Osong Public Health and Research Perspectives最新文献

Background: The coronavirus disease 2019 (COVID-19) pandemic continues to pose significant challenges to the public health sector, including that of the United Arab Emirates (UAE). The objective of this study was to assess the efficiency and accuracy of various deep-learning models in forecasting COVID-19 cases within the UAE, thereby aiding the nation's public health authorities in informed decision-making.

Methods: This study utilized a comprehensive dataset encompassing confirmed COVID-19 cases, demographic statistics, and socioeconomic indicators. Several advanced deep learning models, including long short-term memory (LSTM), bidirectional LSTM, convolutional neural network (CNN), CNN-LSTM, multilayer perceptron, and recurrent neural network (RNN) models, were trained and evaluated. Bayesian optimization was also implemented to fine-tune these models.

Results: The evaluation framework revealed that each model exhibited different levels of predictive accuracy and precision. Specifically, the RNN model outperformed the other architectures even without optimization. Comprehensive predictive and perspective analytics were conducted to scrutinize the COVID-19 dataset.

Conclusion: This study transcends academic boundaries by offering critical insights that enable public health authorities in the UAE to deploy targeted data-driven interventions. The RNN model, which was identified as the most reliable and accurate for this specific context, can significantly influence public health decisions. Moreover, the broader implications of this research validate the capability of deep learning techniques in handling complex datasets, thus offering the transformative potential for predictive accuracy in the public health and healthcare sectors.

Background: This study investigated the characteristics of coronavirus disease 2019 (COVID-19) among individuals with disabilities on a nationwide scale in the Republic of Korea, as limited research has examined this population.

Methods: Between January 1 and November 30, 2021, a total of 5,687 confirmed COVID-19 cases among individuals with disabilities were reported through the Korea Disease Control and Prevention Agency's COVID-19 web reporting system. Follow-up continued until December 24, and demographic, epidemiological, and clinical characteristics were analyzed.

Results: Individuals with disabilities represented approximately 1.5% of confirmed cases, with a mean age of 58.1 years. Most resided in or near metropolitan areas (86.6%) and were male (60.6%). Frequent sources of infection included home (33.4%) and contact with confirmed cases (40.7%). Many individuals (75.9%) had underlying conditions, and 7.7% of cases were severe. People with disabilities showed significantly elevated risk of severe infection (adjusted odds ratio [aOR], 1.63; 95% confidence interval [CI], 1.47-1.81) and mortality (aOR, 1.65; 95% CI, 1.43-1.91). Vaccination against COVID-19 was associated with significantly lower risk of severe infection (aORs for the first, second, and third doses: 0.60 [95% CI, 0.42-0.85], 0.28 [95% CI, 0.22-0.35], and 0.16 [95% CI, 0.05-0.51], respectively) and death (adjusted hazard ratios for the first and second doses: 0.57 [95% CI, 0.35-0.93] and 0.30 [95% CI, 0.23-0.40], respectively).

Conclusion: Individuals with disabilities showed higher risk of severe infection and mortality from COVID-19. Consequently, it is critical to strengthen COVID-19 vaccination initiatives and provide socioeconomic assistance for this vulnerable population.

Background: This study was conducted to assess the efficacy of nirmatrelvir/ritonavir treatment in patients with coronavirus disease 2019 (COVID-19), particularly those aged 60 years and older. Using real-world data, the period during which the BN.1 Omicron variant was dominant was compared to the period dominated by the BA.5 variant.

Methods: In this retrospective cohort study, data were collected regarding 2,665,281 patients infected with severe acute respiratory syndrome coronavirus 2 between July 24, 2022, and March 31, 2023. Propensity score matching was utilized to match patients who received nirmatrelvir/ ritonavir in a 1:4 ratio between BN.1 and BA.5 variant groups. Multivariable logistic regression analysis was employed to assess the effects of nirmatrelvir/ritonavir within these groups.

Results: Compared to the prior period, the efficacy of nirmatrelvir/ritonavir did not significantly differ during the interval of Omicron BN.1 variant dominance in the Republic of Korea. Among patients treated with nirmatrelvir/ritonavir, a significantly lower risk of mortality was observed in the BN.1 group (odds ratio [OR], 0.698; 95% confidence interval [CI], 0.557-0.875) compared to the BA.5 group. However, this treatment did not significantly reduce the risk of severe or critical illness, including death, for those in the BN.1 group (OR, 0.856; 95% CI, 0.728-1.007).

Conclusion: Nirmatrelvir/ritonavir has maintained its effectiveness against COVID-19, even with the emergence of the BN.1 Omicron subvariant. Consequently, we strongly recommend the administration of nirmatrelvir/ritonavir to patients exhibiting COVID-19-related symptoms, irrespective of the dominant Omicron variant or their vaccination status, to mitigate disease severity and decrease the risk of mortality.

Background: This study analyzed a large outbreak of coronavirus disease 2019 (COVID-19) that occurred during a high school field trip in the Jeonbuk region and aimed to identify risk factors for COVID-19 infection, with the goal of preventing such outbreaks in the future.

Methods: A retrospective cohort study of 737 participants, including 668 students and 69 staff at High School A, was designed to describe the epidemiological characteristics of this large COVID-19 outbreak. Logistic regression analysis was performed to calculate relative risks (odds ratios [ORs]) and 95% confidence intervals (CIs).

Results: There were 190 confirmed cases (174 students, 16 staff), with an attack rate of 25.8%. Small outbreaks were decreasing before the field trip, but this trend reversed after the trip, leading to larger outbreaks. Logistic regression showed an OR of 2.39 (95% CI, 1.66-3.43; p<0.05) for COVID-19 infection among field trip participants. Among them, 11th graders had an OR of 2.32 (95% CI, 1.53-3.52; p<0.05) compared to 10th graders, while no significant risk difference was found within same-grade teams.

Conclusion: There was a high risk for COVID-19 transmission during extracurricular activities with a large number of participants, such as field trips, even after the nationwide Omicron variant epidemic subsided. Even when students are separated into teams and follow different routes, it is challenging to design routes that entirely prevent contact between teams. Thus, programs should be designed carefully, and students with symptoms should be identified before and during the program to isolate them promptly.

Background: This study investigated the relationship between living arrangements and metabolic syndrome (MetS) risk in the adult population in the Republic of Korea.

Methods: The samples were derived from the data collected during the second year of the seventh Korea National Health and Nutrition Examination Survey. The study targeted a total of 6,265 adults who were aged 20 years and above, and multiple logistic regression analysis was conducted. Living arrangements were classified into 4 categories: single-person households, 1-generation households, 2-generation households, and other family types. MetS was identified by the presence of at least 3 out of the 5 National Cholesterol Education Program Adult Treatment Panel III criteria.

Results: For men, the odds ratio (ORs) for MetS in 1- and 2-generation households, compared to single-person households, were 0.92 (95% confidence interval [CI], 0.55-1.54) and 0.97 (95% CI, 0.58-1.62), respectively. The OR for other types of households was 0.96 (95% CI, 0.79-1.17). For women, the OR for MetS in 1- and 2-generation households, compared to single-person households, were 1.52 (95% CI, 1.15-2.01) and 1.29 (95% CI, 1.01-1.67), respectively.

Conclusion: Our study suggests that a national strategy involving tailored interventions for women living in high-risk conditions is necessary to reduce the risk of MetS in Korean women.

Background: Limited information is available concerning the epidemiology of stroke and acute myocardial infarction (AMI) in the Republic of Korea. This study aimed to develop a national surveillance system to monitor the incidence of stroke and AMI using national claims data.

Methods: We developed and validated identification algorithms for stroke and AMI using claims data. This validation involved a 2-stage stratified sampling method with a review of medical records for sampled cases. The weighted positive predictive value (PPV) and negative predictive value (NPV) were calculated based on the sampling structure and the corresponding sampling rates. Incident cases and the incidence rates of stroke and AMI in the Republic of Korea were estimated by applying the algorithms and weighted PPV and NPV to the 2018 National Health Insurance Service claims data.

Results: In total, 2,200 cases (1,086 stroke cases and 1,114 AMI cases) were sampled from the 2018 claims database. The sensitivity and specificity of the algorithms were 94.3% and 88.6% for stroke and 97.9% and 90.1% for AMI, respectively. The estimated number of cases, including recurrent events, was 150,837 for stroke and 40,529 for AMI in 2018. The age- and sex-standardized incidence rate for stroke and AMI was 180.2 and 46.1 cases per 100,000 person-years, respectively, in 2018.

Conclusion: This study demonstrates the feasibility of developing a national surveillance system based on claims data and identification algorithms for stroke and AMI to monitor their incidence rates.

The exact factors predicting outcomes following traumatic brain injury (TBI) remain elusive. In this systematic review and meta-analysis, we examined factors influencing outcomes in adult patients with TBI, from 3 months to 1 year after injury. A search of four electronic databases-PubMed, Scopus, Web of Science, and ScienceDirect-yielded 29 studies for review and 16 for meta-analysis, in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analysis guidelines. In patients with TBI of any severity, mean differences were observed in age (8.72 years; 95% confidence interval [CI], 4.77-12.66 years), lymphocyte count (-0.15 109/L; 95% CI, -0.18 to -0.11), glucose levels (1.20 mmol/L; 95% CI, 0.73-1.68), and haemoglobin levels (-0.91 g/dL; 95% CI, -1.49 to -0.33) between those with favourable and unfavourable outcomes. The prevalence rates of unfavourable outcomes were as follows: abnormal cisterns, 65.7%; intracranial pressure above 20 mmHg, 52.9%; midline shift of 5 mm or more, 63%; hypotension, 71%; hypoxia, 86.8%; blood transfusion, 70.3%; and mechanical ventilation, 90%. Several predictors were strongly associated with outcome. Specifically, age, lymphocyte count, glucose level, haemoglobin level, severity of TBI, pupillary reaction, and type of injury were identified as potential predictors of long-term outcomes.