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BACKGROUND The number of mobile health apps is rapidly increasing. This means that consumers are faced with a bewildering array of choices, and finding the benefit of such apps may be challenging. The significant international burden of breast cancer (BC) and the potential of mobile health apps to improve medical and public health practices mean that such apps will likely be important because of their functionalities in daily life. As the app market has grown exponentially, several review studies have scrutinized cancer- or BC-related apps. However, those reviews concentrated on the availability of the apps and relied on user ratings to decide on app quality. To minimize subjectivity in quality assessment, quantitative methods to assess BC-related apps are required. OBJECTIVE The purpose of this study is to analyze the content and quality of BC-related apps to provide useful information for end users and clinicians. METHODS Based on a stepwise systematic approach, we analyzed apps related to BC, including those related to prevention, detection, treatment, and survivor support. We used the keywords “breast cancer” in English and Korean to identify commercially available apps in the Google Play and App Store. The apps were then independently evaluated by 2 investigators to determine their eligibility for inclusion. The content and quality of the apps were analyzed using objective frameworks and the Mobile App Rating Scale (MARS), respectively. RESULTS The initial search identified 1148 apps, 69 (6%) of which were included. Most BC-related apps provided information, and some recorded patient-generated health data, provided psychological support, and assisted with medication management. The Kendall coefficient of concordance between the raters was 0.91 (P2 years ago, or by individuals, had significantly lower MARS scores compared to other apps (P CONCLUSIONS The quality of BC-related apps was generally acceptable according to the MARS, but the gaps between the highest- and lowest-rated apps were large. In addition, apps using personalized data were of higher quality than those merely giving related information, especially after treatment in the cancer care continuum. We also found that apps that had been updated within 1 year and developed by private companies had higher MARS scores. This may imply that there are criteria for end users and clinicians to help choose the right apps for better clinical outcomes.

The use of an ostomy for urination and defecation leads to reduced quality of life. Although many ostomy management strategies are needed, such strategies are often implemented by patients. Thus, there is a need for a home health care service platform that can be used in ostomy patient management.We developed an ostomy patient management platform by identifying the needs of patients and medical staff through the Chronic Care Ostomy Self-Management Training Program in the United States and from studies conducted in Korea.The platform encompassed physical management, psychological management, maintenance of social function, spiritual stability, and home medical care. These components were implemented through monitoring, self-care guidance, and a community platform. For the monitoring function, a patient entered their health status in a mobile application (app); the medical staff at the affiliated hospital then monitored the stoma status through a web interface.Our platform allows medical staff to monitor ostomy patients through a web interface and help such patients to fully manage their ostomy at home using an app. We expect that the continued development of patient-oriented functions in our app will allow ostomy patients to experience quality of life improvements.

Particulate matter (PM) air pollution has challenged the global community and the International Agency for Research on Cancer (IARC) classified airborne particulate matter as carcinogenic to humans. However, while most studies of cancer examined a single cancer type using different cohorts, few studies compared the associations of PM between different cancer types. We aimed to compare the association of long-term exposure to PM (PM10 and PM2.5) and cancer mortality across 17 different types of cancer using a population-based cohort in the Seoul Metropolitan Area (SMA), South Korea; Our study population includes 87,608 subjects (mean age: 46.58 years) residing in the SMA from the National Health Insurance Services–National Sample cohort (NHIS–NSC) and followed up for 2007–2015. We used the time-dependent Cox proportional hazards model to estimate hazard ratios (HRs) and 95% confidence intervals (95% CIs) of each cancer mortality per 10 μg/m3 increase in PM concentrations, after adjusting for individual and areal characteristics. During eight years of follow-up, 1487 people died with any of 17 cancer types. Lung cancer death was the highest, followed by liver and stomach cancer. Although we did not find the association for all cancer types, possibly because of limited cancer cases, HRs of PM2.5 were relatively high for lung, stomach, pancreas, non-Hodgkin’s lymphoma, prostate, esophagus, oral and pharynx, and brain cancer mortality (HRs = 1.44–7.14). High HRs for pancreas, non–Hodgkin’s lymphoma, esophagus, and oral and pharynx cancer were also seen for PM10; our findings suggest PM air pollution as a potential risk factor of cancer mortality for upper digestive tracts, mouth, pancreas, and non–Hodgkin’s lymphoma in a highly urbanized population with high exposure to PM for a long time.

Background The number of mobile health apps is rapidly increasing. This means that consumers are faced with a bewildering array of choices, and finding the benefit of such apps may be challenging. The significant international burden of breast cancer (BC) and the potential of mobile health apps to improve medical and public health practices mean that such apps will likely be important because of their functionalities in daily life. As the app market has grown exponentially, several review studies have scrutinized cancer- or BC-related apps. However, those reviews concentrated on the availability of the apps and relied on user ratings to decide on app quality. To minimize subjectivity in quality assessment, quantitative methods to assess BC-related apps are required. Objective The purpose of this study is to analyze the content and quality of BC-related apps to provide useful information for end users and clinicians. Methods Based on a stepwise systematic approach, we analyzed apps related to BC, including those related to prevention, detection, treatment, and survivor support. We used the keywords “breast cancer” in English and Korean to identify commercially available apps in the Google Play and App Store. The apps were then independently evaluated by 2 investigators to determine their eligibility for inclusion. The content and quality of the apps were analyzed using objective frameworks and the Mobile App Rating Scale (MARS), respectively. Results The initial search identified 1148 apps, 69 (6%) of which were included. Most BC-related apps provided information, and some recorded patient-generated health data, provided psychological support, and assisted with medication management. The Kendall coefficient of concordance between the raters was 0.91 (P2 years ago, or by individuals, had significantly lower MARS scores compared to other apps (P Conclusions The quality of BC-related apps was generally acceptable according to the MARS, but the gaps between the highest- and lowest-rated apps were large. In addition, apps using personalized data were of higher quality than those merely giving related information, especially after treatment in the cancer care continuum. We also found that apps that had been updated within 1 year and developed by private companies had higher MARS scores. This may imply that there are criteria for end users and clinicians to help choose the right apps for better clinical outcomes.

Although outdoor air pollution including particulate matter (PM) was classified as carcinogenic to humans based on accumulating epidemiological evidence, these findings were suggested mostly from low-dose environments in North America and Europe. We aimed to examine the association of long-term exposure to PM ≤ 10 and 2.5 μm in diameter (PM10 and PM2.5) and nitrogen dioxide (NO2) with lung cancer incidence using a population-based cohort in the Seoul Metropolitan Area (SMA), South Korea. Our study included 83,478 people residing in the SMA and followed up for 2007–2015 from the National Health Insurance Service-National Sample Cohort. This cohort was constructed based on the National Health Insurance database that contains sociodemographic and medical information under universal health coverage. Individual long-term concentrations of PM10, PM2.5, and NO2 were estimated at people's district-level and annually-updated residential addresses for the previous 5 years by using previously-validated prediction models. We applied a time-dependent Cox proportional hazards model and estimated hazard ratios (HRs) per 10 μg/m3 and 10 ppb increases in PM and NO2, respectively, after adjusting for individual characteristics. During 9 years of follow-up, 489 lung cancer new cases occurred (714,012 person-year). The adjusted HRs for PM10 were greater than 1 but statistically non-significant (HR = 1.15; 95% CI = 0.88–1.52). We also did not find associations for PM2.5 and NO2. Despite null associations for the total population, our subgroup analysis suggested associations with PM in family members with cancer (PM10: HR = 2.59, 95% CI = 1.26–5.32; PM2.5: 5.55, 1.09–27.91) and in those who have smoked more than 1 pack per day (1.77, 0.96–3.25; 3.81, 1.00–14.44) or for less than 20 years (2.81; 1.13–7.07; 2.02, 0.21–19.23). Our study based on a highly urbanized population exposed to relatively high air pollution provides no evidence of the association between PM and lung cancer incidence in the total population but indicates the potential susceptibility in heavy smokers for relatively short periods and family members of cancer patients. Future studies should re-examine the association using improved exposure assessment and extended population.

Objective In 2007, the American College of Obstetricians and Gynecologists (ACOG) recommended that all pregnant women be offered screening or diagnostic tests for chromosomal abnormalities regardless of their age. Noninvasive prenatal testing (NIPT) for common chromosomal aneuploidies was introduced as a screening test in case of high-risk pregnancies. We assessed the rates of prenatal tests in women aged 35 years and older. Methods A retrospective study was conducted to compare the rates of amniocentesis, chorionic villus sampling (CVS), serum screening, and NIPT from January 2005 through March 2017 in women aged 35 years and older. We divided the initial 12 months after NIPT introduction into 4-month intervals, beginning in April 2016 through March 2017. Results The rates of amniocentesis were 56% before the ACOG statement, 38% between the ACOG statement and NIPT introduction, and 10% after NIPT introduction (P=0.001). The rates of CVS during the same periods were 0.5%, 2.1%, and 4.3% (P=0.016), respectively. The rates of serum screening were 44.2%, 61.3%, and 55.1% (P=0.049), respectively. During the 3 quarters after NIPT introduction, the rates of amniocentesis were 16.2%, 12.3%, and 7.3% (P=0.002), respectively; the rates of serum screening were 62%, 54%, and 46% (P=0.03), respectively; and the rates of NIPT were 19.9%, 30.3%, and 39.5% (P=0.007), respectively. The rates of CVS over the same periods were not significantly different. Conclusion The ACOG statement and NIPT introduction significantly decreased the rate of amniocentesis in women of advanced maternal age. NIPT also reduced the rate of serum screening.

Background The 2015 Middle East respiratory syndrome (MERS) outbreak in South Korea was a serious threat to public health, and was exacerbated by the inappropriate responses of major institutions and the public. This study examined the sources of confusion during the MERS outbreak and identified the factors that can affect people's behavior. Methods An online survey of the risk perception of university students in South Korea was performed after the epidemic had peaked. The questionnaire addressed the major social determinants in South Korea during the MERS epidemic. The analysis included data from 1,470 subjects who provided complete answers. Results The students had 53.5% of the essential knowledge about MERS. Women showed higher risk perception than men, and trust in the media was positively associated with risk perception (P

Objective We evaluated the effect on treatment using the new International Association of Diabetes and Pregnancy Study Group (IADPSG) criteria for gestational diabetes mellitus (GDM) diagnosis. Methods Singleton pregnant women whose plasma glucose levels were ≥140 mg/dL on the 50 g glucose challenge test (GCT) underwent 75 g oral glucose tolerance for GDM diagnosis. During the first half of the study period, GDM was diagnosed using 2 abnormal values by Carpenter-Coustan (C-C) criteria. In the second half of the study period, 1 or more abnormal values by IADPSG criteria were used for GDM diagnosis. Pregnant women were classified into 5 groups: normal 50 g GCT, positive 50 g GCT but non-GDM, GDM by IADPSG criteria and non-treated, GDM by IADPSG criteria and treated, GDM by C-C criteria and treated. The odds ratios (ORs) for large for gestational age (LGA) and macrosomia were analyzed. Results Of the 2,678 patients, the frequency of GDM diagnosed by C-C and IADPSG criteria was 2.6% and 7.5%. ORs (95% confidence intervals [CIs]) for LGA and macrosomia in the group with GDM by IADPSG criteria and non-treated were 2.81 (95% CI, 1.47–5.38) and 2.84 (95% CI, 1.08–7.47). The risk of LGA and macrosomia did not increase in the group with GDM by IADPSG criteria and treated. Conclusion The risk of LGA and macrosomia for mild GDM diagnosed solely by IADPSG criteria depends on whether they are treated or not. Treatment of GDM based on IADPSG criteria reduces the risk of excessive fetal growth. Trial Registration Clinical Research Information Service Identifier: KCT0000776