BackgroundAlthough the Life-Sustaining Treatment (LST) Decision Act was enforced in 2018 in Korea, data on whether it is well established in actual clinical settings are limited. Hospital-acquired pneumonia (HAP) is a common nosocomial infection with high mortality. However, there are limited data on the end-of-life (EOL) decision of patients with HAP. Therefore, we aimed to examine clinical characteristics and outcomes according to the EOL decision for patients with HAP.MethodsThis multicenter study enrolled patients with HAP at 16 referral hospitals retrospectively from (...) January to December 2019. EOL decisions included do-not-resuscitate (DNR), withholding of LST, and withdrawal of LST. Descriptive and Kaplan–Meier curve analyses for survival were performed.ResultsOf 1,131 patients with HAP, 283 deceased patients with EOL decisions (105 cases of DNR, 108 cases of withholding of LST, and 70 cases of withdrawal of LST) were analyzed. The median age was 74 (IQR 63–81) years. The prevalence of solid malignant tumors was high (32.4% vs. 46.3% vs. 54.3%, P = 0.011), and the ICU admission rate was lower (42.9% vs. 35.2% vs. 24.3%, P = 0.042) in the withdrawal group. The prevalence of multidrug-resistant pathogens, impaired consciousness, and cough was significantly lower in the withdrawal group. Kaplan–Meier curve analysis revealed that 30-day and 60-day survival rates were higher in the withdrawal group than in the DNR and withholding groups (log-rank P = 0.021 and 0.018). The survival of the withdrawal group was markedly decreased after 40 days; thus, the withdrawal decision was made around this time. Among patients aged below 80 years, the rates of EOL decisions were not different (P = 0.430); however, mong patients aged over 80 years, the rate of withdrawal was significantly lower than that of DNR and withholding (P = 0.001).ConclusionsAfter the LST Decision Act was enforced in Korea, a DNR order was still common in EOL decisions. Baseline characteristics and outcomes were similar between the DNR and withholding groups; however, differences were observed in the withdrawal group. Withdrawal decisions seemed to be made at the late stage of dying. Therefore, advance care planning for patients with HAP is needed. (shrink)

미래 한국의 기초는 신뢰, 도덕적 원칙, 개인적 자율, 상호주의, 공평성이라는 도덕적 패러다임을 중심으로 구축되어야 한다고 이야기 한다. 이를 위해서 이 책에 참여한 사회학자들은 일상생활에서 우리가 규범을 따르는 이류하는 아주 간단한 원리에서부터 기업경영의 성패, 패륜적 범죄, 여성문제에서의 도덕, 과학윤리, 시민문화, 시장경제에서의 도덕성까지 사회 전반의 문제를 매우 현실적 사례와 함께 다루고 있다. 그리고 사회를 이해하는 핵심 코드가 바로 도덕이며, 미래 한국사회의 경쟁력도 도덕이 제공할 수 있다고 역설한다.

Since the Korean Philosophy of Education Society was established in 1964, the question regarding the nature of Philosophy of Education as a modern discipline has always been a vexing question to mo...

Alternative splicing is a well‐characterized mechanism by which multiple transcripts are generated from a single mRNA precursor. By allowing production of several protein isoforms from one pre‐mRNA, alternative splicing contributes to proteomic diversity. But what do we know about the origin of this mechanism? Do the same evolutionary forces apply to alternatively and constitutively splice exons? Do similar forces act on all types of alternative splicing? Are the products generated by alternative splicing functional? Why is “improper” recognition of exons and (...) introns allowed by the splicing machinery? In this review, we summarize the current knowledge regarding these issues from an evolutionary perspective. BioEssays 30:38–47, 2008. © 2007 Wiley Periodicals, Inc. (shrink)

This paper examines Alfred Schutz’s insights on types and typification. Beginning with a brief overview of the history and meaning of typification in interpretive sociology, the paper further addresses both the ubiquity and the necessity of typification in social life and scientific method. Schutz’s contribution itself is lacking in empirical application and grounding, but examples are provided of ongoing empirical research which advances the understanding of types and typification. As is suggested by illustrations from scholarship in the social studies of (...) social science, studies of social identity associated with membership categorization analysis, and constructionist social problems theory, typification can be found to be central to social research whether it is taken up as a largely unacknowledged resource or whether it is addressed by different names. The overview and illustrations suggest the continuing, widespread, and indeed foundational relevance of Schutz’s insights into types and typification. (shrink)

An incoherent feed‐forward loop (FFL) is one of the most‐frequently observed motifs in biomolecular regulatory networks. It has been thought that the incoherent FFL is designed simply to induce a transient response shaped by a ‘fast activation and delayed inhibition’. We find that the dynamics of various incoherent FFLs can be further classified into two types: time‐dependent biphasic responses and dose‐dependent biphasic responses. Why do the structurally identical incoherent FFLs play such different dynamical roles? Through computational studies, we show that (...) the dynamics of the two types of incoherent FFLs are mutually exclusive. Following from further computational results and experimental observations, we hypothesize that incoherent FFLs have been optimally designed to achieve distinct biological function arising from different cellular contexts. Additional Supporting Information may be found in the online version of the article. BioEssays 30:1204–1211, 2008. © 2008 Wiley Periodicals, Inc. (shrink)

원로.중견 학자 및 종교인 9인이 젊은이들에게 주는 철학적 사색의 글들이다.

Through a wide-ranging international collection of papers, this volume provides theoretical and historical insights into the development and application of phenomenological sociology and ethnomethodology and offers detailed examples of research into social phenomena from these standpoints. All the articles in this volume join together to testify to the enormous efficacy and potential of both phenomenological sociology and ethnomethodology.

Cancer chemotherapy has been the most common cancer treatment. However, it has side effects that kill both tumor cells and immune cells, which can ravage the patient’s immune system. Chemotherapy should be administered depending on the patient’s immunity as well as the level of cancer cells. Thus, we need to design an efficient treatment protocol. In this work, we study a feedback control problem of tumor-immune system to design an optimal chemotherapy strategy. For this, we first propose a mathematical model (...) of tumor-immune interactions and conduct stability analysis of two equilibria. Next, the feedback control is found by solving the Hamilton–Jacobi–Bellman equation. Here, we use an upwind finite-difference method for a numerical approximate solution of the HJB equation. Numerical simulations show that the feedback control can help determine the treatment protocol of chemotherapy for tumor and immune cells depending on the side effects. (shrink)

Cover Photograph: Resolving developmental genetics in the fourth dimension: an illustration (by Kwang‐Hyun Cho himself) of the principle of dynamic network motifs in Drosophila development. Hitherto largely considered in terms of time‐invariant networks, drosophila development is viewed in the article by Man‐Sun Kim, Jeong‐Rae Kim, and Kwang‐Hyun Cho as the result of networks of gene interactions that change during the course of development. Using this paradigm, pivotal developmental events can be correlated with particular changes from one constellation of (...) gene interactions to a different one, and the method allows the identification of certain network motifs that are not identifiable using static approaches. Features article: “Dynamic network rewiring determines temporal regulatory functions in the Drosophila melanogaster development processes”, see pages 505 – 513. (shrink)