Health behaviors according to the ability to understand health information in Korean adults.

This study aimed to verify the relationship between the level of understanding of health information and health behaviors among Korean adults. In total, 228 984 adults who participated in the 2021 Korea Community Health Survey were included. Participants were divided into three groups according to age (19-44, 45-64 and 65+). The ability to understand verbal and written health information was included, and its association with health behaviors, including smoking, alcohol consumption and preventive health service uptake, was assessed. Associations between the ability to understand health information and health behaviors were analyzed using chi-squared tests and multiple logistic regression analyses. Approximately 22.7% and 20% of the participants responded that verbal and written health information were easy to understand, respectively, with significant differences by age group. Compared to those with easy-to-understand verbal health information, those with difficulty in understanding had a higher risk of current cigarette smoking and monthly drinking and were less likely to engage in more than moderate physical activity, walking, influenza vaccination in 1 year, cancer examination in 2 years and medical examination in 2 years. Difficulty in understanding or no interest in written health information was also associated with unhealthy behaviors. A strong ability to understand health information is related to positive health behaviors. However, there are differences in the associations by age group, which should be considered when establishing a health literacy improvement strategy. These findings could promote health literacy and ultimately contribute to helping individuals make better choices for positive health behaviors.

Carcinogenicity assessment of tegoprazan in Sprague-Dawley (Crl:CD) rats and ICR (Crl:CD1) mice.

Tegoprazan is a novel potassium-competitive acid blocker (P-CAB) that reversibly inhibits the proton pump in gastric parietal cells and has been approved for the treatment of acid-related diseases in Korea. This study aimed to evaluate the carcinogenic potential of tegoprazan in Sprague-Dawley rats and CD-1 mice. Tegoprazan was administered daily by oral gavage to rats for up to 94 weeks and mice for up to 104 weeks. Evidence of carcinogenic potential of tegoprazan was identified in rats only and was limited to benign and/or malignant neuroendocrine cell tumors at exposures >7-fold of the recommended human dose. Glandular stomach findings were considered secondary to the expected pharmacology of tegoprazan, characterized by their location in the fundic and body regions of the stomach. Overall, tegoprazan induced gastric enterochromaffin-like (ECL) cell tumors in SD rats, but did not produce any treatment-related statistically significant increase in the incidence of neoplasms relevant to humans when administered to SD rats and CD-1 mice by gavage at doses up to 300 and 150 mg/kg/day, respectively. Gastric ECL cell tumors are thought to be induced by the exaggerated indirect pharmacological effect of tegoprazan, similar to that reported for proton pump inhibitors (PPIs) and other P-CABs.

Assessment of radiological impact on the surrounding environment and biota for phosphogypsum waste stockyard in Korean facility.

In this study, the effects of deposited gypsum residues on the surrounding environment and radiation exposure in plants and animals were evaluated under various exposure situations. A waste stockyard in a Korean facility (surrounded by mountains and sea) was used to store phosphogypsum, a byproduct of phosphoric acid processes, in a slurry form in a large gypsum storage facility (provided separately on the facility site). The ERICA tool was used to evaluate the impact of radiation on nonhuman environments for mineral processing and waste storage for risk estimation. The impact of radiation on the environment due to the phosphogypsum stockyard was negligible with a screening dose of less than 10 µGy h-1. However, to conservatively evaluate the environmental impact of rain and wind in the phosphogypsum stockyard, the soil at the interface of the stockyard, where plants could not grow, was considered as an input value, and the estimated dose rate of shrubs was found to be 45 µGy h-1. The effects of the phosphogypsum stockyard on the surrounding environment accounted for 95-100% of the total dose for internal exposure in biota. In general, radium was found to be the highest contributor to biota, and the next lead and polonium were contributors to the dose. The findings contribute to an understanding of the radiological impact of waste stored and disposed of at the facility on the environment and biota (all routes of exposure) and to developing sustainable operations and pollution monitoring policies.

Methyl p­hydroxycinnamate exerts anti­inflammatory effects in mouse models of lipopolysaccharide­induced ARDS.

Methyl p­hydroxycinnamate (MH), an esterified derivative of p­Coumaric acid exerts anti­inflammatory effects on lipopolysaccharide (LPS)­stimulated RAW264.7 macrophages. Based on these effects, the present study investigated the protective role of MH in a mouse model of LPS­induced acute respiratory distress syndrome (ARDS). The results demonstrated that administration of LPS (5 mg/kg intranasally) markedly increased the neutrophil/macrophage numbers and levels of inflammatory molecules (TNF­α, IL­6, IL­1ß and reactive oxygen species) in the bronchoalveolar lavage fluid (BALF) of mice. On histological examination, the presence of inflammatory cells was observed in the lungs of mice administered LPS. LPS also notably upregulated the secretion of monocyte chemoattractant protein­1 and protein content in BALF as well as expression of inducible nitric oxide synthase in the lungs of mice; it also caused activation of p38 mitogen­activated protein kinase (MAPK) and NF­κB signaling. However, MH treatment significantly suppressed LPS­induced upregulation of inflammatory cell recruitment, inflammatory molecule levels and p38MAPK/NF­κB activation, and also led to upregulation of heme oxygenase­1 (HO­1) expression in the lungs of mice. In addition, the ability of MH to induce HO­1 expression was confirmed in RAW264.7 macrophages. Taken together, the findings of the present study indicated that MH may exert protective effects against airway inflammation in ARDS mice by inhibiting inflammatory cell recruitment and the production of inflammatory molecules.

Deep learning-based framework for cardiac function assessment in embryonic zebrafish from heart beating videos.

Zebrafish is a powerful and widely-used model system for a host of biological investigations, including cardiovascular studies and genetic screening. Zebrafish are readily assessable during developmental stages; however, the current methods for quantifying and monitoring cardiac functions mainly involve tedious manual work and inconsistent estimations. In this paper, we developed and validated a Zebrafish Automatic Cardiovascular Assessment Framework (ZACAF) based on a U-net deep learning model for automated assessment of cardiovascular indices, such as ejection fraction (EF) and fractional shortening (FS) from microscopic videos of wildtype and cardiomyopathy mutant zebrafish embryos. Our approach yielded favorable performance with accuracy above 90% compared with manual processing. We used only black and white regular microscopic recordings with frame rates of 5-20 frames per second (fps); thus, the framework could be widely applicable with any laboratory resources and infrastructure. Most importantly, the automatic feature holds promise to enable efficient, consistent, and reliable processing and analysis capacity for large amounts of videos, which can be generated by diverse collaborating teams.

Ultrasound shear wave elastography in assessment of skeletal muscle stiffness in senior volunteers.

PURPOSE: The aim of the study was to evaluate the reliability of ultrasound shear wave elastography (SWE) to assess biceps brachii muscle (BBM) and quadriceps muscle (QM) stiffness in senior volunteers. METHODS: Using a linear array ultrasound transducer (7 MHz), we prospectively measured shear wave velocity (SWV) of BBM and QM in passive joints (elbow and knee) flexion (90°) and extension (180°) in 19 senior volunteers by two operators. We developed SWV rate (SWVelbow-extension - SWVelbow-flexion)/SWVelbow-flexion to assess BBM contractibility. Statistical analysis included unpaired t-test to examine the difference in SWV of muscle between left vs right limbs, men vs women, and athletes vs nonathletes; Intraclass correlation coefficient (ICC) and violin plots for analyzing intra- and inter-observer reliability in performing SWE in muscles. RESULTS: There was no significant difference in SWV between left vs right (flexion or extension), male vs female (flexion or extension), for BBM and QM, and athlete vs nonathlete extension for QM (all p > 0.05). The difference in SWV of BBM in elbow extension and in SWV rate between athlete and nonathlete was significant (p < 0.05). The difference in muscle SWV between joint flexion and extension was also significant (p < 0.05). Reliability in performing SWE of BBM and QM was good (ICC > 0.75). CONCLUSIONS: Our results suggest that ultrasound SWE is feasible in estimating BBM and QM stiffness in seniors with good reproducibility. SWV rate and SWV of the extended BBM representing muscle contractibility in athlete were higher than in nonathlete.

Epidemiology and management of primary immune thrombocytopenia: A nationwide population-based study in Korea.

INTRODUCTION: The epidemiology of immune thrombocytopenia (ITP) is not well characterized in an Asian population. MATERIALS AND METHODS: From July 2010 to June 2014, ITP patients were identified using the Korean Health Insurance Review and Assessment Service database. RESULTS: The overall incidence rate of ITP was 5.3 per 100,000 person-years (95% CI: 5.1-5.5). The overall incidence rate ratios of children under 15years old to adults and females to males were 3.8 (95% CI: 3.7-3.9) and 1.3 (95% CI: 1.2-1.4), respectively. Of the total 10,814 patients, 3388 patients (31%) needed treatment for ITP; of these, 54% continued treatment for more than three months. First-line therapy consisted of corticosteroids (CS) in 42%, immunoglobulin (IVIg) in 35%, CS with IVIg in 19%, and other immunosuppressive agents (ISA) in 4%. Among treated patients, 75% of adults and 33% of children continued treatment for more than three months. After three months, the most frequently used drug was CS alone in 63% of patients. Only 104 patients underwent splenectomy; of these, 51% received salvage treatment after a median of one month after surgery (range: 0-27). The proportion of patients who received platelet transfusions of 12units or more per month for at least two consecutive months was significantly higher among patients treated for more than three months compared with patients who completed treatment within three months. CONCLUSIONS: This population-based study is the first to describe the incidence of ITP and its treatment reality for patients in Korea.

Difference in adherence to and influencing factors of a healthy lifestyle between middle-aged and elderly people in Korea: A multilevel analysis.

AIM: Comprehensive research for factors related to healthy lifestyles of the elderly is limited. The present study aimed to elucidate the factors associated with adherence to a healthy lifestyle by age groups. METHOD: The present study was based on data from the 2005 Korea National Health and Nutrition Examination Survey. We calculated crude proportions and adjusted proportions of cigarette smokers, problem alcohol drinkers, and physically inactive people in two age groups (40-59 years and ≥60 years). We carried out multilevel analysis to elucidate factors associated with healthy lifestyles. RESULTS: Of 3194 respondents included in the analysis, 1154 (36.13%) were aged 60 years or older. Older participants smoked less (23.0% vs 17.4%) and exercised less frequently (52.4% vs 66.9%; all P < 0.001) than their middle-aged counterparts. After adjustment, the proportion of regular exercisers was inversed (adjusted proportion 0.468, 95% CI 0.436-0.501 vs 0.377, 95% CI 0.337-0.419, P = 0.004). In multilevel analysis, contextual factors, such as local tax per capita, was associated significantly with cigarette smoking only in the elderly (OR 1.037, 95% CI 1.005-1.070). CONCLUSIONS: Different factors were associated with healthy lifestyles of elderly people when compared with middle-aged people. In addition, local tax per capita, an area level variable, was more likely to be associated with smoking in the elderly than the middle-aged group.

Factors affecting the prescribing patterns of antibiotics and injections.

There are serious problems concerning the inadequate prescription of antibiotics and overuse of injections in primary care. However, the determinants of prescription patterns in Korea are not well-documented. To examine the area characteristics affecting the prescription of antibiotics and injections in primary care practices in the treatment of respiratory tract infections (RTIs), a nationwide cross-sectional study was performed in all 250 administrative districts of Korea. The outcome was modeled as a binary variable: over-prescription or not compared with the nation-wide average. Over-prescription of antibiotics was associated with the ratio of specialists to general physicians and over-prescription in previous years in the area (adjusted odds ratio [aOR], 4.8; 95% confidence interval [CI] 1.5-14.8; and aOR, 12.0; 95% CI 5.5-25.9, respectively). Over-use of injections was associated with younger population, urban living and the number of hospital beds in the area (aOR, 0.2; 95% CI 0.1-0.4; aOR, 0.3; 95% CI 0.1-0.8; and aOR, 0.4, 95% CI 0.2-0.9; respectively). There were differences in the prescribing patterns in different districts; prescription patterns were affected more by supply factors than by demand factors. Highly competitive medical environment associated with supply factors is a significant determinant of prescription patterns in Korea.

The association between the supply of primary care physicians and population health outcomes in Korea.

BACKGROUND AND OBJECTIVES: Several studies reported that primary care improves health outcomes for populations. The objective of this study was to examine the relationship between the supply of primary care physicians and population health outcomes in Korea. METHODS: Data were extracted from the 2007 report of the Health Insurance Review, the 2005 report from the Korean National Statistical Office, and the 2008 Korean Community Health Survey. The dependent variables were age-adjusted all-cause and disease-specific mortality rates, and independent variables were the supply of primary care physicians, the ratio of primary care physicians to specialists, the number of beds, socioeconomic factors (unemployment rate, local tax, education), population (population size, proportion of the elderly over age 65), and health behaviors (smoking, exercise, using seat belts rates). We used multivariate linear regression as well as ANOVA and t tests. RESULTS: A higher number of primary care physicians was associated with lower all-cause mortality, cancer mortality, and cardiovascular mortality. However, the ratio of primary care physicians to specialists was not related to all-cause mortality. In addition, the relationship between socioeconomic variables and mortality rates was similar in strength to the relationship between the supply of primary care physicians and mortality rates. Accident mortality, suicide mortality, infection mortality, and perinatal mortality were not related to the supply of primary care physicians. CONCLUSIONS: The supply of primary care physicians is associated with improved health outcomes, especially in chronic diseases and cancer. However, other variables such as the socioeconomic factors and population factors seem to have a more significant influence on these outcomes.