Psychometric properties of a short self-reported measure of medication adherence among patients with hypertension treated in a busy clinical setting in Korea.

BackgroundWe examined the psychometric properties of the Korean version of the 8-item Morisky Medication Adherence Scale (MMAS-8) among adults with hypertension.MethodsA total of 373 adults with hypertension were given face-to-face interviews in 2 cardiology clinics at 2 large teaching hospitals in Seoul, South Korea. Blood pressure was measured twice, and medical records were reviewed. About one-third of the participants (n = 109) were randomly selected for a 2-week test-retest evaluation of reliability via telephone interview.ResultsInternal consistency reliability was moderate (Cronbach α = 0.56), and test-retest reliability was excellent (intraclass correlation = 0.91; P < 0.001), although a ceiling effect was detected. The correlation of MMAS-8 scores with scores for the original 4-item scale indicated that convergent validity was good (r = 0.92; P < 0.01). A low MMAS-8 score was significantly associated with poor blood pressure control (χ(2) = 29.86; P < 0.001; adjusted odds ratio = 5.08; 95% CI, 2.56-10.08). Using a cut-off point of 6, sensitivity and specificity were 64.3% and 72.9%, respectively. Exploratory factor analysis identified 3 dimensions of the scale, with poor fit for the 1-dimensional construct using confirmatory factory analysis.ConclusionsThe MMAS-8 had satisfactory reliability and validity and thus might be suitable for assessment and counseling regarding medication adherence among adults with hypertension in a busy clinical setting in Korea

The impact of out of pocket payments on health care inequality: the case of national health insurance in South Korea

The global financial crisis of 2008 has led to the reinforcement of patient cost sharing in health care policy. This study aimed to explore the impact of direct out-of pocket payments (OOPs) on health care utilization and the resulting financial burden across income groups under the South Korean National Health Insurance (NHI) program with universal population coverage. We used the fourth Korean National Health and Nutrition Examination Survey (KNHNES-IV) and the Korean Household Income and Expenditure Survey (KHIES) of 2007, 2008 and 2009. The Horizontal Inequity Index (HIwv) and the average unit OOPs were used to measure income-related inequity in the quantitative and qualitative aspects of health care utilization, respectively. For financial burden, the incidence rates of catastrophic health expenditure (CHE) were compared across income groups. For outpatient and hospital visits, there was neither pro-poor or pro-rich inequality. The average unit OOPs of the poorest quintile was approximately 75% and 60% of each counterpart in the richest quintile in the outpatient and inpatient services. For the CHE threshold of 40%, the incidence rates were 5.7%, 1.67%, 0.72%, 0.33% and 0.27% in quintiles I (the poorest quintile), II, III, IV and V, respectively. Substantial OOPs under the NHI are disadvantageous, particularly for the lowest income group in terms of health care quality and financial burden

Full sequence analysis and characterization of the South Korean Norovirus GII-4 variant CUK-3

<p>Abstract</p> <p>Background</p> <p>Many of researchers have focused on the emerging pathogen, Norovirus, since its first identification as the causing agent of nonbacterial acute gastroenteritis in humans. One of the virulence factors of norovirus, the great genetic diversity attributed to point mutations and recombinations, has brought forth the result of significant changes in the circulating norovirus genotype patterns.</p> <p>Findings</p> <p>In recognition of the necessity for tracking and monitoring of genetic diversity, a norovirus variant among the most prevalent genotype GII-4, Norovirus Hu/GII-4/CUK-3/2008/KR (CUK-3), was isolated from stool samples and analyzed on the level of whole genome sequence. Whole genome sequence analysis revealed three ORF composites of the whole genome, ORF1 (5100 bp), ORF2 (1623 bp), and ORF3 (807 bp). Each genetic relationship of CUK-3 variant analysis located the ORF1 (5,100 bp) in Cluster I, ORF2 (1623 bp) in Cluster I (2006b), ORF3 (807 bp) in Cluster I, and the whole genome sequence (about 5.1 kb) in Cluster I in the phylogenetic tree. And the phylogenetic analyses showed the same location of CUK-3 strain with the GII-4/2006b cluster in the phylogenetic tree.</p> <p>Conclusions</p> <p>In This study, a first concerning the full-length sequence of a NoV variant in South Korea is meaningful in that it can be used not only as a full-length NoV variant sequence standard for future comparison studies, but also as useful material for the public health field by enabling the diagnosis, vaccine development, and prediction of new emerging variants.</p

Encoder-decoder multimodal speaker change detection

The task of speaker change detection (SCD), which detects points where speakers change in an input, is essential for several applications. Several studies solved the SCD task using audio inputs only and have shown limited performance. Recently, multimodal SCD (MMSCD) models, which utilise text modality in addition to audio, have shown improved performance. In this study, the proposed model are built upon two main proposals, a novel mechanism for modality fusion and the adoption of a encoder-decoder architecture. Different to previous MMSCD works that extract speaker embeddings from extremely short audio segments, aligned to a single word, we use a speaker embedding extracted from 1.5s. A transformer decoder layer further improves the performance of an encoder-only MMSCD model. The proposed model achieves state-of-the-art results among studies that report SCD performance and is also on par with recent work that combines SCD with automatic speech recognition via human transcription.Comment: 5 pages, accepted for presentation at INTERSPEECH 202

Optimality of minimum-error discrimination by the no-signalling condition

In this work we relate the well-known no-go theorem that two non-orthogonal (mixed) quantum states cannot be perfectly discriminated, to the general principle in physics, the no-signalling condition. In fact, we derive the minimum error in discrimination between two quantum states, using the no-signalling condition.Comment: 4 pages, 1 figur

Prospective Multi-Center Trial for the Efficacy of Ecabet Sodium on the Relief of Dyspepsia in Korean Patients with Chronic Gastritis

Anti-peptic and anti-inflammatory actions of ecabet sodium might be beneficial in either improving gastritis or relieving dyspeptic symptoms. This study was designed to evaluate the clinical efficacy of ecabet sodium on dyspeptic symptoms and to elucidate the molecular mechanism attributable to symptom relief in patients with chronic gastritis. Two hundred and sixty eight chronic gastritis patients with persistent dyspepsia received ecabet sodium 1 g b.i.d. for 2 weeks, after which dyspeptic symptoms were reassessed with a questionnaires as before. The changes of interleukin-8 (IL-8), inducible nitric oxide synthase (iNOS), prostaglandin E2 (PGE2), and vascular endothelial growth factor (VEGF) levels in gastric juices were measured by ELISA. The changes of nitrotyrosine in gastric mucosa were measured by immunohistochemical staining. The most common dyspeptic symptom in Korean patients with chronic gastritis was epigastric soreness (76.8%), which was improved significantly after ecabet sodium treatment (81.7%, p<0.001). Ecabet sodium was more effective in patients with epigastric pain than vague abdominal discomfort (p = 0.02), especially in patients with old age. Complete relief of discomfort was more highly achieved in patients with positive Helicobacter pylori than without (p = 0.01). In spite of clear tendency that the decreased levels of IL-8, iNOS, and PGE2 and increased levels of VEGF were measured in gastric juices after ecabet sodium treatment, no statistical significance was noted, which might be due to high inter-individual variations. The nitrotyrosine expressions were significantly decreased after ecabet sodium treatment than before (p<0.01). In conclusion, ecabet sodium treatment was very useful for the relief of dyspeptic symptoms in chronic gastritis, to which both attenuated inflammatory and enhanced regenerative mechanisms were contributive

Functional and anatomical alterations in bilateral vestibulopathy: A multimodal neuroimaging study and clinical correlation

ObjectTo study multimodal neuroimaging study including resting state functional MRI (rs-fMRI), anatomical connectivity and brain morphology in patients with bilateral vestibulopathy (BVP) and relationship with clinical correlation.MethodsThirteen patients with BVP (7 women; mean age ± SD = 63.5 ± 14.7 years, 22–80 years) and eighteen age and gender-matched controls were compared rs-fMRI and anatomical MRI. Also, we analyzed the relationship between multimodal neuroimaging and Dizziness Handicap Inventory score (DHI), Vestibular Disorders Activities of Daily Living Scale (VDRL), Geriatric Depression Scale (GDS) and Hospital Anxiety and Depression Scale (HADS).ResultsCompared with controls, BVP patients showed decreased functional connectivity among the key nodes of the salience network, auditory (including vestibular) network, bilateral posterior parahippocampal gyri, bilateral paracingulate gyri, and right frontoparietal network, and the anatomical connectivity in the right cerebellum, corpus callosum tapetum, and left fornix. BVP patients showed decreased gray matter volume in the bilateral parahippocampal gyri, right precentral gyrus, anterior cingulate gyrus, and right middle temporal gyrus and increased gray matter volume in the right superior frontal gyrus compared with controls. Correlation analyses showed rs-fMRI and clinical variables showed no significant result. DHI correlated negatively with anatomical connectivity in the bilateral frontal parahippocampal cingulum, corpus callosum, right inferior fronto-occipital fasciculus, bilateral fornix, and gray matter volumes in the bilateral middle occipital gyri, right superior occipital gyrus, left angular gyrus, and right cuneus in BVP. VADL correlated negatively with Anatomical connectivity in the corpus callosum, bilateral fornix, bilateral cerebellum, bilateral superior and anterior thalamic radiation, right inferior fronto-occipital fasciculus, bilateral fronto-parietal cingulum, right dentatoruburothalamic tract and gray matter volumes in the right angular gyri, bilateral parahippocampal gyri, right middle temporal gyrus, right cuneus, bilateral inferior occipital gyri, left middle occipital gyrus, right superior frontal gyrus, left fusiform gyrus, bilateral caudate, left cerebellar crus, and bilateral calcarine gyri in BVP.ConclusionsThis study identified reductions in the volume of the hippocampus and alterations in functional and anatomical connectivity that concurs with previously established characteristics of BVP. The degree of disability can be inferred from the change in the connectivity and volume between vestibular cortical areas and their network

Focal adhesion and actin organization by a cross-talk of TM4SF5 with integrin alpha 2 are regulated by serum treatment

The biological functions of transmembrane 4 L6 family member 5 (TM4SF5) homologues to a tumor-associated antigen L6 are unknown, although it is over-expressed in certain forms of cancer. In the present study, the ectopic expression of TM4SF5 in Cos7 cells reduced integrin signaling under serum-containing conditions, but increased integrin signaling upon serum-free replating on substrates. TM4SF5 regulated actin organization and focal contact dynamics via the serum treatment-dependent differential regulation of FAK Tyr925 and paxillin Tyr118 phosphorylations and their localizations on peripheral cell boundaries. Y925F FAK mutation abolished the TM4SF5 effects. TM4SF5 associated with integrin alpha 2 subunit, and this association was abolished by serum treatment. Furthermore, functional blocking anti-integrin alpha 2 antibody abolished TM4SF5-enhanced signaling activity and caused membrane blebbing with abnormal actin organization. TM4SF5 increased chemotactic but decreased haptotactic migration. Altogether, this study reveals the functions of TM4SF5 collaborative with integrin signaling to alter focal contact dynamics, actin reorganization, and migration. Furthermore, this study suggests a mechanism of cross-talk between TM4SF5 and integrin which is further regulated by growth factor signaling. (c) 2006 Elsevier Inc. All rights reserved.N