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Introduction: Since 2019, the Korean government has implemented a pilot project for integrated care to encourage healthy aging of older adults. This study investigated the changes in hospitalization rates among older adults who participated in the integrated care pilot project. Methods: Administrative survey data collected from 13 local governments and the National Health Insurance Database were used in present study. The participants comprised 17,801 older adults who participated in the pilot project between August 01, 2019 and April 30, 2022 and 68,145 matched controls. A propensity score matching method was employed to select the control group, and this study employed difference-in-differences (DID) approach to examine variations in the hospitalization rate. Results: The DID analysis revealed that the odds ratio for rates of hospitalization among older adults who participated in the pilot project was 0.88 (95% confidence interval [CI] 0.84, 0.91) in comparison to control group. In specifically, as compared to the control group, the odds ratio for hospitalization rates among the pilot project's discharged patients was 0.17 (95% CI 0.15, 0.20). Although not statistically significant, the odds ratio of older adults who utilized LTCI services was 0.93 (95% CI 0.83, 1.05), and the odds ratio of older adults who applied for LTCI but were rejected or were intensive social care was 1.09 (95% CI 0.95, 1.26) compared to the comparison group. Discussion: The findings imply that the discharged patient group had greater medical demands than the other types, and it can be claimed that this is the group that may anticipate greater efficacy while using health services. In addition, the integrated care services provided by the pilot project have the effect of reducing unnecessary hospitalization such as social hospitalization. Conclusion: Participants in the integrated care pilot project showed a lower hospitalization rate than the older adults who did not participate in the project but had similar characteristics. In particular, the admission rate of discharged patients showed a sharp decline.
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Efficient support materials are crucial for maximizing the efficacy of nanomaterials in various applications such as energy storage, drug delivery, catalysis, and environmental remediation. However, traditional supports often hinder nanomaterial performance due to their high weight ratio and limited manageability, leading to issues like tube blocking and secondary pollution. To address this, a novel grapefruit-inspired polymeric capsule (GPC) as a promising carrier platform is introduced. The millimeter-scale GPC features a hydrophilic shell and an internal hierarchical microstructure with 80% void volume, providing ample space for encapsulating diverse nanomaterials including metals, polymers, metal-organic frameworks, and silica. Through liquid-phase bottom-up methods, it is successfully loaded Fe2O3, SiO2, polyacrylic acid, and Prussian blue nanomaterials onto the GPC, achieving high mass ratio (1776, 488, 898, and 634 wt.%, respectively). The GPC shell prevents nanomaterial leakage and the influx of suspended solids, while its internal framework enhances structural stability and mass transfer rates. With long-term storage stability, high carrying capacity, and versatile applicability, the GPC significantly enhances the field applicability of nanomaterials.
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There is a growing demand for adsorption technologies for recovering and recycling precious metals (PMs) in various industries. Unfortunately, amine-functionalized polymers widely used as metal adsorbents are ineffective at recovering PMs owing to their unsatisfactory PM adsorption performance. Herein, a star-shaped, hydrazide-functionalized polymer (S-PAcH) is proposed as a readily recoverable standalone adsorbent with high PM adsorption performance. The compact chain structure of S-PAcH containing numerous hydrazide groups with strong reducibility promotes PM adsorption by enhancing PM reduction while forming large, collectable precipitates. Compared with previously reported PM adsorbents, commercial amine polymers, and reducing agents, S-PAcH exhibited significantly higher adsorption capacity, selectivity, and kinetics toward three PMs (gold, palladium, and platinum) with model, simulated, and real-world feed solutions. The superior PM recovery performance of S-PAcH was attributed to its strong reduction capability combined with its chemisorption mechanism. Moreover, PM-adsorbed S-PAcH could be refined into high-purity PMs via calcination, directly utilized (upcycled) as catalysts for dye reduction, or regenerated for reuse, demonstrating its high practical feasibility. Our proposed PM adsorbents would have a tremendous impact on various industrial sectors from the perspectives of environmental protection and sustainable development.
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Emerging micropollutants, such as pharmaceuticals and microplastics (MPs), have become a pressing water environmental concern. The aim of this study is to synthesize chitosan sponges using graphene oxide (GO) and genipin (GP) for the removal of pharmaceuticals (diclofenac (DCF) and triclosan (TCS)) and MPs, verify their adsorption mechanisms, evaluate the effects of temperature, pH, and salinity on their adsorption capacities, and determine their reusability. The GO5/CS/GP sponge exhibited a macroporous nature (porosity = 95%, density = 32.6 mg/cm3). GO and cross-linker GP enhanced the adsorption of DCF, TCS, and polystyrene (PS) MPs onto the CS sponges. The adsorption of DCF, TCS, and PS MPs involved multiple steps: surface diffusion and pore diffusion of the sponge. The adsorption isotherms demonstrated that Langmuir model was the most fitted well model to explain adsorption of TCS (qm = 7.08 mg/g) and PS MPs (qm = 7.42 mg/g) on GO5/CS/GP sponge, while Freundlich model suited for DCF adsorption (qm = 48.58 mg/g). DCF adsorption was thermodynamically spontaneous and endothermic; however, the adsorption of TCS and PS MPs was exothermic (283-313 K). The optimal pH was 5.5-7 due to the surface charge of the GO5/CS/GP sponge (pHzpc = 5.76) and ionization of DCF, TCS, and PS MPs. As the salinity increased, DCF removal efficiency drastically decreased due to the weakening of electrostatic interactions; however, TCS removal efficiency remained stable because TCS adsorption was mainly caused by hydrophobic and π-π interactions rather than electrostatic interaction. The removal of PS MPs was enhanced by the electrostatic screening effects of high Na+ ions. PS nanoplastics (average size = 26 nm) were removed by the GO5/CS/GP sponge at a rate of 73.0%, which was better than that of PS MPs (41.5%). In addition, the GO5/CS/GP sponge could be recycled over five adsorption-desorption cycles.
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Quitosano , Diclofenaco , Grafito , Iridoides , Microplásticos , Triclosán , Contaminantes Químicos del Agua , Grafito/química , Diclofenaco/química , Quitosano/química , Adsorción , Contaminantes Químicos del Agua/química , Triclosán/química , Microplásticos/química , Iridoides/química , Purificación del Agua/métodos , Concentración de Iones de HidrógenoRESUMEN
In natural environments, the fate and migratory behavior of metalloid contaminants such as antimony (Sb) significantly depend on the interfacial reactivity of mineral surfaces. Although boehmite (γ-AlOOH) is widely observed in (sub)surface environments, its underlying interaction mechanism with Sb oxyanions at the molecular scale remains unclear. Considering Sb-contaminated environmental conditions in this study, we prepared boehmite under weakly acidic conditions for use in the systematic investigation of interfacial interactions with Sb(III) and Sb(V). The as-synthesized boehmite showed a nanorod morphology and comprised four crystal facets in the following order: 48.4% (010), 27.1% (101), 15.0% (001), and 9.5% (100). The combined results of spectroscopic analyses and theoretical calculations revealed that Sb(III) formed hydrogen bonding outer-sphere complexation on the (100), (010), and (001) facets and that Sb(V) preferred to form bidentate inner-sphere complexation via mononuclear edge-sharing configuration on the (100), (001), and (101) facets and binuclear corner-sharing configuration on the (010) facet. These findings indicate that the facet-mediated thermodynamic stability of the surface complexation determines the interaction affinity toward the Sb species. This work is the first to document the contribution of boehmite to (sub)surface media, improving the ability to forecast the fate and behavior of Sb oxyanions at mineral-water interfaces.
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Electrolysis in seawater is a low-cost but difficult method of producing hydrogen. Herein, self-assembled hierarchical three-dimensional (3D) porous trimetallic palladium-iron and cobalt oxide anchored on a cheap and high surface area nickel foam (NF) (PdFeCo3-xO4/NF) were synthesized using a simple and low-cost impregnation-hydrothermal and thermal reduction strategy. The as-fabricated PdFeCo3-xO4/NF electrode showed both superhydrophilic and superaerophobic properties, which favored the fat removal of oxygen bubbles from the electrode surface owing to the close interaction between the electrode and electrolyte. Furthermore, the significant synergistic effect of trimetallics and the NF-matrix resulted in substantially enhanced oxygen evolution reaction (OER) intrinsic activity. The self-assembled PdFeCo3-xO4/NF catalyst exhibited critical low overpotentials of 300 and 340 mV to achieve an extremely large current density of 100 mA cm-2 in 1 M KOH solution and 1 M KOH seawater. Cell voltages as low as 1.44 and 1.51 V were required to drive 10 mA cm-2 in alkaline solution and seawater electrolytes for the full cell overall water splitting performance. This work suggests a promising strategy for developing next-generation electrocatalysts appropriate for natural seawater with cost-effective.
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Gongji Stream flows into Lake Uiam, a potable water source for the capital region of Chuncheon, South Korea. Algal blooms often occur downstream of the Gongji stream in combination with drastic flow rate variations. Downstream water quality may also be affected by Yaksa stream. Yaksa stream joins Gongji stream before it reaches Uiam Lake, which is a drinking water source for the city. Limited data exists on the Yaksa stream water quality. Therefore, water quality parameters (pH, electrical conductivity (EC), biological oxygen demand (BOD), total nitrogen (T-N), total phosphorous (T-P), chlorophyll-a (Chl-a), total coliforms, and Escherichia coli (E. coli) concentration) were sampled from Gongji (at sites GJ1 and GJ2) and Yaksa (at sites YS1 and YS2) streams from May to September, 2022. The results revealed the overall water quality of both streams was good (BOD = 0.27-3.66 mg/L; TP = 0.003-0.074 mg/L), except on August 3. On August 3, the concentrations of BOD, TP, total coliforms, and E. coli were elevated, with the highest concentrations in samples from GJ2. The recent heavy rainfall potentially caused sewage inflows near GJ2. The correlation analysis revealed positive linear relationships in the 1-day cumulative precipitation with BOD (r = 0.503), total coliforms (r = 0.547), and TP (r = 0.814). The Yaksa stream may be an Anabaena sp. source, which contaminated samples from YS1, YS2, and GJ2, but not at GJ1 (upstream of the tributary).
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Monitoreo del Ambiente , Calidad del Agua , Estaciones del Año , Escherichia coli , Clorofila A/análisis , Fósforo/análisisRESUMEN
The Korean government implemented the pilot project for community care for older adults in June 2019. This study investigated the outcomes of the pilot project among Korean older adults by linking survey data from the pilot project with data of Korean National Health Insurance Service. The final sample included 17,801 pilot project participants and 68,145 in a matched comparison group. Pilot program participants experienced an increase of 4.8 days for length of home stay and a reduction of $956 (US) per participant relative to the matched comparison group. Pilot program participants with long-term care insurance who used home care services experienced an increase of 8.9 days for length of home stay and a reduction in $1,177 (US) in total costs, along with a reduction in the admission to long-term care facilities, compared to the matched comparison group. Patients discharged from hospitals indicated an increase of 35.2 days for length of home stay and a reduction of $6,947 (US) in total costs, but a 3.53 times increase in hospital readmissions relative to the matched comparison group. The pilot project for community care resulted in increased length of home stay and reduced total costs among older adults in Korea.
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The accumulation of plastic debris in aquatic organisms has raised serious concerns about the potential health implications of their incorporation into the food chain. However, conventional water remediation techniques are incapable of effectively removing nanoplastics (NPs) smaller than 200 nm, which can have harmful effect on animal and human health. Herein, we demonstrate the "on-the-fly" capture of NPs through their enlargement (approximately 4,100 times) using self-propelled nanobots composed of a metal-organic framework. Under visible-light irradiation, the iron hexacyanoferrate (FeHCF) nanobot exhibits fuel-free motion by electrostatically adsorbing NPs. This strategy can contribute to reducing plastic pollution in the environment, which is a significant environmental challenge. Light-induced intervalence charge transfer in the FeHCF nanobot lattice induces bipolarity on the nanobot surface, leading to the binding of negatively charged NPs. The local electron density in the lattice then triggers self-propulsion, thereby inducing agglomeration of FeHCF@NP complexes to stabilize their metastable state. The FeHCF nanobot exhibits a maximum removal capacity of 3,060 mgâg-1 and rate constant of 0.69 min-1, which are higher than those recorded for materials reported in the literature.
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Microplásticos , Contaminantes Químicos del Agua , Animales , Humanos , Contaminantes Químicos del Agua/análisis , Luz , Contaminación Ambiental , AguaRESUMEN
Introduction: Although the risk of coronavirus disease 2019 (COVID-19) infection is higher in patients who are diagnosed with diabetes than in those who are not, research on the risk of cardiovascular disease (CVD) in COVID-19 infected patients diagnosed with diabetes compared to those who are not infected by COVID-19 is lacking. This study aimed to examine the association between COVID-19, incidence of CVD, and all-cause mortality in patients with diabetes. Methods: This study used data from the Health Insurance Review and Assessment, and included 16,779 patients with COVID-19 and 16,779 matched controls between January 2017 and June 2021. The outcomes included cardiovascular disease (CVD), coronary heart disease, stroke, and all-cause mortality. Cox proportional hazards regression models were used to evaluate these associations. Results: Patients with diabetes hospitalized because of COVID-19 had a significantly increased risk of CVD (adjusted hazard ratio [AHR], 2.12; 95% confidence interval [CI]: 1.97, 2.27) than those without COVID-19. The risks of coronary heart disease (AHR, 2.00; 95% CI: 1.85, 2.17) and stroke (AHR, 2.21; 95% CI: 1.90, 2.57) were higher in the intervention group than in the control group. In the case of all-cause mortality for middle-aged adults, we observed a higher risk in diabetes patients hospitalized due to COVID-19 than in patients without COVID-19 (AHR, 1.37; 95% CI: 1.18, 1.59). Conclusions: This study showed that patients with diabetes hospitalized due to COVID-19 had an increased risk of CVD, coronary heart disease, stroke incidence, and mortality than those who were not COVID-19 infected, suggesting more careful prevention and management among patients with COVID-19.
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COVID-19 , Enfermedades Cardiovasculares , Enfermedad Coronaria , Diabetes Mellitus , Accidente Cerebrovascular , Adulto , Persona de Mediana Edad , Humanos , Enfermedades Cardiovasculares/epidemiología , Enfermedades Cardiovasculares/etiología , Incidencia , COVID-19/complicaciones , COVID-19/epidemiología , Diabetes Mellitus/epidemiología , Accidente Cerebrovascular/complicacionesRESUMEN
INTRODUCTION: This study examined the association between smoking status and death from COVID-19. METHODS: This study used nationwide cohort data collected from the Korean National Health Insurance Service, linking to information on all individuals who tested positive for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). The smoking status of subjects who participated twice in national health screenings between 2015 and 2018 was measured. This study investigated death from COVID-19 among those who tested positive from 1 January to 30 May 2020. RESULTS: This study included 4259 patients who tested positive for SARS-CoV-2 in Korea. After adjusting for all potential confounding factors, current smokers (adjusted odds ratio, AOR=3.75; 95% CI: 1.23-11.36) and recent quitters (AOR=3.74; 95% CI: 1.12-12.53) were associated with an increased risk of death from COVID-19 compared to never smokers. Compared with current smokers, long-term quitters (AOR=0.33; 95% CI: 0.11-0.95) and never smokers (AOR=0.27; 95% CI: 0.09-0.81) were associated with a reduced risk of death from COVID-19. CONCLUSIONS: Smoking was associated with an increased risk of death among patients with COVID-19. Given the lower possibility of death in long-term quitters with COVID-19, continuous smoking cessation among smokers or recent quitters is needed.
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The development of efficient adsorbents for the practical recovery of precious metals from electronic waste is vital to advanced energy/environment industries. Ti3 C2 Tx MXene-based materials are promising adsorbents for aqueous environments; however, the highly defective and super hydrophilic nature of the MXene surface hinders its practical applications. Here, we report that nitrogen-doped MXene (N-MXene) nanosheet stacks, prepared via high-energy planetary ball milling under N2 purging, exhibited a long-term stable and excellent recovery capability for Au and Ag ions via the nitrogenation of defective vacancies. Notably, these microscale nanosheets could facilitate the sustainable production of Au and Ag from secondary sources, exhibiting a high recovery rate and capability (1198 mg g-1 for Au and 1528 mg g-1 for Ag), long-term stable storability (21 d), and high selectivity (Kd of 1.67 × 106 for Au and 2.07 × 107 for Ag). Furthermore, the reversible redox chemistry of N-MXene facilitated its repeated use in adsorption/desorption cycles.
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OBJECTIVES: Although Korea issued a law and developed benefits of National Health Insurance (NHI) to enable the provision of home-based primary care (HBPC) along with implementation of a pilot project for community care for older adults in August 2019, the outcomes of HBPC services were not surveyed in Korea. This study aimed to assess the outcomes of HBPC among older adults. DESIGN: Analyses were conducted using data from the National Health Insurance Service in connection with administrative survey data. Difference-in-differences analysis was performed using a generalized estimating equation and Cox proportional hazards model. SETTING AND PARTICIPANTS: Overall, 538 older adults who used HBPC services in a pilot project for community care and 2059 propensity score-matched older individuals who did not use HBPC services in Korea were included. METHODS: The length of home stay, total costs of NHI, hospitalizations, and admission to long-term care (LTC) facilities were measured as outcomes, and the outcomes of the participants were compared to those of the control group. RESULTS: The findings indicated an increase of 8.3 days (95% CI 2.1-14.5) in the length of home stay and a reduction of US$1241 (95% CI -2342 to -139) in total costs of NHI among older adults who used HBPC services compared to the control group. The odds ratio for rates of hospitalization among older adults who utilized HBPC services was 0.77 (95% CI 0.60-0.98) and the hazard ratio for the admission of LTC facilities was 0.12 (95% CI 0.04-0.32) in comparison to the control group. CONCLUSIONS AND IMPLICATIONS: The HBPC intervention has resulted in an increased length of home stay and reduced total costs, hospitalizations, and admission to LTC facilities among Korean older adults. In the future, new HBPC models must be developed to provide interprofessional team-based HBPC services with a standardized protocol of service provision.
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Servicios de Atención de Salud a Domicilio , Atención Primaria de Salud , Humanos , Anciano , Proyectos Piloto , Hospitalización , República de CoreaRESUMEN
Industrial wastewater typically contains both cationic and anionic heavy metals; therefore, their simultaneous removal must be considered to ensure environmental sustainability. Herein, nitrogen heteroatom (N) doped hydrochar derived from corncob was prepared via facile NH4Cl-aided hydrothermal carbonization and used for the simultaneous adsorption of divalent copper (Cu(II)) and hexavalent chromium (Cr(VI)) in aqueous solutions. During hydrothermal carbonization, NH4Cl played a vital role as the porogen and N dopant, which contributed to the efficient adsorption affinity toward coexisting Cu(II) and Cr(VI). The theoretical maximum adsorption capacities of the N-doped hydrochar were determined to be 1.223 mmol/g for Cu(II) and 1.995 mmol/g for Cr(VI), which were much better than those of the pristine hydrochar. Furthermore, in the binary-component system, the synergistic effect between Cu(II) and Cr(VI) significantly promoted the adsorption affinity of N-doped hydrochar, resulting in adsorption capacities for Cu(II) and Cr(VI) 9.48 and 1.92 times higher than those of the single-component system, respectively. A series of adsorption experiments and spectroscopic analyses demonstrated that multiple mechanisms, including electrostatic shielding, cation bridging, and redox reactions, mutually contributed to the synergistic effect in the adsorption of coexisting Cu(II) and Cr(VI). Overall, the N-doped hydrochar proved to be effective in simultaneously removing both cationic and anionic heavy metal pollutants.
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Metales Pesados , Contaminantes Químicos del Agua , Contaminantes Químicos del Agua/análisis , Cromo/química , Cationes , Agua , Adsorción , CinéticaRESUMEN
OBJECTIVES: The purposes of this study were to investigate the association between excessive alcohol consumption and control of hypertension and the associations stratified by sex, age, and duration of hypertension among Korean adults who were diagnosed with hypertension under medication. METHODS: This study was cross-sectional design with a secondary data analysis using national data from the Korea National Health and Nutrition Evaluation Survey (KNHANES) collected from 2013 to 2018, including 4278 participants who were diagnosed with hypertension under medication. A multiple logistic regression analysis was conducted to evaluate the associations between excessive alcohol consumption and hypertension control while controlling for potential confounding variables. RESULTS: The hypertensive patients who consumed excessive alcohol were more associated with uncontrolled hypertension (OR, 1.31; 95% CI, 1.04-1.65) than those who do not consumed excessive alcohol. Specially, Excessive consumption of alcohol in men and young adults (<65 years) and short duration of hypertension (<5 years) were significantly more associated with uncontrolled hypertension compared to their counterparts. DISCUSSION: To improve blood pressure (BP) control in hypertensive patients, healthcare plan should be focused to modifiable risk factors and the intervention for unhealthy alcohol consumption should be part of comprehensive treatment for hypertension.
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Hipertensión , Masculino , Adulto Joven , Humanos , Estudios Transversales , Hipertensión/complicaciones , Hipertensión/tratamiento farmacológico , Factores de Riesgo , Consumo de Bebidas Alcohólicas/efectos adversos , Presión Sanguínea/fisiología , Etanol/uso terapéuticoRESUMEN
For the in-situ remediation of the contaminated subsurface environment, the injection of nutrients and microorganisms changes chemical and physical conditions, which control the delivery and immobilization of microorganisms. We investigated the injection strategy for effective bacterial delivery in a bioaugmentation scheme by controlling ionic strength (IS) and pore-water velocity (v). A set of bacterial transport tests was conducted using the saturated sand column to mimic the saturated subsurface environment. The effectiveness of the injection strategies was evaluated by applying solutions with different ionic strengths into the sand column with different pore-water velocities. The deposition and delivery of bacteria through the sand column were analyzed using the first-order deposition model. The deposition and delivery of bacteria injected by various strategies were numerically simulated considering the variable deposition rate. The breakthrough curves from column experiments revealed that the bacterial deposition on the sand surface was increased by an increase in the ionic strength and by a decrease in the pore-water velocities. The rates of bacterial deposition (k1) on sand could be determined as a function of ionic strength and pore-water velocity, and it was applicable to simulate the delivery of bacteria under dynamic groundwater conditions. The numerical case study considering various injection strategies showed that the nutrient concentration controlled the bacterial delivery to the target area more significantly than the injection flow rate. Injection of bacterial solution with lower nutrient concentration could be increased the deposited bacterial concentration at the target point (Stp) by 6.2-7.1 times higher. Short pulse injection with a high injection rate decreased Stp by 67-78%. The efficiency of bacterial delivery (Ed) could be increased three times higher by lowering nutrient concentration in the injection solution. The process of evaluating the efficiency of bacterial delivery could be a prominent approach to determining the injection strategy for in-situ remediation considering variable conditions of a contaminated site.
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Arena , Agua , Agua/química , Concentración Osmolar , Porosidad , Dióxido de SilicioRESUMEN
Little is known about the risk of hypertension and type 2 diabetes in relation to changes in frequency and amount of alcohol consumption. This study investigated associations between changes in alcohol consumption and the risk of both conditions. This study included 96,129 individuals without hypertension and/or diabetes mellitus aged ≥ 20 years between 2006 and 2008, with follow-up until 31 December 2015. This study identified 29,043 and 18,784 incident cases of hypertension and type 2 diabetes, respectively, during an average follow-up period of 6.2 ± 2.6 and 6.9 ± 1.9 years. This study measured changes in frequency and amount of alcohol consumption using standardized self-administered questionnaires over approximately 2 years. Hazard ratio (HR) and 95% confidence interval (CI) were calculated for the respective risks of the two conditions. Repeated occasional or frequent binge drinking was associated with an increased risk of hypertension (HR: 1.16 or 1.32; 95% CI: 1.11, 1.21 or 1.16, 1.51) and type 2 diabetes (HR: 1.14 or 1.36; 95% CI: 1.09, 1.20 or 1.17, 1.58) compared with continuous nondrinking. Reductions as well as increases in frequency of alcohol consumption among binge drinkers were associated with higher hypertension (HR: 1.29 or 1.30; 95% CI: 1.11, 1.49 or 1.13, 1.49) and type 2 diabetes (HR: 1.26 or 1.56; 95% CI: 1.06, 1.49 or 1.34, 1.81) risk. This study demonstrated that repeated binge drinking, even with a reduction of weekly alcohol consumption frequency, was associated with a higher risk of hypertension and type 2 diabetes.
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Consumo Excesivo de Bebidas Alcohólicas , Diabetes Mellitus Tipo 2 , Hipertensión , Consumo de Bebidas Alcohólicas/efectos adversos , Consumo de Bebidas Alcohólicas/epidemiología , Consumo Excesivo de Bebidas Alcohólicas/complicaciones , Estudios de Cohortes , Diabetes Mellitus Tipo 2/epidemiología , Diabetes Mellitus Tipo 2/etiología , Etanol , Humanos , Hipertensión/complicaciones , Hipertensión/epidemiología , Factores de RiesgoRESUMEN
We investigated the association of changes in the frequency of moderate-to-vigorous physical activity (MVPA) and the risks of all-cause and cardiovascular disease (CVD) mortality. This study used the nationally representative National Health Insurance Service-National Sample Cohort database. We included 286,402 individuals aged ≥20 years and estimated changes in the frequency of MVPA over a two-year period. Hazard ratios (HRs) and 95% confidence intervals (CIs) were calculated using Cox proportional hazard regression models. The HRs (95% CIs) for the risk of all-cause and CVD mortality for an increased frequency of MVPA from physical inactivity compared with continual physical inactivity were 0.82 and 0.68 (0.73-0.92 and 0.51-0.91) for 1-2, 0.72 and 0.48 (0.62-0.84 and 0.31-0.74) for 3-4, and 0.73 and 0.70 (0.63-0.85 and 0.50-0.98) for ≥5 sessions of MVPA/week. The HRs (95% CIs) for the risk of all-cause and CVD mortality were 1.28 and 1.58 (1.07-1.53 and 1.01-2.46), 1.25 and 2.17 (1.01-1.57 and 1.14-4.12), and 1.43 and 1.44 (1.15-1.77 and 0.84-2.47) for changes from 1-2, 3-4, and ≥5 sessions of MVPA/week to physical inactivity, respectively. This study showed the beneficial effect of increasing physical activity, particularly for those who were physically inactive at baseline, as well as the increased risk of all-cause and CVD mortality after adapting a physically inactive lifestyle regardless of their baseline physical activity status.
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Enfermedades Cardiovasculares , Estudios de Cohortes , Ejercicio Físico , Humanos , Modelos de Riesgos Proporcionales , Conducta SedentariaRESUMEN
Although cancer patients are known to experience mental disorders and face suicide risk, little is known about the relationship between mental illness and death by suicide in this group. As such, this study aims to examine the association between mental disorders and suicide risk among cancer patients. We used nationally representative cohort data, and included newly diagnosed cancer patients from 2004 to 2012 with whom we followed-up throughout 2013. We used the clinical diagnoses of all mental disorders as an independent variable and suicide death as a dependent variable to estimate the adjusted hazard ratio (AHR) of suicide deaths in patients with cancer using a Cox proportional hazard model. Among total cancer patients (n = 36,220), the 10,567 patients with mental disorders showed higher suicide risk than non-cancer patients (AHR, 1.53; 95% confidence interval [CI], 1.07-2.17), particularly in those who experienced mental disorders prior to cancer diagnosis (AHR, 2.24; 95% CI, 1.35-3.71). Suicide risk among cancer patients who had mood disorders (AHR, 2.23, 95% CI, 1.31-3.81) or anxiety and somatoform disorders (AHR, 1.61, 95% CI, 1.02-2.55) was higher than for those without mental disorders. Suicide risk of stomach (AHR, 3.32; 95% CI, 1.36-8.10) and liver (AHR, 7.57; 95% CI, 1.86-30.72) cancer patients who had mental disorders was higher than for patients without mental disorders. Cancer patients with mental disorders are at increased risk for suicide. During follow-ups after cancer diagnosis, early mental health support needs were provided to patients with mental disorders.
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Trastornos Mentales , Neoplasias , Suicidio , Estudios de Cohortes , Humanos , Trastornos Mentales/psicología , Salud Mental , Neoplasias/epidemiología , Modelos de Riesgos Proporcionales , Factores de RiesgoRESUMEN
An intelligent robot requires episodic memory that can retrieve a sequence of events for a service task learned from past experiences to provide a proper service to a user. Various episodic memories, which can learn new tasks incrementally without forgetting the tasks learned previously, have been designed based on adaptive resonance theory (ART) networks. The conventional ART-based episodic memories, however, do not have the adaptability to the changing environments. They cannot utilize the retrieved task episode adaptively in the working environment. Moreover, if a user wants to receive multiple services of the same kind in a given situation, the user should repeatedly command multiple times. To tackle these limitations, in this article, a novel hierarchical clustering resonance network (HCRN) is proposed, which has a high clustering performance on multimodal data and can compute the semantic relations between learned clusters. Using HCRN, a semantic relation-aware episodic memory (SR-EM) is designed, which can adapt the retrieved task episode to the current working environment to carry out the task intelligently. Experimental simulations demonstrate that HCRN outperforms the conventional ART in terms of clustering performance on multimodal data. Besides, the effectiveness of the proposed SR-EM is verified through robot simulations for two scenarios.