National prevalence and determinants of COVID-19 vaccine hesitancy during the initial phase pandemic

OBJECTIVE

Although previous studies have explored the causes of COVID-19 vaccine hesitancy during the pandemic, there is a lack of generality and reproducibility in these studies. Therefore, we aimed to comprehensively identify the determinants of COVID-19 vaccine hesitancy through a representative nationwide cross-sectional study conducted in South Korea.

SUBJECTS AND METHODS

We used a nationwide, representative, and large-scale dataset from the 2021 Community Health Survey. By analyzing 193,495 participants, we investigated the nationwide incidence of COVID-19 vaccine hesitancy and the various causes thereof.

RESULTS

The national prevalence of COVID-19 vaccine hesitancy was 5.7% (95% CI, 5.5-5.8). COVID-19 vaccine hesitancy was associated with an increased incidence of the following factors: (1) demographic factors including early-middle adulthood [vs. late; odds ratio (OR), 1.51; 95% CI, 1.38-1.65] and male sex (vs. female sex; OR, 1.08; 95% CI, 1.01-1.14); (2) physically healthy subjects; (3) lower socio-economic status (vs. high household income; OR, 1.28; 95% CI, 1.19-1.38); (4) having mental illness (vs. normal mental status; OR, 1.25; 95% CI, 1.13-1.38); and (5) unhealthy habits such as current smoking (vs. non-smoking; OR, 1.22; 95% CI, 1.13-1.31); and insufficient physical activity (vs. sufficient; OR, 1.08; 95% CI, 1.01-1.17). Common reasons for vaccine hesitancy were concerns about side effects (41.34%), health problems (24.60%), and inability to select the type of vaccine (14.13%).

CONCLUSIONS

This representative large-scale nationwide study conducted in South Korea investigated the nationwide prevalence and determinants of vaccine hesitancy. Our results provide useful public health information, especially on novel aspects of vaccination strategies, for policymakers to improve the acceptance of COVID-19 vaccines.

National prevalence and socioeconomic factors associated with the acceptance of COVID-19 vaccines in South Korea: a large-scale representative study in 2021

OBJECTIVE

Among the global efforts toward preventing the COVID-19 pandemic, vaccines are a pivotal factor in ending the pandemic. Thus, through a large-scale population-based study, we investigated the individual-, social-, and family-associated factors affecting the acceptance of COVID-19 vaccines in South Korea.

PATIENTS AND METHODS

Data were obtained from a nationwide representative study (Korea Community Health) conducted in 2021. To determine the individual-, social-, and family-associated variables for COVID-19 vaccination acceptance, we investigated data from 225,319 individuals.

RESULTS

In the total sample (n=225,319), 184,529 COVID-19-vaccinated people and 40,790 non-vaccinated people were evaluated. The factors related to the acceptance of COVID-19 vaccination were significantly associated with the demographic factors, namely, older age group, female sex, and a history of influenza vaccination, as well as medical conditions such as diabetes, hypertension, and depression. Socioeconomic conditions influencing the acceptance of COVID-19 vaccination were significantly associated with low-income families and blue-collar workers. Health-related risk factors were high in the obese group. However, a noteworthy negative association was found between the acceptance of vaccination and smoking habits and alcohol consumption. Conversely, a positive association was observed between academic level and vaccination acceptance.

CONCLUSIONS

Our findings suggest that old age, female sex, a history of influenza vaccination, medical conditions, such as diabetes, hypertension, and depression, low-income families, blue-collar workers, and health-related risk factors, such as obesity, were associated with the acceptance of COVID-19 vaccination. Additionally, a high academic level, absence of smoking habits, and non-current alcohol use were positively associated with vaccine acceptance.

Ethnic and sex differences in the distributions of body mass index and waist circumference among adults: a binationally representative study in South Korea and the United States

OBJECTIVE

The ethnic and sex differences in the distributions of body mass index (BMI) and waist circumference (WC) among adults are largely unknown. Therefore, we aimed to investigate the percentiles of BMI and WC in groups divided according to age, sex, and ethnicity.

PATIENTS AND METHODS

We conducted a population-based binational study of adults aged ≥20 years based on data from two sources: US National Health and Nutrition Examination Survey (2015 to 2020) and Korea National Health and Nutrition Examination Survey (2016 to 2019).

RESULTS

Weight, height, and WC were measured in 13,144 American adults and 30,191 Korean adults. Overall, BMI increased at younger ages and decreased at older ages, which indicates a reversed U-shaped relationship, and differed in terms of age, sex, and ethnicity. Women in the other Hispanic, non-Hispanic white, non-Hispanic black, and "other ethnic groups" showed a common BMI peak at ages 50-54 years. The patterns of WC distribution were similar to those of BMI distribution.

CONCLUSIONS

In this binational representative study, we found varied distributions of ethnic and sex differences in BMI and WC. Considering the differences in these distributions may help improve individual and personalized treatment strategies.

Stachydrine alleviates lipid-induced skeletal muscle insulin resistance via AMPK/HO-1-mediated suppression of inflammation and endoplasmic reticulum stress

OBJECTIVE

Insulin resistance develops due to skeletal muscle inflammation and endoplasmic reticulum (ER) stress. Stachydrine (STA), extracted from Leonurus heterophyllus, has been shown to suppress proliferation and induce apoptosis in breast cancer cells and exert anti-inflammatory properties in the brain, heart, and liver. However, the roles of STA in insulin signaling in skeletal muscle remain unclear. Herein, we examined the impacts of STA on insulin signaling in skeletal muscle under hyperlipidemic conditions and its related molecular mechanisms.

METHODS

Various protein expression levels were determined by Western blotting. Levels of mouse serum cytokines were measured by ELISA.

RESULTS

We found that STA-ameliorated inflammation and ER stress, leading to attenuation of insulin resistance in palmitate-treated C2C12 myocytes. STA dose-dependently enhanced AMPK phosphorylation and HO-1 expression. Administration of STA attenuated not only insulin resistance but also inflammation and ER stress in the skeletal muscle of high-fat diet (HFD)-fed mice. Additionally, STA-ameliorated glucose tolerance and insulin sensitivity, as well as serum TNFα and MCP-1, in mice fed a HFD. Small interfering (si) RNA-associated suppression of AMPK or HO-1 expression abolished the effects of STA in C2C12 myocytes.

CONCLUSIONS

These results suggest that STA activates AMPK/HO-1 signaling, resulting in reduced inflammation and ER stress, thereby improving skeletal muscle insulin resistance. Using STA as a natural ingredient, this research successfully treated insulin resistance and type 2 diabetes.

Gastric intestinal metaplasia development in African American predominant United States population

BACKGROUND

Gastric cancer significantly contributes to cancer mortality globally. Gastric intestinal metaplasia (GIM) is a stage in the Correa cascade and a premalignant lesion of gastric cancer. The natural history of GIM formation and progression over time is not fully understood. Currently, there are no clear guidelines on GIM surveillance or management in the United States.

AIM

To investigate factors associated with GIM development over time in African American-predominant study population.

METHODS

This is a retrospective longitudinal study in a single tertiary hospital in Washington DC. We retrieved upper esophagogastroduodenoscopies (EGDs) with gastric biopsies from the pathology department database from January 2015 to December 2020. Patients included in the study had undergone two or more EGDs with gastric biopsy. Patients with no GIM at baseline were followed up until they developed GIM or until the last available EGD. Exclusion criteria consisted of patients age < 18, pregnancy, previous diagnosis of gastric cancer, and missing data including pathology results or endoscopy reports. The study population was divided into two groups based on GIM status. Univariate and multivariate Cox regression was used to estimate the hazard induced by patient demographics, EGD findings, and Helicobacter pylori (H. pylori) status on the GIM status.

RESULTS

Of 2375 patients who had at least 1 EGD with gastric biopsy, 579 patients were included in the study. 138 patients developed GIM during the study follow-up period of 1087 d on average, compared to 857 d in patients without GIM (P = 0.247). The average age of GIM group was 64 years compared to 56 years in the non-GIM group (P < 0.001). In the GIM group, adding one year to the age increases the risk for GIM formation by 4% (P < 0.001). Over time, African Americans, Hispanic, and other ethnicities/races had an increased risk of GIM compared to Caucasians with a hazard ratio (HR) of 2.12 (1.16, 3.87), 2.79 (1.09, 7.13), and 3.19 (1.5, 6.76) respectively. No gender difference was observed between the study populations. Gastritis was associated with an increased risk for GIM development with an HR of 1.62 (1.07, 2.44). On the other hand, H. pylori infection did not increase the risk for GIM.

CONCLUSION

An increase in age and non-Caucasian race/ethnicity are associated with an increased risk of GIM formation. The effect of H. pylori on GIM is limited in low prevalence areas.

Temporal characterization of a two-color laser field using tunneling ionization

The superposition of a fundamental laser pulse and its second harmonic can form an asymmetric laser field that is useful in many applications. The temporal characterization of the two-color laser field becomes necessary. However, the temporal characterization of the two-color laser pulse is a challenging task due to its broad bandwidth and a spectral gap between the two frequency components. Here we demonstrate the temporal characterization of the two-color laser field using multiple ionization yield measurements near the laser focus. This new approach enables the complete temporal characterization of the two-color laser field, including the relative phase between the two frequency components.

The Value of Pre-Screening in the Alzheimer's Prevention Initiative (API) Autosomal Dominant Alzheimer's Disease Trial

The Alzheimer's Prevention Initiative (API) Autosomal Dominant Alzheimer's Disease (ADAD) trial evaluates the anti-amyloid-β antibody crenezumab in cognitively unimpaired persons who, based on genetic background and age, are at high imminent risk of clinical progression, and provides a powerful test of the amyloid hypothesis. The Neurosciences Group of Antioquia implemented a pre-screening process with the goals of decreasing screen failures and identifying participants most likely to adhere to trial requirements of the API ADAD trial in cognitively unimpaired members of Presenilin1 E280A mutation kindreds. The pre-screening failure rate was 48.2%: the primary reason was expected inability to comply with the protocol, chiefly due to work requirements. More carriers compared to non-carriers, and more males compared to females, failed pre-screening. Carriers with illiteracy or learning/comprehension difficulties failed pre-screening more than non-carriers. With the Colombian API Registry and our prescreening efforts, we randomized 169 30-60 year-old cognitively unimpaired carriers and 83 non-carriers who agreed to participate in the trial for at least 60 months. Our findings suggest multiple benefits of implementing a pre-screening process for enrolling prevention trials in ADAD.

Passive functional mapping guides electrical cortical stimulation for efficient determination of eloquent cortex in epilepsy patients

Electrical cortical stimulation (ECS) is often used in presurgical evaluation procedures for patients suffering from pharmacoresistant epilepsy. Real-time functional mapping (RTFM) is an alternative brain mapping methodology that can accompany traditional functional mapping approaches like ECS. In this paper, we present a combined RTFM/ECS system that aims to exploit the common ground and the advantages of the two procedures for improved time/effort effectiveness, patients' experience and safety. Using the RTFM and ECS data from four patients who suffer epilepsy, we demonstrate that the RTFM-guided ECS procedure hypothetically reduces the number of electrical stimulations necessary for eloquent cortex detection by 40%.

Monte Carlo modeling of ion beam induced secondary electrons

Ion induced secondary electrons (iSE) can produce high-resolution images ranging from a few eV to 100keV over a wide range of materials. The interpretation of such images requires knowledge of the secondary electron yields (iSE δ) for each of the elements and materials present and as a function of the incident beam energy. Experimental data for helium ions are currently limited to 40 elements and six compounds while other ions are not well represented. To overcome this limitation, we propose a simple procedure based on the comprehensive work of Berger et al. Here we show that between the energy range of 10-100keV the Berger et al. data for elements and compounds can be accurately represented by a single universal curve. The agreement between the limited experimental data that is available and the predictive model is good, and has been found to provide reliable yield data for a wide range of elements and compounds.

Modification to the accelerator of the NBI-1B ion source for improving the injection efficiency

Minimizing power loss of a neutral beam imposes modification of the accelerator of the ion source for further improvement of the beam optics. The beam optics can be improved by focusing beamlets. The injection efficiencies by the steering of ion beamlets are investigated numerically to find the optimum modification of the accelerator design of the NBI-1B ion source. The beam power loss was reduced by aperture displacement of three edge beamlets arrays considering power loadings on the beamline components. Successful testing and operation of the ion source at 60 keV/84% of injection efficiency led to the possibility of enhancing the system capability to a 2.4 MW power level at 100 keV/1.9 μP.

Movement related cortical potentials in severe chronic stroke

Movement related cortical potentials (MRCPs) have been studied for many years and controlled using brain computer interfaces (BCIs). Furthermore, MRCPs have been proposed as reliable and immediate indicators of cortical reorganizations in motor learning and after stroke. In this study MRCPs preceding and during hand movements in severe chronic stroke were investigated. Eight severely impaired (no residual finger extension) chronic stoke patients underwent EEG and EMG recordings during a cue triggered hand movement paradigm. Four patients presented subcortical lesions only while the other four presented mixed (cortical and subcortical) lesions. MRCPs were measured before (slow cortical potentials SCPs) and at movement onset (motor potentials MPs). SCPs were observed during paretic hand movements only. Latencies were longer and reached their negativity peak earlier during paretic hand movement. When dividing the patients in subcortical only and mixed lesion patients, we observed significantly bigger MP peak amplitudes over the lesioned hemisphere during paretic and healthy hand movements in subcortical stroke patients. Furthermore, we observed a significant difference in MP peak latency between subcortical and mixed stroke patients during paretic hand movements. We demonstrated for the first time significant differences between subcortical only and mixed (cortical and subcortical) stroke patients' MRCPs during motor preparation and execution. Furthermore, we demonstrated how stroke produces a longer MRCP and that lesion location affects MP peak amplitude and latency. Finally, we propose the use MRCP based BCIs to reduce their duration (towards normal) and induce motor function recovery.

Accuracy of computed tomography in nodal staging of colon cancer patients

AIM

To predict node-positive disease in colon cancer using computed tomography (CT).

METHODS

American Joint Committee on Cancer stage I-III colon cancer patients who underwent curavtive-intent colectomy between 2007-2010 were identified at a single comprehensive cancer center. All patients had preoperative CT scans with original radiology reports from referring institutions. CT images underwent blinded secondary review by a surgeon and a dedicated abdominal radiologist at our institution to identify pericolonic lymph nodes (LNs). Comparison of outside CT reports to our independent imaging review was performed in order to highlight differences in detection in actual clinical practice. CT reviews were compared with final pathology. Results of the outside radiologist review, secondary radiologist review, and surgeon review were compared with the final pathologic exam to determine sensitivity, specificity, positive and negative predictive values, false positive and negative rates, and accuracy of each review. Exclusion criteria included evidence of metastatic disease on CT, rectal or appendiceal involvement, or absence of accompanying imaging from referring institutions.

RESULTS

From 2007 to 2010, 64 stageI-III colon cancer patients met the eligibility criteria of our study. The mean age of the cohort was 68 years, and 26 (41%) patients were male and 38 (59%) patients were female. On final pathology, 26 of 64 (40.6%) patients had node-positive (LN+) disease and 38 of 64 (59.4%) patients had node-negative (LN-) disease. Outside radiologic review demonstrated sensitivity of 54% (14 of 26 patients) and specificity of 66% (25 of 38 patients) in predicting LN+ disease, whereas secondary radiologist review demonstrated 88% (23 of 26) sensitivity and 58% (22 of 38) specificity. On surgeon review, sensitivity was 69% (18 of 26) with 66% specificity (25 of 38). Secondary radiology review demonstrated the highest accuracy (70%) and the lowest false negative rate (12%), compared to the surgeon review at 67% accuracy and 31% false negative rate and the outside radiology review at 61% accuracy and 46% false negative rate.

CONCLUSION

CT LN staging of colon cancer has moderate accuracy, with administration of NCT based on CT potentially resulting in overtreatment. Active search for LN+ may improve sensitivity at the cost of specificity.

Highly effective heterogeneous chemosensors of luminescent silica@coordination polymer core-shell micro-structures for metal ion sensing

Heterogeneous solid sensors are regarded as promising next-generation sensor due to their excellent chemical stability, low contamination, and excellent recyclability, despite their low sensitivity and weak signal. The dispersity and signals specifically from the exterior of solid sensors are critical aspects which define the sensing sensitivity and selectivity. A novel strategy for the preparation of ideal heterogeneous sensors based upon luminescent lanthanide coordination polymers (LnCP) has been demonstrated. Ideal heterogeneous sensors are systematically achieved by producing the sensors in small, uniform, and thin core-shell particles (silica@LnCP, Ln = Eu, Tb). Eventually, we found that the extremely small amount of well-structured silica@LnCP microsphere, less than ca. 1/400 compared to the amount of several known coordination polymer-based sensors, was sufficient to achieve a reliable Cu²⁺ sensing with even much greater sensitivity (ca. 550% improvement).

Controlled isotropic or anisotropic nanoscale growth of coordination polymers: formation of hybrid coordination polymer particles

The ability to fabricate multicompositional hybrid materials in a precise and controlled manner is one of the primary goals of modern materials science research. In addition, an understanding of the phenomena associated with the systematic growth of one material on another can facilitate the evolution of multifunctional hybrid materials. Here, we demonstrate precise manipulation of the isotropic and/or anisotropic nanoscale growth of various coordination polymers (CPs) to obtain heterocompositional hybrid coordination polymer particles. Chemical composition analyses conducted at every growth step reveal the formation of accurately assembled hybrid nanoscale CPs, and microscopy images are used to examine the morphology of the particles and visualize the hybrid structures. The dissimilar growth behavior, that is, growth in an isotropic or anisotropic fashion, is found to be dependent on the size of the metal ions involved within the CPs.

SU-E-T-296: Optimization of the Energy Selection System with Varying Magnetic Field for Laser-Accelerated Proton Beams

PURPOSE

Laser-based accelerated proton beams are unsuitable for clinical use because of their broad energy spectra. For this reason, it is essential to employ an energy selection system (ESS). The purpose of this study is to determine optimum parameters of the ESS which uses a varying magnetic field to generate Bragg-peak.

METHODS

We simulated an accelerated proton beams using radiation pressure acceleration mechanism with carbon-proton mixture target. The density ratio (n = 6) between the protons and the carbon ions is one of optimization parameters in determining the accelerating mechanisms. The ESS was implemented by the Geant4 Monte Carlo toolkit. In order to optimize the hole size and position of the energy selection collimator, and magnetic field at ESS, these parameters were simulated for acquiring energy and dose distributions by changing each values.

RESULTS

The proton energy distributions had a poly-energetic distribution after passing through the ESS. As the magnetic field was increased, the mean energy of the proton beams also was increased. Also as the hole size was increased, the energy bandwidth of proton passed through the ESS was increased. The hole size and position of the energy selection collimator were effectively optimized to 2 cm and 5 cm from the z-axis, respectively.

CONCLUSIONS

We simulated laser-accelerated proton beams using ESS for generation of Bragg-peak. Our results suggest that the ESS with magnetic field variation can effectively generate a Bragg-peak suitable for use in proton radiation therapy. Our ESS can be applied to pencil beam scanning proton therapy.

Multi component self-assembly: supramolecular organic frameworks containing metal-rotaxane subunits (RSOFs)

A facile, one-pot synthesis of rotaxanated supramolecular organic frameworks (RSOFs) is reported. These systems consist of bis-carboxylate anions threaded through the core of tetraimidazolium macrocycles. Trivalent metal cations, yttrium(III) and smaller lanthanides, are used to "lock" the threaded strut in place. This results in the formation of three-dimensional RSOFs.

Anion-directed assembly of a three-dimensional metal-organic rotaxane framework

A three-dimensional extended, metal-organic rotaxane framework (MORF) that incorporates encircled "struts" has been synthesized through a one-pot self-assembly process involving a macrocyclic tetraimidazolium "molecular box", naphthalene dicaboxylate dianion, and Zn(II) cations. The present system represents progress towards controlling the features of three-dimensional metal-organic frameworks.