Sex-Specific Relationships between HDL-Cholesterol Levels and 10-Year Mortality in Individuals with Atherosclerotic Cardiovascular Disease: A Nationwide Cohort Study of South Koreans.

Large epidemiological studies show U-shaped relationships between high-density lipoprotein cholesterol (HDL-C) levels and all-cause mortality in individuals without atherosclerotic cardiovascular diseases (ASCVD). Association in those with ASCVD by sex is unclear. We examined the association between HDL-C levels and 10-year all-cause mortality in subjects (≥40 years of age) with ASCVD using the 2010 National Health Insurance Service and the National Death Registry of Korea. We categorized HDL-C levels into three groups (low: <40 mg/dL for males, <50 mg/dL for females; high: 40-90 mg/dL for males, 50-90 mg/dL for females; extremely high: >90 mg/dL) and 10 mg/dL intervals. We conducted a sex-stratified and adjusted Cox proportional hazards analysis. Out of 1,711,548 individuals (54% female, mean age 61.4 years), 10-year mortality was observed in 218,252 (12.8%). Males had a higher mortality rate than females (16.2% vs. 9.8%; p < 0.001). When adjusting for age, body mass index, LDL-cholesterol, triglycerides, hypertension, diabetes, smoking, and alcohol consumption, the low and extremely high HDL-C groups had significantly higher hazard ratios for 10-year mortality compared to the high HDL-C group in males [1.183 (1.166-1.199), 1.359 (1.288-1.434)] and in females [1.153 (1.138-1.169), 1.095 (1.029-1.167)]. The frequency distribution bars for the 10-year mortality rate showed sex-specific nadirs of 50-59 mg/dL in males and 70-79 mg/dL in females. In this ASCVD cohort, the extremely high HDL-C (>90 mg/dL) group had 35.9% and 9.5% higher 10-year mortality risks than the high HDL-C group for males and females, respectively. There was a slightly U-shaped relationship between baseline HDL-C levels and a 10-year mortality rate, with earlier inflection in males than in females.

Risk of cancer, cardiovascular disease, thromboembolism, and mortality in patients with rheumatoid arthritis receiving Janus kinase inhibitors: a real-world retrospective observational study using Korean health insurance data.

OBJECTIVES: This study investigated whether Janus kinase inhibitors (JAKis) raise the risk of cardiovascular disease (CVD), venous thromboembolism (VTE), and cancer in patients with rheumatoid arthritis (RA). METHODS: We conducted a real-world retrospective observational study using data obtained from the Korean National Health Insurance Service database. Two data sets were analyzed: tumor necrosis factor inhibitor (TNFi)/JAKi-naive RA patients (set 1) and all RA patients who used TNFis or JAKis (set 2). The incidence rate ratios (IRRs) and hazard ratios (HRs) for acute myocardial infarction (AMI), stroke, cardiovascular (CV)-related mortality, major adverse cardiovascular events (MACE), VTE, arterial thromboembolism (ATE), cancer, and all-cause mortality were compared between the JAKi and TNFi groups. RESULTS: Set 1 included 1,596 RA patients (JAKi group: 645; TNFi group: 951), and set 2 included 11,765 RA patients (JAKi group: 2,498; TNFi group: 9,267). No adverse events (AEs) showed significantly higher IRRs in the JAKi groups than in the TNFi groups of sets 1 and 2. The HRs for MACE in the JAKi groups of sets 1 and 2 were 0.59 (95% confidence [CI], 0.35 to 0.99) and 0.80 (95% CI, 0.67 to 0.97), respectively. The JAKi group of set 2 showed a significantly higher risk of all-cause mortality (HR, 1.71; 95% CI, 1.32 to 2.20), but the other AEs did not demonstrate increased risks in the JAKi groups. CONCLUSIONS: In this study, JAKis did not increase the risk of AMI, stroke, CV-related mortality, MACE, VTE, ATE, or cancer in Korean RA patients relative to TNFis.

Composition of Organically Modified Silica for the Superhydrophobic Surface with Low Sliding Angle.

Extremely water-repellent surfaces with low sliding angle (SA) have been obtained with a facile single-step sol-gel strategy via co-condensation of tetraethoxysilane (TEOS) and hexadecyltrimethoxysilane (HDTMS) in basic media with an efficient self-cleaning property. We investigated the effect of the molar ratio of HDTMS and TEOS on the properties of the modified silica-coated poly(ethylene terephthalate) (PET) film. A high water contact angle (WCA) of 165° and a low SA of 1.35° were obtained at a molar ratio of 0.125. The dual roughness pattern for the low SA was developed by a one-step coating of the modified silica with a molar ratio of 0.125. The evolution of the surface to the dual roughness pattern by nonequilibrium dynamics depended on the size and shape factor of modified silica. The primitive size and the shape factor of the organosilica with a molar ratio of 0.125 were 70 nm and 0.65, respectively. We also presented a new method to determine the superficial surface friction (ζ) of the superhydrophobic surface. The ζ was a physical parameter that characterized the slip and rolling behavior of water droplets on the superhydrophobic surface along with the equilibrium property WCA and the static frictional property SA.

[Interorganizational Networks for Smoking Prevention and Cessation: A Blockmodeling Approach].

PURPOSE: This study examined characteristics and patterns of interorganizational networks for smoking prevention and cessation in Korea. METHODS: We surveyed two community health centers, ninety-five hospitals or clinics, ninety-two pharmacies, and sixty-five health welfare organizations in two districts of Seoul in 2020. Data on the organizations' characteristics of smoking cessation and interorganizational activities for information sharing, client referral, and program collaboration were collected and analyzed using network statistics and blockmodeling. RESULTS: Network size was in the order of information sharing, client referral, and program collaboration networks. Network patterns for interorganizational activities on information sharing, client referral, and program collaboration among four organizations were similar between the two districts. Community health centers provided information and received clients from a majority of the organizations. Their interactions were not unidirectional but mutual with other organizations. Pharmacies were involved in information sharing with health welfare organizations and client referrals to hospitals or clinics. Health welfare organizations were primarily connected with the community health centers for client referrals and program collaboration. CONCLUSION: A community health center is the lead agency in interorganizational activities for smoking prevention and cessation. However, hospitals or clinics, pharmacies, and health welfare organizations also participate in interorganizational networks for smoking prevention and cessation with diverse roles. This study would be evidence for developing future interorganizational networks for smoking prevention and cessation.

Sex and Economic Disparity Related to Reperfusion Therapies for Patients with Acute Ischemic Stroke in South Korea across a 10-Year Period: A Nationwide Population-Based Study Using the National Health Insurance Database.

A complete enumeration study was conducted to evaluate trends related to reperfusion therapies (intravenous thrombolysis (IVT) and endovascular treatment (EVT)) in acute ischemic stroke (AIS) in South Korea, according to sex, economic status, and age, over a 10-year period retrospectively, using the National Health Information Database (NHIS-2020-1-481). This study included AIS patients aged ≥20 years who were hospitalized in a general hospital or tertiary hospital for ≥4 days and underwent brain imaging during the same period. Study participants were classified by sex, economic status (Medical Aid beneficiaries and National Health Insurance beneficiaries) and age (20-44, 45-64, 65-79, and ≥80 years). Women showed a significantly lower OR (Odds ratio) than men in IVT (OR: 0.75; 95% CI: 0.73-0.77), EVT (OR: 0.96; 95% CI: 0.93-0.99), and any therapy (OR: 0.82; 95% CI: 0.80-0.84). The Medical Aid beneficiaries showed significantly lower OR in IVT (OR 0.91, 95% CI 0.88-0.95), EVT (OR 0.93, 95% CI 0.89-0.98), and either therapy (OR 0.92, 95% CI 0.90-0.95) than the National Health Insurance beneficiaries. This study showed sex and economic disparity related to reperfusion therapies in patients with AIS in Korea.

Sex-Specific U-Shaped Relationships Between High-Density Lipoprotein Cholesterol Levels and 10-year Major Adverse Cardiovascular Events: A Nationwide Cohort Study of 5.7 Million South Koreans.

BACKGROUND: High-density lipoprotein cholesterol (HDL-C) is a well-known predictor of atherosclerotic cardiovascular diseases (ASCVD). We explored the relationships between HDL-C levels and 10-year major adverse cardiovascular events (MACE) and provided sex-specific upper reference limits for HDL-C levels. METHODS: Based on the Korean National Health Insurance Sharing Service, we identified 5,703,897 subjects (women, 48%) with age ≥40 years, eligible HDL-C results, and no prior ASCVD in 2009. We investigated the distribution of 10-year MACE according to HDL-C levels in 10 mg/dL (0.26 mmol/L) intervals and in three HDL-C groups (low: men <40 mg/dL [1.03 mmol/L], women <50 mg/dL [1.29 mmol/L]; high: between low and extremely high levels; and extremely high: >90 mg/dL [2.33 mmol/L]). RESULTS: There were U-shaped relationships between HDL-C levels and 10-year MACE with later inflection in women than in men (nadir: 80-99 mg/dL [2.07-2.56 mmol/L] and 50-59 mg/dL [1.29-1.53 mmol/L], respectively). In men, the extremely high HDL-C group showed significantly higher 10-year MACE than the high group (28.1% vs. 24.6%, P< 0.0001). In women, the extremely high group showed the lowest 10-year MACE; if the extremely high starting point was raised to 130 mg/dL, it became similar to that in men and showed higher 10-year MACE than the high group (25.6% vs. 20.1%, P<0.0001). CONCLUSIONS: The 10-year MACE showed U-shaped relationships with HDL-C levels, and extremely high HDL-C level at 90 mg/dL (2.33 mmol/L) in men was corresponding in risk to 130 mg/dL (3.36 mmol/L) in women.

Abscopal Effect of Radiotherapy Enhanced with Immune Checkpoint Inhibitors of Triple Negative Breast Cancer in 4T1 Mammary Carcinoma Model.

Local radiotherapy (RT) is important to manage metastatic triple-negative breast cancer (TNBC). Although RT primarily reduces cancer cells locally, this control can be enhanced by triggering the immune system via immunotherapy. RT and immunotherapy may lead to an improved systemic effect, known as the abscopal effect. Here, we analyzed the antitumor effect of combination therapy using RT with an anti-programmed cell death-1 (PD-1) antibody in primary tumors, using poorly immunogenic metastatic mouse mammary carcinoma 4T1 model. Mice were injected subcutaneously into both flanks with 4T1 cells, and treatment was initiated 12 days later. Mice were randomly assigned to three treatment groups: (1) control (no treatment with RT or immune checkpoint inhibitor (ICI)), (2) RT alone, and (3) RT+ICI. The same RT dose was prescribed in both RT-alone and RT+ICI groups as 10Gy/fx in two fractions and delivered to only one of the two tumor burdens injected at both sides of flanks. In the RT+ICI group, 200 µg fixed dose of PD-1 antibody was intraperitoneally administered concurrently with RT. The RT and ICI combination markedly reduced tumor cell growth not only in the irradiated site but also in non-irradiated sites, a typical characteristic of the abscopal effect. This was observed only in radiation-sensitive cancer cells. Lung metastasis development was lower in RT-irradiated groups (RT-only and RT+ICI groups) than in the non-irradiated group, regardless of the radiation sensitivity of tumor cells. However, there was no additive effect of ICI on RT to control lung metastasis, as was already known regarding the abscopal effect. The combination of local RT with anti-PD-1 blockade could be a promising treatment strategy against metastatic TNBC. Further research is required to integrate our results into a clinical setting.

Effect of vibration foam rolling on the range of motion in healthy adults: a systematic review and meta-analysis.

Professionals use foam rollers to improve range of motion (ROM). Recently, a vibrating foam roller (VFR) that combines the vibration function with a foam roller (FR) has been used. The purpose of this systematic review and meta-analysis was to determine the effects of a VFR on the improvement of ROM in healthy individuals. A systematic literature search was carried out in five international databases: PubMed, Embase, PEDro, Cochrane Library, and Google Scholar. Eight clinical studies, composed of six randomized controlled trials and two randomized crossover trials that involved 230 healthy participants were selected for analysis. Methodological quality was identified using the PEDro scale. The mean scores, 4.75±0.71, of the eight included studies, were classified as fair. The results demonstrated that the VFR achieved better gains than the FR in improving ROM (standardized mean difference [SMD], 0.53; 95% confidence intervals [CIs], 0.29-0.77; I 2=55%). The VFR was more effective in improving the ROM than the FR in the hip and knee joints (hip: SMD, 0.56; 95% CI, 0.28-0.85; I 2=0%; knee: SMD, 0.86; 95% CI, 0.42-1.30; I 2=79%). The VFR may be an additional option to improve the ROM in healthy adults and athletes.

The incidence of urologic complications requiring urologic procedure in radical hysterectomy and difference between abdominal radical hysterectomy and laparoscopic radical hysterectomy.

OBJECTIVE: To evaluate the incidence of urologic complications requiring a urologic procedure during the perioperative period and compare the differences between abdominal radical hysterectomy (ARH) and laparoscopic radical hysterectomy (LRH). METHODS: We identified all Korean women who underwent radical hysterectomy (RH) between January 2006 and December 2019 using the National Health Insurance Service database. Complications requiring surgical intervention-based urologic procedures between ARH and LRH were investigated. RESULTS: A total of 12,068 patients were classified into the ARH group and 8,837 patients were classified into the LRH group. Urologic complications requiring urologic procedures occurred in 1,546 of 20,905 patients (7.40%) who underwent RH. The most common urologic procedure was double-J insertion (R326, 5.18%), followed by bladder repair (R3550, 0.90%). There was no significant difference in urologic complications requiring urologic procedures between the ARH and LRH groups (odds ratio [OR]=1.027; 95% confidence interval [CI]=0.925-1.141; p=0.612). The incidence of bladder repair (R3550) was significantly higher in patients who underwent LRH (OR=1.620; 95% CI=1.220-2.171; p<0.001). Urologic complications requiring urologic procedures were statistically higher in the LRH group during the first half (OR=1.446; 95% CI=1.240-1.685; p<0.001), but more in the ARH group during the second half (OR=0.696; 95% CI=0.602-0.804; p<0.001) of the study period. CONCLUSION: There was no difference of urologic complications between ARH and LRH with regard to urologic procedures. The incidence of urologic procedures decreases with time in patients who underwent LRH.

Effect of respiratory exercise on pulmonary function, balance, and gait in patients with chronic stroke.

[Purpose] This study investigated the effect of respiratory exercise on pulmonary function, balance, and gait in chronic stroke patients. [Participants and Methods] Twenty patients with chronic stroke were randomly assigned to experimental and control groups (n=10 each). The patients in both groups underwent neurodevelopmental treatment. Moreover, the experimental group performed respiratory exercise. Pulmonary function was measured using a pneumatometer. Balance was measured using a Berg Balance Scale and Functional Reach Test. Gait was measured with a 10-m walk test and Timed Up-and-Go Test. [Results] Intragroup comparison showed significant differences in forced vital capacity, forced expiratory volume in one second, Berg Balance Scale, Functional Reach Test, 10-meter walk test, and Timed Up-and-Go Test. Intergroup comparison showed that the differences in forced vital capacity, forced expiratory volume in one second, Berg Balance Scale, Functional Reach Test, 10-meter walk test, and Timed Up-and-Go Test for the experimental group were significantly related to those for the control group. [Conclusion] Based on these results it was concluded that respiratory exercise effectively improves the pulmonary function, balance, and gait in patients with chronic stroke.

The effects of pain scrambler therapy on the pain and quality of life of degenerative gonarthritis patients.

[Purpose] The purpose of this study was to identify the effects of pain scrambler therapy on the pain and quality of life of degenerative gonarthritis patients. [Subject and Methods] This study is a single case study. Pain scrambler therapy was applied for 40 minutes per session once a day for 15 days to a 62-year-old female patient diagnosed with degenerative gonarthritis. Pain was measured using the Visual Analogue Scale and quality of life was measured using the short form-36 item after therapy. [Results] Decrease in pain and improved quality of life were evident after pain scrambler therapy. [Conclusion] Pain scrambler therapy had a potential to decrease pain and improve the quality of life in degenerative gonarthritis patients.

Resonant magneto-optic Kerr effects of a single Ni nanorod in the Mie scattering regime.

We present a systematic, theoretical investigation of the polar magneto-optical (MO) Kerr effects of a single Ni nanorod in the Mie regime. The MO Kerr rotation, ellipticity, amplitude ratio, and phase shift are calculated as a function of the length and width of the nanorod. The electric field amplitude ratio of the MO Kerr effect is locally maximized when the nanorod supports a plasmonic resonance in the polarization state orthogonal to the incident light. The plasmonic resonances directly induced by the incident light do not enhance the amplitude ratio. In the Mie regime, multiple local maxima of the MO Kerr activity are supported by the resonant modes with different modal characteristics. From the viewpoint of first-order perturbation analysis, the spatial overlap between the incident-light-induced electric field and the Green function determines the local maxima.

Inhibition of Experimental Systemic Inflammation (Septic Inflammation) and Chronic Bronchitis by New Phytoformula BL Containing Broussonetia papyrifera and Lonicera japonica

Broussonetia papyrifera and Lonicera japonica have long been used in the treatment of inflammatory disorders in Chinese medicine, especially respiratory inflammation. Previously, a new phytoformula (BL) containing B. papyrifera and L. japonica was found to exert strong anti-inflammatory activity against several animal models of inflammation, especially against an animal model of acute bronchitis. In the present investigation, the effects of BL on animal models of septic inflammation and chronic bronchitis are examined. Against lipopolysaccharide (LPS)-induced septic inflammation in mice, BL (200-400 mg/kg) reduced the induction of some important proinflammatory cytokines. At 1 h after LPS treatment, BL was found to considerably inhibit TNF-alpha production when measured by cytokine array. At 3 h after LPS treatment, BL inhibited the induction of several proinflammatory cytokines, including IFN-gamma and IL-1beta, although dexamethasone, which was used as a reference, showed a higher inhibitory action on these biomarkers. Against chronic bronchitis induced by LPS/elastase instillation in rats for 4 weeks, BL (200-400 mg/kg/day) significantly inhibited cell recruitment in bronchoalveolar lavage fluid. Furthermore, BL considerably reduced lung injury, as revealed by histological observation. Taken together, these results indicate that BL may have a potential to treat systemic septic inflammation as well as chronic bronchitis.

Volatile Organic Compounds in Ambient Air at Four Residential Locations in Seoul, Korea.

To investigate the environmental behavior of volatile organic compounds (VOCs) in urban areas, their concentrations were measured at four urban monitoring sites (namely, N, S, E, and W) in Seoul, Korea (February to December 2009). A total of 27 compounds were quantified that consist of four chemical groups: aromatic (AR), halogenated aromatic, halogenated paraffin, and halogenated olefin. Results were evaluated by focusing on these four functional groups just mentioned and their summation term as total VOC (TVOC) along with several individual species (mainly AR species, that is, benzene, toluene, ethylbenzene, and xylene). The highest concentration of chemical groups was found from AR (71.1±42.1 ppbC), while that for individual species confirmed the dominance of toluene (7.48±3.88 ppb). The analysis of spatial distribution indicated that high TVOC levels were recorded at sites N and W, while it was not so significant such as S and E in terms of TVOC budget. Seasonal variation of these VOCs was characterized by the peak values in December to reflect the combined effects of pronounced source activities and meteorological conditions. Analysis of spatial variations in VOC levels between the four urban sites indicated that their distributions are tightly affected by local source processes in each area.