Specialist Perception of Severe Asthma in Korea: A Questionnaire Survey

The Working Group on Severe Asthma of the Korean Academy of Allergy and Clinical Immunology recently published an expert opinion paper on the management of severe asthma in Korea. When developing a consensus, the working group encountered several diagnostic and treatment issues and decided to perform a questionnaire survey of Korean specialists with regard to severe asthma. An e-mail with a uniform resource locator link to the questionnaire was sent to 121 asthma specialists, of whom 44.6% responded. The most commonly accepted definitions of severe asthma were a history of fatal exacerbation or an asthma-triggered need for mechanical ventilation, 3-4 oral corticosteroid (OCS) bursts/year, and maintenance of OCS therapy for 3-6 months per year. Before diagnosing severe asthma, most physicians contemplate chest computed tomography, seek to control chronic rhinosinusitis, and consider poor inhaler compliance. For patients with uncontrolled severe asthma accompanied by type 2 (T2)-high inflammation, most biologics available in Korea were considered appropriate, but gaps were apparent in terms of T2-low asthma treatments. These findings about specialist perception of diagnosis and treatment of severe asthma will inform the use of emerging new drugs and facilitate personalized therapy.ope

Evaluation and Management of Difficult-to-Treat and Severe Asthma: An Expert Opinion From the Korean Academy of Asthma, Allergy and Clinical Immunology, the Working Group on Severe Asthma

Severe asthma (SA) presents in about 3%-5% of adult asthmatics and is responsible for over 60% of asthma-related medical expenses, posing a heavy socioeconomic burden. However, to date, a precise definition of or clear diagnostic criteria for SA have not been established, and therefore, it has been challenging for clinicians to diagnose and treat this disease. Currently, novel biologics targeting several molecules, such as immunoglobulin E, interleukin (IL)5, and IL4/IL13, have emerged, and many new drugs are under development. These have brought a paradigm shift in understanding the mechanism of SA and have also provided new treatment options. However, we need to agree on a precise definition of and its diagnostic criteria for SA. Additionally, it is necessary to explain the diagnostic criteria and to summarize current standard and additional treatment options. This review is an experts' opinion on SA from the Korean Academy of Asthma, Allergy, and Clinical Immunology, the Working Group on Severe Asthma, and aims to provide a definition of and diagnostic criteria for SA, and propose future direction for SA diagnosis and management in Korea.ope

Functional Encryption을 이용한 프라이버시 보호 온라인 타겟 광고 시스템

학위논문(석사) -- 서울대학교대학원 : 공과대학 컴퓨터공학부, 2023. 2. 권태경.As interest in protecting user privacy began to surge, the online advertising industry, a multi-billion market, is also facing the same challenge. Currently, online ads are delivered through real-time bidding (RTB) and behavioral targeting of users. This is done by tracking users across websites to infer their interests and preferences and then used when selecting ads to present to the user. The user profile sent in the ad request contains data that infringes on user privacy and is delivered to various RTB ecosystem actors, not to mention the data stored by the bidders to increase their performance and profitability. I propose a framework named FAdE to preserve user privacy while enabling behavioral targeting and supporting the current RTB ecosystem by introducing minimal changes in the protocols and data structure. My design leverages the functional encryption (FE) scheme to preserve the user's privacy in behavioral targeted advertising. Specifically, I introduce a trusted third party (TTP) who is the key generator in my FE scheme. The user's profile originally used for behavioral targeting is now encrypted and cannot be decrypted by the participants of the RTB ecosystem. However, the demand-side platforms (DSPs) can submit their functions to the TTP and receive function keys. This function derives a metric, a user score, based on the user profile that can be used in their bidding algorithm. Decrypting the encrypted user profiles with the function keys results in the function's output with the user profile as its input. As a result, the user's privacy is preserved within the RTB ecosystem, while DSPs can still submit their bids through behavioral targeting. My evaluation showed that when using a user profile bit vector of length 2,000, it took less than 20ms to decrypt the encrypted user profile and derive the user score metric through the inner-product function. This is much smaller than my criteria of 50ms, which is based on the typical bidding timeframe (100–1,000ms) used in the ad industry. Moreover, my result is smaller than the state-of-the-art privacy-preserving proposals using homomorphic encryption or multi-party computations. To demonstrate the potential for real-world deployment., I build a prototype implementation of my design that consists of a publisher's website, an ad exchange (ADX), the DSP, and the TTP.최근 사용자 개인 정보 보호에 대한 관심이 급증하면서 수십억 규모의 시장인 온라인 광고 산업도 같은 문제에 직면해 있다. 현재의 온라인 광고는 Real-time Bidding (RTB)과 사용자 타깃 광고 (targeted advertising)로 대표된다. 이는 웹사이트에서 사용자의 정보를 바탕으로 관심과 선호도를 추정하고 이를 이용해 사용자에게 표시할 적절한 광고를 입찰, 선택하는 방식이다. 광고 요청을 위해 전송되는 user profile에는 사용자의 개인 정보를 침해하는 데이터가 포함되어 있으며, RTB 생태계의 여러 참여자에게 있는 그대로 전달되는 문제점이 있다. 본 연구는 사용자의 개인 정보를 보호하는 동시에 기존의 프로토콜 및 데이터 구조에는 최소한의 변경을 도입함으로써 현재의 RTB 생태계에서 계속해서 타깃 광고가 가능하도록 지원하는 FAdE를 제안한다. 제안하는 디자인은 Functional Encryption (FE)과 그 key 생성자인 Trusted Third Party (TTP)의 도입을 통해 개인정보 보호가 가능한 타깃 광고를 제공한다. 본 디자인에서는, 기존 타깃 광고를 위해 사용되던 user profile을 암호화(encrypt)하여 전달하므로 다른 RTB 환경의 참여자가 해독(decrypt)할 수 없다. Demand Side Platform (DSP)은 광고 요청에 대한 입찰 여부와 입찰가격을 결정하기 위해 암호화된 유저 데이터(encrypted user data, ciphertext)를 사용한다. DSP는 사전에 사용자의 점수를 연산하기 위한 function을 작성하고 이를 TTP에 제출하여 function key를 획득한다. 이 function key를 이용해 암호화된 유저 데이터를 해독(decrypt) 하면 DSP의 내부 입찰 알고리즘에 메트릭(metric)으로 활용할 수 있는 user score를 얻게 되고 이를 입찰 결정에 활용하게 된다. 결과적으로 RTB 환경 내에서 사용자의 개인정보는 보호하면서 DSP는 사용자의 숨겨진 정보를 기반으로 타깃 광고 입찰에 참여할 수 있다. 마지막으로, FAdE 디자인의 실제 활용 가능성에 대한 분석을 진행한다. user profile은 충분한 길이로 확인된 2,000 길이의 0과 1로 이루어진 벡터 (bit vector) 형태로 생성한다. 이 user profile vector를 FE로 암호화(encrypt)한 후, weight vector에 해당하는 임의의 function과 벡터 내적(Inner product) 연산에 소요되는 시간을 측정하였을 때, user score를 도출하는 데 20ms 미만이 소요되는 것을 확인한다. 이는 광고 업계에서 일반적으로 사용되는 입찰 제한 시간(100-1,000ms)을 바탕으로 정의한 본 연구의 자체 기준 50ms 보다 충분히 작은 값에 해당한다. 이 결과는 동형 암호화(Homomorphic Encryption) 또는 Multi-Party Computation(MPC) 등을 사용하는 온라인 광고에서의 다른 개인정보 보호 제안보다 성능 상의 이점을 갖는다. 또한 제안 디자인을 활용해 타깃광고가 실제로 가능함을 확인하기 위해 Publisher 웹사이트, Ad Exchange(ADX), 3개의 DSP 그리고 TTP로 구성된 제안 디자인의 프로토타입 구현을 제시한다. 본 연구에서 제안된 FAdE를 통해 사용자의 개인 정보는 보호하면서 기존과 같은 수준의 타깃 광고가 가능하고, 이를 수용 가능한 수준의 적은 오버헤드로 적용이 가능하였음을 확인하였다. 연구의 결과가 향후 실제 온라인 광고 생태계에서 사용자의 프라이버시 보호에 기여할 수 있을 것으로 기대한다.Chapter 1 Introduction 1 Chapter 2 Background 5 2.1 Online Advertising 5 2.1.1 RTB Ecosystem 6 2.1.2 OpenRTB 8 2.2 Functional Encryption 9 2.2.1 Overview of FE 10 2.2.2 Difference between FE and FHE 11 2.2.3 Information Leakage in Functional Encryption 12 2.2.4 Inner Product Functional Encryption (IPFE) 13 Chapter 3 Design 14 3.1 The approach to preserving privacy 15 3.1.1 Encrypted user profile using FE 15 3.2 Setup phase 18 3.2.1 TTP 18 3.2.2 User Browser 18 3.2.3 DSP 19 3.3 Bidding Phase 20 3.3.1 Browser (User) 21 3.3.2 DSP 21 Chapter 4 Evaluation 24 4.1 Criteria 24 4.1.1 Time 24 4.1.2 File size 25 4.2 Environment 26 4.2.1 Testbed 26 4.2.2 FE Library 26 4.3 Result 26 4.3.1 FAdE design 26 4.3.2 Extra test 30 4.4 Prototyping 33 Chapter 5 Related work 36 Chapter 6 Conculsion 40 Appendix A 48 A.1 Bid Request Sample (OpenRTB 2.5) 48 A.2 Functional Encryption Algorithm 50 국문초록 53석

Characteristics of Adult Severe Refractory Asthma in Korea Analyzed From the Severe Asthma Registry

Purpose: Although mild to moderate asthma is much more common, the morbidity and mortality of severe asthma are much higher. This study was performed to identify and analyze the clinical characteristics of severe asthma in Korea. Methods: We registered patients with severe refractory asthma into the Severe Asthma Registry supported by the Severe Asthma Work Group of the Korean Academy of Asthma, Allergy and Clinical Immunology. Patients were enrolled since 2010 from the 15 university hospitals nationwide in Korea. Severe asthma was defined according to modified European Respiratory Society/American Thoracic Society criteria. Information on demographics, medical history, pulmonary function tests and skin prick tests was collected; the clinical characteristics of severe asthmatics were analyzed from the collected data. Results: A total of 489 patients were enrolled with a mean age of 62.3; 45% are male. Sixty percent of patients received Global Initiative for Asthma step 4 treatment, and 30% received step 5 treatment. The most common comorbidities were allergic rhinitis (58.7%). Aspirin hypersensitivity was observed in 14.0%. Approximately half (53.9%) are non-smokers. Atopy was proven in 38.5% of the patients. Regarding asthma medications, inhaled corticosteroids and long-acting β-agonist combination inhalers were most commonly prescribed (96.5%), followed by leukotriene antagonists (71.0%). A recombinant anti-immunoglobulin E monoclonal antibody (omalizumab) has been used in 1.8% of the patients. The mean forced vital capacity (FVC), forced expiratory volume in 1 second (FEV1) and FEV1/FVC were 78.7%, 67.5% and 67.9% of predicted values, respectively. The mean Asthma Control Test and quality of life questionnaire scores were 16.5 out of 25 and 59.5 out of 85, respectively. Conclusions: The baseline characteristics of severe asthma patients in the Korea Severe Asthma Registry were analyzed and reported for the first time. With this cohort, further prospective studies should be performed to search for ways to improve management of severe refractory asthma.ope

Impact of Chronic Urticaria on the Self-Assessed Health Status

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Learning from Korean Smart City Programs

학위논문 (석사) -- 서울대학교 대학원 : 공학전문대학원 응용공학과, 2021. 2. 김성우Young Hoon Kwak박창우지석호.South Korea has a long history of the planning, development, and management of smart cities to integrate emerging technological advances into complex physical infrastructure. However, a long-term successful smart city model has yet to be introduced. This study explores lessons learned from smart city programs in South Korea to better understand the challenges and opportunities of future sustainable smart city innovation and development. This research was guided by a research question: What are the essential characteristics of a successful sustainable smart city beyond technology adaptation and implementation? To define this research question, this research conducted a comprehensive review and qualitative analysis of South Koreas smart city programs and conceptualized a sustainable smart city framework that will assist policymakers, planners, citizens, and other key stakeholders. To do so, firstly, this research interweaves megaproject and smart city literature reviews. One of author's previous research discussed smart cities have similar characteristics to megaprojects [1]. Secondly, media articles collected to identify key factors during the execution of smart city programs. The key factors validated with multi-source evidence. Lastly, framework was developed by mean of comprehensive case analysis on Korea smart city programs and literature reviews. The findings of this research answer our research question. First, the Smart City Master Planner and Project Governance Board are key to the success of smart cities. Second, regulatory innovation can revolutionize smart city services. Third, it is critical to provide services that reflect the ideas and demands of citizens rather than to provide a service in a packaged form that often fails in action. This research proposed Governance, Policy, and Services (GPS) as the three pillars of a successful smart city framework, in addition to integrating physical and cyber infrastructures. The study argues that a smart city should function as a service platform that incubates and delivers long-term services to citizens and society. This study also emphasizes that a strong groundwork of the GPS framework will lead to the successful adaptation of innovative technologies and ideas for future smart city programs.본 연구는 스마트시티 건설의 주요 요소를 파악하기 위해 다음의 연구질문으로 연구를 시작한다. 기술적용과 구현을 넘어 성공적이고 지속가능한 스마트시티 건설을 위한 주요 특성은 무엇인가? 연구질문을 정의하기 위해 한국 스마트시티 프로그램에 대한 포괄적인 검토 및 질적연구를 수행하였으며, 확인한 주요특성을 반영하여 프레임워크를 제시하였다. 프레임워크를 설계하기 위해 첫째, 스마트시티와 메가프로젝트 관련문헌을 검토하였다. 저자의 과거 연구에서 스마트시티와 메가프로젝트에 유사한 특성이 있다는 것을 확인했으며 [1], 이 연구에서도 메가프로젝트관련 문헌조사를 활용하였다. 둘째, 한국의 오랜 스마트시티 프로그램 실행 과정에서의 핵심 이슈를 파악하기 위해 관련기사를 수집하여 분석하였으며, 여기서 확인한 주요 요소를 다양한 소스의 데이터를 활용하여 검증하였다. 마지막으로 한국 스마트시티 프로그램의 사례를 종합적으로 분석하여 프레임워크를 개발하였다. 개발한 프레임 워크는 지속가능한 스마트시티 건설을 위해 정책 결정자, 기획자, 기타 주요 이해 관계자가 활용할 수 있다. 연구질문에 대한 결과는 다음과 같다. 첫째, 다양한 기술과 정보를 통합관리하기 위해서 마스터플래너와 프로젝트 거버넌스위원회를 운영해야 한다. 둘째, 규제 혁신은 스마트시티에 혁신적인 서비스를 제공할 수 있게 한다. 셋째, 지속가능한 스마트시티 서비스를 위해서 일괄된 서비스를 제공하는 것보다 도시와 시민의 요구를 반영하고 수익을 창출할 수 있는 서비스를 제공하는 것이 중요하다. 이 연구결과에 대한 대안으로 물리적 인프라와 신기술의 디지털 인프라를 통합하는 것 외에도 성공적인 스마트 시티 건설을 위한 프레임 워크의 세 가지 요소로 거버넌스, 정책, 서비스(GPS)를 제안했으며, 이를 통해 스마트 시티가 시민과 사회를 위한 새로운 서비스를 제공하는 인큐베이팅 플랫폼으서 기능해야 한다고 도출하였다. 본 연구가 지속가능하면서도 혁신적인 스마트시티 건설의 거시적 관점과 이해에 기여할 것으로 기대한다.I. Introduction 1 1.1 Background 1 1.2 Purpose of Research 4 1.3 Research Structure 5 II. Literature Review 6 2.1 Characteristics of Smart Cities 6 2.2 Characteristics of Megaprojects 13 2.3 Review of Smart City Frameworks 17 III. Research Methodology 19 3.1 Case Study Approach 19 3.2 Data Collection 21 IV. Three Generations of Koreas Smart City Program 23 4.1 Overview 23 4.2 First Generation (2009 ∼ 2013) 29 4.3 Second Generation (2014 ∼ 2018) 32 4.4 Third Generation (2019 ∼) 33 V. GPS (Governance, Policy, and Services) Smart City Framework 39 5.1 Introduction of the GPS Smart City Framework 39 5.2 Discussion on Smart City Governance 41 5.3 Discussion on Smart City Policy 45 5.4 Discussion on Smart City Services 48 VI. Conclusion 53 6.1 Summary and Conclusions 53 6.2 Limitation & Future Research Direction 56 6.3 The Future of Sustainable Smart Cities 57 Abstract 61 Bibliography 63Maste

Laminin α1 is a genetic modifier of TGF-β1-stimulated pulmonary fibrosis

The pathogenetic mechanisms underlying the pathologic fibrosis in diseases such as idiopathic pulmonary fibrosis (IPF) are poorly understood. To identify genetic factors affecting susceptibility to IPF, we analyzed a murine genetic model of IPF in which a profibrotic cytokine (TGF-β1) was expressed in the lungs of 10 different inbred mouse strains. Surprisingly, the extent of TGF-β1-induced lung fibrosis was highly strain dependent. Haplotype-based computational genetic analysis and gene expression profiling of lung tissue obtained from fibrosis-susceptible and -resistant strains identified laminin α1 (Lama1) as a genetic modifier for susceptibility to IPF. Subsequent studies demonstrated that Lama1 plays an important role in multiple processes that affect the pulmonary response to lung injury and susceptibility to fibrosis, which include: macrophage activation, fibroblast proliferation, myofibroblast transformation, and the production of extracellular matrix. Also, Lama1 mRNA expression was significantly increased in lung tissue obtained from IPF patients. These studies identify Lama1 as the genetic modifier of TGF-β1 effector responses that significantly affects the development of pulmonary fibrosis.ope

Biologic agents for asthma treatment

Most treatment strategies for asthma currently include inhaled corticosteroids, with the addition of long-acting beta-2-agonists or leukotriene modifiers, if necessary. However, some patients may not respond to conventional treatment. A better understanding of the pathophysiology of asthma has recently led to the development of biological agents, which have shown promising results for symptom control and future risk reduction in severe asthmatics. This article reviews currently available biologic agents, introduces related studies, and describes the subgroup of patients benefitting from each of biologic agents in the view point of precision medicine.ope

Chronic idiopathic urticaria and antithyroid autoantibodies

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Management of Allergic Patients During the COVID-19 Pandemic in Asia

Although a viral infection is a major triggering factor of asthma and allergic diseases, asthma is suggested to be not a predisposing condition for coronavirus disease 2019 (COVID-19) infection. However, patients with severe asthma/allergic disease requiring systemic corticosteroids or immunosuppressive agents may be at higher risk of more severe clinical course of this infectious disease. For allergic patients who have been followed up at an allergy clinic in our region, it is recommended that they (patients with asthma, rhinitis, atopic dermatitis or chronic urticaria) continue to receive maintenance therapy and be in a well-controlled status. Patients who have used biologics (currently available for targeting type 2 inflammation) and allergen immunotherapy should continue the treatment while minimizing hospital and face-to-face visits. It is essential to wear protective equipment for the protection of health care workers as well as patients. We report this consensus to support allergists and clinical immunologists to make optimal decisions under the urgent situation in Asia.ope