• Title/Summary/Keyword: Disparities

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Demographic and Survivorship Disparities in Non-muscle-invasive Bladder Cancer in the United States

  • Seo, Munseok;Langabeer, James R. II
    • Journal of Preventive Medicine and Public Health
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    • v.51 no.5
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    • pp.242-247
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    • 2018
  • Objectives: To examine survivorship disparities in demographic factors and risk status for non-muscle-invasive bladder cancer (NMIBC), which accounts for more than 75% of all urinary bladder cancers, but is highly curable with early identification and treatment. Methods: We used the US National Cancer Institute's Surveillance, Epidemiology, and End Results registries over a 19-year period (1988-2006) to examine survivorship disparities in age, sex, race/ethnicity, and marital status of patients and risk status classified by histologic grade, stage, size of tumor, and number of multiple primary tumors among NMIBC patients (n=29 326). We applied Kaplan-Meier (K-M) and Cox proportional hazard methods for survival analysis. Results: Among all urinary bladder cancer patients, the majority of NMIBCs were in male (74.1%), non-Latino white (86.7%), married (67.8%), and low-risk (37.6%) to intermediate-risk (44.8%) patients. The mean age was 68 years. Survivorship (in median life years) was highest for non-Latino white (5.4 years), married (5.4 years), and low-risk (5.7 years) patients (K-M analysis, p<0.001). We found significantly lower survivorship for elderly, male (female hazard ratio [HR], 0.96), Latino (HR, 1.20), and unmarried (married HR, 0.93) patients. Conclusions: Survivorship disparities were ubiquitous across age, sex, race/ethnicity, and marital status groups. Non-white, unmarried, and elderly patients had significantly shorter survivorship. The implications of these findings include the need for a heightened focus on health policy and more organized efforts to improve access to care in order to increase the chances of survival for all patients.

Calcification on the Surface of Silicone Nasal Implants: Regional Properties of Calcification Deposits (실리콘비삽입물 표면의 석회화: 부위별 석회침착물의 특성)

  • Lee, Min Jae;Kim, Hyun Ji;Han, Ki Hwan;Kim, Jun Hyung;Son, Dae Gu
    • Archives of Plastic Surgery
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    • v.33 no.3
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    • pp.324-329
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    • 2006
  • The silicone rubber implants are widely used in plastic surgery because of various advantages; however, calcification in surface of implant(as a chemical resistance) may transform or destroy the high molecular biomaterial when it stays too long within the human body. The purpose of this study is to determine the relationship between calcification and the histological disparities of the tissues surrounding the area adjoining the silicone nasal implant by examining the regional characteristics of calcium deposits in the silicone nasal implant via elemental analyses using EDX(energy-dispersive X-ray analysis) and ultrastructural analyses using SEM(scanning electron microscopy). The subjects of the study were 19 silicone nasal implants removed by revision rhinoplasty, all displaying calcification. According to the tissue characters, the implant surface was divided into 4 zones with the rhinion as the basis. For each zone, elemental and ultrastructural analyses were performed. Elemental analysis revealed that the calcium deposits consisted of Ca and P only. There were no statistically significant disparities among the ratios between Ca and P according to the zones. Ultrastructural analysis showed acellular mineral-like deposits coalesced to create amorphous deposits in all zones; however, in zones 1 and 3(more pressurized zones by periosteum or nasal bone), additional flaky cylinder-shaped calcium deposits were detected. Thus, it seems that the histological disparities in the surrounding tissues do not affect the components and their proportions in the calcification process. However, it can be inferred that the physical environment due to the histological disparities in the surrounding tissues affects the ultrastructures of calcium deposits.

Distorted perception of 3D slant caused by disjunctive-eye-movements (반향 눈 운동에 의한 3차원 경사의 왜곡된 지각)

  • 이형철;감기택;김은수;윤장한
    • Korean Journal of Cognitive Science
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    • v.13 no.2
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    • pp.37-45
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    • 2002
  • Despite dynamical retinal image changes caused by pursuit eye movements, we usually perceive the stable spatial properties of the environment suite successfully Helmholtz and his followers have suggested that the visual system coordinates the retinal and extraretinal eye position information to represent the spatial properties of the environment. However. there have been a significant amount of researches showing that this kind of mechanism may not operate perfectly, and the pursuit eye movement employed in those researches were limited to conjugate eye movements. When an observer tracks an object moving away from the observer with his/her eyes. the two eyes rotate in opposite direction. and this kind of disjunctive eye movement may produce undesirable binocular disparities for the objects in the background. The present study examined whether the visual system compensated for the undesirable binocular disparities caused by disjunctive eye movements with extraretinal eye position information. Although the target object was presented frontoparellely to the subjects. the subjects reported that the object was slanted toward (or alway from) them in consistent with the undesirable binocular disparities produced by the disjunctive eye movements. These results imply that the visual system may not perfectly compensate for the undesirable binocular disparities with extraretinal eye position information.

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Feature-Based Disparity Estimation for Intermediate View Reconstruction of Multiview Images (3차원 영상의 중간시점 영상 합성을 위한 특징 기반 변이 추정)

  • 김한성;김성식;손정영;손광훈
    • The Journal of Korean Institute of Communications and Information Sciences
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    • v.26 no.11A
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    • pp.1872-1879
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    • 2001
  • As multiview video applications become more popular, correspondence problem for stereo image matching plays an important role in expanding view points. Thus, we propose an efficient dense disparity estimation algorithm considering features of each image pair of multiview image sets. Main concepts of the proposed algorithm are based on the region-dividing-bidirectional-pixel-matching method. This algorithm makes matching process efficient and keeps the reliability of the estimated disparities. Other improvement have obtained by proposed cost function, matching window expanding technique, disparity regularization, and disparity assignment in ambiguous region. These techniques make disparities more stable by removing false disparities and ambiguous regions. The estimated disparities are used to synthesize intermediate views of multiview images. Computer simulation demonstrates the excellence of the proposed algorithm in both subjective and objective evaluations. In addition, processing time is reduced as well.

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Disparities in Health Care Utilization Among Urban Homeless in South Korea: A Cross-Sectional Study

  • Yoon, Chang-Gyo;Ju, Young-Su;Kim, Chang-Yup
    • Journal of Preventive Medicine and Public Health
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    • v.44 no.6
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    • pp.267-274
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    • 2011
  • Objectives: We examined health care disparities in Korean urban homeless people and individual characteristics associated with the utilization of health care. Methods: We selected a sample of 203 homeless individuals at streets, shelters, and drop-in centers in Seoul and Daejeon by a quota sampling method. We surveyed demographic information, information related to using health care, and health status with a questionnaire. Logistic regression analysis was adopted to identify factors associated with using health care and to reveal health care disparities within the Korean urban homeless population. Results: Among 203 respondents, 89 reported that they had visited health care providers at least once in the past 6 months. Twenty persons (22.5%) in the group that used health care (n = 89) reported feeling discriminated against. After adjustment for age, sex, marital status, educational level, monthly income, perceived health status, Beck Depression Inventory score, homeless period, and other covariates, three factors were significantly associated with medical utilization: female sex (adjusted odds ratio [aOR, 15.95; 95% CI, 3.97 to 64.04], having three or more diseases (aOR, 24.58; 95% CI, 4.23 to 142.78), and non-street residency (aOR, 11.39; 95% CI, 3.58 to 36.24). Conclusions: Health care disparities in Seoul and Daejeon homeless exist in terms of the main place to stay, physical illnesses, and gender. Under the current homeless support system in South Korea, street homeless have poorer accessibility to health care versus non-street homeless. To provide equitable medical aid for homeless people, strategies to overcome barriers against health care for the street homeless are needed.

Exploring Regional Disparities in Unmet Healthcare Needs and Their Causes in South Korea: A Policy-Oriented Study (한국 미충족 의료 니즈 수준 및 발생 사유의 거주지역 간 격차 분석과 정책적 시사점)

  • Woojin Chung
    • Health Policy and Management
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    • v.33 no.3
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    • pp.273-294
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    • 2023
  • Background: Most developed countries are working to improve their universal health coverage systems. This study investigates regional disparities in unmet healthcare needs and their causes in South Korea. Additionally, it compares the unmet healthcare needs rate in South Korea with that of 33 European countries. Methods: The analysis incorporates information from 13,359 adults aged 19 or older, using data from the Korea Health Panel. The dependent variables encompass the experience of unmet healthcare needs and the three causes of occurrence: "burden of medical expenses," "time constraints," and "lack of care." The primary variable of interest is the region of residence, while control variables encompass 14 socio-demographic, health, and functional characteristics. Multivariable binary logistic regression analysis, accounting for the sampling design, is conducted. Results: The rate of unmet healthcare needs in Korea is 11.7% (95% confidence interval [CI], 11.0%-13.3%), which is approximately 30 times higher than that of Austria (0.4%). The causes of unmet healthcare needs, ranked in descending order, are "lack of care," "time constraints," and "burden of medical expenses." Predictive probabilities for experiencing unmet healthcare needs and each cause differ significantly between regions. For instance, the probability of experiencing unmet healthcare needs due to "lack of care" is approximately 10 times higher in Gangwon-do (13.5%; 95% CI, 13.0%-14.1%) than in Busan (1.3%; 95% CI, 1.3%-1.4%). The probability due to "burden of medical expenses" is approximately 14 times higher in Seoul (4.1%; 95% CI, 3.6%-4.6%) compared to Jeollanam-do (0.3%; 95% CI, 0.2%-0.4%). Conclusion: Amid rapid sociodemographic transitions, South Korea must make significant efforts to alleviate unmet healthcare needs and the associated regional disparities. To effectively achieve this, it is recommended that South Korea involves the National Assembly in healthcare policy-making, while maintaining a centralized financing model and delegating healthcare planning and implementation to regional authorities for their local residents-similar to the approaches of the United Kingdom and France.

Trends in Regional Disparities in Cardiovascular Surgery and Mortality in Korea: A National Cross-sectional Study

  • Dal-Lae Jin;Kyoung-Hoon Kim;Euy Suk Chung;Seok-Jun Yoon
    • Journal of Preventive Medicine and Public Health
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    • v.57 no.3
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    • pp.260-268
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    • 2024
  • Objectives: Regional disparities in cardiovascular care in Korea have led to uneven patient outcomes. Despite the growing need for and access to procedures, few studies have linked regional service availability to mortality rates. This study analyzed regional variation in the utilization of major cardiovascular procedures and their associations with short-term mortality to provide better evidence regarding the relationship between healthcare resource distribution and patient survival. Methods: A cross-sectional study was conducted using nationwide claims data for patients who underwent coronary artery bypass grafting (CABG), percutaneous coronary intervention (PCI), stent insertion, or aortic aneurysm resection in 2022. Regional variation was assessed by the relevance index (RI). The associations between the regional RI and 30-day mortality were analyzed. Results: The RI was lowest for aortic aneurysm resection (mean, 26.2; standard deviation, 26.1), indicating the most uneven regional distribution among the surgical procedures. Patients undergoing this procedure in regions with higher RIs showed significantly lower 30-day mortality (adjusted odds ratio [aOR], 0.73; 95% confidence interval, 0.55 to 0.96; p=0.026) versus those with lower RIs. This suggests that cardiovascular surgery regional availability, as measured by RI, has an impact on mortality rates for certain complex surgical procedures. The RI was not associated with significant mortality differences for more widely available procedures like CABG (aOR, 0.96), PCI (aOR, 1.00), or stent insertion (aOR, 0.91). Conclusions: Significant regional variation and underutilization of cardiovascular surgery were found, with reduced access linked to worse mortality for complex procedures. Disparities should be addressed through collaboration among hospitals and policy efforts to improve outcomes.

Semantic Modeling for SNPs Associated with Ethnic Disparities in HapMap Samples

  • Kim, HyoYoung;Yoo, Won Gi;Park, Junhyung;Kim, Heebal;Kang, Byeong-Chul
    • Genomics & Informatics
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    • v.12 no.1
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    • pp.35-41
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    • 2014
  • Single-nucleotide polymorphisms (SNPs) have been emerging out of the efforts to research human diseases and ethnic disparities. A semantic network is needed for in-depth understanding of the impacts of SNPs, because phenotypes are modulated by complex networks, including biochemical and physiological pathways. We identified ethnicity-specific SNPs by eliminating overlapped SNPs from HapMap samples, and the ethnicity-specific SNPs were mapped to the UCSC RefGene lists. Ethnicity-specific genes were identified as follows: 22 genes in the USA (CEU) individuals, 25 genes in the Japanese (JPT) individuals, and 332 genes in the African (YRI) individuals. To analyze the biologically functional implications for ethnicity-specific SNPs, we focused on constructing a semantic network model. Entities for the network represented by "Gene," "Pathway," "Disease," "Chemical," "Drug," "ClinicalTrials," "SNP," and relationships between entity-entity were obtained through curation. Our semantic modeling for ethnicity-specific SNPs showed interesting results in the three categories, including three diseases ("AIDS-associated nephropathy," "Hypertension," and "Pelvic infection"), one drug ("Methylphenidate"), and five pathways ("Hemostasis," "Systemic lupus erythematosus," "Prostate cancer," "Hepatitis C virus," and "Rheumatoid arthritis"). We found ethnicity-specific genes using the semantic modeling, and the majority of our findings was consistent with the previous studies - that an understanding of genetic variability explained ethnicity-specific disparities.

Multi-Range Approach of Stereo Vision for Mobile Robot Navigation in Uncertain Environments

  • Park, Kwang-Ho;Kim, Hyung-O;Baek, Moon-Yeol;Kee, Chang-Doo
    • Journal of Mechanical Science and Technology
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    • v.17 no.10
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    • pp.1411-1422
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    • 2003
  • The detection of free spaces between obstacles in a scene is a prerequisite for navigation of a mobile robot. Especially for stereo vision-based navigation, the problem of correspondence between two images is well known to be of crucial importance. This paper describes multi-range approach of area-based stereo matching for grid mapping and visual navigation in uncertain environment. Camera calibration parameters are optimized by evolutionary algorithm for successful stereo matching. To obtain reliable disparity information from both images, stereo images are to be decomposed into three pairs of images with different resolution based on measurement of disparities. The advantage of multi-range approach is that we can get more reliable disparity in each defined range because disparities from high resolution image are used for farther object a while disparities from low resolution images are used for close objects. The reliable disparity map is combined through post-processing for rejecting incorrect disparity information from each disparity map. The real distance from a disparity image is converted into an occupancy grid representation of a mobile robot. We have investigated the possibility of multi-range approach for the detection of obstacles and visual mapping through various experiments.

Hierarchical Disparity Estimation for Image Synthesis in Stereo Mixed Reality (스테레오 혼합 현실 영상 합성을 위한 계층적 변이 추정)

  • 김한성;최승철;손광훈
    • Journal of Broadcast Engineering
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    • v.7 no.3
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    • pp.229-237
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    • 2002
  • Natural synthesis of real and virtual images is a key technology in mixed reality. For this purpose, we propose an efficient dense disparity estimation algorithm and a synthesis algorithm considering features of stereo images. Dense disparities are estimated hierarchically from the low to high resolution images. In the process, the region-dividing-bidirectional-matching algorithm makes matching process efficient and keeps the reliability of the estimated disparities, and dense disparities are assigned considering edge information. finally, mixed reality stereo images are synthesized by comparing depth data of real and virtual Images. Computer simulation shows that the proposed algorithms estimate very stable disparity vectors with sharp edge and synthesize natural stereo mixed reality images.