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Aim: To evaluate the potential association between suicidality and glucagon‐like peptide‐1 receptor agonists (GLP‐1RAs), as well as other medications used for obesity and diabetes, using comprehensive global data. Materials and Methods: This study utilized the World Health Organization's pharmacovigilance database, encompassing adverse drug reaction reports from 1967 to 2023, from 170 countries (total reports, N = 131 255 418). We present the reported odds ratios (RORs) with 95% confidence intervals (CIs) and information component (IC) with IC025 regarding the association between GLP‐1RA use and suicidality. Results: Although reports of GLP‐1RA‐associated suicidality increased gradually from 2005 to 2023 (n = 332), no evidence of an association was observed (ROR 0.15 [95% CI 0.13 to 0.16]; IC −2.77 [IC025 −2.95]). The lack of evidence of an association persisted regardless of whether GLP‐1RAs were used for diabetes treatment (ROR 0.13 [95% CI 0.11 to 0.14]; IC −2.95 [IC025 −3.14]) or obesity treatment (ROR 0.44 [95% CI 0.34 to 0.58]; IC −1.16 [IC025 −1.62]). However, an association was found between suicidality and other diabetes medications excluding GLP‐1RAs (ROR 1.13 [95% CI 1.10 to 1.15]; IC 0.17 [IC025 0.13]). Similarly, the potential association with suicidality was observed in medications used to treat obesity excluding GLP‐1RAs (ROR 1.08 [95% CI 1.01 to 1.14]; IC 0.10 [IC025 0.01]). Conclusions: The suspected association between GLP‐1RA use and suicidality, as raised by the European Medicines Agency, was not found in our global analysis. This indicates that the sporadic reports of GLP‐1RA‐associated suicidality are likely influenced by factors such as comorbidities present in the GLP‐1RA user population. [ABSTRACT FROM AUTHOR]

Research on Guillain-Barré syndrome (GBS) as a neurological adverse effect of vaccines on a global scale is scarce, highlighting the need for further investigation to evaluate its long-term impact and associated risk factors comprehensively. Hence, this study aims to assess the global burden of vaccine-associated GBS and its associated vaccines. This study utilized data from VigiBase, the World Health Organization global database of adverse event reports of medicines and vaccines, encompassing the period from 1967 to 2023 (total reports, n = 131,255,418) to investigate vaccine-associated GBS. Reported odds ratios (ROR) and information components (IC) were analyzed to assess the association between 19 vaccines and the occurrence of vaccine-associated GBS over 170 countries. We identified 15,377 (8072 males [52.49%]) reports of vaccine-associated GBS among 22,616 reports of all drugs-cause GBS from 1978 to 2023. Cumulative reports of vaccine-associated GBS have been increasing steadily over time, with a notable surge observed since the commencement of COVID-19 vaccines administration in 2020. Most vaccines showed significant associations with GBS such as Ad5-vectored COVID-19 vaccines (ROR, 14.88; IC, 3.66), COVID-19 mRNA vaccines (ROR, 9.66; IC, 2.84), and inactivated whole-virus COVID-19 vaccines (ROR, 3,29; IC 1.69). Influenza vaccines showed the highest association (ROR, 77.91; IC 5.98). Regarding age-and sex-specific risks, the association remained similar regardless of sex, with an increased association observed with advancing age. The mean time to onset was 5.5 days. Amid the COVID-19 pandemic, the reports of GBS surged in response to widespread COVID-19 vaccination. Nonetheless, COVID-19 vaccines exhibited the lowest association compared to other vaccines. Vigilance for at least one-week post-vaccination is crucial, particularly for older adults. Further research is warranted to elucidate the underlying mechanisms linking vaccines and GBS. [ABSTRACT FROM AUTHOR]

School counsellors in South Korea face significant emotional exhaustion due to their challenging occupational environment. Previous studies have shown that cognitive reappraisal (CR) reduces emotional exhaustion, whereas expressive suppression (ES) increases it. However, these findings predominantly rely on trait questionnaires within cross‐sectional approaches, overlooking the dynamic nature of emotion regulation (ER) strategy selection. Individuals may choose strategies that deviate from their general tendencies based on situational demands. There is limited empirical knowledge regarding the interaction between trait and state regulation strategies and their influence on exhaustion. Utilizing the strategy‐situation fit hypothesis, this study examines the context‐specific effects of ER strategies, considering both situational contexts and individual response tendencies. A multilevel analysis was performed to examine the influence of state and trait ER strategies on daily emotional exhaustion. A daily diary study was conducted for 5 days with 111 Korean school counsellors. Daily CR was associated with lower daily exhaustion and daily ES predicted higher daily exhaustion. Contrastingly, none of the trait ER strategies had an impact on daily exhaustion, but the trait level of both strategies significantly moderated the relationship between daily CR and exhaustion. The positive impact of daily CR was more pronounced in school counsellors who often utilized suppression strategies, and this impact was also evident in trait reappraisal. Re‐evaluating daily emotions instead of suppressing them may assist in coping with emotional exhaustion caused by work. The effectiveness of these strategies may vary based on an individual's inclination to regulate emotions as state and trait. ER may aid in implementing preventive interventions for school counsellors experiencing emotional exhaustion. [ABSTRACT FROM AUTHOR]

Vaccine‐associated rheumatic diseases are rare but one of the most feared adverse drug reactions (ADRs). However, this topic has been investigated less with large‐scale data in the literature. With the rapid progress in the development and approval of vaccines during the pandemic, public concerns regarding their safety have been raised. To assess the global and regional burden, long‐term trends, and potential risk factors of vaccines‐associated six types of rheumatic diseases (ankylosing spondylitis [AS], polymyalgia rheumatica [PMR], rheumatoid arthritis [RA], Sjögren's syndrome, Systemic lupus erythematosus [SLE], Systemic scleroderma), this study conducted disproportionality analysis based on the reports from the World Health Organization International Pharmacovigilance Database documented between 1967 and 2023 (n for total reports = 131 255 418) across 156 countries and territories. We estimated the reporting odds ratio (ROR) and information component (IC) to determine the disproportionality signal for rheumatic diseases. Of 198 046 reports of all‐cause rheumatic diseases, 14 703 reports of vaccine‐associated rheumatic diseases were identified. While the reporting counts have gradually increased over time globally, we observed a dramatic increase in reporting counts after 2020, potentially due to a large portion of reports of COVID‐19 mRNA vaccine‐associated rheumatic diseases. The disproportionality signal for rheumatic diseases was most pronounced in HBV vaccines (ROR, 4.11; IC025, 1.90), followed by COVID‐19 mRNA (ROR, 2.79; IC025, 1.25), anthrax (ROR, 2.52; IC025, 0.76), papillomavirus (ROR, 2.16; IC025, 0.95), encephalitis (ROR, 2.01; IC025, 0.58), typhoid (ROR, 1.91; IC025, 0.44), influenza (ROR, 1.49; IC025, 0.46), and HAV vaccines (ROR, 1.41; IC025, 0.20). From age‐ and sex‐specific perspective, young females and old males are likely to have vaccine‐associated rheumatic disease reports. Furthermore, overall vaccines showed a disproportionality signal for PMR (IC025, 3.13) and Sjögren's syndrome (IC025, 0.70), systemic scleroderma (IC025, 0.64), specifically while the COVID‐19 mRNA vaccines are associated with all six types of diseases. Although multiple vaccines are associated with rheumatic disease reports, healthcare providers should be aware of the potential of autoimmune manifestations following vaccination, particularly the COVID‐19 mRNA and HBV vaccines, and take into account for risk factors associated with these ADRs. Most ADRs exhibited an average time to onset of 11 days, underscoring the significance of monitoring and timely management by clinicians. [ABSTRACT FROM AUTHOR]

Impaired ion channels regulating Golgi pH lead to structural alterations in the Golgi apparatus, such as fragmentation, which is found, along with cognitive impairment, in Alzheimer's disease. However, the causal relationship between altered Golgi structure and cognitive impairment remains elusive due to the lack of understanding of ion channels in the Golgi apparatus of brain cells. Here, we identify that a transmembrane protein TMEM87A, renamed Golgi-pH-regulating cation channel (GolpHCat), expressed in astrocytes and neurons that contributes to hippocampus-dependent memory. We find that GolpHCat displays unique voltage-dependent currents, which is potently inhibited by gluconate. Additionally, we gain structural insights into the ion conduction through GolpHCat at the molecular level by determining three high-resolution cryogenic-electron microscopy structures of human GolpHCat. GolpHCat-knockout mice show fragmented Golgi morphology and altered protein glycosylation and functions in the hippocampus, leading to impaired spatial memory. These findings suggest a molecular target for Golgi-related diseases and cognitive impairment. Impaired ion channels regulating Golgi pH may cause altered Golgi morphology. Here authors identify TMEM87A as a pH-regulation cation channel expressed in astrocytes and neurons and determine the cryo-EM structure to understand the ion permeation pathway. [ABSTRACT FROM AUTHOR]

This study aims to figure out the worldwide prevalence of anticancer therapy-associated acute kidney injury (AKI) and tubulointerstitial nephritis (TIN) and the relative risk of each cancer drug. We conducted an analysis of VigiBase, the World Health Organization pharmacovigilance database, 1967–2023 via disproportionate Bayesian reporting method. We further categorized the anticancer drugs into four groups: cytotoxic therapy, hormone therapy, immunotherapy, and targeted therapy. Reporting odds ratio (ROR) and information component (IC) compares observed and expected values to investigate the associations of each category of anticancer drugs with AKI and TIN. We identified 32,722 and 2056 reports (male, n = 17,829 and 1,293) of anticancer therapy-associated AKI and TIN, respectively, among 4,592,036 reports of all-drug caused AKI and TIN. There has been a significant increase in reports since 2010, primarily due to increased reports of targeted therapy and immunotherapy. Immunotherapy exhibited a significant association with both AKI (ROR: 8.92; IC0.25: 3.06) and TIN (21.74; 4.24), followed by cytotoxic therapy (7.14; 2.68), targeted therapy (5.83; 2.40), and hormone therapy (2.59; 1.24) for AKI, and by cytotoxic therapy (2.60; 1.21) and targeted therapy (1.54; 0.61) for TIN. AKI and TIN were more prevalent among individuals under 45 years of age, with a female preponderance for AKI and males for TIN. These events were reported in close temporal relationship after initiation of the respective drug (16.53 days for AKI and 27.97 days for TIN), and exhibited a high fatality rate, with 23.6% for AKI and 16.3% for TIN. These findings underscore that kidney-related adverse drug reactions are of prognostic significance and strategies to mitigate such side effects are required to optimize anticancer therapy. [ABSTRACT FROM AUTHOR]

Although previous studies have focused on hepatobiliary and gastrointestinal adverse drug reactions (ADRs) associated with COVID‐19 vaccines, literature on such ADRs with other vaccines is limited, particularly on a global scale. Therefore, we aimed to investigate the global burden of vaccine‐associated hepatobiliary and gastrointestinal ADRs and identify the vaccines implicated in these occurrences. This study utilized data from the World Health Organization (WHO) international pharmacovigilance database to extract reports of vaccine‐associated hepatobiliary and gastrointestinal ADRs from 1967 to 2023 (total reports = 131 255 418). Through global reporting counts, reported odds ratios (ROR) with 95% confidence interval (CI), and information components (IC) with IC0.25, the study examined the association between 16 vaccines and the incidence of hepatobiliary and gastrointestinal ADRs across 156 countries. Of the 6 842 303 reports in the vaccine‐associated ADRs, 10 786 reports of liver injury, 927 870 reports of gastrointestinal symptoms, 2978 reports of pancreas and bile duct injury, and 96 reports of intra‐abdominal hemorrhage between 1967 and 2023 were identified. Most hepatobiliary and gastrointestinal ADRs surged after 2020, with the majority of reports attributed to COVID‐19 messenger RNA (mRNA) vaccines. Hepatitis A vaccines exhibited the highest association with liver injury (ROR [95% CI]: 10.30 [9.65–10.99]; IC [IC0.25]: 3.33 [3.22]), followed by hepatitis B, typhoid, and rotavirus. Specifically, ischemic hepatitis had a significant association with both Ad5‐vectored and mRNA COVID‐19 vaccines. Gastrointestinal symptoms were associated with all vaccines except for tuberculosis vaccines, particularly with rotavirus (11.62 [11.45–11.80]; 3.05 [3.03]) and typhoid (11.02 [10.66–11.39]; 3.00 [2.96]). Pancreas and bile duct injury were associated with COVID‐19 mRNA (1.99 [1.89–2.09]; 0.90 [0.83]), MMR (measles, mumps, and rubella), and papillomavirus vaccines. For intra‐abdominal hemorrhage, inactivated whole‐virus COVID‐19 vaccines (3.93 [1.86–8.27]; 1.71 [0.41]) had the highest association, followed by COVID‐19 mRNA (1.81 [1.42–2.29]; 0.77 [0.39]). Most of these ADRs had a short time to onset, within 1 day, and low mortality rate. Through a global scale database, the majority of ADRs occurred within 1 day, emphasizing the importance of healthcare workers' vigilant monitoring and timely management. [ABSTRACT FROM AUTHOR]

Previous research has not investigated the persistent cutaneous immune‐related adverse events (cirAEs) related to long COVID to investigate the long‐term sequelae. This multinational study, using a propensity‐matched overlap weighting method, utilizes large national claims‐based cohorts, using ICD‐10 code diagnosis, focusing on patients aged ≥20 years from three countries: South Korean, Japanese, and the British cohorts. To estimate the risk of cirAEs in long COVID, the persistence or emergence of cirAEs occurring 4 weeks after the initial SARS‐CoV‐2 infection, we employed a Cox proportional hazard regression model. The Korean cohort (n = 5,937,373; mean age 49.2 years [SD: 13.2]), the Japanese cohort (n = 4,307,587; 42.5 years [13.6]), and the UK cohort (n = 395,435; 71.0 years [8.07]) were presented. An increased risk of cirAEs in long COVID was observed (HR, 1.10; 95% CI, 1.06–1.14) in Korean cohort, while a similar association was observed in Japanese and UK cohorts. The long‐term risk of cirAEs in long COVID was higher in more severe COVID‐19 cases (1.31; 1.22–1.39). Unlike the increased risk of cirAEs in long COVID, COVID‐19 vaccination attenuated the risk, especially with two or more doses (1.03; 0.95–1.11) or heterologous regimens (0.98; 0.76–1.27). The time attenuation effect indicated a sustained risk for up to 6 months postinfection (<3 months: 1.13 [1.07–1.19]; 3‐6 months: 1.14 [1.06‐1.22]). SARS‐CoV‐2 infection is associated with an increased risk of cirAEs in the aspect of long COVID. Vaccination might reduce this risk, highlighting the need for preventive strategies in long COVID management. [ABSTRACT FROM AUTHOR]

This study aimed to present a new approach to predict to delirium admitted to the acute palliative care unit. To achieve this, this study employed machine learning model to predict delirium in patients in palliative care and identified the significant features that influenced the model. A multicenter, patient-based registry cohort study in South Korea between January 1, 2019, and December 31, 2020. Delirium was identified by reviewing the medical records based on the criteria of the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition. The study dataset included 165 patients with delirium among 2314 patients with advanced cancer admitted to the acute palliative care unit. Seven machine learning models, including extreme gradient boosting, adaptive boosting, gradient boosting, light gradient boosting, logistic regression, support vector machine, and random forest, were evaluated to predict delirium in patients with advanced cancer admitted to the acute palliative care unit. An ensemble approach was adopted to determine the optimal model. For k-fold cross-validation, the combination of extreme gradient boosting and random forest provided the best performance, achieving the following accuracy metrics: 68.83% sensitivity, 70.85% specificity, 69.84% balanced accuracy, and 74.55% area under the receiver operating characteristic curve. The performance of the isolated testing dataset was also validated, and the machine learning model was successfully deployed on a public website () to provide public access to delirium prediction results in patients with advanced cancer. Furthermore, using feature importance analysis, sex was determined to be the top contributor in predicting delirium, followed by a history of delirium, chemotherapy, smoking status, alcohol consumption, and living with family. Based on a large-scale, multicenter, patient-based registry cohort, a machine learning prediction model for delirium in patients with advanced cancer was developed in South Korea. We believe that this model will assist healthcare providers in treating patients with delirium and advanced cancer. [ABSTRACT FROM AUTHOR]

Previous studies have proposed alopecia areata (AA) as a potential outcome of COVID‐19 infection among autoimmune diseases, yet the findings might be inconclusive and difficult to generalize due to limited sample sizes and evidence levels. Thus, we aimed to investigate in detail the long‐term risk of AA following SARS‐CoV‐2 infection based on large, binational, general population‐based cohort studies. Our study investigated the long‐term AA risk after SARS‐CoV‐2 infection by analyzing bi‐national, claim‐based cohorts in South Korea and Japan: a Korean nationwide cohort (K‐COV‐N cohort; discovery cohort; total n = 10 027 506) and a Japanese claims‐based cohort (JMDC cohort; validation cohort; total n = 12 218 680). AA was identified based on the international classification of diseases 10th revision code (L63) requiring at least three claims within 1 year. After exposure‐driven propensity score matching, SARS‐CoV‐2 infection was associated with an increased risk of incident AA (aHR, 1.66; 95% CI, 1.38–1.99). This increased risk was observed and persisted for up to 6 months. A similar pattern was observed in the validation cohort. As modifiable factors, severe COVID‐19 increased the risk of AA, whereas receiving two or more doses of the COVID‐19 vaccine before infection decreased the risk of AA. Through a bi‐national cohort study in South Korea and Japan, SARS‐CoV‐2 infection was associated with an elevated risk for incident AA in the aspect of long COVID. [ABSTRACT FROM AUTHOR]

A comprehensive analysis of the international pharmacovigilance database, VigiBase, was conducted to examine the global burden of vaccine-associated alopecia. The study analyzed data from 1979 to 2023 and included reports from over 156 countries. The results showed that vaccine-associated alopecia was highly linked to COVID-19 mRNA vaccines, papillomavirus vaccines, and Ad5-vectored COVID-19 vaccines. The study also found that reports of vaccine-associated alopecia were more prevalent among males and showed a U-shaped association with age. However, the study acknowledged limitations, such as underrepresentation of vaccine-associated alopecia from low-income countries. The findings highlight the need for strengthening vaccine safety measures and enhancing adverse-event monitoring. [Extracted from the article]

Developing sustainable Li‐ion batteries requires high‐energy cathodes based on low‐cost, earth‐abundant elements, moving away from low‐reserve nickel and cobalt. Fe‐based oxide cathodes with Fe3+/4+ and O2−/n− redox couples offer potential but face low initial Coulombic efficiency and significant voltage hysteresis. This study investigates Li‐excess Fe‐based disordered rock‐salt (DRX) oxyfluorides (Li2Fe0.5M0.5O2F; M = Fe, Ti, Mn) using combined electrochemical/spectroscopic characterization and first‐principles calculation. Oxygen‐dependent Fe3+/4+ redox, related to Fe 3d–O 2p hybrid state, can be stabilized when combined with Mn3+/4+ redox in DRX structure owing to the unusual decrease in its redox potential. The moderately high charge transfer gap stabilizes Fe4+ against ligand‐to‐metal charge transfer (LMCT) on charge, reduces the amount of oxygen oxidation, thereby increasing Coulombic efficiency. On discharge, it allows metal‐to‐ligand charge transfer (MLCT) without substantial overpotential, reducing hysteresis in oxygen redox. The resulting composition exhibits high capacity (309 mAh g−1) and energy density (998 Wh kg−1), providing insights for next‐generation Ni‐ and Co‐free cathode materials. [ABSTRACT FROM AUTHOR]

Vaccine‐associated multiple sclerosis (MS) is rare, with insufficient evidence from case reports. Given the scarcity of large‐scale data investigating the association between vaccine administration and adverse events, we investigated the global burden of vaccine‐associated MS and potential related vaccines from 1967 to 2022. Reports on vaccine‐associated MS between 1967 and 2022 were obtained from the World Health Organization International Pharmacovigilance Database (total number of reports = 120 715 116). We evaluated global reports, reporting odds ratio (ROR), and information components (IC) to investigate associations between 19 vaccines and vaccine‐associated MS across 156 countries and territories. We identified 8288 reports of vaccine‐associated MS among 132 980 cases of all‐cause MS. The cumulative number of reports on vaccine‐associated MS gradually increased over time, with a substantial increase after 2020, owing to COVID‐19 mRNA vaccine‐associated MS. Vaccine‐associated MS develops more frequently in males and adolescents. Nine vaccines were significantly associated with higher MS reporting, and the highest disproportional associations were observed for hepatitis B vaccines (ROR 19.82; IC025 4.18), followed by encephalitis (ROR 7.42; IC025 2.59), hepatitis A (ROR 4.46; IC025 1.95), and papillomavirus vaccines (ROR 4.45; IC025 2.01). Additionally, MS showed a significantly disproportionate signal for COVID‐19 mRNA vaccines (ROR 1.55; IC025 0.52). Fatal clinical outcomes were reported in only 0.3% (21/8288) of all cases of vaccine‐associated MS. Although various vaccines are potentially associated with increased risk of MS, we should be cautious about the increased risk of MS following vaccination, particularly hepatitis B and COVID‐19 mRNA vaccines, and should consider the risk factors associated with vaccine‐associated MS. [ABSTRACT FROM AUTHOR]

Background: Vaccine‐associated anaphylaxis is a rare but life‐threatening reaction that occurs within minutes to hours of exposure to allergens. As studies utilizing large‐scale data to investigate this topic are limited, further research is needed to assess its burden, long‐term trends, and associated risk factors so as to gain a comprehensive understanding of vaccine‐associated anaphylaxis globally. Therefore, this study aimed to investigate the global burden of vaccine‐associated anaphylaxis and related vaccines. Method: This study utilized the World Health Organization International Pharmacovigilance Database, in which reports of vaccine‐associated anaphylaxis between 1967 and 2023 were obtained (total reports = 131,255,418). We estimated the global reporting counts, reported odds ratio (ROR), and information component (IC) to identify the relationship between 19 vaccines and associated anaphylaxis in 156 countries and territories. Results: We identified 31,676 reports of vaccine‐associated anaphylaxis among 363,290 reports of all‐cause anaphylaxis. The cumulative number of reports on vaccine‐associated anaphylaxis has gradually increased over time, with a dramatic increase after 2020, owing to reports of COVID‐19 mRNA vaccine‐associated anaphylaxis. The typhoid vaccines were associated with the most anaphylactic reports (ROR: 4.35; IC0.25: 1.86), followed by encephalitis (3.27; 1.45), hepatitis B (2.69; 1.30), cholera (2.65; 0.54), hepatitis A (2.44; 1.12), influenza (2.36; 1.16), inactivated whole‐virus COVID‐19 (2.21; 1.02), and COVID‐19 mRNA vaccines (1.89; 0.79). In terms of age‐ and sex‐specific risks, vaccine‐associated anaphylaxis reports develop more frequently in females and at young ages. The Ad5‐vectored COVID‐19 vaccine anaphylaxis reports were associated with the highest fatality rate (15.0%). Conclusions: Although multiple vaccines are associated with various spectra and risks of anaphylaxis, clinicians should recognize the possibility of anaphylaxis occurring with all vaccines, particularly the COVID‐19 mRNA and inactivated whole‐virus COVID‐19 vaccines, and consider the risk factors associated with vaccine anaphylaxis reports. Further studies are warranted to identify better ways of preventing vaccine‐associated anaphylaxis. [ABSTRACT FROM AUTHOR]