Exploring socio-demographic, physical, psychological, and quality of life-related factors related with fear of cancer recurrence in stomach cancer survivors: a cross-sectional study.

BACKGROUND: Stomach cancer is one the most common neoplasms with high mortality. However, fear of cancer recurrence (FCR) in stomach cancer survivors has been scarcely evaluated. Thus, the aim of this study was to evaluate FCR and factors related to FCR in Korean stomach cancer survivors. METHODS: A total of 363 stomach cancer survivors who had completed primary treatment and had no metastasis or recurrence were recruited between September 2014 and March 2017 regardless of time lapse after the initial diagnosis. FCR was assessed using the Korean version of the FCR Inventory (FCRI). Participants were divided into two groups; clinical FCRI group (score of severity subscale of FCRI ≥ 13) and non-clinical FCRI group (the scores < 13). Socio-demographic factors, cancer stage, treatment, psychological factors, health-related quality of life (HRQoL), and health promotion and disease prevention behaviors were obtained using a self-administered questionnaire supplemented with face-to-face interview to fill out incomplete information. Factors associated with FCR were evaluated using linear regression analysis and multiple logistic regression analysis after adjusting for age, sex, cancer stage, time since cancer diagnosis, family cancer diagnosis, and comorbidities. RESULTS: Average (standard deviation) time interval between cancer diagnosis and study participation was 7.3 (3.2) years. The distribution of socio-demographic and cancer-related factors did not differ according to the level of FCR. The higher FCRI level was associated with lower levels of social support (ß: -0.190, p < 0.001), lower emotional function (ß: -0.356, p < 0.001), more severe fatigue (ß: 0.333, p < 0.001), more sleep problems (ß: 0.299, p = 0.002), higher anxiety (ß: 0.443, p < 0.001), and higher depression (ß: 0.207, p < 0.001). However, clinical level of FCR was not associated with health promotion and disease prevention behaviors. CONCLUSIONS: FCR in stomach cancer survivors was associated with social, psychological, and HRQoL factors rather than demographic, socioeconomic, or cancer-related factors. This finding suggests that careful attention to FCR is necessary to provide more comprehensive survivorship care for stomach cancer survivors.

Physical and psychological symptoms and signs in dying digestive tract cancer patients: the East Asian collaborative cross-cultural Study to Elucidate the Dying process (EASED).

BACKGROUND: Well detection of the symptoms and signs of dying patients is essential for providing proper palliative care. Our goal is to evaluate the predominant symptoms and compare the changes in dying patients with digestive tract cancer in Japan, South Korea, and Taiwan. METHODS: A total of 1057 cancer patients aged 18 years or older admitted in palliative care units with locally advanced or metastatic gastroesophageal, colorectal, and pancreaticobiliary cancer were enrolled from January 2017 to March 2019. The severity of physical and psychological symptoms and signs assessed by physicians and/or nurses upon admission, 1 week after admission, and within 3 days of death, was compared according to cancer type and country of origin. RESULTS: Among the 338 gastroesophageal, 358 pancreaticobiliary, and 361 colorectal cancer patients, 894 (93.1%) died during the observation period. Fatigue was the most severe symptom in all cancer groups before dying. Dyspnea, fatigue, drowsiness, and ascites improved after hospitalization albeit they worsened prior to death. In particular, ascites was a marked symptom in patients with pancreaticobiliary cancer. Delirium and hallucination gradually worsened during the period leading to death. Differences in manifestations with respect to the country of origin were not significant. CONCLUSION: We identified the most prevalent signs and symptoms in patients from East Asia who were dying from digestive tract cancers. Proper management, based on these prevalent signs and symptoms during the dying period, plays a vital role in providing adequate palliative care.

Incidence of osteoporosis and ambient air pollution in South Korea: a population-based retrospective cohort study.

BACKGROUND: This study investigated the associations between exposure to ambient air pollutants and the incidence of osteoporosis using the Korean National Insurance Service-National Sample Cohort. METHODS: This nationwide, population-based, retrospective cohort study included 237,149 adults aged ≥40 years that did not have a diagnosis of osteoporosis at baseline between January 1, 2003, and December 31, 2015. Osteoporosis was defined as claim codes and prescriptions of bisphosphonates or selective estrogen receptor modulators at least twice annually. After matching values for PM10, NO2, CO, and SO2 during the 2002-2015 time period and PM2.5 in 2015 with residential areas, the incidence of osteoporosis was analyzed using a Cox proportional hazards regression model according to the quartile of average yearly concentrations of pollutants. RESULTS: Overall 22.2% of the study subjects, 52,601 (male: 5.6%, female: 37.6%) adults in total, were newly diagnosed with osteoporosis and treated. Exposure to PM10 was positively associated with incidence of osteoporosis (Q4: 1798 per 100,000 person-years vs. Q1: 1655 per 100,000 person-years). The adjusted hazard ratio (HR) with 95% confidence interval (CI) of Q4 in PM10 was 1.034 (1.009-1.062). The effect of PM10 on osteoporosis incidence was distinct in females (adjusted sub-HR: 1.065, 95% CI: 1.003-1.129), subjects aged < 65 years (adjusted sub-HR: 1.040, 95% CI: 1.010-1.072), and for residents in areas with low urbanization (adjusted sub-HR: 1.052, 95% CI: 1.019-1.087). However, there was no increase in osteoporosis based on exposure to NO2, CO, SO2, or PM2.5. CONCLUSIONS: Long-term exposure to PM10 was associated with newly diagnosed osteoporosis in Korean adults aged ≥40 years. This finding can aid in policy-making that is directed to control air pollution as a risk factor for bone health.

A cross-sectional study of factors associated with influenza vaccination in Korean cancer survivors.

OBJECTIVE: To investigate factors associated with influenza vaccination in cancer survivors. METHODS: Study subjects were 1,945 Korean adult cancer survivors. Through medical record review and self-administered questionnaires, social and medical information was collected. Influenza vaccination was defined as ever having received a flu vaccine between one year before cancer diagnosis and the survey date. Multiple logistic regression analysis was used to evaluate factors associated with influenza vaccination. RESULTS: Overall, 60.8% of study subjects had received an influenza vaccination. Younger survivors had a significantly lower vaccination rate than did the elderly survivors (80.22% vs. 54.73%). In younger survivors, longer time elapsed since cancer diagnosis, lifestyle modification counselling during cancer treatment, adequate physical exercise (≥150 min/week) and complementary medication use were positively associated with vaccination, whereas extra-pulmonary cancers, multimodality (≥3) cancer treatment and higher educational achievement were inversely associated. In elderly survivors, fewer factors had a positive (adequate physical exercise) or inverse (multimodality cancer treatment and current smoking) association with influenza vaccination. CONCLUSION: Influenza vaccination rate was suboptimal, especially among younger cancer survivors. Targeted strategies are necessary to improve influenza vaccination in cancer survivors with consideration of individual characteristics such as age, lifestyle, cancer treatment modality, cancer type and education level.

Association between nutrition education, dietary habits, and body image misperception in adolescents.

BACKGROUND AND OBJECTIVES: In adolescents, adequate nutrition education is essential for making decisions regarding healthy eating habits. We aimed to investigate differences in dietary habits and body image misperception according to nutrition education status. METHODS AND STUDY DESIGN: We analyzed 60,389 adolescents aged 12-18 years old, using the 2017 Korea Youth Risk Behavior Web-based Survey data. Participants were divided into nutrition-educated (EDU) and uneducated (non-EDU) groups, according to nutrition education status within the past year. Skipping breakfast was defined as skipping breakfast ≥5 times/week. Desirable dietary behaviors were divided into the frequency of consumption of 3 items: vegetables ≥1 time/day, milk ≥1 time/day, and fruits ≥1 time/day. Participants with normal weight who reported being slightly fat or very fat were defined as having body image misperception. RESULTS: Compared to the non-EDU group, the odds ratio (OR) and 95% confidence interval (CI) for desirable dietary behaviors in the EDU group were 1.08 (1.04-1.13), 1.14 (1.09-1.19), and 1.16 (1.12-1.20) for the intake of fruits, milk, and vegetables, respectively. The EDU group was less associated with skipping breakfast than the non-EDU group (OR=0.91, 95% CI: 0.87-0.95, p<0.001). The OR and 95% CI of body image misperception in the EDU group were lower than in the non-EDU group (OR=0.92, 95% CI: 0.87- 0.97, p<0.001). CONCLUSIONS: Nutrition education have positive effects on healthy dietary behaviors. It also shows a negative association with body image misperception, confirming the importance of nutrition education at school.

Association between perception of care coordination and health outcomes in Korean cancer survivors.

BACKGROUND: To determine relationship between cancer survivors' perception of care coordination and their health outcomes. METHODS: Study subjects were 1306 Korean adulthood cancer survivors who were enrolled in two academic hospital and completed a questionnaire consisting of questions asking two aspects of care coordination for cancer treatment they had received: 1) who played a main coordinator role and 2) whether care services had met their necessitated health concerns. We measured health outcomes including new comorbidity, number of clinic visits, health-related quality of life (HRQoL) and fear of cancer recurrence (FCR). Associations between the level of care coordination and health outcomes were evaluated by multiple logistic regression analysis after adjusting for covariates. RESULTS: Survivors with uncoordinated care were more likely to have more new comorbidities after cancer diagnosis, visit clinic more frequently and have worse HRQoL and higher FCR. Females and unmarried survivors were more likely to have received uncoordinated care than males and ever married survivors. Uncoordinated care group had an increased the risk of new comorbidity (odds ratio 1.73, [95% confidence interval] 1.02-2.92), multiple clinic visits (1.69, 1.00-2.88), severe FCR (2.28, 1.33-3.93), low EuroQoL Visual Analogue Scale (1.82, 1.28-2.60), low global health status (1.51, 1.04-2.21), and poor physical (2.00, 1.31-3.04), role (2.46, 1.69-3.56) and emotional function (2.62, 1.81-3.78). CONCLUSIONS: Coordinated care of Korean cancer survivors was associated with their health outcomes, including new comorbidity, clinic visits, HRQoL and FCR. Good care coordination may be reinforced to improve outcomes of survivorship care.

Development of a senior-specific, citizen-oriented healthcare service system in South Korea based on the Canadian 48/6 model of care.

BACKGROUND: In the age of aging, Korea's current medical delivery system threatens to increase the number of medical and caring refugees. This study attempts to develop an integrated senior citizen-oriented healthcare service system in which daily care, professional care, and rehabilitation are organically organized between medical institutions and local communities, thereby meeting the daily life needs of the elderly and inducing well-being, wellness, and well-dying. METHODS: To develop the integrated healthcare system, data collection and analyses were conducted through a systematic review, literature review, benchmarking, focus group interviews, and expert consultation. RESULTS: The senior-specific, citizen-oriented healthcare service system developed in this study is designed to screen patients aged 65 or older within 24 h of being admitted, using the Geriatric Screening for Care-10. If there is reason for concern as a result of the screening, further evaluation is performed through assessment. Doctors and nurses create a care plan and a discharge plan based on the results from the screening and assessment. The nurse further uses the screening to monitor the patient's condition before discharge. Based on the screening results at the time of discharge, a transitional care plan is prepared and provided to elderly patients and/or their families. This process enables a systematic link between medical institutions and community resources, aiming for the continuous management of health issues. It also establishes a multidisciplinary treatment plan that considers patients and their families so that diseases common to the elderly are diagnosed and treated promptly. CONCLUSIONS: The most important issue for the elderly is to be able to live healthily and independently for the rest of their lives through well-being, wellness, and well-dying. The senior-specific, citizen-oriented healthcare service proposed in this study is an integrated medical treatment system for elderly users the implementation of which requires the daily care, professional care, and rehabilitation of elderly members of society to be organically organized according to the role of the patients, their families, and the caregiver.

The Experience of Providing Older Adult Patients with Transitional Care from an Acute Care Hospital to Home in Cooperation with a Public Health Center.

BACKGROUND: This study aimed to describe the experience of providing older adult patients with transitional care from an acute care hospital to home in cooperation with a public health center, in order to present the barriers to that care and suggest better organizational methods. METHODS: This was a cross-sectional study to show the results of the Geriatric Screening for Care-10 (GSC-10) and outcomes of transitional care. Among 659 hospitalized patients aged 65 years or above who lived in an administrative district, forty-five subjects were enrolled between June 24, 2019 and January 23, 2020. Within 48 hours of admission, using the 10 areas of GSC-10, they were assessed for cognitive impairment, depression, polypharmacy (5 or more medications), functional mobility, dysphagia, malnutrition, pain, and incontinence, and were reassessed before discharge. The transitional care plan (containing the treatment summary, the results of the GSC-10 assessment, and the post-discharge plan) was forwarded to a representative of the public health center, who provided continued disease management and various health care services, such as chronic disease and frailty care, and physical rehabilitation. RESULTS: Of all the participants, 64.4% had more than 1 GSC-10 concern. The most prevalent concerns were functional immobility (35.6%) and polypharmacy (22.2%). About 15.6% of the participants were readmitted to a nursing home or hospital. A total of 38 participants received the transitional care intervention. They received an average of 2.7 administered interventions. However, the rate of rejection was high (30.1%) and patients were visited an average of 16.5 days after discharge. CONCLUSION: Through our experience of providing transitional care from an acute care hospital to home in cooperation with a public health center, we expect that the transitional care suitable for the Korean medical situation could be established and successful.

Risk of comorbid cardiovascular disease in Korean long-term cancer survivors.

BACKGROUND: Cardiovascular disease (CVD) is a common cause of death in cancer survivors. We evaluated the risk of comorbid CVD in long-term cancer survivors according to specific cancer site. METHODS: Study subjects included 47,171 Koreans aged over 40 years who visited a health promotion centre between 2010 and 2012. Information on CVD and cancer was obtained from self-report. Comorbid CVD was defined as stroke, myocardial infarction or angina pectoris. The risk of comorbid CVD in survivors was compared with that in non-cancer subjects using multiple logistic regression analysis. RESULTS: Among cancer survivors (n = 3,753), 330 events of CVD were reported. Age- and sex-adjusted analysis showed that odds ratio (OR) for comorbid CVD in survivors was 1.52 (95% confidence interval: 1.34-1.72) compared to non-cancer subjects (n = 43,418). After adjusting for health-related behaviour and medical history, only lung cancer survivors had 2.44 (1.01-5.89)-fold higher OR for CVD. In stratified analysis, significantly higher OR for CVD was evident in lung cancer survivors with hypertension who did not perform regular physical exercise. CONCLUSIONS: Adult cancer survivors may have an increased risk of comorbid CVD that might be mediated in part by known cardiovascular risk factors depending on the specific cancer site.

Influence of time lapse after cancer diagnosis on the association between unmet needs and quality of life in family caregivers of Korean cancer patients.

OBJECTIVE: This study explored the association between healthcare needs and quality of life (QoL) of Korean cancer family caregivers according to the time lapse after cancer diagnosis. METHODS: Self-administered comprehensive needs assessment tool and EuroQol-5-dimension index for 686 cancer family caregivers were classified into four groups according to time lapse after cancer diagnosis (≤12, 13-36, 37-60,>60 months). We estimated the association between unmet needs and QoL by multiple linear regression analyses after adjusting for age, sex, cancer site and caregivers' comorbid conditions. RESULTS: Female or elder caregivers had lower QoL and higher unmet needs. The highest unmet needs existed in healthcare staff domain followed by information/education domain persistently along all periods. QoL of caregivers was significantly associated with family/social support and health/psychological problem during the time lapse of ≤12 months as well as >60 months. Practical support was consistently associated with QoL across all time lapses. Religious/spiritual support and hospital facilities and services showed significant association with QoL only in ≤12 months and >60 months respectively. CONCLUSIONS: The QoL of Korean cancer family caregivers was differentially associated with their unmet needs according to the time lapse after cancer diagnosis and by specific domains of needs.

Practice Patterns in Distinguishing Between Background Pain and Breakthrough Pain During Patient Education: a Korean Physician Survey.

This study sought to explore the association between physician practice patterns and patient education, with a focus on breakthrough cancer pain (BTcP). A nationwide online survey was conducted by 92 Korean physicians. Thirteen questions on Korean physician's assessment, prescription, patient education practices, and knowledge regarding BTcP were administered. Based on their responses, physicians were divided using two methods: (1) by their patient education practices, where the "education group" always explained the distinction between background pain and BTcP and the "less education group" which explained it less frequently; and (2) by their definition of BTcP, as occurring "after control of background pain" or "regardless of background pain." We compared practice patterns using Fisher's exact test or Student's t test and performed multiple logistic regression analysis. The "education group" (65 physicians, 70.7 %) was more likely than the "less education group" to assess BTcP meticulously (odds ratio [OR] 17.13, 95 % confidence interval [CI] 4.98-58.94), prepare rescue medications in advance (OR 3.67, 95 % CI 1.36-9.90), and give explicit instructions regarding medications (OR 36.68, 95 % CI 5.63-239.15). Physicians who defined BTcP as occurring "after control of background pain" were more likely to explain how to take rescue medication (P < 0.05) than physicians who defined BTcP as occurring "regardless of background pain." Korean physicians' BTcP practice patterns may be affected by whether they consistently educate patients on the distinction between background pain and BTcP, regardless of their knowledge of the definition of BTcP.

Thiopurine Prodrugs Mediate Immunosuppressive Effects by Interfering with Rac1 Protein Function.

6-Thiopurine (6-TP) prodrugs include 6-thioguanine and azathioprine. Both are widely used to treat autoimmune disorders and certain cancers. This study showed that a 6-thioguanosine triphosphate (6-TGTP), converted in T-cells from 6-TP, targets Rac1 to form a disulfide adduct between 6-TGTP and the redox-sensitive GXXXXGK(S/T)C motif of Rac1. This study also showed that, despite the conservation of the catalytic activity of RhoGAP (Rho-specific GAP) on the 6-TGTP-Rac1 adduct to produce the biologically inactive 6-thioguanosine diphosphate (6-TGDP)-Rac1 adduct, RhoGEF (Rho-specific GEF) cannot exchange the 6-TGDP adducted on Rac1 with free guanine nucleotide. The biologically inactive 6-TGDP-Rac1 adduct accumulates in cells because of the ongoing combined actions of RhoGEF and RhoGAP. Because other Rho GTPases, such as RhoA and Cdc42, also possess the GXXXXGK(S/T)C motif, the proposed mechanism for the inactivation of Rac1 also applies to RhoA and Cdc42. However, previous studies have shown that CD3/CD28-stimulated T-cells contain more activated Rac1 than other Rho GTPases such as RhoA and Cdc42. Accordingly, Rac1 is the main target of 6-TP in activated T-cells. This explains the T-cell-specific Rac1-targeting therapeutic action of 6-TP that suppresses the immune response. This proposed mechanism for the action of 6-TP on Rac1 performs a critical role in demonstrating the capability to design a Rac1-targeting chemotherapeutic agent(s) for autoimmune disorders. Nevertheless, the results also suggest that the targeting action of other Rho GTPases in other organ cells, such as RhoA in vascular cells, may be linked to cytotoxicities because RhoA plays a key role in vasculature functions.

Cross-sectional association between testosterone, sex hormone-binding globulin and metabolic syndrome: The Healthy Twin Study.

OBJECTIVES: This study evaluated an association between testosterone, sex hormone-binding globulin (SHBG) and metabolic syndrome (MetS).We also evaluated the genetic and environmental influences on the association. DESIGN: Cross-sectional. SETTING: Community-based study. PARTICIPANTS: A total of 1098 Korean adult men including 139 monozygotic twin pairs. MAIN OUTCOME MEASURE: MetS was defined using the National Cholesterol Education Program-Third Adult Treatment Panel (NCEP ATP III) and International Diabetes Federation (IDF) criteria. The associations between MetS and sex hormones were evaluated using linear mixed model and generalized estimating equation model. RESULTS: After considering covariates such as smoking, alcohol consumption and physical exercises as well as SHBG or testosterone, the risk of MetS defined by NCEP ATP III criteria decreased by 31%, 29%, and 48%, respectively, with 1-standard deviation increase in total testosterone (TT), free testosterone (cFT) and SHBG. Similar findings were revealed with IDF criteria. Metabolic component specific analysis showed that sex hormones were inversely associated with several components of MetS: TT with abdominal obesity, low high-density lipoprotein cholesterol (HDL-C) and high blood pressure; cFT with abdominal obesity and high blood pressure; SHBG with all components except high blood pressure. Cotwin control analysis found an inverse correlation between within-pair differences in testosterone and SHBG levels and within-pair differences in waist circumference only. CONCLUSION: Both testosterone and SHBG were inversely associated with MetS although the inverse associations with the sex hormones were not consistently found across individual metabolic components. Findings from cotwin analysis suggest a significant contribution of unshared unique environmental effect to the association between testosterone and SHBG and abdominal obesity.

Comparison of the association of mammographic density and clinical factors with ductal carcinoma in situ versus invasive ductal breast cancer in Korean women.

BACKGROUND: In spite of the increasing incidence of in situ breast cancer, the information about the risk factors of in situ breast cancer (DCIS) is scarce as compared to the information available for invasive ductal breast cancer (IDC), with inconsistent findings regarding the difference in risk factors between DCIS and IDC. METHODS: We enrolled 472 women with IDC and 90 women with DCIS and 1088 controls matching for age and menopausal status. Information on risk factors was collected through self-administered questionnaire. Percent mammographic dense area (PDA), absolute mammographic dense area (ADA), and nondense area were assessed using a computer-assisted thresholding technique. Odds ratio (OR) and 95% confidence intervals (CI) were estimated by conditional logistic regression model with adjustment for covariates. RESULTS: Later age at menarche and regular physical exercise were associated with decreased risk of IDC, whereas alcohol consumption, previous benign breast disease, and family history of breast cancer were associated with increased risk of IDC. For DCIS, previous benign breast disease and alcohol consumption were associated with the increased risk, and regular physical exercise was associated with decreased risk. Increase of ADA by 1-quartile level and PDA increase by 10% were associated with 1.10 (95% CI: 1.01, 1.21) and 1.10 (95% CI: 1.01, 1.19) times greater risk of IDC, respectively. The increase of ADA by 1-quartile level and PDA increase by 10% were associated with 1.17 (95% CI: 0.91, 1.50) times and 1.11 (95% CI:0.90,1.37) times greater risk of DCIS, respectively, but the associations were not statistically significant. There was no significant difference in the association with risk factors and mammographic density measures between IDC and DCIS (P > 0.1). CONCLUSIONS: Differential associations of DCIS with mammographic density and risk factors as compared with the associations of IDC were not evident. This finding suggests that IDC and DCIS develop through the shared causal pathways.

Association between Lumbar Bone Mineral Density and Carotid Intima-Media Thickness in Korean Adults: a Cross-sectional Study of Healthy Twin Study.

Bone mineral density (BMD) has been suggested to be associated with atherosclerosis. In the present study, we evaluated the association between lumbar BMD and the segments of carotid intima-media thickness (CIMT), a surrogate marker of subclinical atherosclerosis, in Korean adults, with consideration of sex and menopause status. Among 1,679 Korean adults who enrolled in a Healthy Twin Study, 723 men, 690 premenopausal women, and 266 postmenopausal women measured the CIMT at the common carotid artery intima-media thickness (CCA-IMT), carotid bifurcation intima-media thickness (BIF-IMT), internal carotid artery intima-media thickness (ICA-IMT) using B-mode ultrasound and lumbar BMD using dual-energy X-ray absorptiometry. The composite CIMT was calculated as the mean value of three CIMTs. The association was evaluated using linear mixed models. In premenopausal women, lumbar BMD was positively associated with composite CIMT and with CCA-IMT (P = 0.008 and 0.002, respectively). However, no association was observed between BMD and CIMT in men or in postmenopausal women. Stratified analysis revealed the effect of body mass index (BMI) on the association between BMD and CIME. The positive association in premenopausal women persisted only in low BMI (< 25 kg/m²) group, whereas a positive association appeared at high BMI (≥ 25 kg/m²) group in men. A high lumbar BMD may indicate an elevated risk of subclinical atherosclerosis in premenopausal women and men with high BMI.

Validation Study for the Korean Version of Fear of Cancer Recurrence Inventory.

Fear of cancer recurrence (FCR) is one of the most prevalent unmet psychosocial needs. This study aimed to confirm the cultural equivalence, reliability, and validity of the Korean version of Fear of Cancer Recurrence Inventory (K-FCRI). We conducted a forward-backward translation of the English version FCRI to Korean version through meticulous process including transcultural equivalence test. The psychometric property of the K-FCRI was then validated in 444 survivors from cancers at various sites. The Korean translation was accepted well by participants. There was a good cultural equivalence between the Korean version and the English version of FCRI. Confirmatory factor analysis supported the original seven-factor structure with slightly insufficient level of goodness-of-fit indices (comparative fit index = 0.900, non-normed fit index = 0.893, root mean square error of approximation = 0.060). The K-FCRI had high internal consistency (α = 0.85 for total scale and α = 0.77-0.87 for subscales) and test-retest reliability (r = 0.90 for total scale and r = 0.54-0.84 for subscales). The K-FCRI had significant correlations with the Korean version of Fear of Progression Questionnaire, European Organization for Research and Treatment of Cancer Quality of Life Questionnaire Version 3.0, Hospital Anxiety and Depression Scale, and Fatigue Severity Score, supporting the good construct validity and psychometric properties of K-FCRI. The K-FCRI was confirmed as a valid and reliable psychometric test for measuring FCR of Korean survivors from cancers at various sites.

Comparison between Discrete Multi-Wavelength Near-Infrared Spectroscopy and Bioelectrical Impedance Analysis in the Assessment of Muscle Mass for Community-Dwelling Older People.

(1) Background: This study evaluated the clinical implications of a new measurement technique for muscle mass using discrete multi-wavelength near-infrared spectroscopy (DMW-NIRS) compared with multifrequency bioelectrical impedance analysis (BIA) in older adults. (2) Methods: In a cross-sectional study involving 91 participants aged 65 years, the agreement of total lean mass for each measurement was assessed using the intraclass correlation coefficient (ICC) and Pearson's correlation analysis. The study was conducted at a university hospital from 10 July 2023 to 1 November 2023. (3) Results: A total of 45 men (mean age, 74.1) and 46 women (mean age, 73.6) were analyzed. In the comparisons of total lean mass between DMW-NIRS and BIA, ICC (2.1) was 0.943 and Cronbach's α coefficient was 0.949 (p < 0.001). Across all segments of lean mass, we found excellent agreement with the ICCs (>0.90) and acceptable values of the correlation coefficients (>0.6) between DMW-NIRS and BIA. (4) Conclusions: This study confirmed agreement in the measurements of muscle mass between portable devices using DMW-NIRS and BIA among community-dwelling older adults. A simple screening of muscle mass in a home setting would help to detect early decreases in muscle mass.

Efficacy and Safety of WCFA19 (Weissella confusa WIKIM51) in Reducing Body Fat in Overweight and Obese Adults.

Background: WCFA19 (Weissella confusa WIKIM51), found during the fermentation of kimchi, is known for its inhibitory effects on body weight and body fat. This study looked at the impact of WCFA19 isolated from dandelion kimchi on weight loss in overweight and obese adults that are otherwise healthy. Methods: This study was conducted as a multicenter, double-blind, randomized, placebo-controlled study with 104 overweight and obese subjects. Subjects were randomized evenly into the test group (WCFA19, 500 mg, n = 40) or control group (n = 34) for 12 weeks from 14 June 2021 to 24 December 2021. Effects were based on DEXA to measure changes in body fat mass and percentage. Results: Among the 74 subjects analyzed, WCFA19 oral supplementation for 12 weeks resulted in a significant decrease in body fat mass of 633.38 ± 1396.17 g (p = 0.0066) in overweight and obese individuals in the experimental group. The control group showed an increase of 59.10 ± 1120.57 g (p = 0.7604), indicating a statistically significant difference between the two groups. There was also a statistically significant difference (p = 0.0448) in the change in body fat percentage, with a decrease of 0.41 ± 1.22% (p = 0.0424) in the experimental group and an increase of 0.17 ± 1.21% (p = 0.4078) in the control group. No significant adverse events were reported. Conclusions: Oral supplementation of 500 mg of WCFA19 for 12 weeks is associated with a decrease in body weight, particularly in body fat mass and percentage.

Serum Lipid Levels and Suicidal Ideation of Adults: A Cross-Sectional Study Using the Korea National Health and Nutrition Examination Survey.

Cholesterol plays a crucial role in the brain, which suggests that changes in its concentration levels may have an impact on the central nervous system. To examine the association between serum lipid levels and suicidal ideation according to sex, we performed a cross-sectional study using data from the Korea National Health and Nutrition Examination Survey 2014-2018. A total of 13,772 adults 19 years or older were analyzed. The ninth item of the Patient Health Questionnaire was used to evaluate the suicidal ideation of participants. After sorting by sex, a complex logistic regression was performed to measure the association between serum lipid indicators and suicidal ideation. The analysis adjusted for age, body mass index, smoking, heavy drinking, regular exercise, household income, education level, dyslipidemia medication, depression, and chronic diseases. Compared to the intermediated category, the lowest range of low-density lipoprotein cholesterol (LDL-C; <100 mg/dL) was associated with increased suicidal ideation in men (odds ratio [OR] = 1.97; 95% confidence interval [CI]: 1.30-3.01). The association between lipid levels and suicidal ideation was not clear in women. We found an association between lower LDL-C levels and an increased risk of suicidal ideation among Korean men aged 19 years or older.

Association between glycemic status and age-related macular degeneration: A nationwide population-based cohort study.

AIM: The risk of dry and wet age-related macular degeneration (AMD) based on fasting glucose levels and disease duration of type 2 diabetes was investigated. METHODS: Using a health insurance claims database and the results of health examinations in South Korea, we conducted a retrospective, population-based cohort study of 2,103,604 adults ≥ 45 years of age who were AMD-free based on health checkups in 2009 and observed from January 1, 2011, to December 31, 2018. Glycemic status was classified into five groups: normal, impaired fasting glucose, new-onset diabetes (fasting glucose level ≥ 126 mg/dl but no diabetes diagnosis or diabetes medication), diabetes diagnosis < 5 years, and diabetes ≥ 5 years. According to the presence and absence of choroidal neovascularization, AMD was classified as wet AMD and dry AMD, respectively. Adjusted hazard ratios (HRs) of AMD occurrence were estimated in each category. RESULTS: For dry AMD (n = 36,271, 1.72%), the HR was 1.192 (1.141-1.245) among subjects with diabetes < 5 years and 1.294 (1.242-1.349) among subjects with diabetes ≥ 5 years compared with subjects with normal glycemic status after adjusting for age, sex, body mass index, lifestyle, and medical history. For wet AMD (n = 12,912, 0.61%), the HR was 1.103 (1.011-1.203) among subjects with new-onset diabetes, 1.252 (1.167-1.344) among subjects with diabetes < 5 years, and 1.506 (1.413-1.605) among subjects with diabetes ≥ 5 years. The HR of AMD was significantly increased among participants ≤ 65 years old and those who did not have hypertension. CONCLUSIONS: The incidence of dry and wet AMD increased among diabetes patients compared to the normal glycemic status group. These risks increased when the duration of diabetes was 5 years or more. The risk of wet AMD was increased among new-onset diabetes patients. These results suggest that high blood glucose levels without treatment might induce the vision-threatening condition of wet AMD, emphasizing the importance of early blood glucose management.