Mood regulation in euthymic patients with a history of antidepressant-induced mania.

INTRODUCTION: The use of antidepressants in bipolar disorder (BD) remains contentious, in part due to the risk of antidepressant-induced mania (AIM). However, there is no information on the architecture of mood regulation in patients who have experienced AIM. We compared the architecture of mood regulation in euthymic patients with and without a history of AIM. METHODS: Eighty-four euthymic participants were included. Participants rated their mood, anxiety and energy levels daily using an electronic (e-) visual analog scale, for a mean (SD) of 280.8(151.4) days. We analyzed their multivariate time series by computing each variable's auto-correlation, inter-variable cross-correlation, and composite multiscale entropy of mood, anxiety, and energy. Then, we compared the data features of participants with a history of AIM and those without AIM, using analysis of covariance, controlling for age, sex, and current treatment. RESULTS: Based on 18,103 daily observations, participants with AIM showed significantly stronger day-to-day auto-correlation and cross-correlation for mood, anxiety, and energy than those without AIM. The highest cross-correlation in participants with AIM was between mood and energy within the same day (median (IQR), 0.58 (0.27)). The strongest negative cross-correlation in participants with AIM was between mood and anxiety series within the same day (median (IQR), -0.52 (0.34)). CONCLUSION: Patients with a history of AIM have a different underlying mood architecture compared to those without AIM. Their mood, anxiety and energy stay the same from day-to-day; and their anxiety is negatively correlated with their mood.

Marginal Accuracy of Monolithic and Veneered Zirconia Crowns Fabricated by Conventional and Digital Workflows.

PURPOSE: To compare the marginal accuracy of zirconia crowns fabricated by different workflows (conventional and digital) and designs (monolithic and veneered). MATERIALS AND METHODS: A prepared maxillary first molar was used for the study. Four workflow combinations were evaluated: (1) intraoral scanning and monolithic zirconia (IOS-M), (2) intraoral scanning and veneered zirconia (IOS-V), (3) conventional impression and monolithic zirconia (IMP-M), and (4) conventional impression and veneered zirconia (IMP-V). All of the specimens had similar designs. The veneered groups had a buccal cutback for esthetic veneer application. A total of 10 crowns were produced in each workflow. The vertical and horizontal marginal accuracies were measured with a traveling microscope. Depending on the normality of the data, one-way analysis of variance test or Kruskal-Wallis test were applied to evaluate the differences among the groups (α = 0.05). RESULTS: The most superior vertical marginal accuracy was observed for IOS-V (mean = 22.5 µm; SD = 6.7 µm), followed by IMP-V (mean = 23.9 µm; SD = 7.8 µm), IOS-M (mean = 28.7 µm; SD = 10.3 µm), and IMP-M (mean = 39.8 µm; SD = 22.0 µm), respectively (p < 0.001). The IOS-M had the greatest mean horizontal discrepancies (mean = 23.9 µm; SD = 4.3 µm) followed by IMP-M (mean = 21.3 µm; SD = 5.7 µm), IMP-V (mean = 19.2 µm; SD = 5.3 µm) and IOS-V (mean = 17.6 µm; SD = 5.7 µm) (p < 0.001). CONCLUSIONS: Monolithic zirconia crowns fabricated digitally had superior marginal accuracy than monolithic zirconia crowns fabricated conventionally. Esthetic buccal veneering of predominantly monolithic zirconia copings improved the vertical and horizontal marginal accuracies.

Biglycan reduces body weight by regulating food intake in mice and improves glucose metabolism through AMPK/AKT dual pathways in skeletal muscle.

While biglycan (BGN) is suggested to direct diverse signaling cascades, the effects of soluble BGN as a ligand on metabolic traits have not been studied. Herein, we tested the effects of BGN on obesity in high-fat diet (HFD)-induced obese animals and glucose metabolism, with the underlying mechanism responsible for observed effects in vitro. Our results showed that BGN administration (1 mg/kg body weight, intraperitoneally) significantly prevented HFD-induced obesity, and this was mainly attributed to reduced food intake. Also, intracerebroventricular injection of BGN reduced food intake and body weight. The underlying mechanism includes modulation of neuropeptides gene expression involved in appetite in the hypothalamus in vitro and in vivo. In addition, BGN regulates glucose metabolism as shown by improved glucose tolerance in mice as well as AMPK/AKT dual pathway-driven enhanced glucose uptake and GLUT4 translocation in L6 myoblast cells. In conclusion, our results suggest BGN as a potential therapeutic target to treat risk factors for metabolic diseases.

Hypoxia-inducible factor 2α is a novel inhibitor of chondrocyte maturation.

Hypoxic environment is essential for chondrocyte maturation and longitudinal bone growth. Although hypoxia-inducible factor 1 alpha (Hif-1α) has been known as a key player for chondrocyte survival and function, the function of Hif-2α in cartilage is mechanistically and clinically relevant but remains unknown. Here we demonstrated that Hif-2α was a novel inhibitor of chondrocyte maturation through downregulation of Runx2 stability. Mechanistically, Hif-2α binding to Runx2 inhibited chondrocyte maturation by Runx2 degradation through disrupting Runx2/Cbfß complex formation. The Hif-2α-mediated-Runx2 degradation could be rescued by Cbfß transfection due to the increase of Runx2/Cbfß complex formation. Consistently, mesenchymal cells derived from Hif-2α heterozygous mice were more rapidly differentiated into hypertrophic chondrocytes than those of wild-type mice in a micromass culture system. Collectively, these findings demonstrate that Hif-2α is a novel inhibitor for chondrocyte maturation by disrupting Runx2/Cbfß complex formation and consequential regulatory activity.

Risk of Osteoarthritis is Positively Associated with Vitamin D Status, but Not Bone Mineral Density, in Older Adults in the United States.

OBJECTIVE: We examined the risk of osteoarthritis (OA) according to vitamin D status and bone mineral density (BMD) using a cross-sectional nationally representative database. METHODS: National Health and Nutrition Examination Survey (NHANES) data from 2007 to 2010 were used to assess the relationship between OA and vitamin D status in adults aged ≥40 years (n = 2934). NHANES data from 2005 to 2010 and 2013 to 2014 were analyzed to investigate the association between OA and BMD (n = 5949). Vitamin D status was categorized as serum 25-hydroxyvitamin D (25OHD) <20 ng/mL or ≥20 ng/mL. Bone health was classified according to T-score (normal, osteopenia, or osteoporosis) and BMD tertile. Risk of OA was assessed using logistic regression and adjusted for covariates. RESULTS: Participants with serum 25OHD <20 ng/mL had a 37% lower risk of OA (95% confidence interval (CI) [0.39-0.99], P = 0.046). When stratified by sex, the odds ratio for OA in men with lower vitamin D status was 0.35 (95% CI [0.15-0.81], P = 0.02). No association was found in women. The risk for OA did not differ according to BMD tertile or T-score classification. CONCLUSIONS: The risk of OA is lower in older men with 25OHD less than 20 ng/mL but not in older women. Bone mineral density is not associated with OA risk in older adults in the United States.

Structure-based programming of lymph-node targeting in molecular vaccines.

In cancer patients, visual identification of sentinel lymph nodes (LNs) is achieved by the injection of dyes that bind avidly to endogenous albumin, targeting these compounds to LNs, where they are efficiently filtered by resident phagocytes. Here we translate this 'albumin hitchhiking' approach to molecular vaccines, through the synthesis of amphiphiles (amph-vaccines) comprising an antigen or adjuvant cargo linked to a lipophilic albumin-binding tail by a solubility-promoting polar polymer chain. Administration of structurally optimized CpG-DNA/peptide amph-vaccines in mice resulted in marked increases in LN accumulation and decreased systemic dissemination relative to their parent compounds, leading to 30-fold increases in T-cell priming and enhanced anti-tumour efficacy while greatly reducing systemic toxicity. Amph-vaccines provide a simple, broadly applicable strategy to simultaneously increase the potency and safety of subunit vaccines.

Association among genetic variants in the vitamin D pathway and circulating 25-hydroxyvitamin D levels in Korean adults: results from the Korea National Health and Nutrition Examination Survey 2011-2012.

Vitamin D deficiency affects >60% of the Korean population. Recent reports in Caucasian, African American, and Chinese populations indicate an association between vitamin D status and related single nucleotide polymorphisms (SNPs), but specific associations differ among study populations. We investigated the relationship between five SNPs involved in the vitamin D metabolic pathway (DHCR7 rs12785878, GC rs2282679, CYP2R1 rs12794714, CYP2R1 rs10741657, and CYP24A1 rs6013897) and serum 25-hydroxyvitamin D [25(OH)D] status in Koreans using the Korea National Health and Nutrition Examination Survey, a nationwide database. Whether the association was modified by demographic and lifestyle factors, including sex, body mass index (BMI), smoking status, drinking status, physical activity, and sun exposure, were also investigated. The results showed the serum level of 25(OH)D was associated with rs12785878, rs2282679, and rs12794714 genotypes, but not with rs10741657 or rs6013897. The genetic risk score (GRS) calculated by summing the number of alleles of these 5 SNPs was associated with low circulating levels of 25(OH)D. However, the negative association between 25(OH)D and GRS was modified by obesity and sun exposure. Specifically, negative associations between 25(OH)D and GRS were present in adults with lower BMI (<25 kg/m2) and longer sun exposure time (≥2 h/day). In conclusion, common variants of vitamin D-related SNPs are associated with vitamin D status in Koreans, and this genetic effect was masked when BMI ≥25 kg/m2 or sun exposure <2 h/day. Additionally, seasonal variation must be considered in future studies among Koreans.

Automated Attenuation Based Tube Potential Selection of the Lower Extremity Runoff: A Comparison to Fixed Kilovolt with Automated Tube Current Modulation.

PURPOSE: The aim of this study was to evaluate the impact of automated attenuation-based tube potential selection (ATPS) on image quality and radiation dose exposure parameters at a computed tomography angiography (CTA) lower-extremity runoff. MATERIALS AND METHODS: Two hundred forty patients (156 men, 84 women) underwent CTA examinations of the lower-extremity runoff on a second-generation dual-source computed tomography system: 120 patients at a fixed tube potential of 120 kV and a tube current of 180 reference mAs, another 120 patients using automated ATPS. Volume computed tomography dose index (CTDIvol), dose-length-product (DLP), body diameters, noise, signal-to-noise ratio, and subjective image quality were compared. RESULTS: In the ATPS group, 80 kV was automatically selected in 102 patients, 100 kV in 15 patients, and 120 kV in 3 patients; 140 kV was not chosen in any of the cases. The median CTDIvol of 4.81 mGy (2.2-10.6 mGy) and DLP of 568 mGy⋅cm (203-1324 mGy⋅cm) in the ATPS group were significantly lower compared with the CTDIvol of 8.1 mGy (4.4-14.4 mGy) and DLP of 1027.5 mGy⋅cm (509-1806 mGy⋅cm) in the fixed 120-kV group (P < 0.01). Image quality was comparable (P > 0.05). CONCLUSION: Automated ATPS allows for significant dose savings in lower-extremity runoff CTA, whereas image quality remains constant at a high level.

Core Binding Factor ß Plays a Critical Role During Chondrocyte Differentiation.

Core binding factor ß (Cbfß) is a partner protein of Runx family transcription factors with minimally characterized function in cartilage. Here we address the role of Cbfß in cartilage by generating chondrocyte-specific Cbfß-deficient mice (Cbfb(Δch/Δch) ) from Cbfb-floxed mice crossed with mice expressing Cre from the Col2a1 promoter. Cbfb(Δch/Δch) mice died soon after birth and exhibited delayed endochondral bone formation, shorter appendicular skeleton length with increased proliferative chondrocytes, and nearly absent hypertrophic chondrocyte zones. Immunohistochemical and quantitative real-time PCR analyses showed that the number and size of proliferative chondrocytes increased and the expression of chondrocyte maturation markers at the growth plates, including Runx2, osterix, and osteopontin, significantly diminished in Cbfb(Δch/Δch) mice compared to wild type mice. With regard to signaling pathways, both PTHrP-Ihh and BMP signaling were compromised in Cbfb(Δch/Δch) mice. Mechanistically, Cbfß deficiency in chondrocytes caused a decrease of protein levels of Runx transcription factors by accelerating polyubiquitination-mediated proteosomal degradation in vitro. Indeed, Runx2 and Runx3, but not Runx1, decreased in Cbfb(Δch/Δch) mice. Collectively, these findings indicate that Cbfß plays a critical role for chondrocyte differentiation through stabilizing Runx2 and Runx3 proteins in cartilage.

Habitual dietary intake of ß-carotene, vitamin C, folate, or vitamin E may interact with single nucleotide polymorphisms on brachial-ankle pulse wave velocity in healthy adults.

PURPOSE: The interaction between genetics and diet may explain the present disagreement in the protective role of vitamin intake on cardiovascular disease. We cross-sectionally assessed the interaction of habitual dietary intake of ß-carotene, vitamin C, folate, and vitamin E with single nucleotide polymorphisms (SNPs) on brachial-ankle pulse wave velocity (baPWV), a measure of arterial stiffness. METHODS: Dietary intakes of ß-carotene, vitamin C, folate, and vitamin E were quantified by a food frequency questionnaire in 3198 healthy men and women (≥ 40 years) from the Korea Multi-Rural communities Cohort study. baPWV was measured, and 19 SNPs were genotyped. The associations and interactions between dietary vitamin intake, SNP genotype, and baPWV were assessed using general linear models. RESULTS: In both men and women, dietary intake of ß-carotene, vitamin C, folate, or vitamin E and baPWV were not directly associated. Vitamin C, folate, and vitamin E intake had an interaction with rs4961 (ADD1) genotype on baPWV in men. rs4961 also interacted with folate intake on baPWV in women. In women, rs10817542 (ZNF618) and rs719856 (CD2AP) had an interaction with ß-carotene and folate intake and rs5443 (GNB3) had an interaction with vitamin E intake on baPWV. In general, minor allele homozygotes with low vitamin intake had higher baPWV than other subgroups. Results were similar when supplement users were excluded. CONCLUSIONS: Higher intake of dietary vitamin C, folate, and vitamin E may be related to high baPWV in healthy Korean men who are minor allele homozygotes of rs4961. In healthy Korean women, dietary folate, ß-carotene, and vitamin E intake may affect baPWV differently according to rs4961, rs10817542, rs719856, or rs5443 genotype. Greater dietary intake of these nutrients may protect those that are genetically vulnerable to stiffening of the arteries.

Risk of all-cause mortality is associated with multiple health-related lifestyle behaviors and does not differ between urban and rural areas in Korea.

BACKGROUND/OBJECTIVES: Urban-rural inequities in health and mortality exist in Korea, a highly centralized developed country. The potential impact of multiple health-related lifestyle behaviors on mortality and difference between urban and rural areas is not fully understood. This study aimed to investigate the effect of high-risk health behaviors on all-cause mortality among residents living in urban and rural in Korea. SUBJECTS/METHODS: Cross-sectional analyses were conducted on 8,298 adults aged 40 yrs and older from the Korea National Health and Nutrition Examination Survey 2013-2015. High-risk behaviors were defined as having poor diet quality, current smoking, high-risk drinking, or insufficient physical activity. Mortality status was linked to the Cause of Death data followed up to December 31, 2019. The associations between all-cause mortality and high-risk behaviors were evaluated using Cox proportional hazard regression models adjusted for age, sex, education, income, and survey year. Population attributable fractions (PAFs) were calculated, and effect modification analysis was conducted. Participants were stratified by residential area (urban or rural). RESULTS: During the follow-up (median: 5.4 yrs), 313 deaths occurred. A higher proportion of rural residents than urban residents engaged in multiple high-risk behaviors (28.9% vs. 22.6%; P < 0.0001). As individual factors, a greater risk of mortality was associated with poor diet quality, current smoking, and inadequate physical activity, and these tendencies persisted in rural residents, especially for diet quality. Multiple high-risk behaviors were positively associated with a higher risk of mortality in Koreans living in urban and rural areas. PAF (95% confidence interval) was 18.5% (7.35-27.9%) and 29.8% (16.1-40.2%) in urban and rural residents, respectively. No additive or multiplicative effect of the region was observed. CONCLUSION: The higher prevalence of multiple high-risk lifestyle behaviors in rural residents may explain the higher mortality in rural areas compared to urban areas. Comprehensive public health policies to improve health-related behaviors in rural populations may be needed.

Biorobotic hybrid heart as a benchtop cardiac mitral valve simulator.

In this work, we developed a high-fidelity beating heart simulator that provides accurate mitral valve pathophysiology. The benchtop platform is based on a biorobotic hybrid heart that combines preserved intracardiac tissue with soft robotic cardiac muscle providing dynamic left ventricular motion and precise anatomical features designed for testing intracardiac devices, particularly for mitral valve repair. The heart model is integrated into a mock circulatory loop, and the active myocardium drives fluid circulation producing physiological hemodynamics without an external pulsatile pump. Using biomimetic soft robotic technology, the heart can replicate both ventricular and septal wall motion, as well as intraventricular pressure-volume relationships. This enables the system to recreate the natural motion and function of the mitral valve, which allows us to demonstrate various surgical and interventional techniques. The biorobotic cardiovascular simulator allows for real-time hemodynamic data collection, direct visualization of the intracardiac procedure, and compatibility with clinical imaging modalities.

Development of a Database for the Estimation of Heme Iron and Nonheme Iron Content of Animal-Based Foods.

Background: Total iron (TI) intake and differentiation between heme iron (HI) and nonheme iron (NHI) are uncommon despite markedly different bioavailability. Objectives: To create a database compiling information from studies that directly assessed the HI content of animal products using the Hornsey method, and to explore differences in estimates of HI intake between the data compiled and the Monsen method. Methods: A literature search identified studies that chemically characterized the HI content of animal-based foods using the Hornsey method; HI, NHI, and TI contents (mg/100 g) were compiled. Information was grouped by animal type and cooking method, and mean (± SD) HI% was calculated. Using a 24-h dietary record, differences in HI and NHI intake using the compiled information and the Monsen approach were explored. Results: Actual HI% values ranged from 7% to 94%. Raw foods had the highest HI% [raw duck (94% ± 4%), raw blood curd (82% ± 4%), and raw beef (79% ± 9%)]. Boiled foods had the lowest HI% [boiled shrimp (11% ± 5%) and meatballs (15% ± 6%)]. Cooked foods with the highest HI% were beef (70% ± 10%) and lamb (70% ± 9%). In many instances, applying actual HI% from the complied database produced markedly different measures of the HI content of foods [cooked beef (Monsen: 1.3 mg/100 g); (Hornsey: 2.3 mg/100 g)]. Estimation of iron intake in a 24-h recall demonstrated that using animal-specific HI% results in different estimates of HI intake [Monsen: 1.2 mg HI (40%); Hornsey: 1.8 mg HI (59%)]. Conclusions: Animal-based foods have variable HI%. A fixed HI:NHI ratio does not reflect this variation and could give rise to inaccurate estimates of HI content in food and HI intake. Consideration of this variation in HI% may improve our ability to link dietary intake with iron status and important health outcomes.

A Tunable Soft Silicone Bioadhesive for Secure Anchoring of Diverse Medical Devices to Wet Biological Tissue.

Silicone is utilized widely in medical devices for its compatibility with tissues and bodily fluids, making it a versatile material for implants and wearables. To effectively bond silicone devices to biological tissues, a reliable adhesive is required to create a long-lasting interface. BioAdheSil, a silicone-based bioadhesive designed to provide robust adhesion on both sides of the interface is introduced here, facilitating bonding between dissimilar substrates, namely silicone devices and tissues. The adhesive's design focuses on two key aspects: wet tissue adhesion capability and tissue-infiltration-based long-term integration. BioAdheSil is formulated by mixing soft silicone oligomers with siloxane coupling agents and absorbents for bonding the hydrophobic silicone device to hydrophilic tissues. Incorporation of biodegradable absorbents eliminates surface water and controls porosity, while silane crosslinkers provide interfacial strength. Over time, BioAdheSil transitions from nonpermeable to permeable through enzyme degradation, creating a porous structure that facilitates cell migration and tissue integration, potentially enabling long-lasting adhesion. Experimental results demonstrate that BioAdheSil outperforms commercial adhesives and elicits no adverse response in rats. BioAdheSil offers practical utility for adhering silicone devices to wet tissues, including long-term implants and transcutaneous devices. Here, its functionality is demonstrated through applications such as tracheal stents and left ventricular assist device lines.

Validity of Interviewer-Administered 24-h Dietary Recalls in Older Korean Women: A Pilot Study.

Despite the wide use of 24-h dietary recalls and differences in food culture between Western and Asian countries, limited studies validating 24-h dietary recalls have been performed in rice-based meals and in Asians. To determine the accuracy of 24-h dietary recalls in Koreans, 22 older women participating in a controlled-feeding study completed a single interviewer-administered 24-h dietary recall. The recalls of food items were classified as matches, exclusions, or intrusions. Portion size reports were categorized as corresponding (≤10% error), overreport, underreport, and missing. Recall accuracy was analyzed according to the type of dish, food group, or nutrients and compared by one-way analysis of variance or paired t-test. Participants reported 95% of the foods that they consumed. Sauces were most frequently missing. Corresponding portion sizes were 24%, while 43% were underreported. Kimchi was most frequently underreported. No difference was found among food groups. The recalled intakes of energy and most nutrients were similar to the actual intakes, with the exception of fat and sodium, which were underreported. The interviewer-administered 24-h dietary recall may be a reliable tool to assess food and nutrient intake in older Korean women. More accurate methods are necessary to assess sauce, kimchi, fat, and sodium intakes in the Korean diet.

Korean Working Group on Sarcopenia Guideline: Expert Consensus on Sarcopenia Screening and Diagnosis by the Korean Society of Sarcopenia, the Korean Society for Bone and Mineral Research, and the Korean Geriatrics Society.

Despite the introduction of a diagnostic code and acceptance of a diagnostic process for sarcopenia as a new health technology in Korea, many practitioners remain unfamiliar with the evaluation of sarcopenia. Thus, the Korean Working Group on Sarcopenia (KWGS) developed clinical practice guidelines for the diagnosis of sarcopenia in older Korean adults. A two-phase Delphi interview comprising 19 questions was conducted with 40 expert panelists, 22 of whom participated in the first round between June and August 2022. The second round of the Delphi interview included the remaining 11 questions that were not agreed upon in the first round. The screening process for sarcopenia includes various questionnaires and examinations used in different research and clinical settings. The diagnostic process for sarcopenia was simplified by combining the steps of case finding and assessment. The Short Physical Performance Battery test was given particular emphasis owing to its multifaceted nature. Regardless of muscle mass, having low muscle strength with low physical performance is considered clinically relevant and newly defined as "functional sarcopenia." Comprehensive geriatric assessment is important for diagnosing sarcopenia. The KWGS's clinical guideline aims to facilitate the early detection of sarcopenia by allowing various screening tools to be used in a unified process and reducing confusion about which tools to use for diagnosis. This recommendation expands the conceptual definition of sarcopenia as a complex pathophysiological state in line with the concept of frailty and aims to stimulate further research on the diagnosis and management of sarcopenia in clinical settings.

Robotic right ventricle is a biohybrid platform that simulates right ventricular function in (patho)physiological conditions and intervention.

The increasing recognition of the right ventricle (RV) necessitates the development of RV-focused interventions, devices and testbeds. In this study, we developed a soft robotic model of the right heart that accurately mimics RV biomechanics and hemodynamics, including free wall, septal and valve motion. This model uses a biohybrid approach, combining a chemically treated endocardial scaffold with a soft robotic synthetic myocardium. When connected to a circulatory flow loop, the robotic right ventricle (RRV) replicates real-time hemodynamic changes in healthy and pathological conditions, including volume overload, RV systolic failure and pressure overload. The RRV also mimics clinical markers of RV dysfunction and is validated using an in vivo porcine model. Additionally, the RRV recreates chordae tension, simulating papillary muscle motion, and shows the potential for tricuspid valve repair and replacement in vitro. This work aims to provide a platform for developing tools for research and treatment for RV pathophysiology.

Emergent mechanical control of vascular morphogenesis.

Vascularization is driven by morphogen signals and mechanical cues that coordinately regulate cellular force generation, migration, and shape change to sculpt the developing vascular network. However, it remains unclear whether developing vasculature actively regulates its own mechanical properties to achieve effective vascularization. We engineered tissue constructs containing endothelial cells and fibroblasts to investigate the mechanics of vascularization. Tissue stiffness increases during vascular morphogenesis resulting from emergent interactions between endothelial cells, fibroblasts, and ECM and correlates with enhanced vascular function. Contractile cellular forces are key to emergent tissue stiffening and synergize with ECM mechanical properties to modulate the mechanics of vascularization. Emergent tissue stiffening and vascular function rely on mechanotransduction signaling within fibroblasts, mediated by YAP1. Mouse embryos lacking YAP1 in fibroblasts exhibit both reduced tissue stiffness and develop lethal vascular defects. Translating our findings through biology-inspired vascular tissue engineering approaches will have substantial implications in regenerative medicine.

Older Korean men with inadequate vitamin D status have lower odds of radiologic osteoarthritis.

Most studies on osteoarthritis (OA) and vitamin D status were performed in Whites with relatively adequate vitamin D status. Associations may differ by baseline 25-hydroxyvitamin D (25(OH)D) and race. We assessed the odds of OA and joint pain according to vitamin D status in Korean adults ≥ 50 years of age in the nationally representative Korea National Health and Nutrition Examination Survey (n = 8575). Agreement between radiologic OA (ROA) and self-reported OA were also assessed. Multivariate logistic regression was performed and participants were stratified by sex. Adults with serum 25(OH)D < 12 ng/mL and 12 to < 20 ng/mL had 26% and 18% lower odds of knee ROA, respectively, compared to those with 25(OH)D ≥ 20 ng/mL. Similar results were observed in men, but not women. No associations were found between 25(OH)D and knee ROA severity, lumbar spine ROA, symptomatic OA, or knee pain. Sensitivity of self-reported OA was low (27%), indicating a weak possibility of reverse causation. Prospective studies are required to identify the possible causality of vitamin D on OA in Korean men.

Low Vitamin D Status Is Associated with Increased Risk of Mortality in Korean Men and Adults with Hypertension: A Population-Based Cohort Study.

Background Recent randomized controlled trials (RCTs) have shown no effect of vitamin D supplementation on cardiovascular disease, cancer events and mortality or all-cause mortality in Western populations. However, there has been a lack of research on populations with low vitamin D status, including Asians. In addition, there have been indications that an individual's sex or hypertension status may affect the relationship between vitamin D status and mortality. In this study, we retrospectively assessed the association between vitamin D status and all-cause, cardiovascular, and cancer mortality in Koreans using a national database, and stratified participants according to sex and hypertension status. Methods Participants in the Korean Health and Nutrition Examination Survey 2008−2014, who consented to their data being synthesized with mortality data (up to December 2019), were included (n = 22,742; mean follow-up: 8.9 years). Participants' level of serum 25-hydroxyvitamin D (25(OH)D) was measured by radioimmunoassay and categorized as <12, 12−19.9, and ≥20 ng/mL. A Cox proportional hazard model was used to assess the risk of mortality. Results In the total sample, risk of all-cause, cancer, and cardiovascular mortality was greater in adults with a serum 25(OH)D level below 12 and 12−19.9 ng/mL than those with ≥20 ng/mL. Men and adults with hypertension, who had low vitamin D status, had a higher risk of cancer and cardiovascular mortality, but not women or adults without hypertension. Similar results were observed when various cutoffs for 25(OH)D were employed, or extrinsic deaths were excluded. Conclusions Vitamin D status below 20 ng/mL is associated with a higher risk of mortality in Korean adults, especially in men and those with hypertension, on the basis of data from a nationally representative sample. Further RCTs on Asian adults with low vitamin D status are warranted.