• Health Policy and Management
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• v.28 no.3
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• pp.240-250
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• 2018

By the end of 2017, in a world of 7.6 billion people, there were inequalities in healthcare indices both within and between nations, and this gap continues to increase. Therefore, this study aims to understand the current status of regional inequalities in healthcare indices and to find an action plan to tackle regional health inequality through a geo-economic review in Korea. Since 2008, there was great inequality in life expectancy and healthy life expectancy by region in not only metropolitan cities but also districts in Korea. While the community health statistics from 2008-2017 show a continuous increase of inequality during the last 10 years in most healthcare indices related to noncommunicable diseases (except for some, like smoking), the inequality has doubled in 254 districts. Furthermore, health inequality intensified as the gap between urban (metropolitan cities) and rural regions (counties) for rates of obesity (self-reported), sufficient walking practices, and healthy lifestyle practices increased from twofold to fivefold. However, regionalism and uneven development are natural consequences of the spatial perspective caused by state-lead developmentalism as Korea has fixed the accumulation strategy as its model for growth with the background of export-led industrialization in the 1960s and heavy and chemical industrialization in the 1970s, although the Constitution of the Republic of Korea recognizes the legal value of balanced development within the regions by specifying "the balanced development of the state" or "ensuring the balanced development of all regions." In addition, the danger of a 30% decline or extinction of local government nationwide is expected by 2040 as we face not only a decline in general and ageing populations but also the era of the demographic cliff. Thus, the government should continuously operate the "Special Committee on Regional Balanced Development" with a government-wide effort until 2030 to prevent disparities in the health conditions of local residents, which is the responsibility of the nation in terms of strengthening governance. To address the regional inequalities of rural and urban regions, it is necessary to re-adjust the basic subsidy and cost-sharing rates with local governments of current national subsidies based mainly on population scale, financial independence of local government, or distribution of healthcare resources and healthcare indices (showing high inequalities) overall.

• Journal of the Korean Regional Science Association
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• v.37 no.4
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• pp.33-47
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• 2021

In urban declining areas, the population is decreasing, and drying environments such as buildings and facilities are aging. Therefore, it is vulnerable in the event of disaster, and recovery takes a lot of time and money. The purpose of this study is to develop an evaluation technique for comprehensively diagnosing disasters in declining areas and to present implications through case analysis. Evaluation indicators were selected to calculate the comprehensive diagnosis index of disasters, and weights were calculated for each class, including disaster types, components, and evaluation indicators, through Analytic Hierarchy Process analysis. The comprehensive diagnoses index for each type of disaster was calculated with the calculated weight, and the risk according to the level of urban decline was analyzed. As a result of analyzing Seoul as a case area, it was analyzed that the overall risk of disasters was high in southern regions such as Seocho-gu, Dongjak-gu, Geumcheon-gu, and Gangseo-gu, and relatively low in downtown and northern Seoul, parks and green areas. The results of this study are of academic significance in that they presented a comprehensive diagnostic index evaluation system and technique for each type of disaster, including natural and social disasters.

• Korean Journal of Ichthyology
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• v.33 no.2
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• pp.74-83
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• 2021

Distribution status, habitat characteristics, and extinction threat evaluation of the endangered species, Brachymystax lenok tsinlingensis were investigated in 2015 and 2019. Historical distribution reports of B. l. tsinlingensis were divided into before 1990, 1997~2006, 2000~2011, and 2010~2019. Among the 150 sampling sites investigated during the study period, number of individuals of B. l. tsinlingensis were collected 542 individuals from 67 sites. The streams inhabited of B. l. tsinlingensis were Naerincheon (11 stations), Odaecheon (11 stations), Bukcheon (10 stations), Bangtaecheon (8 stations), Songjeongricheon (4 stations), Suipcheon (3 stations), Inbukcheon (3 stations), Hyeondongcheon (3 stations) etc. The main habitat of B. l. tsinlingensis was upstream of the river with a high altitude of more than 400 m, 4~20 m water flow width, 1~2 m water depth, and high ratio (70~80%) boulder bottoms. The main reasons for the decline in population size were assumed as river works, construction of reservoirs and bridges, discharge of contaminated water into the river, the inflow of summer vacationers, and weir. Compared to our results there exists evidence that states a 20.7% reduction in occupancy within 10 years, in a small appearance range (7,732 km²) and occupancy area (268 km²), number of disconnected locations (15 locations), and a decline in habitat quality. Therefore, B. l. tsinlingensis is now considered as Near Threatened (NT) based on the results (Near meets VU A2acd, B1b(i,ii,iii)+B2b(i,ii,iii)) of IUCN Red List categories and criteria.

• Korean Journal of Ichthyology
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• v.34 no.1
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• pp.34-43
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• 2022

A distribution survey was conducted from March to August 2021 to evaluate the distribution status, habitat characteristics, and threat of extinction of the Korean cold-water fish Ladislabia taczanowskii Dybowski (Cypriniformes, Cyprinidae). Historical distribution reports were divided into 1997~2005, 2006~2012, 2013~2019, and distribution surveyed 169 sampling sites, and 1,040 individuals were collected from 72 sites. Areas where the habitat was confirmed were Namhan River (27 stations), Han River (17 stations), Bukhan River (16 stations), Samcheok Osipcheon (4 stations), Yeongokcheon (3 stations), Gangneung Namdaecheon (2 stations), Jeoncheon (1 station), Chucheon (2 stations). The main habitat of L. taczanowskii was upstream of the river with a high altitude of more than 300 m, 2~30 m water flow width, 0.3~1.5 m water depth, and high ratio (50~90%) boulder bottoms. The main reasons for the decline in population size were assumed as river works, construction of reservoirs and bridges, discharge of contaminated water into the river, the inflow of summer vacationers, and weir. Compared to our results there exists evidence that states a 36.1% reduction in occupancy within 10 years, in a small appearance range (7,820 km²) and occupancy area (288 km²), number of disconnected locations (19 locations), and a decline in habitat quality. Therefore, L. taczanowskii is now considered as Vulnerable (VU) based on the results (VU A2ac, Near meets B1b (i, ii, iii)+B2b (i, ii, iii)) of IUCN Red List categories and criteria. Lastly, the conservation plan of Ladislabia taczanowskii was discussed.

• Journal of Environmental Health Sciences
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• v.48 no.6
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• pp.306-314
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• 2022

Background: Due to the rapid aging of the South Korean population, neurological diseases such as dementia are increasing. Many studies have reported that the incidence of dementia is associated with environmental factors along with age. Objectives: This study analyzed the association between cognitive function and ten heavy metals in the body: arsenic, aluminum, chromium, manganese, cobalt, nickel, iron, copper, zinc, and lead. Methods: From 2018 to 2019, a total of 120 participants who suffered from cognitive impairment were recruited for this study. Blood and urine samples were collected and analyzed for heavy metal concentrations using an inductively coupled plasma mass spectrometer. Demographic information was obtained through face-to-face questionnaires completed by a trained investigator. Cognitive function was evaluated with the Korean version of the Mini-Mental State Examination and the Korean version of the Boston Name Waiting Test. The associations between cognitive function scores and heavy metal concentrations were analyzed using multiple logistic regression analysis. Results: The average age of the 120 participants was 72.7 years, and 69.2% were female. The mean of the MMSE-K and K-BNT scores were 22.9 and 37.9, respectively. The geometric mean of aluminum (Al) was 8.42 ㎍/L. MMSE-K was associated with iron (Fe), but the significance was removed in the logistic regression based on 24 points. K-BNT was significantly associated with aluminum and the odds ratio for K-BNT above 38 decreased by 45% as the aluminum concentration increased. Conclusions: The association between aluminum and the K-BNT score indicated that aluminum is associated with language-related cognitive decline. Based on this result, further study will be conducted by considering co-exposure effects of heavy metals including aluminum.

• Korean Journal of Ichthyology
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• v.34 no.4
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• pp.262-269
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• 2022

A distribution survey was conducted from 2018 to 2020 to evaluate the distribution status, habitat characteristics, and extinction threat of the short ninespine stickleback Pungitius kaibarae (Gasterosteidae). Literature reports of P. kaibarae distribution have been sorted by each period, 1980~1996, 1997~2005, and 2007~2017, and the samples were collected in 32, 43, and 64 stations for each period. Among the 75 streams and 193 sampling sites investigated during the study period, 1,400 P. kaibarae individuals were collected from 26 streams at 39 sites. The main habitat of P. kaibarae was downstream or brackish water zones with a low altitude, slow water velocity, and many aquatic plants. The main reasons for the decline in population size were assumed to be drought and flood, river work for flood restoration and river maintenance, bridges construction, and predation by the exotic fish species Micropterus salmoides. Previous evidence reported a 42.6% reduction in occupancy within 10 years, a decline in habitat quality, and the spread and impact of the exotic fish species Micropterus salmoides. Therefore, P. kaibarae is now considered a Vulnerable (VU A2ace) species based on the IUCN Red List categories and criteria. Therefore, P. kaibarae should be redesignated as an endangered species by the Ministry of Environment and systematically managed.

• IMMUNE NETWORK
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• v.23 no.5
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• pp.39.1-39.15
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• 2023

Coronavirus disease 2019 (COVID-19) vaccination may non-specifically alter the host immune system. This study aimed to evaluate the effect of COVID-19 vaccination on hepatitis B surface Ag (HBsAg) titer and host immunity in chronic hepatitis B (CHB) patients. Consecutive 2,797 CHB patients who had serial HBsAg measurements during antiviral treatment were included in this study. Changes in the HBsAg levels after COVID-19 vaccination were analyzed. The dynamics of NK cells following COVID-19 vaccination were also examined using serial blood samples collected prospectively from 25 healthy volunteers. Vaccinated CHB patients (n=2,329) had significantly lower HBsAg levels 1-30 days post-vaccination compared to baseline (median, -21.4 IU/ml from baseline), but the levels reverted to baseline by 91-180 days (median, -3.8 IU/ml). The velocity of the HBsAg decline was transiently accelerated within 30 days after vaccination (median velocity: -0.06, -0.39, and -0.04 log₁₀ IU/ml/year in pre-vaccination period, days 1-30, and days 31-90, respectively). In contrast, unvaccinated patients (n=468) had no change in HBsAg levels. Flow cytometric analysis showed that the frequency of NK cells expressing NKG2A, an NK inhibitory receptor, significantly decreased within 7 days after the first dose of COVID-19 vaccine (median, -13.1% from baseline; p<0.001). The decrease in the frequency of NKG2A⁺ NK cells was observed in the CD56^dimCD16⁺ NK cell population regardless of type of COVID-19 vaccine. COVID-19 vaccination leads to a rapid, transient decline in HBsAg titer and a decrease in the frequency of NKG2A⁺ NK cells.

• Journal of Preventive Medicine and Public Health
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• v.45 no.5
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• pp.323-328
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• 2012

Objectives: Economic growth and development of medical technology help to improve the average life expectancy, but the western diet and rapid conversions to poor lifestyles lead an increasing risk of major chronic diseases. Coronary heart disease mortality in Korea has been on the increase, while showing a steady decline in the other industrialized countries. An age-period-cohort analysis can help understand the trends in mortality and predict the near future. Methods: We analyzed the time trends of ischemic heart disease mortality, which is on the increase, from 1985 to 2009 using an age-period-cohort model to characterize the effects of ischemic heart disease on changes in the mortality rate over time. Results: All three effects on total ischemic heart disease mortality were statistically significant. Regarding the period effect, the mortality rate was decreased slightly in 2000 to 2004, after it had continuously increased since the late 1980s that trend was similar in both sexes. The expected age effect was noticeable, starting from the mid-60's. In addition, the age effect in women was more remarkable than that in men. Women born from the early 1900s to 1925 observed an increase in ischemic heart mortality. That cohort effect showed significance only in women. Conclusions: The future cohort effect might have a lasting impact on the risk of ischemic heart disease in women with the increasing elderly population, and a national prevention policy is need to establish management of high risk by considering the age-period-cohort effect.

• The Korean Journal of Pain
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• v.33 no.4
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• pp.352-358
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• 2020

Background: Korean society is afflicted with rapid aging. Aging is a risk factor for pain, and pain can reduce patients' quality of life. Thus, adequate management and monitoring of changing trends accompanying the demographic shift are highly valuable. However, this study was conducted because no studies have investigated the recent changes in the prevalence of pain. Methods: The extent of the prevalence of pain was determined by questions related to quality of life based on the data derived from the Korea National Health and Nutrition Survey (KNHNS) from 2005 to 2016. The annual frequencies of the pain group and severe pain group were calculated using the survey questionnaire. Multiple logistic regression analysis was performed to determine possible differences in prevalence by year. Results: The prevalence of pain in all populations was 30.6% in 2005 and 18.9% in 2016. The average prevalence from 2005 to 2016 was 21.9%. A declining trend occurred over time with an odds ratio of 0.929 per year (95% CI: 0.921-0.938). The prevalence of severe pain was 2.35% in 2005 and 1.88% in 2016. Likewise, a decrease was observed over time, with an odds ratio of 0.920 per year at 95% CI 0.901-0.939. The decline in age-/sex-stratified analysis also showed a statistically significant trend in all groups. Conclusions: The prevalence of pain in Korean society, based on the KNHNS, has declined since 2005. Such a trend was observed in all ages and sexs, and was most significant in the elderly.

• Journal of Forest and Environmental Science
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• v.28 no.3
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• pp.158-169
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• 2012

Sabah has experienced a rapid decline in the extent of forest cover. The precise impact of habitat loss on the conservation status of the plants of Sabah is uncertain. In this study we use the niche modelling algorithm MAXENT to construct preliminary, revised and final ecological niche models for Dipterocarpus lamellatus and Dipterocarpus ochraceus and combined these models with data on current land-use to derive conservation assessments for each species. Preliminary models were based on herbarium data alone. Ground surveys were conducted to evaluate the performance of these preliminary models, and a revised niche model was generated from the combined herbarium and ground survey data. The final model was obtained by constraining the predictions of the revised models by filters. The range overlap between the preliminary and revised models was 0.47 for D. lamellatus and 0.39 for D. ochraceus, suggesting poor agreement between them. There was substantial variation in estimates of habitat loss for D. ochraceus, among the preliminary, revised and constrained models, and this has the potential to lead to incorrect threat assessments. From these estimates of habitat loss, the historic distribution and estimates of population size we determine that both species should be classified as Critically Endangered under IUCN Red List guidelines. Our results suggest that ground-truthing of ecological niche models is essential, especially if the models are being used for conservation decision making.