Analysis of Out-of-Hospital First Aid for Recovery of Spontaneous Circulation after Cardiac Arrest in Korea.

The characteristics of an individual patient experiencing out-of-hospital cardiac arrest who recovered spontaneous circulation with the assistance of witnesses and paramedics were examined. The analysis of bystander cardiopulmonary resuscitation (CPR) and the professional first aid efforts of paramedics in the pre-hospital environment is pivotal to enhancing the survival rate of out-of-hospital cardiac arrest patients. The data used in this study were extracted from the Korea Centers for Disease Control and Prevention (KCDC) nationally recognized statistics, Acute Heart Failure big data survey. Out-of-hospital cardiac arrest (OHCA) customer data were collected from the Gangwon Fire Headquarters public information database as social management data. The data were analyzed using SPSS 24. The study's results emphasized the significance of offering basic CPR training to the public. This is evident from the fact that 90.5% of the first witnesses in the study performed CPR on OHCA patients, resulting in the recovery of spontaneous circulation (ROSC). The majority of patients with ROSC were male, with the highest age group being 41-50 years. Heart disease, hypertension, and diabetes were common medical conditions. The rate of witnessing cardiac arrest was high. Among the first witnesses, about 78.4% were of cardiac arrest incidents involving family members, co-workers, or acquaintances; 12.2% were on-duty medical healthcare personnel; and 9.5% were off-duty healthcare personnel. Cardiac arrest was treated in 83.8% of cases, with 90% of witnesses performing CPR. The percentage of witnesses that used an automated external defibrillator (AED) was 13.5%. In this study, the rates of ECG monitoring, CPR performance, and defibrillation performed by paramedics were high, but intravascular access and drug administration had a lower rate of performance. The time elapsed depended on the patient's physical fitness. The study found that paramedics had the highest CPC restoration rate in patients with cardiac arrest, followed by EMTs and nurses. Significant differences were observed in cerebral performance scores after care by these paramedics and nurses. To increase the performance of AEDs, more AEDs should be installed in public spaces so that the public can access them conveniently in cases of emergency. In addition, it is necessary to improve the quality of professional first aid physical activity services performed by first-class paramedics.

Interstitial lung disease following COVID-19 vaccination: a disproportionality analysis using the Global Scale Pharmacovigilance Database (VigiBase).

BACKGROUND AND OBJECTIVE: Despite several case reports, population-based studies on interstitial lung disease (ILD) following COVID-19 vaccination are lacking. Given the unprecedented safety issue of COVID-19 vaccination, it is important to assess the worldwide patterns of ILD following COVID-19 vaccination. This study aimed to investigate the signals of COVID-19 vaccine-associated ILD compared with other vaccinations using disproportionality analysis. METHODS: We analysed the VigiBase database during the period between 13 December 2020 and 26 January 2023. We adopted the case/non-case approach to assess the disproportionality signal of ILD for COVID-19 vaccines via 1:10 matching by age and sex. We compared COVID-19 vaccines with all other vaccines as the reference group. RESULTS: Among 1 233 969 vaccine-related reports, 679 were reported for ILD. The majority of ILD cases were related to tozinameran (376 reports, 55.4%), Vaxzevria (129 reports, 19.0%) and elasomeran (78 reports, 11.5%). The reporting OR of ILD following COVID-19 vaccination was 0.86 (95% CI 0.64 to 1.15) compared with all other vaccines. CONCLUSION: No significant signal of disproportionate reporting of ILD was observed for COVID-19 vaccines compared with all other vaccines. Moreover, when compared with the influenza vaccines that are known to cause ILD, no signal was observed. This study results might help decision-making on the subsequent COVID-19 vaccination strategy of ILD. Further large and prospective studies are required for more conclusive evidence.

Association between social isolation and subjective cognitive decline in Korean older adult population: A nationwide cross-sectional study in South Korea.

This study aimed to analyze the association between social isolation (SI) and subjective cognitive decline (SCD) in Koreans aged 65 years or older. The cross-sectional study of the Korea Community Health Survey (KCHS) was conducted on 72,904 individuals aged 65 years or older. SI was defined using five indicator, and an increasing number of SI indicators signifies a higher level of SI. SCD was defined as self-observed impairment of more frequent or worsening memory loss or confusion within the previous 12 months. The cognitive function questionnaire included questions regarding SCD. Chi-square test and weighted logistic regression analysis were used to analyze the association between SI and SCD. SI group had higher odds of SCD experience rate than the non-SI (AOR:1.15, 95 % CI: 1.08-1.22). Subgroup analysis showed that when SI occurred in the non-Moderate or Vigorous Physical Exercise (MVPE) group, SI group was more likely to experience SCD compared with the non-SI (AOR: 1.17, 95 % CI: 1.10-1.25). However, when SI occurred in the MVPE group, there were not find out the association between SI and SCD. The results of this study showed that the SI group had a higher rate of SCD than the non-SI group. Particularly, a strong association was observed in the non-MVPE. Therefore, even if SI occurs, SCD can be prevented by educating individuals regarding the importance of participating in MVPE and depression.

Relationship between functional limitations due to subjective cognitive decline and falling focusing exercise intensity: Results from the Korean Community Health Survey.

Background: To explore the association between functional limitation due to subjective cognitive decline (SCD) and falling by focusing on exercise intensity in the Korean population aged 45 years and older. Study Design: The 2019 Korean Community Health Survey (KCHS) was used to analyze 35,387 people by applying individual weights imposed from the raw data. Methods: To analyze the association between functional limitation due to SCD and falling in the Korean population aged 45 years and older, weighted logistic regression analysis and weighted zero-inflated Poisson regression analysis were used. Results: In both the middle-aged group and the older adult group, the functional limitation due to SCD had a higher fall experience rate and more falls than the non-functional limitation due to SCD group. Additionally, the middle-aged group and the moderate or vigorous physical exercise (MVPE) group had a higher fall experience rate and number of falls than the non-MVPE group; however, the older adult group walking regularly and performing MVPE had a lower fall experience rate and number of falls than the non-exercise group. Conclusions: Active participation in exercise is encouraged and should lead to fewer falls in older adults. Furthermore, a group with functional limitations due to SCD should be provided with exercise guidelines and a community program and facilities that enable regular participation should be developed.

Effect of dementia on all-cause mortality in hip fracture surgery: a retrospective study on a nationwide Korean cohort.

OBJECTIVES: We aimed to evaluate the effect of dementia on the 1-year all-cause mortality in elderly patients who underwent hip fracture surgery, using a nationwide cohort in Korea. DESIGN, SETTING, AND PARTICIPANTS: This was a nationwide, retrospective study. Elderly patients (≥60 years) with and without dementia who underwent hip fracture surgery between January 2005 and December 2012 were distinguished using the data from the Korean National Health Insurance Service-Senior cohort. INTERVENTIONS: None. PRIMARY AND SECONDARY OUTCOME MEASURES: The mortality rates with 95% CIs and the impact of dementia on all-cause mortality were calculated using a generalised linear model with Poisson distribution and a multivariable-adjusted Cox proportional hazards model, respectively. RESULTS: Among the 10 833 patients who underwent hip fracture surgery, 13.4% were diagnosed with dementia. During the 1-year follow-up period, 1586 patients with hip fracture without dementia died in 8356.5 person-years (incidence rate (IR)=189.2 per 1000 person-years, 95% CI 179.91 to 198.99), while 340 deaths were confirmed in patients with hip fracture with dementia in 1240.8 person-years (IR, 273.1 per 1000 person-years, 95% CI 244.94 to 304.58). Patients with hip fracture and dementia were 1.23 times more likely to die than those in the control group in the same period (HR=1.23, 95% CI 1.09 to 1.39). CONCLUSION: Dementia is a risk factor for 1-year all-cause mortality after hip fracture surgery. To improve the postoperative outcomes of patients with dementia who have undergone hip fracture surgery, effective treatment models such as multidisciplinary diagnosis and strategic rehabilitation should be established.

Identifying the Group Vulnerable to Unmet Medical Needs Due to Food Security: According to Children in the Household.

OBJECTIVE: Adults may experience unmet medical needs for various reasons. The purpose of this study was to examine the effect of food security on unmet medical needs according to the presence of children in the household of adults, as well as to identify the medically vulnerable group considering individual and household characteristics. METHODS: This study was conducted using data from the National Health and Nutrition Examination Survey for 2013-2015 and 2019-2020. The subjects of the study were 23,069 adults 19 years of age or older, and were divided into two groups according to whether or not children were included in the household. In order to observe the association between food security and unmet medical needs, multiple logistic regression analysis was performed. In addition, a subgroup analysis was performed in consideration of individual and household characteristics. RESULTS: When food security was unstable for households with children, or without children, there was a high correlation with unmet medical needs. Considering individual and household characteristics, in groups with lower age and household income level, or higher number of members in household and subjective health status, food security was strongly correlated with unmet medical needs in households with children. Contrarily, households without children showed a high correlation in the opposite characteristics of households with children, excluding household income level. CONCLUSION: Food security was highly correlation with unmet medical needs regardless of whether or not children were included in the household. However, according to the individual and household characteristics of households with and without children, the relationship between food security and unmet medical needs was found to be different. Therefore, it is necessary to prepare a health policy that can increase access to medical services in consideration of food security and individual and household characteristics depending on whether or not children are included in the household.

Healthcare vulnerability disparities in pancreatic cancer treatment and mortality using the Korean National Sample Cohort: a retrospective cohort study.

BACKGROUND: The gap in treatment and health outcomes after diagnosis of pancreatic cancer is a major public health concern. We aimed to investigate the differences in the health outcomes and treatment of pancreatic cancer patients in healthcare vulnerable and non-vulnerable areas. METHODS: This retrospective cohort study evaluated data from the Korea National Health Insurance Corporation-National Sample Cohort from 2002 to 2019. The position value for relative comparison index was used to define healthcare vulnerable areas. Cox proportional hazard regression was used to estimate the risk of mortality in pancreatic cancer patients according to healthcare vulnerable areas, and multiple logistic regression was used to estimate the difference in treatment. RESULTS: Among 1,975 patients, 279 (14.1%) and 1,696 (85.9%) lived in the healthcare vulnerable and non-vulnerable areas, respectively. Compared with the non-vulnerable area, pancreatic cancer patients in the vulnerable area had a higher risk of death at 3 months (hazard ratio [HR]: 1.33, 95% confidence interval [CI] = 1.06-1.67) and 6 months (HR: 1.23, 95% CI = 1.03-1.48). In addition, patients with pancreatic cancer in the vulnerable area were less likely to receive treatment than patients in the non-vulnerable area (odds ratio [OR]: 0.70, 95% CI = 0.52-0.94). This trend was further emphasized for chemotherapy (OR: 0.68, 95% CI = 0.48-0.95). CONCLUSION: Patients with pancreatic cancer belonging to medically disadvantaged areas receive less treatment and have a higher risk of death. This may be a result of the late diagnosis of pancreatic cancer among these patients.

The Association between Perceived Discrimination and Mental Health of Wage Workers with Disabilities: Findings from the Panel Survey of Employment for the Disabled 2016-2018.

Despite efforts to integrate society, persons with disabilities (PWD) still experience considerable discrimination. Therefore, this study examined the association between experiences of discrimination and stress/depressive symptoms in wage working PWD. This study used data from the Panel Survey of Employment for the Disabled 2016-2018 in South Korea. This study included 1566 wage working PWD aged 15-64. The dependent variable was stress and depressive symptoms, and the independent variable was the experience of discrimination due to disability in daily life (Never, Rarely, Often, and Regularly) and the experience of discrimination at the workplace (0, 1, 2, ≥3). This study used a generalized estimating equations model to consider the repeated measurement data. Wage working PWD who experienced more discrimination in their daily life due to disability and at workplaces showed a higher odds ratio (OR) of stress and depressive symptoms than those who did not experience discrimination. As a result of the analysis including both discrimination experiences, those who always experienced discrimination due to disability in daily life had the highest OR to stress and depression (OR = 2.64, 95% Confidence Interval (CI): 1.37-5.08; OR = 4.96, 95% CI: 2.58-9.56, respectively). According to the experience at workplaces, wage working PWD who faced discrimination by two factors (OR = 1.66, 95% CI: 1.22-2.25) had the highest OR of stress, and those who experienced three or more factors had the highest OR of depressive symptoms (OR = 1.33, 95% CI: 0.83-2.11). Discrimination due to disability in daily life was more associated with the mental distress of working PWD than discrimination at workplaces. For the mental health of working PWD, not only policies or systems to eliminate discrimination in the workplace, but also overall social integration efforts based on improving awareness, are needed so that they do not experience discrimination in their daily life.

Arthritis status changes and depressive symptoms among middle-aged and older Koreans: Analysis of data from the Korean Longitudinal Study of Aging survey.

OBJECTIVE: Arthritis can negatively affect physical and mental health, especially among middle-aged and older people. This study investigated the longitudinal association between changes in arthritis status and depressive symptoms among Korean adults aged ≥45 years. METHODS: We analyzed data from the Korean Longitudinal Study of Aging 2008-2018, using a generalized estimating equation model to investigate associations between arthritis status change and depressive symptoms, which were assessed using five categories according to measurements based on the Center for Epidemiological Studies Depression Scale (CES-D-10). RESULTS: Both men and women whose arthritis status changed to "worse" or remained "same" scored higher for depressive symptoms than those who reported "no symptoms of arthritis" (men, worse = ß: 1.07, P ≤ .001, same = ß: 0.25 P = .031; women, worse = ß: 0.99, P ≤ .001, same = ß: 0.13, P = .049). Conversely, men with a "better" arthritis status (ß: -0.71, P ≤ .001) and women with a "recovered" arthritis status (ß: -0.56, P = .031) scored lower for depressive symptoms than those who reported "no symptoms of arthritis." CONCLUSIONS: Arthritis status changes are associated with depressive symptoms in middle-aged and older Koreans. Therefore, mental health evaluation and management interventions are recommended for patients with arthritis and changes in disease status.

Association between healthy lifestyle score changes and quality of life and health-related quality of life: a longitudinal analysis of South Korean panel data.

OBJECTIVES: We aimed to determine the influence of changes in the aggregate score of healthy lifestyle factors on health-related quality of life (HRQOL) and overall quality of life (QOL) in the Korean older adult population. DESIGN: This study used a longitudinal design. SETTING AND PARTICIPANTS: Data on 9474 participants aged 45 years or older were extracted from the Korean Longitudinal Study on Aging for the period 2006-2016. A composite score of four lifestyle factors (smoking, drinking, physical activity and body mass index) was calculated, and biennial changes in aggregate score were computed. PRIMARY AND SECONDARY OUTCOME MEASURES: The primary outcomes were HRQOL and QOL. RESULTS: Generalised estimating equation analysis results showed that those with healthy lifestyle score changes from 'Low-High' (ß =-0.987, p=0.002; ß =-1.288, p<0.0001), 'High-Low' (ß =-1.281, p<0.0001; ß =-1.952, p<0.0001) and 'Low-Low' (ß =-1.552, p<0.0001; ß =-2.398, p<0.0001) groups were more likely to be have lower HRQOL and QOL estimates than those in 'High-High' group. Female gender, older age and depression had a more negative impact on HRQOL, while male gender and younger age had a more negative impact on QOL, especially in the Low-Low group. The relationship between changes in scores and HRQOL and QOL varied across different elements of healthy lifestyle scores. Changes in physical activity, drinking and smoking status were significantly associated with lower HRQOL and QOL. CONCLUSION: The findings suggest an association between a low healthy lifestyle score and poor quality of life, in both general and health-related aspects. Strategies targeting the Korean ageing demographic to promote a healthier lifestyle should be encouraged.

Therapeutic Application of Exosomes in Inflammatory Diseases.

Immunomodulation is on the cusp of being an important therapy for treating many diseases, due to the significant role of the immune system in defending the human body. Although the immune system is an essential defense system, overactivity can result in diverse sicknesses such as inflammation and autoimmune disease. Exosomes are emerging as a state-of-the-art therapeutic strategy for treating an overactive immune system. Thus, exosomes have drawn great interest for their potential clinical applications in treating diseases associated with abnormal immune regulation. Hence, in this review, we will discuss trends in exosome research related to inflammatory and autoimmune diseases. Possible therapeutic applications of exosomes will be summarized. Finally, an outlook to the future of exosomal therapy will be introduced.

Effects of spouse's employment status on depression.

OBJECTIVES: Whether the spouse's employment status would be associated with individual's mental health condition is uncertain. Therefore, the aim of this study was to investigate the effects of spouse's employment status on depression. METHODS: Data included the second to sixth wave of the Korean Longitudinal Study of Ageing (KLoSA). Depression was measured based on the CES-D10. Spouse's employment status was divided into 4 categories based on their employment changes. RESULTS: Participants with still unemployed spouse were more likely to have high scores of depression (male: ß = 0.32, female: ß = 0.42). Participants who are employed and have unemployed spouse have higher depression scores (male: ß = 0.45, female: ß = 0.77). CONCLUSION: This study identified the effect of spouse's employment status on depression by gender, and the results were significant. We should consider the possibility of conducting interventions with people who are remained unemployed.

Urinary incontinence status changes and depressive symptoms among middle-aged and older women: Using data from a survey of the Korean Longitudinal Study of Aging.

BACKGROUND: Urinary incontinence (UI) affects 200 million people worldwide and is a common problem in middle-aged and older women. The symptoms of UI in women are known to have a variety of effects on their health. Therefore, this study aimed to identify the effects of changes in UI status on depressive symptoms and identify determinants of the progression of UI among South Korean women 45 years old and above. METHODS: Data were collected from the Korean Longitudinal Study of Aging from 2012 to 2016. Participants were categorized into five groups by the results of a prior panel survey on UI status: "Recovered," "Better," "Same," "Worse," and "No symptoms of urinary incontinence." We used the generalized estimating equation model and performed subgroup analyses based on age, working status, household income, perceived health status, and the number of chronic medical conditions. RESULTS: A total of 3,957 middle-aged and older women were included in the analysis. Those with a change to "worse" UI status (ß: 0.408, P=0.005) had higher depressive symptom scores than those who reported "no symptoms of UI." Conversely, those with a "better" (ß: -0.271, P=0.0131) or "recovered" (ß: -0.518, P=0.0020) UI status had lower depressive symptom scores than those with "no symptom of UI". Younger women and those with a "better" or "recovered" status showed a tendency of having fewer depressive symptoms. Older women and those with a "worse" status showed a tendency of having more depressive symptoms. LIMITATIONS: The cause of UI could not be evaluated. Changes in UI status were evaluated based on self-reported data. CONCLUSION: This study showed that a change in UI status is associated with depression in middle-aged and older Korean women. It is important to consider UI management to relieve depressive symptoms.

Association between changes in economic activity and catastrophic health expenditure: findings from the Korea Health Panel Survey, 2014-2016.

BACKGROUND: The rate of catastrophic health expenditure (CHE) continues to rise in South Korea. This study examined the association between changes in economic activity and CHE experiences in South Korea. METHODS: This study analyzed the Korea Health Panel Survey data using a logistic regression analysis to study the association between changes in economic activity in 2014-2015 and the participants' CHE experiences in 2015. The study included a total of 12,454 individuals over the age of 19. The subgroup analyses were organized by sex, age, health-related variables, and household level variables, and the reasons for leaving economic activity. RESULTS: Those who quit economic activities were more likely to experience CHE than those who continued to engage in economic activities (OR [odds ratio] = 2.10; 95% CI [confidence interval]: 1.31-3.36). The subgroup analysis results, according to health-related variables, showed that there is a tendency to a higher Charlson comorbidity index, a higher OR, and, in groups that quit their economic activities, people with disabilities were more likely to experience CHE than people without disabilities (OR = 5.63; 95% CI 1.71-18.59, OR = 1.82; 95% CI 1.08-3.08, respectively). Another subgroup analysis found that if the reason for not participating in economic activity was a health-related issue, the participant was more likely to experience CHE (active → inactive: OR = 2.40; 95% CI 0.61-9.43, inactive → inactive OR = 1.65; 95% CI 1.01-2.68). CONCLUSIONS: Those individuals who became unemployed were more likely to experience CHE, especially if health problems precipitated the job loss. Therefore, efforts are needed to expand coverage for those people who suffer from high medical expenses.

Association between change in lifestyle and cognitive functions among elderly Koreans: findings from the Korean longitudinal study of aging (2006-2016).

BACKGROUND: South Korea is an aged society that continues to age rapidly. Therefore, the purpose of this study was to investigate the association between changes in lifestyle and cognitive functions in the South Korean elderly using a nationally representative survey. METHODS: We analyzed data from the Korean Longitudinal Study of Aging (KLoSA) 2006-2016, a biannual panel survey. Multiple linear regression analysis was performed with repeated measurements data to examine the association between lifestyle change and cognitive functions over 2 years. Lifestyle combined the scores of four factors (smoking status, alcohol drinking status, body weight, and exercise), and then categorized them into four groups (Good→Good, Bad→Good, Good→Bad, and Bad→Bad) according to the two-year change. Cognitive functions were set according to the scores measured through the Korean Mini-Mental State Examination (K-MMSE). RESULTS: Among females, the K-MMSE score was the highest in the Bad→Good group compared to the reference group, Bad→Bad (ß = 0.914; SD = 3.744; p < .0001). The next highest scores were in the Good→Good group (ß = 0.813; SD = 4.654; p = 0.0005) and the Good→Bad group (ß = 0.475; SD = 4.542; p = 0.0481). Among males, only the K-MMSE of the Good→Good group was statistically significant (ß = 0.509; SD = 3.245; p = 0.0077). The results of subgroup analysis showed that the K-MMSE scores of females who did not participate in any social activities were more affected by their lifestyle (Good-Good: ß = 1.614; SD = 4.270; p = 0.0017, Bad-Good: ß = 1.817; SD = 3.945; p < .0001). Subgroup analysis showed that females who started drinking more than a moderate amount of alcohol had lower K-MMSE scores (Good-Bad: ß = - 2.636; SD = 2.915; p = 0.0011). Additionally, in both sexes, exercising, among the four lifestyle options, had a strong and significant association with higher K-MMSE scores. CONCLUSIONS: Following a healthy lifestyle or improving an unhealthy lifestyle can help people prevent or slow down cognitive decline. Regularly engaging in an adequate amount of exercise can help the cognitive function of the elderly. Females, specifically, can experience positive effects on their cognitive function if they participate in social activities while maintaining healthy lifestyles, in particular not drinking too much alcohol.

Association between health behaviours and depression: findings from a national cross-sectional study in South Korea.

BACKGROUND: Depression is a leading cause of disability, and it has been reported that more than 264 million people worldwide have depression. The causes of depression may be numerous, and physical health has also been linked to depression. Therefore, the aim of this study was to determine the effect of health behaviours on depression. METHODS: This study used the data of 224,868 participants from the Community Health Survey, conducted in 2017. We defined health behaviours by combining three variables: no smoking, not belonging to high-risk drinking group, and walking frequently. Depression was measured using the Patient Health Questionnaire-9. Logistic regression was used to examine the association between health behaviours and depression. RESULTS: Both men and women who did not practise health behaviours were more likely to experience depressive symptoms than those who did (men, odds ratio (OR): 1.48, 95% confidence interval (CI): 1.31-1.68; women, OR: 1.42, 95% CI: 1.32-1.53). Not walking frequently had the strongest association with depression in men and the risk of depression was the highest in women who smoked. Participants who did not practise any health behaviours were the most likely to have depressive symptoms (men, OR: 1.69, 95% CI: 1.38-2.07; women, OR: 3.08, 95% CI: 2.27-4.19). CONCLUSION: Our study found that lack of health behaviours is significantly associated with depression. Furthermore, the most influential factor of health behaviours in depression was different for men and women. It is necessary to manage depression through interventional methods customised to gender characteristics. Additionally, national-level policies are needed to encourage steps to improve personal lifestyles, including practising health behaviours.

The impact of poverty transitions on frailty among older adults in South Korea: findings from the Korean longitudinal study of ageing.

BACKGROUND: Frailty is an emerging public health concern among aging populations. Although socioeconomic status is a well-known contributor to frailty, there is limited research investigating the effects of poverty on frailty. This study aimed to examine the association between poverty transitions and frailty prevalence in older adults. METHODS: Data were collected from the six-wave Korean Longitudinal Study of Ageing (2006-2016). A total of 9263 middle-aged and older adults were included in the analysis. Poverty was defined as being below 50% of the median household income based on the equivalized household. Frailty was measured using an instrument comprising items on physical phenotype (grip strength) and psychological (exhaustion) and social aspects (isolation). Analyses using generalized estimating equations were conducted to estimate the relationship between poverty transition and frailty status. RESULTS: Among the 9263 respondents, 9.4% of the male respondents (n = 388) and 13.6% of the female respondents (n = 700) were frail. After controlling for covariates, female participants who transitioned into poverty (OR = 1.31, 95% CI: 1.02-1.69) and persistently remained in poverty (OR = 1.36, 95% CI: 1.10-1.68) showed increased odds of frailty in the follow-up year. We did not find significant results in the male participants. CONCLUSIONS: The findings suggest that those who experience poverty transitions, enter poverty, and remain in poverty persistently are at higher risk of frailty. To improve age-related health status among the elderly, interventions aiming to prevent and reduce frailty among the elderly should target individuals who are more vulnerable to the negative effects of frailty.

Current Knowledge and Future Perspectives on Mesenchymal Stem Cell-Derived Exosomes as a New Therapeutic Agent.

Mesenchymal stem cells (MSCs) are on the cusp of regenerative medicine due to their differentiation capacity, favorable culture conditions, ability to be manipulated in vitro, and strong immunomodulatory activity. Recent studies indicate that the pleiotropic effects of MSCs, especially their immunomodulatory potential, can be largely attributed to paracrine factors. Exosomes, vesicles that are 30-150 nanometers in diameter that function in cell-cell communication, are one of the key paracrine effectors. MSC-derived exosomes are enriched with therapeutic miRNAs, mRNAs, cytokines, lipids, and growth factors. Emerging evidences support the compelling possibility of using MSC-derived exosomes as a new form of therapy for treating several different kinds of disease such as heart, kidney, immune diseases, neural injuries, and neurodegenerative disease. This review provides a summary of current knowledge and discusses engineering of MSC-derived exosomes for their use in translational medicine.

Associations of electronic and conventional cigarette use with periodontal disease in South Korean adults.

BACKGROUND: The aim of this study was to examine the association of conventional cigarette smoking and electronic cigarette vaping with periodontal disease in South Korean adults. METHODS: For this study, data from 13,551 participants, a subset derived from the Korean National Health and Nutrition Examination Survey conducted between 2013 and 2015, were examined. Participants were divided into four categories: electronic cigarettes vapers, conventional cigarettes smokers, ex-users, and non-users. Periodontal status was measured by the Community Periodontal Index. Multiple logistic regression analysis was performed to examine the association of periodontal disease with smoking and vaping individually. RESULTS: Out of 187 men and 35 women who vape electronic cigarette, 67 (35.8%) men and 10 (28.6%) women had periodontal diseases. Out of 1,957 men and 363 women who smoke conventional cigarettes, 861 (44.0%) men and 121 (35.3%) women had periodontal diseases. Periodontal disease was more prevalent in each vapers and smokers than non-users in men (electronic cigarettes: odds ratio [OR] = 2.34, 95% confidence interval [CI] = 1.52 to 3.59, conventional cigarettes: OR = 2.17, 95% CI = 1.76 to 2.68). Furthermore, both vaping and smoking had significant relation to dental caries, toothache, and dental damages. CONCLUSIONS: Electronic and conventional cigarette use was each significantly associated with increased periodontal disease rates. After adjusting for demographic, socioeconomic, and health-related characteristics, both vaping and smoking each had significant association with periodontal diseases. Therefore, this study suggests that vaping may not be a safe alternative to smoking. Cessation of both types of cigarettes is necessary for maintaining oral health.

Association between the Type of Diabetes Treatment and Depressive Symptoms among Patients with Diabetes: A Cross-Sectional Study of Korea Community Health Surveys Data, 2011-2016.

The purpose of this study was to examine the association between the different types of treatment for diabetes and depressive symptoms. In particular, this study assessed the presence of depressive symptoms in patients with diabetes who are undergoing pharmacological treatments in terms of sex. This study used data from the 2011-2016 Korea Community Health Survey, which included responses from 50,774 male and 48,978 female participants with diabetes who were receiving pharmacological treatments. Patients aged ≥30 years were included. Logistic regression analysis was conducted to examine the significance of the association. Male participants treated with insulin injection were more likely to experience depressive symptoms than those taking oral hypoglycemic (oral agents) only (odds ratio (OR) = 1.27; 95% confidence interval (CI): 1.04-1.56). Male patients treated with both oral agents and insulin injection had the highest OR value of depressive symptoms among different types of treatments (OR = 1.41, 95% CI: 1.25-1.60). The same tendency was observed in female participants. In female patients, however, the association between depressive symptoms and insulin injection was statistically insignificant (both oral agents and insulin injection OR = 1.35, 95% CI: 1.22-1.50, insulin injection OR = 1.17, 95% CI: 0.98-1.41). The association between depressive symptoms and the type of diabetes treatment was more significant in male than in female patients. Those who were treated with oral agents and insulin injection were more likely to have depressive symptoms than those receiving oral agents of treatment.