Socioeconomic disparities in behavioral risk factors and health outcomes by gender in the Republic of Korea

<p>Abstract</p> <p>Background</p> <p>Few studies have examined socioeconomic disparities in health and behavioral risk factors by gender in Asian countries and in South Korea, specifically. We investigated the relationship between socioeconomic position (education, income, and occupation) and subjective and acute and chronic health outcomes and behavioral risk factors by gender, and compared results from 1998 and 2005, in the Republic of Korea.</p> <p>Methods</p> <p>We examined data from a nationally representative stratified random sample of 4213 men and 4618 women from the 1998 Korea National Health and Nutrition Examination Survey, and 8289 men and 8827 women from the 2005 Korea National Health and Nutrition Examination Survey using General Linear Modeling and multiple logistic regression methods.</p> <p>Results</p> <p>Controlling for behavioral risk factors (smoking, drinking, obesity, exercise, and sleep), those in lower socioeconomic positions had poorer health outcomes in both self-reported acute and chronic disease and subjective measures; differences were especially pronounced among women. A socioeconomic gradient for education and income was found for both men and women for morbidity and self-reported health status, but the gradient was more pronounced in women. In 1998, the odds ratios (ORs) of higher morbidity for illiterate vs. college educated females was 5.4:1 and 1.9:1 for females in the lowest income quintile vs. the highest. The OR for education decreased in 2005 to 2.9:1 and that for income quintiles remained the same at 1.9:1. The OR of lower self-reported health status for illiterate vs. college educated females was 2.9:1 and 1.6:1 for females in the lowest income quintile vs. the highest in 1998, and 3.3:1 and 2.3:1 in 2005.</p> <p>Conclusions</p> <p>Among Korean adults, men and women in lower socioeconomic position, as denoted by education, income, and somewhat less by occupation, experience significantly higher levels of morbidity and lower self-reported health status, even after controlling for standard behavioral risk factors. Disparities were more pronounced for women than for men. Efforts to reduce health disparities in South Korea require attention to the root causes of socioeconomic inequality and gender differences in the impact of socioeconomic position on health.</p

Solving Weighted Least Squares (WLS) problems on ARM-based architectures

TheWeighted Least Squares algorithm (WLS) is applied to numerous optimization problems, but requires the use of high computational resources, especially when complex arithmetic is involved. This work aims to accelerate the resolution of a WLS problem by reducing the computational cost (relaying on BLAS/LAPACK routines) and the computational precision from double to single. As a test case, we design an IIR filter for a Graphic Equalizer, where the numerical errors due to single precision are easily visualized. In addition, given the importance of low power architectures for this kind of implementations, we evaluate the performance, scalability, and energy efficiency of each method on two different processors implementing the ARMv7 architecture, widely used in current mobile devices with power constraints. Results show that the method that exhibits a high theoretical computational cost overcomes in efficiency other methods with lower theoretical cost in architectures of this type.This work started in spring 2016 when Jose A. Belloch was a visiting postdoctoral researcher at Budapest University of Technology and Economics thanks to the European Network COST Action IC1305 inside the program Short Term Scientific Mission with the following reference: COST-SPASM-ECOST-STSM-IC1305-020416-072431. Dr. Jose A. Belloch is supported by GVA contract APOSTD/2016/069. The researchers from Universitat Jaume I are supported by the CICYT projects TIN2014-53495-R of MINECO and FEDER. The authors from the Universitat Politecnica de Valencia are supported by MINECO Projects TEC2015-67387-C4-1-R, PROMETEOII/2014/003 and CAPAP-H5 network TIN2014-53522-REDT. The researcher from UCM is supported by the EU (FEDER) and the Spanish MINECO, under Grants TIN 2015-65277-R and TIN2012-32180. The work of Balazs Bank was supported by the UNKP-16-4-III New National Excellence Program of the Ministry of Human Capacities, Hungary.Belloch Rodríguez, JA.; Bank, B.; Igual Peña, FD.; Quintana Ortí, ES.; Vidal Maciá, AM. (2017). Solving Weighted Least Squares (WLS) problems on ARM-based architectures. Journal of Supercomputing. 73(1):530-542. https://doi.org/10.1007/s11227-016-1910-9S530542731Smith TM, van de Geijn RA, Smelyanskiy M, Hammond JR, Van Zee FG (2014) Anatomy of high-performance many-threaded matrix multiplication. In: 28th IEEE International Parallel and Distributed Processing Symposium (IPDPS 2014)Burrus CS (2012) Iterative reweighted least squares. OpenStax-CNC document, May 2012, module m45285. http://cnx.org/content/m45285/1.12 . Accessed 2 Nov 2016Khang SW (1972) Best $$L_p$$ L p approximation. Math Comput 26(118):505–508Jackson LB (2008) Frequency-domain Steiglitz-McBride method for least-squares filter design, ARMA modeling, and periodogram smoothing. IEEE Signal Process Lett 15:49–52Bank B (2012) Magnitude-priority filter design for audio applications. In: Proceedings of $$132^{{\rm nd}}$$ 132 nd AES Convention, Preprint No. 8591, Budapest, Hungary, May 2012Daubechies I, Devire R, Fornasier M, Gntrk CS (2010) Iteratively reweighted least squares minimization for sparse recovery. Comput Music J 23(2):52–69Rämö J, Välimäki V, Bank B (2014) High-precision parallel graphic equalizer. IEEE/ACM Trans Audio Speech Lange Proc 22(12):1894–1904Perez Gonzales E, Reiss J (2009) Automatic equalization of multi-channel audio using cross-adaptive methods. In: Proceedings of AES 127th Convention, New York, Oct. 2009Rämö J, Välimäki V (2013) Live sound equalization and attenuation with a headset. In: Proceedings of AES 51st International Conference, Helsinki, Finland, Aug. 2013Mäkivirta A, Antsalo P, Karjalainen M, Välimäki V (2003) Modal equalization of loudspeaker-room responses at low frequencies. J Audio Eng Soc 51(5):324–343Holters M, Zölzer U (2006) Graphic equalizer design using higher-order recursive filters. In: Proceedings of International Conference Digital Audio Effects, Montreal, QC, pp 37–40Tassart S (2013) Graphical equalization using interpolated filter banks. J Audio Eng Soc 61(5):263–279Chen Z, Geng GS, Yin FL, Hao J (2014) A pre-distortion based design method for digital audio graphic equalizer. Digital Signal Process 25:296–302Välimäki V, Reiss J (2016) All about audio equalization: solutions and frontiers. Appl Sci 6(5):129–145Belloch JA, Välimäki V (2016) Efficient target-response interpolation for a graphic equalizer. In: 2016 IEEE International Conference on Acoustics, Speech and Signal Processing (ICASSP), March 2016, pp 564–568Belloch JA, Alventosa FJ, Alonso P, Quintana-Ortí ES, Vidal AM (2016) Accelerating multi-channel filtering of audio signal on arm processors. J Supercomput, pp 1–12. doi: 10.1007/s11227-016-1689-8Belloch JA, Gonzalez A, Igual FD, Mayo R, Quintana-Ortí ES (2015)Vectorization of binaural sound virtualization on the ARM cortex-A15 architecture. In: Proceedings of 23rd European Signal Processing Conference, (EUSIPCO), Nize, France, September 2015Mitra G, Johnston B, Rendell A, McCreath E, Zhou J (2013) Use of simd vector operations to accelerate application code performance on low-powered arm and intel platforms. In: IEEE 27th International Parallel and Distributed Processing Symposium Workshops PhD Forum (IPDPSW), May 2013, pp 1107–1116Tomov S, Dongarra J, Baboulin M (2008) Towards dense linear algebra for hybrid gpu accelerated manycore systems. LAPACK Working Note, Tech. Rep. 210, Oct. 2008. http://www.netlib.org/lapack/lawnspdf/lawn210.pdf . Accessed 2 Nov 2016Dongarra JJ, DuCroz J, Hammarling S, Hanson RJ (1985) A proposal for an extended set of fortran basic linear algebra subprograms. ACM Signum Newsletter, New York, pp 2–18Golub GH, Loan CFV (2013) Matrix Comput, 4th edn. The John Hopkins University Press, BaltimoreAlonso P, Badia RM, Labarta J, Barreda M, Dolz MF, Mayo R, Quintana-Ortí ES, Reyes R (2012) Tools for power-energy modelling and analysis of parallel scientific applications. In: 41st International Conference on Parallel Processing—ICPP, 2012, pp 420–42

The Cysteine Rich Necrotrophic Effector SnTox1 Produced by Stagonospora nodorum Triggers Susceptibility of Wheat Lines Harboring Snn1

The wheat pathogen Stagonospora nodorum produces multiple necrotrophic effectors (also called host-selective toxins) that promote disease by interacting with corresponding host sensitivity gene products. SnTox1 was the first necrotrophic effector identified in S. nodorum, and was shown to induce necrosis on wheat lines carrying Snn1. Here, we report the molecular cloning and validation of SnTox1 as well as the preliminary characterization of the mechanism underlying the SnTox1-Snn1 interaction which leads to susceptibility. SnTox1 was identified using bioinformatics tools and verified by heterologous expression in Pichia pastoris. SnTox1 encodes a 117 amino acid protein with the first 17 amino acids predicted as a signal peptide, and strikingly, the mature protein contains 16 cysteine residues, a common feature for some avirulence effectors. The transformation of SnTox1 into an avirulent S. nodorum isolate was sufficient to make the strain pathogenic. Additionally, the deletion of SnTox1 in virulent isolates rendered the SnTox1 mutated strains avirulent on the Snn1 differential wheat line. SnTox1 was present in 85% of a global collection of S. nodorum isolates. We identified a total of 11 protein isoforms and found evidence for strong diversifying selection operating on SnTox1. The SnTox1-Snn1 interaction results in an oxidative burst, DNA laddering, and pathogenesis related (PR) gene expression, all hallmarks of a defense response. In the absence of light, the development of SnTox1-induced necrosis and disease symptoms were completely blocked. By comparing the infection processes of a GFP-tagged avirulent isolate and the same isolate transformed with SnTox1, we conclude that SnTox1 may play a critical role during fungal penetration. This research further demonstrates that necrotrophic fungal pathogens utilize small effector proteins to exploit plant resistance pathways for their colonization, which provides important insights into the molecular basis of the wheat-S. nodorum interaction, an emerging model for necrotrophic pathosystems

The potential interaction between time perception and gaming: a narrative review

Compromised time control is a variable of interest among disordered gamers because time spent on videogames can directly affect individuals’ lives. Although time perception appears to be closely associated with this phenomenon, previous studies have not systematically found a relationship between time perception and gaming. Therefore, the purpose of this narrative review is to explore how gaming disorder may be associated with time perception. It has been found that gamers exhibit a stronger attentional focus as well as an improved working memory compared with non-gamers. However, gamers (and especially disordered gamers) exhibit a stronger reaction to gaming cues which—coupled with an altered emotion regulation observed among disordered gamers—could directly affect their time perception. Finally, “'flow states”' direct most of the attentional resources to the ongoing activity, leading to a lack of resources allocated to the time perception. Therefore, entering a flow state will result in an altered time perception, most likely an underestimation of duration. The paper concludes that the time loss effect observed among disordered gamers can be explained via enhanced emotional reactivity (facilitated by impaired emotion regulation)

Diseases, Injuries, and Risk Factors in Child and Adolescent Health, 1990 to 2017: Findings From the Global Burden of Diseases, Injuries, and Risk Factors 2017 Study.

Importance:Understanding causes and correlates of health loss among children and adolescents can identify areas of success, stagnation, and emerging threats and thereby facilitate effective improvement strategies. Objective:To estimate mortality and morbidity in children and adolescents from 1990 to 2017 by age and sex in 195 countries and territories. Design, Setting, and Participants:This study examined levels, trends, and spatiotemporal patterns of cause-specific mortality and nonfatal health outcomes using standardized approaches to data processing and statistical analysis. It also describes epidemiologic transitions by evaluating historical associations between disease indicators and the Socio-Demographic Index (SDI), a composite indicator of income, educational attainment, and fertility. Data collected from 1990 to 2017 on children and adolescents from birth through 19 years of age in 195 countries and territories were assessed. Data analysis occurred from January 2018 to August 2018. Exposures:Being under the age of 20 years between 1990 and 2017. Main Outcomes and Measures:Death and disability. All-cause and cause-specific deaths, disability-adjusted life years, years of life lost, and years of life lived with disability. Results:Child and adolescent deaths decreased 51.7% from 13.77 million (95% uncertainty interval [UI], 13.60-13.93 million) in 1990 to 6.64 million (95% UI, 6.44-6.87 million) in 2017, but in 2017, aggregate disability increased 4.7% to a total of 145 million (95% UI, 107-190 million) years lived with disability globally. Progress was uneven, and inequity increased, with low-SDI and low-middle-SDI locations experiencing 82.2% (95% UI, 81.6%-82.9%) of deaths, up from 70.9% (95% UI, 70.4%-71.4%) in 1990. The leading disaggregated causes of disability-adjusted life years in 2017 in the low-SDI quintile were neonatal disorders, lower respiratory infections, diarrhea, malaria, and congenital birth defects, whereas neonatal disorders, congenital birth defects, headache, dermatitis, and anxiety were highest-ranked in the high-SDI quintile. Conclusions and Relevance:Mortality reductions over this 27-year period mean that children are more likely than ever to reach their 20th birthdays. The concomitant expansion of nonfatal health loss and epidemiological transition in children and adolescents, especially in low-SDI and middle-SDI countries, has the potential to increase already overburdened health systems, will affect the human capital potential of societies, and may influence the trajectory of socioeconomic development. Continued monitoring of child and adolescent health loss is crucial to sustain the progress of the past 27 years

Global, regional, and national burden of neurological disorders during 1990-2015: a systematic analysis for the Global Burden of Disease Study 2015

Background Comparable data on the global and country-specific burden of neurological disorders and their trends are crucial for health-care planning and resource allocation. The Global Burden of Diseases, Injuries, and Risk Factors (GBD) Study provides such information but does not routinely aggregate results that are of interest to clinicians specialising in neurological conditions. In this systematic analysis, we quantified the global disease burden due to neurological disorders in 2015 and its relationship with country development level. Methods We estimated global and country-specific prevalence, mortality, disability-adjusted life-years (DALYs), years of life lost (YLLs), and years lived with disability (YLDs) for various neurological disorders that in the GBD classification have been previously spread across multiple disease groupings. The more inclusive grouping of neurological disorders included stroke, meningitis, encephalitis, tetanus, Alzheimer's disease and other dementias, Parkinson's disease, epilepsy, multiple sclerosis, motor neuron disease, migraine, tension-type headache, medication overuse headache, brain and nervous system cancers, and a residual category of other neurological disorders. We also analysed results based on the Socio-demographic Index (SDI), a compound measure of income per capita, education, and fertility, to identify patterns associated with development and how countries fare against expected outcomes relative to their level of development. Findings Neurological disorders ranked as the leading cause group of DALYs in 2015 (250·7 [95% uncertainty interval (UI) 229·1 to 274·7] million, comprising 10·2% of global DALYs) and the second-leading cause group of deaths (9·4 [9·1 to 9·7] million], comprising 16·8% of global deaths). The most prevalent neurological disorders were tension-type headache (1505·9 [UI 1337·3 to 1681·6 million cases]), migraine (958·8 [872·1 to 1055·6] million), medication overuse headache (58·5 [50·8 to 67·4 million]), and Alzheimer's disease and other dementias (46·0 [40·2 to 52·7 million]). Between 1990 and 2015, the number of deaths from neurological disorders increased by 36·7%, and the number of DALYs by 7·4%. These increases occurred despite decreases in age-standardised rates of death and DALYs of 26·1% and 29·7%, respectively; stroke and communicable neurological disorders were responsible for most of these decreases. Communicable neurological disorders were the largest cause of DALYs in countries with low SDI. Stroke rates were highest at middle levels of SDI and lowest at the highest SDI. Most of the changes in DALY rates of neurological disorders with development were driven by changes in YLLs. Interpretation Neurological disorders are an important cause of disability and death worldwide. Globally, the burden of neurological disorders has increased substantially over the past 25 years because of expanding population numbers and ageing, despite substantial decreases in mortality rates from stroke and communicable neurological disorders. The number of patients who will need care by clinicians with expertise in neurological conditions will continue to grow in coming decades. Policy makers and health-care providers should be aware of these trends to provide adequate services

Global, regional, and national burden of neurological disorders during 1990-2015 : a systematic analysis for the Global Burden of Disease Study 2015

Background Comparable data on the global and country-specific burden of neurological disorders and their trends are crucial for health-care planning and resource allocation. The Global Burden of Diseases, Injuries, and Risk Factors (GBD) Study provides such information but does not routinely aggregate results that are of interest to clinicians specialising in neurological conditions. In this systematic analysis, we quantified the global disease burden due to neurological disorders in 2015 and its relationship with country development level. Methods We estimated global and country-specific prevalence, mortality, disability-adjusted life-years (DALYs), years of life lost (YLLs), and years lived with disability (YLDs) for various neurological disorders that in the GBD classification have been previously spread across multiple disease groupings. The more inclusive grouping of neurological disorders included stroke, meningitis, encephalitis, tetanus, Alzheimer's disease and other dementias, Parkinson's disease, epilepsy, multiple sclerosis, motor neuron disease, migraine, tension-type headache, medication overuse headache, brain and nervous system cancers, and a residual category of other neurological disorders. We also analysed results based on the Socio-demographic Index (SDI), a compound measure of income per capita, education, and fertility, to identify patterns associated with development and how countries fare against expected outcomes relative to their level of development. Findings Neurological disorders ranked as the leading cause group of DALYs in 2015 (250.7 [95% uncertainty interval (UI) 229.1 to 274.7] million, comprising 10.2% of global DALYs) and the second-leading cause group of deaths (9.4 [9.1 to 9.7] million], comprising 16.8% of global deaths). The most prevalent neurological disorders were tensiontype headache (1505 9 [UI 1337.3 to 1681.6 million cases]), migraine (958.8 [872.1 to 1055.6] million), medication overuse headache (58.5 [50.8 to 67.4 million]), and Alzheimer's disease and other dementias (46.0 [40.2 to 52.7 million]). Between 1990 and 2015, the number of deaths from neurological disorders increased by 36.7%, and the number of DALYs by 7.4%. These increases occurred despite decreases in age-standardised rates of death and DALYs of 26.1% and 29.7%, respectively; stroke and communicable neurological disorders were responsible for most of these decreases. Communicable neurological disorders were the largest cause of DALYs in countries with low SDI. Stroke rates were highest at middle levels of SDI and lowest at the highest SDI. Most of the changes in DALY rates of neurological disorders with development were driven by changes in YLLs. Interpretation Neurological disorders are an important cause of disability and death worldwide. Globally, the burden of neurological disorders has increased substantially over the past 25 years because of expanding population numbers and ageing, despite substantial decreases in mortality rates from stroke and communicable neurological disorders. The number of patients who will need care by clinicians with expertise in neurological conditions will continue to grow in coming decades. Policy makers and health-care providers should be aware of these trends to provide adequate services.Peer reviewe

Global, regional, and national incidence, prevalence, and mortality of HIV, 1980–2017, and forecasts to 2030, for 195 countries and territories: a systematic analysis for the Global Burden of Diseases, Injuries, and Risk Factors Study 2017

Background Understanding the patterns of HIV/AIDS epidemics is crucial to tracking and monitoring the progress of prevention and control efforts in countries. We provide a comprehensive assessment of the levels and trends of HIV/AIDS incidence, prevalence, mortality, and coverage of antiretroviral therapy (ART) for 1980–2017 and forecast these estimates to 2030 for 195 countries and territories. Methods We determined a modelling strategy for each country on the basis of the availability and quality of data. For countries and territories with data from population-based seroprevalence surveys or antenatal care clinics, we estimated prevalence and incidence using an open-source version of the Estimation and Projection Package—a natural history model originally developed by the UNAIDS Reference Group on Estimates, Modelling, and Projections. For countries with cause-specific vital registration data, we corrected data for garbage coding (ie, deaths coded to an intermediate, immediate, or poorly defined cause) and HIV misclassification. We developed a process of cohort incidence bias adjustment to use information on survival and deaths recorded in vital registration to back-calculate HIV incidence. For countries without any representative data on HIV, we produced incidence estimates by pulling information from observed bias in the geographical region. We used a re-coded version of the Spectrum model (a cohort component model that uses rates of disease progression and HIV mortality on and off ART) to produce age-sex-specific incidence, prevalence, and mortality, and treatment coverage results for all countries, and forecast these measures to 2030 using Spectrum with inputs that were extended on the basis of past trends in treatment scale-up and new infections. Findings Global HIV mortality peaked in 2006 with 1·95 million deaths (95% uncertainty interval 1·87–2·04) and has since decreased to 0·95 million deaths (0·91–1·01) in 2017. New cases of HIV globally peaked in 1999 (3·16 million, 2·79–3·67) and since then have gradually decreased to 1·94 million (1·63–2·29) in 2017. These trends, along with ART scale-up, have globally resulted in increased prevalence, with 36·8 million (34·8–39·2) people living with HIV in 2017. Prevalence of HIV was highest in southern sub-Saharan Africa in 2017, and countries in the region had ART coverage ranging from 65·7% in Lesotho to 85·7% in eSwatini. Our forecasts showed that 54 countries will meet the UNAIDS target of 81% ART coverage by 2020 and 12 countries are on track to meet 90% ART coverage by 2030. Forecasted results estimate that few countries will meet the UNAIDS 2020 and 2030 mortality and incidence targets. Interpretation Despite progress in reducing HIV-related mortality over the past decade, slow decreases in incidence, combined with the current context of stagnated funding for related interventions, mean that many countries are not on track to reach the 2020 and 2030 global targets for reduction in incidence and mortality. With a growing population of people living with HIV, it will continue to be a major threat to public health for years to come. The pace of progress needs to be hastened by continuing to expand access to ART and increasing investments in proven HIV prevention initiatives that can be scaled up to have population-level impact

Cardiovascular disease, chronic kidney disease, and diabetes mortality burden of cardiometabolic risk factors from 1980 to 2010: a comparative risk assessment

Background High blood pressure, blood glucose, serum cholesterol, and BMI are risk factors for cardiovascular diseases and some of these factors also increase the risk of chronic kidney disease and diabetes. We estimated mortality from cardiovascular diseases, chronic kidney disease, and diabetes that was attributable to these four cardiometabolic risk factors for all countries and regions from 1980 to 2010. Methods We used data for exposure to risk factors by country, age group, and sex from pooled analyses of populationbased health surveys. We obtained relative risks for the eff ects of risk factors on cause-specifi c mortality from metaanalyses of large prospective studies. We calculated the population attributable fractions for- each risk factor alone, and for the combination of all risk factors, accounting for multicausality and for mediation of the eff ects of BMI by the other three risks. We calculated attributable deaths by multiplying the cause-specifi c population attributable fractions by the number of disease-specifi c deaths. We obtained cause-specifi c mortality from the Global Burden of Diseases, Injuries, and Risk Factors 2010 Study. We propagated the uncertainties of all the inputs to the fi nal estimates. Findings In 2010, high blood pressure was the leading risk factor for deaths due to cardiovascular diseases, chronic kidney disease, and diabetes in every region, causing more than 40% of worldwide deaths from these diseases; high BMI and glucose were each responsible for about 15% of deaths, and high cholesterol for more than 10%. After accounting for multicausality, 63% (10\ub78 million deaths, 95% CI 10\ub71\u201311\ub75) of deaths from these diseases in 2010 were attributable to the combined eff ect of these four metabolic risk factors, compared with 67% (7\ub71 million deaths, 6\ub76\u20137\ub76) in 1980. The mortality burden of high BMI and glucose nearly doubled from 1980 to 2010. At the country level, age-standardised death rates from these diseases attributable to the combined eff ects of these four risk factors surpassed 925 deaths per 100 000 for men in Belarus, Kazakhstan, and Mongolia, but were less than 130 deaths per 100 000 for women and less than 200 for men in some high-income countries including Australia, Canada, France, Japan, the Netherlands, Singapore, South Korea, and Spain. Interpretation The salient features of the cardiometabolic disease and risk factor epidemic at the beginning of the 21st century are high blood pressure and an increasing eff ect of obesity and diabetes. The mortality burden of cardiometabolic risk factors has shifted from high-income to low-income and middle-income countries. Lowering cardiometabolic risks through dietary, behavioural, and pharmacological interventions should be a part of the globalresponse to non-communicable diseases