Background: Lithium hydroxide (LiOH) is increasingly used in electric vehicle battery production; however, its health effects in the work environment remain underreported. This study characterizes the acute health effects on workers following accidental occupational exposure to LiOH at a Korean lithium plant in March 2024. Methods: We analyzed health effects from two LiOH exposure accidents on March 6 and 9, 2024, involving 50–100 kg powder spills. Two datasets were examined: acute symptoms from 115 workers who visited hospitals immediately after exposure, and a symptom severity survey from 474 workers conducted 2 weeks post-exposure. Workers were stratified by distance from the leak source (<10 m, 10–20 m, >20 m) and respirator use. Univariate general linear modeling was applied to analyze the relationship between symptom occurrence and both the distance from the exposure source and respirator use. Results: Among workers visiting hospitals immediately, local irritation symptoms predominated: sore throat (58.3%), cough (28.7%), and skin dermatoses (17.4%). Systemic symptoms included headache (45.2%), nausea (18.3%), chest tightness (12.2%), and dizziness (9.6%). Two-week follow-up revealed overall symptom improvement; severe cough decreased from 22.2% to 10.1%. However, despite general improvement, a significant portion of workers reported persistent respiratory issues, including cough (28.7%) and sputum production (31.0%). Symptom severity showed a significant dose-response relationship with proximity to the source (p < 0.001). While respirator use offered initial protection (p = 0.021), this effect was not statistically significant after 2 weeks. Conclusions Occupational LiOH exposure caused acute irritation and systemic symptoms, demonstrating immediate tissue damage consistent with its alkalinity and systemic toxicity upon absorption. As lithium battery production expands globally, these results emphasize the necessity for developing specific occupational exposure limits and medical surveillance guidelines for lithium compounds.

Background and Objectives: We evaluated 20-year trends in heart failure (HF) epidemiology in Korea to quantify changes in its burden from 2002 to 2023. Methods: A nationwide analysis was conducted using a random 50% sample from the Korean National Health Information Database linked to mortality records (2002–2023). HF was defined using diagnostic codes recorded as a primary or secondary condition. We calculated crude and age-standardized rates of prevalence, incidence, hospitalization, and mortality. Survival was assessed using the Kaplan–Meier method, stratified by inpatient versus outpatient diagnosis.Trends in heart transplantation and left ventricular assist device implantations were also examined. Results: By 2023, approximately 1,750,228 individuals had HF (3.41% prevalence). The age-standardized prevalence has more than doubled from 2002 to 2023. The crude incidence increased over time; the age-standardized incidence remained stable in men and declined in women.Hospitalization rates for any cause or secondary HF diagnoses have increased substantially, whereas primary HF hospitalization rates have remained relatively stable. The annual mortality rate in patients with HF was approximately 6.0% in 2023, being markedly higher in older adults.Although short-term survival has improved, particularly in hospitalized patients, long-term survival remains limited. Use of advanced therapies significantly increased. Conclusions The burden of HF in Korea has increased substantially over the past two decades, driven primarily by population aging and improved survival rather than increasing age-adjusted incidence. Despite therapeutic advances, hospitalization and long-term mortality rates remain high, highlighting the need for comprehensive HF strategies in aging societies.

Background: The quality of a vaccine depends strongly on the effects of the adjuvants applied simultaneously with the antigen in the vaccine. The adjuvants enhance the protective effect of the vaccine against a viral challenge. Conversely, oil-type adjuvants leave oil residue inside the bodies of the injected animals that can produce a local reaction in the muscle. The longterm immunogenicity of mice after vaccination was examined. ISA206 or ISA15 oil adjuvants maintained the best immunity, protective capability, and safety among the oil adjuvants in the experimental group. Objectives: This study screened the adjuvant composites aimed at enhancing foot-andmouth disease (FMD) immunity. The C-type lectin or toll-like receptor (TLR) agonist showed the most improved protection rate. Methods: Experimental vaccines were fabricated by mixing various known oil adjuvants and composites that can act as immunogenic adjuvants (gel, saponin, and other components) and examined the enhancement effect on the vaccine. Results: The water in oil (W/O) and water in oil in water (W/O/W) adjuvants showed better immune effects than the oil in water (O/W) adjuvants, which have a small volume of oil component. The W/O type left the largest amount of oil residue, followed by W/O/W and O/W types. In the mouse model, intramuscular inoculation showed a better protection rate than subcutaneous inoculation. Moreover, the protective effect was particularly weak in the case of inoculation in fatty tissue. The initial immune reaction and persistence of long-term immunity were also confirmed in an immune reaction on pigs. Conclusions The new experimental vaccine with immunostimulants produces improved immune responses and safety in pigs than general oil-adjuvanted vaccines.

Foot-and-mouth disease (FMD) is an acute epidemic that spreads rapidly among cattle and pigs. In 2014, in Korea, despite enforced vaccination, the type O Southeast Asia (SEA) topotype viruses (Mya-98 lineage) infected mainly cattle and pigs simultaneously, thereby causing enormous damage. If a vaccine that is completely protective against this FMD virus is developed and used, it can become a very important preventive measure in Asia, which is where this type of virus mainly circulates. The SEA topotype has been steadily evolving and transforming into new variations since it became epidemic in Asia. Therefore, it became necessary to develop a new vaccine that could provide protection against the FMD virus strain that was responsible for the 2014–2015 outbreak in Korea. This study aimed to develop a vaccine that would provide complete protection against the SEA topotype FMD virus to control sporadic FMD outbreaks, which occur despite the enforcement of vaccination, and to completely prevent virus shedding, thereby preventing the virus from spreading. The vaccine candidate virus developed in this study showed low pathogenicity and can be distinguished from the wild-type FMD virus strain. The developed vaccine was able to protect mice from SEA and Middle East–South Asia topotype virus strains and induced high titers of antibodies against both virus strains in pigs, thereby confirming the sufficiency of its protective function. In particular, the results of the SEA topotype virus challenge test in pigs revealed that perfect immunity was created in the vaccinated pigs, without virus shedding and viremia.
Animals ; Antibodies ; Asia ; Asia, Southeastern ; Cattle ; Disease Outbreaks ; Foot-and-Mouth Disease ; Korea ; Mice ; Swine ; Vaccination ; Viremia ; Virulence ; Virus Shedding

PURPOSE: The purpose of this study was to identify the knowledge, perception and hand hygiene performance rate of hospital nurses and to identify any correlation between them.METHOD: Data were collected from 205 nurses working in a university hospital in Chungcheong-do. A self-report survey method was utilized. Participants completed the hand hygiene knowledge questionnaire.RESULTS: The average knowledge of hand hygiene was 11.76 (out of 18 points), and the average perception of hand hygiene was 35.55 (out of 96). The hand hygiene performance rate was 85.62%. Knowledge of hand hygiene showed significant differences according to age (F = 75.821, p < .001), gender (t = 25.049, p < .001) and working period (F = 24.843, p < .001). The most important explanatory factor in hand hygiene performance was hand hygiene perception (β= .26), followed by working period (β= .14). These variables accounted for 10.0% of subjects' hand hygiene performance.CONCLUSION: The results of this study suggest that continuous and effective education is needed to strengthen knowledge and perception of the importance of hand hygiene practice for nurses to prevent healthcare-associated infections.
Cross Infection ; Education ; Hand Hygiene ; Hand ; Methods ; Surveys and Questionnaires

On December 3, 2014, a type O foot-and-mouth disease (FMD) outbreak began in Korea. Although vaccinations were administered, FMD cases increased steadily for five months, and reached 185 cases by April 2015. Most of the affected animals were pigs, which are vulnerable to vaccination. The FMD virus belonged to the South-East Asia (SEA) topotype that had been observed three times in Korea between April 2010 and July 2014. However, the FMD virus isolated in December 2014 had a unique feature; that is, partial deletion of the 5′ non-coding region, a deletion not seen in previous SEA topotype isolates identified in Korea. We conclude that this outbreak included the introduction of a new FMD strain to Korea, and that Korea was now affected by genetically similar FMD virus strains that are related to those from neighboring countries.
Animals ; Asia ; Foot-and-Mouth Disease ; Korea ; Swine ; Vaccination

In many countries, vaccines are used for the prevention of foot-and-mouth disease (FMD). However, because there is no protection against FMD immediately after vaccination, research and development on antiviral agents is being conducted to induce protection until immunological competence is produced. This study tested whether well-known chemicals used as RNA virus treatment agents had inhibitory effects on FMD viruses (FMDVs) and demonstrated that ribavirin showed antiviral effects against FMDV in vitro/in vivo. In addition, it was observed that combining the administration of the antiviral agents orally and complementary therapy with vaccines synergistically enhanced antiviral activity and preserved the survival rate and body weight in the experimental animals. Antiviral agents mixed with an adjuvant were inoculated intramuscularly along with the vaccines, thereby inhibiting virus replication after injection and verifying that it was possible to induce early protection against viral infection prior to immunity being achieved through the vaccine. Finally, pigs treated with antiviral agents and vaccines showed no clinical signs and had low virus excretion. Based on these results, it is expected that this combined approach could be a therapeutic and preventive treatment for early protection against FMD.
Animals ; Antiviral Agents ; Body Weight ; Foot-and-Mouth Disease ; Immunocompetence ; Ribavirin ; RNA Viruses ; Survival Rate ; Swine ; Vaccination ; Vaccines ; Virus Replication

We investigated the incidence, predictors, and long-term clinical outcomes of new-onset diabetes mellitus (DM) after percutaneous coronary intervention (PCI) with drug-eluting stent (DES). A total of 6,048 patients treated with DES were retrospectively reviewed and divided into three groups: 1) known DM (n = 2,365; fasting glucose > 126 mg/dL, glycated hemoglobin > 6.5%, already receiving DM treatment, or previous history of DM at the time of PCI); 2) non-DM (n = 3,247; no history of DM, no laboratory findings suggestive of DM at PCI, and no occurrence of DM during follow-up); and 3) new-onset DM (n = 436; non-DM features at PCI and occurrence of DM during follow-up). Among 3,683 non-DM patients, 436 (11.8%) patients were diagnosed with new-onset DM at 3.4 ± 1.9 years after PCI. Independent predictors for new-onset DM were high-intensity statin therapy, high body mass index (BMI), and high level of fasting glucose and triglycerides. The 8-year cumulative rate of major adverse cardiac events (a composite of cardiovascular death, myocardial infarction, stent thrombosis, or any revascularization) in the new-onset DM group was 19.5%, which was similar to 20.5% in the non-DM group (P = 0.467), but lower than 25.0% in the known DM group (P = 0.003). In conclusion, the incidence of new-onset DM after PCI with DES was not low. High-intensity statin therapy, high BMI, and high level of fasting glucose and triglycerides were independent predictors for new-onset DM. Long-term clinical outcomes of patients with new-onset DM after PCI were similar to those of patients without DM.
Body Mass Index ; Coronary Artery Disease ; Diabetes Mellitus* ; Drug-Eluting Stents* ; Fasting ; Glucose ; Hemoglobin A, Glycosylated ; Humans ; Hydroxymethylglutaryl-CoA Reductase Inhibitors ; Incidence* ; Myocardial Infarction ; Percutaneous Coronary Intervention* ; Retrospective Studies ; Stents ; Thrombosis ; Triglycerides

With the current commercial foot-and-mouth disease vaccine, inoculating twice increases the formation of denatured meat due to granuloma or residual adjuvant at the injection site in pigs, resulting in economic loss. Therefore, we investigated protective antibody levels after reducing the amount of adjuvant in the vaccine. Field applicability of the experimental vaccine, made with a new adjuvant ISA 201, was tested by vaccinating farm animals with half-volume doses (1 mL/animal) of commercial vaccine and monitoring their immunogenicity. Among pigs, the group that received a half-volume dose showed similar or higher titers of structural protein antibody and neutralizing antibody than those receiving the standard dose (2 mL). In pigs, the durable effects of antibody titer of the reduced vaccine volume did not diminish up to the time of slaughter. Among cattle, boosting with a second 1 mL vaccine increased virus neutralizing antibody for the protective effects. The boosting effects were more marked in cattle than in pigs. The immune responses differed between species with the effect of the half-volume vaccination being lower in cattle than in pigs. In conclusion, the immune response to the half-volume vaccine was similar to that from the standard volume vaccine in pigs, but not in cattle.
Animals ; Animals, Domestic ; Antibodies, Neutralizing ; Cattle* ; Foot-and-Mouth Disease* ; Granuloma ; Meat ; Swine* ; Vaccination

Despite nation-wide immunization with O, A, and Asia 1 type vaccines in Republic of Korea, foot-and-mouth disease type O occurred again in July 2014 after three years and three months. This virus was a Mya-98 strain of the Southeast Asian topotype and was most similar to the identified type that circulated in East Asia in 2014. This was new virus with the deletion of 23 amino acids in 3A/3B1 region and low pathogenic property.
Amino Acids ; Animals ; Asia ; Asian Continental Ancestry Group ; Far East ; Foot-and-Mouth Disease Virus* ; Foot-and-Mouth Disease* ; Humans ; Immunization ; Korea* ; Republic of Korea ; Sequence Deletion ; Vaccination ; Vaccines