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Articles from open access and local journals are important resources for research in Korea and the usage trends of these articles are important indicators for the assessment of the current research practice. We analyzed an institutional collection of published papers from 1998 to 2014 authored by researchers from Seoul National University, and their references from papers published between 1998 and 2011. The published papers were collected from Web of Science or Scopus and were analyzed according to the proportion of articles from open access journals. Their cited references from published papers in Web of Science were analyzed according to the proportion of local (South Korean) or open access journals. The proportion of open access papers was relatively stable until 2006 (2.5 ~ 5.2% in Web of Science and 2.7 ~ 4.2% in Scopus), but then increased to 15.9% (Web of Science) or 18.5% (Scopus) in 2014. We analyzed 2,750,485 cited references from 52,295 published papers. We found that the overall proportion of cited articles from local journals was 1.8% and that for open access journals was 3.0%. Citations of open access articles have increased since 2006 to 4.1% in 2011, although the increase in open access article citations was less than for open access publications. The proportion of citations from local journals was even lower. We think that the publishing / citing mismatch is a term to describe this difference, which is an issue at Seoul National University, where the number of published papers at open access or local journals is increasing but the number of citations is not. The cause of this discrepancy is multi-factorial but the governmental / institutional policies, social / cultural issues and authors' citing behaviors will explain the mismatch. However, additional measures are also necessary, such as the development of an institutional citation database and improved search capabilities with respect to local and open access documents. [ABSTRACT FROM AUTHOR]

By utilizing cognitive mapping and leveraging georeferenced text data, this paper aims to suggest a new visualization method that combines the advantages of both conventional and state-of-the-art research techniques to depict the collective identity of place in a single image. The study addressed two research questions: (1) Can crowd-sourced text data be utilized in representing place identity? (2) Can collective place identity be expressed in the form of a cognitive map? By confirming that text data gathered from social media effectively demonstrate people’s behaviors and perceptions related to places, we propose a novel method to create a visual representation of urban identity–a “crowd-sourced cognitive map”. In particular, to improve the conventional cognitive mapping method to depict the collective identity of a city, we draw cognitive maps of Bundang and Ilsan developed in the 1990s, as well as Songdo and Dongtan developed in the 2000s, just outside of the administrative boundaries of Seoul in Korea, through a computational method based on crowd-sourced opinions collected from social media. We open the possibility for the use of social media text data to capture the identity of cities and suggest a graphical image through which people without prior information could also easily apprehend the overall image of a city. The work in this paper is expected to provide a methodological technique for appropriate decision-making and the evaluation of urban identity to shape a more unique and imageable city. [ABSTRACT FROM AUTHOR]

With recent aging demographic trends, the needs for enhancing geo-spatial analysis capabilities and monitoring the status of accessibilities of its citizens with healthcare services have increased. The accessibility to healthcare is determined not only by geographic distances to service locations, but also includes travel time, available modes of transportation, and departure time. Having access to the latest and accurate information regarding the healthcare accessibility allows the municipal government to plan for improvements, including expansion of healthcare infrastructure, effective labor distribution, alternative healthcare options for the regions with low accessibilities, and redesigning the public transportation routes and schedules. This paper proposes a new method named, Seoul Enhanced 2-Step Floating Catchment Area (SE2SFCA), which is customized for the city of Seoul, where population density is higher and the average distance between healthcare-service locations tends to be shorter than the typical North American or European cities. The proposed method of SE2SFCA is found to be realistic and effective in determining the weak accessibility regions. It resolves the over-estimation issues of the past, arising from the assignment of high healthcare accessibility for the regions with large hospitals and high density of population and hospitals. [ABSTRACT FROM AUTHOR]

South Korea is ranked as 4th among 34 nations of the Organization for Economic Cooperation and Development with 102 deaths in road accidents per one million population. This paper aims to investigate the factors associated with road accidents in South Korea. The rainfall data of the Korea Meteorological Administration and road accidents data of Traffic Accident Analysis System of Korea Road Traffic Authority is analyzed for this purpose. In this connection, multivariate regression analysis and ratio analysis with the descriptive analysis are performed to uncover the catastrophic factors involved. In turn, the results reveal that traffic volume is the leading factor in road accidents. The limited road extension of 1.47% compared to the 4.14% per annum growth of the vehicles is resulting in road accidents at such a large scale. The increasing proportion of passenger cars accelerate road accidents as well. 56% of accidents occur by the infringement of safety driving violations. The drivers with higher driving experience tend to have a higher accident ratio. The collected data is analyzed in terms of gender, driver experience, type of violations and accidents as well as the associated time of the accidents when they happen. The results indicate that 36.29% and 53.01% of accidents happen by male drivers in the day and night time, respectively. 29.15% of crashes happen due to safety infringement and violations of 41 to 60 years old drivers. The results demonstrate that population density is associated with the accidents frequency and lower density results in an increased number of accidents. The necessity of the state-of-the-art regulations to govern the urban road traffic is beyond dispute, and it becomes even more crucial for citizens’ relief since in our daily lives road accidents are getting more diverse. [ABSTRACT FROM AUTHOR]

Background: No study of obesity risk for people in developed countries has conducted a multi-dimensional analysis of the association of socioeconomic status with obesity. In this paper, we investigated if education functions as either a confounder or an effect modifier in the association of another socioeconomic status indicator with obesity. Methods: This cross-sectional study analyzed data of an adult population sample (10,905 men and 14,580 women) from the Korea National Health and Nutrition Examination Survey (2010–2014). The study performed multivariate logistic regression analyses for three education levels and four indicators of socioeconomic status (i.e., marital status, residential area, occupation, and income). Results: The overall prevalence of obesity was 38.1% in men and 29.1% in women (p < 0.001). In men, while education functioned as an effect modifier in the association between marital status and obesity (p for interaction = 0.006), it functioned as both a confounder (p < 0.001) and an effect modifier (p for interaction < 0.001) in the association between residential area and obesity. In contrast, in women, education functioned as a confounder in the association of residential area with obesity (p = 0.010). However, it functioned as both a confounder (p < 0.001) and an effect modifier (p for interaction = 0.012) in the association between income and obesity. A prediction showed that unlike in women, education was positively associated with obesity risk for some socioeconomic indicator groups in men; for example, in a rural resident group, a higher level of education increased the probability of being obese by 19.7%. Conclusions: The present study suggests the need to examine sex-specific studies regarding the role of education on the association between other socioeconomic status indicators and obesity. This should be considered in planning education policies to reduce the risk of obesity. [ABSTRACT FROM AUTHOR]

Air pollution is closely associated with the development of respiratory illness. Behavioral adaptations of people to air pollution may influence its impact, yet this has not been investigated in the literature. Our hypothesis is that people experience and learn the underlying air quality to decide their adaptation, and they have a stronger incentive to behaviorally adapt to the air quality as it deteriorates. We tested our hypothesis on a sample of approximately 25,700 individuals from South Korea from 2002 to 2013 that contained information on daily doctor’s visits due to respiratory disease. We matched individuals to the mean of the past seven-day concentration of the particulate matter of size between 2.5 and 10 micrometers (PM10) in their county of residence. We examined whether people living in counties with greater air pollution suffer less from respiratory disease when the concentration increases. For the analysis, we separated counties into quintiles based on their mean seven-day PM10, and regressed the binary indicator of a daily doctor’s visit with a resulting diagnosis of respiratory disease on the seven-day PM10 concentration of the county of residence interacted with the quintile dummies. The key findings are that a 1-standard-deviation increase in the seven-day PM10 concentration in the two lowest quintiles is associated with an increase of 0.054 percentage points in the likelihood of a doctor’s visit with a resulting diagnosis of respiratory disease, which is about 40% larger than the effect in higher quintiles, and the size of 1-standard-deviation gradually increases from 0.037 percentage points in the third quintile to 0.040 percentage points in the fifth quintile. The smaller increase in the likelihood of respiratory disease in more polluted locations can be explained by the behavioral adaptation to the environment, but the effectiveness of the adaptation seems limited among the highly polluted locations. [ABSTRACT FROM AUTHOR]

As the airline industry has become ever-more competitive and profitability more tenuous, airline service quality management has grown more important to airlines. Although many studies have focused on the evaluation of airline service quality, some common limitations need to be noted. First, traditional fuzzy logics were utilized to present linguistic variables as fuzzy numbers. However, precise quantification of lower and upper bounds with a single number is often difficult; thus, interval-valued fuzzy sets that represent the lower and upper bounds in the fuzzy number as an interval form should be applied instead. Second, while some studies have applied various multiple-criteria decision-making method [MCDM] and the service quality (SERVQUAL) method for evaluation of airline service quality, few have utilized grey relational analysis (GRA, a simple and data-driven MCDM method applicable to environments with incomplete information) and the service performance (SERVPERF), a performance-based measure that can resolve the ambiguity issue of the expectations construct in SERVQUAL. Third, extant studies dealing with the issue of weighting criteria in the evaluation of airline service quality have focused only on either subjective or objective weights, though weighting criteria based on a combined objective/subjective approach would be much better than those just considering the subjective approach. The present study endeavored to fill these literature gaps by developing, for evaluation of airline service quality, interval-valued fuzzy GRA with SERVPERF based on both subjective and objective weights. It contributes to the field by incorporating the 22 criteria from SERVPERF to effectively account for the various characteristics of airline service. Additionally, it is the first study to utilize interval-valued fuzzy GRA together with a novel technique that combines a subjective/objective weighting method for integration of objective decision-matrix-derived information with subjective decision-maker preferences. The supplemental empirical case study of airline service evaluation, further, provides researchers and practitioners with a means of better understanding the proposed approach in the practical perspectives. [ABSTRACT FROM AUTHOR]

Background: This study investigated Borrelia species prevalence in ticks from vegetation, through a molecular method, in Gwangju Metropolitan City, South Korea. Methodology/Principal findings: A total of 484 ticks were collected through flagging and dragging in a suburban area of Gwangju Metropolitan City, South Korea, in 2014. These ticks were morphologically identified and subjected to nested PCR, targeting Borrelia–specific CTP synthase (pyrG), outer surface protein A (ospA) and flagellin (flaB) genes. Molecular biological species identification of Borrelia-positive ticks was conducted via 16S rRNA PCR assays. Of the 484 ticks collected, 417 (86.2%) were identified as Haemaphysalis longicornis, 42 (8.7%) as H. flava, and 25 (5.2%) as Ixodes nipponensis. All the ixodid ticks containing Borrelia species bacteria were confirmed to be I. nipponensis adults, by both morphological and molecular methods. Of the 25 I. nipponensis ticks collected, four (16%) were positive for Borrelia species, three of which were B. afzelii and one B. miyamotoi. Conclusions/Significance: Our study has shown the harboring of B. miyamotoi by I. nipponensis in South Korea. Morphological and molecular genetic analyses revealed that, in South Korea, I. nipponensis could potentially transmit B. miyamotoi to humans. [ABSTRACT FROM AUTHOR]

Background: English editing services are effective for improving manuscript quality as well as providing learning opportunities for non-native English-speaking authors. Herein, we describe the effects of a combined system of in-house and external editing services for handling large volumes of editing requests and providing personalized editing service in academic hospitals. Methods: We established the Scientific Publications Team (SPT), an in-house editing team in Asan Medical Center in Seoul, Korea. The SPT is composed of two professional editors who manage editing requests sent to external companies while also providing one-on-one in-house editing services. We gathered author satisfaction data from 936 surveys between July 2017 and December 2018 and analyzed the number of editing requests and research publications by segmented regression analysis of interrupted time series data. Results: The SPT processed 3931 editing requests in 2017–2018, which was a marked increase compared with prior to its establishment (P = 0.0097). The authors were generally satisfied with the quality of editing services from both in-house and external editors. Upon conducting regular quality control, overall author satisfaction with one external company gradually increased over the course of one year (P for trend = 0.086). Author satisfaction survey results revealed that overall satisfaction of editing service was most strongly correlated with how well the edits conformed to the authors’ intentions (R = 0.796), and was only weakly correlated with quick turnaround time (R = 0.355). We also observed a significant increase in the trend of the number of research publications (P = 0.0007) at one year after the establishment of the SPT. Conclusion: Providing a combination of in-house and external editing services resulted in high author satisfaction and subsequent hospital-wide increases in manuscript writing and publication. Our model system may be adapted in academic hospitals to better address the editing needs of non-native English-speaking researchers. [ABSTRACT FROM AUTHOR]

During the winter of 2016-2017, an epidemic of highly pathogenic avian influenza (HPAI) led to high mortality in poultry and put a serious burden on the poultry industry of the Republic of Korea. Effective control measures considering spatial heterogeneity to mitigate the HPAI epidemic is still a challenging issue. Here we develop a spatial-temporal compartmental model that incorporates the culling rate as a function of the reported farms and farm density in each town. The epidemiological and geographical data of two species, chickens and ducks, from the farms in the sixteen towns in Eumseong-gun and Jincheon-gun are used to find the best-fitted parameters of the metapopulation model. The best culling radius to maximize the final size of the susceptible farms and minimize the total number of culled farms is calculated from the model. The local reproductive number using the next generation method is calculated as an indicator of virus transmission in a given area. Simulation results indicate that this parameter is strongly influenced not only by epidemiological factors such as transmissibility and/or susceptibility of poultry species but also by geographical and demographical factors such as the distribution of poultry farms (or density) and connectivity (or distance) between farms. Based on this result, we suggest the best culling radius with respect to the local reproductive number in a targeted area. [ABSTRACT FROM AUTHOR]

Objectives: This study investigated how the essential elements of informed consent are realised during the consent process and examined the challenges in obtaining genuine informed consent in Korea. Methods: Through purposive sampling, we recruited 21 subjects from those participating in anticancer drug research since 2013. We undertook 1:1 in-depth interviews and analysed the data by framework analysis. Results: Themes raised throughout the interviews were categorised into ‘disclosure’ and ‘understanding’ of clinical information and ‘decision’. Provider-centred information, both verbal and written, was delivered to each participant. There were few tools that the research staff might evaluate study participants’ level of understanding of the provided information during the clinical trial. Although participants did not understand basic clinical trial concepts as much as desired, they may not seek to solve difficulties through communication with trial researchers. Doubts were raised about whether participants had sufficient capacity and free will to provide informed consent. Conclusion: There is a concern that informed consent can fall short of genuine in Korea. To ensure informed consent meets the international standard, greater efforts should be made to establish an explicit standard operational protocol for obtaining informed consent. [ABSTRACT FROM AUTHOR]

Enterovirus (EV) 71 is the main pathogen associated with hand-foot-mouth disease (HFMD) and can lead to the disease with severe mortality in children. Since 2009, in the Republic of Korea, an outbreak of EV71 C4a infection with neurologic involvement emerged, where in HFMD involvement was identified and central nervous system complications were reported. In this study, EV71 C4a virus-like particles (VLPs) produced by recombinant technology were generated in a baculovirus expression system. To improve the production yield, EV71 VLP was constructed using the dual promoter system baculovirus P1 and 3CD (baculo-P1-3CD), which harbored both the structural protein-encoding P1 region under the control of the polyhedron promoter and the 3CD protease gene under the regulation of the CMV-IE, lef3, gp41, or chitinase promoters to augment the level of gene transcription. Efficient VLP expression was demonstrated through optimization of incubation time and insect cell type. In addition, to evaluate the potential of VLP as a vaccine candidate, we tested the neutralizing antibodies and total anti-EV71 IgG from the purified EV71 C4a VLP serum. The recombinant EV71 VLP exhibited the morphology of self-assembled VLP, as determined by electron microscopy. Use of baculo-P1-3CD-gp41 led to a high yield (11.3mg/L < 40kDa) of VLPs in High-FiveTM cells at 3 days post-infection. Furthermore, the potential of VLP as a vaccine was evaluated through the neutralizing ability elicited by the purified EV71 VLP after immunization of BALB/c mice, which was shown to induce potent and long-lasting humoral immune responses as evidenced by the cross-neutralization titer. Our results could be used to expedite the developmental process for vaccines under clinical trials and to ensure manufacturing consistency for licensing requirements. [ABSTRACT FROM AUTHOR]

Objectives: The South Korean government required the submission of economic evidence when it implemented the Positive-List System in December 2006. This study investigates the key factors that influenced actual public insurance reimbursement decisions, including the role of economic evidence, after 10 years of decision practice under compulsory health technology assessment (HTA) for new drugs. Method: Logistic regression analysis was used to estimate the impact of the variables involved, including cost-effectiveness ratio as a key variable, on reimbursement decisions. The latter were defined as “yes” or “no” at a submitted price and indication. Only cases (n = 91) that present a cost-effectiveness ratio, and that have been reviewed based on this ratio from January 2007 to December 2016, were included in the analysis. Results: Cases with higher cost-effectiveness ratios were less likely to be accepted. In addition, drugs that were used to treat severe diseases and drugs with no substitute were more likely to be recommended. The probability of acceptance declined along with the level of uncertainty in the submitted evidence. The acceptance rate for severe-disease drugs has increased since 2013, when the government introduced several policies that lowered the existing barriers to positive reimbursement. However, such an increase was not statistically significant. Conclusions: Cost-effectiveness is one of the most influential factors in drug-reimbursement decisions. However, inclusion of other explanatory variables, in addition to the cost-effectiveness ratio, predicted the results of decisions more accurately. [ABSTRACT FROM AUTHOR]

Objective: This study aimed to administer a Delphi panel survey and provide evidence for the development of a psychological intervention protocol for use after disasters in South Korea. Method: A three-round Delphi survey was conducted. In all rounds, respondents answered open- or closed-ended questions regarding their views on i) the concept of disaster, ii) evaluation, iii) intervention, and iv) considerations in a disaster. Data from Round 1 were subjected to content analysis. In Round 2, items with content validity ratios (CVRs) greater than 0.49 were included, and in Round 3, items with a CVR≥0.38 were accepted. Results: The response rates for the Delphi survey were high: 83% (n = 15, Round 1), 80% (n = 16, Round 2), and 86% (n = 24, Round 3). The data collected during this survey showed a need for a support system for children; for preventive strategies, including disaster readiness plans; for the protection of children's safety; and for the development of post-disaster psychosocial care. Conclusions: The panel experts reached a consensus regarding the steps they considered critical in post-disaster evaluation and intervention. The findings suggest a unified model for advancing the development of the Korean version of an intervention protocol for children and adolescents exposed to traumatic events. [ABSTRACT FROM AUTHOR]

Objectives: As personalized medicine (PM) is expected to greatly improve health outcomes, efforts have recently been made for its clinical implementation in Korea. We aimed to evaluate public awareness and attitude regarding PM. Methods: We performed a self-administered questionnaire survey to 703 adults, who participated in the survey on a voluntary basis. The primary outcome measures included public knowledge, attitude, and acceptance of PM. We conducted multinomial multivariate logistic analysis for outcome variables with three response categories and performed multivariate logistic regression analyses for dichotomous outcome variables. Results: Only 28% of participants had knowledge that genetic factors can contribute to inter-individual variations in drug response and the definition of PM (199 out of 702). Higher family income was correlated with greater knowledge concerning PM (OR = 3.76, p = 0.034). A majority of respondents preferred integrated pharmacogenomic testing over drug-specific testing and agreed to inclusion of pharmacogenomic testing in the national health examination (64% and 77%, respectively), but only 51% were willing to pay for it. Discussion: Our results identify the urgent need for public education as well as the potential health disparities in access to PM. This study helps to frame policies for implementing PM in clinical practice. [ABSTRACT FROM AUTHOR]

Background: Severe fever with thrombocytopenia syndrome (SFTS) is an emerging tick-borne viral disease caused by the SFTS virus (SFTSV) from Bunyaviridae that is endemic in East Asia. However, the genetic and evolutionary characteristics shared between tick- and human-derived Korean SFTSV strains are still limited. Methodology/Principal findings: In this study we identify, for the first time, the genome sequence of a tick (Haemaphysalis longicornis)-derived Korean SFTSV strain (designated as KAGWT) and compare this virus with recent human SFTSV isolates to identify the genetic variations and relationships among SFTSV strains. The genome of the KAGWT strain is consistent with the described genome of other members of the genus Phlebovirus with 6,368 nucleotides (nt), 3,378 nt, and 1,746 nt in the Large (L), Medium (M) and Small (S) segments, respectively. Compared with other completely sequenced human-derived Korean SFTSV strains, the KAGWT strain had highest sequence identities at the nucleotide and deduced amino acid level in each segment with the KAGWH3 strain which was isolated from SFTS patient within the same region, although there is one unique amino acid substitution in the Gn protein (A66S). Phylogenetic analyses of complete genome sequences revealed that at least four different genotypes of SFTSV are co-circulating in South Korea, and that the tick- and human-derived Korean SFTSV strains (genotype B) are closely related to one another. Although we could not detect reassortant, which are commonly observed in segmented viruses, further large-scale surveillance and detailed genomic analysis studies are needed to better understand the molecular epidemiology, genetic diversity, and evolution of SFTSV. Conclusions/Significance: Full-length sequence analysis revealed a clear association between the genetic origins of tick- and human-derived SFTSV strains. While the most prevalent Korean SFTSV is genotype B, at least four different genotypes of SFTSV strains are co-circulating in South Korea. These findings provide information regarding the molecular epidemiology, genetic diversity, and evolution of SFTSV in East Asia. [ABSTRACT FROM AUTHOR]

This study investigated the effect of implementing the act of prohibition on sex trafficking (PST) on sexually transmitted disease (STD) infections among South Korean female sex workers (FSWs) working at prostitution blocks. Research data were collected twice through the Korean government-sanctioned survey for female sex workers (1st wave = 1,083; 2nd wave = 926). We examined the associations among health behavior, working conditions, and the effect of PST act via hierarchical logistic regression analyses using propensity score matching. After adjusted covariates, the risk probability was 0.288 times lower among FSWs who had remained in prostitute blocks after the PST act enforcement compared to FSWs who had worked before the PST. Similarly, the risk probability for a gonorrhea infection was 0.219 times lower among FSWs who had remained in prostitute blocks after the PST act compared to FSWs who had worked before the PST. Therefore, this study showed that, besides already known factors, the implementation and establishment of the PST Act was a strong factor that suppressed STD infections among FSWs. [ABSTRACT FROM AUTHOR]

Background: Sleep is important in terms of good general health and appropriate sleep duration has been linked to quality-of-life. Dysphonia may impair communication and social relationships, and is thus also closely related to quality-of-life. No large-scale, cross-sectional epidemiological study of a sample representative of the population of an entire country has yet assessed the possible existence of a relationship between sleep duration and dysphonia. Methods: We investigated a possible association between subjective voice problems and self-reported sleep duration in South Korean subjects using 2010–2012 data from the Korean National Health and Nutrition Examination Survey (KNHANES). Cross-sectional data on 17,806 adults (7,578 males and 10,228 females) over the age of 19 years who completed the KNHANES were analyzed. All participants reported voice problems (if present) and their daily average sleep duration using a self-reporting questionnaire. Sleep duration was classified into five categories as follows: ≤5, 6, 7, 8, and ≥9 h/day. Results: The overall prevalence of dysphonia was 6.8%; 5.7% in males and 7.7% in females. The prevalence for dysphonia by sleep duration exhibited a U-shape, with the lowest point being at sleep duration of 7-8h. After adjustment for covariates (age, sex, smoking status, alcohol consumption, regular exercise, low income, high-level education), a sleep duration of ≤5 h (OR = 1.454; 95% CI, 1.153–1.832) and a sleep duration of ≥9 h (OR = 1.365; 95% CI, 1.017–1.832) were significantly associated with dysphonia, compared to a sleep duration of 7 h. In terms of gender, males who slept for ≥9 h were at a 2-fold (OR = 2.028; 95% CI, 1.22–3.35) higher odds for dysphonia (p<0.05) compared to those who slept for 7 h. A sleep duration ≤5 h was associated with a 1.6-fold (OR = 1.574; 95% CI, 1.203–2.247) higher odds of dysphonia ≥3 weeks in duration (long-term dysphonia). Conclusions: This is the first study to show that both short and long sleep duration were significantly associated with the development of dysphonia. The association between sleep duration and dysphonia was more marked in males than females. A sleep duration ≤5 h had a significant impact on the prevalence of long-term dysphonia. [ABSTRACT FROM AUTHOR]

Objectives: The effect of employment insecurity on employee health is an important public health issue due to the recent effects of neoliberalism and the global financial crisis (2007–2008) on labor markets. This study aims to evaluate the differences in cardiovascular health status and the use of preventive screening services between standard and nonstandard workers. Methods: Waged employees (N = 5,338) between the ages of 20 and 64 were grouped into standard (full-time, permanent) and nonstandard (part-time, temporary, or daily) employees. Data from the Fourth Korea National Health and Nutrition Examination Survey, 2007–2009, a nationwide representative survey, were examined, including cardiovascular health risk behaviors (tobacco, alcohol, physical inactivity), measured morbidities (blood pressure, blood glucose level, lipid profiles, body mass index), and the use of screening services for hypertension and diabetes mellitus. Results: Female nonstandard employees tended to have higher blood pressure than did female standard employees (adjusted odds ratio, aOR 1.42, 95% confidence interval, CI 1.02 to 1.98). However, nonstandard employees (both men and women) were less likely to use preventive screening services for hypertension (aOR 0.72, 95% CI 0.54 to 0.94 in men; aOR 0.56, 95% CI 0.43 to 0.73 in women) and diabetes (aOR 0.58, 95% CI 0.43 to 0.79 in men; aOR 0.55, 95% CI 0.43 to 0.71 in women). Conclusion: Nonstandard work is associated with the underuse of screening services and poorer cardiovascular health in a specific population. Policies to reduce employment insecurity and encourage nonstandard employees to receive health screening services should be prioritized. [ABSTRACT FROM AUTHOR]

Background: Inappropriate antibiotic use significantly contributes to antibiotic-resistance, resulting in reduced antibiotic efficacy and increasing physical burden and cost of disease. The goal of this study was to explore antibiotic usage patterns in South Korea using 2007–2014 health insurance claims data. Methods: We used the Health Insurance Review & Assessment Service data, which represents nearly the entire population of South Korea, to discern patterns in antibiotic prescribing practices. The daily dose, as defined by the World Health Organization ([defined daily doses]/1000 inhabitants/day, [DID]), was used as a measure of antibiotic use. Subgroup analyses were performed on the basis of patient characteristics (sex, age, and disease) and provider characteristics (type of medical institution). Results: Antibiotic use in DID increased from 23.5 in 2007 to 27.7 in 2014. The ≤ 6 years old age group showed the highest level of usage at 59.21 DID in 2014, and showed an increasing trend each year. DIDs of beta-lactam antibacterials, penicillins (J01C), other beta-lactam antibacterials (J01D), lincosamides and streptogramins (J01F), quinolone antibacterials (J01M), and other antibacterials (J01X) increased over time. Conclusion: This study provides valuable statistics regarding antibiotic usage in South Korea; this is important for guiding health policy with regard to antibiotic usage. There is a need for further study exploring antibiotics use and resistance. [ABSTRACT FROM AUTHOR]

Viruses are the most abundant biological entities in the oceans, and account for a significant amount of the genetic diversity of marine ecosystems. However, there is little detailed information about the biodiversity of viruses in marine environments. Rapid advances in metagenomics have enabled the identification of previously unknown marine viruses. We performed metagenomic profiling of seawater samples collected at 6 sites in Goseong Bay (South Sea, Korea) during the spring, summer, autumn, and winter of 2014. The results indicated the presence of highly diverse virus communities. The DNA libraries from samples collected during four seasons were sequenced using Illumina HiSeq 2000. The number of viral reads was 136,850 during March, 70,651 during June, 66,165 during September, and 111,778 during December. Species identification indicated that Pelagibacter phage HTVC010P, Ostreococcus lucimarinus OIV5 and OIV1, and Roseobacter phage SIO1 were the most common species in all samples. For viruses with at least 10 reads, there were 204 species during March, 189 during June, 170 during September, and 173 during December. Analysis of virus families indicated that the Myoviridae was the most common during all four seasons, and viruses in the Polyomaviridae were only present during March. Viruses in the Iridoviridae were only present during three seasons. Additionally, viruses in the Iridoviridae, Herpesviridae, and Poxviridae, which may affect fish and marine animals, appeared during different seasons. These results suggest that seasonal changes in temperature contribute to the dynamic structure of the viral community in the study area. The information presented here will be useful for comparative analyses with other marine viral communities. [ABSTRACT FROM AUTHOR]

Background: To investigate the association between heavy metal levels and open-angle glaucoma (OAG) with low- and high-teen baseline intraocular pressure (IOP) using a population-based study design. Methods: This cross-sectional study included 5,198 participants older than 19 years of age who participated in the Korean National Health and Nutrition Examination Survey (KNHANES) from 2008 to 2012 and had blood heavy metal levels available. The OAG with normal baseline IOP (IOP ≤ 21 mmHg) subjects were stratified into low-teen OAG (baseline IOP ≤ 15 mmHg) and high-teen OAG (15 mmHg < baseline IOP ≤ 21 mmHg), and the association between blood lead, mercury, and cadmium levels and glaucoma prevalence was assessed for low- and high-teen OAG. Results: The adjusted geometric mean of blood cadmium levels was significantly higher in subjects with low-teen OAG than that of the non-glaucomatous group (P = 0.028), whereas there were no significant differences in blood lead and mercury levels. After adjusting for potential confounders, the low-teen OAG was positively associated with log-transformed blood cadmium levels (OR, 1.41; 95% confidence interval (CI), 1.03–1.93; P = 0.026). For high-teen OAG, log-transformed blood levels of the three heavy metals were not associated with disease prevalence. The association between log-transformed blood cadmium levels and low-teen OAG was significant only in men (OR, 1.65; 95% CI, 1.10–2.48; P = 0.016), and not in women (OR, 1.10; 95% CI, 0.66–1.85; P = 0.709). Conclusions: The results of this study suggest that cadmium toxicity could play a role in glaucoma pathogenesis, particularly in men and in OAG with low-teen baseline IOP. [ABSTRACT FROM AUTHOR]

We estimated the disability weights in the South Korean population by using a paired comparison-only model wherein ‘full health’ and ‘being dead’ were included as anchor points, without resorting to a cardinal method, such as person trade-off. The study was conducted via 2 types of survey: a household survey involving computer-assisted face-to-face interviews and a web-based survey (similar to that of the GBD 2010 disability weight study). With regard to the valuation methods, paired comparison, visual analogue scale (VAS), and standard gamble (SG) were used in the household survey, whereas paired comparison and population health equivalence (PHE) were used in the web-based survey. Accordingly, we described a total of 258 health states, with ‘full health’ and ‘being dead’ designated as anchor points. In the analysis, 4 models were considered: a paired comparison-only model; hybrid model between paired comparison and PHE; VAS model; and SG model. A total of 2,728 and 3,188 individuals participated in the household and web-based survey, respectively. The Pearson correlation coefficients of the disability weights of health states between the GBD 2010 study and the current models were 0.802 for Model 2, 0.796 for Model 1, 0.681 for Model 3, and 0.574 for Model 4 (all P-values<0.001). The discrimination of values according to health state severity was most suitable in Model 1. Based on these results, the paired comparison-only model was selected as the best model for estimating disability weights in South Korea, and for maintaining simplicity in the analysis. Thus, disability weights can be more easily estimated by using paired comparison alone, with ‘full health’ and ‘being dead’ as one of the health states. As noted in our study, we believe that additional evidence regarding the universality of disability weight can be observed by using a simplified methodology of estimating disability weights. [ABSTRACT FROM AUTHOR]

Objective: The purpose of this cross-sectional study was to investigate the relationship between bone-specific physical activity (BPAQ) scores, body composition, and bone mineral density (BMD) in healthy young college women. Methods: Seventy-three college women (21.7 ± 1.8 years; 162.1 ± 4.6 cm; 53.9 ± 5.8 kg) between the ages of 19 and 26 years were recruited from the universities in Seoul and Gyeonggi province, South Korea. We used dual energy X-ray absorptiometry to measure the lumbar spine (L2-L4) and proximal femur BMD (left side; total hip, femoral neck). The BPAQ scores (past, pBPAQ; current, cBPAQ; total, tBPAQ) were used to obtain a comprehensive account of lifetime physical activity related to bone health. We used X-scan plus II instrumentation to measure height (cm), weight (kg), fat free mass (FFM, kg), percent body fat (%), and body mass index (BMI). Participants were asked to record their 24-hour food intake in a questionnaire. Results: There were positive correlations between BPAQ scores and total hip (pBPAQ r = 0.308, p = 0.008; tBPAQ, r = 0.286, p = 0.014) and FN BMD (pBPAQ r = 0.309, p = 0.008; tBPAQ, r = 0.311, p = 0.007), while no significant relationships were found in cBPAQ (p > 0.05). When FFM, Vitamin D intake, cBPAQ, pBPAQ, and tBPAQ were included in a stepwise multiple linear regression analysis, FFM and pBPAQ were predictors of total hip, accounting for 16% (p = 0.024), while FFM and tBPAQ predicted 14% of the variance in FN (p = 0.015). Only FFM predicted 15% of the variance in L2-L4 (p = 0.004). There was a positive correlation between Vitamin D intake and L2-L4 (p = 0.025), but other dietary intakes variables were not significant (p > 0.05). Conclusions: BPAQ-derived physical activity scores and FFM were positively associated with total hip and FN BMD in healthy young college women. Our study suggests that osteoporosis awareness and effective bone healthy behaviors for college women are required to prevent serious bone diseases later in life. [ABSTRACT FROM AUTHOR]

Coxiella burnetii and Coxiella-like bacteria (CLB) are genetically and ecologically distinct despite some genetic similarities. Furthermore, CLB are exceptionally diverse and widespread in ticks, but rarely detected in domestic animals. Since Coxiella bacteria can be transmitted from infected horses by inhalation or by coming in contact with ticks during activities such as horseback riding, it is necessary to study their prevalence. To the best of our knowledge, this is the first large-scale nationwide investigation of the prevalence of C. burnetii and CLB among horses reared in South Korea. Of 816 blood samples collected between 2007 and 2013, 11 (1.3%) were identified as C. burnetii by ELISA, and six (0.7%) as CLB by 16S rRNA sequencing. While a sequence from Jeju Island was similar (97.9–100%) to those within clade B, five sequences obtained from the northern region were categorized into a new clade, indicating the sequence diversity of the genus Coxiella. Studies until date had detected CLB only in ticks; here, we describe their detection in mammals. Given their zoonotic potential, strategic monitoring and appropriate control programs for Coxiella species need to be established. [ABSTRACT FROM AUTHOR]

Although hyponatremia is related to poorer outcomes in several clinical settings, its significance remains unresolved in kidney transplantation. Data on 1,786 patients who received kidney transplantations between January 2000 and December 2011 were analyzed. The patients were divided into two groups according to the corrected sodium values for serum glucose 3 months after their transplantations (<135 mmol/L vs. ≥135 mmol/L). Subsequently, the hazard ratios (HRs) for biopsy-proven acute rejection, graft failure, and all-cause mortality were calculated after adjustments for several immunological and non-immunological covariates. 4.0% of patients had hyponatremia. Patients with hyponatremia had higher risks for graft failure and all-cause mortality than did the counterpart normonatremia group; the adjusted HRs for graft failure and mortality were 3.21 (1.47–6.99) and 3.03 (1.21–7.54), respectively. These relationships remained consistent irrespective of heart function. However, hyponatremia was not associated with the risk of acute rejection. The present study addressed the association between hyponatremia and graft and patient outcomes in kidney transplant recipients. Based on the study results, our recommendation is to monitor serum sodium levels after kidney transplantations. [ABSTRACT FROM AUTHOR]

Of 1,050 fecal specimens collected from January 2013 to August 2015 from children with acute gastroenteritis, 149 (14.2%) were found to be positive for norovirus. Norovirus GII was the most predominant genogroup (98.65%; 147 of 149). The genotypes detected in this study were GI (2; 1.3%), GII.Pe-GII.4 (109; 73.1%), GII.P17-GII.17 (16; 10.7%), GII.P12-GII.3 (8; 5.4%), GII.P12-GII.12 (8; 5.4%), GII.P4-GII.4 (5; 3.4%), and the recombinant GII.Pe-GII.17 (1; 0.7%). Of these, the novel GII.17 strain was the second most predominant, and the number of affected children appeared to continuously increase over time (2013 [2; 4.4%], 2014 [4; 9.3%], and 2015 [10; 16.4%]). Phylogenetic analysis of the full genome and ORF1, ORF2, and ORF3 nucleotide sequences showed that GII.17 was grouped in cluster III with other strains isolated from 2013 to 2015 and had a different evolutionary history from strains collected in 1978 to 2002 and 2005 to 2009 formed clusters I and II. However, the phylogenetic trees also showed that cluster III was divided into subclusters IIIa (CAU-55 and CAU-85) and IIIb (Kawasaki 2014) (CAU-193, CAU-265, CAU-267, CAU-283, and CAU-289). Comparative analysis of the VP1 capsid protein using 15 complete amino acid sequences from noroviruses isolated from 1978 to 2015 showed 99 amino acid changes. These results could be helpful for epidemiological studies to understand circulating norovirus genotypes in population. [ABSTRACT FROM AUTHOR]

Background: Skeletal muscle mass (SMM) plays a crucial role in systemic glucose metabolism. Objective: To obtain reference data on absolute and relative values of SMM for Korean children and adolescents. Methods: Cross-sectional results from 1919 children and adolescents (1024 boys) aged 10–18 years that underwent dual-energy X-ray absorptiometry (DXA) during the Korean National Health and Nutrition Examination Survey 2009–2011 were analyzed. SMMs were evaluated as follows; absolute SMM (appendicular skeletal muscle mass [ASM]) and relative SMMs, namely, height-adjusted skeletal muscle index (SMI; ASM/height2), %SMM (ASM/weight x 100), and skeletal muscle-to-body fat ratio (MFR; ASM/body fat mass). Results: Percentile curves illustrated the developmental patterns of the SMMs of Korean children and adolescents. ASM and SMI increased with age in both genders, and increased from age 10 throughout adolescence in boys, whereas in girls, they increased until age 13 and then stabilized. In boys, %SMM and MFR were highest at age 15 and then slowly stabilized or decreased, whereas in girls, they peaked at age 10 to 11 and then decreased through adolescence. Cut-off values for low MFR were identified and a significant association was found between a low MFR and high risk of metabolic syndrome. However, this association was found to be dependent on gender and the level of BMI. Conclusion: This study provides reference values of absolute and relative SMM for Korean children and adolescents. Detailed body composition analyses including skeletal muscle and fat mass might provide improved measures of metabolic risk. [ABSTRACT FROM AUTHOR]

Background: Vivax malaria was successfully eliminated from the Republic of Korea (ROK) in the late 1970s but re-emerged in 1993. Two decades later as the ROK enters the final stages of malaria elimination, dedicated surveillance of the local P. vivax population is critical. We apply a population genetic approach to gauge P. vivax transmission dynamics in the ROK between 2010 and 2012. Methodology/Principal Findings: P. vivax positive blood samples from 98 autochthonous cases were collected from patients attending health centers in the ROK in 2010 (n = 27), 2011 (n = 48) and 2012 (n = 23). Parasite genotyping was undertaken at 9 tandem repeat markers. Although not reaching significance, a trend of increasing population diversity was observed from 2010 (HE = 0.50 ± 0.11) to 2011 (HE = 0.56 ± 0.08) and 2012 (HE = 0.60 ± 0.06). Conversely, linkage disequilibrium declined during the same period: IAS = 0.15 in 2010 (P = 0.010), 0.09 in 2011 (P = 0.010) and 0.05 in 2012 (P = 0.010). In combination with data from other ROK studies undertaken between 1994 and 2007, our results are consistent with increasing parasite divergence since re-emergence. Polyclonal infections were rare (3% infections) suggesting that local out-crossing alone was unlikely to explain the increased divergence. Cases introduced from an external reservoir may therefore have contributed to the increased diversity. Aside from one isolate, all infections carried a short MS20 allele (142 or 149 bp), not observed in other studies in tropical endemic countries despite high diversity, inferring that these regions are unlikely reservoirs. Conclusions: Whilst a number of factors may explain the observed population genetic trends, the available evidence suggests that an external geographic reservoir with moderate diversity sustains the majority of P. vivax infection in the ROK, with important implications for malaria elimination. [ABSTRACT FROM AUTHOR]

Age-related hearing impairment (ARHI) is becoming a more significant issue as geriatric population increases. Sarcopenia in older people is known to have a diverse health problem in various circumstances in recent studies. We assessed whether the decrease in muscle mass is related to ARHI. We used the 2010 data of the Korea National Health and Nutrition Examination Survey (KNHANES) to examine the associations between sarcopenia and ARHI. A total number of participants was 1,622 including 746 males and 876 females aged 60 years or older. Muscle mass was assessed as an appendicular skeletal muscle mass, and hearing loss was defined as the pure-tone averages (PTA) of test frequencies 0.5, 1, 2, 4 kHz at a threshold of 40 dB or higher in worse hearing side of the ear. Among 1,622 participants, 298 men and 256 women had hearing loss. Appendicular muscle mass (ASM), expressed as kg, was categorized in tertiles. In female population, after adjusting for age, smoking, drinking, amount of exercise, total body fat, education level, income level, and tinnitus, the odds ratio (OR) for hearing loss was 1.57 (95% confidence interval (CI) = 0.92–2.68) in the middle tertile and 1.79 (1.03–3.08) in the lowest tertile, compared with the highest tertile. P for trend in this model was 0.036. Controlling further for hypertension, diabetes mellitus, chronic kidney disease, and three types of noise exposure did not change the association. Larger muscle mass is associated with lower prevalence of hearing loss in elderly Korean females. [ABSTRACT FROM AUTHOR]

Objectives: Little is known about health outcomes related to electronic cigarette (EC) use, despite its growing popularity. The aim of this study is to investigate the association between EC use and asthma. Methods: The study design is a cross-sectional study. A total of 35,904 high school students were included as the final study population. The presence of asthma was based on a student’s self-reported doctor diagnosis of asthma in the past 12 months. Results: Prevalence rates of asthmatics in ‘current EC users’ (n = 2,513), ‘former EC users’ (n = 2,078), and ‘never EC users’ (n = 31,313), were 3.9% (n = 98), 2.2% (n = 46) and 1.7% (n = 530), respectively. Comparing ‘current EC’ users with ‘never EC’ users, the unadjusted OR for asthma was 2.36 (95% CI: 1.89–2.94). In order to control for the effect of conventional cigarette (CC) smoking, after stratifying the subjects by the three CC smoking categories (never CC, former CC, and current CC), within the ‘never CC’ category, the unadjusted OR for asthma for ‘current EC’ users was 3.41 (95% CI: 1.79–6.49), and the adjusted OR was 2.74 (95% CI: 1.30–5.78). Severe asthma was reflected by the number of days absent from school due to asthma symptoms; current EC users had the highest adjusted OR for severe asthma compared to ‘never EC’ users. Conclusions: When compared to a reference population of high school students in South Korea, EC users have an increased association with asthma and are more likely to have had days absent from school due to severe asthma symptoms. In conclusion, the results indicate that EC use may be a risk factor for asthma. The results may be useful in developing a scientific basis for the evaluation of a potential health hazard by EC. [ABSTRACT FROM AUTHOR]

Accurate information on the distribution of existing species is crucial to assess regional biodiversity. However, data inventories are insufficient in many areas. We examine the ability of Multivariate Adaptive Regression Splines (MARS) multi-response species distribution model to overcome species’ data limitations and portray plant species distribution patterns for 199 South Korean plant species. The study models species with two or more observations, examines their contribution to national patterns of species richness, provides a sensitivity analysis of different range threshold cutoff approaches for modeling species’ ranges, and presents considerations for species modeling at fine spatial resolution. We ran MARS models for each species and tested four threshold methods to transform occurrence probabilities into presence or absence range maps. Modeled occurrence probabilities were extracted at each species’ presence points, and the mean, median, and one standard deviation (SD) calculated to define data-driven thresholds. A maximum sum of sensitivity and specificity threshold was also calculated, and the range maps from the four cutoffs were tested using independent plant survey data. The single SD values were the best threshold tested for minimizing omission errors and limiting species ranges to areas where the associated occurrence data were correctly classed. Eight individual species range maps for rare plant species were identified that are potentially affected by resampling predictor variables to fine spatial scales. We portray spatial patterns of high species richness by assessing the combined range maps from three classes of species: all species, endangered and endemic species, and range-size rarity of all species, which could be used in conservation planning for South Korea. The MARS model is promising for addressing the common problem of few species occurrence records. However, projected species ranges are highly dependent on the threshold and scale criteria, which should be assessed on a per-project basis. [ABSTRACT FROM AUTHOR]

Metabolic syndrome (MetS) is associated with a higher risk of morbidity and/or mortality for various chronic diseases. The aim of this study was to investigate the relationships of MetS and its components with olfactory dysfunction in a representative Korean population. We analyzed the data from the Korean National Health and Nutrition Examination Survey (2008–2010). A total of 11,609 adults who underwent otolaryngological examination were evaluated. The olfactory function was classified as normosmia or hyposmia by a self-report questionnaire according to the sense problems of smell during the past 3 months. MetS was diagnosed if a participant had at least three of the following: (1) WC ≥90 cm in men and ≥80 cm in women; (2) fasting blood sugar ≥ 100 mg/dL or medication use for elevated glucose; (3) fasting triglyceride ≥ 150 mg/dL or cholesterol-lowering medication use; (4) HDL-cholesterol <40 mg/dL in men and <50 mg/dL in women or cholesterol-lowering medication use; and (5) SBP ≥ 130 mmHg and/or DBP ≥ 85 mmHg or antihypertensive drug use for patients with a history of hypertension. The prevalence of olfactory dysfunction in the study population was 6.3%. The prevalence of olfactory dysfunction was significantly higher in older people with MetS than in those without MetS in both sexes (male, 42.0 ± 3.4% vs. 34.7 ± 0.9%, p = 0.0354; female, 46.2 ± 2.8% vs. 37.8 ± 0.8%, p = 0.0026). However, elevated waist circumference, elevated fasting glucose, elevated triglycerides, reduced HDL cholesterol, elevated blood pressure, severe stress, depressed mood, and suicidal ideation were significantly associated with olfactory dysfunction only in women. After controlling for confounders, olfactory dysfunction was significantly associated with MetS (odds ratio, 1.352; 95% confidence interval, 1.005–1.820) only in women. MetS are associated with olfactory dysfunction only in Korean women. [ABSTRACT FROM AUTHOR]

After an extensive vaccination policy, Japanese encephalitis (JE) was nearly eliminated since the mid-1980s in South Korea. Vaccination in children shifted the affected age of JE patients from children to adults. However, an abrupt increase in JE cases occurred in 2010, and this trend has continued. The present study aimed to investigate the prevalence of neutralizing antibodies to the JE virus (JEV) among high-risk age groups (≥40 years) in South Korea. A plaque reduction neutralization test was conducted to evaluate the prevalence of neutralizing antibodies to JEV in 945 subjects within four age groups (30–39, 40–49, 50–59, and 60–69 years) in 10 provinces. Of the 945 enrolled subjects, 927 (98.1%) exhibited antibodies against JEV. No significant differences were found in the prevalence of neutralizing antibodies according to sex, age, or occupation. However, there were significant differences in the plaque reduction rate according to age and occupation; oldest age group had a higher reduction rate, and subjects who were employed in agriculture or forestry also had a higher value than the other occupations. We also found that three provinces (Gangwon, Jeonnam, and Gyeongnam) had a relatively lower plaque reduction rate than the other locations. In addition, enzyme-linked immunosorbent assays were conducted to determine recent viral infections and 12 (2.2%) subjects were found to have been recently infected by the virus. In conclusion, the present study clearly indicated that the prevalence of neutralizing antibodies has been maintained at very high levels among adult age groups owing to vaccination or natural infections, or both. In the future, serosurveillance should be conducted periodically using more representative samples to better understand the population-level immunity to JE in South Korea. [ABSTRACT FROM AUTHOR]

The Korean National Health Insurance, which provides universal coverage for the entire Korean population, is now facing financial instability. Frequent emergency department (ED) users may represent a medically vulnerable population who could benefit from interventions that both improve care and lower costs. To understand the nature of frequent ED users in Korea, we analyzed claims data from a population-based national representative sample. We performed both bivariate and multivariable analyses to investigate the association between patient characteristics and frequent ED use (4+ ED visits in a year) using claims data of a 1% random sample of the Korean population, collected in 2009. Among 156,246 total ED users, 4,835 (3.1%) were frequent ED users. These patients accounted for 14% of 209,326 total ED visits and 17.2% of $76,253,784 total medical expenses generated from all ED visits in the 1% data sample. Frequent ED users tended to be older, male, and of lower socio-economic status compared with occasional ED users (p < 0.001 for each). Moreover, frequent ED users had longer stays in the hospital when admitted, higher probability of undergoing an operative procedure, and increased mortality. Among 8,425 primary diagnoses, alcohol-related complaints and schizophrenia showed the strongest positive correlation with the number of ED visits. Among the frequent ED users, mortality and annual outpatient department visits were significantly lower in the alcohol-related patient subgroup compared with other frequent ED users; furthermore, the rate was even lower than that for non-frequent ED users. Our findings suggest that expanding mental health and alcohol treatment programs may be a reasonable strategy to decrease the dependence of these patients on the ED. [ABSTRACT FROM AUTHOR]

This study was conducted to investigate the prevalence of alcohol consumption and identify the sociodemographic factors associated with alcohol consumption among individuals with hepatitis B virus(HBV) infection. We used data from the Korean National Health and Nutrition Examination Surveys, a nationwide survey conducted between 2007 and 2011. “Monthly alcohol consumption” was defined as having consumed alcohol at least once per month during the past year, and “high-risk alcohol consumption” was defined as having consumed alcohol twice or more per week and, for males, having consumed at least 60 g of alcohol on one occasion or, for females, having consumed at least 40 g of alcohol on more than one occasion. The prevalence of monthly alcohol consumption was 53.2%, and that of high-risk alcohol consumption was 11.8% among HBV carriers. Less education was associated with both monthly and high-risk alcohol consumption(OR = 1.75 [95% CI = 1.02−3.02] for monthly alcohol consumption among those with less than a high school education; OR = 2.48 [95% CI = 1.19−5.17] for high-risk alcohol consumption among those with less than a high school education and OR = 2.02 [95% CI = 1.12−3.64] among those with a high school education). Additionally, smoking and being male increased the risk of alcohol consumption, and older age and having a normal body mass index decreased the risk. HBV carriers who were less educated, overweight, and smokers were more likely to consume alcohol or meet criteria for high-risk drinking. Health policies and intervention programs aimed at promoting a generally healthy lifestyle in HBV carriers should consider educational inequalities and alcohol consumption. [ABSTRACT FROM AUTHOR]

Background: Albuminuria is associated with cardiovascular disease, and the relationship between albuminuria and hypertension is well established in many studies. So the control of hypertension is critical for decreasing cardiovascular events and albuminuria. Obesity and abdominal obesity are also associated with hypertension and albuminuria. Therefore, we analyzed the relationship between albuminuria and the prevalence and control of hypertension in the general Korean population according to obesity status. Methods: We analyzed data from the 2011–2012 Korea National Health and Nutrition Examination Survey, and 9,519 subjects were included. Subjects were divided into four groups: non-obese/normal waist circumference, non-obese/high waist circumference, obese/normal waist circumference, and obese/high waist circumference. Results: Systolic blood pressure and diastolic blood pressure were positively associated with albumin–creatinine ratio in all groups (all p values <0.005). Non-obese/normal waist circumference group were more likely to have hypertension (odds ratios [95% confidential intervals (CIs)] were 3.20 [2.21–4.63] in microalbuminuria level and 3.09 [1.05–9.14] in macroalbuminuria level), and less likely to have controlled hypertension (odds ratios <1 for both albuminuria levels) after adjusting for all covariates. Obese/normal waist circumference group were also more likely to have hypertension (odds ratio [95% CI] were 3.10 [1.56–6.15] in microalbuminuria level and 21.75 [3.66–129.04] in macroalbuminuria level), and less likely to have controlled hypertension in macroalbuminuria level (odds ratio [95% CI], 0.04 [0.01–0.15]). Conclusions: Non-obese and normal waist circumference subjects have an increased prevalence and decreased control of hypertension in microalbuminuria and macroalbuminuria levels. Screening for albuminuria may provide helpful information about hypertension and blood pressure control, particularly in the non-obese and normal waist circumference subjects. [ABSTRACT FROM AUTHOR]

Numerous studies have demonstrated that tree survival is influenced by negative density dependence (NDD) and differences among species in shade tolerance could enhance coexistence via resource partitioning, but it is still unclear how NDD affects tree species with different shade-tolerance guilds at later life stages. In this study, we analyzed the spatial patterns for trees with dbh (diameter at breast height) ≥2 cm using the pair-correlation g(r) function to test for NDD in a temperate forest in South Korea after removing the effects of habitat heterogeneity. The analyses were implemented for the most abundant shade-tolerant (Chamaecyparis obtusa) and shade-intolerant (Quercus serrata) species. We found NDD existed for both species at later life stages. We also found Quercus serrata experienced greater NDD compared with Chamaecyparis obtusa. This study indicates that NDD regulates the two abundant tree species at later life stages and it is important to consider variation in species' shade tolerance in NDD study. [ABSTRACT FROM AUTHOR]

Background: Cardiovascular disease and related risk factors have been suggested as a mechanism leading to atherosclerosis of the lumbar vessels and consequent lumbar pain or sciatica. But there is continued controversy concerning its generalization. This study examined whether cardiovascular disease or its risk factors were associated with chronic low back pain (cLBP) in Koreans. Methods: Health surveys and examinations were conducted on a nationally representative sample (n = 23,632) of Koreans. A total of 13,841 eligible participants (aged 20 to 89 years) were examined to determine the association between cardiovascular disease, the Framingham risk score, major cardiovascular risk factors (blood pressure, diabetes, cholesterol, and smoking habits) and chronic LBP. Results: The total prevalence of cLBP was 16.6% (men: 10.8%, women: 21.1%) and that in patients with a history of cardiovascular diseases was 36.6% (men: 26.5%, women: 47.1%). The results showed that patients’ medical history of cardiovascular disease was significantly associated with cLBP in both men and women when adjusted for covariates (men: OR 2.16; 95%CI 1.34∼3.49; women: OR 2.26; 95%CI 1.51∼3.38). No association was observed between cLBP and the Framingham risk score, medication for hyperlipemia, hypertension, diabetes, and major cardiovascular risk factors (systolic blood pressure, total cholesterol, high density lipoprotein cholesterol, triglycerides, glucose and smoking habits) in either men or women. Conclusions: The prevalence of cLBP is correlated to a history of cardiovascular disease, but not to the major cardiovascular risk factors from the Framingham study. Further studies on whether these results were affected by psychological factors in patients with a history of cardiovascular diseases or whether new potential risk factors from the artery atherosclerosis hypothesis applying to Koreans exist are needed. [ABSTRACT FROM AUTHOR]

Background: Multiple prevention measures have the possibility of impacting HIV incidence in South Korea, including early diagnosis, early treatment, and pre-exposure prophylaxis (PrEP). We investigated how each of these interventions could impact the local HIV epidemic, especially among men who have sex with men (MSM), who have become the major risk group in South Korea. A mathematical model was used to estimate the effects of each these interventions on the HIV epidemic in South Korea over the next 40 years, as compared to the current situation. Methods: We constructed a mathematical model of HIV infection among MSM in South Korea, dividing the MSM population into seven groups, and simulated the effects of early antiretroviral therapy (ART), early diagnosis, PrEP, and combination interventions on the incidence and prevalence of HIV infection, as compared to the current situation that would be expected without any new prevention measures. Results: Overall, the model suggested that the most effective prevention measure would be PrEP. Even though PrEP effectiveness could be lessened by increased unsafe sex behavior, PrEP use was still more beneficial than the current situation. In the model, early diagnosis of HIV infection was also effectively decreased HIV incidence. However, early ART did not show considerable effectiveness. As expected, it would be most effective if all interventions (PrEP, early diagnosis and early treatment) were implemented together. Conclusions: This model suggests that PrEP and early diagnosis could be a very effective way to reduce HIV incidence in South Korea among MSM. [ABSTRACT FROM AUTHOR]