1.A perspective on partially hydrolyzed protein infant formula in nonexclusively breastfed infants
Yvan VANDENPLAS ; Zakiudin MUNASIR ; Badriul HEGAR ; Dewi KUMARAWATI ; Ahmad SURYAWAN ; Muzal KADIM ; Julistio Tb DJAIS ; Ray Wagiu BASROWI ; Deni KRISNAMURTI
Korean Journal of Pediatrics 2019;62(5):149-154
The World Health Organization recommends that infants should be exclusively breastfed for the first 6 months of life to provide optimal nutrition in this critical period of life. After this, infants should receive nutritionally adequate and safe complementary foods while breastfeeding continues for up to 2 years of age or beyond. For nonbreastfed infants, infant formula is an available option to provide the nutrition needed. Infant formula is usually prepared from industrially modified cow's milk and processed to adjust for the nutritional needs of infants. However, cow's milk is one of the most common causes of food allergy, affecting 2%–5% of all formula-fed infants during their first year of life. One strategy to prevent cow's milk allergy in nonbreastfed infants is the use of partially hydrolyzed formula (pHF) in high-risk infants, which are infants born in families with atopic disease. However, based on an epidemiological study, approximately half of the infants who develop allergy are not part of the at-risk group. This is because the non-at-risk group is significantly larger than the at-risk group and the non-at-risk infants have approximately 15% risk of developing allergies. This study aimed to evaluate the effects of partially hydrolyzed whey formula (pHF-W) in nonbreastfed infants and determine whether pHF-W can prevent atopic disease in high-risk infants and can be used as routine starter formula regardless of the allergy risk status.
Breast Feeding
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Critical Period (Psychology)
;
Epidemiologic Studies
;
Food Hypersensitivity
;
Humans
;
Hypersensitivity
;
Infant Formula
;
Infant
;
Milk
;
Milk Hypersensitivity
;
Whey
;
World Health Organization
2.Modifiable prenatal environmental factors for the prevention of childhood asthma
Allergy, Asthma & Respiratory Disease 2019;7(4):179-185
The prevalence of asthma in children is increasing worldwide, yet risk factors for the development of asthma is unclear. Evidence to date indicates that environmental factors are the main reason of the recent increase in the prevalence of asthma. For example, exposure to air pollution and diet as well as microbial alterations are reported as environmental factors. In addition, we should focus on the critical period of the exposure, especially pregnancy period as an important period for human development. Therefore, environmental exposure during pregnancy to tobacco smoke or air pollutants, maternal stress, obesity, and vitamin D may contribute to the development of childhood asthma. Herein, modifiable prenatal exposure, its mechanisms associated with childhood asthma and multiple intervention controlling risk factors needed during pregnancy in order to achieve primary prevention of asthma has been described.
Air Pollutants
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Air Pollution
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Asthma
;
Child
;
Critical Period (Psychology)
;
Diet
;
Environmental Exposure
;
Human Development
;
Humans
;
Obesity
;
Pregnancy
;
Prevalence
;
Primary Prevention
;
Risk Factors
;
Smoke
;
Tobacco
;
Vitamin D
3.Nature of Complex Network of Dengue Epidemic as a Scale-Free Network
Hafiz Abid Mahmood MALIK ; Faiza ABID ; Nadeem MAHMOOD ; Mohamed Ridza WAHIDDIN ; Asif MALIK
Healthcare Informatics Research 2019;25(3):182-192
OBJECTIVES: Dengue epidemic is a dynamic and complex phenomenon that has gained considerable attention due to its injurious effects. The focus of this study is to statically analyze the nature of the dengue epidemic network in terms of whether it follows the features of a scale-free network or a random network. METHODS: A multifarious network of Aedes aegypti is addressed keeping the viewpoint of a complex system and modelled as a network. The dengue network has been transformed into a one-mode network from a two-mode network by utilizing projection methods. Furthermore, three network features have been analyzed, the power-law, clustering coefficient, and network visualization. In addition, five methods have been applied to calculate the global clustering coefficient. RESULTS: It has been observed that dengue epidemic follows a power-law, with the value of its exponent γ = −2.1. The value of the clustering coefficient is high for dengue cases, as weight of links. The minimum method showed the highest value among the methods used to calculate the coefficient. Network visualization showed the main areas. Moreover, the dengue situation did not remain the same throughout the observed period. CONCLUSIONS: The results showed that the network topology exhibits the features of a scale-free network instead of a random network. Focal hubs are highlighted and the critical period is found. Outcomes are important for the researchers, health officials, and policy makers who deal with arbovirus epidemic diseases. Zika virus and Chikungunya virus can also be modelled and analyzed in this manner.
Administrative Personnel
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Aedes
;
Arboviruses
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Chikungunya virus
;
Critical Period (Psychology)
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Dengue Virus
;
Dengue
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Humans
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Methods
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Zika Virus
4.Integrated Management Plan for Graduate Medical Education and Accreditation Bodies in Korea
Korean Medical Education Review 2018;20(3):123-127
Graduate medical education is the most important phase among the three stages of medical education. It links basic medical education and continuing professional development. It is also a critical period in acquiring meaningful knowledge, skills and professionalism. The residents should be able to develop the core common competencies on top of their specialozeds field's expertise, in order to function as independent and qualified physicians. Despite the obvious importance of graduate medical education, the system in Korea has been designed and executed to meet the needs of the hospitals in the perspective of manpower management, rather than to educate and empower the residents. As a result, graduate medical education in Korea lacks clear educational objectives and systemic, resident-centered curriculums. Yet, we have no accreditation body to evaluate graduate medical education programs. In order to normalize graduate medical education, an integrated and unified institution that manages the whole process of the graduate medical education is desperately needed. Special attention should be given to the role of medical schools in educating the core common competencies. The Korean Association of Medical Colleges, the Korean Institute for Medical Education and Evaluation, and the Korean Academy of Medical Sciences should cooperate intimately to establish a new organization for the systemic management and development of graduate medical education.
Accreditation
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Critical Period (Psychology)
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Curriculum
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Education, Medical
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Education, Medical, Graduate
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Korea
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Professionalism
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Schools, Medical
5.Effects of Tianeptine on Adult Rats Following Prenatal Stress.
Hwayoung LEE ; Hyung Ki KIM ; Jun Tack KWON ; Young Ock KIM ; Jonghoon SEO ; Sanghyun LEE ; Ik Hyun CHO ; Hak Jae KIM
Clinical Psychopharmacology and Neuroscience 2018;16(2):197-208
OBJECTIVE: Exposing a pregnant female to stress during the critical period of embryonic fetal brain development increases the risk of psychiatric disorders in the offspring. The objective of this study was to investigate the effect of antidepressant tianeptine on prenatally stressed (PNS) rats. METHODS: In this study, a repeated variable stress paradigm was applied to pregnant rats during the last week of gestation. To investigate the effects of antidepressant tianeptine on PNS rats, behavioral and protein expression analyses were performed. Forced swim test, open field test, and social interaction test were performed to determine changes in PNS rats compared to non-stressed offspring. Haloperidol was used as a positive control as an antipsychotic drug based on previous studies. RESULTS: Behavioral changes were restored after treatment with tianeptine or haloperidol. Western blot and immunohistochemical analyses of the prefrontal cortex revealed downregulation of several neurodevelopmental proteins in PNS rats. After treatment with tianeptine or haloperidol, their expression levels were increased. CONCLUSION: Downregulation of several proteins in PNS rats might have caused subsequent behavioral changes in PNS rats. After tianeptine or haloperidol treatment, behavioral changes in PNS rats were restored. Therefore, tianeptine might decrease incidence of prenatal stress related-psychiatric disorders such as depression and schizophrenia.
Adult*
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Animals
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Behavior Rating Scale
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Blotting, Western
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Brain
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Critical Period (Psychology)
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Depression
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Down-Regulation
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Female
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Haloperidol
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Humans
;
Incidence
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Interpersonal Relations
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Models, Animal
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Prefrontal Cortex
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Pregnancy
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Rats*
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Schizophrenia
6.Fat and bone in children – where are we now?.
Annals of Pediatric Endocrinology & Metabolism 2018;23(2):62-69
The risk of fracture secondary to low-impact trauma is greater in obese children, suggesting obese children are at risk of skeletal fragility. However, despite this finding, there is a lack of agreement about the impact of excessive adiposity on skeletal development. The combination of poor diet, sedentary lifestyle, greater force generated on impact through falls, and greater propensity to falls may in part explain the increased risk of fracture in obese children. To date, evidence suggests that in early childhood years, obesity confers a structural advantage to the developing skeleton. However, in time, this relationship attenuates and then reverses, such that there is a critical period during skeletal development when obesity has a detrimental effect on skeletal structure and strength. Fat mass may be important to the developing cortical and trabecular bone compartments, provided that gains in fat mass are not excessive. However, when fat accumulation reaches excessive levels, unfavorable metabolic changes may impede skeletal development. Evidence from studies examining bone microstructure suggests skeletal adaption to excessive load fails, and bone strength is relatively diminished in relation to body size in obese children. Mechanisms that may explain these changes include changes in the hormonal environment, particularly in relation to alterations in adipokines and fat distribution. Given the concomitant rise in the prevalence of childhood obesity and fractures, as well as adult osteoporosis, further work is required to understand the relationship between obesity and skeletal development.
Accidental Falls
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Adipokines
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Adiposity
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Adult
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Body Size
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Bone Density
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Child*
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Critical Period (Psychology)
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Diet
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Humans
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Obesity
;
Osteoporosis
;
Pediatric Obesity
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Prevalence
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Sedentary Lifestyle
;
Skeleton
7.Effect of Motivations and Attitudes toward Nutrition Information on College Students' Use Intentions of Menu Labeling at University Dining Services.
Sunny HAM ; Youngshin KIM ; Yunhui JEONG ; Shinhye PARK ; Meeyoung JOE
Journal of the Korean Dietetic Association 2017;23(1):94-105
A menu labeling initiative is a lawful regulation with an aim to promote public health by providing customers the right to make informed menu choices. As college years are a critical period in which students form dietary habits, which are sustained throughout their lives, provision of nutritional information at the university dining services is important to students' health and life. Due to the lack of research on menu labeling at university dining services, the purpose of this study was to examine college students' attitudes and motivations toward menu labeling at university dining services, as well as their use intentions toward nutrition information at university dining services. Data were collected from a self-administered survey distributed to 484 college students who had experienced university dining services. Motivations of university students toward menu labeling were categorized into ‘knowledge pursuit’ and ‘health pursuit’. Students' attitudes toward menu labeling had a positive effect on their intention to use menu labeling at university dining services. The findings of the study indicated that female students, or those who frequently used nutrition information, tended to have higher attitudes, motivations, and use intentions toward nutrition information. The study results suggest that facilitation of healthy eating environments at university dining services by offering nutrition information, and nutrition and health education is necessary.
Critical Period (Psychology)
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Eating
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Female
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Food Habits
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Health Education
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Humans
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Intention*
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Jurisprudence
;
Public Health
8.What is fetal programming?: a lifetime health is under the control of in utero health.
Obstetrics & Gynecology Science 2017;60(6):506-519
The “Barker hypothesis” postulates that a number of organ structures and associated functions undergo programming during embryonic and fetal life, which determines the set point of physiological and metabolic responses that carry into adulthood. Hence, any stimulus or insult at a critical period of embryonic and fetal development can result in developmental adaptations that produce permanent structural, physiological and metabolic changes, thereby predisposing an individual to cardiovascular, metabolic and endocrine disease in adult life. This article will provide evidence linking these diseases to fetal undernutrition and an overview of previous studies in this area as well as current advances in understanding the mechanism and the role of the placenta in fetal programming.
Adult
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Chronic Disease
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Critical Period (Psychology)
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Embryonic and Fetal Development
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Endocrine System Diseases
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Fetal Development*
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Fetal Nutrition Disorders
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Humans
;
Malnutrition
;
Placenta
9.Postpartum modern contraceptive use in northern Ethiopia: prevalence and associated factors.
Teklehaymanot Huluf ABRAHA ; Alemayehu Shimeka TEFERRA ; Abebaw Addis GELAGAY
Epidemiology and Health 2017;39(1):e2017012-
OBJECTIVES: The postpartum period is a critical period for addressing widespread unmet needs in family planning and for reducing the risks of closely spaced pregnancies. However, contraception during the extended postpartum period has been underemphasized in Ethiopia. Therefore, this study aimed to assess postpartum modern contraceptive use among women in northern Ethiopia and to identify factors associated with modern contraceptive use in the postpartum period. METHODS: A community based cross-sectional study was conducted from March to April, 2015. Data were entered using Epi Info version 7 and then exported into Stata version 12 for analysis. Bivariate and multivariate logistic regression models were fitted to identify the determinants of postpartum modern contraceptive use. Adjusted odds ratios (aORs) with 95% confidence intervals (CIs) were calculated, and p-values < 0.05 were considered to indicate statistical significance. RESULTS: Nearly half (48.0%) of women used modern contraceptives during the extended postpartum period. Postpartum modern contraceptive use was significantly associated with secondary and tertiary education levels (aOR, 4.25; 95% CI, 1.29 to 14.00; aOR, 5.36 ; 95% CI, 1.14 to 25.45, respectively), family planning counseling during prenatal and postnatal care (aOR, 5.72 ; 95% CI, 2.67, 12.28), having postnatal care (aOR, 2.36; 95% CI, 1.15 to 4.87), resuming sexual activity (aOR, 9.53; 95% CI, 3.74 to 24.27), and menses returning after birth (aOR, 6.35; 95% CI, 3.14 to 13.39). In addition, experiencing problems with previous contraceptive use was negatively associated with modern contraceptive use (aOR, 0.34; 95% CI, 0.16 to 0.72). CONCLUSIONS: Low rate of postpartum modern contraceptive use were found in the study area. Therefore, strengthening family planning counseling during antenatal and postnatal care visits, improving utilization of postnatal care services and improving women's educational status are crucial steps for to enhance modern contraceptive use among postpartum women.
Contraception
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Contraceptive Agents
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Counseling
;
Critical Period (Psychology)
;
Cross-Sectional Studies
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Education
;
Educational Status
;
Ethiopia*
;
Family Planning Services
;
Female
;
Humans
;
Logistic Models
;
Odds Ratio
;
Parturition
;
Postnatal Care
;
Postpartum Period*
;
Pregnancy
;
Prevalence*
;
Sexual Behavior
10.The current status of health data on Korean children and adolescents.
Eunyoung LEE ; Dahye BAIK ; Yoon PARK ; Moran KI
Epidemiology and Health 2017;39(1):e2017059-
Childhood and adolescence are critical periods that affect adults' health status. Therefore, the factors influencing the health of children and adolescents should be analyzed. In Korea, a wide range of youth-related health data has been obtained, both on the regional level and on the national level. This report summarizes the current status of studies related to the health of Korean children and adolescents. Data for which open access is offered include the Korea Youth Risk Behavior Web-based Study, the Panel Study on Korean Children, the Korean Youth Panel Survey, the Korean Children and Youth Panel Survey, and the Student Health Examination. In addition, the Health Examination of Korean Youth Outside of School, the Korean Children and Adolescents Obesity Cohort Study, the Korean Children's Environmental Health Study, the Korea Youth Media Use and Harmful Environment Survey, the Comprehensive Survey of Korean Youth, and the Multicultural Adolescents Panel Study are summarized.
Adolescent Health
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Adolescent*
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Child Health
;
Child*
;
Cohort Studies
;
Critical Period (Psychology)
;
Environmental Health
;
Health Surveys
;
Humans
;
Korea
;
Obesity
;
Risk-Taking

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