Immune checkpoint inhibitors with chemotherapy for primary advanced mismatch repair-deficient endometrial cancer: A cost-effectiveness analysis.

OBJECTIVE: The addition of immune checkpoint inhibitors (ICIs), pembrolizumab or dostarlimab, to paclitaxel and carboplatin (TC) has shown better response rates and survival outcomes for patients with primary advanced mismatch repair-deficient (MMRd) endometrial cancer (EC) in NRG-GY018 and RUBY, respectively. Nonetheless, the high cost of ICIs remains a major concern when implementing this strategy in the real world. This study aimed to determine the cost-effectiveness of pembrolizumab and dostarlimab with chemotherapy compared to TC for primary advanced MMRd EC. METHODS: We developed a Markov model including 6600 patients with primary advanced MMRd EC to simulate treatment outcomes. The initial decision points in the model were treatment with pembrolizumab with TC (PEM-TC), dostarlimab with TC (DOS-TC), and TC. Model probabilities, costs, and health utility values were derived with assumptions from published literature. Effectiveness was determined as average quality-adjusted life years (QALYs) gained. The primary outcome was the incremental cost-effectiveness ratio (ICER). RESULTS: TC was the least costly strategy, whereas PEM-TC was the most effective strategy for primary advanced MMRd EC. TC was cost-effective based on a willingness-to-pay (WTP) threshold of $100,000/QALY compared with PEM-TC (ICER, $377,718/QALY), and DOS-TC exhibited absolute dominance (ICER, $401,859/QALY). PEM-TC was cost-effective when the cost of pembrolizumab 200 mg was reduced to $4361 (61% reduction). PEM-TC was selected in 16.5% with a WTP threshold of $300,000/QALY, but in <1% with a WTP threshold range of $100,000-200,000/QALY. CONCLUSION: PEM-TC can become cost-effective for primary advanced MMRd EC when the cost of pembrolizumab substantially decreases.

The Differential Impact of Neglectful and Intrusive Parenting Behavior on Adolescents' Relationships with Peers and Teachers Using Longitudinal data: Mediating Effects of Depression and Social Withdrawal.

This study used longitudinal data to verify the mediating effects of depression and social withdrawal on the impacts of neglectful and intrusive parenting behavior on adolescents' interpersonal relationships with peers and teachers in school. We used data from the Korea Children and Youth Panel Survey's (KCYPS, 2010) 4-6th waves, which followed fourth graders across Korea. To analyze the data, we conducted a descriptive analysis, bivariate correlation analysis, and structural equation modeling. Specifically, the results showed that depression and social withdrawal had a greater indirect effect on the link between neglectful parenting behavior and relationships with peers and/or teachers than did intrusive parenting behavior. Based on these findings, we also highlighted the importance of parenting behavior in improving relationships with peers and teachers as well as the need for tailored interventions based on adolescents' degree of depression and social withdrawal.

The impact of the COVID-19 pandemic and the expansion of free vaccination policy on influenza vaccination coverage: An analysis of vaccination behavior in South Korea.

BACKGROUND: Annual vaccination for influenza is globally recommended for some prioritized groups due to its high morbidity and mortality. Until 2019, South Korea has provided free influenza vaccination to children aged ≤12, adults aged ≥65, and pregnant women to enhance vaccination coverage. In 2020, with the COVID-19 pandemic, free flu vaccination was temporarily broadened to adults aged 62-64 and children aged 13-18. We analyzed the trends in influenza vaccination coverages in South Korea and evaluated the impact of the COVID-19 pandemic and the expansion of the free vaccination policy on influenza vaccination coverage. METHODS: We conducted a cross-sectional study with nationwide survey data from Korea National Health and Nutrition Examination Survey (KNHANES). We evaluated the trends in influenza vaccination coverages of target populations from 2010 to 2020. Influenza vaccination coverages of children aged 13-18, adults aged 62-64, and adults aged ≥65 were compared between 2019 and 2020. RESULTS: In total, 72,443 individuals were analyzed. From 2019 to 2020, with the expansion of free influenza vaccination and the COVID-19 pandemic, the vaccination coverage of children aged 13-18 increased from 27.8% to 43.5% (P<0.001) but that of people aged 62-64 showed insignificant change from 57.4% to 51.5% (P = 0.266). Furthermore, the vaccination coverage in adults aged ≥65 declined from 87.2% to 79.1% (P<0.001). CONCLUSION: In 2020, along with COVID-19 outbreaks, a decline of influenza vaccination coverage in older adults was observed regardless of free immunizations. It is likely due to behavioral changes to reduce the risk of COVID-19 transmission. This is supported by a greater reduction of influenza vaccination coverage in regions with higher COVID-19 outbreaks, as well as by South Korea's high medical accessibility and highly congested medical facilities. To sustain a high level of vaccination coverage of high-risk population during epidemics, additional efforts beyond free vaccination policies should be implemented.

The impact of free vaccination policies under the Korean Influenza National Immunization Program: Trends in influenza vaccination rates in South Korea from 2010 to 2019.

BACKGROUND: Annual vaccination for influenza is recommended for high-risk populations for its high morbidity and mortality. South Korea provides free influenza vaccination to some target groups under the National Immunization Program (NIP), and discrepantly high vaccination rates are observed in such populations. In this study, we analyzed the trends in influenza vaccination rates and evaluated the impact of the recent expansion of financial coverage to children ≤12 years and pregnant women. METHODS: We conducted a cross-sectional study with nationwide survey data from Korea National Health and Nutrition Examination Survey (KNHANES). From 2010 to 2019, we evaluated the trends in influenza vaccination rates of the following four target groups: children ≤12 years, adults ≥65 years, pregnant women, and people with chronic diseases. RESULTS: In total, 80,861 individuals were analyzed. From 2017 to 2019, the vaccination coverage of children ≤12 years increased from 66.2% to 83.1%; pregnant women from 44.1% to 68.5% (comparing the mean of 2010-2017 and 2018-2019, P <0.001 for both). The elderly ≥65 years showed the highest rates (85.8% in 2019), while people with chronic diseases marked the lowest (41.9% in 2019). People with liver diseases showed the lowest vaccination rate of 27.8%, while that of other common diseases ranged between 31.7-44.1%. CONCLUSION: The discrepancy between target groups corresponds to their financial coverage under NIP. The recent expansion of financial aids to children ≤12 years and pregnant women was followed by significant increases in vaccination rates in both groups. We suggest that free vaccination policy is one of the most effective strategies to enhance vaccination coverage, and we call for its expansion to other under-vaccinated target groups, especially people with chronic diseases.

A 5-Year Analysis of Aviation Medical Examinations in South Korea.

INTRODUCTION: Little has been studied to promote aviation health in South Korea. The aim of this study was to analyze the results of aviation medical examinations conducted in South Korea over the past 5 yr and, in doing so, provide evidence for establishing a health promotion, disease prevention plan.METHODS: Subjects of the study consisted of applicants who underwent aviation medical examinations from January 1, 2016, to December 31, 2020.RESULTS: Over the past 5 yr, the total number of aviation medical examinations in South Korea has shown an annual increase of more than 10%. In the presence of the COVID-19 pandemic in 2020, the number of aviation medical examinations, both renewal and initial, for all types of licenses, except renewal aviation medical examinations for the ATCL, decreased. Disqualification rates were generally higher in initial examinations than in renewal examinations. The examination results for license renewal showed the ATPL disqualification rate to be the highest at 3.5 per 1000 pilots per year in their 50s, with cardiology cases being the most common reason for disqualification, followed by ophthalmology cases and psychiatry cases. Diagnostic categories for those disqualified after initial aviation medical examinations were similar, though ophthalmological causes were most common, followed by cases of psychiatry and neurology.CONCLUSION: Main causes of disqualification in airmen and air traffic controllers were identified as the presence of cardiovascular, ophthalmic, and psychiatric diseases. The results of this study provide evidence for improving health promotion activity plans to manage risk factors of such diseases for aviation workers.Kim JS, Han BS, Kwon YH, Lim J. A 5-yr analysis of aviation medical examinations in South Korea. Aerosp Med Hum Perform. 2022; 93(6):499-506.

Use of acid-suppressive drugs and risk of pneumonia: a systematic review and meta-analysis.

BACKGROUND: Observational studies and randomized controlled trials have yielded inconsistent findings about the association between the use of acid-suppressive drugs and the risk of pneumonia. We performed a systematic review and meta-analysis to summarize this association. METHODS: We searched three electronic databases (MEDLINE [PubMed], Embase and the Cochrane Library) from inception to Aug. 28, 2009. Two evaluators independently extracted data. Because of heterogeneity, we used random-effects meta-analysis to obtain pooled estimates of effect. RESULTS: We identified 31 studies: five case-control studies, three cohort studies and 23 randomized controlled trials. A meta-analysis of the eight observational studies showed that the overall risk of pneumonia was higher among people using proton pump inhibitors (adjusted odds ratio [OR] 1.27, 95% confidence interval [CI] 1.11-1.46, I(2) 90.5%) and histamine(2) receptor antagonists (adjusted OR 1.22, 95% CI 1.09-1.36, I(2) 0.0%). In the randomized controlled trials, use of histamine(2) receptor antagonists was associated with an elevated risk of hospital-acquired pneumonia (relative risk 1.22, 95% CI 1.01-1.48, I(2) 30.6%). INTERPRETATION: Use of a proton pump inhibitor or histamine(2) receptor antagonist may be associated with an increased risk of both community- and hospital-acquired pneumonia. Given these potential adverse effects, clinicians should use caution in prescribing acid-suppressive drugs for patients at risk.

Recent trends of refractive surgery rate and detailed analysis of subjects with refractive surgery: The 2008-2015 Korean National Health and Nutrition Examination Survey.

The present study was conducted to investigate recent trends of refractive surgery rates and analyze subjects undergoing refractive surgery using large-scale population studies over the past 8 years. We used the dataset of the Korean National Health and Nutrition Examination Surveys, a nationwide population-based cross-sectional study which were performed from 2008 to 2015. Of the 21,415 participants aged 20 to 49 years, 1,621 had refractive surgeries. Seventy three percent of them were females and 81% of them were aged under 40 years old. Over the past 8 years, cumulative prevalence of refractive surgery rate increased more than 10%. Although young (< 40 years, odds ratio (OR) 0.31, P<0.001) women (OR 1.86, P<0.001) living in urban areas (OR 0.51, P<0.001) with high educational attainment (OR 2.67, P<0.001) and income levels (OR 3.16, P<0.001) accounted for a high proportion in refractive surgery group through all survey years, subgroup analyses revealed that gaps between genders (ORs 3.8 in 2008-2009, 2.1 in 2010-2012, and 1.5 in 2013-2015), educational level (ORs 3.0, 2.5, and 2.1, respectively), and highest/lowest quartiles of household income (ORs 5.2, 2.6, and 2.4, respectively) were decreasing over time. Overall, our study suggests that refractive surgery has reached an age where the majority accepts it, and indeed more and diverse people are undergoing refractive surgeries.

Organizing an in-class hackathon to correct PDF-to-text conversion errors of Genomics & Informatics 1.0.

This paper describes a community effort to improve earlier versions of the full-text corpus of Genomics & Informatics by semi-automatically detecting and correcting PDF-to-text conversion errors and optical character recognition errors during the first hackathon of Genomics & Informatics Annotation Hackathon (GIAH) event. Extracting text from multi-column biomedical documents such as Genomics & Informatics is known to be notoriously difficult. The hackathon was piloted as part of a coding competition of the ELTEC College of Engineering at Ewha Womans University in order to enable researchers and students to create or annotate their own versions of the Genomics & Informatics corpus, to gain and create knowledge about corpus linguistics, and simultaneously to acquire tangible and transferable skills. The proposed projects during the hackathon harness an internal database containing different versions of the corpus and annotations.

Trends in influenza vaccination coverage rates in South Korea from 2005 to 2014: Effect of public health policies on vaccination behavior.

BACKGROUND: Influenza is a major cause of morbidity and mortality worldwide. Annual vaccination is effective in its prevention and is recommended especially in susceptible populations such as the elderly over 65 years, children younger than 5, pregnant women, and people with chronic diseases. Overall, South Korea has a high vaccination rate owing to its National Immunization Program, although the method and extent of its coverage varies among the target subgroups. The aim of this study is to assess the trend of influenza vaccination coverage between 2005 and 2014 in South Korea to address the influence of sociodemographic and disease factors on vaccination behavior. Also, we aim to compare the vaccination coverage of target subgroups and evaluate the effect of relevant policies to provide suggestions for their improvement. METHODS: A total of 61,036 respondents from the Korea National Health and Nutrition Examination Surveys III to VI were included. RESULTS: The total influenza vaccination coverage increased from 38.0% in 2005 to 44.1% in 2014. Vaccination coverage was higher among the elderly aged ≥65 years (range, 70.0-79.8%; p-for-trend <0.001) and children under 5 (range, 64.6-78.9%; p-for-trend < 0.001) than among pregnant women (range, 9.4-37.8%; p-for-trend = 0.122) and people with chronic diseases (range, 29.6-42.6%; p-for-trend = 0.068) from 2005 to 2014. High vaccination coverage was associated with female gender, rural residence, low education level, high income, and increasing number of chronic diseases. But the effect of high income on high vaccination coverage was absent in the elderly aged ≥65 years and children under 5. CONCLUSION: Influenza vaccination rates have steadily increased from 2005 to 2014 in South Korea. Disparities between target groups correspond to their financial coverage under the National Immunization Program, and financial aids remove the influence of high income on higher vaccination rates. Future vaccination policies should focus on pregnant women and people with chronic diseases.

The effectiveness and limitation of the national childhood hepatitis A vaccination program in the Republic of Korea: Findings from the Korean National Health and Nutrition Examination Survey (KNHANES), 2015.

BACKGROUND: Vaccination for hepatitis A virus (HAV) has been implemented as one of the national vaccination programs despite the epidemiological transition of HAV in the Republic of Korea. While the national HAV vaccination program is largely associated with the shift of socioeconomic trend in the country, concerns have been raised on the effectiveness of the HAV immunization. The objective of this study was to examine the epidemiological trend of HAV and assess the effectiveness of the nationwide HAV vaccination policy based on a nationally representative sample of the Korean population collected in 2015. METHODS: We analyzed anti-HAV of 5,856 respondents aged ≥10 years collected from Korean National Health and Nutrition Examination Survey (KNHANES) data in 2015. We estimated age-adjusted anti-HAV prevalence by sociodemographic and other characteristics. We evaluated the factors associated with anti-HAV positivity among each age group (10-19, 20-29, 30-45 and over 45 years old). RESULTS: The prevalence of anti-HAV among adults aged ≥10 years was 72.5% (95% confidence interval, CI, 73.7-71.4) in 2015. The lowest age-specific prevalence was among adults aged 20-29 years with 11.9% (95% CI 9.3-15.1%). The prevalence of anti-HAV among those aged 10-14 and 15-19 years was 59.7% (95% CI 52.7-66.4) and 24.0% (95% CI 19.5-29.3), respectively. The prevalence of anti-HAV among adults aged between 30 and 44 years rapidly increased from below 20% to above 90%. The prevalence of anti-HAV among adults aged ≥45 years was 97.8% (95% CI 96.0-97.6). Factors significantly associated with anti-HAV positivity among those aged 10-19 years old were young age, higher house income and high influenza vaccination rate. Compared to the respondents aged 10-19 years (those who were subject to the national childhood vaccine recommendation), those aged 20-29 years (those who were not subject to the recommendation) had low adjusted odds ratio (OR, 0.52 95% CI 0.34-.81 P-value = 0.004) for anti-HAV positivity. CONCLUSIONS: The age-adjusted anti-HAV prevalence showed a U-shaped association, implying the high dependence of anti-HAV prevalence on age and the epidemiological shift. The inclusion of the hepatitis A vaccine into the national immunization recommendation was effective shown by the increase of immunity in the general population. However, the vaccination rate was low in the low-income group. Young adults aged 20-39 years may benefit from inclusion in the HAV vaccination program due to the significantly low vaccination rate.

Association between vitamin D status and metabolic syndrome risk among Korean population: based on the Korean National Health and Nutrition Examination Survey IV-2, 2008.

AIMS: Low serum 25-hydroxyvitamin D (25(OH)D) levels have been linked to metabolic syndrome. However, community-based data for healthy Korean individuals are lacking. We aimed to assess the vitamin D status and the association of 25(OH)D deficiency with metabolic syndrome in the South Korean population (latitude 33-38°N). METHODS: In this population-based study, we assessed 5559 South Korean adults selected from the Korean National Health and Nutrition Examination Survey IV-2, 2008. We used multiple logistic regression analysis to assess the association between vitamin D deficiency and metabolic syndrome. RESULTS: The prevalence of vitamin D deficiency (<20 ng/mL) was 56.0%. Subjects with vitamin D deficiency were younger and had higher education, lower physical activity, and lower alcohol consumption than those with normal vitamin D levels. The overall risk of metabolic syndrome was not associated with 25(OH)D concentration. The adjusted OR of reduced high density lipoprotein cholesterol (HDL-C) decreased across the quintiles of 25(OH)D concentrations (OR=0.72; 95% confidence interval=0.54-0.95 for comparisons of lowest vs. highest quintile; P for trend=0.003). CONCLUSIONS: A high prevalence of vitamin D deficiency was noted in the general South Korean population. Serum 25(OH)D concentration was inversely associated with the risk of having reduced HDL-C.