The effect of sex and physical frailty on incident disability after 2 years among community-dwelling older adults: KFACS study.

BACKGROUND: This study investigated the impact of physical frailty on the development of disabilities in mobility, activities of daily living (ADL), and instrumental activities of daily living (IADL) according to sex among community-dwelling Korean older adults. METHODS: We used data of 2,905 older adults aged 70-84 years from the Korean Frailty and Aging Cohort Study (KFACS) at baseline (2016-2017) and Wave 2 (2018-2019). Fried's physical frailty phenotype was used to identify frailty. RESULTS: After adjustment, frailty showed a higher impact for women than men on developing mobility disability (odds ratio [OR]=14.00, 95% confidence interval [CI]=4.8-40.78 vs. OR=9.89, 95% CI=4.28-22.86) and IADL disability after two years (OR=7.22, 95% CI=2.67-19.56 vs. OR=3.19, 95% CI=1.17-8.70). Pre-frailty led to mobility disability for women and men (OR=2.77, 95% CI=1.93-3.98 vs. OR=2.49, 95% CI=1.66-3.72, respectively), and IADL disability only for women (OR=3.01, 95% CI=1.28-7.09). Among the IADL components, both men and women who were prefrail or frail showed increased disability in 'using transportation'. Among men, pre-frailty was significantly associated with disability in "going out" and "shopping". In women, frailty was significantly associated with disability in "doing laundry," "performing household chores," "shopping," and "managing money". CONCLUSIONS: Physical frailty increased disability over 2 years for women more than men. Physical frailty increased disability in outdoor activity-related IADL components in men and household work-related IADL components in women. This study highlights the need for gender-specific policies and preventative programs for frailty, particularly restorative interventions that focus on women who are physically frail.

Association of decreased grip strength with lower urinary tract symptoms in women: a cross-sectional study from Korea.

BACKGROUND: Lower urinary tract symptoms (LUTS) including frequency, nocturia, urgency, and incontinence, are common in women and cause significant discomfort in daily life. However, diagnosis and treatment of LUTS are often delayed because many patients with such symptoms do not complain to the physician of discomfort and do not seek medical attention. LUTS are known to be associated with muscle weakness. We investigated the association between grip strength and LUTS in women of different ages. METHODS: This study included 4225 women (mean age 48.6 years) who underwent self-referred health screening between April 2015 and December 2019. LUTS were evaluated using a self-reported questionnaire, and the overactive bladder symptom score was used to screen for an overactive bladder. Low muscle strength was defined as a hand grip strength of < 18 kg (decreased grip strength). RESULTS: We observed decreased grip strength in 13.7% (n = 580) of the participants. Nocturia, urgency, incontinence, and overactive bladder were more common in women with decreased grip strength than in women with normal grip strength. After adjusting for age, comorbidities (hypertension, diabetes, hyperlipidemia), smoking status, alcohol consumption, regular exercise, and stress, nocturia (odds ratio [OR] 1.19, 95% confidence interval [CI] 1.01-1.52), urinary incontinence (OR 1.32, 95% CI 1.01-1.72), and an overactive bladder (OR 1.75, 95% CI 1.35-2.27) were significantly associated with decreased grip strength. CONCLUSIONS: The findings suggest that LUTS, especially nocturia, incontinence, and an overactive bladder are associated with decreased grip strength in women. Therefore, physicians should be aware that patients may not seek help, even if they are uncomfortable, and it is important to obtain a detailed medical history and perform additional tests, even in the absence of complaints, in patients with low grip strength, who are at high risk of LUTS.

Importance of Multiple Reinforcing Comments and Areas for Change in Optimizing Dietary and Exercise Self-Monitoring Feedback in Behavioral Weight Loss Programs: Factorial Design.

BACKGROUND: Individualized dietary and physical activity self-monitoring feedback is a core element of behavioral weight loss interventions and is associated with clinically significant weight loss. To our knowledge, no studies have evaluated individuals' perspectives on the composition of feedback messages or the effect of feedback composition on the motivation to self-monitor. OBJECTIVE: This study aims to assess the perceptions of feedback emails as a function of the number of comments that reinforce healthy behavior and the number of areas for change (ie, behavioral changes that the individual might make to have an impact on weight) identified. METHODS: Emailed feedback followed a factorial design with 2 factors (ie, reinforcing comments and areas for change), each with 3 levels (ie, 1, 4, or 8 comments). A total of 250 adults with overweight or obesity who were interested in weight loss were recruited from the Qualtrics research panel. Participants read 9 emails presented in a random order. For each email, respondents answered 8 questions about the likelihood to self-monitor in the future, motivation for behavioral change, and perceptions of the counselor and the email. A mixed effects ordinal logistic model was used to compute conditional odds ratios and predictive margins (ie, average predicted probability) on a 5-point Likert response scale to investigate the optimal combination level of the 2 factors. RESULTS: Emails with more reinforcing comments or areas for change were better received, with small incremental benefits for 8 reinforcing comments or areas for change versus 4 reinforcing comments or areas for change. Interactions indicated that the best combination for 3 of 8 outcomes assessed (ie, motivation to make behavioral changes, counselor's concern for their welfare, and the perception that the counselor likes them) was the email with 8 reinforcing comments and 4 areas for change. Emails with 4 reinforcing comments and 4 areas for change resulted in the highest average probability of individuals who reported being very likely to self-monitor in the future. CONCLUSIONS: The study findings suggest how feedback might be optimized for efficacy. Future studies should explore whether the composition of feedback email affects actual self-monitoring performance.

Myeloperoxidase Inhibition Increases Neurogenesis after Ischemic Stroke.

The relationship between inflammation and neurogenesis in stroke is currently not well understood. Focal ischemia enhances cell proliferation and neurogenesis in the neurogenic regions, including the subventricular zone (SVZ), dentate gyrus, as well as the non-neurogenic striatum, and cortex in the ischemic hemisphere. Myeloperoxidase (MPO) is a potent oxidizing enzyme secreted during inflammation by activated leukocytes, and its enzymatic activity is highly elevated after stroke. In this study, we investigated whether the inhibition of MPO activity by a specific irreversible inhibitor, 4-aminobenzoic acid hydrazide (ABAH) (MPO-/- mice) can increase neurogenesis after transient middle cerebral artery occlusion in mice. ABAH administration increased the number of proliferating bromodeoxyuridine (BrdU)-positive cells expressing markers for neural stems cells, astrocytes, neuroprogenitor cells (Nestin), and neuroblasts (doublecortin) in the ischemic SVZ, anterior SVZ, striatum, and cortex. MPO inhibition also increased levels of brain-derived neurotrophic factor, phosphorylation of cAMP response element-binding protein (Ser133), acetylated H3, and NeuN to promote neurogenesis in the ischemic SVZ. ABAH treatment also increased chemokine CXC receptor 4 expression in the ischemic SVZ. MPO-deficient mice treated with vehicle or ABAH both showed similar effects on the number of BrdU+ cells in the ischemic hemisphere, demonstrating that ABAH is specific to MPO. Taken together, our results underscore a detrimental role of MPO activity to postischemia neurogenesis and that a strategy to inhibit MPO activity can increase cell proliferation and improve neurogenesis after ischemic stroke.

Synthesis and Properties of Cellulose-Functionalized POSS-SiO2/TiO2 Hybrid Composites.

The mechanical, thermal, optical, electrical and morphological properties of cellulose, an excellent natural biomaterial, can be improved by organic-inorganic hybrid composite methods. Based on the pristine properties of cellulose, the preparation of cellulose-metal oxide hybrid nanocomposites using a dispersion process of nanoparticles into the cellulose host matrix by traditional methods, has limitations. Recently, the functionalized cellulose-polymer-based materials were considered to be an important class of high-performance materials, providing the synthesis of various functional hybrid nanocomposites using a sol-gel method. Transparent cellulose-POSS-amine-silica/titania hybrids were prepared by an in-situ sol-gel process in the presence of γ-aminopropyltrimethoxylsilane (γ-APTES). The methodology involves the formation of covalent bonding between the cellulose-POSS amine and SiO2/TiO2 hybrid nanocomposite material. An analysis of the synthesized hybrid material by Fourier transform infrared spectroscopy, X-ray diffraction, thermogravimetric analysis, differential thermal calorimetry, scanning electron microscopy, and transmission electron microscopy indicated that the silica/titania nanoparticles were bonded covalently and dispersed uniformly into the cellulose-POSS amine matrix. In addition, biological properties of the cellulose-POSS-silica/titania hybrid material were examined using an antimicrobial test against pathogenic bacteria, such as Bacillus cereus (F481072) and E. coli (ATCC35150) for the bacterial effect.

Spontaneous echo-contrast in the internal jugular veins of patients with ischemic stroke.

PURPOSE: Spontaneous echo-contrast (SEC) appears on B-mode images as moving curls of smoke in the lumen of veins. The aims of this study were to investigate the prevalence and characteristics of internal jugular vein SEC among patients with stroke, in comparison with control subjects. METHODS: We enrolled 97 Korean patients with acute ischemic stroke and 50 controls. Both internal jugular veins were examined for the presence and severity of SEC and measurement of flow velocity. Venous samples were obtained for laboratory evaluation of hematologic factors. RESULTS: In 294 internal jugular veins, the prevalence of SEC was 81% in stroke patients and 68% in controls (odds ratio, 2.0; 95% confidence interval, 1.1-3.6; p = 0.013). Stroke patients were more likely to have SEC on the left (p = 0.025) than on the right (p = 0.184) internal jugular vein. Overall, the association between stroke and SEC remained significant after adjustment for other variables (odds ratio, 4.3; 95% confidence interval, 1.7-10.8; p = 0.002). CONCLUSIONS: Internal jugular vein SEC was found more frequently in stroke patients than in controls. However, local as well as systemic factors must be considered in the interpretation of this finding.

Antagonism of VEGF-A-induced increase in vascular permeability by an integrin α3ß1-Shp-1-cAMP/PKA pathway.

In cancer, VEGF-induced increase in vascular permeability results in increased interstitial pressure, reducing perfusion and increasing hypoxia, which reduce delivery of chemotherapeutic agents and increase resistance to ionizing radiation. Here, we show that both TIMP-2 and Ala + TIMP-2, a TIMP-2 mutant without matrix metalloproteinase inhibitory activity, antagonize the VEGF-A-induced increase in vascular permeability, both in vitro and in vivo. Like other agents known to preserve endothelial barrier function, TIMP-2 elevates cytosolic levels of cAMP and increases cytoskeletal-associated vascular endothelial cadherin in human microvascular endothelial cells. All of these effects are completely ablated by selective knockdown of integrin α3ß1 expression, expression of a dominant negative protein tyrosine phosphatase Shp-1 mutant, administration of the protein tyrosine phosphatase inhibitor orthovanadate, or the adenylate cyclase inhibitor SQ22536. This TIMP-2-mediated inhibition of vascular permeability involves an integrin α3ß1-Shp-1-cAMP/protein kinase A-dependent vascular endothelial cadherin cytoskeletal association, as evidenced by using siRNAs to integrin α3ß1 and Shp-1, or treatment with Shp-1 inhibitor NSC87877 and protein kinase A inhibitor H89. Our results demonstrate the potential utility for TIMP-2 in cancer therapy through "normalization" of vascular permeability in addition to previously described antiangiogenic effects.

Long-term follow up of surgical management of blood blister-like aneurysms at non-branching sites of the internal carotid artery.

To describe long-term follow-up of 25 patients who presented with subarachnoid hemorrhages due to blood blister-like aneurysms (BBAs) treated with direct clipping or clip reinforcement with or without direct neck repair. Between June 1993 and July 2009, 25 consecutive patients with ruptured BBAs of the supraclinoid internal carotid artery were retrospectively reviewed. The mean age of patients was 39.5 ± 11.3 years. The mean duration of clinical follow-up was 128.9 months (range, 85-196 months). All aneurysms were located in the supraclinoid portion of the internal carotid artery. The mean aneurysm diameter was 4.04 ± 1.3 mm on intra-operative microscopic field. Tearing of the aneurysmal neck during dissection occurred in 8 (32%) patients. Six of 7 patients with neck tearing underwent direct neck repair. Surgeons treated aneurysms via direct clipping with a Bemsheet® in 5 (20%) patients or by clip reinforcement with a silicone sheet in 20 (80%) patients. Clinical outcomes were favorable (modified Rankin Scale [mRS]: 0-2) in 21 (84%) of 25 patients. Four (16%) patients had an unfavorable outcome (mRS: 3-6). The patient with severe disability (mRS: 4) was treated with clip reinforcement and direct neck repair. Mild stenosis, moderate stenosis, and total occlusion of the parent artery were confirmed in 10 (40%) patients, 6 (24%) patients, and 1 (4%) patient, respectively. Although surgical treatment of BBAs was associated with varying degrees of parent vessel patency loss, long-term follow-up results for more than 10 years showed that direct surgical clipping or clip reinforcement with a silicone sheet appeared to be a curative surgery.

Ultrahighly Sensitive Surface-Enhanced Raman Spectroscopy Film of Silver Nanoparticles Dispersed in Three Dimensions on a Thin Alumina Nanowire Framework.

To develop highly sensitive surface-enhanced Raman spectroscopy (SERS) films, various types of aggregated Ag nanowire (NW) and nanoparticle (NP) complex structures were fabricated using anodic aluminum oxide (AAO) templates and thermal evaporation. Aggregated AgNW structures with numerous tapered nanogaps were fabricated via Ag deposition on aggregated thin alumina nanowires of different lengths. AgNP complex structures were obtained by collapsing vertically aligned thin alumina nanowires 1 µm in length and depositing AgNPs on their tops and sides using surface tension during ethanol drying after functionalization. The Raman signal enhancement factors (EFs) of the samples were evaluated by comparing the SERS signal of the thiophenol (TP) self-assembled monolayer (SAM) on the nanostructures with the Raman signal of neat TP. EFs as high as ~2.3 × 107 were obtained for the optimized aggregated AgNW structure (NW length of 1 µm) and ~3.5 × 107 for the optimized AgNP complex structure. The large EF of the AgNP complex film is attributed mainly to the AgNPs dispersed in three dimensions on the sides of the thin alumina nanowires, strongly implying some important, relevant physics yet to be discovered and also a very promising nanostructure scheme for developing ultrahighly sensitive SERS films with EF > 108.

Pleiotropic influence of DNA methylation QTLs on physiological and ageing traits.

DNA methylation is influenced by genetic and non-genetic factors. Here, we chart quantitative trait loci (QTLs) that modulate levels of methylation at highly conserved CpGs using liver methylome data from mouse strains belonging to the BXD family. A regulatory hotspot on chromosome 5 had the highest density of trans-acting methylation QTLs (trans-meQTLs) associated with multiple distant CpGs. We refer to this locus as meQTL.5a. Trans-modulated CpGs showed age-dependent changes and were enriched in developmental genes, including several members of the MODY pathway (maturity onset diabetes of the young). The joint modulation by genotype and ageing resulted in a more 'aged methylome' for BXD strains that inherited the DBA/2J parental allele at meQTL.5a. Further, several gene expression traits, body weight, and lipid levels mapped to meQTL.5a, and there was a modest linkage with lifespan. DNA binding motif and protein-protein interaction enrichment analyses identified the hepatic nuclear factor, Hnf1a (MODY3 gene in humans), as a strong candidate. The pleiotropic effects of meQTL.5a could contribute to variations in body size and metabolic traits, and influence CpG methylation and epigenetic ageing that could have an impact on lifespan.

The impact of ambient air pollution on lung function and respiratory symptoms in elite athletes.

BACKGROUND: Air pollution has become a significant public health concern. During exercise, many physiological factors are thought to increase the effects of air pollution. Air pollution most affects lung function and respiratory symptoms. We investigated the association between lung function, respiratory symptoms, and air pollutant concentration with meteorological factors in elite sports athletes. METHODS: A total of 59 elite sports athletes from the Korea National Sports University participated in this prospective, observational study from September 2019 to June 2020. At ten visits, lung function and respiratory symptoms were obtained after a training session. We measured six air pollutants, including SO2, CO, O3, NO2, PM10, and PM2.5, and two meteorological factors, including humidity and temperature. Air pollutants and meteorological factors were measured by two nearest depositories of the national air pollution information system in Korea. RESULTS: In a single-pollutant model, PM2.5, PM10, NO2, and CO were inversely associated with both FEV1 and FEV6, 10 µg/m3 in PM2.5 was associated with a 32.31 mL decrease in FEV1 and a 36.93 mL decrease in FEV6. Meanwhile, O3 and temperature had positive associations with both FEV1 (13.00 and 3.15 mL) and FEV6 (16.91 and 4.76 mL) and humidity with FEV6 (11.98 mL). In the multi-pollutant model at lag 0, FEV1 was associated negatively with O3 and NO2 (-50.68 and -6.87 mL) and positively with SO2 and temperature (65.76 and 8.08 mL). In the multi-pollutant model at lag 6, temperature was associated with FEV1 and FEV6 (6.01 and 8.89 mL). PM2.5, PM10, NO2, CO, and temperature were significantly associated with FEV1 and FEV6 through lag 0-6. CONCLUSIONS: Air pollutants and meteorological factors are associated with lung function and respiratory symptoms and have cumulative effects among elite athletes. In the multi-pollutant model, temperature has the most significant effect on lung function.

A phantom study on usefulness of modifying image parameters to reduce radiation exposure and maintain image quality in chest HRCT.

PURPOSE: To investigate the feasibility of reducing radiation dose by modifying tube voltage, window settings, and algorithm while maintaining image quality, based on the qualitative evaluation of its quality and the radiation dose, using raw data acquired in chest high-resolution computed tomography (HRCT). METHODS: Radiation exposure was measured using a Fluke dosimeter while modifying the tube voltage to 80 and 100 from 120 kVp in a 64-slice multi-detector computed tomography for comparison and analysis. Changes in image quality as a result of the different tube voltage settings, 3 different window settings (-550, -600, and -700), and 2 algorithms (standard and edge) were analyzed using ImageJ. RESULTS: Relative to 120kVp, the dose decreased by approximately 67.8% and 36.9% at 80 and 100 kVp, respectively. Image quality assessment showed that changing the window setting to -700 (window level) after scanning with the tube voltage set at 100 kVp and applying the edge algorithm reduced the radiation dose while maintaining the image quality. CONCLUSIONS: The findings are significant with respect to the reduction of scan dose in that they demonstrate how radiation exposure can be reduced in a clinical scenario by altering the settings on an existing HRCT apparatus. Additional clinical trials and image assessments should be conducted on human participants to confirm the feasibility of altering HRCT settings for reducing scan doses.

Quantitative analysis of trace N2, Ar in O2 using glow discharge optical emission spectroscopy.

A trace level of N2 and Ar gases in O2 ambience were quantitatively analyzed for the first time by glow discharge optical emission spectroscopy. Microplasma was generated in a compact gas cell by a metal (Au) electrode pair of 1 mm diameter and ∼1 mm separation with the driving voltage of ∼0.9 kV and the current of ∼5 mA in ∼60 Torr. 358 and 813 nm optical emission bands were used for N2 and Ar detection, respectively. A spectroscopy fiber bundle having a circular input cross section of ∼700 µm in diameter and an output of 100 µm in width and 3 mm in height was employed to promote the signal collection efficiency while preserving high spectral resolution. As a result, the detection sensitivities <1 ppm (3 - σ) were attained for both N2 and Ar within 10 s. The detection accuracy was also promoted by correcting the N2 and Ar band signal intensities using the neighboring O emission band intensities, which led to detection errors <2% (3 - σ) for both N2 and Ar.

A Pragmatic Intervention Using Financial Incentives for Pregnancy Weight Management: Feasibility Randomized Controlled Trial.

BACKGROUND: Excessive gestational weight gain (GWG) is common and can result in maternal and child health complications. Pragmatic behavioral interventions that can be incorporated into standard obstetric care are needed, and financial incentives are a promising approach. OBJECTIVE: The aim of this study is to evaluate the feasibility of recruitment, randomization, and retention, as well as treatment engagement and intervention satisfaction, in a behavioral program. The program provided small incentives for meeting behavioral goals of self-weighing and physical activity as well as larger outcome incentives for meeting GWG goals. METHODS: We recruited 40 adult women in their first trimester of pregnancy from February 2019 to September 2019 at an obstetric clinic. Participants were randomized to 3 intervention components using a 2×2×2 factorial design: daily incentives for self-weighing (lottery vs certain loss), incentives for adhering to the Institute of Medicine's GWG guidelines based on BMI category (monthly vs overall), and incentives for reaching physical activity goals (yes vs no). Participants were asked to complete daily weigh-ins using the Withings Body wireless scale provided by the study, as well as wear a physical activity tracker (Fitbit Flex 2). Feasibility outcomes of recruitment, randomization, and retention, as well as treatment engagement and intervention satisfaction, were assessed. Weight assessments were conducted at baseline, 32-week gestation, and 36-week gestation. RESULTS: Participants were enrolled at, on average, 9.6 (SD 1.8) weeks' gestation. Of the 39 participants who were oriented to their condition and received the intervention, 24 (62%) were Black or African American, 30 (77%) were not married, and 29 (74%) had an annual household income of less than US $50,000. Of the 39 participants, 35 (90%) completed the follow-up data collection visit. Participants were generally quite positive about the intervention components, with a particular emphasis on the helpfulness of, and the enjoyment of using, the e-scale in both the quantitative and qualitative feedback. Participants who received the loss incentive, on average, had 2.86 times as many days of self-weighing as those who received the lottery incentive. Participants had a relatively low level of activity, with no difference between those who received a physical activity incentive and those who did not. CONCLUSIONS: A financial incentive-based pragmatic intervention was feasible and acceptable for pregnant women for promoting self-weighing, physical activity, and healthy GWG. Participants were successfully recruited early in their first trimester of pregnancy and retained for follow-up data collection in the third trimester. Participants demonstrated promising engagement in self-weighing, particularly with loss-based incentives, and reported finding the self-weighing especially helpful. This study supports further investigation of pragmatic, clinic-based financial incentive-based interventions for healthy GWG behaviors. TRIAL REGISTRATION: ClinicalTrials.gov NCT03834194; https://clinicaltrials.gov/ct2/show/NCT03834194.

Speeding up eQTL scans in the BXD population using GPUs.

The BXD family of mouse strains are an important reference population for systems biology and genetics that have been fully sequenced and deeply phenotyped. To facilitate interactive use of genotype-phenotype relations using many massive omics data sets for this and other segregating populations, we have developed new algorithms and code that enable near-real-time whole-genome quantitative trait locus (QTL) scans for up to one million traits. By using easily parallelizable operations including matrix multiplication, vectorized operations, and element-wise operations, our method is more than 700 times faster than a R/qtl linear model genome scan using 16 threads. We used parallelization of different CPU threads as well as GPUs. We found that the speed advantage of GPUs is dependent on problem size and shape (the number of cases, number of genotypes, and number of traits). Our approach is ideal for interactive web services, such as GeneNetwork.org that need to display results in real-time. Our implementation is available as the Julia language package LiteQTL at https://github.com/senresearch/LiteQTL.jl.

Implications of electronic cigarette use for depressive mood: A nationwide cross-sectional study.

Despite the controversy surrounding electronic cigarette (e-cigarette) safety, global consumption has been rapidly increasing. We investigated the relationship between e-cigarette use and mental health conditions in adults of various ages.We conducted a secondary data analysis of adults aged 19 to 80 who participated in the first year of the 7th Korea National Health and Nutrition Examination Survey (2016). The total number of participants was 5469, including 3398 non-smokers, 1700 smokers who had never used e-cigarettes, and 371 smokers who had previously used e-cigarettes, selected based on self-report questionnaires. Mental health factors including stress status, depressive mood, suicide plan, and suicide attempt were assessed by self-reported questionnaire. The Patient Health Questionnaire (PHQ-9) was used to assess depressive mood, with a cut-off value of 10. The relationship between e-cigarette use and stress status with depressive mood were analyzed with adjustment for potential confounders.Both male and female smokers who previously used e-cigarettes showed higher levels of stress than non-smokers or smokers who had never used e-cigarettes. The average PHQ-9 score was higher among previous e-cigarette-using smokers relative to non-smokers and smokers who had never used e-cigarettes, regardless of gender. The number of participants with depressive mood was significantly higher in the group of smokers who previously used e-cigarettes. In multivariable-adjusted logistic regression analyses, there was a significantly higher odds ratio for higher stress in male smokers who had previously used e-cigarettes and for depressive mood in female smokers who had previously used e-cigarettes, compared with non-smokers.This study analyzed the association between adult e-cigarette use and mental health conditions, including stress and depressive mood, and showed that e-cigarette use was significantly related to both conditions in men and women.

Association Between Electronic Cigarette Use and Levels of High-Sensitivity C-Reactive Protein and Uric Acid.

The present study investigated whether electronic cigarette use, which is becoming increasingly common, was related to systemic inflammation that may lead to cardiovascular disease, similar to conventional cigarette smoking. The study included 1208 men (19-65 years old) who participated in the 7th Korean National Health and Nutrition Examination Survey (2016). The participants were categorized as electronic cigarette users, conventional cigarette users, and nonsmokers. Serum high-sensitivity C-reactive protein was used as an inflammatory index, and uric acid level was used as a metabolic indicator. After adjusting for confounding factors, electronic cigarette use was significantly associated with elevated serum high-sensitivity C-reactive protein levels (ß = 1.326, P = .002), uric acid levels (ß = 0.400, P = .042), and hyperuricemia (uric acid level of >7 mg/mL; odds ratio = 2.67, 95% confidence interval = 1.27-5.58). These findings suggest that electronic cigarette use may be associated with systemic inflammation markers, similar to conventional cigarette use.

Differentiating pseudo-occlusion from true occlusion of proximal internal carotid artery in acute ischemic stroke on CT angiography.

OBJECTIVE: A lack of visualization of the proximal internal carotid artery (ICA) on computed tomography angiography (CTA) in acute ischemic stroke may be caused by an atherosclerotic occlusion or a pseudo-occlusion by a massive thrombus in the ICA. Pseudo-occlusion of the proximal ICA is caused by stagnant flow from a distal ICA occlusion. The purpose of this study aimed to use imaging findings of CTA to differentiate pseudo-occlusions from true occlusions of the proximal ICA. PATIENTS AND METHODS: All eligible patients undergoing endovascular treatment after CTA from January 2013 to March 2018 were respectively reviewed. Patients with <2 cm of ICA on CTA images were enrolled in this study. CTA images were classified as having a beak, dome, or flat pattern. RESULTS: Our sample included a total of 66 eligible patients (true occlusion: 31, pseudo-occlusion: 35). The total length of opacification of the proximal ICA in the pseudo-occlusion group was significantly higher compared to that in the true occlusion group (13.9 ±â€¯4.0 vs. 6.1 ±â€¯4.8, p < 0.001). A beak pattern of the proximal ICA on CTA images was significantly higher in the pseudo-occlusion group (82.9% vs. 16.1%, p < 0.001), but a flat pattern was significantly higher in the true occlusion group (58.1% vs. 0%, p < 0.001). Gradual contrast decline of the proximal ICA on CTA images only appeared in the pseudo-occlusion group (51.4%, p < 0.001). CONCLUSIONS: On CTA, imaging patterns of the proximal ICA can be differentiated between true occlusions and pseudo-occlusions.

Association between weekend catch-up sleep and health-related quality of life of Korean adults.

Sleep debt is known to have harmful effects on health. Weekend catch-up sleep (CUS) is a behavior to cope with weekday sleep debt. However, it is unclear whether weekend CUS has advantageous effects on health because sleep hygiene guidelines recommend regularizing bed time and arousal time. The aim of this study was to identify whether weekend CUS behavior has an association with better health-related quality of life (HRQoL)According to the inclusion criteria, 4871 participants were selected from the 2016 Korea National Health and Nutrition Examination Survey. Sleep questionnaires and European quality of life scale-5 dimensions (EQ-5D) questionnaire were used to collect data about the participants' sleep patterns and HRQoL. Odds ratios (ORs) with 95% confidence intervals (95% CIs) for each dimensional problem of EQ-5D were derived by logistic regression. Mean EQ-5D index scores were compared between weekend CUS and non-CUS groups based on their weekday sleep durations and quintile of chronotype.The ORs of dimensional problems of HRQoL of non-CUS group versus weekend CUS group were 1.63 (95% CI 1.07, 2.47) for usual activities, and 1.45 (95% CI 1.11, 1.90) for anxiety/depression. Mean EQ-5D scores of the weekend CUS group were significantly higher than those of the non-CUS group for sleeping less than 6 hours (0.953 ±â€Š0.004 vs 0.936 ±â€Š0.007, P = .036) and sleeping 6 to 7 hours (0.965 ±â€Š0.003 vs 0.955 ±â€Š.0.004, P = .045). These findings were similar in the fourth quintile (Q4) of chronotype (0.965 ±â€Š0.007 vs 0.951 ±â€Š0.008, P = .008) and fifth quintile (Q5) (0.952 ±â€Š0.006 vs 0.941 ±â€Š0.007, P = .022).Weekend CUS behavior was associated with better HRQoL than non-CUS among Korean adults. Especially, it was significant in participants who slept for less than 7 hours or participants whose chronotype was the fourth or fifth quintile. Attention may be needed for subjects with sleep short time and later chronotype who do not have weekend-CUS behaviors, because there is a risk that their HRQoL might be compromised.

Impact of a Live Attenuated Classical Swine Fever Virus Introduced to Jeju Island, a CSF-Free Area.

Here, we examine the effects of LOM(Low virulence of Miyagi) strains isolated from pigs (Jeju LOM strains) of Jeju Island, where vaccination with a live attenuated classical swine fever (CSF) LOM vaccine strain was stopped. The circulation of the Jeju LOM strains was mainly caused by a commercial swine erysipelas (Erysipelothrix rhusiopathiae) vaccine mixed with a LOM vaccine strain, which was inoculated into pregnant sows of 20 pig farms in 2014. The Jeju LOM strain was transmitted to 91 pig farms from 2015 to 2018. A histopathogenic investigation was performed for 25 farms among 111 farms affected by the Jeju LOM strain and revealed pigs infected with the Jeju LOM strain in combination with other pathogens, which resulted in the abortion of fetuses and mortality in suckling piglets. Histopathologic examination and immunohistochemical staining identified CSF-like lesions. Our results also confirm that the main transmission factor for the Jeju LOM strain circulation is the vehicles entering/exiting farms and slaughterhouses. Probability estimates of transmission between cohabiting pigs and pigs harboring the Jeju LOM strain JJ16LOM-YJK08 revealed that immunocompromised pigs showed horizontal transmission (r = 1.22). In a full genome analysis, we did not find genetic mutation on the site that is known to relate to pathogenicity between Jeju LOM strains (2014-2018) and the commercial LOM vaccine strain. However, we were not able to determine whether the Jeju LOM strain (2014-2018) is genetically the same virus as those of the commercial LOM vaccine due to several genetic variations in structure and non-structure proteins. Therefore, further studies are needed to evaluate the pathogenicity of the Jeju LOM strain in pregnant sow and SPF pigs and to clarify the characteristics of Jeju LOM and commercial LOM vaccine strains.