The global burden of sudden infant death syndrome from 1990 to 2019: a systematic analysis from the Global Burden of Disease study 2019.

BACKGROUND: Sudden infant death syndrome (SIDS) still remains one of the leading causes of infant death worldwide, especially in high-income countries. To date, however, there is no detailed information on the global health burden of SIDS. AIMS: To characterize the global disease burden of SIDS and its trends from 1990 to 2019 and to compare the burden of SIDS according to the socio-demographic index (SDI). DESIGN: Systematic analysis based on the Global Burden of Disease (GBD) 2019 data. METHODS: Epidemiological data of 204 countries from 1990 to 2019 were collected via various methods including civil registration and vital statistics in the original GBD study. Estimates for mortality and disease burden of SIDS were modeled. Crude mortality and mortality rates per 100 000 population were analyzed. Disability-adjusted life years (DALYs) and DALY rates were also assessed. RESULTS: In 2019, mortality rate of SIDS accounted for 20.98 [95% Uncertainty Interval, 9.15-46.16] globally, which was a 51% decrease from 1990. SIDS was most prevalent in Western sub-Saharan Africa, High-income North America and Oceania in 2019. The burden of SIDS was higher in males than females consistently from 1990 to 2019. Higher SDI and income level was associated with lower burden of SIDS; furthermore, countries with higher SDI and income had greater decreases in SIDS burden from 1990 to 2019. CONCLUSIONS: The burden of SIDS has decreased drastically from 1990 to 2019. However, the improvements have occurred disproportionately between regions and SDI levels. Focused preventive efforts in under-resourced populations are needed.

MRI-Based Assessment of the Pharyngeal Constrictor Muscle as a Predictor of Surgical Margin after Transoral Robotic Surgery in HPV-Positive Tonsillar Cancer.

BACKGROUND AND PURPOSE: Transoral robotic surgery is an emerging strategy for treating human papillomavirus-positive cancers, but the role of MR imaging in predicting the surgical outcome has not been established. We aimed to identify preoperative MR imaging characteristics that predispose the outcome of transoral robotic surgery toward an insecure (positive or close) surgical margin in human papillomavirus-positive tonsillar squamous cell carcinoma. MATERIALS AND METHODS: Between December 2012 and May 2019, sixty-nine patients underwent transoral robotic surgery at our institution. Among these, 29 who were diagnosed with human papillomavirus-positive tonsillar squamous cell carcinoma, did not receive neoadjuvant treatment, underwent preoperative 3T MR imaging, and had postoperative pathologic reports and were included in this retrospective study. Two neuroradiologists evaluated the preoperative MR imaging scans to determine the tumor spread through the pharyngeal constrictor muscle using a 5-point scale: 1, normal constrictor; 2, bulging constrictor; 3, thinning constrictor; 4, obscured constrictor; and 5, tumor protrusion into the parapharyngeal fat. The risk of an insecure surgical margin (involved or <1 mm) according to the MR imaging scores was predicted using logistic regression with the Firth correction. RESULTS: The interobserver agreement for the MR imaging scores was excellent (κ = 0.955, P < .001). A score of ≥4 could predict an insecure margin with 87.5% sensitivity and 92.3% specificity (area under the curve = 0.899) and was the only significant factor associated with an insecure margin in the multivariable analysis (OR, 6.59; 95% CI, 3.11-22.28; P < .001). CONCLUSIONS: The pre-transoral robotic surgery MR imaging scoring system for the pharyngeal constrictor muscle is a promising predictor of the surgical margin in human papillomavirus-positive tonsillar squamous cell carcinoma.

Dosimetric evaluation and beam characterization of pair production enhanced radiotherapy (PPER) with the use of organometallics.

The current study evaluates dosimetric and spectral effects when platinum (Pt)-based chemotherapeutics and less toxic tungstophosphoric-acid (TPA) organometallics are present during x-ray radiotherapy. We hypothesize that the use of high energy photon beams (i.e. 18 MV) will increase absorbed dose due to increased pair production from high-Z elements and thus result in additional tumor cell kill. EGSnrc code was used to examine the contribution of pair production to dose in the presence of the high-Z material (TPA, Pt mixtures and tungsten, W) as a function of beam energy. Variables included different concentrations (100 µmolar, 1 mmolar), depths (5 mm, 10 cm), thicknesses (5 mm, 5 cm) and energies (6, 18 MV). Overall, for the deeper depth, the 511 keV photon fluence increase was up 31% (18 MV-1 mmolar) while at 6 MV it was between 10%-11% depending on the concentration. For the shallower depth, 18 MV fluence increase was up 14.6% (1 mmolar) and 18.6% (1 mmolar) for the 6 MV. The dose enhancement effect due to pair production was up 25%-30% and a total 33%-58% depending on the depth. The benefit related to pair production was more for 18 MV and under conditions that simulated a realistic clinical setup. While part of the effect could be attributed to photoabsorption, a significant contribution of dose could result from pair production. Experimental clonogenic survival assay was consistent with the theory in that the low dose shoulder region of a cell survival curve was reduced using TPA and 18 MV compared with TPA and 6 MV or compared with no TPA and 18 MV; RBE was approximately 2 at the dose commonly used in conventional fractionated clinical radiotherapy. This suggests a potential new strategy for dose enhancement based on pair production using higher energy beamlines.

Quality analysis of randomized controlled trials in the International Journal of Impotence Research: quality assessment and relevant clinical impact.

The quality of randomized controlled trials (RCTs) reported in the International Journal of Impotence Research (IJIR) was analyzed. The original articles that reported RCTs and were published in the IJIR in 1997-2014 were identified by PubMed. Their methodological quality was assessed using the Jadad scale, van Tulder scale and Cochrane Collaboration Risk of Bias Tool. The review period was divided into three periods: early (1997-2002), mid (2003-2008) and late (2009-2014). The effect of study subject and presence of Institutional Review Board approval, intervention, funding and adequate allocation concealment on RCT quality was assessed. The frequency of RCT publication in the IJIR did not change over the 19-year study period. Numbers of low risk of bias articles were 1 (3.0%), 2 (4.4%) and 4 (12.1%) in the early, mid and late periods in Cochrane Collaboration Risk of Bias Tool (P=0.04). High-quality low risk of bias RCT publication frequency increased over time. Intervention and funding significantly influenced RCT quality. Thus, the number of RCTs published in the IJIR over time has remained constant while their quality has improved. Ongoing efforts to expand the numbers of RCTs and further improve the quality of research published by the IJIR will improve clinical practice.

Vertebral bone attenuation on low-dose chest CT: quantitative volumetric analysis for bone fragility assessment.

This study evaluated the use of low-dose chest computed tomography (LDCT) for detecting bone fragility. LDCT-measured vertebral bone attenuation by volumetric methods showed good correlation with bone mineral density (BMD) measured by dual-energy x-ray absorptiometry (DXA, and good diagnostic performance for identifying osteoporosis and compression fractures. The results of this study suggest the feasibility of obtaining comprehensive information on bone health in subjects undergoing LDCT. INTRODUCTION: Osteoporosis is a prevalent but underdiagnosed disease that increases fracture risk. This study evaluated the utility of vertebral attenuation derived from low-dose chest computed tomography (LDCT) compared to dual-energy x-ray absorptiometry (DXA) for detecting bone fragility. METHODS: A total of 232 subjects (78 men and 154 women) aged above 50 years who underwent both LDCT and DXA within 30 days were evaluated. LDCT-measured bone attenuation in Hounsfield units (HU) of four vertebrae (T4, T7, T10, and L1) was evaluated using volumetric methods for correlation with DXA-measured bone mineral density (BMD) and for the diagnosis of compression fractures, osteoporosis, and low BMD (osteoporosis or osteopenia) in men and women, with DXA measurements as the reference standard. RESULTS: The average attenuation of the four vertebrae showed strong correlation with DXA-measured BMD of the lumbar spine (r = 0.726, p < 0.05). In receiver-operating characteristic (ROC) analyses, the area under the curve (AUC) across LDCT-measured thresholds of the average attenuation to distinguish compression fractures was 0.827, and a threshold of 129.5 HU yielded 90.9 % sensitivity and 64.4 % specificity. Similarly, average attenuation showed high AUCs and good diagnostic performance for detecting osteoporosis and low BMD in both men and women. Among 44 subjects with compression fractures, the average bone attenuation showed strong negative correlation with both the worst fracture grade (r = -0.525, p < 0.05) and cumulative fracture grade score (r = -0.633, p < 0.05). CONCLUSION: LDCT-measured bone attenuation by volumetric methods showed good correlation with BMD measured by DXA and good diagnostic performance for identifying bone fragility.

Comparison of ceiling effects between two patient-rating scores and a physician-rating score in the assessment of outcome after the surgical treatment of distal radial fractures.

We compared the ceiling effects of two patient-rating scores, the Disability of the Arm, Shoulder and Hand (DASH) and Patient-Rated Wrist Evaluation (PRWE), and a physician-rating score, the Modified Mayo Wrist Score (MMWS) in assessing the outcome of surgical treatment of an unstable distal radial fracture. A total of 77 women with a mean age of 64.2 years (50 to 88) who underwent fixation using a volar locking plate for an unstable distal radial fracture between 2011 and 2013 were enrolled in this study. All completed the DASH and PRWE questionnaires one year post-operatively and were assessed using the MMWS by the senior author. The ceiling effects in the outcome data assessed for each score were estimated. The data assessed with both patient-rating scores, the DASH and PRWE, showed substantial ceiling effects, whereas the data assessed with MMWS showed no ceiling effect. Researchers should be aware of a possible ceiling effect in the assessment of the outcome of the surgical treatment of distal radial fractures using patient-rating scores. It could also increase the likelihood of a type II error.

Assessment of early therapeutic response to sorafenib in renal cell carcinoma xenografts by dynamic contrast-enhanced and diffusion-weighted MR imaging.

OBJECTIVE: To investigate the feasibility of dynamic contrast-enhanced MRI (DCE-MRI) and diffusion-weighted MRI (DWI) in monitoring early therapeutic response to sorafenib in renal cell carcinoma (RCC) xenograft models. METHODS: Sorafenib (40 mg kg(-1)) was administered orally to BALB/c nude mice (n = 9) bearing subcutaneous tumours of human RCC ACHN xenografts. DCE-MRI and DWI were obtained 0, 1, 3 and 7 days after therapy, and DCE-MRI parameters (K(trans) and ve) and apparent diffusion coefficient (ADC) values were calculated. Tumour size and volume changes were correlated with changes in DCE-MRI parameters or ADC values after therapy. RESULTS: Following therapy, K(trans) showed a significant decrease over time (p = 0.005), whereas ve did not demonstrate significant changes between time points (p = 0.97). ADC values showed a progressive increase over time (p = 0.004). Compared with pre-therapy, K(trans) showed a significant decrease after 3 days of therapy (p = 0.039), and ADC values increased significantly after 7 days (p = 0.039). Tumour size and volume did not show significant changes during 7 days. Tumour size and volume changes were not associated with changes in DCE-MRI parameters or ADC values. CONCLUSION: DCE-MRI and DWI may show early physiological changes within 1 week after initiating sorafenib treatment on human RCC xenografts. ADVANCES IN KNOWLEDGE: The quantitative parameters of DCE-MRI and DWI may offer the potential for assessing early therapeutic response to sorafenib in clinical trials.

Assessment of apple core collections constructed using phenotypic and genotypic data.

Several types of information can be used to select core collections, including passport data, agronomic data, and molecular data. However, little is known about the ability of core collections to retain the genetic diversity and structure of the whole collection for characters that were not considered during the selection, particularly when molecular markers are used. In this study, two core subsets were established for the apple (Malus spp) germplasm bank curated at the Apple Research Station, National Institute of Horticultural and Herbal Science, Korea, based upon genetic diversity estimated with 14 simple sequence repeat markers, and phenotypic diversity based on 23 traits. Comparisons between these two subsets and with the whole collection were used to determine the effect of the data used in the selection on phenotypic and genetic diversity, and population structure. The two subsets had a similar diversity and did not differ from the original collection, according to the Nei and Shannon diversity indices. Allele and class frequencies were also maintained in the two subsets. Overall, the type of data used to construct the core collection had little influence on the phenotypic and genetic diversity retained. Therefore, in the case of apple collections, the use of molecular markers is preferable, because they allow rapid and reliable characterization.

Traditional Yangsaeng oriental health promotion in patients with cardiovascular disease.

BACKGROUND: A traditional Korean health behavior regimen, 'Yangsaeng' is an ancient Chinese concept that incorporates health promoting behaviours. AIM: The purpose of this study was to test a hypothesized model that identified the effects of activity status, internal health locus of control, and resilience on Yangsaeng among patients with cardiovascular disease. METHODS: Secondary data were utilized in this study. Originally, 543 Korean patients with cardio-vascular disease were recruited from general hospitals, although only 532 were included in this study. Path analysis was performed using AMOS 17.0. RESULTS: Resilience was significantly associated with and accounted for 37% of the variance in Yangsaeng. Activity status and internal health locus of control were significantly associated with and accounted for 4% of the variance in resilience. LIMITATIONS: Given the cross-sectional data used, the sequencing and/or direction of the relationships found remains uncertain. There may be complex interactions that were not considered. CONCLUSIONS: These results suggest that enhancing resilience is essential to foster a health-promoting lifestyle that helps prevent the recurrence of cardio-vascular disease. IMPLICATIONS FOR NURSING AND HEALTH POLICY: Nurse development of a Yangsaeng program for patients with cardiovascular disease may be a useful means of enhancing resilience in western as well as eastern cultures. This will help such patients to recognize the health benefits of improving their resilience through heightened activity levels and adopting an internal health locus of control.

In vivo assessment of the effect of taxifolin glycoside on atopic dermatitis-like skin lesions using biomedical tools in NC/Nga mice.

BACKGROUND: Noninvasive methods of assessment are widely used in clinical trials. However, such methods have not been established in atopic dermatitis (AD), which is a chronic inflammatory skin disease. AIM: To demonstrate, using biomedical tools, the benefits of a new substance, taxifolin glycoside (TAX), in an AD model, the NC/Nga mouse. METHODS: We evaluated the efficacy of topical TAX for AD by measuring clinical skin severity score, cytokine expression and serum IgE level, and by using biomedical measures (vapometry and corneometry). Topical TAX was applied to AD-induced NC/Nga mice for 3 weeks. The anti-inflammatory effects of this compound were demonstrated noninvasively using biomedical tools and immunological assays. RESULTS: Our method of AD assessment using biomedical tools is more objective and accurate than visual inspection. The results obtained using the biomedical tools were identical to those obtained using immunological assays. CONCLUSIONS: In vivo biomedical tools are useful for diagnosing and monitoring treatment effects in AD.

Health care use and economic burden of patients with diagnosed chronic obstructive pulmonary disease in Korea.

BACKGROUND: The prevalence and economic burden of chronic obstructive pulmonary disease (COPD) are increasing worldwide. However, little information is available concerning COPD-associated health care use and costs in Korea. OBJECTIVE: To analyse 1) health care use, medical costs and medication use in 2009, and 2) changes in costs and medication use over 5 years (2006-2010). DESIGN: Using the database of the Korean Health Insurance Review and Assessment Service, COPD patients were identified by searching on both ICD-10 codes and COPD medication. RESULTS A total of 192,496 COPD patients were identified in 2009. Total medical costs per person were US$2803 ± 3865; the average annual number of days of out-patient care and days of hospitalisation were respectively 40 ± 36 and 11 ± 33. Methylxanthine and systemic beta-agonists were the most frequently used drugs. However, the number of prescriptions for long-acting muscarinic antagonist increased rapidly. The total cost of COPD-related medications increased by 33.1% over 5 years. CONCLUSION: The present study provides new insight into health care use and the economic burden of COPD in Korea. Changing patterns of COPD-related medication use could help inform COPD management policies.

Relationship between socioeconomic status and anemia prevalence in adolescent girls based on the fourth and fifth Korea National Health and Nutrition Examination Surveys.

BACKGROUND/OBJECTIVES: We studied the relationship between socioeconomic status (SES), represented by household income, and the prevalence of anemia and iron deficiency anemia (IDA) among adolescent girls in Korea. SUBJECTS/METHODS: The samples were based on the data from a four-year (2008-2011) collection for the Korea National Health and Nutrition Examination Survey (1312 girls, age 10-18 years). The survey included demographic, anthropometric, biochemical and nutritional parameters. A multiple regression analysis after adjusting for age, body mass index (BMI), red blood cell count, white blood cell count and red meat intake was performed. Anemia was defined as hemoglobin level lower than 11.5 g/dl for ages 10-11 years and 12.0 g/dl for ages 12-14 years. Iron deficiency was defined as serum ferritin level below 15 µg/l. RESULTS: The prevalences of anemia and IDA in Korean girls were 5.3 and 4.2%, respectively. Girls with anemia were older, taller, weighed more, had higher BMI, had higher portion of menarche experience and consumed less red meat than girls without anemia. Girls with higher income had lower anemia prevalence and consumed more iron and vitamins. Logistic regression analysis showed a decreasing trend in anemia prevalence as household income increased. Correlation analysis demonstrated that there is a relationship between household income and serum hemoglobin and ferritin levels (P=0.003 and P=0.026, respectively). CONCLUSIONS: Higher SES leads to lower prevalence of anemia and IDA in Korean adolescent girls. This may be due to the fact that higher SES individuals consume more iron and vitamin C.

Pathological Internet use and associated factors among university students in Hong Kong.

1. Among university entrants, the prevalence of pathological Internet use (PIU) increased more than three-fold (from 5.0 to 15.7%) after 18 months of university life. Psycho-social factors such as depression, life dissatisfaction, and use of the Internet for recreational purposes were associated with the development of PIU. 2. University health workers should be aware that PIU is associated with inferior mental well-being, increased sleeping disorders, and deterioration of family relationships. Special attention should be given to Mainland Chinese students and those with pre-existing psychological problems, as they are more prone to developing PIU. 3. Most university students with PIU were unaware of the health implications of the condition and thus not motivated to seek help. Health workers must take a pro-active approach.

Evidence for direct CP violation in B±â†’ηh± and observation of B0→ηK0.

We report measurements of the branching fractions and CP asymmetries for B(±)→ηh(±) (h=K or π) and the observation of the decay B(0)→ηK(0) from the final data sample of 772×10(6) B ̅B pairs collected with the Belle detector at the KEKB asymmetric-energy e(+)e(-) collider. The measured branching fractions are B(B(±)→ηK(±))=(2.12±0.23±0.11)×10(-6), B(B(±)→ηπ(±))=(4.07±0.26±0.21)×10(-6), and B(B(0)→ηK(0))=(1.27(-0.29)(+0.33)±0.08)×10(-6), where the last decay is observed for the first time with a significance of 5.4 standard deviations (σ). We also find evidence for CP violation in the charged B modes, A(CP)(B(±)→ηK(±))=-0.38±0.11±0.01 and A(CP)(B(±)→ηπ(±))=-0.19±0.06±0.01 with significances of 3.8 σ and 3.0 σ, respectively. For all measurements, the first and second uncertainties are statistical and systematic, respectively.

Effect of Flammulina velutipes on spent-hen breast meat tenderization.

An experiment was carried out to investigate the effects of powdered vegetable dip sauces to improve the tenderness of spent-hen breast meat. Our overall purpose was to find lower-priced materials for the tenderization of spent-hen breast meat. The spent-hen breast meat was dipped into vegetable powder for 24 h at 4°C, and then the samples were analyzed. In the results for vegetable-powder treated samples, those treated with papain and pineapple had higher (P ≤ 0.05) myofibrillar fragmentation indices compared with those of the other samples. The kiwi-, pineapple-, and Flammulina velutipes-powder (winter mushroom) treated samples had new peptides of about 32 kDa and degradation to 30 kDa. Also, the Flammulina velutipes-powder treated samples showed new peptides of 15 kDa. These data imply that Flammulina velutipes is superior for common use than papain or pineapple for the tenderization of spent-hen meat.

Assessment of radiation dose for surrounding organs and persons approaching implanted patients upon brachytherapy of prostate cancer with Iridium-192.

To assess a proper dose for radiation therapy fitting the typical physical characteristics of male Korean bodies, a mathematical phantom was prepared based on standard Korean male measurements. Upon brachytherapy of prostate cancer by implanting 192Ir into the prostate gland (the source organ), the absorbed dose of the prostate gland and surrounding organs and the expected dose of people within the vicinity were assessed. 192Ir, which has been the radionuclide of choice for prostate cancer brachytherapy, was selected for the simulation. It was assumed that 1 Ci of initial radioactivity would be administered. As a result, 1.28E-02 Gy/Ci was exhibited in the prostate gland of the source organ, and the dose to which persons within the vicinity were exposed was exhibited to be 9.19E-06 Sv at a distance of 30 cm from the front.

Assessment of meat quality properties and development of a palatability prediction model for Korean Hanwoo steer beef.

Effects of the Korean carcass-grading system on carcass traits and meat quality parameters for the longissimus dorsi (LD) and semimembranosus (SM) muscles were investigated for Hanwoo steer beef. High quality grade beef cuts had significantly higher intramuscular fat content than those of low quality grade beef cuts. To establish a guaranteed system of eating quality for Hanwoo steer beef, a palatability prediction model was developed. The model development approach used canonical discriminant analysis and multivariate regression to assess effects of muscle type, cooking method, and aging treatment on Hanwoo beef quality grade. The palatability prediction model can provide Korean consumers with detailed information about expected eating quality for an individual cut, as well as provide critical information to the industry for maintaining high-quality beef production. The model is a significant advance in grading compared with the traditional carcass grading system, which applies a single quality grade to an entire carcass.

Efficacy of moxibustion after rolling correction in dairy cows with abomasal displacement.

This study was performed to assess the efficacy of moxibustion after rolling correction in dairy cows with abomasal displacement (AD). The experimental group comprised 86 Holstein cows with left displacement of the abomasum (LDA) and right displacement of the abomasum (RDA), with a mean age of 3.8 with AD during a 2-year period. The cows were rolled for correction of AD. After the rolling procedure, moxibustion was conducted on six acupoints once a day during the course of treatment. After repositioning the abomasums, the bilateral points of BL-20, BL-21 and BL-26 were then stimulated. During the follow-up of 1 week, 67 (93.1%) of 72 LDA and 12 (85.7%) of 14 RDA cows were released as cured after moxibustion. In conclusion, moxibustion effectively treats AD following rolling correction in dairy cows.

Spatial and temporal pollutant budget analyses toward the total maximum daily loads management for the Yeongsan watershed in Korea.

This paper delivers two issues: water quality in the Yeongsan (YS) watershed which is one of the major watersheds in Korea and new watershed management plans with respect to the total maximum daily loads (TMDL) management. Field studies were conducted to estimate the pollutant loads according to the spatial and temporal distribution based on the biochemical oxygen demand (BOD) concentration and the volumetric flow rate (VFR) data from YS watershed. The results of both spatial and temporal analyses show the main pollutant source was originated from the city of Gwangju and the pollutant load from the city to YS watershed was the most out of five cities during this study period. Concerning YS reservoir located downstream of YS watershed, it also shows the worst water quality in the entire watershed during the study period. These results collectively demonstrate that the city of Gwangju is a main region which generates numerous point and non-point pollutant sources and eventually the pollutants are accumulated in YS reservoir. Based on the results, we suggest two different management plans for YS watershed. One is the flow-control approach that is to increase the amount of dam discharge in order to guarantee the river management flow for the midstream region. The other is the mass-control approach that is to dredge the contaminated sediments in YS reservoir for removing pollutants chronically accumulated in the sediment. Simulations for the former and the latter provide the pollution mitigation rate in the watershed up to 6 and 8% for BOD5, respectively. The methodology proposed here for TMDL management can be applied to a wide range of watersheds in Korea.

Risk assessment of human exposure to cypermethrin during treatment of mandarin fields.

The potential dermal and respiratory exposure assessment and risk assessment for applicator were performed with cypermethrin EC. The pesticide was applied on a mandarin field using a power sprayer. Gloves were used for the hand exposure assessment, mask for face, and dermal patches for the other parts of the body. Personal air monitor equipped with a XAD-2 resin was used for the respiratory exposure assessment. During the application of cypermethrin in the field, the rate of potential dermal exposure ranged from 28.1 to 58.8 mg/h. The major exposure parts were upper-arms (22.1-24.6%) and legs (thigh and shin, 28.3-29.2%) for females and thigh (21.0-46.9%) and hand (14.9-19.3%) for males. Females were exposed more than males. No exposure was detected from the respiratory monitoring. For risk assessment, the potential dermal exposure (PDE), the absorbable quantity of exposure (AQE), and the margin of safety (MOS) were calculated. Among those four risk assessments, MOS was < 1 in only trial I, which indicated any possibility of risk. However, in the others, the possibility of risk was little. Moreover, the safe work time ranged from 3.61 h to 9.69 h.