in South Korea. Full article

Avian influenza A viruses (IAVs) pose a persistent threat to the poultry industry, causing substantial economic losses. Although traditional vaccines have helped reduce the disease burden, they typically rely on multivalent antigens, emphasize humoral immunity, and require intensive production. This study aimed to establish a genetically matched host–cell system to evaluate antigen-specific immune responses and identify conserved CD8+ T cell epitopes in avian influenza viruses. To this end, we developed an MHC class I genotype (B21)-matched host (Lohmann VALO SPF chicken) and cell vector (DF-1 cell line) model. DF-1 cells were engineered to express the hemagglutinin (HA) gene of clade 2.3.4.4b H5N1 either transiently or stably, and to stably express the matrix 1 (M1) and nucleoprotein (NP) genes of A/chicken/South Korea/SL20/2020 (H9N2, Y280-lineage). Following prime-boost immunization with HA-expressing DF-1 cells, only live cells induced strong hemagglutination inhibition (HI) and virus-neutralizing (VN) antibody titers in haplotype-matched chickens. Importantly, immunization with DF-1 cells transiently expressing NP induced stronger IFN-γ production than those expressing M1, demonstrating the platform’s potential for differentiating antigen-specific cellular responses. CD8+ T cell epitope mapping by mass spectrometry identified one distinct MHC class I-bound peptide from each of the HA-, M1-, and NP-expressing DF-1 cell lines. Notably, the identified HA epitope was conserved in 97.6% of H5-subtype IAVs, and the NP epitope in 98.5% of pan-subtype IAVs. These findings highlight the platform’s utility for antigen dissection and rational vaccine design. While limited by MHC compatibility, this approach enables identification of naturally presented epitopes and provides insight into conserved, functionally constrained viral targets. Full article

Background/Objectives: Evidence-based nursing practice (EBNP) is essential in high-acuity settings such as intensive care units (ICUs) and emergency departments (EDs), where nurses are frequently required to make time-critical, high-stakes clinical decisions that directly influence patient safety and outcomes. Despite its recognized importance, the implementation of EBNP remains inconsistent, with frontline nurses often facing barriers to accessing and applying current evidence. Methods: This descriptive, cross-sectional study systematically mapped and prioritized clinical questions generated by ICU and ED nurses at a tertiary hospital in South Korea. Using open-ended questionnaires, 204 clinical questions were collected from 112 nurses. Each question was coded and classified according to the Nursing Interventions Classification (NIC) taxonomy (8th edition) through a structured cross-mapping methodology. Inter-rater reliability was assessed using Cohen’s kappa coefficient. Results: The majority of clinical questions (56.9%) were mapped to the Physiological: Complex domain, with infection control, ventilator management, and tissue perfusion management identified as the most frequent areas of inquiry. Patient safety was the second most common domain (21.6%). Notably, no clinical questions were mapped to the Family or Community domains, highlighting a gap in holistic and transitional care considerations. The mapping process demonstrated high inter-rater reliability (κ = 0.85, 95% CI: 0.80–0.89). Conclusions: Frontline nurses in high-acuity environments predominantly seek evidence related to complex physiological interventions and patient safety, while holistic and community-oriented care remain underrepresented in clinical inquiry. Utilizing the NIC taxonomy for systematic mapping establishes a reliable framework to identify evidence gaps and support targeted interventions in nursing practice. Regular protocol evaluation, alignment of continuing education with empirically identified priorities, and the integration of concise evidence summaries into clinical workflows are recommended to enhance EBNP implementation. Future research should expand to multicenter and interdisciplinary settings, incorporate advanced technologies such as artificial intelligence for automated mapping, and assess the long-term impact of evidence-based interventions on patient outcomes. Full article

Effective flood management in agricultural fields has become increasingly important due to the rising frequency and intensity of rainfall events driven by climate change. This study investigates the applicability of urban flood analysis models—SWMM (1D) and K-Flood (2D)—to irrigated agricultural fields with artificial drainage systems. A case study was conducted in a rural area near the Sindae drainage station in Cheongju, South Korea, using rainfall data from an extreme weather event in 2017. The models simulated inland flooding and were validated against flood trace maps provided by the Ministry of the Interior and Safety (MOIS). Receiver Operating Characteristic (ROC) analysis showed a true positive rate of 0.565, a false positive rate of 0.21, and an overall accuracy of 0.731, indicating reasonable agreement with observed inundation. Scenario analyses were also conducted to assess the effectiveness of three improvement strategies: reducing the Manning coefficient, increasing pump station capacity, and widening drainage channels. Among them, increasing pump capacity most effectively reduced flood volume, while channel widening had the greatest impact on reducing flood extent. These findings demonstrate the potential of urban flood models for application in agricultural contexts and support data-driven planning for rural flood mitigation. Full article

The sharing economy (SE) has rapidly expanded to become a key component of the global economy. However, as SE platforms evolve, a growing disconnect may exist between the value propositions companies emphasize and the values consumers actually perceive. Do the value frames communicated by SE companies align with those perceived as important by consumers, and how does this alignment differ across cultural contexts such as South Korea and the U.S.? Drawing on two complementary studies, we examine value alignment between SE companies and consumers in South Korea and the U.S. Study 1 employs content analysis of marketing messages from 246 SE platforms across five sectors, identifying the core value propositions emphasized. Study 2 applied structural topic modeling (STM) to consumer reviews from major SE platforms in both countries, focusing on three sectors: accommodation, service exchanges, and second-hand transactions. The findings reveal that SE companies in both countries primarily emphasize functional and economic values, with U.S. companies placing greater additional emphasis on emotional and social values than their South Korean counterparts. Similarly, consumers in both countries value functional, emotional, and economic aspects, showing general alignment with company marketing communications. However, South Korean consumers tended to emphasize functional and economic values more, while U.S. consumers were relatively more oriented toward emotional and social values. Notably, sustainability, widely regarded as a core principle of the SE, was not strongly emphasized by either companies or consumers. These findings contribute to the theoretical understanding of value dynamics in the SE and offer practical implications for developing culturally informed and value-driven marketing strategies. Full article

Elaeocarpus sylvestris (Lour.) Poir. var. ellipticus (Thunb.) H.Hara, an evergreen tree species native to Jeju Island, South Korea, has experienced a progressive decline associated with phytoplasma infection. This study aimed to evaluate the efficacy of oxytetracycline-based tree injection for suppressing phytoplasma and improving tree vitality. Two formulations—oxytetracycline hydrochloride (4.3%) and oxytetracycline calcium alkyltrimethyl ammonium (17%)—were administered to 40 infected individuals across two sites using a gravity-fed injection system. Treatment efficacy was evaluated based on chlorophyll content as an indicator of physiological recovery, while phytoplasma presence was assessed by PCR at 150 days after injection. The oxytetracycline hydrochloride group showed the highest suppression, with a 70% phytoplasma non-detection rate as determined by PCR analysis. Treated trees exhibited significantly higher chlorophyll content compared to untreated infected controls. These findings suggest that minimally invasive tree injection using oxytetracycline can provide temporary suppression of phytoplasma and support physiological recovery in E. sylvestris. Full article