Infrastructure-building for Public Health : The World Health Organization and Tuberculosis Control in South Korea, 1945-1963

This paper examines WHO’s involvement in South Korea within the context of the changing organization of public health infrastructure in Korea during the years spanning from the end of the Japanese occupation, through the periods of American military occupation and the Korean War, and to the early years of the Park Chung Hee regime in the early 1960s, in order to demonstrate how tuberculosis came to be addressed as a public health problem. WHO launched several survey missions and relief efforts before and during the Korean War and subsequently became deeply involved in shaping government policy for public health through a number of technical assistance programs, including a program for tuberculosis control in the early 1960s. This paper argues that the principal concern for WHO was to start rebuilding the public health infrastructure beyond simply abolishing the remnants of colonial practices or showcasing the superiority of American practices vis-à-vis those practiced under a Communist rule. WHO consistently sought to address infrastructural problems by strengthening the government’s role by linking the central and regional health units, and this was especially visible in its tuberculosis program, where it attempted to take back the responsibilities and functions previously assumed by voluntary organizations like the Korea National Tuberculosis Administration (KNTA). This interest in public health infrastructure was fueled by WHO’s discovery of a cost-effective, drug-based, and communityoriented horizontal approach to tuberculosis control, with a hope that these practices would replace the traditional, costly, disease-specific, and seclusion-oriented vertical approach that relied on sanatoria. These policy imperatives were met with the unanticipated regime change from a civilian to a military government in 1961, which created an environment favorable for the expansion of the public health network. Technology and politics were intricately intertwined in the emergence of a new infrastructure for public health in Korea, as this case of tuberculosis control illustrates

Regulation of estrogen receptor-alpha mediated gene expression and endocrine resistance through estrogen receptor-alpha phosphorylation and micro-RNA in breast cancer

Estrogens are associated with the development and progression of breast cancer in addition to their role in normal reproductive physiology, and estrogen receptors (ER) mediate the actions of estrogen in target tissues by regulating the expression of numerous biologically important target genes. The progression of human breast cancer and the development of resistance to endocrine therapies are thought to be associated with ER phosphorylation. We generated multiple combinations of ER phospho-mutants, at residues serine 104, 106, 118, 167, 236, and 305, and examined their impact on receptor half-life, the agonist and antagonist balance of selective estrogen receptor modulators (SERMs) and selective estrogen receptor downregulators (SERDs), the regulation of ER transcriptional activity, and stimulation of cell proliferation in response to estradiol and SERMs/SERD. We showed that changes in ER affecting the phosphorylation status of the receptor greatly impact receptor function and differential SERM and SERD modulated cellular responses that could contribute to resistance to endocrine therapies in breast cancer. We also studied the regulation of microRNAs (miRNAs) by estradiol and growth factors through ER and extracellular signal-regulated kinase 2 (ERK2) in order to understand their physiological impact on breast cancer. We identified nine miRNA- encoding genes harboring overlapping ER and ERK2 binding sites close to their transcription start sites, which require ER and ERK2 for transcriptional induction as well as estradiol- mediated miRNA regulation. We then identified TP63, a target of miR-101, miR-190 and miR- 196a2, and showed that TP63 plays an important role in estradiol- or growth factor-mediated cellular response in breast cancer cells (MCF-7 and MDA-MB-231) by increasing tumor cell growth and in vitro invasion mainly controlled by miR-196a2 action. These results suggest a tumor-suppressive role of miR-196a2 in regulating TP63 expression and the aggressive behavior of breast cancers

Integrating Geospatial Information: How the Republic of Korea Overcame Institutional Obstacles to Improve Data Management, 1998–2016

Following two gas explosions in 1995 that resulted from poor management of information on underground pipes, the Republic of Korea accelerated its efforts to update and integrate spatial data, such as underground maps. The Ministry of Construction and Transportation (which became the Ministry of Land, Infrastructure and Transport in 2013) led the integration initiative, but the ministry faced a lack of cooperation from counterpart ministries and agencies. It was often at a stalemate with its main counterpart, the Ministry of Home Affairs: the two ministries could not reach a consensus over how landrelated information should be collected, managed, and shared. This case study describes how the land ministry overcame these challenges by seeking mediation or windows of opportunity through higher bureaucratic channels, and by leveraging its experience and resources to scale up geospatial data integration. From its start combining just two datasets in 1998, it went on to establish a fully integrated geospatial data system consisting of nearly 80 datasets from different agencies, which it then disseminated across the entire nation. By 2016, the Republic of Korea’s National Spatial Data Infrastructure (NSDI) had not only prevented further disasters, but also dramatically reduced administrative costs and inefficiencies in the public sector. The integrated data system also enabled government officials to make better-informed policy decisions

Effects of Electromagnetic Waves with LTE and 5G Bandwidth on the Skin Pigmentation In Vitro

With the rapid growth of wireless communication devices, the influences of electromagnetic fields (EMF) on human health are gathering increasing attention. Since the skin is the largest organ of the body and is located at the outermost layer, it is considered a major target for the health effects of EMF. Skin pigmentation represents one of the most frequent symptoms caused by various non-ionizing radiations, including ultraviolet radiation, blue light, infrared, and extremely low frequency (ELF). Here, we investigated the effects of EMFs with long-term evolution (LTE, 1.762 GHz) and 5G (28 GHz) bandwidth on skin pigmentation in vitro. Murine and Human melanoma cells (B16F10 and MNT-1) were exposed to either LTE or 5G for 4 h per day, which is considered the upper bound of average smartphone use time. It was shown that neither LTE nor 5G exposure induced significant effects on cell viability or pigmentation. The dendrites of MNT-1 were neither lengthened nor regressed after EMF exposure. Skin pigmentation effects of EMFs were further examined in the human keratinocyte cell line (MNT-1-HaCaT) co-culture system, which confirmed the absence of significant hyper-pigmentation effects of LTE and 5G EMFs. Lastly, MelanoDerm™, a 3D pigmented human epidermis model, was irradiated with LTE (1.762 GHz) or 5G (28 GHz), and image analysis and special staining were performed. No changes in the brightness of MelanoDerm™ tissues were observed in LTE- or 5G-exposed tissues, except for only minimal changes in the size of melanocytes. Collectively, these results imply that exposure to LTE and 5G EMFs may not affect melanin synthesis or skin pigmentation under normal smartphone use condition

Adaptive Scheme of Denoising Autoencoder for Estimating Indoor Localization Based on RSSI Analytics in BLE Environment

In indoor environments, estimating localization using a received signal strength indicator (RSSI) is difficult because of the noise from signals reflected and refracted by walls and obstacles. In this study, we used a denoising autoencoder (DAE) to remove noise in the RSSI of Bluetooth Low Energy (BLE) signals to improve localization performance. In addition, it is known that the signal of an RSSI can be exponentially aggravated when the noise is increased proportionally to the square of the distance increment. Based on the problem, to effectively remove the noise by adapting this characteristic, we proposed adaptive noise generation schemes to train the DAE model to reflect the characteristics in which the signal-to-noise ratio (SNR) considerably increases as the distance between the terminal and beacon increases. We compared the model’s performance with that of Gaussian noise and other localization algorithms. The results showed an accuracy of 72.6%, a 10.2% improvement over the model with Gaussian noise. Furthermore, our model outperformed the Kalman filter in terms of denoising

The Republic of Korea’s first 70 days of responding to the COVID-19 outbreak

The COVID-19 pandemic has become a daunting global crisis with profound health, economic, and social impacts felt across the world. As of April 9, 2020, more than 1.5 million positive cases had been confirmed and nearly 90,000 people had died as a result of the virus. As the disease continues to spread, governments are tackling this crisis in different ways, and their efforts are yielding varying results, with some countries continuing to experience increasing numbers of new cases daily and others starting to see a flattening of the growth curve. The Republic of Korea was one of the first countries to respond to COVID-19. The first positive case was identified on January 20, 2020, and daily confirmed cases peaked at 813 on February 29. Since then, the number of new cases has declined until reaching about 100 per day in mid-March. Although it remains uncertain how the crisis will play out over the longer term, Korea’s approach has been effective in slowing the spread of COVID-19. Policy makers and practitioners are asking how Korea has been able to achieve this encouraging outcome while many other countries continue to experience exponential growth in their number of new cases. This case study provides an overview of how Korea responded to the outbreak and how it achieved positive results in containing the disease. As was the case in many countries, the basic elements of Korea’s response to COVID-19 combined using diagnostic testing, tracing contacts, isolating confirmed and suspected cases, providing treatment, and encouraging social distancing. Korea’s sense of urgency, strong implementation capacity, and effective communication and public outreach strategy have distinguished the country’s approach and contributed to its effectiveness. Although Korea’s approach may hold lessons for other countries, it is important to note that some elements may not be directly transferable due to contextual factors including differences in information technology infrastructure, data privacy standards, and health care systems. This case study describes how Korea has undertaken prevention efforts, developed testing kits, tested thousands of people, implemented epidemiological investigations, treated patients, and built the institutional capacity needed to respond to this crisis