We aimed to use deep learning to detect tuberculosis in chest radiographs in annual workers’ health examination data and compare the performances of convolutional neural networks (CNNs) based on images only (I-CNN) and CNNs including demographic variables (D-CNN). The I-CNN and D-CNN models were trained on 1000 chest X-ray images, both positive and negative, for tuberculosis. Feature extraction was conducted using VGG19, InceptionV3, ResNet50, DenseNet121, and InceptionResNetV2. Age, weight, height, and gender were recorded as demographic variables. The area under the receiver operating characteristic (ROC) curve (AUC) was calculated for model comparison. The AUC values of the D-CNN models were greater than that of I-CNN. The AUC values for VGG19 increased by 0.0144 (0.957 to 0.9714) in the training set, and by 0.0138 (0.9075 to 0.9213) in the test set (both p < 0.05). The D-CNN models show greater sensitivity than I-CNN models (0.815 vs. 0.775, respectively) at the same cut-off point for the same specificity of 0.962. The sensitivity of D-CNN does not attenuate as much as that of I-CNN, even when specificity is increased by cut-off points. Conclusion: Our results indicate that machine learning can facilitate the detection of tuberculosis in chest X-rays, and demographic factors can improve this process.

The burden of rare diseases on society and patients’ families has increased in Korea. However, because of the infrequency of rare diseases, there is a lack of resources and information to address these cases and inadequate funding for the management of these patients. We investigated the average annual cumulative incidence of rare diseases and the trends in annual cumulative incidence from 2011 to 2015 in Korea by using nationwide administrative data from the Korean National Health Insurance Service (NHIS) database for patients registered with the co-payment assistance policy for rare and incurable diseases. Annual cumulative incidence per 10,000,000 was calculated as the total number of newly enrolled patients with the Korean Standard Classification of Diseases (KCD)-7 code in the register, divided by the number of residents with health insurance coverage during each year. We employed simple linear regression analysis to evaluate the trends in annual cumulative incidence/10,000,000 population per year for each rare disease. Overall, national support was provided for patients with 415 KCD codes listed among the targeted rare diseases. The total number of newly enrolled patients with rare diseases was 53,831 in 2011, 52,658 in 2012, 52,955 in 2013, 71,530 in 2014, and 70,559 in 2015. The number of rare diseases with an average annual cumulative incidence of 100/10,000,000 and above was 22 (5.30%), while there were 227 (54.70%) and 148 (35.66%) with an average cumulative incidence between 1/10,000,000 and 100/10,000,000 and less than 1/10,000,000, respectively. The trends in the annual cumulative incidence for 43 rare diseases were statistically significant (p-value < 0.05). The rare diseases for which the incremental trend per year was statistically significant were sarcoidosis (D86, D86.0, D86.1, D86.2, D86.3, D86.8, D86.9), Parkinson’s disease (G20), Guillain-Barré syndrome (G61.0), primary biliary cirrhosis (K74.3) and Sjogren’s syndrome (M35.0). The number of rare diseases showing an increasing trend in annual cumulative incidence was higher than the number of diseases showing a decreasing trend in annual cumulative incidence. Given that the definition and diagnosis vary based on country and that there is difficulty in identifying valid cases, further detection strategies are needed to establish the incidence of each rare disease considering the importance of establishing a health policy based on the actual incidence of the targeted diseases.

Lim SS, et al. J Korean Med Sci. 2016 Nov;31(11):1696-1702. https://doi.org/10.3346/jkms.2016.31.11.1696

Work schedules comprise various variables and generate health and safety outcomes, including work-related injury, which causes socioeconomic problems, such as productivity loss and damage to worker health. We investigated the association between work schedule irregularity and the incidence of work-related injury among South Korean manual workers using data from the 5th Korean Working Conditions Survey. In total, 18,330 manual workers were included. A multivariate logistic regression analysis was performed to understand the association between work schedule and work-related injury and the influence of sufficient safety information and work schedule on work-related injury. We calculated the influence of an irregular work schedule on occupational injury after controlling for personal and work environment-related factors. The adjusted odds ratio (OR) for work-related injury was 1.66 (95% confidence interval (CI) 1.32–2.09) for an irregular work schedule. The interaction had an additive effect when the work schedule was irregular, even when sufficient safety information was provided. Manual workers had a higher incidence of injury (2.1%). Even in adjusted analyses, work schedule irregularity conferred greater risks of work injury, particularly when not working the same number of days weekly (OR 1.52, 95% CI 1.21–1.90). Policymakers and health professionals need to consider the impact of work schedule irregularity on worker safety and health.

Background: Is there a relationship between economic inequality and infanticide rates? Few studies have examined the socioeconomic factors that trigger infanticide. This study aims to statistically analyze the effect of these factors on infanticide rates. Methods: This study used infant death records in South Korea from 2003 to 2017 to assess the impact of unemployment rates and various statistical indicators (e.g., GDP and income inequality index) on the rate of infanticide. A generalized additive model and a quasi-Poisson regression were used for statistical analyses. Results: A time-trend analysis shows that the infanticide rate tended to grow despite a decreasing trend in the quarterly infant mortality rate. A 1% increase in the unemployment rate is associated with a significant rise in the relative risk of infanticide after a lag of two quarters. Relative risks increased significantly three and four quarters after a 0.1 rise in the p80/p20 ratio (income inequality index). Conclusions: Policymakers should pay attention to socioeconomic factors while formulating healthcare regulations to protect potential infanticide victims, including vulnerable infants and their parents.

Objectives We investigated the association between parents’ occupational characteristics and untreated dental caries in their children. Methods We analyzed the data of 4764 and 5862 children merged with data of their mothers and fathers, respectively, derived from the Korean National Health and Nutrition Examination Survey, 2008–2015. Dentists assessed untreated dental caries, and occupational characteristics were self-reported. The associations between untreated dental caries in children and their parents’ occupational characteristics were assessed with logistic regression analysis. Results The prevalence of untreated dental caries was 18.58% and 16.39% in the mother- and father-matched data, respectively. Compared to children whose mothers worked regular hours, those whose mothers worked overtime had increased odds of untreated dental caries [odds ratio (OR) 1.19, 95% confidence interval (CI) 1.02–1.39]. Children of female self-employed workers/employers/unpaid family workers had higher odds of untreated dental caries than those of wage earners (OR 1.18, 95% CI 1.00–1.39). The OR of untreated dental caries was higher among children with shift-working parents than those whose parents worked daytime hours (mother: OR 1.29, 95% CI 1.11–1.51; father: OR 1.36, 95% CI 1.18–1.58). Conclusions The children of non-white-collar workers, non-wage earners, and workers working overtime or doing shift work had higher odds of untreated dental caries. The effects of parental occupational characteristics on untreated dental caries differed by sex (mother versus father). Public health programs targeting the prevention of dental caries among children should consider parental occupational characteristics.