South Korea Research Articles

Historical Gulfs, Strategic Bridges: A Pragmatic-Symbolic Analysis of the GSOMIA Between Japan and South Korea

Abstract In 2016, Japan and South Korea signed the General Security of Military Information Agreement (GSOMIA)—the first military agreement between the two countries. The agreement called for the sharing of military intelligence concerning North Korea and its missile and nuclear programs. Despite numerous similarities between Japan and South Korea and their shared concerns, the process of signing the GSOMIA was strewn with controversies and setbacks that continue to haunt it long after the signing. This paper aims to understand the interplay between the pragmatic considerations and the symbolic meanings that affected the dynamics surrounding the GSOMIA. The analysis relies on a theoretical framework we offer by linking constructivism with collective memory theory. This approach, we argue, best explains why historical disputes have become extremely influential in Japan-South Korea relations, particularly during the GSOMIA process. It is also argued that, in such a context, the main advantage of the GSOMIA is its limited scope. The agreement is potentially a trust-building mechanism. By partially setting historical differences aside, both countries can build a stronger foundation for regional stability. This, in turn, can serve as a trust-building exercise within a larger process that could help them find an acceptable solution to their difficult shared past.

Using nostalgia to increase tourists’ destination loyalty in heritage cities: from imagined to productive nostalgia

ABSTRACT This study examines how nostalgia influences the relationships between emotional solidarity, tourists’ satisfaction, and destination loyalty in heritage cities. An online survey of tourists in South Korea was administered. Through the data analysis techniques of PLS-SEM, we found that the three dimensions of tourists’ emotional solidarity with local residents, consisted of feeling welcomed, emotional closeness, and sympathetic understanding, are significantly related to satisfaction, but only feeling welcomed is significantly related to destination loyalty. The relationship between emotional solidarity and destination loyalty was mediated by tourists’ satisfaction, which also had a positive association with it. Moreover, the study proposes nostalgia as a moderating factor in these associations, and shows that nostalgia strongly moderated the relationship between emotional solidarity and destination loyalty. The results emphasize how crucial emotional solidarity is for raising tourist satisfaction and loyalty, especially when it comes to feeling welcomed. It has been demonstrated that nostalgia, greatly increases the effect that emotional solidarity has on destination loyalty. The results are discussed through the lens of productive nostalgia, which aims to contribute to the implementation of strategies for sustainable tourism in heritage cities.

Change in exacerbation rate of COPD patients before and after COVID-19 infection

The COVID-19 pandemic has profoundly affected global health system, significantly altering not only the acute management of viral infection, but also management strategies for chronic diseases. This study aimed to investigate the impact of COVID-19 infection on exacerbation rates and the economic burden in patients with COPD. We conducted a retrospective cohort study using data from the national insurance reimbursement data of South Korea. Eligible participants included COPD patients diagnosed with COVID-19 between January and December 2020. We analyzed exacerbation rates, healthcare utilization, and medical costs pre- and post-COVID-19 infection. In 3,445 COPD patients who were infected by COVID-19, COVID-19 infection resulted in increased annual moderate-to-severe and severe exacerbations compared to pre-COVID-19 infection (IRR = 1.062 [95%CI 1.027–1.099]; IRR = 1.315 [95%CI 1.182–1.481], respectively). Among previously non-exacerbators, 11.2% of patients transitioned to exacerbator after COVID-19 infection. Older age, comorbidities and use of triple therapy were the factors associated with transitioners. Direct medical costs escalated significantly from approximately $6810 to $11,032, reflecting the increased intensity of care after COVID-19 infection. COVID-19 infection has significantly increased rate of exacerbations in patients with COPD and imposed a heavier economic burden on healthcare system. Among non-exacerbators, substantial number of patients transitioned to exacerbators after COVID-19 infection.

The effect of childhood interpersonal trauma on social anxiety: Implications for using emotion-focused therapy with young adults

Abstract According to emotion-focused therapy (EFT), childhood interpersonal trauma predicts social anxiety in adulthood through internalized shame. While internalized shame is characterized by the negative self-evaluation of the self, the mechanism linking childhood trauma and internalized shame remains unclear. This study examined whether emotional clarity, as posited by EFT, serves as a mediating factor between childhood interpersonal trauma and subsequent internalized shame. Specifically, it investigated the sequential mediating effect of emotional clarity and internalized shame on the relationship between childhood interpersonal trauma and social anxiety among Korean college students. A group of 202 undergraduate students in South Korea participated in the study by completing self-report questionnaires on key variables. The research model was evaluated using structural equation modeling. The results showed that the model fit was acceptable, explaining 46% of the variance for social anxiety. The indirect effect of childhood interpersonal trauma on social anxiety via internalized shame was significant at the p < .05 level. The indirect effect of childhood interpersonal trauma on social anxiety through emotional clarity and internalized shame was also significant at the p < .05 level. The findings support the applicability of an EFT model for working with young adults with social anxiety. Childhood interpersonal trauma can foster a shame-ridden/defective-self scheme, leading to anxiety in social situations where perceived flaws might be ridiculed. Improving one’s emotional clarity is likely to alleviate internalized shame, consequentially reducing social anxiety.

Assessment of Antimicrobial Use for Companion Animals in South Korea: Developing Defined Daily Doses and Investigating Veterinarians' Perception of AMR.

There are global concerns regarding the transmission of antimicrobial-resistant pathogens from animals to humans. Especially, companion animals are increasingly recognized as a potential source due to their close interactions with people, despite a limited number of reported cases. Although, social demands regarding comprehensive surveillance for antimicrobial resistance (AMR) among companion animals are highlighted, there is a lack of a relevant system in South Korea. In this regard, we conducted preliminary investigation on antimicrobial use (AMU) among small animal clinics, along with veterinary practitioner's knowledge and attitude regarding this issue in South Korea. We collected data on 684,153 antimicrobial prescription visits for canine and feline patients from 2019 to 2022 at 100 veterinary facilities in South Korea, using electronic medical records. To evaluate antimicrobial use (AMU) and facilitate comparisons across institutions and time periods, we developed the Defined Daily Dose for Animals (DDDA) and the Defined Animal Daily Dosages per 1000 Animal-Days (DAPD). In addition, we conducted an online survey of 362 veterinary practitioners, which included questions on their perceptions, attitudes, and practices regarding antimicrobial prescriptions. Simple frequency analyses were performed to examine temporal trends, regional differences and variations by facility size in AMU, and to summarize survey responses. Descriptive analysis using data from 100 veterinary clinics revealed a rising trend in AMU between 2019 and 2022, with higher usage observed in larger clinics and non-capital regions. DDDA values for dogs were generally higher than for cats. Survey results highlighted that, while veterinarians exhibited high awareness of AMR, prescribing practices were significantly influenced by clinical judgments and owner demands, often deviating from established guidelines. The adoption of an electronic veterinary prescription management system (e-Vet) was proposed to enhance antimicrobial stewardship. However, concerns regarding the system's efficiency and administrative burden were prominent. To our best knowledge, this study provided DDDA for companion animals for the first time in South Korea. Although the indicator should be improved with more comprehensive data and expert opinion, our study showed that it enables reasonable situation analysis regarding AMU in companion animals. The identified factors that affect veterinarians' prescription practices can also be used to design an effective strategy for promoting appropriate antimicrobial usage.

Boundary extension replicates in samples from South Korea and China

ABSTRACT Boundary extension ocurrs when individuals shown a photograph later claim that a second presentation of the identical photograph shows a closer view than the photo they saw earlier. An open question is whether the phenomenon extends beyond Western samples so we assessed boundary extension in non-Western samples. Participants included adults recruited from coffee shops around Busan and Seoul, South Korea (n = 36), and around Beijing, China (n = 36). East Asian groups showed significant boundary extension, supporting the robustness of the phenomenon. To assess whether the size of boundary extension varied across Western and East Asian groups, we used the same recruitment method near Charlotte, NC (n = 36 for South Korean comparison and n = 36 for Chinese comparison). We found no differences across cultural groups. The demonstration of boundary extension in two distinct non-Western samples is consistent with the idea that boundary extension is a universal human phenomenon.

Remapping visibility: Layerability of gay dating apps and hybrid placemaking in Seoul, Korea

ABSTRACT This article recenters physical contexts in mediated communication, drawing on scholarship on communication and space and interviews with gay dating app (GDA) users in Seoul, South Korea. Findings suggested that GDAs virtually expanded the heavily stigmatized population’s everyday capacity to navigate and co-construct (parts of) Seoul as a fluctuating gay place(s) but with ongoing contextualizations through their physical situatedness. Physical gayborhoods’ boundedness shifted as GDAs enabled them to hybridly merge spatial contexts. Rather than simple virtualization, negotiations around societal and in-group stigmas and desires for physically grounded belonging were observed, and the gayborhoods importantly constituted the hybrid space by materially and discursively congregating diverse users. Based on the findings, I propose “layerability,” a topologically specified approach to visibility affordance.

Emergency department visits for patients with end-stage kidney disease in Korea: registry data from the National Emergency Department Information System 2019-2021.

Patients with end-stage kidney disease (ESKD) frequently visit the emergency department (ED) due to complications from comorbidities and dialysis. This study aimed to investigate the clinical outcomes and patterns of ED visits, hospitalizations, and in-hospital mortality among ED visits by ESKD patients in South Korea. This study utilized data from the National Emergency Department Information System from 2019 to 2021. ED visits were analyzed for ESKD patients and compared with non-chronic kidney disease (non-CKD) patients. Logistic regression analyses were conducted to assess factors associated with hospitalization and mortality, adjusting for demographics, insurance, and clinical characteristics, including the Korean Triage and Acuity Scale (KTAS). The study included 125,392 ED visits from ESKD patients and 19,287,972 from non-CKD patients. ED visits by ESKD patients had significantly higher hospitalization (66.7%) and in-hospital mortality (9.4%) rates compared to those by non-CKD patients (21.0% and 5.1%, respectively). ESKD patients were older, more frequently female, and more likely to receive medical aid. Factors strongly associated with higher hospitalization and mortality rates included advanced age, male sex, transfer from another facility, higher KTAS scores, and prolonged ED stays. Common causes of ED visits in ESKD patients included vascular device complications, digestive system disorders, pneumonia, pulmonary edema, and fluid or electrolyte imbalances. ED visits by patients with ESKD were characterized by high severity, hospitalization rates, and in-hospital mortality. Further research on factors affecting clinical outcomes may improve mortality and morbidity in this population.

Comparison of the Efficacy and Safety of Bupropion Versus Aripiprazole Augmentation in Adults with Treatment-Resistant Depression: A Nationwide Cohort Study in South Korea.

Comparison of the Efficacy and Safety of Bupropion Versus Aripiprazole Augmentation in Adults with Treatment-Resistant Depression: A Nationwide Cohort Study in South Korea.

Sentiment analysis of internet posts on vaccination using ChatGPT and comparison with actual vaccination rates in South Korea

Sentiment analysis of internet posts on vaccination using ChatGPT and comparison with actual vaccination rates in South Korea

A Systematic Literature Review on the Burden of Disease for Patients With Moderate to Severe Acute Ischemic Stroke.

A vast amount of literature is available on the burden of acute ischemic stroke (AIS). Yet, most information on AIS burden does not stratify by stroke severity, and the inclusion of mild strokes (National Institute of Health Stroke Scale < 5) might obscure the true impact of moderate-to-severe AIS. Therefore, it is important to understand the literature as it pertains to the epidemiological, clinical, humanistic, and economic burden of moderate-to-severe AIS from a global perspective. A systematic literature review (SLR) was conducted, including articles published between January 2015 and June 2023. The clinical burden search focused on patients with moderate or severe AIS. Due to the paucity of evidence, the humanistic and economic burdens were evaluated based on overall AIS studies. Abstract and full-text screening were conducted by 2 reviewers, with data extraction completed by 1 reviewer. In all, 136 studies were included in the SLR. AIS caused a substantial burden for patients and the healthcare system. The clinical burden of AIS (specifically severe AIS) resulted in high mortality and worse functional outcomes across multiple demographics (female sex, older age, and patients with comorbidities). The economic burden of overall AIS was substantial, with inpatient costs as the primary driver (a mean or median stay of 7 days). The highest inpatient costs were reported in South Korea ($45,180) and the United States ($38,470). The review highlighted the huge burden of moderate-to-severe AIS, with patients experiencing worse outcomes with increased stroke severity. Further focus is needed on outcomes relating to moderate-to-severe AIS to fully understand the burden of stroke in this patient population.

Measuring the Risk Spillover Effect of RCEP Stock Markets: Evidence from the TVP-VAR Model and Transfer Entropy.

This paper selects daily stock market trading data of RCEP member countries from 3 December 2007 to 9 December 2024 and employs the Time-Varying Parameter Vector Autoregression (TVP-VAR) model and transfer entropy to measure the time-varying volatility spillover effects among the stock markets of the sampled countries. The results indicate that the signing of the RCEP has strengthened the interconnectedness of member countries' stock markets, with an overall upward trend in volatility spillover effects, which become even more pronounced during periods of financial turbulence. Within the structure of RCEP member stock markets, China is identified as a net risk receiver, while countries like Japan and South Korea act as net risk spillover contributors. This highlights the current "fragility" of China's stock market, making it susceptible to risk shocks from the stock markets of economically developed RCEP member countries. This analysis suggests that significant changes in bidirectional risk spillover relationships between China's stock market and those of other RCEP members coincided with the signing and implementation of the RCEP agreement.

Illness attitudes and the flourishing of university students of South Korea in a pandemic: a cross-sectional descriptive study

ABSTRACT Since the onset of the Coronavirus-19 (COVID-19) pandemic in 2019, the virus has continued to experience periodic resurgences, and the evolution of new variants remains unpredictable. The greatest anxiety in Korean is now related to novel diseases, with a significant increase from 2.9% in 2018 to 32.8% in 2022. Excessive health concerns during the pandemic can lead to negative health behavior, highlighting their impact on well-being. This study aimed to identify how illness attitudes perceived by students during the pandemic influence their flourishing lives, and to examine the effects of health-promoting behaviors and social support on this relationship. A cross-sectional study was conducted using self-report questionnaires of 226 university students aged 18 to 35 years. We found that mental health issues among university students can hinder their flourishing growth in both the present and the future, while social support and health-promoting behavior act as sequential mediators between illness attitudes and flourishing. Healthcare professionals should offer flexible interventions that encourage health behaviors even in constrained environments and collaboration with social support within meaningful relationships is also required.

Comparing green customer citizenship attitudes and behaviours in South Africa and South Korea

Comparing green customer citizenship attitudes and behaviours in South Africa and South Korea

Parental Roles and Challenges in Managing Pediatric Obesity: Insights from Focus Group Interviews in Korea.

Pediatric obesity is a global public health concern. South Korea is witnessing a notable increase in obesity rates among children and adolescents, despite various governmental interventions. Parents play a crucial role in preventing and managing pediatric obesity, as they are typically the primary observers of their child's weight and daily habits. This study involved 10 parents of overweight or obese children and adolescents in South Korea, identified from a 2023 student health examination. Focus group interviews were conducted to explore participants' experiences, followed by a rigorous qualitative content analysis of the data. The analysis revealed one main theme, parental roles and challenges in managing pediatric obesity, that encompassed five categories: parental awareness and perception of pediatric obesity; causes of pediatric obesity; parental strategies for managing obesity; barriers to management; and support systems and resources. Parental recognition of their child's obesity was predominantly initiated through student health examinations at school, and the cause of obesity was multifactorial. Parents use various strategies, such as dietary changes and exercise promotion, but face barriers, including stigma and resource constraints. Parents demand comprehensive support from schools, healthcare providers, and community programs to effectively manage obesity. These findings highlight the need for tailored interventions to address parents' specific obstacles in managing pediatric obesity. Enhancing parental awareness, providing clear information, and strengthening support systems are essential for preventing and managing pediatric obesity in South Korea.

Stable H–O and radiogenic Sr isotopic ratios in bottled water in South Korea

ABSTRACT Stable H–O and radiogenic Sr isotopic compositions of bottled water in South Korea were investigated to trace water origins and to elucidate hydrogeochemical water–rock interactions within aquifers. Eighty-one bottled water samples were collected across the country. The δD and δ18O values, and 87Sr/86Sr ratios and Sr contents of groundwater-sourced bottled water samples were in the ranges of −68 to −40 ‰, −10 to −7 ‰, 0.7050–0.8112, and 14–400 μg L−1, respectively. The corresponding ranges for desalinated deep-ocean water samples were −1.2 to 1.6 ‰, −0.35 to 0.10 ‰, 0.7078–0.7092, and 12–407 μg L−1, respectively. Isotopic compositions indicate spatial variations in stable isotopic signatures with geographical location, while Sr isotopic ratios are correlated with the geological characteristics of water sources. Oxygen isotopic compositions of bottled water show a negative correlation with latitude, while Sr isotopic ratios vary with aquifer geology. The integration of stable and radiogenic isotopic compositions improves our understanding of water–rock interactions, enabling accurate authentication of water sources.

Revealing a novel GI-19 lineage infectious bronchitis virus sub-genotype with multiple recombinations in South Korea using whole-genome sequencing.

Infectious bronchitis (IB), caused by the infectious bronchitis virus (IBV), is a highly contagious chicken disease, causing economic losses worldwide. New IBV strains and variants continue to emerge despite using inactivated and live-attenuated vaccines to prevent or control IB. In this study, the S1 genes of 46 IBV strains, isolated from commercial chicken flocks between 2003 and 2024 in Korea were sequenced and genetically characterized. The IBV isolates belonged to Korean group II (K-II), which was included in the GI-19 lineage. The K-II was divided into five sub-genogroups (a-e) based on phylogenetic tree analysis results and nucleotide identification of the S1 gene. Of these, K-IId was the most common genotype in Korea; however, eight novel isolates belonging to the K-IIe sub-genotype were discovered. The nucleotide and amino acid identities of the other four K-II sub-genotypes and the eight isolates were 84.42-95.89% and 84.02-95.86%, respectively. The complete genomes of the eight K-IIe isolates were obtained using next-generation sequencing. Various recombination patterns were observed despite the high homology of the S1 gene among the eight IBV strains. Among the eight K-IIe isolates, six were recombinants, exhibiting recombinations between K-IIe and K-IIc, K-IIe and K-IIa, and with the live vaccine strain. Most recombination breakpoints were detected in the nsp2 region of the ORF1a, S2, and M genes. The present study proposed new classification criteria for the K-II belonged to the GI-19 lineage prevalent in South Korea and revealed the recombination patterns of recently identified novel isolates, providing important information on novel viral sub-genotype strains and IBV evolution.

Nelonemdaz Treatment for Patients With Out-of-Hospital Cardiac Arrest: A Randomized Clinical Trial

Objectives: Nelonemdaz is a N-methyl d-aspartate receptor subtype 2B-selective N-methyl-D-aspartate receptor antagonist and a potent free-radical scavenger that might ameliorate hypoxic-ischemic brain injury after out-of-hospital cardiac arrest (OHCA). We investigated the efficacy of nelonemdaz for patients with OHCA. Design: A double-blind, placebo-controlled, randomized, multicenter phase II trial. Setting: This trial enrolled 105 patients at five sites in South Korea between November 18, 2018, and February 23, 2023. Participants: OHCA patients undergoing targeted temperature management. Interventions: Patients were randomly assigned to high-dose (5250 mg), low-dose (3250 mg), and placebo groups at a 1:1:1 ratio. Measurements and Main Results: Patients with a median age of 61 years (82% male) were assigned to the high-dose (n = 37), low-dose (n = 35), and placebo (n = 33) groups. The primary outcome, the serum level of neuron-specific enolase (NSE) at 48–52 hours, was evaluated in 93 patients. There was no difference in serum NSE between high-dose (median and interquartile range; 23.7, 15.0–69.9) and placebo (17.5, 13.6–113.0) groups, or between low-dose (26.6, 16.2–83.4) and placebo groups (all p &gt; 0.05). Brain MRI fractional anisotropy was significantly higher in the high-dose group compared with the placebo group (0.465, 0.449–0.485 vs. 0.441, 0.431–0.464; p = 0.028), but not between low-dose (0.462, 0.439–0.480) and placebo groups (p &gt; 0.05). At day 90, the common odds ratio (95% CI) indicating a numerically favorable shift in the modified Rankin Scale was 1.25 (0.48–3.24) and 1.22 (0.47–3.20) in the high-dose and low-dose groups, respectively, compared with placebo group (all p &gt; 0.05). No serious adverse events were reported. Conclusions: Nelonemdaz treatment of patients after OHCA did not reduce serum NSE levels compared with controls. Patients treated with high-dose nelonemdaz showed higher brain MRI fractional anisotropy suggesting less cerebral white matter damage.

An 18-year comprehensive safety study on microfocused ultrasound and monopolar radiofrequency combined with cosmetic injectables in 1,040 patients.

Microfocused ultrasound (MFU) and (MRF) are non-invasive modalities widely used for skin rejuvenation and are often combined with injectables, including neuromodulators and soft tissue fillers. However, large-scale, long-term safety data on such combination therapies are lacking. To address this gap, we conducted a retrospective chart review at two private practice dermatology clinics in South Korea from June 2005 to December 2023. A total of 1,040 patients were included, comprising 515 (49.5%) and 525 (50.5%) patients undergoing MFU and MRF, respectively. Regarding combination therapy, the patients received neuromodulators (76.9%) or dermal filler injections using hyaluronic acid (HA) (17.3%) or poly-L-lactic acid (PLLA) (5.8%) in conjunction with MFU/MRF. Documented adverse events included one case of paradoxical bulging and three cases of eyelid ptosis among those treated with MFU/MRF and neuromodulators (overall incidence: 0.1% and 0.4%, respectively), two cases of surface irregularity among those treated with MFU/MRF and HA fillers (overall incidence: 1.1%), and one case of cheek asymmetry among those treated with MFU/MRF and PLLA injections (overall incidence: 1.7%). No adverse events such as infection, necrosis, burn, filler migration, or unexpected premature loss of filler were reported. While limited by its retrospective design and the inclusion of only two dermatology clinics, which restricts the generalizability of the findings, our study highlights the favorable long-term safety profile of combining MFU and MRF with cosmetic injectables. Our study offers reassurance to clinicians and patients considering these approaches.

First-line pembrolizumab-axitinib versus sunitinib in metastatic RCC: subgroup analysis of patients enrolled in the phase 3 KEYNOTE-426 in Eastern Asia.

The phase 3 open-label KEYNOTE-426 study demonstrated that first-line pembrolizumab plus axitinib improved overall survival (OS) and progression-free survival (PFS) versus sunitinib for metastatic renal cell carcinoma (mRCC) in a global population. This subgroup analysis investigated the efficacy and safety of pembrolizumab-axitinib versus sunitinib in patients enrolled in KEYNOTE-426 in East Asia (Japan, South Korea, and Taiwan). Adults with clear cell mRCC were randomly assigned 1:1 to receive intravenous pembrolizumab 200mg every 3weeks with oral axitinib 5mg twice daily or oral sunitinib 50mg once daily (4weeks on/2weeks off). Dual primary endpoints were OS and PFS, assessed by blinded independent central review. Secondary endpoints were objective response rate (ORR) and safety. The East Asian subgroup comprised 130 patients (pembrolizumab-axitinib, n=62; sunitinib, n=68; 15.1% of the global intention-to-treat population). Compared with sunitinib, pembrolizumab-axitinib OS hazard ratio (HR) was 0.85 [95% confidence interval (CI) 0.50-1.44; 36-month rates, 62.9% and 58.8%, respectively] and PFS HR was 0.59 (95% CI 0.38-0.92) in favor of pembrolizumab-axitinib. ORR favored pembrolizumab-axitinib (64.5% vs 44.1% for sunitinib). The results were generally consistent with the intention-to-treat population. Grade≥3 treatment-related adverse events (TRAEs) occurred in 69.4% of patients on pembrolizumab-axitinib and 74.6% on sunitinib; 16 (25.8%) patients on pembrolizumab-axitinib and 17 (25.4%) patients on sunitinib discontinued due to adverse events. No deaths from TRAEs occurred. Pembrolizumab-axitinib improved efficacy for East Asian patients with untreated clear cell mRCC, consistent with results from the global population. Safety was manageable. ClinicalTrials.gov identifier: NCT02853331.