Earticle

모바일 앱 시장은 스마트폰의 등장으로 폭발적으로 성장하였다. 최근 모바일 앱은 단순한 스마트폰 구성요소가 아니라 다양한 마케팅 채널로 활용되고 있으며 스타트업이 성장할 수 있는 발판이 되었다. 본 연구에서는 모바일 앱이 시장에 미치는 영향에 대해서 연구하고자 하였다. 안내원과의 전화를 통해서 소비자에게 서비스를 제공하던 전통적인 콜택시 산업이 카카오택시라는 새로운 모바일 앱 채널의 진입을 통해서 어떠한 영향을 받고 있는지 살펴보고자 한다. 최근 자가용과 대중교통의 발전으로 택시 수요는 감소한 반면, 개인택시 증가 등으로 택시 공급은 증가하고 있다. 택시산업은 크게 일반택시와 콜택시로 나누어진다. 일반택시는 택시기사가 직접 고객을 찾아다니기 때문에 우연적이고 비효율적인 행태를 보인다. 하지만 콜택시는 고객이 사용의도를 가지고 택시를 찾는다는 점에서 더 효율적인 업무가 가능하다. 이러한 장점에도 불구하고 콜택시 시장은 불완전한 고객-택시기사 매칭 시스템과 택시기사 관리 부족으로 크게 성장하지 못하였다. DID(differences in differences)는 하나의 시간 흐름에서 발생한 특정한 사건이 유의한 영향력을 행사하는가를 밝히는 계량경제학의 연구 방법이다. 본 연구 에서는 DID를 사용하여 최근 큰 이슈와 함께 출시 된 다음의 카카오택시 어플리케이션이 기존의 콜택시 사업에 미치는 영향력을 밝히고자 하였다. 거기서 더 나아가 비윤리적인 행태로 여겨지는 대기업의 문어발식 산업 확장이 해당 시장에 어떠한 영향을 미치는지 알아보고자 하였다. 이를 위해 카카오택시 전후 콜택시 산업의 크기 비교를 통해서 콜택시 시장 변화를 확인하였다. 본 연구를 위해 2014년 8월부터 2015년 7월까지 1년치의 콜택시 수요 데이터를 수집하였으며 control group으로 사용한 대리운전 수요 데이터도 같은 기간 동안 수집하였다.

Mobile application is growing explosively with the advent of a new technology: smartphones. Mobile application is a new marketing channel and performs as a start-up platform. This study examines the effect of mobile application on the off-line market. Despite the continuous declining demand for taxi service, paradoxically, the supply of taxi service has increased. The taxi industry can be categorized into general taxi and call taxi. General taxi is accidental and inefficient because it has to search for its own passenger. As call taxi takes the request of a passenger, it is more efficient than general taxi. However, the current defective passenger–taxi driver matching system and insufficient taxi driver management hinder the development of the call taxi market. Differences in differences (DID) is an econometrical methodology that examines whether or not an event has meaningful influence. This research uses DID to investigate the effect of the Kakao taxi application on the call taxi industry. Furthermore, it examines the effect of major companies’ reckless diversification, which is considered unethical behavior. The passengers of call taxi data from August 2014 to July 2015 and those of designated driving service data of the same period were collected as the control group.

Purpose: The purpose of this study was to investigate how pediatric intensive care unit (PICU) nurses and the mothers of hospitalized children perceived their partnership and identify the detailed differences in the common domains of partnership between them. Methods: A qualitative descriptive design with semi-structured and open-ended interviews was used. Interviews with mothers of hospitalized children and nurses in the PICU were conducted at a national university hospital in South Korea. Results: Five integrated categories were identified concerning nurses' and mothers' perceptions of partnership. Five common domains were derived by merging the partnership categories perceived by each PICU mother and nurse: expectation of trust, sharing and communication, participation in care, equality in the relationship, and coordination of opinion However, there were significant differences in the composition of the categories of these common domains. Conclusion: These results may facilitate more effective partnerships between parents and PICU nurses. Efforts should be taken to promote the formation of trust between nurses and parents and create an environment that is conductive to regular open communication in particular, steps should be taken to reduce gaps in awareness concerning this partnership and information sharing, nursing methods, and decision-making.

Purpose To assess knowledge and attitude toward hepatitis B virus (HBV) infection among Korean immigrants in two cities in the Rocky Mountain region and to determine whether sociodemographic and cultural factors are related to the level of HBV knowledge. Methods Community-based participatory study was conducted in five Korean churches in the Rocky Mountain region to develop baseline data on HBV infection and vaccination behavior. All documents, including announcements, brochures, consent forms, and questionnaires were in Korean and English, and trained Korean interviewers collected the surveys by reviewing the questionnaires with participants at the churches. Results Knowledge of HBV infection was low and city of residence did not have a statistically significant impact on HBV infection knowledge. In the total sample, 62% identified transmission by sharing utensils and 21% believed that HBV was hereditary, while only 21% thought that HBV was spread through sexual contact. The majority of participants (61%) rated their English level as “minimum”. Knowledge of HBV infection was found to be associated with both demographic and acculturation factors (p < .05). Conclusion This study found not only a low level of knowledge of HBV infection but also misunderstanding of the risks of HBV infection. Knowledge of HBV infection was significantly associated with education and acculturation; therefore, culturally sensitive and group-tailored public health education for Korean and other Asian American Pacific Islanders should be developed to clarify misconceptions and misunderstandings about HBV infection.

This study aimed to examine the effects of several essential oils on insomnia in dementia patients following transdermal treatment (aromatherapy). The mean change rates (%) of sleep biomarkers were compared between the single essential and jojoba (vehicle) oil massage groups in this study. The lavender (L) essential oil massage group demonstrated a significant decrease in the mean change rate (%) of 24-h urinary free cortisol, whereas the valerian (V) essential oil massage group demonstrated a significant increase in the mean change rate (%) of serum 5-hydroxytryptamine. In addition, a significant increase in the mean change rate (%) of 24-h urinary norepinephrine was observed in the chamomile (C) essential oil massage group only. Based on these results, valerian, lavender, and chamomile oils were mixed in different ratios to produce blending oils A (L:C:V=2:2:1), B (L:C:V=3:1:1) and C (L:C:V=1:3:1). The highest level of serum 5-hydroxytryptamine was observed after administering blending oil A. These results suggest that blending oil A might possess therapeutic effects against insomnia. Overall, it is hypothesized that the optimally blended essential oil will produce synergic effects when combined with hypnotic drugs.

Purpose: To examine the prevalence of depressive symptoms and differentiate factors associated with them in urban and rural areas by applying the Ecological Models of Health Behavior. Methods: We employed a cross-sectional design and convenience sample of 460 female adolescents. The instruments included the Adolescent Mental-Health Problem-Behavior Questionnaire (AMPQ-II) and the Beck Depression Inventory (BDI). Results: Depressive symptoms were confirmed in 15.7% of urban adolescents and 22.9% of rural adolescents (p<.05). In the urban group, perception of health and stress associated with school performance were significantly associated with depressive symptoms. In the rural group, academic/internet related problems and rule violations were significantly associated with depressive symptoms (p<.05). General life happiness, worry/anxiety, and mood/suicidal ideation were common factors in both urban and rural areas (p<.05). Conclusion: Multiple factors were associated with depressive symptoms, and those significant factors differed between urban and rural female youths. Accordingly, tailored approaches are required considering urban and rural differences. The approaches should include intrapersonal, interpersonal, and organizational levels of interventions.

Background As people age, changes in speech characteristics naturally occur. If differences in speech features exist between frail older adults and those experiencing healthy aging, speech assessment could become a valuable tool for monitoring frailty. Purpose The purpose of this study was to investigate the differences in speech characteristics according to frailty in older adults. Study design A cross-sectional design Methods Forty-two individuals aged 65 and older were recruited from senior community centers. Frailty was assessed based on weight loss, self-reported exhaustion, low physical activity, slow gait speed, and weak grip strength, classifying participants into three groups: frail, pre-frail, and robust. Speech variables, including total speech duration, voiced and unvoiced duration, speech and articulation rates, mean syllable duration, and number of pauses during speech, were compared across the three groups. Results Frail and pre-frail older adults exhibited significantly slower speech and articulation rates, taking longer to speak the same sentences compared to robust adults. Additionally, frail older adults showed a significantly longer mean syllable duration and more pauses during speech than their robust participants. Conclusions These findings suggest that speech characteristics could be valuable indicators of frailty in older adults. Future large-scale studies should further explore the relationship between frailty and these speech features.

Purpose: This study investigated the differences in physical function, self-efficacy (SE), and health-related quality of life (HRQoL) categorized by disease severity in community-dwelling patients with chronic obstructive pulmonary disease (COPD). Methods: This cross-sectional study included 182 patients with COPD selected from the pulmonology outpatient department of a tertiary hospital. Disease severity was measured using forced expiratory volume in 1 second (FEV1). Physical function, SE, and HRQoL were measured with the six-minute walking distance, Pulmonary Rehabilitation Adapted Index of Self-Efficacy (PRAISE), and St. George's Respiratory Questionnaire (SGRQ). Disease duration, FEV1, and 12-month history of exacerbations were obtained from medical records. Patients were categorized by Global Initiative for Chronic Obstructive Lung Disease (GOLD) category. Data were analyzed using the χ2 test, and one-way ANOVA. Results: Most of the participants were male and nonsmokers. The disease duration was 10.76 ± 10.03 years, the mean FEV1% was 62.13 ± 22.80, and 70.3% of the participants were in GOLD category 2 (moderate) or milder. Half of the participants reported modified Medical Research Council scores ≥ 2. Patients in GOLD categories 1 and 3 (mild and severe) exhibited significantly higher PRAISE scores than those in the other groups (F = 8.23, p < .001). The total SGRQ scores were highest in GOLD 4 (very severe), indicating the lowest HRQoL. Significant differences were identified among GOLD 1, GOLD 2 and 3, and GOLD 4 (F = 9.92, p < .001). Conclusion: We identified potentially useful variables to comprehensively assess disease severity and tailor management strategies, including airflow limitation, and to determine the consequences of COPD from patients’ perspectives.

Feed cost is the main factor affecting the economic benefits of pig industry. Improving the feed efficiency (FE) can reduce the feed cost and improve the economic benefits of pig breeding enterprises. Liver is a complex metabolic organ which affects the distribution of nutrients and regulates the efficiency of energy conversion from nutrients to muscle or fat, thereby affecting feed efficiency. MicroRNAs (miRNAs) are small non-coding RNAs that can regulate feed efficiency through the modulation of gene expression at the post-transcriptional level. In this study, we analyzed miRNA profiling of liver tissues in High-FE and Low-FE pigs for the purpose of identifying key miRNAs related to feed efficiency. A total 212~221 annotated porcine miRNAs and 136~281 novel miRNAs were identified in the pig liver. Among them, 188 annotated miRNAs were co-expressed in High-FE and Low-FE pigs. The 14 miRNAs were significantly differentially expressed (DE) in the livers of high-FE pigs and low-FE pigs, of which 5 were downregulated and 9 were upregulated. Kyoto Encyclopedia of Genes and Genomes analysis of liver DE miRNAs in high-FE pigs and low-FE pigs indicated that the target genes of DE miRNAs were significantly enriched in insulin signaling pathway, Gonadotropin- releasing hormone signaling pathway, and mammalian target of rapamycin signaling pathway. To verify the reliability of sequencing results, 5 DE miRNAs were randomly selected for quantitative reverse transcription-polymerase chain reaction (qRT-PCR). The qRT-PCR results of miRNAs were confirmed to be consistent with sequencing data. DE miRNA data indicated that liver-specific miRNAs synergistically acted with mRNAs to improve feed efficiency. The liver miRNAs expression analysis revealed the metabolic pathways by which the liver miRNAs regulate pig feed efficiency.

Purpose: This descriptive study compared the perceived parental stress levels between parents with very low birth weight infants (VLBWIs) and nurses in the neonatal intensive care unit (NICU). Methods: In total, 83 parents of VLBWIs and 78 NICU nurses were enrolled. Data were collected with the Parental Stress Scale (PSS) and analyzed using the t-test and analysis of variance in SAS version 9.4. Results: The average PSS score was 3.31 among parents and 3.45 among nurses. The stress score was significantly higher among nurses with children (t=2.46, p=.016) and senior nurses (t=2.12, p=.037). There was a significant difference in the stress score according to parents' education (t=3.29, p=.002) and occupation (F=3.14, p=.049) in the sights and sounds subscale. Mothers had significantly higher stress scores than fathers in the parental role alterations subscale (t=2.32, p=.023). Parental stress scores were higher than those perceived by nurses in the infant's appearance and behaviors subscale for breathing patterns (t=2.95, p=.004), followed by jerky/ restless behavior (t=2.70, p=.008). Conclusion: Nurses should provide explanations to parents of VLBWIs in order to reduce parental stress about the appearances and behavior of VLBWIs. This is more important than aspect of the NICU environment and education about parental roles.

Purpose: The purpose of this study was to assess the differences in the prevalence of metabolic syndrome in women in their 30s and 40s by breastfeeding experience, using the the fifth Korea National Health and Nutrition Examination Survey (2010) data. Methods: In this cross-sectional study, a total of 1,053 healthy women in their 30s and 40s, who had given birth was analyzed. To compare women with and without breastfeeding experience, chi-quare test and t test were used. The relationship between metabolic syndrome and breastfeeding was assessed using logistic regression analysis adjusted demographic and lifestyle covariates. Results: The breastfeeding experience ofwomen in their 30s was associated with a decreased risk of elevated triglyceride after controlling for income, education, exercise andthe last childbirthage [odds ratio (OR)=0.44, 95% confidence interval (CI) (0.21, 0.95)]. In addition, women who breastfed more children had high odds of metabolic syndrome [OR = 4.03, 95%CI (2.03, 8.00)], and components of metabolic syndrome [abdominal obesity: OR = 2.02, 95%CI (1.17, 3.51), elevated triglyceride: OR = 1.98, 95%CI (1.14, 3.45), elevated blood pressure: OR = 2.65, 95%CI (1.28, 5.49)] than those who never breastfed children. Conclusions: This study found that postpartum breastfeeding may play a significant role in reducing the risk of metabolic syndrome and also that childbearing is associated with a higher incidence of metabolic syndrome among women in their 30s. For women in their 40s, the risk of metabolic syndrome did not significantly differ depending on the breastfeeding experience. This study indicated that breastfeeding can be a way to reduce metabolic health burdens in women in their 30s.

Neural correlates of episodic memory deficits may be different in schizophrenia patients with hallucinations (SH) and patients without hallucinations (SnH). However, little is known about how specific neural correlates involved in episodic retrieval may differ between SH and SnH. We aimed to determine whether neural oscillations in SH during episodic retrieval are different from those in SnH and normal controls (NC) after navigating rooms in a virtual environment (VE). The VE was used to enhance patient motivation in episodic memory test by engaging higher cognitive involvement. Subjects experienced a navigation session and a retrieval session. Electroencephalogram (EEG) was recorded during the retrieval session, and time-frequency analyses were examined (7 NC, 7 SnH, and 7 SH). Consistent with previous reports, the results revealed that theta power was correlated with successful episodic retrieval, suggesting that the reductions of theta power may contribute to episodic memory deficits in SH and SnH. Notably, the theta power differences between the old and new conditions was positively correlated with episodic retrieval performances across SH, SnH, and NC. Other oscillatory activities (i.e., alpha and beta) may also contribute to episodic retrieval with a diversity of functional relevance across groups. Overall results showed deficits in episodic retrieval, corresponding oscillations in EEG frequency bands. The neural oscillations across different frequencies and their relationship to cognitive processes, including inhibition and attention in episodic memory, are also discussed.

Autism spectrum disorder (ASD) remains unexplained and untreated despite the high attention of research in recent years. Aside from its various characteristics is the baffling male preponderance over the female population. Using a validated animal model of ASD which is the telomerase reverse transcriptase overexpressing mice (TERT-tg), we conducted ASD-related behavioral assessments and protein expression experiments to mark the difference between male and females of this animal model. After statistically analyzing the results, we found significant effects of TERT overexpression in sociability, social novelty preference, anxiety, nest building, and electroseizure threshold in the males but not their female littermates. Along these differences are the male-specific increased expressions of postsynaptic proteins which are the NMDA and AMPA receptors in the prefrontal cortex. The vGluT1 presynaptic proteins, but not GAD, were upregulated in both sexes of TERT-tg mice, although it is more significantly pronounced in the male group. Here, we confirmed that the behavioral effect of TERT overexpression in mice was male-specific, suggesting that the aberration of this gene and its downstream pathways preferentially affect the functional development of the male brain, consistent with the male preponderance in ASD.

Chronic mild stress (CMS) has been reported to induce an anhedonic-like state in mice that resembles some of the symptoms of human depression. In the present study, we used a chronic mild stress animal model of depression and anxiety to examine the responses of two strains of mice that have different behavioral responsiveness. An outbred ICR and an inbred C57BL/6 strain of mice were selected because they are widely used strains in behavioral tests. The results showed that the inbred C57BL/6 and outbred ICR mice were similarly responsive to CMS treatment in sucrose intake test (SIT) and open field test (OFT). However, the two strains showed quite different responses in forced swimming test (FST) and novelty-suppressed feeding (NSF) test after 3 weeks of CMS treatment. Only C57BL/6 mice displayed the depression- and anxiety-like behavioral effects in response to CMS treatment in FST and NSF test. Our results suggest that there are differences in responsiveness to CMS according to the different types of strain of mice and behavioral tests. Therefore, these results provide useful information for the selection of appropriate behavioral methods to test depression- and anxiety-like behaviors using CMS in ICR and C57BL/6 mice.

This study was conducted to find gender differences in physical activity, dietary habit and nutrient intake in 4∼6th grade students in elementary school. Physical activity assessment showed that males significantly engaged in more vigorous activity with longer duration than females. It was found that females skipped their breakfast more often and had more snack than males. On the other hand, males were more indulged in peaky eating, despite their good practice of drinking milk. Twenty-four hour dietary recall revealed that energy intakes in both males and females were not sufficient. Furthermore, subjects, regardless of gender, consumed marginal intakes of Ca and Fe. Special attention should be given to marginal intakes of Ca in the subjects. Due to low Fe intake in females, more caution should be taken to include a meal which can enhance iron absorption. It might be suggested that effective intervention strategies need to be developed and implemented to choose nutrient dense foods and activities that lead to better health.

Purpose: The financial independence rate (FIR) is an important regional factor that may be associated with older adults’ health status in the context of the COVID-19 pandemic. However, a comprehensive examination of older adults’ health status, healthcare utilization, and health behaviors by residential area is lacking. This study aimed to analyze regional differences in health status (including physical and mental health) among older adults across two survey years (2019 and 2020), and to examine its associations with health behaviors and healthcare utilization. Methods: In this descriptive correlational study, data were collected from 74,547 older adults in 2019 and 72,812 in 2020 across metropolitan and non-metropolitan areas categorized by FIR, reflecting local governments’ fiscal capacity. Results: In both survey years, older adults living in non-metropolitan areas with below-average FIR had higher odds of unhealthy subjective health status (adjusted odds ratio [AOR]=1.44~1.52, 95% confidence interval [CI]=1.38~1.60) and unhealthy subjective oral health status (AOR=1.26~1.37, 95% CI=1.21~1.44) compared with those in the metropolitan region, along with lower physical activity and greater unmet healthcare needs. The association between region and depressive symptoms was significant in 2019 (AOR=1.09, 95% CI=1.03~1.15) but not in 2020 (AOR=0.95, 95% CI=0.90~1.01). Conclusion: Regional disparities in health behaviors and healthcare utilization were observed among older adults, particularly in non-metropolitan areas with below-average FIR. Policies improving healthcare accessibility and chronic disease management, alongside community-based and nurse-led interventions, may help reduce these regional health disparities.

Purpose: This study aims to investigate gender differences in the association between depressive symptoms and weight, weight perception, and body satisfaction among Korean adolescents. Methods: A secondary data analysis was performed on data from 33,374 adolescents who participated in the 2015 Adolescent Health Behavior Online Survey. They were classified as underweight, normal weight, or overweight/obese; weight perception was classified into perception of being underweight, normal weight, or overweight/obese; and weight satisfaction into desire to gain weight, satisfied, and desire to lose weight. Results: Among boys, perception of being underweight (adjusted odds ratio [AOR]: 1.20, 95% confidence interval [CI]: 1.07~1.35) and desire to gain weight (AOR: 1.45, 95% CI: 1.30~1.62) were associated with depression. Among girls, perception of being overweight or obese (AOR: 1.18, 95% CI: 1.07~ 1.29) and a desire to lose weight (AOR: 1.30, 95% CI: 1.18~1.42) were associated with depression. Conclusion: Gender differences were observed in the association between weight perception and depression in adolescents. The perception of being underweight among boys and the perception of being overweight/overweight among girls were associated with depression. Thus, gender-specific intervention programs to correct weight perception and weight satisfaction are needed in order to relieve depressive symptoms in adolescents.

Objective To determine the age-related changes in cardiac rehabilitation (CR) outcomes, which includes hemodynamic and metabolic factors, in patients with myocardial infarction (MI).Methods CR was administered for 8 weeks to 32 men (mean age, 54.0±8.8 years) who underwent percutaneous coronary intervention for acute MI between July 2012 and January 2016. The exercise tolerance tests were performed before and after the CR. The results were stratified based on a cut-off age of 55 years.Results In the whole patient group, the hemodynamic variables such as the resting heart rate (HRrest), systolic blood pressure (SBPrest), submaximal HR (HRsubmax), SBP (SBPsubmax), and rate pressure product (RPPsubmax) significantly decreased and the maximal HR (HRmax) and RPP (RPPmax) significantly increased. All metabolic variables displayed significant improvement, to include maximal oxygen consumption (VO2max) and ventilation (VEmax), anaerobic threshold (AT), and the maximal oxygen pulse (O2pulsemax). However, upon stratification by age, those who were younger than 55 years of age exhibited significant changes only in the HRrest and RPPsubmax and those aged 55 years old or greater displayed significant changes in all hemodynamic variables except diastolic BP. Both groups displayed significant increases in the VO2max, VEmax, and AT; the older group also exhibited a significant increase in O2pulsemax. The magnitude of the changes in the hemodynamic and metabolic variables before and after CR, based on age, did not differ between the groups; although, it tended to be greater among the older participants of this study’s sample.Conclusion Because the older participants tended to show greater hemodynamic and metabolic changes due to CR, a more aggressive CR program must be administered to elderly patients with MI.

Objective To investigate the changing patterns of edema, quality of life (QOL), and patient-satisfaction after complex decongestive therapy (CDT) in three trajectories: arm lymphedema (AL), secondary leg lymphedema (LL) and primary leg lymphedema (PL).Methods Candidates for AL (n=35), LL (n=35) and PL (n=14) were identified from prospective databases. The patients were treated with CDT for 2 weeks, and lymphedema volume was measured before and immediately following the therapy. Patients then self-administered home therapy for 3 months and presented for a follow-up visit. The Korean version of Short Form-36 (SF-36) was used to assess QOL, and we administered a study-specific satisfaction survey. Results There was no significant difference in the volume reductions between the 3 groups. There were no significant differences in all of the measures between PL and LL. Overall initial QOL was significantly lower in patients with LL than in patients with AL. SF-36 scores post-CDT did not differ significantly between AL and LL. Clinically significant differences were noted between AL and LL in the mean values of the satisfaction survey.Conclusion AL, LL, and PL may have different longitudinal courses. We suggest that lower extremity lymphedema patients present more favorable outcomes after CDT with respect to QOL and satisfaction than upper extremity lymphedema patients. Clinicians should approach patients with different therapeutic considerations specific to each type or region of lymphedema before using CDT in clinical practice.

Background: During postural control, older adults are more dependent on proprioception than are young adults. Ankle proprioception, which plays an important role in maintaining postural balance, decreases with age. Published studies are insufficient to establish a significant age difference in postural sway resulting from the known age-related decrease in ankle proprioception and do not examine various detailed test conditions. Objects: The present study aimed to compare ankle proprioception between older and younger groups along dimensions of position vs. force proprioception and dorsiflexion vs. plantarflexion. The present study also aimed to compare postural sway between young and older women during quiet standing under two sensory conditions. Methods: We recruited seven young women aged 21-24 and seven older women aged 60-63. Ankle proprioception was assessed as the accuracy of the joint position sense (JPS) and the force sense (FS). Postural sway was assessed using center-of-pressure measurements recorded during quiet standing under two sensory positions: eyes open and eyes closed with head tilted back. Results: Older women had lower JPS in dorsiflexion and lower FS in plantarflexion than did younger women. We found no significant age differences in JPS in plantarflexion or in FS in dorsiflexion. We observed a main effect of group on postural sway in two sway parameters out of three. We observed significant differences in JPS with dorsiflexion, and in FS with plantarflexion. Conclusion: Proprioception for ankle plantar flexor decreased more significantly with aging than did that for ankle dorsiflexor, accounting for the impaired postural balance observed in older women.

Purpose: This study examined the factors affecting mortality and clinical severity score (CSS) of male and female patients with Coronavirus Disease 2019 (COVID-19) using clinical epidemiological information provided by the Korea Disease Control and Prevention Agency. Methods: This is a retrospective, observational cohort study. From January 21 to April 30, 2020, a total of 5624 patients who were released from quarantine or died were analyzed. Results: The factors influencing release or death that differed by sex were high heart rate and malignancy in males and chronic kidney disease in females. In addition, the factors influencing progression to severe CSS were high BMI (severe obesity) and rheumatic disease in males and high temperature, sputum production, absence of sore throat and headache, chronic kidney disease, malignancy, and chronic liver disease in females. Older age, low lymphocyte count and platelets, dyspnea, diabetes mellitus, dementia, and intensive care unit (ICU) admission affected mortality in all the patients, and older age, low lymphocyte count and platelets, fever, dyspnea, diabetes mellitus, dementia, and ICU admission affected progression to severe stage of CSS. Conclusions: This study is expected to contribute to the general results by analyzing nationally representative data. The results of this study present an important basis for development of differentiated nursing and medical management strategies in consideration of factors that influence treatment effects and outcomes according to sex of patients with COVID-19.