Depopulation, super aging, and extreme heat events in South Korea.

South Korea's population is declining and its composition changing, associated with lowest-low fertility rates and rapid aging (super aging). When estimating changes in future exposure to extreme heat events (EHE), events that are predicted to be intensified due to climate change, it is important to incorporate demographic dynamics. We analyze business-as-usual (BAU) population and climate scenarios-where BAU refers to no significant change in current processes and trends in either domain-from 2010 to 2060 for South Korea. Data for both BAU scenarios are spatially linked and used to measure and identify national and sub-national and age-group specific EHE exposure. The results reveal an increasing exposure to EHE over time at the national level, but this varies widely within the country, measured at the municipal level. The most intensive exposure levels will be in the decade ending in 2040 driven by high estimated severe EHE. Sub-nationally, Seoul will be the most vulnerable municipality associated with super aging, while severe EHE not demographic factors will be relevant in Daegu, the second-most vulnerable metropolitan area. By 2060, national estimates suggest the older population will be up to four times more exposed to EHE than today. While the population of South Korea will decline, the rapid aging of the population ensures that specific regions of the country will become exceedingly vulnerable to EHE.

Super Aging in South Korea Unstoppable but Mitigatable: A Sub-National Scale Population Projection for Best Policy Planning.

This research portrays the spatial and temporal progression of super-aging in regions throughout South Korea. Using a single-year population projection considering gross domestic migration, this research identifies which regions will shortly become a super-aged society. A cohort-component method with a migrant pool model is applied. The county-level national population registration data (2000-2018) are aggregated into 37 regions for the model run. In 2020, 16 rural regions will become super-aged societies. By 2029, all 37 regions, including the metropolitan areas, will join the group, with Sejong, the administrative capital, being the last to enter. In brief, the rural areas become super-aged earlier than the metropolitan areas, and within a decade, those 65 years old or older will make up the majority of the national population. Among all the metropolitan areas, Busan, the largest harbor city, will be the first to be super-aged in 2023. Sejong will experience the most radical change between 2020 and 2050. The research outcomes demonstrate that demographic changes in the rural and metropolitan areas are different; hence, the recent population policies, such as promoting fertility, may not work in the rural areas as they have already lost their population momentum due to the extreme and ongoing urbanization throughout the nation. The unstoppable aging will pose adverse effects on future citizens (who are mostly senior) both financially and medically. An increase in health care expenditure and a nationwide blood shortage for transfusion are anticipated, for example.

Massive pneumoperitoneum after scuba diving.

Pneumoperitoneum usually indicates rupture of a hollow viscus and considered a surgical emergency. But air may also enter the peritoneum from the lung or the genital organs in female without visceral perforation. While scuba diving, the rapid ascent is usually controlled by placing in a decompression chamber and the excess gas volume is exhaled. Failure to allow this excess gas to escape will result in overdistension of air passage, which may rupture resulting in pulmonary interstitial emphysema or, if air enters the circulation, air embolus can occur. Pneumo-peritoneum is a rare complication of diving accidents. While the majority of cases are not related to an intraabdominal catastrophy, more than 20% have been the result of gastric rupture. We report a 42-yr-old male patient with massive pneumoperitoneum after scuba diving, who presented himself with dyspnea and abdominal distension. Knowledge of this rare condition and its benign course may allow the emergency physician and surgeon to order appropriate studies to help avoid unnecessary surgical treatment. It is important to determine promptly whether the air emanated from a ruptured viscus or was introduced from an extraperitoneal source. Free air in the abdomen does not always indicate a ruptured intra-abdominal viscus.