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Introduction: The aim of our study is to analyze the association of usage and type of warming device with the risk of surgical site infection (SSI) in patients who underwent hip arthroplasty, and to analyze the factors that increase the risk of SSI if the warming device is not used. Materials and methods: This retrospective cross-sectional study identified subjects from data of "Evaluation of the Appropriate Use of Prophylactic Antibiotics". Included patients were defined as those who underwent elective unilateral hip hemiarthroplasty or total hip arthroplasty (THA). Patients were classified into no intraoperative warming device, forced air warming devices, and devices using conduction. Multiple logistic regression analysis was conducted to estimate adjusted odds ratios (aORs) and 95% confidence intervals (CIs) to assess the association between warming devices and SSI. Results: A total of 3945 patients met the inclusion criteria. Compared to those who received an intraoperative warming device, the odds of developing SSI were 1.9 times higher in those who did not receive intraoperative warming devices (aOR 1.9; 95% CI 1.1–3.6). The risk of SSI was 2.2 times higher with forced air warming devices compared to devices using conduction but this difference was not statistically significant (aOR 2.2; 95% CI 0.7–6.8). The risk of SSI increased in males (aOR 2.8; 95% CI 1.1–7.2), in patients under 70 years of age (aOR 4.4; 95% CI 1.6–10.4), in patients with a Charlson's comorbidity index of 2 or higher (aOR 3.3; 95% CI 1.3–8.7), and in patients who underwent THA (aOR 3.8; 95% CI 1.7–8.3) when intraoperative warming devices were not used. Conclusions: The use of intraoperative active warming devices is highly recommended to prevent SSI during elective hip arthroplasty. In particular, male patients younger than 70 years, those with a high CCI, and those undergoing THA are at significantly increased risk of SSI if intraoperative active warming devices are not used. Intraoperative warming device using conduction is likely superior to forced air warming device, but further studies are needed to confirm this. [ABSTRACT FROM AUTHOR]

Post-traumatic stress disorder (PTSD) is associated with the development of dementia; however, the association of dementia risk with overall stress-related disorders is less known. This study investigated the association between stress-related disorders and the risk of dementia in a Korean nationwide sample cohort. The data analyzed in this study were acquired from the Korean National Health Insurance Service National Sample Cohort between 2002 and 2013. Using a 1:3 propensity score matching, 8906 patients with stress-related disorders and 26,718 control participants were included in the analysis. Patients with stress-related disorders had a higher risk of developing dementia after adjusting for covariates (hazard ratio [HR] = 1.15; 95% confidence interval [CI] 1.01–1.30) than control participants. Patients with PTSD showed the highest risk of increase (HR = 1.78) than those with other types of stress-related disorders. Patients with stress-related disorders showed the highest and significantly increased risk for Alzheimer's dementia (HR = 1.22, 95% CI 1.04–1.56). These results indicated an association between a history of stress-related disorders and the risk of dementia in the South Korean population. Further research investigating the causal mechanisms is needed. [ABSTRACT FROM AUTHOR]

Complications of the endotracheal tube (ETT) displacement during head and neck positional changes are related to not only the tip position but also the cuff pressure against the larynx. Here, we evaluated movement of the ETT cuff relative to laryngeal structures as well as tip displacement from the carina. Sixty-two patients scheduled for thyroidectomy were recruited. The distance from the cricoid cartilage to the upper margin of the cuff (CC) and that from the ETT tip to the carina (TC) were measured using ultrasonography and fiberoptic bronchoscopy, respectively, during flexion and extension. The total tracheal length (TTL) was defined as the combination of CC, TC, and the distance from the upper margin of the cuff to the tip. During flexion, the CC and TC were 1.5 ± 0.6 and 2.9 ± 1.0 cm respectively. Seven patients (11.7%) exhibited excessively deep intubation. After adjusting the cuff position under ultrasonography (CC = 0), the tip position was corrected in 96.7%. While the TC increased by 2.1 ± 1.0 cm after the positional change in extension, the CC decreased by 0.6 ± 0.7 cm because the TTL lengthened (1.4 ± 1.1 cm). Four patients (6.7%) exhibited excessive cuff displacement beyond the cricoid cartilage, which could have been corrected under ultrasonography. In conclusion, the ETT cuff displaced toward the larynx in a less degree than the tip did from the carina due to the tracheal lengthening during head and neck extension. Nevertheless, we suggest that ultrasonographic assessment of cuff position may avoid ETT misplacement. Trial registrationhttps://cris.nih.go.kr/ (approval no. KCT0005319); registered on May 14, 2019. [ABSTRACT FROM AUTHOR]

There is a clear relationship between rheumatoid arthritis (RA) and major osteoporotic fracture (MOF), although there is limited evidence on the effect of continuity of care (COC) on MOF in these patients. We investigated the association between COC and risk of MOF, including fractures of the lumbar spine and pelvis, forearm, and hip, among newly diagnosed RA patients aged ≥ 60 years. A total of 8715 incident RA patients from 2004 to 2010 were included from the Korean National Health Insurance Service-Senior cohort database. Participants were categorized into a good and bad COC group according to the COC index. The cumulative incidence of MOF was higher in RA patients with bad than in those with good COC (p < 0.001). The incidence rates of MOF were 4439 and 3275 cases per 100,000 person-years in patients with bad and good COC, respectively. RA patients with bad COC had an increased incidence of overall MOF (adjusted hazard ratio, 1.32; 95% confidence interval, 1.14–1.53), with the highest increase in risk being that of forearm fracture. An increased MOF risk in patients with bad COC was predominantly observed in females. This study suggested that interventions that can improve COC in patients with RA should be considered. [ABSTRACT FROM AUTHOR]

Circadian misalignment caused by differences in sleep duration between weekends and weekdays may be associated with adolescent mental health and sleep quality may be able to compensate for this problem. This study aimed to investigate the association between weekend catch-up sleep (CUS) ratio and sleep quality with depressive symptoms and suicidal ideation among South Korean adolescents. We used data from the Korea Youth Risk Behavior Web-based Survey 2015–2019 involving 270,619 adolescents. The weekend CUS ratio was calculated by dividing the average weekend sleep duration by the average weekday sleep duration (< 1.00, 1.00 ≤ CUS < 1.50, or ≥ 1.50). Subjective sleep quality was categorized as poor, moderate, or good. Multiple logistic regression analyses were performed. A weekend CUS ratio of < 1.00 and poor sleep quality was significantly associated with mental health. Absolutely short sleep duration (CUS < 1.00 and weekday sleep duration < 5 h) was most associated with depressive symptoms and suicidal ideation. Furthermore, adolescents with a CUS ratio of ≥ 1.50 showed increased odds of depressive symptoms despite having good sleep quality. Appropriate weekend CUS may benefit adolescents' mental health. When investigating the relationship between adolescents' sleep and mental health, a weekend CUS ratio should be considered in addition to sleep quality and duration. [ABSTRACT FROM AUTHOR]

Recent studies suggest that sensory impairment is related to cognitive function at older ages. Therefore, we aimed to investigate the impact of sensory impairment on cognitive function in the Korean population. We used the Korean Longitudinal Study of Aging data from 2006 to 2018. Cognitive function was measured by the Korean version of the Mini-Mental State Examination scale. A score < 24 at the time of assessment was defined as cognitive impairment. Sensory impairment was assessed according to the self-reported levels of hearing or vision, and the development of sensory impairment was investigated using records of prior survey. We used the generalized estimating equation model to determine association between cognitive function and sensory impairment. A total of 4844 participants (age range: 47–95 years; mean age: 58) were included in the study. Compared to people without sensory impairment, people with a single sensory impairment of hearing or vision had a higher risk of cognitive impairment (odds ratio (OR) = 1.65 [95% confidence interval (CI), 1.49–1.82]). People with dual sensory impairment had the greatest risk of cognitive impairment (OR = 3.23 [95% CI, 2.52–4.12]). The findings suggested the need for timely assessment of sensory function in older persons, which may be useful in identifying individuals at risk for cognitive impairment. [ABSTRACT FROM AUTHOR]

This study aimed to determine whether significant associations exist between multicultural families and adolescent smoking risks in South Korea. Data from the Korea Youth Risk Behavior Web-based survey from 2016 to 2020 were analyzed. Participants were classified into four family types (South Korean mother–foreign father, South Korean father–foreign mother, both foreign parents, and both South Korean parents) according to their parents' country of birth and smoking was assessed using a self-reported questionnaire. A logistic regression analysis was used to examine the significance of the associations. Overall, 194,259 participants (boys: 94,793, girls: 99,466) enrolled in this study. Adolescents whose parents were born overseas were more likely to smoke than native South Korean adolescents (boys: odds ratio [OR] = 2.61, confidence interval [CI] = 1.79–3.81, girls: OR 3.94, CI 2.42–6.43). When the mother's country of birth was a developing country, there was an increased likelihood of girls smoking, and there was an increased likelihood of smoking among boys when the mother's country of birth was North Korea. When both parents were born abroad, and the mother's country of birth was a developing country, the likelihood of smoking risks among their multicultural teenage children increased. Policies and interventions need to be established and implemented to lower the smoking rate among multicultural teenagers. [ABSTRACT FROM AUTHOR]

Background: Studies investigating the association between migraine and dementia have reported inconsistent findings. This study aimed to evaluate whether patients with migraine have an increased risk of dementia compared to individuals without migraine. Methods: We obtained data from the 2002–2019 Korean National Health Insurance Health Screening Cohort. Non-migraine controls were selected using a 1:1 risk-set matching with a time-dependent propensity score. The main outcome was the development of all-cause dementia, and the secondary outcome was the development of each cause of dementia (Alzheimer's, vascular, mixed or other specified, and unspecified dementia). The incidence rate of dementia was calculated using Poisson regression, and the association between migraine and dementia was evaluated using Cox proportional hazards regression. Results: Among 88,390 participants, 66.1% were female, and the mean baseline age was 55.3 ± 9.4 years. During the study period, dementia cases were identified in 4,800 of the 44,195 patients with migraine and 3,757 of the 44,915 matched controls. The incidence rate of dementia was 139.6 (95% confidence interval [CI], 135.7–143.5) and 107.7 (95% CI, 104.3–111.1) cases per 10,000 person-years in patients with migraine and matched controls, respectively. Patients with migraine had a 1.30 (hazard ratio [HR], 1.30; 95% CI, 1.25–1.35), 1.29 (HR, 1.29; 95% CI, 1.23–1.35), 1.35 (HR, 1.35; 95% CI, 1.19–1.54), 1.36 (HR, 1.36; 95% CI, 1.00–1.83), and 1.30 (HR, 1.30; 95% CI, 1.17–1.45) times higher risk of developing all-cause dementia, Alzheimer's dementia, vascular dementia, mixed or other specified dementias, and unspecified dementia than their matched controls, respectively. Conclusion: Our results suggest that migraine is associated with an increased risk of subsequent dementia. Further research is warranted to confirm these findings and to reveal the underlying mechanisms. [ABSTRACT FROM AUTHOR]

Depression in older adults is a global socioeconomic burden. Identifying factors, such as physical activity or exercise that can help prevent depression is important. We aimed to investigate the relationship between changes in handgrip strength and the presence of depression using longitudinal, nationwide data of older Korean adults. Data from the Korean Longitudinal Study of Aging were used in this study. A total of 6783 participants who had undergone a handgrip strength test and completed the short-form Center for Epidemiologic Studies Depression Scale (CESD-10-D) questionnaire from 2006 to 2018 were included. General estimating equations were used to assess the temporal effect of the changes in handgrip strength on depression. A decrease in handgrip strength was associated with high CESD-10-D scores (β = 0.1889 in men, β = 0.1552 in women). As a continuous variable, handgrip strength was negatively correlated with CESD-10-D scores(β = − 0.0166 in men, β = − 0.0196 in women). Changes in the handgrip strength were associated with depressive symptoms in our longitudinal study. Those who experienced a decrease in handgrip strength had severe depressive symptoms compared to those with unchanged or increased handgrip strength. These findings can be used to guide general health policies for the prevention of depression. [ABSTRACT FROM AUTHOR]

Although previous studies have demonstrated increased depression related to COVID-19, the reasons for this are not well-understood. We investigated the association of compliance with COVID-19 public health measures with depression. Data from the 2020 Korea Community Health Survey were analyzed. The main independent variable was compliance with rules based on three performance variables (social distancing, wearing a mask in indoor facilities, and outdoors). Depression was assessed using Patient Health Questionnaire-9 scores. Of 195,243 participants, 5,101 participants had depression. Bad and moderate performance scores for compliance were associated with depression (Bad score, men: adjusted odds ratio [aOR] = 2.24, 95% confidence interval [CI] = 1.29–3.87; women: aOR = 2.42, 95% CI = 1.42–4.13; moderate score, men: aOR = 1.31, 95% CI = 1.02–1.68; women: aOR = 1.28, 95% CI = 1.07–1.53). In the subgroup analysis, among the quarantine rules, not wearing a mask indoors was the most prominently associated with depression. In participants with a high level of education, non-compliance with quarantine rules was significantly associated with depression. People who do not comply with public health measures are more likely to be depressed. The preparation and observance of scientific quarantine rules can help mental health in the ongoing COVID-19 pandemic and another infectious disease pandemic that may come. [ABSTRACT FROM AUTHOR]

Oxidative stress plays important roles in inflammatory responses during acute lung injury (ALI). Recently, nanoconstruct (Nano)-based drug-delivery systems have shown promise in many models of inflammation. In this study, we evaluated the anti-inflammatory effects of N-acetylcysteine (NAC) loaded in a biocompatible Nano using a rat model of ALI. We synthesized a Nano with a good NAC-releasing capacity using porous silica Nano, which was used to produce Nano/NAC complexes. For in vivo experiments, Sprague–Dawley rats were intraperitoneally administered NAC or Nano/NAC 30 min after intratracheal instillation of lipopolysaccharide. After 6 h, bronchoalveolar lavage fluids and lung tissues were collected. The anti-oxidative effect of the Nano/NAC complex was confirmed by demonstrating reduced levels of reactive oxygen species after treatment with the Nano/NAC in vitro. In vivo experiments also showed that the Nano/NAC treatment may protect against LPS‐induced ALI thorough anti‐oxidative and anti‐inflammatory effects, which may be attributed to the inactivation of the NF‐κB and MAPK pathways. In addition, the effects of Nano/NAC treatment were shown to be superior to those of NAC alone. We suggest the therapeutic potential of Nano/NAC treatment as an anti‐inflammatory agent against ALI. Furthermore, our study can provide basic data for developing nanotechnology-based pharmacotherapeutics for ALI. [ABSTRACT FROM AUTHOR]

Subunit vaccines have been developed as promising vaccines with safety. However, subunit vaccines have difficulties in commercialization due to low efficiencies of delivery and immune response. As a result, studies of adjuvants that improve the immune-inducing ability of vaccines have been conducted globally. Aluminum salts (alum) have been extensively used as vaccine adjuvants, but they cannot induce potent cellular immunity. In this study, chitosan particles were fabricated by the precipitation-coacervation method on four different conditions. Ovalbumin (OVA), as a model antigen, was encapsulated in chitosan particles. The optimized fabrication conditions of chitosan particles were 8 mL/min drop rate of sodium sulfate and 0.5 mg/mL chitosan concentration in a sonication bath. Properties of the optimized chitosan particle were about 300 nm diameter, 0.1 polydispersity index, 16.2 mV zeta potential, and 90% loading efficiency. Chitosan particle-containing OVA showed 76% uptake efficiency by mouse macrophage cells and suitable cell viability. Immunization of mice by chitosan particles exhibited IgG1 titer and Interleukin-4 production of a similar level with the alum. Moreover, chitosan particles showed significantly enhanced IgG2 titer and Interferon-gamma production related to Th1-mediated cellular immune response. These results indicated that chitosan particles could be expected to be a promising adjuvant inducing cellular and humoral immunity for subunit vaccine delivery. [ABSTRACT FROM AUTHOR]

Magnetic nanoparticles have been applied in various fields because of their interesting magnetic properties. Immobilization on magnetic nanoparticles is a very important step in functionalizing them. We examined protein immobilization efficiency using interactions between his-tagged enhanced green fluorescence protein and affordable cationic ferrite magnetic nanoparticles for the first time. Four types of ferrite magnetic nanoparticles were verified: cobalt iron oxide, copper iron oxide, nickel iron oxide, and iron (III) oxide as negative controls. Among the four ferrite magnetic nanoparticles, copper ferrite magnetic nanoparticle was confirmed to have the highest immobilization efficiency at 3.0 mg proteins per gram ferrite magnetic nanoparticle and 78% of total enhanced green fluorescence protein. In addition, the maximum binding efficiency was determined for copper ferrite magnetic nanoparticle. Consequently, this newly verified his-tag-immobilizing capacity of copper ferrite magnetic nanoparticle could provide a facile, capable, and promising strategy for immobilizing his-tagged proteins or peptides with high purity for biosensors, magnetic separation, or diagnostics. [ABSTRACT FROM AUTHOR]

Transdermal drug delivery systems have been studied as an attractive alternative to conventional delivery routes. However, the outermost layer of the skin, the stratum corneum, acts as a primary barrier to drug delivery. A synergistic combination of microneedles (MNs) and low-frequency ultrasound (U) was used to enhance the penetration of siRNA and ovalbumin. The specific gene knockdown caused by siRNAs through the RNA interference pathway is more stable when delivered via the transdermal route. Ovalbumin, a representative adjuvant, causes a more efficient immune response in the skin because of the numerous immune cells in the skin. The synergistic transdermal delivery resulted in approximately 7 times and 15 times greater penetration of siRNA and ovalbumin respectively than in their respective negative controls, and histological analysis showed minimal invasion. Thus, as the synergistic transdermal delivery enhanced the penetration of biomacromolecules into the skin, this technique is expected to yield a promising technology for a transdermal drug delivery system. [ABSTRACT FROM AUTHOR]

Correction to: I Scientific Reports i https://doi.org/10.1038/s41598-022-20791-7, published online 12 October 2022 The original version of this Article contained errors in Table 1, where there was a missing value in a row under "Smoking exposure at home - Yes" in column "Girls - No - N". [Extracted from the article]

Fibrous polyp of the gallbladder is a rare variant of benign gallbladder polyp. Differentiation between a benign polyp and polypoid carcinoma of the gallbladder is often difficult when the polyp is more than 1 cm in diameter. We report a rare case of a large fibrous polyp of the gallbladder mimicking a carcinoma. A 44-year-old Korean woman who presented with abdominal pain was diagnosed with a large gallbladder polyp, measuring 1.26 cm in diameter, by abdominal ultrasonography. The lesion was echogenic with a nodular surface on ultrasonography, and showed contrast enhancement on computed tomography. Neither evidence of infiltration into the gallbladder wall nor lymph node enlargement was shown. The resected gallbladder showed a 1.2 × 0.8-cm-sized polyp with a nodular surface. Histologically, it showed a leaf-like configuration and loose or cellular connective stroma containing scattered duct-like structures, varying-sized vessels, and patchy infiltration of chronic inflammatory cells. Stromal cells were immunoreactive for vimentin and smooth-muscle actin and negative for S-100 protein and desmin. Large fibrous polyps of the gallbladder should be considered in the differential diagnosis of benign and malignant polypoid lesions of the gallbladder. [ABSTRACT FROM AUTHOR]

Objective. To analyze the findings of intramuscular vascular malformations of an extremity on MR imaging and to correlate these findings with histopathologic examination. Design and patients. The findings on MR imaging and the medical records of 14 patients with an intramuscular vascular malformation of the extremity were retrospectively studied. All patients underwent surgical excision. Diagnoses were based on the results of pathologic examination. Findings on MR imaging were noted and correlated with the histopathologic findings. Results. Intramuscular vascular malformations of an extremity showed multi-septate, honeycomb, or mixed appearance on MR imaging. Multi-septate areas correlated with dilated and communicating vascular spaces with flattened endothelium. Honeycomb areas corresponded to vascular spaces with inconspicuous small lumina and thickened vascular walls. Areas of increased signal intensity on T2-weighted images were found in all intramuscular vascular malformations. Infiltrative margins were more commonly seen in intramuscular lymphaticovenous malformations. Adherence to neurovascular structures and orientation of the lesion along the long axis of the affected muscle were more commonly seen in intramuscular venous malformations. Conclusions. Intramuscular vascular malformations showed either a multi-septate, honeycomb, or mixed appearance, reflecting the size of the vascular spaces and the thickness of the smooth muscles of the vessel walls. Prediction of the subtype of an intramuscular vascular malformation of an extremity on MR imaging seems to be difficult, although there are associated findings that may be helpful in the differential diagnosis of each subtype. [ABSTRACT FROM AUTHOR]