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This design-based study explored the digital and linguistic practices of South Korean adolescents from a rural area within the Write4Change global online community, emphasizing their use of image-driven tools. Framed within the cosmopolitan literacies perspective, these adolescents adeptly merge local and global dimensions, integrating their multilingual identities, and compelling visual narratives into their work. They navigate English, the dominant language of the online community, while incorporating multilingual elements to enrich community dialogues. These practices reflect their linguistic adaptability and digital literacies and underscore the significant role of cosmopolitan literacies in transforming literacy studies. The study highlights the impactful digital practices of South Korean adolescents, contributing to a broader understanding of inclusivity and diversity in global literacies.

Abstract Interstitial lung disease (ILD) leads to worse outcomes in subjects with rheumatoid arthritis (RA). Few large-scale longitudinal studies have provided comprehensive data on the incidence and risk of ILD in RA compared with non-RA populations. We compare the risk of incident ILD in subjects with RA and matched controls, while also evaluating the impact of RA serologic status. Using the Korean National Health Insurance Service Data between 2010 and 2017, we identified 52,325 individuals with RA and 261,625 without RA. During a median follow-up period of 4.4 years, 3.7% of the RA cohort and 0.5% of the matched cohort developed ILD, with incidence rates of 8.30 and 1.01 per 1,000 person-years. Compared to controls, the risk of incident ILD was significantly higher in the RA cohort (adjusted hazard ratio [aHR] 7.84 [7.29–8.44]), and seropositive and seronegative RA exhibited aHRs of 9.00 (8.34–9.72) and 4.81 (4.25–5.44). Although the risk of ILD was higher in seropositive RA than seronegative RA, the risk of developing ILD was also higher in subjects with seronegative RA than in matched controls, suggesting that close monitoring for ILD should be performed in this population.

Abstract Background The Citrus species are major fruit crops cultivated in the world and have complex genetic relationships due to sexual comparability between Citrus and related genera. Of these, satsuma mandarin (C. unshiu (Mak.) Marc.) and sweet orange (C. sinensis (L.) Osb.) are widely grown diploid species. In this study, genotyping by sequencing (GBS) was conducted to identify single nucleotide polymorphisms (SNPs) for investigating genetic variation in a citrus collection. Results A total of 26,903 high-quality SNPs were detected across nine chromosomes in the 144 citrus varieties, consisting of 70 C. unshiu, 40 C. sinensis, 22 interspecific hybrids, and 12 others. Of these, a core set of 481 SNPs was filtered based on polymorphism information content and genome distribution. Both principal component analysis (PCA) and model-based clustering showed genetic differentiation between C. unshiu and C. sinensis. For interspecific hybrids, these were separated from two species in PCA, but were mixed with each species in model-based clustering. Significant genetic differentiations between three populations were also found using the pairwise F st. In addition, interspecific hybrids showed higher level of genetic diversity relative to the C. unshiu and C. sinensis populations. With the 481 SNPs, four subsets (192, 96, 48, and 24 SNPs) were generated to evaluate their performance for variety identification. Both 192 and 96 SNP sets distinguished all 144 varieties, while the 48 and 24 SNP sets separated 134 (93.1%) and 110 (76.4%), respectively. Conclusions The GBS-based SNP discovery led to robust and cost-effective molecular marker sets to assess genetic variation in the cultivated citrus species with narrow genetic bases. The resulting SNP sets are a resource to enhance the phenotype-based DUS testing by developing a DNA barcode system and thus facilitate new variety breeding and protection in citrus.

Abstract Background Previous studies have shown that weight change has a reverse J-shape association with all-cause mortality. However, its association with suicide mortality remains undetermined. In this study, we investigated the association between weight change and suicide mortality using a large-scale, population-based cohort from the Korean National Health Insurance Service database. Methods A total of 2,103,525 subjects aged ≥ 20 years who underwent a general health screening program twice in the 2-year interval between 2007 and 2009 were included. Subjects were categorized into five groups according to the percent weight change during this period: severe weight loss (

Background: Interest in cardiac rehabilitation therapy has been increasing in Korea after the addition of cardiac rehabilitation as a benefit item in the National Health Insurance Service in 2017. However, few epidemiological studies have characterized cardiac rehabilitation in Korea. Objects: To assess the national epidemiological data on cardiac rehabilitation therapy in Korea from 2017 to 2023. Methods: This study analyzed MM453, a prescription code for cardiac rehabilitation therapy in the Health Insurance Review and Assessment database. The data reviewed included the total number of cases per year and the number of cardiac rehabilitation therapy prescriptions per 100,000 people, along with sex and age distribution of patients undergoing cardiac rehabilitation therapy. Results: The number of cardiac rehabilitation therapy prescriptions in Korea increased from 4,443 in 2017 to 15,646 in 2023 (252.1% increase in 7 years). The incidence per 100,000 person-years rose from 8.64 in 2017 to 30.22 in 2023. The number of males undergoing therapy increased from 3,183 (incidence: 12.35) in 2017 to 11,276 (incidence: 43.53) in 2023. The number of females undergoing therapy increased from 1,260 (incidence: 4.91) in 2017 to 4,370 (incidence: 16.89) in 2023. The highest number of patients undergoing therapy from 2017 to 2023 was observed in the 60s age group (patients: 4,747, incidence: 9.17), followed by the 70s, 50s, and > 80s age groups. Conclusion: From 2017 to 2023, the number of patients undergoing cardiac rehabilitation therapy in Korea increased consistently. The therapy is approximately 2.6 times more common in males than that in females and is predominantly administered to individuals in their 60s, followed by those in their 70s, 50s, and 80s and above.

Abstract Purpose During breast cancer surgery, the use of dyes such as indigo carmine, methylene blue, or indocyanine green (ICG) for targeting axillary lymph nodes (ALNs) under ultrasound guidance can result in rapid diffusion, complicated tissue differentiation, and disruption of staining. LuminoMark™, a novel ICG-hyaluronic acid mixture, can provide real-time visualization and minimize dye spread, thereby ensuring a clear surgical field. The aim of our study was to evaluate the efficacy of LuminoMark™ for targeting ALNs in patients with breast cancer. Methods A total of 13 patients with breast cancer (mean age 56.5 years; 92.3% female) and suspicious ALNs underwent targeted axillary surgery (TAS) with activated charcoal and LuminoMark™ injected into the LNs in the surgical field. The clinicopathological variables of the patients and diagnostic performance were assessed. The LNs injected with LuminoMark™ were examined for consistency with sentinel LNs (SLNs) and non-SLNs, as well as with charcoal-tattooed LNs. Results The identification of SLNs took approximately 15.6 min from the start of skin incision, and it required 25.6 and 17.7 min, for charcoal-tattooed and LuminoMarkTM-illuminated LNs, respectively. The identification rate was 92.3% with charcoal and 100% with LuminoMark™. The concordance rate between LuminoMark™ illumination and SLNs was higher than that between charcoal tattooing and SLNs. The concordance rate between the two methods was 76.9% (n = 10). Three months after surgery, the charcoal tattoo remained visible on the skin; however, LuminoMark™ was not visible. Conclusion Although both methods demonstrated high detection rates, the rate was higher using LuminoMark™. As LuminoMark™ was administered directly into LNs, this improved the accuracy of identifying LNs.

Abstract Aims An association between obesity, metabolic abnormalities and clinical hypertrophic cardiomyopathy (HCM) expression has been reported. We investigated whether managing dyslipidaemia with fibrates could affect the clinical expression of HCM. Methods We screened patients who used fibrates between 2010 and 2017 from a nationwide database. After excluding patients with a history of HCM, we identified fibrate‐user group (n = 412 823). We then constructed a 1:1 matched cohort of fibrate‐naïve participants (n = 412 823). After a 1 year lag period, we identified the incident HCM cases for the following 5 years. Results During a median follow‐up period of 3.96 years, we identified 454 incident clinical HCM cases. After adjusting for covariates, fibrate use was associated with a lower risk of clinical HCM expression [hazard ratio (HR) 95% confidence interval (CI): 0.763 (0.630–0.924)]. In subgroup analyses, fibrate use was associated with a reduced risk of clinical HCM expression in patients with a body mass index ≥25 kg/m2 and those with abdominal obesity [HR (95% CI): 0.719 (0.553–0.934) and 0.655 (0.492–0.872)], but not in those without obesity. Fibrate use was also associated with lower risks of incident clinical HCM in patients with triglyceride levels ≥150 mg/dL and those with metabolic syndrome [HR (95% CI): 0.741 (0.591–0.929) and 0.750 (0.609–0.923)], but not in their counterparts. Regarding lifestyle behaviours, fibrate use appeared to provide more prognostic benefits in patients who currently smoked, consumed alcohol or did not engage in regular physical activities. Conclusion The use of fibrates is associated with a lower incidence of clinical HCM expression. This association was also more prominent in those with obesity, unhealthy metabolic profiles and poor lifestyle behaviours.

Abstract Transcranial brain stimulation is a promising technology for safe modulation of brain function without invasive procedures. Recent advances in transcranial optogenetic techniques with external light sources, using upconversion particles and highly sensitive opsins, have shown promise for precise neuromodulation with improved spatial resolution in deeper brain regions. However, these methods have not yet been used to selectively excite or inhibit specific neural populations in multiple brain regions. In this study, we created a wireless transcranial optogenetic brain modulator that combines highly sensitive opsins and upconversion particles and allows for precise bimodal neuromodulation of multiple brain regions without optical crosstalk. We demonstrate the feasibility of our approach in freely behaving mice. Furthermore, we demonstrate its usefulness in studies of complex behaviors and brain dysfunction by controlling extorting behavior in mice in food competition tests and alleviating the symptoms of Parkinson’s disease. Our approach has potential applications in the study of neural circuits and development of treatments for various brain disorders.

The prevalence of obesity in Korea has steadily increased over the past decade, reaching 38.4% in 2021. Notably, the rate of class II–III obesity, defined as a body mass index (BMI) of 30 kg/m2 or higher, exceeded 7% in the same year. Since January 2019, the National Health Insurance Service (NHIS) has provided coverage for bariatric surgery (BS) for eligible patients. Coverage is available for individuals with a BMI of 35 kg/m2 or higher, or those with a BMI of 30 kg/m2 or higher who also have obesity-related comorbidities. Additionally, partial reimbursement is offered for BS in patients with type 2 diabetes mellitus who have BMI values between 27.5 and 30 kg/m2. From 2019 to 2022, the NHIS recorded 9,080 BS procedures, with sleeve gastrectomy being the most commonly performed. The average percentage of weight loss 198±99.7 days post-surgery was 17.9%, with 80.0% of patients losing more than 10% of their body weight. This article presents the trends in obesity and BS in Korea.

Prior research has highlighted poor clinical outcomes in coronavirus disease 2019 (COVID-19)-infected patients with diabetes; however, susceptibility to COVID-19 infection in patients with diabetes has not been extensively studied. Participants aged ≥30 years who underwent COVID-19 testing from December 2019 to April 2020 were analyzed using the National Health Insurance Service data in South Korea. In a cohort comprising 29,433 1:1 propensity score-matched participants, COVID-19 positivity was significantly higher in participants with diabetes than in those without diabetes (512 [3.5%] vs. 395 [2.7%], P

This study thoroughly investigated the diet composition and feeding habits of black rockfish, Sebastes inermis along the Yeosu Coast, South Korea. The stomach content of S. inermis was dominated by shrimp (Acetes japonicus and Crangon hakodatei) and brachyura (Charybdis bimaculata and Charybdis japonica). Shrimp was the dominant prey throughout the seasons, with an increase in fish consumption observed during autumn. Predator size and sampling period influenced the average degree of stomach fullness in black rockfish; however, the significance of fish as prey increased with increasing size. Dietary overlap analysis demonstrated a high overlap among smaller size classes and a low overlap between smaller and larger size classes. The results of this study indicate that black rockfish are specialist predators of shrimp.

BackgroundLittle information is available regarding whether active physical activity lowers mortality risk in individuals with bronchiectasis.MethodsWe used the Korean National Health Insurance Service database from 2010 to 2016 to evaluate the association between changes in physical activity and mortality risk in individuals with bronchiectasis. Of 552,510 individuals with newly diagnosed bronchiectasis, we enrolled 165,842 individuals who had two consecutive health examinations before and after bronchiectasis diagnosis, within two years, as the study aimed to measure changes in exercise habits between the two time points. Active physical activity was defined as engaging in moderate- or vigorous-intensity physical activity at least once a week, either before or after bronchiectasis diagnosis. The outcome measure was all-cause mortality.ResultsDuring a mean follow-up of 6.2 ± 2.1 years, 10,535 (6.4%) individuals with bronchiectasis died. Individuals with bronchiectasis who were physically active exhibited a lower mortality rate than those who were physically inactive. Mortality reduction was particularly evident in the exercise maintainers group (aHR [adjusted hazard ratio] = 0.69, 95% confidence interval [CI] = 0.64–0.74) and individuals with physical activity ≥1,000 metabolic equivalent of task-min per week (aHR = 0.73, 95% CI = 0.70–0.77) compared to those who were physically inactive.ConclusionEngaging in active physical activity is associated with a decreased risk of mortality in individuals with bronchiectasis.

BackgroundDespite a high tuberculosis incidence in Korea, the association between tuberculosis and depression remains underexplored. This study aims to assess depression risk in tuberculosis survivors.MethodsUtilizing South Korea’s National Health Insurance Sharing Service (NHISS) database, we conducted a gender-age-matched analysis comparing depression risk between tuberculosis survivors and the general population.ResultsThis study included 137,996 participants, of whom 34,499 had tuberculosis history, and 103,497 age- and sex-matched individuals were selected as the control group. The risk of developing depression was higher in tuberculosis survivors than in the control group (aHR 1.20, 95% CI 1.15-1.25). In men, the risk of developing depression was 1.32 times (95% CI 1.25-1.39) compared with 1.05 times (95% CI 0.98-1.12) in women. Those taking para-aminosalicylate, cycloserine, and prothionamide had a higher risk of developing depression compared to those using other anti-tuberculosis drugs, with the risk ratio ranging from 1.27 to 1.61.ConclusionTuberculosis survivors had a higher risk of developing depression compared to the control group. Although the prevalence of depression was higher in women compared to men, the risk of developing depression was higher in male tuberculosis survivors than in the control group, in contrast to the findings in women. The risk of developing depression in tuberculosis survivors differed depending on the anti-tuberculosis drug used and was mainly high in most of the second-line anti-tuberculosis drugs.

Abstract In esophageal adenocarcinoma, the presence of lymph node metastases predicts patients' survival even after curative resection. Currently, there is no highly accurate marker for detecting the presence of lymph node metastasis. The SEMA3F/NRP2 axis was initially characterized in axon guidance and recent evidence has revealed its significant involvement in lymphangiogenesis, angiogenesis, and carcinogenesis. Hence, the objective of this study was to elucidate the roles of SEMA3F and its receptor NRP2 in esophageal adenocarcinoma. We conducted an immunohistochemical evaluation of SEMA3F and NRP2 protein expression in 776 patients with esophageal adenocarcinoma who underwent Ivor-Lewis esophagectomy at the University Hospital of Cologne. Total and positive cancer cell counts were digitally analyzed using QuPath and verified by experienced pathologists to ensure accuracy. Positive expression was determined as a cell percentage exceeding the 50th percentile threshold. In our cohort, patients exhibiting SEMA3F positive expression experience significantly lower pT- and pN-stages. In contrast, positive NRP2 expression is associated with the presence of lymph node metastases. Survival analyses showed that the expression status of NRP2 had no impact on patient survival. However, SEMA3F positivity was associated with a favorable patient survival outcome (median OS: 38.9 vs. 26.5 months). Furthermore, SEMA3F could be confirmed as an independent factor for better patient survival in patients with early tumor stage (pT1N0-3: HR = 0.505, p = 0.014, pT1-4N0: HR = 0.664, p = 0.024, pT1N0: HR = 0.483, p = 0.040). In summary, SEMA3F emerges as an independent predictor for a favorable prognosis in patients with early-stage esophageal adenocarcinoma. Additionally, NRP2 expression is linked to a higher risk of lymph node metastases occurrence. We hypothesize that low SEMA3F expression could identify patients with early-stage tumors who might benefit from more aggressive treatment options or intensified follow-up. Furthermore, SEMA3F and its associated pathways should be explored as potential tumor-suppressing agents.

Objective This research investigated the effect of administering chromium (Cr) and meloxicam (MEL) on growth performance, cortisol and blood metabolite, and behaviors in young, regrouped heifers. Methods Fifty Holstein dairy heifers (body weight [BW] 198±32.7 kg and 6.5±0.82 months of age) were randomly assigned to non-regrouped group or four regrouped groups. Non-regrouped animals were held in the same pen throughout the entire experimental period (NL: non-regrouping and administration of lactose monohydrate [LM; placebo]). For regrouping groups, two or three heifers maintained in four different pens for 2 weeks were regrouped into a new pen and assigned to one of four groups: regrouping and LM administration (RL); regrouping and Cr administration (RC); regrouping and MEL administration (RM), and regrouping and Cr and MEL administration (RCM). LM (1 mg/kg BW), Cr (0.5 mg Cr picolinate/kg dry matter intake), and MEL (1 mg/kg BW) were orally administered immediately before regrouping. Blood was collected before regrouping (0 h) and at 3, 9, and 24 h and 7 and 14 d thereafter. Behaviors were recorded for 7 consecutive days after regrouping. Results Average daily gain was lower (p

Abstract Background To examine the association between glycemic status and all-cause mortality risk among individuals with dementia. Methods We enrolled 146,832 individuals aged 40 and older with dementia as identified through the Korean National Health Insurance Service health screening test between 2008 and 2016. Mortality status was evaluated at the end of 2019. Participants were classified into normoglycemia, prediabetes, or diabetes mellitus (DM) categories. The duration of diabetes was noted in those with DM. This study focused on the association between glycemic status and all-cause mortality. Results The cohort, which was predominantly elderly (average age 75.1 years; 35.5% male), had a 35.2% mortality rate over an average 3.7-year follow-up. DM was linked with increased all-cause mortality risk (hazard ratio [HR] 1.34; 95% confidence interval [CI]: 1.32–1.37) compared to non-DM counterparts. The highest mortality risk was observed in long-term DM patients (≥ 5 years) (HR 1.43; 95% CI: 1.40–1.47), followed by newly diagnosed DM (HR 1.35; 95% CI: 1.30–1.40), shorter-term DM (

Abstract Although paediatric patients with gastrointestinal (GI) foreign bodies require multiple resources, they often present with few or no discernible symptoms and are typically assigned a low acuity level during triage. We compared the predictive accuracy of the revised Korean Triage and Acuity Scale (rKTAS), which elevates acuity by one step in relation to anticipated resource utilization, with that of the conventional KTAS for clinical outcomes. This was a retrospective study of National Emergency Department Information System data. Data on patient and ED characteristics, resources used, and clinical outcomes were collected from January 2018 to December 2021 for patients with GI foreign bodies aged under 19. The primary outcome was rKTAS accuracy in predicting hospitalization, ICU admission, operating room (OR) use, and ED length of stay (EDLOS). The AUROC was used to evaluate the performance via of the KTAS and rKTAS. In total, 25,324 paediatric patients visited the ED for GI tract foreign bodies. The mean age was 3.8 years, and 51% (12,923) were between 1 and 4 year old. Although most (23,658; 93.4%) were discharged, 4.9% required hospitalization. Two or more resources were utilized in 2514 (9.9%) cases, and 3,514 individuals had their triage levels increased by one step. Compared with those of the KTAS, the AUROCs of the rKTAS for predicting overall hospitalization (p

The purpose of this study was to investigate the effect of the reflector, surface treatment, and length of scintillation crystals on the performance of a time-of-flight and depth-of-interaction (TOF-DOI) PET detector with a dual-ended readout and to determine the best reflector and surface treatment. Various types of crystal arrays with three different reflectors (ESR, BaSO4, and Toray), three different lateral surface treatments (all-polished (AP), all-roughened (AR), and partially roughened (PR, three sides polished, and one side roughened)), and two different lengths (20 and 15 mm) were fabricated. The highest light collection efficiency and best energy resolution were achieved using a crystal with a diffuse reflector (BaSO4 for AP and Toray for AR). In contrast, the best coincidence timing resolution (CTR) was achieved using an AR crystal with a specular reflector (ESR). The best DOI resolution was achieved using an AR crystal with BaSO4. Moreover, the results measured with the 20 mm long crystals were similar to those measured with the 15 mm long crystals. Therefore, we concluded that the dual-ended readout PET detector employing the crystal with AR lateral surface treatment and ESR was a good candidate for TOF-DOI PET because it provided excellent CTR and adequate DOI resolution.

IntroductionEarly age at menopause has been linked to various adverse health outcomes, but its association with suicide risk remains underexplored. This study aims to assess the relationship between age at menopause and suicide risk among postmenopausal women.MethodsThis retrospective cohort study analyzed data from the Korean National Health Insurance System (NHIS), covering 1,315,795 postmenopausal women aged 30 years and above, from 2009 to 2021. Menopausal age was classified as primary ovarian insufficiency (under 40 years), early menopause (40-44 years), average menopause (45-49 and 50-54 years), and late menopause (55 years and older). Suicide incidence was identified using ICD-10 codes for primary cause of death. Multivariable Cox proportional hazards models were utilized to estimate hazard ratios (HRs) and 95% confidence intervals (CIs).ResultsAcross the 12-year follow-up, there were 2,986 suicides. Women with primary ovarian insufficiency exhibited the highest suicide risk (HR, 1.43; 95% CI, 1.14–1.78, p

BackgroundThe brown croaker, Miichthys miiuy, is an economically important fish species in Korean waters. Research on the spawning ecology of M. miiuy in Korea has primarily focused on specimens from the southwestern waters, assessing parameters, such as spawning season and mature body length through histological examination. However, a comprehensive histological analysis across various body sizes during the spawning season is imperative to accurately ascertain these factors, as well as for efficient resource management amidst potential environmental variations. Therefore, this study was undertaken to investigate the spatiotemporal distribution and reproductive biology of M. miiuy in the southwestern waters of Korea.MethodsMonthly changes in gonadal maturity stages, gonadosomatic index (GSI), egg diameter, and fecundity were analyzed. Additionally, total length at sexual maturity at 50%, 75%, and 97.5%, as well as the sex ratio, were determined.ResultsM. miiuy, captured using offshore gillnets and stow nets, exhibited a seasonal migration pattern: a winter presence near Jeju Island, followed by a northward movement in spring, a summer shift to the shallow waters of Shinan, and an autumnal migration to the waters around Jeju Island for overwintering. The overall female-to-male sex ratio was 1:0.8. GSI values peaked in September and August for both sexes; however, microscopic analysis of gonadal tissue revealed a spawning period from July to September 2023, with the primary spawning season for the entire population occurring in August and September. The fork length at 50% maturity was 57.4 cm for females and 54.6 cm for males.ConclusionOverall, these results suggest an earlier shift in the spawning period of brown croakers in the southwestern waters of Korea compared to past observations. This shift is potentially attributable to higher water temperatures, increased resource levels, and alterations in the species composition of major prey items in the spawning grounds. Further research is imperative for a comprehensive understanding of the factors influencing the reproductive ecology of this important fish species.

This study examined the effects of surgical castration and lidocaine-plus-meloxicam treatment on growth, physiology, behaviors, and leukocyte heat shock protein 90 (HSP 90) gene expression in Hanwoo (Korean cattle) bulls. Twenty Hanwoo bulls (body weight 248.8 ± 28.5 kg, age 9.4 ± 1.04 months) were assigned to three treatments: surgical castration with lidocaine injection (5 mL in the scrotum) and oral meloxicam administration (1 mg/kg body weight; LM; n = 7); surgical castration with placebo injection (5 mL of 0.9% NaCl) and oral placebo administration (lactose, 1 mg/kg body weight; CAS; n = 7); and shame castration (SHAM; n = 6). Meloxicam and lactose were administered 3 h before castration, and lidocaine and NaCl were injected immediately before castration. Surgical castration was performed with a Newberry knife and a Henderson castration tool. Wight was measured the day before and 14 d after castration, and behavior was observed from 0.5 h to 4.5 h post-castration. Blood was collected at −1 d, 0.5 h, 6 h, 1 d, 3 d, 7 d, and 14 d after castration to measure plasma cortisol, haptoglobin, and leukocyte HSP 90 mRNA. Castration tended to decrease average daily gain (p = 0.06), but the LM treatment did not affect weight gain. Bulls in CAS showed higher cortisol concentration (p

Background: Job stress was found to directly increase the likelihood of accidents and indirectly increase the likelihood of accidents by lowering the safety atmosphere. Job stress has a significant impact on the safety environment, and job satisfaction is effective in reducing accident rates. Accordingly, we sought to investigate the correlation between safety level, job stress, and job satisfaction in small businesses with a high risk of industrial accidents. Additionally, we aim to investigate factors that may affect job stress, job satisfaction, and safety levels. Methods: This study was conducted on 230 workers in small businesses in Korea. First, hierarchical regression analysis was conducted using SPSS software, and anova analysis was used to investigate significant variables. Finally, the relationships between variables were investigated using structural equation modeling (SEM). Results: The analysis results showed that safety level and job stress had a negative correlation with a coefficient of −0.8. Safety level and job satisfaction had a correlation with a coefficient of 0.2. Job satisfaction and job stress had a negative correlation with a coefficient of −0.7. This shows that when job stress is high, there is a negative correlation between job satisfaction and safety level. In addition, 4 general characteristics items and 3 job characteristics items showed a correlation with job stress. 2 general characteristics items and 8 job characteristics items showed a correlation with job satisfaction. 4 general characteristics items and 11 job characteristics items showed a correlation with safety level. Conclusion: Small businesses' job stress, safety level, and job satisfaction showed a significant correlation. In addition, the relationship between the variables affecting them was significant. In order to reduce the occurrence of accidents among workers in small businesses, control of factors and efforts to reduce job stress are necessary.

Abstract CT‐P13, a biosimilar of infliximab, is used to treat inflammatory diseases that arise from immune system complications, resulting in excessive and persistent inflammation. The subcutaneous (SC) formulation of CT‐P13 overcomes the drawback of prolonged administration associated with the intravenous (IV) infliximab biosimilar, necessitating autoinjector (AI) administration. This randomized, open‐label, two‐arm, parallel‐group, single‐dose clinical pharmacology study aimed to evaluate the pharmacokinetics (PK) and safety of CT‐P13 SC administration via AI compared with the existing pre‐filled syringe (PFS) method. A total of 147 healthy participants were randomized into two groups, of which 139 completed the study. Blood samples were collected from before CT‐P13 SC administration to 2016 h after the start of the administration. Serum concentrations were analyzed using the Meso Scale Discovery electrochemiluminescence method. Geometric mean ratios (90% confidence interval) of the AUCinf (areas under the concentration–time curve from zero to infinity) and Cmax (The maximum serum concentration) for CT‐P13 SC AI versus CT‐P13 SC PFS groups, were 94.15% (85.02%–104.26%), 92.48% (84.66%–101.01%), respectively. CT‐P13 SC AI and CT‐P13 SC PFS achieved comparable PK because the 90% CI was within the predefined equivalence margin. At the end of the study, immunogenicity results revealed that 70 (97.22%) and 73 (98.65%) participants tested positive for anti‐drug antibody (ADA) in the CT‐P13 SC AI and CT‐P13 SC PFS groups, respectively. They were tested positive for neutralizing antibodies. No other significant safety differences were observed between the treatment groups. In conclusion, both administrations demonstrated PK equivalence and were both safe and well‐tolerated.

Abstract Tobacco smoking (TS) is implicated in lung cancer (LC) progression through the development of metabolic syndrome. However, direct evidence linking metabolic syndrome to TS-mediated LC progression remains to be established. Our findings demonstrate that 4-(methylnitrosamino)−1-(3-pyridyl)−1-butanone and benzo[a]pyrene (NNK and BaP; NB), components of tobacco smoke, induce metabolic syndrome characteristics, particularly hyperglycemia, promoting lung cancer progression in male C57BL/6 J mice. NB enhances glucose uptake in tumor-associated macrophages by increasing the expression and surface localization of glucose transporter (GLUT) 1 and 3, thereby leading to transcriptional upregulation of insulin-like growth factor 2 (IGF2), which subsequently activates insulin receptor (IR) in LC cells in a paracrine manner, promoting its nuclear import. Nuclear IR binds to nucleophosmin (NPM1), resulting in IR/NPM1-mediated activation of the CD274 promoter and expression of programmed death ligand-1 (PD-L1). Restricting glycolysis, depleting macrophages, or blocking PD-L1 inhibits NB-mediated LC progression. Analysis of patient tissues and public databases reveals elevated levels of IGF2 and GLUT1 in tumor-associated macrophages, as well as tumoral PD-L1 and phosphorylated insulin-like growth factor 1 receptor/insulin receptor (pIGF-1R/IR) expression, suggesting potential poor prognostic biomarkers for LC patients. Our data indicate that paracrine IGF2/IR/NPM1/PD-L1 signaling, facilitated by NB-induced dysregulation of glucose levels and metabolic reprogramming of macrophages, contributes to TS-mediated LC progression.

Abstract Background We investigated the association between exercise habits before or after thyroidectomy and incident type 2 diabetes mellitus (T2DM) in patients with thyroid cancer. Methods An observational cohort study of 69,526 thyroid cancer patients who underwent thyroidectomy for the treatment of thyroid cancer between 2010 and 2016 was performed using the Korean National Health Information Database. Regular exercise was defined as mid-term or vigorous exercise at least 1 day in a week based on a self-reported questionnaire. Patients were divided into four groups according to exercise habits before and after thyroidectomy: persistent non-exercisers, new exercisers, exercise dropouts, and exercise maintainers. Results During a median follow-up of 4.5 years, 2,720 (3.91%) patients developed T2DM. The incidence of T2DM per 1,000 person years was lower in patients who performed regular exercise before or after thyroidectomy than in persistent non-exercisers (10.77 in persistent non-exerciser group, 8.28 in new exerciser group, 8.59 in exercise dropout group, and 7.61 in exercise maintainer group). Compared with the persistent non-exerciser group, the new exerciser group (hazard ratio [HR] 0.87, 95% confidence interval [CI] 0.78–0.97), the exercise dropout group (HR 0.81, 95% CI 0.72–0.91), and the exercise maintainer group (HR 0.84, 95% CI 0.76–0.93) had lower risks of incident T2DM. Exercising

Background Inconsistent results have been reported regarding the association between the use of antidiabetic drugs and the clinical outcomes of coronavirus disease 2019 (COVID-19). This study aimed to investigate the effect of antidiabetic drugs on COVID-19 outcomes in patients with diabetes using data from the National Health Insurance Service (NHIS) in South Korea. Methods We analyzed the NHIS data of patients aged ≥20 years who tested positive for COVID-19 and were taking antidiabetic drugs between December 2019 and June 2020. Multiple logistic regression analysis was performed to analyze the clinical outcomes of COVID-19 based on the use of antidiabetic drugs. Results A total of 556 patients taking antidiabetic drugs tested positive for COVID-19, including 271 male (48.7%), most of whom were in their sixties. Of all patients, 433 (77.9%) were hospitalized, 119 (21.4%) received oxygen treatment, 87 (15.6%) were admitted to the intensive care unit, 31 (5.6%) required mechanical ventilation, and 61 (11.0%) died. Metformin was significantly associated with the lower risks of mechanical ventilation (odds ratio [OR], 0.281; 95% confidence interval [CI], 0.109 to 0.720; P=0.008), and death (OR, 0.395; 95% CI, 0.182 to 0.854; P=0.018). Dipeptidylpeptidase-4 inhibitor (DPP-4i) were significantly associated with the lower risks of oxygen treatment (OR, 0.565; 95% CI, 0.356 to 0.895; P=0.015) and death (OR, 0.454; 95% CI, 0.217 to 0.949; P=0.036). Sulfonylurea was significantly associated with the higher risk of mechanical ventilation (OR, 2.579; 95% CI, 1.004 to 6.626; P=0.049). Conclusion In patients with diabetes and COVID-19, metformin exhibited reduced risks of mechanical ventilation and death, DPP-4i was linked with lower risks of oxygen treatment and death, while sulfonylurea was related to the increased risk of mechanical ventilation.

Abstract This study investigated the potential associations between allergic diseases (asthma, allergic rhinitis, and atopic dermatitis) and the development of primary open-angle glaucoma. We utilized authorized data from the Korean National Health Information Database (KNHID), which provides comprehensive medical claims data and information from the National Health Screening Program. We compared the baseline characteristics of subjects with and without allergic diseases and calculated the incidence and risk of glaucoma development. Cox proportional hazard regression analysis was used to determine the risk of glaucoma development in subjects with allergic diseases. A total of 171,129 subjects aged 20–39 with or without allergic diseases who underwent a general health examination between 2009 and 2015 were included. Subjects with allergic diseases exhibited a higher incidence of glaucoma compared to the control group. The hazard ratio (HR) of glaucoma onset was 1.49 and 1.39 in subjects with at least one allergic disease before and after adjusting for potential confounding factors, respectively. Among allergic diseases, atopic dermatitis showed the highest risk for glaucoma development (aHR 1.73) after adjusting for confounders. Allergic rhinitis showed an increased risk for incident glaucoma after adjustment (aHR 1.38). Asthma showed the lowest but still increased risk for glaucoma (aHR 1.22). The associations were consistent in all subgroup analyses stratified by sex, smoking, drinking, exercise, diabetes, hypertension, dyslipidemia, or history of steroid. In conclusion, allergic diseases are associated with increased risk of glaucoma development. Among allergic diseases, atopic dermatitis showed the highest risk for glaucoma development followed by allergic rhinitis and asthma.

Abstract Purpose Satisfaction should be prioritized to maximize the value of education for trainees. This study was conducted with professors, fellows, and surgical residents in the Department of general surgery (GS) to evaluate the importance of various educational modules to surgical residents. Methods A questionnaire was administered to professors (n = 28), fellows (n = 8), and surgical residents (n = 14), and the responses of the three groups were compared. Four different categories of educational curricula were considered: instructor-led training, clinical education, self-paced learning, and hands-on training. Results The majority of surgeons regarded attending scrubs as the most important educational module in the training of surgical residents. However, while professors identified assisting operators by participating in surgery as the most important, residents assessed the laparoscopic training module with animal models as the most beneficial. Conclusions The best educational training course for surgical residents was hands-on training, which would provide them with several opportunities to operate and perform surgical procedures themselves.

Abstract The effect of arterial tortuosity on intracranial atherosclerosis (ICAS) is not well understood. This study aimed to evaluate the effect of global intracranial arterial tortuosity on intracranial atherosclerotic burden in patients with ischemic stroke. We included patients with acute ischemic stroke who underwent magnetic resonance angiography (MRA) and classified them into three groups according to the ICAS burden. Global tortuosity index (GTI) was defined as the standardized mean curvature of the entire intracranial arteries, measured by in-house vessel analysis software. Of the 516 patients included, 274 patients had no ICAS, 140 patients had a low ICAS burden, and 102 patients had a high ICAS burden. GTI increased with higher ICAS burden. After adjustment for age, sex, vascular risk factors, and standardized mean arterial area, GTI was independently associated with ICAS burden (adjusted odds ratio [adjusted OR] 1.33; 95% confidence interval [CI] 1.09–1.62). The degree of association increased when the arterial tortuosity was analyzed limited to the basal arteries (adjusted OR 1.48; 95% CI 1.22–1.81). We demonstrated that GTI is associated with ICAS burden in patients with ischemic stroke, suggesting a role for global arterial tortuosity in ICAS.

Background To investigate the prevalence, incidence, comorbidities, and management status of diabetic kidney disease (DKD) and diabetes-related end-stage kidney disease (ESKD) in South Korea. Methods We used the Korea National Health and Nutrition Examination Survey data (2019 to 2021, n=2,665) for the evaluation of prevalence, comorbidities, control rate of glycemia and comorbidities in DKD, and the Korean Health Insurance Service-customized database (2008 to 2019, n=3,950,857) for the evaluation of trends in the incidence and prevalence rate of diabetes-related ESKD, renin-angiotensin system (RAS) blockers and sodium glucose cotransporter 2 (SGLT2) inhibitors use for DKD, and the risk of atherosclerotic cardiovascular disease (ASCVD) and mortality according to DKD stages. DKD was defined as albuminuria or low estimated glomerular filtration rate (eGFR)

Assessing recurrent laryngeal nerve invasion is crucial for the accurate staging of thyroid cancer. This, in turn, determines the extent of surgery or whether active surveillance is appropriate. Ultrasonography is useful in diagnosing extrathyroidal extension to adjacent structures. However, preoperative ultrasound cannot definitely exclude recurrent laryngeal nerve invasion or identify the entire course of the recurrent laryngeal nerve to the thyroid gland. Therefore, it is important to understand the ultrasound features that are most likely to be associated with the gross involvement of the recurrent laryngeal nerve.

Background and Purpose The accurate prediction of functional outcomes in patients with acute ischemic stroke (AIS) is crucial for informed clinical decision-making and optimal resource utilization. As such, this study aimed to construct an ensemble deep learning model that integrates multimodal imaging and clinical data to predict the 90-day functional outcomes after AIS. Methods We used data from the Korean Stroke Neuroimaging Initiative database, a prospective multicenter stroke registry to construct an ensemble model integrated individual 3D convolutional neural networks for diffusion-weighted imaging and fluid-attenuated inversion recovery (FLAIR), along with a deep neural network for clinical data, to predict 90-day functional independence after AIS using a modified Rankin Scale (mRS) of 3–6. To evaluate the performance of the ensemble model, we compared the area under the curve (AUC) of the proposed method with that of individual models trained on each modality to identify patients with AIS with an mRS score of 3–6. Results Of the 2,606 patients with AIS, 993 (38.1%) achieved an mRS score of 3–6 at 90 days post-stroke. Our model achieved AUC values of 0.830 (standard cross-validation [CV]) and 0.779 (time-based CV), which significantly outperformed the other models relying on single modalities: b-value of 1,000 s/mm2 (P

Time-of-flight (TOF) PET detectors with fast-rise-time scintillators and fast-single photon time resolution silicon photomultiplier (SiPM) have been developed to improve the coincidence timing resolution (CTR) to sub-100 ps. The CTR can be further improved with an optimal bandwidth and minimized electronic noise in the readout circuit and this helps reduce the distortion of the fast signals generated from the TOF-PET detector. The purpose of this study was to develop an ultra-high frequency and fully-differential (UF-FD) readout circuit that minimizes distortion in the fast signals produced using TOF-PET detectors, and suppresses the impact of the electronic noise generated from the detector and front-end readout circuits. The proposed UF-FD readout circuit is composed of two differential amplifiers (time) and a current feedback operational amplifier (energy). The ultra-high frequency differential (7 GHz) amplifiers can reduce the common ground noise in the fully-differential mode and minimize the distortion in the fast signal. The CTR and energy resolution were measured to evaluate the performance of the UF-FD readout circuit. These results were compared with those obtained from a high-frequency and single ended readout circuit. The experiment results indicated that the UF-FD readout circuit proposed in this study could substantially improve the best achievable CTR of TOF-PET detectors.

Abstract Objectives We primarily aimed to evaluate whether parotid incidental lesion (PIL) in 18F-fluorodeoxyglucose positron emission tomography/computed tomography (18F-FDG PET/CT) for staging evaluation of patients with hepatocellular carcinoma (HCC) would represent a possibility of extrahepatic metastasis or second primary malignancy (SPM). Additionally, we explored the incidence of PIL in HCC patients and examined any associated risk factors. Methods We retrospectively analyzed patients with HCC who underwent 18F-FDG PET/CT at our institution from 2010 to 2022. The pathological findings of PILs in HCC patients were investigated for confirmatory identification of the risk of HCC metastasis or SPM in parotid gland. Healthy controls received 18F-FDG PET/CT for health screening were also enrolled to compare the incidence of PILs with HCC patients. Various parameters associated with patient demographics and characteristics of HCC were analyzed to find the related factors of PILs. Results A total of 17,674 patients with HCC and 2,090 healthy individuals who had undergone 18F-FDG PET/CT scans were enrolled in the analyses. Among the 54 HCC patients who underwent pathological confirmation for PILs, benign primary parotid tumor was most commonly observed (n = 43 [79.6%]); however, no malignant lesions were detected, including HCC metastasis. The incidence of PILs was higher in patients diagnosed with HCC compared with the control group (485 [2.7%] vs. 23 [1.1%], p = 0.002). Analysis for the risk factors for PILs revealed that patient age, sex, and positive viral markers were significantly associated with the incidence of PILs in patients with HCC (all p

Abstract Hormone receptor (HR)-positive breast cancer can become aggressive after developing hormone-treatment resistance. This study elucidated the role of long non-coding RNA (lncRNA) SOX2OT in tamoxifen-resistant (TAMR) breast cancer and its potential interplay with the tumor microenvironment (TME). TAMR breast cancer cell lines TAMR-V and TAMR-H were compared with the luminal type A cell line (MCF-7). LncRNA expression was assessed via next-generation sequencing, RNA extraction, lncRNA profiling, and quantitative RT-qPCR. SOX2OT overexpression effects on cell proliferation, migration, and invasion were evaluated using various assays. SOX2OT was consistently downregulated in TAMR cell lines and TAMR breast cancer tissue. Overexpression of SOX2OT in TAMR cells increased cell proliferation and cell invasion. However, SOX2OT overexpression did not significantly alter SOX2 levels, suggesting an independent interaction within TAMR cells. Kaplan–Meier plot analysis revealed an inverse relationship between SOX2OT expression and prognosis in luminal A and B breast cancers. Our findings highlight the potential role of SOX2OT in TAMR breast cancer progression. The downregulation of SOX2OT in TAMR breast cancer indicates its involvement in resistance mechanisms. Further studies should explore the intricate interactions between SOX2OT, SOX2, and TME in breast cancer subtypes.

Background and Objectives: Weight-bearing activities exacerbate pain and fatigue in functional flat foot, with uphill walking presenting additional challenges due to increased external loads. The current study investigates whether 3D-printed customized arch-support insoles can enhance gait variables and ankle alignment during uphill walking. Materials and Methods: Twenty healthy young adults, divided into two groups (normal foot condition (control, n = 10), functional flat foot (FF, n = 10)), walked on a treadmill at a 10% incline under two conditions: wearing shoes alone (shoe) or wearing shoes with 3D-printed customized arch-support insoles (SI). Gait pattern, center of force (COF), and ankle joint angles were analyzed by OptoGait, Tekscan, and Kinovea, respectively. Results: The foot flat phase of the gait pattern was prolonged in individuals with FF compared to the control under both shoe and SI conditions, whereas the propulsive phase was shortened with the SI. Medial deviation of the COF during the propulsive phase, observed in individuals with FF under the shoe condition, was corrected to a more lateral alignment with the SI, resembling the COF alignment of the control. Additionally, individuals with FF under the shoe condition exhibited increased ankle pronation compared to the control, whereas the SI moderated pronation, achieving alignment closer to that of the control. Conclusions: These findings indicate that the 3D-printed customized arch-support insoles can improve gait mechanics and ankle alignment in individuals with FF, particularly under challenging conditions such as uphill walking.

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