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This study investigated the incidence and risk factors of mortality in 2,476 patients with variant angina (VA) using the National Health Insurance Service-National Sample Cohort between 2004 and 2011. The risk factors of all-cause and cardiac mortality were investigated using Cox proportional hazards model. Most patients (69.5%) were less than 65 years and 42.9% were women. During the median follow-up duration of 4.9 years, there were 178 (7.2%) and 95 (3.8%) cases of all-cause and cardiac mortality, respectively. Older age, hypertension, diabetes mellitus, poor medication adherence, low household income and tertiary teaching hospitals were independent predictors for all-cause mortality, while older age, hypertension, low household income and tertiary teaching hospitals were independent predictors for cardiac mortality. In conclusion, our findings suggest that traditional risk factor control and continued medication are important to improve VA outcomes, and that household income-level factors should be considered in the assessment of risk of VA patients. [ABSTRACT FROM AUTHOR]

For ideal clinical benefit, human immunodeficiency virus (HIV)-infected individuals should receive continuous medication. This is the first nationwide antiretroviral therapy (ART) adherence study in Asia, where medication monitoring at national level is systemically available. We estimated the ART adherence of incident HIV-infected individuals and investigated factors affecting low medication adherence using the national health insurance (NHI) claims data from 2007 to 2016. Medication possession ratio (MPR) was used to measure medication adherence and risk factors were identified by multivariable logistic regression analysis. Of the 8,501 newly diagnosed HIV-infected individuals during 2009-2016 with at least one ART prescription, 70.4% of HIV patients had adequate adherence to ART defined as MPR ≥95%. Requiring prophylactic antibiotics, female gender, age of 0-19 and same or over 50 s compared to 30-39, and having a history of malignancy, lower socioeconomic status, not visiting tertiary hospital, and being diagnosed in the earlier years were risk factors for lower adherence (Odds ratio 1.7, 1.6, 1.6, 1.4, 1.6, 2.1, 1.2, and 1.6 to 3.8 respectively). Health authority should take into consideration of these modifiable and unmodifiable barriers to establish sustainable monitoring system at national level and to improve adherence.

Cadmium (Cd) is an environmental contaminant that exhibits renal toxicity. The target transcription factors involved in Cd renal toxicity are still unknown. In this study, we demonstrated that Cd decreased the activity of the ARNT transcription factor, and knockdown of ARNT significantly decreased the viability of human proximal tubular HK-2 cells. Microarray analysis in ARNT knockdown cells revealed a decrease in the expression of a number of genes, including a known apoptosis inhibitor, BIRC3, whose gene and protein expression level was also decreased by Cd treatment. Although the BIRC family consists of 8 members, Cd suppressed only BIRC3 gene expression. BIRC3 is known to suppress apoptosis through the inhibition effect on caspase-3. Knockdown of BIRC3 by siRNA as well as Cd treatment increased the level of active caspase-3. Moreover, knockdown of BIRC3 not only triggered cell toxicity and apoptosis but also strengthened Cd toxicity in HK-2 cells. Meanwhile, the activation of caspase-3 by suppression of BIRC3 gene expression was mostly specific to Cd and to proximal tubular cells. These results suggest that Cd induces apoptosis through the inhibition of ARNT-regulated BIRC3 in human proximal tubular cells.

The Holocene variability in the East Asian summer monsoon (EASM) based on speleothem δ 18 O records has inconsistencies in timing, duration, and expression of millennial-scale events among nearby regions, and even within the same cave. Here, we present another stalagmite δ 18 O record with multi-decadal time resolution from the temperate Korean Peninsula (KP) for the last 5500 years in order to compare with Holocene millennial-scale EASM events from Southeast Asia. Based on our new stalagmite δ 18 O record, millennial-scale events since the mid-Holocene were successfully identified in the KP, representing a noticeable cyclic pattern with a periodicity of around 1000 years. We propose that the Holocene millennial-scale events are common hydroclimatic phenomena at least in the East Asian monsoon system. Meanwhile, the shorter periodicity of millennial-scale events than that of the North Atlantic region is likely to decouple the EASM system from the North Atlantic climate system. This observation suggests that weak EASM and North Atlantic Bond events may have been induced independently by direct solar activity (and then possible feedback) and ocean-ice sheet dynamics, respectively, rather than simple propagation from the North Atlantic to the EASM regions.

We aimed to assess utility weight of health states associated with colorectal cancer (CRC) that reflect the societal preference of the Korean population and to estimate the quality-adjusted life year (QALY) loss with CRC. We recruited 607 individuals from the Korean population; they were surveyed via face-to-face computer-assisted interviews. The participants evaluated each CRC-associated health state using standard gamble. Utility weight for each health state was calculated as the possibility of full health restoration. Moreover, we estimated total QALY loss due to CRC in Korean individuals aged ≥30 years in 2013. To calculate QALY due to morbidity, we yielded utility weights and used epidemiologic data of CRC on severity from the National Cancer Control Institute. QALY loss due to mortality was calculated using mortality of CRC and life expectancy data from the Korean Statistical Information Service. The highest and lowest utility weights were assigned to "adenomatous polyps" and "metastatic colon cancer", respectively. Total QALY loss due to CRC in Korea was 173,662; these patients were more likely to be men or be included in the 70-74-year age group. These utility weights may be useful for conducting cost-utility studies of cancer screening for CRC and for measuring disease burden with QALY.

The electronic and optical properties of graphene are greatly dependent on the the number of layers. For the precise control of the graphene layers, atomic layer etching (ALE), a cyclic etching method achieved through chemical adsorption and physical desorption, can be the most powerful technique due to barely no damage and no contamination. In this study, we demonstrated the ALE process of graphene layers without noticeably damaging the graphene by using a controlled low energy oxygen (O 2 + /O + )-ion for chemical adsorption and a low energy Ar + -ion (11.2 eV) for physical desorption. In addition, using a trilayer graphene, mono- and bi-layer graphene could be successfully fabricated after one- and two-cycle ALE of the trilayer graphene, respectively. We believe that the ALE technique presented herein can be applicable to all layered materials such as graphene, black phosphorous and transition metal dichalcogenides which are important for next generation electronic devices.