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Special Article
Problems and suggested improvement plans for occupational health service in Korea
Dongmug Kang
Ann Occup Environ Med 2023;35:e10.   Published online May 11, 2023
DOI: https://doi.org/10.35371/aoem.2023.35.e10
AbstractAbstract AbstractAbstract in Korean PDFSupplementary MaterialPubReaderePub

The purpose of this paper was to review the problems relating to Korea’s occupational health services and suggest ways to improve them. Korea can be classified as a welfare state type of conservative corporatism partially interwoven with liberalism. While experiencing compressed economic growth, the economic sectors of developed (excess areas) and developing (deficient areas) countries are interwoven. Therefore, it is necessary to perfect conservative corporatism along with a complementary reinforcement of liberal contents and to apply a multilayered approach focusing on complementing the deficient areas. It is essential to form a national representative indicator related to occupational health, and a strategy for selection and concentration is needed. The proposed central indicator is the occupational health coverage rate (OHCR), which is the number of workers who have applied for mandatory occupational health services under the Occupational Safety and Health Act in the numerator with the total working population in the denominator. This paper proposes ways to raise the OHCR, which is currently at the level of 25%–40%, to 70%–80%, which is the level of Japan, Germany, and France. To achieve this target, it is necessary to focus on small businesses and vulnerable workers. This is an area of market failure and requires the active input of community-oriented public resources. For access to larger workplaces, the marketability of services should be strengthened and personal intervention using digital health resources should be actively attempted. Taking a national perspective, work environment improvement committees with tripartite (labor, management, and government) participation for improvement of the working environment need to be established at the center and in the regions. Through this, prevention funds linked to industrial accident compensation and prevention could be used efficiently. A national chemical substance management system must be established to monitor the health of workers and the general public.

한국의 직업보건서비스의 문제점과 개선 방안
한국의 직업보건서비스의 문제점을 살펴보고 개선 방안을 제시하고자 하였다. 발간된 논문과 보고서 및 2022년의 산업보건환경 변화에 따른 대응방안 연구(정책포럼)1의 결과를 중심으로 조사하였다. 한국은 보수적조합주의를 근간으로 한 자유주의가 가미된 형태의 복지국가유형으로 분류할 수 있고, 압축적 경제성장을 경험하면서 선진국과 개발도상국의 영역이 섞여 있어 과잉과 결핍이 혼재되어 있다. 따라서 한국의 직업보건서비스의 발전을 위해서는 보수조합주의적 완성도를 높이면서 부수적으로 자유주의적 내용을 보완하여야 하며, 동일한 발전단계에 대한 단일한 접근법 보다는 결핍영역에 대한 보완을 중심으로 한 중층적 접근법이 필요하다. 직업보건관련 중심적 지표를 형성하고 이에 대한 선택과 집중전략이 필요하며, 중심지표로는 현재 25~40% 수준에 머물러 있는 직업보건 적용율을 독일, 프랑스, 일본 수준인 70~80% 수준으로 제고하는 것을 목표로 삼기를 제안한다. 이렇게 하기 위해서는 소규모 사업장과 취약한 노동자에 대해 집중하여야 하며, 이 영역은 시장실패영역으로서 지역중심의 공공자원의 적극적 투입이 필요한데, 전국 보건소 숫자인 256개 정도의 지역에 지역 직업보건 지원센터를 건립할 것을 제안한다. 중규모 이상의 사업장에 대한 접근으로는 서비스의 수요에 기반한 시장성을 강화하고 디지털헬스를 이용한 개인영역의 중재를 적극 시도하여야 한다. 전국적차원에서 사업장 작업환경개선과 중재를 위한 노사정이 참여하는 작업환경개선위원회를 중앙과 지역에 설치하고, 이를 통해 산재보상과 예방을 연계한 예방기금을 효율적으로 사용하도록 한다. 국가 차원의 화학물질 관리체계를 구축하고, 근로자와 일반국민의 건강을 모니터링할 수 있어야 한다

Citations

Citations to this article as recorded by  
  • Precarious employment and the onset of depressive symptoms and problematic alcohol use in middle-aged or older workers: A Korean longitudinal study (2006–2022)
    Seong-Uk Baek, Yu-Min Lee, Jong-Uk Won, Jin-Ha Yoon
    Social Science & Medicine.2024; 357: 117170.     CrossRef
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    Seong-Uk Baek, Yu-Min Lee, Jin-Ha Yoon
    Journal of Affective Disorders.2024; 351: 931.     CrossRef
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    Seong-Uk Baek, Jong-Uk Won, Yu-Min Lee, Jin-Ha Yoon
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    Seong-Uk Baek, Jong-Uk Won, Jin-Ha Yoon
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  • 248 View
  • 5 Download
  • 5 Web of Science
  • 4 Crossref
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Original Article
Association between coronavirus disease 2019-related workplace interventions and prevalence of depression and anxiety
Hyun Woo Park, Seung Hyun Park, Young Wook Kim, JunSeok Son, Chan Woo Kim, Hyoung Ouk Park, Jun Ho Lee, Young Hoo Shin, Chang Ho Chae, Eui Yup Chung, Hun Jeong
Ann Occup Environ Med 2022;34:e11.   Published online June 3, 2022
DOI: https://doi.org/10.35371/aoem.2022.34.e11
AbstractAbstract AbstractAbstract in Korean PDFSupplementary MaterialPubReaderePub
Background

Although coronavirus disease 2019 is causing a variety of psychological problems for workers, there are few longitudinal studies on changes in workers’ mental health by workplace intervention. This study aimed to evaluate the change in the prevalence of depression and anxiety according to the active involvement of the workplace.

Methods

This study was conducted on 1,978 workers at a workplace who underwent a health screening from January 2019 to August 2020, and classified depression and anxiety disorders using a self-report questionnaire. After the first pandemic, the company stopped health screening, took paid leave and telecommuting, and conducted interventions such as operating its own screening clinic. To see if this workplace intervention affects workers’ mental health, we conducted generalized estimating equations to compare odds ratio (OR).

Results

In the pre-intervention group, 384 people (16.86%) had depression, and 507 people (22.26%) had anxiety disorder. Based on the OR before intervention, the OR of depression decreased to 0.76 (0.66–0.87) and the OR of anxiety disorder decreased to 0.73 (0.65–0.82).

Conclusions

As a result of this study, it was confirmed that workplace intervention was related to a decrease in depression and anxiety. This study provides basic data to improve workers’ mental health according to workplace intervention, and further research is needed according to workplace intervention in the future.

코로나바이러스감염증-19 관련 사업장 개입과 우울증 및 불안장애 유병률 간의 관련성
목적
COVID-19가 근로자에게 다양한 심리적 문제를 야기하고 있지만, 사업장 개입이 근로자의 정신 건강의 변화에 대한 종단적 연구는 거의 없다. 이 연구는 사업장의 적극적인 개입 여부에 따른 우울, 불안의 유병률 변화를 평가하는 것을 목표로 하였다.
방법
본 연구는 2019년 1월부터 2020년 8월까지 건강검진을 받은 한 사업장의 근로자 1,978명을 대상으로 하였으며, 자기기입식 설문지를 이용하여 우울증, 불안장애를 분류하였다. 이 회사는 1차 대유행 이후 건강검진을 중단하고, 유급휴직 및 재택근무, 자체선별진료소 운영 등의 개입을 실시하였다. 이런 사업장 개입이 근로자의 정신건강에 영향을 미치는지 알아보기 위해 Generalized estimating equation(GEE)을 시행하여 Odds ratio(OR)을 비교하였다.
결과
Pre-intervention group에서 우울증은 총 384명(16.86%)이었으며, 불안장애는 총 507명(22.26%)이었다. Pre-intervention group의 OR를 기준으로 하였을 때, post-intervention group의 우울증 OR는 0.76(0.66-0.87), 불안장애의 OR는 0.73(0.65-0.82)로 감소하였다.
결론
본 연구 결과, 사업장의 개입이 우울, 불안의 감소와 관련이 있다는 것을 확인할 수 있었다. 본 연구는 사업장 개입 여부에 따른 근로자 정신건강을 개선시키기 위한 기초자료를 제공하며, 향후 사업장 개입에 따른 추가 연구가 필요할 것으로 본다.

Citations

Citations to this article as recorded by  
  • Telecommuting-related health outcomes during the COVID-19 pandemic in South Korea: a national population-based cross-sectional study
    Seung-Woo Ryoo, Jin-Young Min, Dong-Wook Lee, Baek-Yong Choi, Juho Choi, Ho-Yeon Kim, Kyoung-Bok Min
    BMC Public Health.2023;[Epub]     CrossRef
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    Seong-Uk Baek, Jong-Uk Won, Jin-Ha Yoon
    Preventive Medicine.2023; 177: 107787.     CrossRef
  • 192 View
  • 0 Download
  • 2 Web of Science
  • 2 Crossref
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Case Report
Design and Evaluation of Ergonomic Interventions for the Prevention of Musculoskeletal Disorders in India
Somnath Gangopadhyay, Samrat Dev
Ann Occup Environ Med 2014;26:18-18.   Published online July 1, 2014
DOI: https://doi.org/10.1186/2052-4374-26-18
AbstractAbstract PDFPubReaderePub
Background

Improper workstation, work procedures and tools are found to be the risk factors for the development of musculoskeletal disorders among the informal sector workers of the developing countries. Low cost ergonomic interventions can effectively improve such adverse conditions.

Case presentation

In the present article some studies related to design interventions in different informal and agricultural sectors were discussed and their efficacies were analyzed. It was observed that with the help of appropriate interventions musculoskeletal disorders were reduced, adverse physiological conditions were improved when awkward postures were corrected and ultimately the organisational productivity was increased.

Conclusion

Proper implementation of ergonomic interventions can ultimately improve the economy of the nation.


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Review
An Evidence-Based Multidisciplinary Practice Guideline to Reduce the Workload due to Lifting for Preventing Work-Related Low Back Pain
P Paul FM Kuijer, Jos HAM Verbeek, Bart Visser, Leo AM Elders, Nico Van Roden, Marion ER Van den Wittenboer, Marian Lebbink, Alex Burdorf, Carel TJ Hulshof
Ann Occup Environ Med 2014;26:16-16.   Published online June 24, 2014
DOI: https://doi.org/10.1186/2052-4374-26-16
AbstractAbstract PDFPubReaderePub

We developed an evidence-based practice guideline to support occupational safety and health (OSH) professionals in assessing the risk due to lifting and in selecting effective preventive measures for low back pain (LBP) in the Netherlands. The guideline was developed at the request of the Dutch government by a project team of experts and OSH professionals in lifting and work-related LBP. The recommendations for risk assessment were based on the quality of instruments to assess the risk on LBP due to lifting. Recommendations for interventions were based on a systematic review of the effects of worker- and work directed interventions to reduce back load due to lifting. The quality of the evidence was rated as strong (A), moderate (B), limited (C) or based on consensus (D). Finally, eight experts and twenty-four OSH professionals commented on and evaluated the content and the feasibility of the preliminary guideline. For risk assessment we recommend loads heavier than 25 kg always to be considered a risk for LBP while loads less than 3 kg do not pose a risk. For loads between 3–25 kg, risk assessment shall be performed using the Manual handling Assessment Charts (MAC)-Tool or National Institute for Occupational Safety and Health (NIOSH) lifting equation. Effective work oriented interventions are patient lifting devices (Level A) and lifting devices for goods (Level C), optimizing working height (Level A) and reducing load mass (Level C). Ineffective work oriented preventive measures are regulations to ban lifting without proper alternatives (Level D). We do not recommend worker-oriented interventions but consider personal lift assist devices as promising (Level C). Ineffective worker-oriented preventive measures are training in lifting technique (Level A), use of back-belts (Level A) and pre-employment medical examinations (Level A). This multidisciplinary evidence-based practice guideline gives clear criteria whether an employee is at risk for LBP while lifting and provides an easy-reference for (in)effective risk reduction measures based on scientific evidence, experience, and consensus among OSH experts and practitioners.


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Research Article
Effectiveness of a Comprehensive Stress Management Program to Reduce Work-Related Stress in a Medium-Sized Enterprise
Shin-Ae Kim, Chunhui Suh, Mi-Hee Park, Kunhyung Kim, Chae-Kwan Lee, Byung-Chul Son, Jeong-Ho Kim, Jong-Tae Lee, Kuck-Hyun Woo, Kabsoon Kang, Hyunjin Jung
Ann Occup Environ Med 2014;26:4-4.   Published online February 13, 2014
DOI: https://doi.org/10.1186/2052-4374-26-4
AbstractAbstract PDFPubReaderePub
Objectives

To assess the effectiveness of a comprehensive workplace stress management program consisting of participatory action-oriented training (PAOT) and individual management.

Methods

A comprehensive workplace stress management program was conducted in a medium-sized enterprise. The baseline survey was conducted in September 2011, using the Korean Occupational Stress Scale (KOSS) and Worker’s Stress Response Inventory (WSRI). After implementing both organizational and individual level interventions, the follow up evaluation was conducted in November 2011.

Results

Most of the workers participated in the organizational level PAOT and made Team-based improvement plans. Based on the stress survey, 24 workers were interviewed by a researcher. After the organizational and individual level interventions, there was a reduction of several adverse psychosocial factors and stress responses. In the case of blue-collar workers, psychosocial factors such as the physical environment, job demands, organizational system, lack of rewards, and occupational climate were significantly improved; in the case of white-collar workers, the occupational climate was improved.

Conclusions

In light of these results, we concluded that the comprehensive stress management program was effective in reducing work-related stress in a short-term period. A persistent long-term follow up is necessary to determine whether the observed effects are maintained over time. Both team-based improvement activities and individual interviews have to be sustainable and complementary to each other under the long-term plan.


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Original Article
The Effectiveness of an Intervention Program for Subway Operators for Symptoms of Post-traumatic Stress Disorder After the Persons Had Fallen Under a Train
Suk Kyong Choi, Kang Sook Lee, Seon Young Lee, Jae Hee Yu, A Rum Hong, Jeong Ho Chae, Sei Jin Chang
Korean Journal of Occupational and Environmental Medicine 2010;22(1):29-36.   Published online March 31, 2010
DOI: https://doi.org/10.35371/kjoem.2010.22.1.29
AbstractAbstract PDF
OBJECTIVE: The aims of this study were to evaluate the level of job stress in subway workers and to determine the main factors that aggravated their PTSD(Post-Traumatic Stress Disorder) symptom, which were due to having fallen under a train, and to verify the effectiveness of the intervention program.
METHODS
The questionnaires utilized in the survey were composed of the Korean Occupational Stress Scale (the short form, 24 items), the depression scale, the coping scale II, the PTSD scale and the life style, health status and occupational properties. The intervention program for PTSD symptoms was executed for 18 subway operators who had experienced deadly accidents in their service from June 2004 to May 2006. The intervention programs included exercise, meditation and deep breathing for 8 weeks and a written message was sent twice per week.
RESULTS
Compared with pre-intervention, the post-intervention group showed significantly lower scores for the KOSS, depressive symptom and the PTSD.
CONCLUSION
This study showed the intervention program was effective to lower the job stress, the PTSD symptoms and depressive symptoms, and to improve the coping skills. It was suggested that the mental health promotion program should be implemented for subway workers to prevent occupational mental diseases.

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Original Article
Effect Assessment of Worksite-based, Post-examination, Health Care Management System
Kang Jin Lee, Young Hee Choi, Cha Jae Oh, Hoo Rak Lee, Hyoung June Im, Moon Young Hwang, Byung Mann Cho, Ji Ho Lee
Korean Journal of Occupational and Environmental Medicine 2006;18(1):1-14.   Published online March 31, 2006
DOI: https://doi.org/10.35371/kjoem.2006.18.1.1
AbstractAbstract PDF
OBJECTIVES
This study was conducted to develop a worksite-based, post-examination, health care management system for continuous and systematic management of workers with hypertension, diabetes mellitus, hyperlipidemia, and abnormal LFT detected by periodic health examination and to assess the effectiveness such a system as an intervention study.
METHODS
Study subjects were selected from workers with hypertension, diabetes mellitus, hyperlipidemia, and abnormal LFT according to the selection criteria. The intervention group, but not the control group, received medical treatment of disease, follow up examination, and health education which consisted of information about the disease and the importance of life-style modification through periodic interview using the resources of occupational health service center in the worksite. To assess the effectiveness of this system, we compared follow up examination data from the intervention group with periodic examination data from the worksite control group.
RESULTS
In the intervention group a significant reduction trend was recorded for systolic and diastolic blood pressure, fasting blood sugar, postprandial 2 hour glucose, total cholesterol, triglyceride, LDL-cholesterol, AST, ALT, and gamma-GTP, and a rising trend for HDL-cholesterol. Significant group differences ware recorded for fasting blood sugar, postprandial 2 hour glucose, total cholesterol, AST, and ALT.
CONCLUSIONS
The worksite-based, post-examination, health care management system was effective for the continuous and systematic management of workers who had abnormal findings detected by periodic health examination.

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Original Article
Symptom prevalence and Primary intervention of work-related musculoskeletal disorders and their related factors among manufacturing workers
Hyunjoo Kim, Woo Cheol Jeong
Korean Journal of Occupational and Environmental Medicine 2005;17(2):116-128.   Published online June 30, 2005
DOI: https://doi.org/10.35371/kjoem.2005.17.2.116
AbstractAbstract PDF
OBJECTIVES
To investigate the symptom prevalence and the primary intervention of work-related musculoskeletal diseases(WMSDs) and their related factors among manufacturing workers.
METHOD
A self-administered questionnaire survey was conducted on 2,457 workers, at 22 enterprises in Chungnam province, Korea, from September 1 to December 1, 2003. The contents of the questionnaire included general and work-related characteristics, musculoskeletal symptoms and workers' past one-year experience of primary interventions.
RESULTS
1. The overall symptom prevalence of the musculoskeletal diseases was 23.9%. The WMSD symptom prevalences at the neck/shoulder, arm/elbow, hand/wrist and back/leg were 14.8%. 2.7%. 7.3% and 12.0%, respectively. 2. In multivariate analysis, all WMSD symptom prevalences were high in the high workload, high force & high repetitiveness, and 'high job strain' groups. The WMSD symptom prevalence at neck/shoulder was also high in females and the group experiencing low social support from the supervisor. 3. The rates of the primary interventions were as follows : 13.7% for health education, 5.8% for health counselling, 18.8% for preventive exercise, 24.7% for ergonomic intervention, and 9.8% for administrative intervention. 4. In multivariate analysis, the size of the enterprises and the type of occupational health management system(OHMS) were significantly associated with all primary interventions except health counselling(p<0.05). The other individual-level predictive factors were as follows. Those for the health education were male and union presence. Those for the health counselling were older age(> or =40 years), irregular employment, and the active group of Karasek's job strain model. Those for the preventive exercise were male, older age, longer tenure and regular employment. Those for the ergonomic intervention were longer tenure, job of physical force and/or repetitiveness, high job stain and the group experiencing high social support from the supervisor. The predictive factor for the administrative intervention was male (p<0.05).
CONCLUSIONS
To establish an effective strategy for the primary prevention of WMSDs, approaches are needed which consider the individual nature of small and medium sized enterprises. IAlso necessary is to promote the participation of labor and management because the activation of the primary intervention was associated with the type of OHMS and union presence. Moreover the reduction of workload and increased intervention into the high risk group could be effective in the prevention of WMSDs.

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Original Article
Characteristics of Work-Related Musculoskeletal Disorders and Effect of Intervention Program in Shipyard Workers
Hong Jae Chae, Seong Kwan Lee, Kang Jin Lee, Jai Dong Moon
Korean Journal of Occupational and Environmental Medicine 2002;14(4):468-477.   Published online December 31, 2002
DOI: https://doi.org/10.35371/kjoem.2002.14.4.468
AbstractAbstract PDF
OBJECTIVES
This study was conducted to estimate the characteristics of work-related musculoskeletal disorders and the effect of intervention program in shipyard workers.
METHODS
Information on work related absences,due to musculoskeletal disorders, were collected between January, 1 2000 and August, 31 2002. Age, duration of work, job type, anatomical site of disease, cause and duration of absence due to sickness were investigated.
RESULTS
From a total of 158 cases there were 108(68.4%)and 50(31.6%)cases of back, and other musculoskeletal complaints,respectively. 55(34.8%)of the cases were caused by repetitive trauma and 103(65.2%)were due to non-repetitive causes. 90(83.3%)of the back complaint cases were due to non-repetitive causes, but there was a repetitive cause of other musculoskeletal complaints in 37(74.0%)cases. Back complaints were higher in workers carrying heavy materials, but other musculoskeletal complaints were higher in painting workers.Half of workers after an absence due to sickness had returned to work within 32.0 weeks and 25.4 weeks,in the cases of back and other musculoskeletal complaints, respectively. After the application of an intervention program for musculoskeletal disease, the incidence rate of absence due to work-related musculoskeletal disorders was reduced significantly.
CONCLUSION
The introduction of a musculoskeletal intervention program reduced absences due to work-related musculoskeletal disorders.

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    Gi-Yeol Kim, Jung-Lim Oh, Kyoung-Ok Hwang
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    Yu-Chang Kim
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    Jong-Eun Kim, Young-Ki Kim, Dong-Mug Kang
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Original Article
The effectiveness of the intervention in the workplace on patients suffering from Cervicobrachial disorder
Myung Ho Sohn, Jin Su Choi, Seok Joon Sohn, Yang Ok Kim, Jong Park
Korean Journal of Occupational and Environmental Medicine 1999;11(4):460-475.   Published online December 31, 1999
DOI: https://doi.org/10.35371/kjoem.1999.11.4.460
AbstractAbstract PDF
OBJECTIVES
In order to reveal the effectiveness of the intervention in the workplace on patients suffering from cervicobrachial disorder (CBD), we reexamined 96 workers out of 137 workers suffering from CBD on the assembly lines of an electric manufacturing factory by using questionnaires, physical exams and neurological exams.
METHODS
Analyses were made of the characteristics of the 96 workers of this company suffering from 1994 to 1996 with special concern for differences before and after the improvement of the working environment. After reexamination of the 96 patients the following results were obtained.
RESULTS
We observed an improvement in the 10 most common subjective symptoms of CBD. These symptoms included general fatigue, pain on neck and shoulders, dullness of the upper extremities, back pain and discomfort and a tingling sensation in the hands and wrists (p < 0. 05). The percentage of workers who complained muscle tenderness of neck and shoulder were reduced (p < 0.05). the percentage of workers with abnormal Morley examination was reduced from 28. 5% to 2. 100 (p < 0.01), and of workers with abnormal EMG finding went from 12. 4% to 2. lao (p < 0. 01) and of grade 3 and grade 4 CBD was reduced from 42. 3% and 18. 3% respectively to 33. 3% and 2. ba (p < 0. 01). Grade 3 and over laborers of CBD had higher scores in somatization, anxiety, depression, hostility, interpersonal sensitivity, phobic anxiety, obsessive-compulsive, neurasthenic, hypochondriacal than other sufferers in the SCL-90-R exam (p < 0. 01).
CONCLUSIONS
in conclusion intervention had effectiveness on subjective symptoms of neck and shoulder and decreasing abnormal finding of muscle tenderness, neurological examination and EMG.

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    Han-Na Choi, Seoung-Whon Lee, Cheol-Hong Kim, Hyun-Min Yoon, Kyung-Jeon Jang
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