The Hand, Foot, and Mouth Disease Sentinel Surveillance System in South Korea: Retrospective Evaluation Study.

Background: South Korea has implemented a hand, foot, and mouth disease (HFMD) surveillance system since 2009 to monitor incidence trends and identify disease burden. This nationwide surveillance involves a network of approximately 100 pediatric clinics that report all probable and confirmed HFMD cases. Following the COVID-19 pandemic, infectious disease surveillance systems must be evaluated to ensure the effective use of limited public health resources. Objective: This study aimed to evaluate the HFMD sentinel surveillance system in South Korea from 2017 to 2022, focusing on the transition period after the COVID-19 pandemic. Methods: We retrospectively reviewed the HFMD sentinel surveillance system from the Korea Disease Control and Prevention Agency using systematic guidelines for public health surveillance system evaluation developed by the US Centers for Disease Control and Prevention. We assessed the system's overall performance in 5 main factors: timeliness, stability, completeness, sensitivity, and representativeness (ie, the age and geographic distribution of sentinels). We rated these factors as weak, moderate, or good. Results: Our study showed that the completeness, sensitivity, and age representativeness of the HFMD surveillance performance were temporarily reduced to moderate levels from 2020 to 2021 and recovered in 2022, while the timeliness and geographic representativeness were maintained at a good level throughout the study period. The stability of the surveillance was moderate from 2017 to 2021 and weak in 2022. Conclusions: This is the first study to evaluate the HFMD surveillance system after the acute phase of the COVID-19 pandemic. We identified a temporarily reduced level of performance (ie, completeness, sensitivity, and age-specific representativeness) during the acute phase of the pandemic and good performance in 2022. Surveillance system evaluation and maintenance during public health emergencies will provide robust and reliable data to support public health policy development. Regular staff training programs and reducing staff turnover will improve HFMD surveillance system stability.

Functional trait dataset of benthic macroinvertebrates in South Korean streams.

Functional traits are the result of evolution and adaptation, providing important ecological insights into how organisms interact with their environment. Benthic macroinvertebrates, in particular, have garnered attention as biomonitoring indicators for freshwater ecosystems. This study presents a functional trait dataset for benthic macroinvertebrates, comprising 447 taxa (393 at genus level, 53 at family level and one at class level) from five phyla (Annelida, Arthropoda, Mollusca, Nematomorpha, and Platyhelmenthes), categorized into nine traits related to life history, morphology, and habit. To account for variation in available trait information, we assigned confidence levels to each taxon and functional trait based on the level of evidence using fuzzy coding. Our dataset provides an important resource for understanding the ecology of benthic macroinvertebrates in South Korea, serving as a valuable baseline dataset for studying their biodiversity, conservation, and biomonitoring in freshwater ecosystems.

Interpretable machine learning approach to analyze the effects of landscape and meteorological factors on mosquito occurrences in Seoul, South Korea.

Mosquitoes are the underlying cause of various public health and economic problems. In this study, patterns of mosquito occurrence were analyzed based on landscape and meteorological factors in the metropolitan city of Seoul. We evaluated the influence of environmental factors on mosquito occurrence through the interpretation of prediction models with a machine learning algorithm. Through hierarchical cluster analysis, the study areas were classified into waterside and non-waterside areas, according to the landscape patterns. The mosquito occurrence was higher in the waterside area, and mosquito abundance was negatively affected by rainfall at the waterside. The mosquito occurrence was predicted in each cluster area based on the landscape and cumulative meteorological variables using a random forest algorithm. Both models exhibited good performance (both accuracy and AUROC > 0.8) in predicting the level of mosquito occurrence. The embedded relationship between the mosquito occurrence and the environmental factors in the models was explained using the Shapley additive explanation method. According to the variable importance and the partial dependence plots for each model, the waterside area was more influenced by the meteorological and land cover variables than the non-waterside area. Therefore, mosquito control strategies should consider the effects of landscape and meteorological conditions, including the temperature, rainfall, and the landscape heterogeneity. The present findings can contribute to the development of mosquito forecasting systems in metropolitan cities for the promotion of public health.

Netarsudil as a Predictor of Response for MicroPulse Transscleral Laser Therapy: A Pilot Study.

PURPOSE: To investigate the role of netarsudil as an outcome predictor of MicroPulse transscleral laser therapy (MPTLT). DESIGN: Retrospective comparative study. SUBJECTS: Forty-seven eyes in 33 adult patients with glaucoma with a minimum of 1 month of follow-up after netarsudil treatment and 3 months of follow-up after MPTLT were included. Eyes receiving intraocular pressure (IOP)-lowering procedures in the interim were excluded. INTERVENTION: Ophthalmic eyedrops of netarsudil at 0.02%, followed by MPTLT treatment. MAIN OUTCOME MEASURES: Correlation of success between netarsudil and MPTLT. Netarsudil success was defined as an IOP reduction ≥ 20% from baseline, whereas MPTLT success was defined as an IOP reduction ≥ 20% without additional IOP-lowering medications. Secondary outcomes included success rates, mean IOP reduction, adverse effects after each treatment, and netarsudil discontinuation rate. RESULTS: We found a positive correlation between the netarsudil response and the subsequent MPTLT response (odds ratio, 3.73; 95% confidence interval, 1.05-13.24; P = 0.041). Among netarsudil responders, 73.7% (14/19) of eyes subsequently responded to MPTLT, whereas among netarsudil nonresponders, 42.8% (12/28) of eyes subsequently responded to MPTLT (P = 0.037). From netarsudil, 44.4% of eyes were successful; from MPTLT, 55.3% of eyes were successful. The mean IOP reductions were 2.83 ± 5.74 mmHg from netarsudil and 3.15 ± 6.43 mmHg from MPTLT. Overall, the rate of netarsudil discontinuation was 55.3%. The most common reasons for netarsudil discontinuation were adverse effects (48.9%), followed by high cost (19.1%). The most common adverse effects to netarsudil were conjunctival hyperemia (48.9%) and blurred vision (8.5%). There were no adverse events reported after MPTLT. After MPTLT, 29.8% of eyes required additional IOP-lowering procedures. CONCLUSIONS: The netarsudil response may serve as a predictive marker of the MPTLT response, with over 70% of netarsudil responders subsequently responding favorably to MPTLT in this study.

Response to netarsudil in goniotomy-treated eyes and goniotomy-naïve eyes: a pilot study.

PURPOSE: To compare the intraocular pressure (IOP)-lowering effects of netarsudil on goniotomy-treated eyes versus goniotomy-naïve control eyes. METHODS: Retrospective cohort study of 70 eyes from 49 adult glaucoma patients treated with netarsudil. Thirty-five eyes received sectoral goniotomy using Kahook Dual Blade (KDB) combined with cataract surgery with minimum of 3 months prior to netarsudil treatment. Thirty-five eyes in the control cohort received only cataract surgery prior to netarsudil. Primary outcome was treatment success, defined as ≥ 20% decrease in IOP at minimum 1 month follow-up. Secondary outcome measures included percent of IOP reduction, adverse effects of medication, medication discontinuation rate, and relationship between KDB goniotomy response and netarsudil response. RESULTS: Eighty-three percent of KDB-treated eyes achieved netarsudil treatment success compared to 54% of control eyes (P = .012). IOP reduction was 30.3 ± 16.2% (IQR 21-38%) in KDB-treated eyes and 19.4 ± 12.4% (IQR 9.2-30.8) in control eyes (P = .007). History of prior KDB increased the likelihood of success to netarsudil treatment compared to eyes without prior KDB, regardless of surgical response to KDB (odds ratio 4.51, 95% CI 1.34-15.14, P = .015). The overall rate of adverse effects of netarsudil was 42%, most commonly reported as conjunctival hyperemia, allergy, and blurred vision. CONCLUSIONS: Netarsudil had a greater IOP-lowering effect in eyes treated with prior goniotomy and may serve as a promising adjunctive ocular hypotensive agent to further reduce IOP in eyes with prior goniotomy.

Relationship between selective laser trabeculoplasty and excisional goniotomy outcomes in glaucomatous eyes.

OBJECTIVE: To evaluate the relationship between intraocular pressure (IOP)-lowering success with selective laser trabeculoplasty (SLT) and Kahook Dual Blade (KDB) goniotomy in eyes with glaucoma. DESIGN: Retrospective chart review. PARTICIPANTS: 30 eyes of 24 patients undergoing phacoemulsification combined with a KDB with 6 months follow-up and who had previously undergone SLT in the same eye. METHODS: Data collected from electronic health records included demographic and glaucoma status, IOP and IOP-lowering medication after SLT and KDB. SLT and KDB success were defined as IOP reduction ≥20% or medication reduction ≥1 at 2 and 6 months, respectively. MAIN OUTCOME: Association between SLT success and KDB success. RESULTS: Overall, SLT was successful in 17 of 30 eyes (56.7%) at 2 months, and KDB was successful in 18 of 30 eyes (60%) at 6 months. Nine of 17 eyes (52.9%) with prior successful SLT had successful subsequent KDB, whereas 9 of 13 (69.2%) with prior unsuccessful SLT had successful KDB. There was no significant relationship between SLT and KDB outcome in these 30 eyes (p = 0.465 by Fisher's exact test). CONCLUSION: No relationship between success of SLT and subsequent KDB was observed. However, patients with history of failed SLT still benefited from subsequent KDB.

Taxonomic and Functional Diversity of Benthic Macroinvertebrate Assemblages in Reservoirs of South Korea.

Numerous community indices have been developed to quantify the various aspects of communities. However, indices including functional aspects have been less focused on. Here, we examined how community composition varies in response to the environment and discovered the relationship between taxonomic diversity and functional diversity while considering the environment. Macroinvertebrate communities were collected from 20 reservoirs in South Korea. To characterize functional diversity, functional traits in four categories were considered: generation per year, adult lifespan, adult size, and functional feeding groups. Based on their community composition, we classified the reservoirs using hierarchical cluster analysis. Physicochemical and land use variables varied considerably between clusters. Non-metric multidimensional scaling indicated differences between reservoirs and clusters in terms of structure, functional diversity, and environmental variables. A self-organizing map was used to categorize functional traits, and network association analysis was used to unravel relationships between functional traits. Our results support the characteristics of species' survival strategies such as r- and K-selection. Functional richness exhibited a relationship with taxonomic diversity. Our findings suggest that different types of diversity could play complementary roles in identifying biodiversity. Our findings should prove useful in developing new criteria for assessing freshwater ecosystem health, as well as in evaluating and predicting future alteration of benthic macroinvertebrate communities facing anthropogenic disturbances.

Effect of Excisional Goniotomy with the Kahook Dual Blade (KDB) on Surgically Induced Astigmatism.

PURPOSE: To determine the effect of Kahook Dual Blade goniotomy with phacoemulsification (Phaco-KDB) compared to phacoemulsification alone (Phaco) on surgically induced astigmatism (SIA). DESIGN: Prospective study. PARTICIPANTS: Forty eyes of 28 patients treated with Phaco-KDB and 20 eyes of 13 patients treated with Phaco between 12/27/16 and 7/23/19 with a minimum 1 month follow-up were prospectively enrolled. METHODS: Corneal astigmatism was assessed pre- and post-operatively using the simulated K (simK) values from the Pentacam Holladay report. MAIN OUTCOME MEASURES: SIA was compared between Phaco-KDB and Phaco groups using mean magnitude SIA, rate of ≥0.50 D SIA, and SIA centroids. RESULTS: The difference in mean magnitude SIA was not statistically significant between Phaco-KDB and Phaco (mean = 0.28 D and 0.25 D, respectively, P = 0.621). The difference in the rate of ≥0.50 D SIA was not statistically significant between Phaco-KDB and Phaco (11.6% and 10.0%, respectively, P = 1.00). The SIA centroid for Phaco-KDB was 0.05 D @ 51° ± 0.40 D and 0.07 D @ 3° ± 0.32 D for Phaco. CONCLUSION: Neither the mean magnitude SIA nor the rate of astigmatic change ≥0.50 D was significantly different between Phaco-KDB and Phaco groups. SIA centroids between groups showed comparable and negligible effect on corneal astigmatism. KDB combined with phacoemulsification may not significantly affect SIA compared to phacoemulsification alone based on postoperative topography and is likely an astigmatically neutral procedure.

Comparison Of Surgical Outcomes Of 360° Circumferential Trabeculotomy Versus Sectoral Excisional Goniotomy With The Kahook Dual Blade At 6 Months.

PURPOSE: To compare reductions in intraocular pressure (IOP) and IOP-lowering medication use following sectoral excisional goniotomy with the Kahook Dual Blade (KDB) or 360° trabeculotomy (via either Trab360 or gonioscopy-assisted transluminal trabeculotomy [GATT]) in eyes with open-angle glaucoma (OAG) undergoing phacoemulsification cataract surgery. METHODS: A retrospective review was conducted to collect data from adult subjects with early to advanced primary or secondary OAG undergoing phacoemulsification combined with either KDB or 360° trabeculotomy (Trab360 or GATT) between August 1, 2016 and July 30, 2018 for which 6-month follow-up was available. Data collected included IOP, glaucoma medications, adverse events, and additional IOP-lowering procedures. The primary outcome measure was surgical success (≥20% IOP or ≥1 medication reduction without additional IOP-lowering procedures) at 6 months. RESULTS: Data were collected from 74 eyes of 61 subjects undergoing KDB excisional goniotomy and 27 eyes of 25 subjects undergoing 360° trabeculotomy (19 eyes of 17 subjects undergoing Trab360 and 8 eyes of 8 subjects undergoing GATT). At 6 months, 81.7% (58/71) of KDB eyes and 84.6% (22/26) of 360° trabeculotomy eyes achieved surgical successes (P=0.737). Mean IOP reductions and medication reductions were similar between groups at 6 months. However, more eyes undergoing KDB than Trab360/GATT achieved target IOP ≤18 mmHg (80.0% [56/70] vs 59.3% [16/27], P=0.040) and ≤15 mmHg (61.4% [43/70] vs 25.9% [7/27], P=0.003) without further IOP-lowering interventions at 6 months. The nature and frequency of adverse events were similar between groups. CONCLUSIONS: Both KDB and Trab360 or GATT procedures similarly lowered both IOP and the need for IOP-lowering medications during the first 6 postoperative months. More eyes undergoing KDB excisional goniotomy than 360° trabeculotomy attained target IOP ≤18 mmHg and ≤15 mmHg at 6 months. A full 360° trabecular bypass may not be necessary to achieve maximal efficacy from this class of micro-invasive glaucoma procedures.

Comparison Of Surgical Outcomes Between Excisional Goniotomy Using The Kahook Dual Blade And iStent Trabecular Micro-Bypass Stent In Combination With Phacoemulsification.

PURPOSE: To compare 6-month surgical outcomes of patients who underwent phacoemulsification (Phaco) combined with iStent implantation (iStent) versus excisional goniotomy using Kahook Dual Blade (KDB). METHODS: Retrospective comparative case series of 58 iStent-Phaco eyes and 44 KDB-Phaco eyes operated upon by a single surgeon between 2016 and 2018. Preoperative, intraoperative, and postoperative intraocular pressure (IOP) and IOP-lowering medication data were collected. The primary outcome was the proportion of eyes using ≥1 fewer IOP-lowering medication at Month 6 while maintaining IOP ≤ 18 mmHg. RESULTS: Baseline IOP was 17.2 (standard error 0.7) in the KDB-Phaco group using a mean of 1.9 (0.2) medications; at Month 6, mean IOP was 14.8 mmHg P=0.002) on 1.0 (0.2) medications (P<0.002). Baseline IOP was 16.7 (0.4) in the iStent-Phaco group using a mean of 1.4 (0.1) medications; at Month 6, mean IOP was 14.2 mmHg (P<0.002) on 1.4 (0.1) medications P=0.374). Changes in IOP and medications were not significantly different between groups (P>0.05). Significantly more KDB-Phaco eyes than iStent-Phaco eyes (43.2% vs 17.2%, P=0.004) were using ≥1 fewer medications while maintaining IOP ≤18 mmHg at Month 6. Adverse events were uncommon and similar in nature and frequency between groups with the exception that more KDB-Phaco eyes than iStent-Phaco eyes (8 [18.2%] versus 1 [1.7%]) experienced an IOP elevation presumed to be related to steroid use. CONCLUSION: KDB-Phaco and iStent-Phaco provided comparable IOP and medication reductions. The proportion of eyes able to discontinue 1 or more medications while maintaining IOP ≤ 18 mmHg was significantly greater in eyes undergoing KDB-Phaco.

Outcome of phacoemulsification combined with excisional goniotomy using the Kahook Dual Blade in severe glaucoma patients at 6 months.

PURPOSE: The aim of this study was to describe 6-month rates of achieving target IOP without requiring additional glaucoma surgery after excisional goniotomy using the Kahook Dual Blade combined with phacoemulsification (phaco-KDB) in patients with severe-stage glaucoma. METHODS: Retrospective review of 42 eyes from 36 patients with severe glaucoma who received phaco-KDB. Primary and secondary open-angle and combined-mechanism glaucoma were included. Preoperative, intraoperative, and postoperative data were collected through the 6-month follow-up period. The primary outcome was proportion of patients achieving IOP ≤15 mmHg without additional glaucoma procedures. Secondary outcomes were mean change in IOP, reduction of glaucoma medications, additional glaucoma procedures needed, and adverse events. RESULTS: Preoperative baseline mean IOP was 17.1±4.8 mmHg (mean ± SD) and number of medications was 2.4±1.3. At 6 months, 64.3% (27/42) of eyes had achieved IOP ≤15 mmHg without additional glaucoma procedures, 45.2% (19/42) reached this target IOP on fewer medications, and 31.0% (13/42) on no medications. Mean IOP reduction was 2.1±4.67 mmHg (P=0.022) and mean medication reduction was 1.2±1.4 (P≤0.001). Visually significant complications were experienced by 7.1% (3/42) of eyes, and 7.1% (3/42) required additional IOP-lowering procedures within 6 months of surgery. CONCLUSION: Patients with severe-stage open-angle glaucoma achieved significant IOP and medication reductions following phaco-KDB. Notably, about two-thirds of eyes achieved an IOP of ≤15 mmHg at 6 months without additional glaucoma procedures. Complications and need for additional procedures were rare. Phaco-KDB may be an effective and safe alternative to more invasive filtering surgery in many patients with severe glaucoma.

Oxidative stress-induced senescence markedly increases disc cell bioenergetics.

Cellular senescence is a phenotype characterized by irreversible growth arrest, chronic elevated secretion of proinflammatory cytokines and matrix proteases, a phenomenon known as senescence-associated secretory phenotype (SASP). Biomarkers of cellular senescence have been shown to increase with age and degeneration of human disc tissue. Senescent disc cells in culture recapitulate features associated with age-related disc degeneration, including increased secretion of proinflammatory cytokines, matrix proteases, and fragmentation of matrix proteins. However, little is known of the metabolic changes that underlie the senescent phenotype of disc cells. To assess the metabolic changes, we performed a bioenergetic analysis of in vitro oxidative stress-induced senescent (SIS) human disc cells. SIS disc cells acquire SASP and exhibit significantly elevated mitochondrial content and mitochondrial ATP-linked respiration. The metabolic changes appear to be driven by the upregulated protein secretion in SIS cells as abrogation of protein synthesis using cycloheximide decreased mitochondrial ATP-linked respiration. Taken together, the results of the study suggest that the increased energy generation state supports the secretion of senescent associated proteins in SIS disc cells.

Distribution Patterns of Odonate Assemblages in Relation to Environmental Variables in Streams of South Korea.

Odonata species are sensitive to environmental changes, particularly those caused by humans, and provide valuable ecosystem services as intermediate predators in food webs. We aimed: (i) to investigate the distribution patterns of Odonata in streams on a nationwide scale across South Korea; (ii) to evaluate the relationships between the distribution patterns of odonates and their environmental conditions; and (iii) to identify indicator species and the most significant environmental factors affecting their distributions. Samples were collected from 965 sampling sites in streams across South Korea. We also measured 34 environmental variables grouped into six categories: geography, meteorology, land use, substrate composition, hydrology, and physicochemistry. A total of 83 taxa belonging to 10 families of Odonata were recorded in the dataset. Among them, eight species displayed high abundances and incidences. Self-organizing map (SOM) classified sampling sites into seven clusters (A⁻G) which could be divided into two distinct groups (A⁻C and D⁻G) according to the similarities of their odonate assemblages. Clusters A⁻C were characterized by members of the suborder Anisoptera, whereas clusters D⁻G were characterized by the suborder Zygoptera. Non-metric multidimensional scaling (NMDS) identified forest (%), altitude, and cobble (%) in substrata as the most influential environmental factors determining odonate assemblage compositions. Our results emphasize the importance of habitat heterogeneity by demonstrating its effect on odonate assemblages.