We evaluated the spatial variation in thyroid cancer incidence and its determinants in Korea considering its importance in cancer prevention and control. This study was based on the ecological design ...with cancer incidence data by administrative district from the National Cancer Center and regional characteristics generated from the Korea Community Health Survey Data. We identified spatial clusters of thyroid cancer incidences based on spatial scan statistics. Determinants of regional variation in thyroid cancer incidence were assessed using the Besag-York-Mollie model with integrated nested Laplace approximations. Spatial clusters for low and high thyroid cancer incidences were detected in the northeastern and southwestern regions, respectively. Regional variations in thyroid cancer incidence can be attributed to the prevalence of recipients of basic livelihood security (coefficient, - 1.59; 95% credible interval CI, - 2.51 to - 0.67), high household income (coefficient, 0.53; 95% CI, 0.31 to 0.76), heavy smoking (coefficient, - 0.91; 95% CI, - 1.59 to - 0.23), thyroid dysfunction (coefficient, 3.24; 95% CI, 1.47 to 5.00), and thyroid cancer screening (coefficient, 0.38; 95% CI, 0.09 to 0.67). This study presented the spatial variations in thyroid cancer incidence, which can be explained by the prevalence of socioeconomic factors, thyroid cancer screening, thyroid dysfunction, and smoking.
Coronavirus disease (COVID-19) has been spreading all over the world; however, its incidence and case-fatality ratio differ greatly between countries and between continents. We investigated factors ...associated with international variation in COVID-19 incidence and case-fatality ratio (CFR) across 107 northern hemisphere countries, using publicly available COVID-19 outcome data as of 14 September 2020. We included country-specific geographic, demographic, socio-economic features, global health security index (GHSI), healthcare capacity, and major health behavior indexes in multivariate models to explain this variation. Multiple linear regression highlighted that incidence was associated with ethnic region (p < 0.05), global health security index 4 (GHSI4) (beta coefficient β 0.50, 95% Confidence Interval CI 0.14-0.87), population density (β 0.35, 95% CI 0.10-0.60), and water safety level (β 0.51, 95% CI 0.19-0.84). The CFR was associated with ethnic region (p < 0.05), GHSI4 (β 0.53, 95% CI 0.14-0.92), proportion of population over 65 (β 0.71, 95% CI 0.19-1.24), international tourism receipt level (β - 0.23, 95% CI - 0.43 to - 0.03), and the number of physicians (β - 0.37, 95% CI - 0.69 to - 0.06). Ethnic region was the most influential factor for both COVID-19 incidence (partial Formula: see text = 0.545) and CFR (partial Formula: see text = 0.372), even after adjusting for various confounding factors.
In this study, we evaluated the effectiveness of the bivalent mRNA COVID-19 vaccines against the Omicron variant in individuals with or without prior SARS-CoV-2 infection history. We assessed the ...SARS-CoV-2-specific neutralizing antibody in serum samples by surrogate virus neutralizing assay (sVNT) and determined the serum’s neutralizing capacity against the Omicron BA.5 by a plaque reduction neutralizing test (PRNT50). The results of the sVNT assay demonstrate a higher percentage of inhibition of the serum samples from the infected group than from the uninfected group (p = 0.01) before the bivalent vaccination but a similarly high percentage of inhibition after the vaccination. Furthermore, the results of the PRNT50 assay demonstrate a higher neutralizing capacity of the serum samples against Omicron BA.5 in the infected group compared to the uninfected group, both before and after the bivalent vaccine administration (p < 0.01 and p = 0.02 for samples collected before and after the bivalent vaccination, respectively). A higher neutralizing capacity of the serum samples against BA.5 following bivalent vaccination compared to those before vaccination suggests the efficacy of bivalent mRNA COVID-19 vaccines in triggering an immune response against the Omicron variant, particularly BA.5, regardless of infection history.
To evaluate the prevalence and risk factors of myopia in adult Korean population.
Population-based cross-sectional data of 3,398 subjects aged 19 to 49 years was obtained using the Korea National ...Health and Nutrition Examination Survey 2013-2014 (KNHANES VI). Data, including refractive errors and potential risk factors were analyzed. The prevalence and risk factors of myopia, low myopia, and high myopia-defined as a spherical equivalent (SEQ) ≤ -0.5 diopters (D), -6.0 D < SEQ <-0.5 D, and SEQ ≤ -6.0 D, respectively-were evaluated.
The prevalence of myopia and high myopia were 70.6 (standard error (SE), ±1.1)% and 8.0 (SE, ±0.6)%, respectively. In multivariable analysis, younger age, higher education (≥12 years), parental myopia, lower serum 25-hydroxyvitamin D (25(OH)D) concentration (<9 ng/mL), longer time spent on near work (≥3 hours/day), and higher white blood cell (WBC) count (5-8.9 x 103) were associated with increased prevalence of both myopia and high myopia. Serum 25(OH)D concentration of ≥ 9 ng/ml was significantly associated with decreased prevalence of high myopia in participants with near work of ≥3 hours/day, although the effect was not significant in myopia and low myopia.
The prevalence of myopia and high myopia in Korean adults was substantially high, which increased with decreasing age. In addition to parental myopia, the serum 25(OH)D concentration, near work and inflammation reflected by WBC counts may be associated with myopia.
Abstract
Background
A victim of child abuse can often develop mental illness. The early detection of mental illness of children could be supported by observing sleep quality. Therefore, we examined ...the relationship between sleep quality and the changes in child abuse by the child’s own parents over the study period.
Methods
Data from the 2011–2013 Korean Children and Youth Panel Survey was used, and 2012 was set as the baseline. Adolescents who had poor sleep quality in 2011 were excluded from the analysis to obtain the final study population of 1276 adolescents aged 14 and 15 years. The generalized estimating equation model (GEE) was used for statistical analysis.
Results
Children who had experienced and/or were currently experiencing child abuse showed significantly poorer sleep quality (current year abuse only: odds ratio OR = 0.57, 95% confidence interval CI = 0.41, 0.79; prior year abuse only: OR = 0.72, 95% CI = 0.52, 0.99; continuous abuse: OR = 0.56, 95% CI = 0.39, 0.80) compared to children who had no experience of child abuse.
Conclusion
Child abuse remains a traumatic experience that influences the quality of sleep and hinders the child’s proper psychological development. We suggest approaching this issue at both the community and national levels to protect the victims.
The coronavirus disease (COVID-19) has been a worldwide concern since 2019. Vaccines are predicted to be crucial in preventing further outbreaks. The development and kinetics of immune responses ...determine the efficacy of COVID-19 vaccines.
We measured interferon-gamma (IFN-γ) levels upon administering homologous adenovirus vector-based (ChAdOx1-S AZ, Ad26.COV2.S JAN), mRNA-based (BNT162b2 PF; mRNA-1273 MO), and heterologous (AZ/PF) vaccines in healthy Korean individuals using two IFN-γ release assays: the Covi-FERON ELISA and T-SPOT Discovery SARS-CoV-2 assay. B cell responses were evaluated by assessing the production of neutralizing antibodies by surrogate virus neutralization assay. The immune response among the vaccine groups was compared after adjusting the vaccination dose and interactions between each group.
AZ triggered the highest T cell response after the first dose but showed instability after the second. PF and MO yielded stable and higher increments of T and B cell responses compared to AZ. MO yielded a higher immune response than PF. JAN yielded T and B cell responses at lower levels than the other vaccines. The booster dose triggered significant increases in the T and B cell responses and is therefore needed to protect against SARS-CoV-2 given the possibility of waning immune responses.
Administering two doses of mRNA vaccines provides the most effective results among the administered vaccines in triggering the immune response specific to SARS-CoV-2 in healthy Korean individuals. Administration of booster doses demonstrated a significant increase in the immune response and may provide longer protection against SARS-CoV-2.
There have been reports on regional variation in prevalence of hepatitis B and C, and Clonorchis sinensis (C. sinensis) infection, which indicates potential of spatial variation in liver cancer and ...gallbladder cancer incidence in Korea. Therefore, we aimed to assess the regional variation of liver and gallbladder cancer incidence and its determinants based on the regional distribution of risk factors, including hepatitis B infection in Korea.
This study used an ecological study design and district-level cancer incidence statistics generated by the National Cancer Center. Spatial clusters of liver and gallbladder cancer incidence were detected based on spatial scan statistics using SaTScan™ software. We set the size of maximum spatial scanning window of 25 and 35% of the population at risk for analyses of liver and gallbladder cancer, respectively. Significance level of 0.05 was used to reject the null hypothesis of no cluster. We fitted the Besag-York-Mollie model using integrated nested Laplace approximations to assess factors that influence the regional variation in cancer incidence.
Spatial clusters with high liver cancer incidence rates were detected in the southwestern and southeastern regions of Korea. High gallbladder cancer incidence rates are clustered in the southeastern region. Regional liver cancer incidence can be accounted for the prevalence of high household income (coefficient, - 0.10; 95% credible interval CI, - 0.18 to - 0.02), marital status (coefficient, - 0.14; 95% CI, - 0.25 to - 0.03), the incidence of hepatitis B (coefficient, 0.87; 95% CI, 0.29 to 1.44), and liver cancer screening (coefficient, 0.06; 95% CI, 0.00 to 0.12), while gallbladder cancer incidence was related to the prevalence of high household income (coefficient, - 0.03; 95% CI, - 0.05 to 0.00) and living close to a river with a high prevalence of liver fluke infection (coefficient, 0.55; 95% CI, 0.14 to 0.96).
This study demonstrated geographic variation in liver and gallbladder cancer incidence, which can be explained by determinants such as hepatitis B, income, marital status, and living near a river.
Objectives
Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) vaccine effectiveness in coronavirus disease (COVID-19) patients with breakthrough infections has not been established in South ...Korea. To address this, we assessed the impact of vaccination on symptom occurrence and viral load.
Methods
We performed a retrospective cohort study of 9,030 COVID-19 patients enrolled between February and November 2021. The impact of vaccination on the incidence of symptoms and viral load as indicated by cycle threshold (Ct) values of
RdRp
and
E
genes was evaluated using relative risks (RRs) and 95% confidence intervals (95% CIs).
Results
Compared with unvaccinated patients, fully vaccinated patients were associated with a reduced symptom onset of cough, sputum, and myalgia in COVID-19 patients (RR (95% CI) = 0.86 (0.75–0.99) for cough; RR (95% CI) = 0.74 (0.56–0.98) for sputum; RR (95% CI) = 0.65 (0.53–0.79) for myalgia, respectively). Additionally, lower risk of high viral load, Ct value of
RdRp
gene <15 or Ct value of
E
gene <15, was observed especially in fully vaccinated patients younger than 40 years ((RR (95% CI) = 0.69 (0.49–0.96) for
RdRp
gene; (RR (95% CI) = 0.71 (0.53–0.95) for
E
gene).
Conclusion
SARS-CoV-2 vaccination was associated with a reduced risk of COVID-19 symptoms as well as decreased viral load, especially in patients younger than 40 years.
This study examines the effects of a shift in medical coverage, from National Health Insurance (NHI) to Medical Aid (MA), on health care utilization (measured by the number of outpatient visits and ...length of stay; LOS) and out-of-pocket medical expenses.
Data were collected from the Korean Welfare Panel Study (2010-2016). A total of 888 MA Type I beneficiaries and 221 MA Type II beneficiaries who shifted from the NHI were included as the case group and 2664 and 663 consecutive NHI holders (1:3 propensity score-matched) were included as the control group, respectively. We used the 'difference-in-differences' (DiD) analysis approach to assess changes in health care utilization and medical spending by the group members.
Differential average changes in outpatient visits in the MA Type I panel between the pre- and post-shift periods were significant, but differential changes in LOS were not found. Those who shifted from NHI to MA Type I had increased number of outpatient visits without changes in out-of-pocket spending, compared to consecutive NHI holder who had similar characteristics. However, this was not found for MA Type II beneficiaries.
Our research provides evidence that the shift in medical coverage from NHI to MA Type I increased the number of outpatient visits without increasing the out-of-pocket spending. Considering the problem of excess medical utilization by Korean MA Type I beneficiaries, further researches are required to have in-depth discussions on the appropriateness of the current cost-sharing level on MA beneficiaries.
The coronavirus disease 2019 (COVID-19) pandemic has been one of the most serious global threats to public health recently. The present study examined whether area deprivation is associated with ...concerns related to COVID-19 using large nationwide data across South Korea.
We used nationwide 2020 Korea Community Health Survey and official government database. Of the 225,680 included participants, 123,324 (54.6%) were women, and the mean age was 54.9 17.8 years old. We classified the Area deprivation index (ADI) into Quartile 1 (Least deprived); Quartile 2; Quartile 3; and Quartile 4 (Most deprived). Our primary outcome was the concerns related to COVID-19 (0–16 scores). Multilevel regression analysis was conducted.
The mean score of concerns related to COVID-19 was 11.3 3.2 in the total population. 13.5% of the variability in the scores of concerns related to COVID-19 was accounted for by district areas. Area with Q4 of ADI were associated with an increased score of concerns related to COVID-19 (Q1: reference; Q2: β = 0.218, SE = 0.119, FDR adj.p-value = 0.085; Q3: β = 0.235, SE = 0.133, FDR adj.p-value = 0.094; Q4: β = 0.252, SE = 0.109, FDR adj.p-value = 0.029). 19–49 groups in area with Q4 of ADI were associated with an increase in scores of concerns related to COVID-19 than other age groups in area with Q4 of ADI. Area with Q4 of ADI were associated with a score of concern of being criticized if getting infected compared to area with Q1 of ADI.
We found that the highest quartile ADI was associated with greater concerns related to COVID-19. By identifying vulnerable population to concerns related to COVID-19, health systems may consider preventive intervention to mitigate mental health issues.
•Women, lower household income, married, more depressed individuals had higher concerns related to COVID-19.•Concerns related to COVID-19 was accounted 13.5% by area characteristics.•Individuals lived in most deprived area had higher concerns of COVID-19.•Aged 19–49 lived in most deprived area had higher concerns of COVID-19.•“Concerns of being blamed by others of infection” was the most influential.
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