Effect of general health checks on the treatment of chronic diseases: accounting for self-selection in the retrospective cohort study using Korea National Health Insurance data.

OBJECTIVE: This study examines the effect of general health checks on the detection and treatment of diabetes and hypertension with controlling for the self-selection problem of undergoing general health checks. DESIGN: Retrospective observational cohort study. SETTING: Sample Research Database offered by Korean National Health Insurance Service, between 2002 and 2013. PARTICIPANTS: Two datasets, focusing on diabetes and hypertensions one by one, are constructed. The number of participants for the datasets is 133 329 (diabetes) and 101 738 (hypertension), respectively. METHODS: A bivariate probit model with selection was adopted to investigate the impact of general health checks on the diagnosis of critical chronic diseases. The dependent variable was an indicator variable denoting whether a participant has been treated for diabetes (or hypertension) or not for the first time during the sample period. An indicator variable that indicates whether that participant is eligible for free general health checks or not in the focal year (year of the first treatment or last year in the sample) was used as instrument variables to control for the self-selection problem of undergoing general health checks. RESULTS: We found that there exists substantial self-selection between undergoing general health checks and diagnosis for chronic diseases. The correlations between the unobserved factors influencing the decisions to obtain general health checks and those determining the detection of chronic diseases are highly significant and positive (ie, 0.188 (p<0.001) in diabetes and 0.220 (p<0.001) in hypertension). We confirmed that these positive, significant correlations generate upward bias in the estimated effect of general health checks on the detection and treatment of diabetes (0.312 (p<0.001) when self-selection ignored but 0.099 (p<0.001) when self-selection considered) and hypertension (0.293 (p<0.001) when self-selection ignored but insignificant when self-selection considered). The effect of general health checks and people's self-selection behaviour may differ by socio-economic characteristics of individuals. The general health check is effective in detecting chronic diseases among low-income individuals rather than high-income individuals, implying that general health checks are contributing to helping medically underprivileged low-income people detect and treat their chronic diseases. High-income individuals showed stronger self-selection behaviour than low-income individuals and this may overstate the effect of general health checks if the self-selection is overlooked, particularly among high-income individuals. CONCLUSION: Self-selection due to unobserved factors between undergoing general health checks and diagnosis of chronic diseases are substantial. After accounting for this, the effect of general health checks on the detection and treatment of diabetes and hypertension is insignificant or marginal. The increases in the treatments of the two diseases following general health checks are 1% and insignificant in diabetes and hypertension, respectively.

Efficacy and Safety of MED-01 Probiotics on Vaginal Health: A 12-Week, Multicenter, Randomized, Double-Blind, Placebo-Controlled Clinical Trial.

Bacterial vaginosis (BV) is the most common disease in women of childbearing age and is caused by the growth of abnormal microbiota in the vagina. Probiotic consumption can be an effective alternative treatment to preserve or improve vaginal health. In the present study, MED-01, a complex of five strains of probiotic candidates isolated from the vagina of Korean women, was used. This study was designed as a 12-week, randomized, multicenter, double-blind, placebo-controlled clinical trial to evaluate the efficacy and safety of MED-01 on vaginal health. A total of 101 reproductive-aged women with a Nugent score of 4-6 took MED-01 (5.0 × 109 CFU) or a placebo once a day, and 76 participants completed the procedure. MED-01 significantly reduced the Nugent score compared with the placebo. Quantitative PCR analysis confirmed that Lactobacillus plantarum was significantly increased in the vagina, whereas harmful bacteria such as Mobiluncus spp., Gardnerella vaginalis, and Atopobium vaginae were suppressed after 12 weeks of MED-01 ingestion. No adverse events to the test food supplements were observed in the participants. These results confirmed that MED-01 can be used as a probiotic for treating BV, as it improves the vaginal microbiota.

Effect of Topical Anesthesia on Pain from Needle Insertion and Injection and Its Relationship with Anxiety in Patients Awaiting Apical Surgery: A Randomized Double-blind Clinical Trial.

INTRODUCTION: We aimed to simultaneously investigate the effects of topical anesthesia on needle insertion and injection pain in the labial mucosa of the maxillary central incisors of patients awaiting apical surgery and to assess the relationship between patients' anxiety and pain scores. METHODS: Forty-four patients scheduled for apical surgery of the maxillary anterior incisor or canine were included, and all completed the Modified Dental Anxiety Scale (MDAS) questionnaire. One piece of Xylocaine (AstraZeneca, Sodertalje, Sweden) gauze was applied to the right or left side of the labial vestibule below the central incisor according to a randomization process, and 1 piece of water gauze was applied to the contralateral side of the labial vestibule. Each piece of gauze remained in place for 2 minutes. The subjects were asked to rate their pain according to the numeric rating scale immediately after needle insertion and anesthetic solution injection. RESULTS: Topical anesthetic application significantly reduced both insertion- and injection-related pain. Injection pain was significantly higher than insertion pain throughout the experiment. The difference in pain scores between the placebo and topical anesthetic groups was significantly greater for insertion pain than injection pain. The group with higher MDAS scores showed significantly higher pain scores, except for insertion pain reported by the topical anesthetic group, which did not show a significant difference between MDAS score groups. CONCLUSIONS: The topical anesthetic was highly effective for both insertion and injection pain during infiltration anesthesia in the maxillary central incisors. Highly anxious patients reported higher pain scores; however, topical anesthetics reduced the effect of anxiety on increasing pain.

Intrathecal Transplantation of Embryonic Stem Cell-Derived Spinal GABAergic Neural Precursor Cells Attenuates Neuropathic Pain in a Spinal Cord Injury Rat Model.

Neuropathic pain following spinal cord injury (SCI) is a devastating disease characterized by spontaneous pain such as hyperalgesia and allodynia. In this study, we investigated the therapeutic potential of ESC-derived spinal GABAergic neurons to treat neuropathic pain in a SCI rat model. Mouse embryonic stem cell-derived neural precursor cells (mESC-NPCs) were cultured in media supplemented with sonic hedgehog (SHH) and retinoic acid (RA) and efficiently differentiated into GABAergic neurons. Interestingly, low doses of SHH and RA induced MGE-like progenitors, which expressed low levels of DARPP32 and Nkx2.1 and high levels of Irx3 and Pax6. These cells subsequently generated the majority of the DARPP32(-) GABAergic neurons after in vitro differentiation. The spinal mESC-NPCs were intrathecally transplanted into the lesion area of the spinal cord around T10-T11 at 21 days after SCI. The engrafted spinal GABAergic neurons remarkably increased both the paw withdrawal threshold (PWT) below the level of the lesion and the vocalization threshold (VT) to the level of the lesion (T12, T11, and T10 vertebrae), which indicates attenuation of chronic neuropathic pain by the spinal GABAergic neurons. The transplanted cells were positive for GABA antibody staining in the injured region, and cells migrated to the injured spinal site and survived for more than 7 weeks in L4-L5. The mESC-NPC-derived spinal GABAergic neurons dramatically attenuated the chronic neuropathic pain following SCI, suggesting that the spinal GABAergic mESC-NPCs cultured with low doses of SHH and RA could be alternative cell sources for treatment of SCI neuropathic pain by stem cell-based therapies.

Wet-chemical synthesis of palladium nanosprings.

We report a methodology for synthesis of palladium (Pd) nanospring structures using an anodic aluminum oxide (AAO) membrane template and facile electrochemical deposition. The hydroxyl-terminated surfaces of alumina nanochannels and localized hydrogen evolution contribute to the growth of Pd atoms at peripheral positions of the alumina nanochannels in the presence of an effectual electric potential and a plating solution consisting of PdCl(2), CuCl(2), and HCl. Structural characterization including EDS line analysis and element mapping revealed Pd nanodomains curling up on the Cu nanorods. A clear Pd nanospring shape was observed after selectively removing Cu. The lengths of the nanosprings were dictated by the charges transported through electrodeposition, and the diameters of the nanosprings were tunable by altering the diameter of the alumina nanochannels. Screw dislocation is the most probable crystallographic defect responsible for the formation of coiled Pd nanostructures. Pd nanosprings have potential applications in nanomachines, nanosensors, nanoinductors, and metamaterials. We anticipate that our synthesis method will motivate and inform the synthesis of more advanced nanomaterials.

Nanometer-scale oxide thin film transistor with potential for high-density image sensor applications.

The integration of electronically active oxide components onto silicon circuits represents an innovative approach to improving the functionality of novel devices. Like most semiconductor devices, complementary-metal-oxide-semiconductor image sensors (CISs) have physical limitations when progressively scaled down to extremely small dimensions. In this paper, we propose a novel hybrid CIS architecture that is based on the combination of nanometer-scale amorphous In-Ga-Zn-O (a-IGZO) thin-film transistors (TFTs) and a conventional Si photo diode (PD). With this approach, we aim to overcome the loss of quantum efficiency and image quality due to the continuous miniaturization of PDs. Specifically, the a-IGZO TFT with 180 nm gate length is probed to exhibit remarkable performance including low 1/f noise and high output gain, despite fabrication temperatures as low as 200 °C. In particular, excellent device performance is achieved using a double-layer gate dielectric (Al2O3/SiO2) combined with a trapezoidal active region formed by a tailored etching process. A self-aligned top gate structure is adopted to ensure low parasitic capacitance. Lastly, three-dimensional (3D) process simulation tools are employed to optimize the four-pixel CIS structure. The results demonstrate how our stacked hybrid device could be the starting point for new device strategies in image sensor architectures. Furthermore, we expect the proposed approach to be applicable to a wide range of micro- and nanoelectronic devices and systems.

Acupuncture decreases ischemia-induced apoptosis and cell proliferation in dentate gyrus of gerbils.

BACKGROUND: Acupuncture has been used for the enhancement of functional recovery from various disorders. In the present study, the effect of acupuncture on the apoptosis and new cell proliferation in the hippocampal dentate gyrus of gerbils (n = 25) following transient global ischemia was investigated. METHODS: To determine the level of apoptosis and cell proliferation, terminal deoxynucleotidyl transferase-mediated dUTP nick end-labeling (TUNEL) assay and immunohistochemistry for 5-bromo-2'-deoxyuridine (BrdU) were employed respectively. RESULTS: In the dentate gyrus of ischemic gerbils, the number of both TUNEL- and BrdU-positive cells (66.01 +/- 2.45/mm(2) and 514.38 +/- 44.90/mm(2)) was significantly increased compared to that of the sham-operated gerbils (11.25 +/- 1.85/mm(2) and 111.47 +/- 10.95/mm(2)). Among the acupuncture (ST36, LI4 or non-acupoint) treated groups, ST36 acupoint treated group showed the most potent apoptosis (20.52 +/- 2.40/mm(2)) and proliferation (159.38 +/- 24.05/mm(2)) suppressive effects ( approximately 70% decreases in both apoptosis and cell proliferation). CONCLUSION: These results may suggest that acupuncture treatment alleviates ischemia-induced apoptosis and presents possible therapeutic potentials in the recovery from ischemic cerebral injury.

Multipole plasmon resonances in gold nanorods.

The optical properties of gold rods electrochemically deposited in anodic aluminum oxide templates have been investigated. Homogeneous suspensions of rods with an average diameter of 85 nm and varying lengths of 96, 186, 321, 465, 495, 578, 641, 735, and 1175 nm were fabricated. The purity and dimensions of these rod nanostructures allowed us to observe higher-order multipole resonances for the first time in a colloidal suspension. The experimental optical spectra agree with discrete dipole approximation calculations that have been modeled from the dimensions of the gold nanorods.