Orthopedic Surgery Residency Program Rankings and Gender Diversity.

Background Orthopedic surgery residency programs are some of the least gender-diverse specialty programs in medicine. Despite strong representation at the undergraduate and medical school levels and increased applications to orthopedic surgery residency programs by women, there is still a substantial gender gap at the resident level. This study explores the relationship between the gender diversity of orthopedic surgery residency programs and program rankings. Methodology Program rank, program director gender identity, and gender diversity data were collected for the top 100 programs by reputation in Doximity. Gender diversity was measured as the proportion of female residents in the program and alumni. Results The greatest percentage of women in a program was 33% and the smallest was 3%. After linear regression analysis, we found that there was a statistically significant positive correlation between program rank and the proportion of women. The higher ranked a program was, the greater the proportion of women. There was no significant correlation between program director gender, appointment year, and program rank. Conclusions These results suggest that, although there is still a long way to go before closing the gender gap in orthopedic surgery residency programs, higher-ranked programs are associated with greater gender diversity than their lower-ranked counterparts.

Firefighters' medical use and Korean Medicine experience in Korea: A qualitative study protocol.

INTRODUCTION: Firefighters, compared to other occupational groups, are exposed more frequently in their working environment not only to physical issues, such as musculoskeletal disease, respiratory disease, and burns but also to mental health issues, such as PTSD and depression. Specifically, Korean firefighters experience significantly higher rates of work-related injuries compared to those in other countries. Recent statistics from the Korea National Fire Agency indicate a steady increase in the number of firefighting work-related injuries. However, there is a shortage of measures in place to address these issues. This study aims to investigate the health needs, overall healthcare usage, and unmet needs of firefighters in Korea. We also aim to investigate, through in-depth interviews, perceptions and hindering factors for integrative medicine approaches to fulfilling unmet needs. METHOD: This study was conducted in accordance with the consolidated criteria for reporting qualitative research. Convenience and snowball sampling methods will be used to recruit firefighters to participate in the study, and interviews will be conducted using a semi-structured interview guide. The data will be analyzed in four stages using the qualitative analysis method of Krippendorff. DISCUSSION: In this study, we examine the state of health issues and healthcare usage among Korean firefighters and investigate their perceptions of and needs for integrative medicine. In this way, we aim to explore how integrative medicine and Korean medicine approaches could improve and assist healthcare services for firefighters. Furthermore, our findings will provide policymakers and healthcare providers with the necessary basic information to develop integrative medicine systems suited to firefighters.

Impact of moderate-to-late preterm birth on neurodevelopmental outcomes in young children: Results from retrospective longitudinal follow-up with nationally representative data.

This study investigated the relationship between moderate-to-late preterm (MLPT) birth and the risk of neurodevelopmental impairments (NIs) in young children compared with the risks associated with very preterm (VPT) and full-term (FT) birth based on nationally representative large-scale population data. Retrospective follow-up was conducted over 71 months for 738,733 children who were born and participated in the Korean National Health Screening Program for Infants and Children (NHSPIC) between 2011 and 2013. Using a data linkage between the NHSPIC and Korean healthcare claim information, data on birth year, sex, delivery type, birth weight, growth abnormality, gestational age, breastfeeding history, maternal age, NIs, multiple gestation, preterm labor, premature rupture of membranes (PROM), gestational diabetes, gestational hypertension, smoking during pregnancy, and socioeconomic status were collected and included in the final analysis. Cox proportional hazards models were applied to identify the impact of gestational age on NI risk, with all variables adjusted as appropriate. Overall, 0.9% and 3.8% rates of VPT and MLPT births were identified, respectively. NI incidence was highest among VPT children (34.7%), followed by MLPT (23.9%) and FT (18.2%) children. Both VPT (hazard ratio [HR], 1.45; 95% confidence interval [CI], 1.03 to 2.05) and MLPT (HR, 1.21; 95% CI, 1.04 to 1.41) births were associated with increased NI risk. Low birth weight, PROM, and smoking during pregnancy were also associated with increased NI risk, while longer breastfeeding and higher socioeconomic status were associated with decreased risk. Special attention must be given to NIs for both VPT and MLPT children.

Conversion of Natural Biowaste into Energy Storage Materials and Estimation of Discharge Capacity through Transfer Learning in Li-Ion Batteries.

To simultaneously reduce the cost of environmental treatment of discarded food waste and the cost of energy storage materials, research on biowaste conversion into energy materials is ongoing. This work employs a solid-state thermally assisted synthesis method, transforming natural eggshell membranes (NEM) into nitrogen-doped carbon. The resulting NEM-coated LFP (NEM@LFP) exhibits enhanced electrical and ionic conductivity that can promote the mobility of electrons and Li-ions on the surface of LFP. To identify the optimal synthesis temperature, the synthesis temperature is set to 600, 700, and 800 °C. The NEM@LFP synthesized at 700 °C (NEM 700@LFP) contains the most pyrrolic nitrogen and has the highest ionic and electrical conductivity. When compared to bare LFP, the specific discharge capacity of the material is increased by approximately 16.6% at a current rate of 0.1 C for 50 cycles. In addition, we introduce innovative data-driven experiments to observe trends and estimate the discharge capacity under various temperatures and cycles. These data-driven results corroborate and support our experimental analysis, highlighting the accuracy of our approach. Our work not only contributes to reducing environmental waste but also advances the development of efficient and eco-friendly energy storage materials.

Vision for tobacco endgame in Korea: suggestions for countries with endgame aspirations.

Tobacco endgame is a focal point of discussion at both national and international levels. We aimed to describe efforts related to achieving the tobacco endgame in the Republic of Korea, an exemplar of a country with endgame aspirations, and compare them with the efforts of other nations. We reviewed the tobacco endgame efforts of three nations considered tobacco control leaders: New Zealand (NZ), Australia and Finland. The efforts/attempts of each country were described using an endgame strategy category. The tobacco control leaders had explicit goals to achieve a smoking prevalence of <5% before a target date and had legislation and research centres for tobacco control and/or endgame. NZ is implementing a mixture of conventional and innovative endgame interventions; the others use incremental conventional approaches. In Korea, there has been an attempt to ban the sale and manufacture of combustible cigarettes. The attempt led to the filing of a petition, and a survey of adults showed 70% supported the legislation banning tobacco. The Korean government mentioned a tobacco endgame in a 2019 plan, yet a target and an end date were absent. The 2019 plan in Korea included incremental FCTC strategies. Practices in the leading countries show that legislation and research are key to ending the tobacco epidemic. The MPOWER measures must be strengthened, endgame objectives must be set and bold strategies must be adopted. Key endgame policies include those with evidence of effectiveness, such as retailer reductions.

Factors Associated with the 30-Day and 1-Year Smoking Abstinence of Women in Korea: The Effect of Nicotine Dependency, Self-Efficacy, and Mental Illness.

Despite the success of tobacco control efforts in reducing smoking rates during the past 50 years, data on the factors contributing to quitting success are still lacking. Smoking-related mortality among women has also not declined. Therefore, this study aimed to characterize sociodemographic features, smoking-related behaviors, mental illness, and smoking cessation in woman smokers in Korea who were registered in the Quitline program. Furthermore, factors associated with 30-day and 1-year successful smoking cessation after enrollment in the Quitline program were investigated. A total of 3360 adult woman Quitline users from 2007 to 2018 were included in the final analysis, with information on their age, education level, marital status, body mass index, frequency of alcohol consumption per month, nicotine dependency, self-efficacy for smoking cessation, presence of a smoking cessation supporter, and mental health history collected upon registration with the Quitline program in Korea. Their cessation outcome was investigated with a 1-year follow-up until the end of 2019. A multiple logistic regression analysis was conducted to identify factors associated with smoking cessation at the 30-day and 1-year follow-ups. The results of the multiple logistic regression analysis indicated that lower nicotine dependency, higher self-efficacy, and the presence of a smoking cessation supporter improved the odds of smoking cessation at the 30-day and 1-year follow-ups. In contrast, users with a mental health condition were less likely to achieve smoking cessation. Incorporating methods to increase self-efficacy in women who decide to quit smoking will contribute to facilitating more attempts to quit and achieving greater success in smoking cessation among woman smokers.

An Open Pilot Trial of Written Exposure Therapy for Patients With Post-Traumatic Stress Disorder in Korea.

OBJECTIVE: Written exposure therapy (WET) is exposure therapy for post-traumatic stress disorder (PTSD). Compared to evidencebased treatments for PTSD, WET requires only five sessions, has a shorter session time, and no between-session assignments. The current study examined the efficacy of WET among Korean patients with PTSD due to various traumatic events on PTSD symptoms, depressive symptoms, and global functioning levels. METHODS: The study recruited 41 patients with a current primary diagnosis of PTSD in psychiatric outpatient clinics. Assessments were conducted at baseline, and at 6, 12, and 24 weeks following the first treatment session. RESULTS: In total, 25 patients started WET. Findings showed a significant reduction in the rate of PTSD diagnosis and symptom severity scores. Fourteen of 23 (60.9%) patients at 6 weeks, 15 of 22 (68.2%) patients at 12 weeks, and 14 of 18 (77.8%) patients at 24 weeks no longer met the diagnosis of PTSD. Depressive symptoms and global function scores also improved after WET. The dropout rate was 8% (n=2). CONCLUSION: This study suggests the feasibility of implementing WET among various types of patients with PTSD in Korea and other Asian countries.

Posttraumatic stress disorder symptoms and neurocognitive functioning in fire fighters: The mediating role of sleep problems and resilience.

BACKGROUND: Firefighters are often exposed to terrible and dangerous scenes due to their duties, and thus have a high risk of developing posttraumatic stress disorder(PTSD). The purpose of the study is to examine the relationship between PTSD symptoms, sleep problems, resilience and neurocognitive functioning of firefighters, and to identify the sequential mediating effects of sleep problems and resilience on the relationship between PTSD symptoms and neurocognitive functioning (especially psychomotor speed and processing speed). METHODS: Data were collected from 325 firefighters in eight fire departments in four regions of Korea. Subjects performed neurocognitive function tests and completed the following questionnaires: Primary Care PTSD Screening, Pittsburgh Sleep Quality Index-K and Connor-Davidson Resilience Scale-2. The correlation and dual mediation effects were analysed using SPSS 22.0 program and PROCESS macro 3.4 program. RESULTS: PTSD symptoms, neurocognitive functioning, sleep problems and resilience were significantly correlated with each other. In the sequential mediation model, the relationship between PTSD and psychomotor speed/processing speed was sequentially mediated by sleep problems and resilience after adjusting for demographic variables. CONCLUSIONS: The PTSD symptoms of firefighters were related to a sequential link between sleep problems, low resilience and decreased neurocognitive function. These findings could serve as a basis for more effective and integrated interventional strategies for facilitating better neurocognitive functioning in firefighters.

The Interaction of Inflammatory Markers and Alcohol-Use on Cognitive Function in Korean Male Firefighters.

OBJECTIVE: Cognitive functions have been shown to become impaired due to alcoholism. Recently, neuroinflammation gained attention for playing a role in the neurotoxic effect of alcohol. However, there is limited data on the relationship between alcohol and cognitive function, based on the mechanism of inflammation. This study examined whether the interaction between alcohol use and pro-inflammatory biomarkers is related to cognitive function in Korean male firefighters. METHODS: A total of 474 firefighters were assessed for alcohol-related problems using CAGE, cognitive functions, and pro-inflammatory biomarkers (CRP, IL-6, TNF-α). Sequential multiple regression analyses were conducted to determine if inflammatory markers moderate the relationship between alcohol use and cognitive function. RESULTS: Only a decreased attentional function was associated with the interaction of alcohol use and inflammatory markers, after controlling for age, sex, body mass index, lipid profiles, smoking, depression, fatigue, self-reported hypertension, diabetes, and musculoskeletal problems. CONCLUSION: This study revealed that the interaction between alcohol use and inflammation is related to attentional function in Korean male firefighters. Additionally, this cross-sectional study suggests that diminishing attention, related to alcohol use, may be based on the mechanism of inflammation.

Effect of 'rice' pattern on high blood pressure by gender and obesity: using the community-based KoGES cohort.

OBJECTIVE: The present study aimed to examine the association between dietary pattern and the risk of high blood pressure (BP) and to estimate the attenuated effect by gender and obesity on the association using data from a prospective cohort study in Korea. DESIGN: Prospective study. Diet was assessed using a validated 103-item FFQ and was input into factor analysis after adjustment for total energy intake. SETTING: Community-based Korean Genome Epidemiology Study (KoGES) cohort. PARTICIPANTS: Healthy individuals (n 5151) without high BP at recruitment from the community-based cohort study. RESULTS: Dietary pattern was not associated with the risk of high BP regardless of the type of covariates, with the exception of the 'rice' pattern. The effect of the 'rice' pattern was observed in both men (Ptrend = 0·013) and women (Ptrend < 0·001), but the statistical significance remained only in women after adjustment for confounders (Ptrend = 0·004). The positive association of the 'rice' pattern with high BP risk was attenuated by obesity. After stratification by gender and obese status, in particular, the harmful effect of the 'rice' pattern was predominantly observed in obese women (Ptrend < 0·001) only. CONCLUSIONS: This longitudinal study in Korean adults found a positive association of the 'rice' pattern with long-term development of incident high BP, predominantly in women. The association is likely to be attenuated by gender and obese status.

Correlation between Physical Activity and Lung Function in Dusty Areas: Results from the Chronic Obstructive Pulmonary Disease in Dusty Areas (CODA) Cohort.

BACKGROUND: Although physical activity is known to be beneficial to lung function, few studies have been conducted to investigate the correlation between physical activity and lung function in dusty areas. Therefore, the purpose of this study is to investigate the correlation between physical activity and lung function in a Korean cohort including normal and COPD-diagnosed participants. METHODS: Data obtained from the COPD in dusty areas (CODA) cohort was analyzed for the following factors: lung function, symptoms, and information about physical activity. Information on physical activity was valuated using questionnaires, and participants were categorized into two groups: active and inactive. The evaluation of the mean lung function, modified Medical Research Council dyspnea grade scores, and COPD assessment test scores was done based on the participant physical activity using a general linear model after adjusting for age, sex, smoking status, pack-years, height, and weight. In addition, a stratification analysis was performed based on the smoking status and COPD. RESULTS: Physical activity had a correlation with high forced expiratory volume in 1 second (FEV1) among CODA cohort (p=0.03). While the active group exhibited significantly higher FEV1 compared to one exhibited by the inactive group among past smokers (p=0.02), no such correlation existed among current smokers. There was no significant difference observed in lung function after it was stratified by COPD. CONCLUSION: This study established a positive correlation between regular physical activity in dusty areas and lung function in participants.

Hexacosanol reduces plasma and hepatic cholesterol by activation of AMP-activated protein kinase and suppression of sterol regulatory element-binding protein-2 in HepG2 and C57BL/6J mice.

Policosanols have hypocholesterolemic activity; however, the molecular mechanism of the policosanol effects is currently poorly characterized. We hypothesized that hexacosanol, a policosanol compound derived from barley sprout, may decrease cellular and plasma cholesterol levels; we thus investigated the hypocholesterolemic activity and mechanism of hexacosanol on both hepatocytes and high-fat-induced obese C57BL/6J mice. The reduction of total cholesterol, free cholesterol, and cholesteryl ester concentrations was confirmed in hexacosanol-stimulated hepatocytes (-38%, -33%, and -53%, respectively). Plasma, hepatic cholesterol concentrations, and hepatic steatosis were significantly reduced in high-fat-fed mice orally administered with hexacosanol (0.7 mg/kg body weight a day) for 8 weeks compared with those of vehicle-fed control mice (-15% and -40%, respectively). Hexacosanol in fact bound to the allosteric regulation site of AMP-activated protein kinase (AMPK)-ß subunit and thus activated AMPK that inhibited the activity of 3-hydroxy-3-methyl-glutaryl-coenzyme A reductase by inhibitory phosphorylation. In addition, activation of AMPK by hexacosanol induced hepatic autophagy activity, which could further reduce hepatic lipid accumulation. Alternatively, hexacosanol suppressed the nuclear translocation and activation of sterol regulatory element-binding protein-2 (SREBP-2), a key transcription factor in cholesterol biosynthesis. These results collectively suggest that hexacosanol is a major hypocholesterolemic compound in barley sprouts with regulation of AMPK activation and SREBP-2 suppression. These suppress 3-hydroxy-3-methyl-glutaryl-coenzyme A reductase at both mRNA expression and protein activity levels. In conclusion, hexacosanol activates AMPK and hepatic autophagy and inhibits SREBP2, resulting in hypocholesterolemic activities and improvement of hepatic steatosis.

Effect of zafirlukast on capsular contracture around silicone implants in rats / Efeito do zafirlukast na contratura capsular ao redor de implantes de silicone em ratos

PURPOSE: To evaluate the effect of zafirlukast on capsular contracture around silicone implants by measuring the pressure within the implant, using a rat experimental model. METHODS: Forty adult female Wistar rats were used. Each one received two silicone implants, one with smooth-surface and the other with textured-surface. They were randomly divided into four groups (n=10). The rats of control group I were sacrificed after the implants. The remaining animals were subjected to a daily regimen of intra-peritoneal injection for a period of 90 days and they were distributed as follows: control group II received 0.9 percent physiological saline solution; experimental group I received zafirlukast 1.25 mg/kg; and experimental group II received zafirlukast 5 mg/kg. The measurement of intra-implant pressure of control group I was determined on the surgery day and in other groups on the ninetieth day, after being sacrificed. RESULTS: In the evaluation of textured implants there was an increase of internal pressure in the control group II, and there was no increase in the experimental groups. Compared to the controls there were not significant differences in smooth implants. CONCLUSION: Zafirlukast reduced the risk of developing capsular contracture around silicone implants with textured surface.

OBJETIVO: Avaliar o efeito do zafirlukast na contratura capsular ao redor de implantes de silicone, através da aferição da pressão intra-implante, utilizando-se um modelo experimental de ratos. MÉTODOS: Quarenta ratos fêmeas Wistar foram utilizados. Cada um recebeu dois implantes de silicone, sendo um com superfície lisa e outro texturizada. Foram divididos aleatoriamente em quatro grupos (n=10). Os ratos do grupo controle I foram sacrificados após o implante. O restante dos animais foi submetido a um regime diário de injeção intraperitoneal por um período de 90 dias e foram distribuídos: grupo controle II recebeu solução salina fisiológica 0,9 por cento, grupo experimental I recebeu zafirlukast 1,25 mg/kg, e grupo experimental II recebeu zafirlukast 5 mg/kg. O grupo controle II recebeu solução salina; grupo experimental I, 1,25 mg/kg/dia de zafirlukast; grupo experimental II, 5mg/kg/dia de zafirlukast. A aferição da pressão intra-implante do grupo controle I foi averiguada no dia do ato operatório, e nos outros grupos no nonagésimo dia, após serem sacrificados. RESULTADOS: Na avaliação dos implantes texturizados houve aumento da pressão interna no grupo controle II e, não se observou aumento nos grupos experimentais. Na comparação com os controles não foram observadas diferenças significativas nos implantes lisos. CONCLUSÃO: O Zafirlukast reduziu o risco de desenvolver contratura capsular em torno de implantes de silicone com superfície texturizada.

Effect of zafirlukast on capsular contracture around silicone implants in rats.

PURPOSE: To evaluate the effect of zafirlukast on capsular contracture around silicone implants by measuring the pressure within the implant, using a rat experimental model. METHODS: Forty adult female Wistar rats were used. Each one received two silicone implants, one with smooth-surface and the other with textured-surface. They were randomly divided into four groups (n=10). The rats of control group I were sacrificed after the implants. The remaining animals were subjected to a daily regimen of intra-peritoneal injection for a period of 90 days and they were distributed as follows: control group II received 0.9% physiological saline solution; experimental group I received zafirlukast 1.25 mg/kg; and experimental group II received zafirlukast 5 mg/kg. The measurement of intra-implant pressure of control group I was determined on the surgery day and in other groups on the ninetieth day, after being sacrificed. RESULTS: In the evaluation of textured implants there was an increase of internal pressure in the control group II, and there was no increase in the experimental groups. Compared to the controls there were not significant differences in smooth implants. CONCLUSION: Zafirlukast reduced the risk of developing capsular contracture around silicone implants with textured surface.

Synthetic analogs of indole-containing natural products as inhibitors of sortase A and isocitrate lyase.

Guided by the inhibitory activities of indole-containing natural products against isocitrate lyase (ICL) from Candida albicans and sortase A (SrtA) from Staphylococcus aureus, a series of compounds structurally analogous to natural products were synthesized. Eight SrtA inhibitors and an ICL inhibitor having higher activities than the natural products were discovered by screening the enzyme inhibitory activities of synthesized compounds. Among the SrtA inhibitors discovered, six exhibited higher activities than p-hydroxymercuribenzoic acid, which suggests that these compounds have great potential as alternative antibacterial agents.

Bromophenols as Candida albicans isocitrate lyase inhibitors.

A new series of bromophenols was synthesized by reactions of corresponding phenol analogs with bromine. The synthesized compounds were tested for inhibitory activity against isocitrate lyase (ICL) of Candida albicans and antimicrobial activity against gram-positive and, gram-negative bacteria and fungi. Among the synthesized bromophenols, bis(3-bromo-4,5-dihydroxyphenyl)methanone (11) and (3-bromo-4,5-dihydroxyphenyl)(2,3-dibromo-4,5-dihydroxyphenyl)methanone (12) displayed potent inhibitory activities against ICL, showing a stronger inhibitory effects than were found with natural bromophenol 1. The preliminary structure-activity relationships were investigated in order to determine the essential structural requirements for the inhibitory activities of these compounds against ICL of C. albicans.

5-Hydroxyindole-type alkaloids, as Candida albicans isocitrate lyase inhibitors, from the tropical sponge Hyrtios sp.

Chemical investigations of the tropical marine sponge Hyrtios sp. have resulted in the isolation of a new alkaloid, 1-carboxy-6-hydroxy-3,4-dihydro-beta-carboline (1) together with the known metabolites, 6-hydroxy-3,4-dihydro-1-oxo-beta-carboline (2), 5-hydroxy-1H-indole-3-carboxylic acid methyl ester (3), serotonin (4), hyrtiosin A (5), 5-hydroxyindole-3-carbaldehyde (6), and hyrtiosin B (7). Their structures were elucidated on the basis of mass spectrometry and detailed 2D NMR spectroscopic data. Hyrtiosin B (7) displayed a potent inhibitory activity against isocitrate lyase (ICL) of Candida albicans with an IC(50) value of 89.0 microM.

Experimental model of capsular contracture in silicone implants

The breast implant procedure is one of the most performed into Plastic Surgery and the contracture that occurs the capsule formed around the breast implants one of most frequent complication. We describe here one experimental model of capsule contracture in rats.

O procedimento cirúrgico implante de silicone mamário é um dos mais realizados dentro da Cirurgia Plástica e a contratura que ocorre na cápsula formada ao redor do implante é uma de suas maiores complicações. Descrevemos aqui um modelo experimental de contratura capsular em ratas.

Experimental model of capsular contracture in silicone implants

The breast implant procedure is one of the most performed into Plastic Surgery and the contracture that occurs the capsule formed around the breast implants one of most frequent complication. We describe here one experimental model of capsule contracture in rats.