Mediating the effects of depression in the relationship between university students' attitude toward suicide, frustrated interpersonal needs, and non-suicidal self-injury during the COVID-19 pandemic.

OBJECTIVE: The study aimed to examine the relationship on attitudes toward suicide, frustrated interpersonal needs, and non-suicidal self-injury (NSSI) of the university students. METHODS: The participants included 175 university students. Data were analyzed using the SPSS PROCESS macro (Model 4). RESULTS: Depression showed a fully mediating effect on the relationship between one's attitude toward suicide and NSSI behaviors. Furthermore, depression showed a full mediating impact on the relationship between frustrated interpersonal needs and NSSI behaviors. CONCLUSIONS: These findings indicate that suicidal attitudes and frustrated interpersonal needs should be considered significant factors for developing NSSI preventions and intervention among university students.

Effect of a balanced Korean diet on metabolic risk factors among overweight/obese Korean adults: a randomized controlled trial.

PURPOSE: This study was to see the effects of a balanced Korean diet (BKD) on metabolic risk factors in overweight or obese Korean adults, comparing with those of a typical American diet (TAD) and a diet recommended by the 2010 Dietary Guidelines for Americans (2010DGA). METHODS: The study was designed as a randomized crossover controlled trial, in which 61 overweight or obese volunteers were divided into six groups and each consumed the BKD, 2010DGA, and TAD in a random order for 4 weeks separated by 2-week washout intervals. Anthropometric indices, blood pressure, blood lipid content, fasting blood glucose, and blood insulin level were measured at the beginning and end of each diet period. RESULTS: A total of 54 participants completed the trial. The BKD caused more significant reductions of body mass index (BMI) (p < 0.001), body fat percent (p < 0.001), blood total cholesterol (p < 0.001), and low-density lipoprotein (LDL) cholesterol (p = 0.007) compared with the 2010DGA or TAD (all p values for differences between diets < 0.05). All three diets significantly lowered blood triglyceride levels (p < 0.05). The BKD decreased high-density lipoprotein (HDL) cholesterol (p = 0.001) and increased fasting blood glucose (p = 0.018), whereas TAD and 2010DGA increased HDL cholesterol and did not affect blood glucose levels. Furthermore, the BKD significantly decreased the proportion of individuals with elevated total cholesterol (p < 0.001) and LDL cholesterol (p < 0.01), whereas the 2010DGA significantly reduced the number of obese individuals (p < 0.05), and the TAD decreased the number of participants with elevated triglyceride levels (p < 0.05), but increased that of those with elevated LDL cholesterol (p < 0.05). CONCLUSIONS: The Korean diet based on dietary guidelines improved metabolic risk factors such as BMI, body fat percent, and blood lipid profiles in overweight or obese Korean adults. These results provide evidence to recommend the Korean diet for preventing various metabolic diseases. CLINICAL TRIAL REGISTRATION: The trial was registered at the Clinical Research Information Service (CRIS) in Korea, the primary registry of the World Health Organization (WHO) international clinical trial registry platform, under number KCT0002437.

Utilizing a Spiro Core with Acridine- and Phenothiazine-Based New Hole Transporting Materials for Highly Efficient Green Phosphorescent Organic Light-Emitting Diodes.

Two new hole transporting materials, 2,7-bis(9,9-diphenylacridin-10(9H)-yl)-9,9' spirobi[fluorene] (SP1) and 2,7-di(10H-phenothiazin-10-yl)-9,9'-spirobi[fluorene] (SP2), were designed and synthesized by using the Buchwald-Hartwig coupling reaction with a high yield percentage of over 84%. Both of the materials exhibited high glass transition temperatures of over 150 °C. In order to understand the device performances, we have fabricated green phosphorescent organic light-emitting diodes (PhOLEDs) with SP1 and SP2 as hole transporting materials. Both of the materials revealed improved device properties, in particular, the SP2-based device showed excellent power (34.47 lm/W) and current (38.41 cd/A) efficiencies when compare with the 4,4'-bis(N-phenyl-1-naphthylamino)biphenyl (NPB)-based reference device (30.33 lm/W and 32.83 cd/A). The external quantum efficiency (EQE) of SP2 was 13.43%, which was higher than SP1 (13.27%) and the reference material (11.45%) with a similar device structure. The SP2 hole transporting material provides an effective charge transporting path from anode to emission layer, which is explained by the device efficiencies.

Self-termination of ventricular fibrillation during transport by emergency medical service.

Ventricular fibrillation (VF) is usually sustained, and it typically results in death unless electrical defibrillation is successfully performed within minutes. Although VF has been reported to spontaneously occur in vivo in some animal models and a few cases of self-terminating VF have been documented in clinical practice, no such case has been previously reported involving out-of-hospital emergency medical service(EMS) personnel. We report a case of self-terminating VF due to ST segment elevation myocardial infarction that was documented by continuous electrocardiogram (ECG) strip monitoring. A 70-year-old woman was transported to the emergency department by EMS due to chest discomfort. The EMS personnel monitored her by ECG using an automated external defibrillator with a 3-limb lead. During transport, she developed VF, which persisted for 43 seconds. Chest compression and defibrillation were not applied. The VF self-terminated, after which the patient promptly awoke. Emergency coronary angiography was performed,and a total occlusion of the middle left circumflex coronary artery was treated by percutaneous coronary intervention. Since then, no symptomatic arrhythmia or ST-segment change was detected by continuous ECG monitoring. The patient was discharged home without any sequelae on the fourth hospital day.

Mediating Effect of Self-Control on the Relationship between Obesity-Related Stress and Weight Control Behavior among Female College Students with Overweight and Obesity.

BACKGROUND: This study aimed to determine whether self-regulation acts as a mediating factor in the relationship between obesity-related stress and weight control behavior, targeting Korean female college students. Obesity-related stress and weight control behaviors are important factors affecting an individual's health and well-being, and self-control, a psychological trait, can play a pivotal role in regulating how individuals respond to stress and engage in weight management behaviors. METHODS: This study employed a descriptive correlational design. A total of 109 female college students with overweight and obesity participated in the study. We used a self-report questionnaire to measure obesity-related stress, self-control, and degree of weight control behavior. Data were analyzed using descriptive statistics, Pearson's correlation coefficient analysis, and bootstrapping using Hayes' PROCESS macro for mediation. RESULTS: Significant relationships between obesity-related stress and weight control behavior (r = 0.25, p < 0.001), obesity-related stress and self-control (r = -0.36, p < 0.001), and weight control behavior and self-control (r = 0.26, p < 0.001) were observed. Self-control showed an indirect mediating effect on the relationship between obesity-related stress and weight control behavior (Β = 0.37, p = 0.001). CONCLUSIONS: Through the research results, it was confirmed that self-control is a factor that has a mediating effect in the relationship between obesity-related stress and weight control behavior among female college students with overweight and obesity. These results underscore the importance of addressing self-control strategies in interventions aimed at promoting healthy weight management among female college students with overweight or obesity.

Combined primary tumor and extracranial metastasis status as constituent factor of prognostic indices for predicting the overall survival in patients with brain metastases.

We retrospectively analyzed the prognostic factors on overall survival (OS) in patients with brain metastasis (BM) and evaluated the role of combined primary tumor and extracranial metastasis (ECM) status as a constituent factor for prognostic index. This study involved 897 patients with BMs who underwent radiotherapy between April 2003 and December 2009. Among the clinical parameters, multivariate analysis showed that age, Karnofsky performance status (KPS), combined primary tumor and ECM status, number of BMs, and treatment group were significant prognostic factors for OS (P < 0.05). To compare the discriminatory ability of 5 prognostic indices, i.e., recursive partitioning analysis (RPA), basic score for BMs (BSBM), score index for radiosurgery (SIR), graded prognostic assessment (GPA), and modified GPA including the combined primary tumor and ECM status (mGPA), the Akaike information criteria (AIC) were calculated. The mGPA showed the lowest AIC value, followed by RPA, GPA, SIR, and BSBM, in that order. It is implicated that modified score of pre-existing factors (i.e., age and KPS) and addition of the combined primary tumor and ECM status to the prognostic index can improve its discriminatory ability and the combined primary tumor and ECM status may be useful as one of constituent factors for prognostic index.

Stress, and coping strategy of university students during COVID-19 in Korea: The mediating role of ego-resiliency.

We aimed to identify the level of stress, ego-resiliency (ER), and coping strategies of university students during the onset of coronavirus disease 2019 (COVID-19) and examine the mediating role of ER in the relationship between stress and coping strategies (e.g., problem-solving, social support seeking, and avoidance). We analyzed responses from 160 university students and found that problem-solving was the most common coping strategy (26.02 ± 4.65), followed by social support-seeking (25.08 ± 5.23), and avoidance (19.21 ± 3.78). ER was negatively associated with stress and showed a mediating effect on the relationship between stress and social support, and stress and problem-solving coping strategies. These findings indicate that ER helps decrease stress caused by the pandemic among university students and should be considered a significant factor for developing adaptive stress coping strategies.

Characteristics and Outcomes of Herbal Medicine for Female Infertility: A Retrospective Analysis of Data from a Korean Medicine Clinic During 2010-2020.

Purpose: Few studies have assessed outcomes associated with the use of traditional medicine therapies to manage infertility in clinical practice. The aim of this study was to investigate the clinical characteristics of and infertility treatment effects among patients who visited a Korean medicine (KM) clinic to aid in achieving pregnancy. This study consisted of a 10-year analysis of patient records from a KM clinic. Methods: A retrospective 10-year (2010-2020) chart analysis was performed using the medical records of infertile patients who visited a KM clinic in South Korea for fertility treatment (ICD-10, infertility symptoms: 59 codes). Results: Of the 6194 patients who visited the clinic during the selected time frame, 1786 were female patients seeking fertility treatment to achieve pregnancy. Among the 1786 infertile women, 586 women succeeded in becoming pregnant (32.8%). Among the 586 patients who became pregnant, 476 women had received KM, 92 had been treated using KM and in vitro fertilization (IVF), and 18 had received KM and undergone intrauterine insemination (IUI). The live birth rates achieved with these treatments were 66.0%, 68.8%, and 66.7%, respectively. The most frequently prescribed medicines were Gamiboher-tang (Jiaweiwuxu-tang), Gamiguibi-tang (Jiaweiguipi-tang), and Gamidanggui-san (Jiaweidanggui-san). Additionally, the most frequent adjunct therapies administered to these patients were acupuncture and moxibustion. Conclusion: Infertility therapies using KM may be a successful option to treat infertility when used alone or in addition to IVF and IUI. However, further pharmacological investigations and clinical trials are required to ensure the objectivity of the efficacy evaluation.

Agrifood consumer competency and organic food purchase intentions according to food-related lifestyle: based on data the 2019 Consumer Behavior Survey for Food.

BACKGROUND/OBJECTIVES: The increased consumers' interests in health and food safety have increased the demand for organic foods. Many studies have been performed on consumers' purchase intentions for organic foods and their influencing factors, and various studies have shown that the prices of organic foods and the consumers' willingness to pay are important influencing factors. This study examined the payment value of organic foods and agrifood consumer competency index according to the food-related lifestyles in South Korean consumers. SUBJECTS/METHODS: A cross-sectional analysis was performed using the 2019 Consumer Behavior Survey for Food. A total of 6,176 participants aged 19 to 74 years (male: 2,783, female: 3,393) were included in the analysis. RESULTS: Three factors were extracted by factor analysis (rational consumption-seeking type, convenience-seeking type, and health, and safety-seeking type) to explain the consumers' food-related lifestyles. The results of cluster analysis suggested that consumers were classified into 3 food-related lifestyles as the 'exploratory consumers' (n = 2,485), 'safety-seeking consumers' (n = 1,544), and 'passive consumers' (n = 2,147). Exploratory consumers showed a significantly higher willingness to pay for imported organic foods (P < 0.05). Safety-seeking consumers had a significantly higher willingness to pay for domestic organic foods (P < 0.05). For the agrifood consumer competency index, exploratory consumers had the highest score, followed in order by safety-seeking consumers and passive consumers. CONCLUSIONS: These results provide basic data in understanding consumption tendency for organic foods and agrifoods based on food-related lifestyles of South Korean consumers.

Optimizing External Beam Radiotherapy as per the Risk Group of Localized Prostate Cancer: A Nationwide Multi-Institutional Study (KROG 18-15).

PURPOSE: This nationwide multi-institutional study analyzed the patterns of care and outcomes of external beam radiotherapy (EBRT) in localized prostate cancer patients. We compared various risk classification tools and assessed the need for refinements in current radiotherapy (RT) schemes. METHODS AND MATERIALS: We included non-metastatic prostate cancer patients treated with primary EBRT from 2001 to 2015 in this study. Data of 1573 patients from 17 institutions were analyzed and re-grouped using a risk stratification tool with the highest predictive power for biochemical failure-free survival (BCFFS). We evaluated BCFFS, overall survival (OS), and toxicity rates. RESULTS: With a median follow-up of 75 months, 5- and 10-year BCFFS rates were 82% and 60%, and 5- and 10-year OS rates were 95% and 83%, respectively. NCCN risk classification revealed the highest predictive power (AUC = 0.556, 95% CI 0.524-0.588; p < 0.001). Gleason score, iPSA < 12 ng/mL, intensity-modulated RT (IMRT), and ≥179 Gy1.5 (EQD2, 77 Gy) were independently significant for BCFFS (all p < 0.05). IMRT and ≥179 Gy1.5 were significant factors in the high-risk group, whereas ≥170 Gy1.5 (EQD2, 72 Gy) was significant in the intermediate-risk group and no significant impact of dose was observed in the low-risk group. Both BCFFS and OS improved significantly when ≥179 Gy1.5 was delivered using IMRT and hypofractionation in the high-risk group without increasing toxicities. CONCLUSIONS: With NCCN risk classification, dose escalation with modern high-precision techniques might increase survivals in the high-risk group, but not in the low-risk group, although mature results of prospective studies are awaited.

Theoretical studies on the formation mechanism and explosive performance of nitro-substituted 1,3,5-triazines.

To develop new highly energetic materials, we have considered the design of molecules with high nitrogen content. Possible candidates include 1,3,5-triazine derivatives. In this work, we studied potential synthetic routes for melamine using the MP2/6-31+G(d,p)//B3LYP/6-31G(d) level of theory. The mechanisms studied here are stepwise mechanism beginning with the dimerization of cyanamide and one-step termolecular mechanism. The same type of mechanism is also applied to nitro-substituted 1,3,5-triazines. Values for the heat of formation in the solid phase were predicted from density functional theory calculations. Densities were estimated from a regression equation obtained by molecular surface electrostatic potentials. The Cheetah program was used to study the explosive performance of these compounds. In this study, we found that the explosive properties of 2-amino-4, 6-dinitro-1, 3,5-triazine (ADNTA), and 2,4,6-trinitro-1,3,5-triazine (TNTA) are similar to those of RDX and HMX, respectively.

Cloning and characterization of microRNAs from porcine skeletal muscle and adipose tissue.

MicroRNAs (miRNAs) are an abundant class of small regulatory RNAs that regulate the stability and translation of cognate mRNAs. Although an increasing number of porcine miRNAs has recently been identified, the full repertoire of miRNAs in pig remains to be elucidated. To identify porcine miRNAs potentially involved in myogenesis and adipogenesis, we constructed small RNA cDNA libraries from skeletal muscle and adipose tissue and identified 89 distinct miRNAs that are conserved in pig, of which 15 were new. Expression analysis of all newly identified and selected known porcine miRNAs revealed that some miRNAs were enriched in a tissue-specific manner, whereas others were expressed ubiquitously in the porcine tissues examined. Our results expand the number of known porcine miRNAs and provide useful information for further investigating the biological functions of miRNAs associated with growth and development of skeletal muscle or adipose tissue in pig.

Predicting Functional Outcome Based on Linked Data After Acute Ischemic Stroke: S-SMART Score.

Prediction of outcome after stroke may help clinicians provide effective management and plan long-term care. We aimed to develop and validate a score for predicting good functional outcome available for hospitals after ischemic stroke using linked data. A total of 22,005 patients with acute ischemic stroke from the Clinical Research Center for Stroke Registry between July 2007 and December 2014 were included in the derivation group. We assessed functional outcomes using a modified Rankin scale (mRS) score at 3 months after ischemic stroke. We identified predictors related to good 3-month outcome (mRS score ≤ 2) and developed a score. External validations (geographic and temporal validations) of the developed model were performed. The prediction model performance was assessed using the area under the receiver operating characteristic curve (AUC) and the calibration test. Stroke severity, sex, stroke mechanism, age, pre-stroke mRS, and thrombolysis/thrombectomy treatment were identified as predictors for 3-month good functional outcomes in the S-SMART score (total 34 points). Patients with higher S-SMART scores had an increased likelihood of a good outcome. The AUC of the prediction score was 0.805 (0.798-0.811) in the derivation group and 0.812 (0.795-0.830) in the geographic validation group for good functional outcome. The AUC of the model was 0.812 (0.771-0.854) for the temporal validation group. Moreover, they had good calibration. The S-SMART score is a valid and useful tool to predict good functional outcome following ischemic stroke. This prediction model may assist in the estimation of outcomes to determine care plans after stroke.

Serum level of sex steroid hormone is associated with diversity and profiles of human gut microbiome.

Gut microbiota plays roles in host physiology including endocrine function. Although some data suggest a potential connection between biological sex differences and gut microbiota, the connection between sex steroid hormones and gut microbes remained unexplored. The current study investigates the relationship between gut microbes and serum levels of testosterone in men and estradiol in women. Fecal microbiota from a total of 57 men (n = 31) and women (n = 26) were assessed using 16s rRNA gene sequencing. Based on the levels of serum testosterone and estradiol in men and women, respectively, participants were stratified into three groups of Low, Medium, and High. Microbiome communities were analyzed as a function of the steroid hormone within sex. Men and women in the High group harbored more diverse gut microbial communities than others. In men, the abundance of Acinetobacter, Dorea, Ruminococcus, and Megamonas correlated significantly with testosterone levels. Women in the High group have more Bacteroidetes and less Firmicutes phyla than those in the Low group. Genera Slackia and Butyricimonas were significantly correlated with estradiol levels. These results demonstrate that sex steroid hormone levels are correlated with diversity and gut microbial composition, and provide fundamental information helpful for developing communication networks between human and microbial communities.

A facile one-pot preparation of potassium hydroxyaryl- and (hydroxyalkyl)aryltrifluoroborates.

Potassium hydroxyaryl- and (hydroxyalkyl)aryltrifluoroborates have been prepared in a simple one-pot process from the corresponding hydroxy-substituted aryl halides in 51-98% yields through an in situ protection of the free hydroxyl group with t-BuLi. Also, we successfully performed a microwave-promoted Suzuki-Miyaura cross-coupling reaction of these substrates with aryl- and alkenyl bromides in the presence of 0.5 mol % of Pd(OAc)2 catalyst without ligands.

Targeting Phosphatidylinositol 4-Kinase IIIα for Radiosensitization: A Potential Model of Drug Repositioning Using an Anti-Hepatitis C Viral Agent.

PURPOSE: To investigate which isotype of phosphatidylinositol 4-kinase (PI4K) may affect radiosensitivity and examine whether anti-hepatitis C viral (HCV) agents, some of which have been shown to inhibit PI4K IIIα activity, could be repositioned as a radiosensitizer in human cancer cells. METHODS AND MATERIALS: U251, BT474, and HepG2 cell lines and normal human astrocyte were used. Ribonucleic acid interference, clonogenic assays, Western blotting, immunofluorescence, annexin V assay, lysotracker staining, and ß-galactosidase assay were performed. RESULTS: Of the 4 PI4K isotypes, specific inhibition of IIIα increased radiosensitivity. For pharmacologic inhibition of PI4K IIIα, we screened 9 anti-HCV agents by half-maximal inhibitory concentration assay. Simeprevir was selected, and its inhibition of PI4K IIIα activity was confirmed. Combination of simeprevir treatment and radiation significantly attenuated expression of phospho-phospho-PKC and phospho-Akt and increased radiation-induced cell death in tested cell lines. Pretreatment with simeprevir prolonged γH2AX foci formation and down-regulation of phospho-DNA-PKcs, indicating impairment of nonhomologous end-joining repair. Cells pretreated with simeprevir exhibited mixed modes of cell death, including apoptosis and autophagy. CONCLUSION: These data demonstrate that targeting PI4K IIIα using an anti-HCV agent is a viable approach to enhance the therapeutic efficacy of radiation therapy in various human cancers, such as glioma, breast, and hepatocellular carcinoma.

Locoregional Recurrence by Tumor Biology in Breast Cancer Patients after Preoperative Chemotherapy and Breast Conservation Treatment.

PURPOSE: The purpose of this study is to determine whether breast cancer subtype can affect locoregional recurrence (LRR) and ipsilateral breast tumor recurrence (IBTR) after neoadjuvant chemotherapy (NAC) and breast-conserving therapy (BCT). MATERIALS AND METHODS: We evaluated 335 consecutive patients with clinical stage II-III breast cancer who received NAC plus BCT from 2002 to 2009. Patients were classified according to six molecular subtypes: luminal A (hormone receptor [HR]+/HER2-/Ki-67 < 15%, n=113), luminal B1 (HR+/HER2-/Ki-67 ≥ 15%, n=33), luminal B2 (HR+/HER2+, n=83), HER2 with trastuzumab (HER2[T+]) (HR-/HER2+/use of trastuzumab, n=14), HER2 without trastuzumab (HER2[T-]) (HR-/HER2+, n=31), and triple negative (TN) (HR-/HER2-, n=61). RESULTS: After a median follow-up period of 7.2 years, 26 IBTRs and 37 LRRs occurred. The 5-year LRR-free survival rates were luminal A, 96.4%; B1, 93.9%; B2, 90.3%; HER2(T+), 92.9%; HER2(T-), 78.3%; and TN, 79.6%. The 5-year IBTR-free survival rates were luminal A, 97.2%; B1, 93.9%; B2, 92.8%; HER2(T+), 92.9%; HER2(T-), 89.1%; and TN, 84.6%. In multivariate analysis, HER2(T-) (IBTR: hazard ratio, 4.2; p=0.04 and LRR: hazard ratio, 7.6; p < 0.01) and TN subtypes (IBTR: hazard ratio, 6.9; p=0.01 and LRR: hazard ratio, 8.1; p < 0.01) were associated with higher IBTR and LRR rates. A pathologic complete response (pCR) was found to show correlation with better LRR and a tendency toward improved IBTR controls in TN patients (IBTR, p=0.07; LRR, p=0.03). CONCLUSION: The TN and HER2(T-) subtypes predict higher rates of IBTR and LRR after NAC and BCT. A pCR is predictive of improved IBTR or LRR in TN subtype.

Analysis of consumption frequencies of vegetables and fruits in Korean adolescents based on Korea youth risk behavior web-based survey (2006, 2011).

BACKGROUND/OBJECTIVES: This study analyzed factors affecting consumption frequencies of vegetables and fruits in Korean adolescents. SUBJECTS/METHODS: Consumption frequencies of vegetables and fruits, general characteristics, meal, health, and other variables were analyzed for a total of 147,047 adolescents who participated in the KYRBWS (Korea Youth Risk Behavior Web-based Survey) conducted in 2006 and 2011 by the Korea Centers for Disease Control and Prevention. RESULTS: Consumption frequencies of vegetables and fruits more than once a day significantly decreased in 2011 compared to 2006 based on Chi-square test conducted for every factor employed in the study. Analysis of factors showed that consumption frequencies of vegetables and fruits were reduced in both study years as subjective income decreased, whereas intake frequencies increased with mother's education level and reduction of adolescent stress level. CONCLUSIONS: In general, consumption frequencies of vegetables and fruits decreased in 2011 compared to those in 2006. Thus, future research needs to improve dietary guidelines for nutrition education in order for students to recognize the importance of food consumption and necessity of increasing daily serving sizes of vegetables and fruits for their balanced consumption.

Identification of Risk Factors for Locoregional Recurrence in Breast Cancer Patients with Nodal Stage N0 and N1: Who Could Benefit from Post-Mastectomy Radiotherapy?

INTRODUCTION: The locoregional recurrence (LRR) rate was reported as high as approximately 20% in stage I-II breast cancer following mastectomy. To investigate the risk factors for LRR in pT1-2N0-1 breast cancer patients treated with mastectomy but not radiation, and to define a subgroup of patients at high risk of LRR who may benefit from postmastectomy radiotherapy (PMRT). METHODS AND MATERIALS: In total, 390 patients with pT1-2N0M0 (n = 307) and pT1-2N1M0 (n = 83) breast cancer who underwent total mastectomy without adjuvant radiotherapy from 2002 to 2011 were enrolled in the study. RESULTS: After a median follow-up period of 5.6 years (range, 0.6-11.3 years), 21 patients had 18 systemic relapses and 12 LRRs including six in the chest wall and eight in the regional nodal area. The 5-year LRR-free survival (LRRFS) rates were 97.0% in pN0, 98.8% in pN1, and 97.4% in all patients. Multivariate analysis revealed that age < 50 years (Hazard Ratio, 11.4; p = 0.01) and no adjuvant chemotherapy (Hazard Ratio, 10.2; p = 0.04) were independent risk factors for LRR in pN0 patients. Using these factors, the 5-year LRRFS rates were 100% without any risk factors, 96.4% with one risk factor, and 86.7% with two risk factors. In pN1 patients, multivariate analysis revealed that having a hormone receptor negative tumor (Hazard Ratio, 18.3; p = 0.03) was the only independent risk factor for LRR. The 5-year LRRFS rates were 100.0% for luminal type, and 92.3% for non-luminal type cancer. CONCLUSION: Patients with pT1-2N0-1 breast cancer who underwent total mastectomy without PMRT could be stratified by nodal stage and risk factors for LRR. PMRT may have of value for node negative patients aged less than 50 years and who are not treated with adjuvant chemotherapy, and for non-luminal type patients with one to three positive nodes.

A randomized trial on the effects of 2010 Dietary Guidelines for Americans and Korean diet patterns on cardiovascular risk factors in overweight and obese adults.

BACKGROUND: Dietary patterns that are considered healthy (eg, the Dietary Approaches to Stop Hypertension diet and Mediterranean diet) may be more successful in reducing typical cardiovascular disease risks compared to dietary patterns considered unhealthy (eg, energy-dense diets such as the typical American diet). OBJECTIVE: This study assessed the effects of a Korean diet, the 2010 Dietary Guidelines for Americans (DGA), and a typical American diet on cardiometabolic risk factors, including lipid levels and blood pressure, in overweight, non-Asian individuals in the United States with elevated low-density lipoprotein cholesterol. DESIGN/INTERVENTION: The study was a three-period crossover, controlled-feeding study from January 2012 to May 2012. Thirty-one subjects were randomly allocated to one of six possible sequential orders for consuming the three diets for 4 weeks, each separated by a 10-day break. Data analysis included 27 subjects on the Korean diet periods and 29 in the DGA and typical American diet periods. Subjects remained weight stable. MAIN OUTCOME MEASURES: Lipid profile, blood pressure, insulin, glucose, and 24-hour urinary sodium were determined at baseline and at the end of each diet period. STATISTICAL ANALYSES PERFORMED: The additive main effects multiplicative interactions model was used to test for a subject by diet interaction. Differences among diets were determined using a mixed-models procedure (PROC MIXED) with random intercept for each subject. RESULTS: Total cholesterol and low-density lipoprotein cholesterol significantly decreased on Korean (P<0.0001 and P<0.01, respectively) and DGA (P<0.01 and P<0.05, respectively) diets, but not on the typical American diet. Although an unfavorable outcome, high-density lipoprotein cholesterol significantly decreased on all three diets (Korean: P<0.0001; DGA: P<0.0001; typical American: P<0.05). No diet had a significant effect on serum triglycerides, but a slight increase in triglycerides in the Korean and decrease in the DGA resulted in a significant difference between these two diets (P<0.01). All three diets caused modest decreases in systolic and diastolic blood pressure, which reached statistical significance for DGA only (P<0.05 and P<0.01, respectively). No diet had significant effect on fasting insulin, whereas fasting glucose decreased significantly on the Korean (P<0.01) and typical American (P<0.05) diets only. Urinary sodium output decreased significantly on DGA (P<0.0001). CONCLUSIONS: After a 4-week feeding period, Korean and DGA diet patterns resulted in positive changes in cardiovascular disease risk factors.