Osong Public Health and Research Perspectives最新文献

Background: This study evaluated the effectiveness of government epidemic control policies centered on diagnostic testing and examined their impact on the in vitro diagnostics (IVD) industry. It also analyzed the complex interplay among policy interventions, epidemic dynamics, and the IVD industry's value chain to identify key leverage points for managing future public health crises.

Methods: A system dynamics (SD) model calibrated using national data from the Republic of Korea simulated the interactions between epidemic progression and the IVD value chain. We conducted a scenario analysis encompassing 6 policy interventions: research and development (R&D) investment, public-private collaboration, regulatory easing, diagnostic test performance, testing intensity, and social distancing.

Results: Policies promoting investment, public-private collaboration, and regulatory easing accelerated the market entry of diagnostics, thereby reducing infections and deaths. However, these interventions were associated with lower overall industry revenue, attributable to increased market competition and a reduced patient population. A critical trade-off was noted: although regulatory speed is advantageous, using low-sensitivity diagnostics substantially worsened public health outcomes. Aggressive testing strategies and stringent social distancing were also confirmed to be effective in reducing both infections and mortality.

Conclusion: This study provides a strategic framework for understanding interactions between pandemic control policies and the IVD industry. Sustained pre-crisis investment in R&D, public-private networks, and public health infrastructure is essential for effective pandemic preparedness. During a crisis, policymakers must carefully manage the critical trade-off between regulatory speed and diagnostic quality to ensure that rapid responses do not compromise public health outcomes.

This review examines how biotechnology advances (CRISPR/Cas9, next-generation targeted therapies, nanotechnology-based drug delivery, and immunotherapies) can be applied to address cancer drug resistance worldwide. It also considers the economic burden of resistance, inequities in access to biotechnology solutions, and ethical concerns surrounding rapid innovation, particularly in low-resource settings. A narrative review synthesized evidence from basic science studies, clinical trials, translational research, and policy analyses. Evidence was prioritized for 2015-2025 publications. The synthesis highlights resistance biology and evaluates how precision medicine, biomarker-guided treatment, and high-throughput drug screening can inform individualized regimens and rational combinations. Breakthroughs in gene editing, targeted inhibitors, nanocarriers, and immune engineering can counter key resistance mechanisms, including resistance-conferring mutations, altered drug transport, immune evasion, and tumor microenvironment-mediated protection. Despite progress, implementation barriers remain substantial: high drug and development costs, limited molecular diagnostics and manufacturing capacity, and regulatory and governance challenges that can delay adoption and widen disparities, particularly in low- and middle-income countries. Integrating biotechnology innovations within precision medicine frameworks may improve treatment selection and patient outcomes. Maximizing public health impact requires affordability and financing strategies, robust ethical oversight, timely regulatory pathways, and coordinated global collaboration to ensure access to effective therapies across health systems worldwide.

Background: This study evaluated the effectiveness of rapid diagnostic testing (RDT) for the early detection of imported dengue cases at Gimhae International Airport in the Republic of Korea, and analyzed patient characteristics and response processes following positive results.

Methods: From 2022 to 2024, 334 individuals underwent RDT at the airport. Testing was performed for travelers presenting with dengue-like symptoms or recent mosquito bites. Two dengue RDT kits (NS1 and immunoglobulin G/M) were used, and confirmatory tests-including real-time reverse transcription polymerase chain reaction and enzyme-linked immunosorbent assays-were performed for RDT-positive cases. Time intervals between sample collection and diagnostic confirmation were compared by institution type and day of the week.

Results: Of the 334 cases tested, 12 yielded positive RDT results, and 3 were confirmed as dengue. No confirmed cases were identified among asymptomatic travelers or those with travel durations shorter than 5 days. All 3 confirmed cases showed moderate or higher RDT intensity. The confirmatory results were negative for all 7 marginally positive cases. The average turnaround time for diagnostic confirmation was 4.00 days in hospitals versus 2.71 days in public health centers. Samples collected on weekdays produced faster results (2.33 days) than those collected across weekends (5.00 days). One individual with a strong RDT-positive result declined confirmatory testing.

Conclusion: RDT is a valuable tool for detecting dengue at ports of entry. However, timely confirmatory diagnosis requires improved inter-agency coordination and logistical systems, particularly for weekend operations. These findings offer practical insights for strengthening quarantine-based infectious disease control.

Background: This study aimed to examine the effectiveness of resistance training on hemoglobin A1c (HbA1c) levels and body mass index in patients with diabetes mellitus, categorized by age.

Methods: A comprehensive search of English-language literature published between 1997 and 2025 was performed across 6 databases (Embase, CINAHL, Medline, Cochrane, PubMed, and PEDro). Standardized mean differences and 95% confidence intervals were calculated, and publication bias was assessed using funnel plots and Egger's test. The Joanna Briggs Institute checklist was applied to evaluate study quality.

Results: Thirty randomized controlled trials met the inclusion criteria, comprising 620 participants in the older (<60 years of age) subgroup and 1,389 in the middle-aged (40-59 years of age) subgroup. In both subgroups, resistance training significantly reduced HbA1c levels and body mass index, while increasing muscle strength (primary outcome). It also significantly increased high-density lipoprotein, improved VO₂ peak, and reduced low-density lipoprotein (secondary outcomes). However, the effects of resistance training were significant only in the older-adult subgroup for total cholesterol and only in the middle-aged subgroup for triglycerides.

Conclusion: Resistance training is a recommended rehabilitation exercise for patients with diabetes mellitus. Routine resistance training has been shown to help maintain optimal HbA1c and body mass index levels and improve muscle strength. In addition, it does not pose a risk of adverse events in either middle-aged or older patients. Nonetheless, patients are advised to monitor blood glucose levels and adhere to a proper diet to achieve optimal outcomes.

Background: Although family members of persons with disabilities face elevated suicide risk, predictive models remain underdeveloped in Korean contexts. This study aimed to develop machine learning-based predictive models for suicidal ideation among family members of persons with disabilities and examine differential risk patterns by disability onset type.

Methods: This cross-sectional study analyzed 124,783 adult family members (59.9% spouses, 20.3% parents/ascendants, 14.6% adult children, 5.2% extended family) from the 2018 Korean Disability and Life Dynamics Panel using survey weights. Four predictive models, including machine learning approaches, were compared using 31 variables. The dataset was divided into training (70%) and test (30%) sets, with stratified analyses comparing congenital and acquired disability groups.

Results: Among the 124,783 family members analyzed, least absolute shrinkage and selection operator (LASSO) with cross-validation achieved optimal performance (area under the receiver operating characteristic curve, 0.875 training; 0.853 test). LASSO selected 16 of 31 variables for the total sample, with family members' depression as the strongest predictor (β=0.554), followed by disabled persons' suicidal ideation (β=0.425). Stratified LASSO analyses revealed that national basic livelihood beneficiary status was the strongest predictor for families with congenital disability (β=0.541), while family members' depression was the strongest predictor for families with acquired disability (β=0.562), demonstrating distinct predictive patterns by disability onset.

Conclusion: These findings show that predictive factors differ substantially by disability onset type, indicating the need for tailored intervention approaches and offering an evidence-based foundation for targeted suicide prevention strategies.

Background: This study aimed to analyze the epidemiology and trends of hemorrhagic fever with renal syndrome (HFRS) in Weifang, China (2013-2021) and to guide prevention strategies.

Methods: The study examined the prevalence and incidence trends of HFRS in Weifang (2013-2021). Spearman correlation and wavelet analysis were employed to explore variable relationships and their associations with HFRS incidence. Generalized additive models (GAMs) were used to identify key risk factors, while structural equation modeling (SEM) quantified direct and indirect pathways influencing HFRS transmission. Finally, Bayesian time-series models were applied to predict future HFRS risk.

Results: Weifang reported 2,118 HFRS cases, which displayed distinct seasonality. Spearman correlation linked economic factors (gross domestic product [GDP], crop area, grain output, green space) and meteorological factors (temperature, pressure) to incidence (r>0.8). Wavelet analysis identified Mus musculus (2013-2016) and Rattus norvegicus (2017-2021) as dominant reservoirs, with temperature, precipitation, and humidity correlating with incidence. GAMs revealed a U-shaped relationship between rodent density and HFRS and an inverted U-shaped relationship between temperature (threshold, 11.64 °C) and HFRS. SEM highlighted the direct and indirect effects of climate via rodent density, mirrored by economic factors (e.g., GDP). Bayesian models effectively predicted HFRS (root mean square error, 7.36; mean absolute percentage error, 0.28; R2=0.65).

Conclusion: Climate, economic, and anthropogenic factors drive the spread of HFRS. Prevention strategies should integrate local economic conditions with meteorological and anthropogenic factors. Bayesian time-series modeling effectively predicts HFRS trends, supporting precision prevention strategies.

Background: This study aimed to examine trends and factors associated with severe physical and psychological consequences following induced abortion among women in the Republic of Korea.

Methods: An online survey was conducted of adolescent and adult Korean women aged 13 to 64 years, termed the 2022 Sex and Reproductive Health Survey. Respondents who reported a history of induced abortion were analyzed. Logistic regression models that accounted for individual risk factors were fitted to calculate adjusted odds ratios (aOR).

Results: The prevalence of induced abortion was 20.1% (914 of 4,552 respondents). The most frequent indications for abortion were social reasons, and across all periods, approximately half of the women or more reported non-medical challenges at the time of their most recent abortion. Severe physical and psychological sequelae after abortion increased 5-fold from 1980-1992 to 2013-2022. Among those whose most recent abortion occurred in 2003 or later, the risk of severe psychological sequelae was higher in 2013-2022, after the Korean Constitutional Court upheld the existing criminal codes, than in 2003-2012 (aOR, 2.31; 95% confidence interval, 1.09-4.91).

Conclusion: In the absence of institutionalized safe and respectful abortion services, severe physical and psychological sequelae among women who underwent induced abortion were more likely to occur. These findings highlight the importance of safe, affordable, nondiscriminatory, and respectful abortion care.

Objectives: This study aimed to investigate the association of demographic variables and serum calcium with hypercalciuria among the Meitei adult population of Manipur, Northeast India.

Methods: A cross-sectional study was conducted involving 413 participants (272 females and 141 males) aged 19 to 60 years. Participants were selected through a multistage sampling method from 5 valley districts of Manipur. Demographic and biochemical parameters were collected, including serum calcium, creatinine, and spot urine calcium and creatinine levels. One-way analysis of variance, Tukey's post hoc test, chi-square test, multinomial logistic regression, and receiver operating characteristic (ROC) curve analysis were performed. The area under the ROC curve was calculated to determine the cut-off value of random urine calcium.

Results: The overall prevalence of hypercalciuria was 18.64%. The incidence of hypercalciuria increased with age; 41 to 60 age group were 3 times more likely to develop hypercalciuria than those in the 19 to 40 age group (95% confidence interval [CI], 1.86-5.47; p<0.001). A significant association (p<0.05) was also found between serum calcium and urine calcium levels. Hypocalcemic individuals were 3.5 times more likely to have hypercalciuria than normocalcemic individuals (95% CI, 1.33-9.31; p=0.01). ROC analysis revealed a predictive cut-off value of 23.07 mg/dL for random urine calcium.

Conclusion: This study demonstrates a high prevalence of hypercalciuria exceeding the global average. Given that Manipur has also been reported to have a high prevalence of kidney stones, this finding indicates a considerable health risk. Early intervention could therefore improve public health outcomes related to calcium and mineral metabolism.

Objectives: The aim of this study was to investigate the relationship between diabetes medication self-efficacy and quality of life in older adults with diabetes.

Methods: The study included 192 older adults who attended the diabetes clinic of a public hospital in Istanbul. Data were collected between June and October 2024. Participants were informed about the study and provided both verbal and written consent. Data collection instruments comprised a sociodemographic questionnaire, the diabetes medication self-efficacy scale, and the quality of life scale for older adults.

Results: Of the participants, 98 (51.0%) were women and 105 (54.7%) were aged 65 to 74 years. The mean diabetes medication self-efficacy score was 38.95±10.31, and the mean quality of life score was 18.24±6.37. A weak but statistically significant positive correlation was observed between the autonomy and satisfaction subscale of quality of life and the necessity subscale of self-efficacy (p<0.05).

Conclusion: This study, which examined the relationship between self-efficacy in diabetes management and quality of life in older adults, provides valuable guidance for clinical practice aimed at improving care for this population.