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Background: Many cases of deep vein thrombosis (DVT) are diagnosed in the emergency department, and abbreviated lower extremity venous point-of-care ultrasound (POCUS) has already shown an accuracy comparable to that of specialists. This study aimed to identify the learning curve necessary for emergency medicine (EM) residents to achieve expertise-level accuracy in diagnosing DVT through a 3-point lower extremity venous POCUS. Methods: This prospective study was conducted at an emergency department between May 2021 and October 2022. Four EM residents underwent a one-hour POCUS training session and performed DVT assessments in participants with DVT symptoms or confirmed pulmonary embolism. POCUS was performed at three proximal lower extremity sites to evaluate the thrombi presence and vein compressibility, with results validated by specialized radiology ultrasound. Cumulative sum (CUSUM) and the Bush and Mosteller models were used to analyze the learning curve, while generalized estimating equations were used to identify factors affecting diagnostic accuracy. Results: 91 POCUS scans were conducted in 49 patients, resulting in 22% DVT confirmed by specialized venous ultrasound. In the CUSUM analysis, all four EM residents attained a 90% success rate at the common femoral vein, whereas only half achieved this rate when all three sites were considered. According to Bush and Mosteller models, 13–18 cases are required to attain 90–95% diagnostic accuracy. After 10–16 cases, the examination time for each resident decreased, and a 20% increase in examiner confidence was linked to a 2.506-fold increase in the DVT diagnosis accuracy. Conclusion: EM residents generally required 13–18 cases for 90–95% DVT diagnostic accuracy, but proficiency varied among individuals, particularly requiring more cases for regions outside the common femoral vein. [ABSTRACT FROM AUTHOR]

This study examined the 10‐year trends in the prevalence of osteoporosis according to disability grade and type compared with those without disabilities in South Korea. We linked national disability registration data with the National Health Insurance claims data. Age‐ and sex‐standardized prevalence of osteoporosis were analyzed from 2008 to 2017 according to sex, disability type, and disability grade. Adjusted odds ratios for osteoporosis according to disability characteristics in the most recent years' data were also confirmed by multivariate analysis. Over the past decade, the prevalence of osteoporosis has increased in people with disabilities compared with people without disabilities, and the gap has gradually widened from 7% to 15%. By analysis of the most recent year data, both male and female individuals with disabilities had a higher risk of osteoporosis than those without disability (odds ratios [OR] 1.72, 95% confidence interval [CI] 1.70–1.73 in males; OR 1.28, 95% CI 1.27–1.28 in females); the multivariate‐adjusted OR was especially prominent in disability related to respiratory disease (OR 2.07, 95% CI 1.93–2.21 in males; OR 1.74; 95% CI 1.60–1.90 in females), epilepsy (OR 2.16, 95% CI 1.78–2.61 in males; OR 1.71; 95% CI 1.53–1.91 in females), and physical disability types (OR 2.09, 95% CI 2.06–2.21 in males; OR 1.70; 95% CI 1.69–1.71 in females). In conclusion, the prevalence and risk of osteoporosis have increased in people with disabilities in Korea. In particular, the risk of osteoporosis increases significantly in people with respiratory diseases, epilepsy, and physical disability types. © 2023 The Authors. JBMR Plus published by Wiley Periodicals LLC on behalf of American Society for Bone and Mineral Research. [ABSTRACT FROM AUTHOR]

Background: This study was conducted to investigate the effects of combining nutritional and physical activity (PA) factors on four different categories, according to the presence or absence of sarcopenia and central obesity. Methods: From the 2008–2011 Korea National Health and Nutrition Examination Survey, 2971 older adults aged ≥ 65 years were included and divided into four groups based on their sarcopenia and central obesity status: healthy control (39.3%), central obesity (28.9%), sarcopenia (27.4%), and sarcopenic obesity (4.4%). Central obesity was defined as a waist circumference of ≥ 90 cm in men and ≥ 85 cm in women. Sarcopenia was defined as an appendicular skeletal mass index of < 7.0 kg/m2 in men and < 5.4 kg/m2 in women, and sarcopenic obesity was defined as the coexistence of sarcopenia and central obesity. Results: Participants who consumed more energy and protein than the average requirement had a lower likelihood of having sarcopenia (odds ratio (OR): 0.601, 95% confidence interval (CI): 0.444–0.814) than those who did not consume enough nutrients. The likelihood of central obesity and sarcopenic obesity decreased in groups with recommended PA levels, regardless of whether energy intake met or did not meet the average requirement. Whether PA met or did not meet the recommended level, the likelihood of sarcopenia decreased in groups with energy intake that met the average requirement. However, when PA and energy requirements were met, there was a greater reduction in the likelihood of sarcopenia (OR: 0.436, 95% CI: 0.290–0.655). Conclusion: These findings suggest that adequate energy intake that meets requirements is more likely to be effective as a major prevention and treatment goal for sarcopenia, whereas PA guidelines should be prioritized in the case of sarcopenic obesity. [ABSTRACT FROM AUTHOR]

Microcephaly is a prevalent phenotype in patients with neurodevelopmental problems, often with genetic causes. We comprehensively investigated the clinical phenotypes and genetic background of microcephaly in 40 Korean patients. We analyzed their clinical phenotypes and radiologic images and conducted whole exome sequencing (WES) and analysis of copy number variation (CNV). Infantile hypotonia and developmental delay were present in all patients. Thirty-four patients (85%) showed primary microcephaly. The diagnostic yield from the WES and CNV analyses was 47.5%. With WES, we detected pathogenic or likely pathogenic variants that were previously associated with microcephaly in 12 patients (30%); nine of these were de novo variants with autosomal dominant inheritance. Two unrelated patients had mutations in the KMT2A gene. In 10 other patients, we found mutations in the GNB1, GNAO1, TCF4, ASXL1, SMC1A, VPS13B, ACTG1, EP300 , and KMT2D genes. Seven patients (17.5%) were diagnosed with pathogenic CNVs. Korean patients with microcephaly show a genetic spectrum that is different from that of patients with microcephaly of other ethnicities. WES along with CNV analysis represents an effective approach for diagnosis of the underlying causes of microcephaly. [ABSTRACT FROM AUTHOR]

This study investigated whether sociodemographic, health behavioral, biomedical, and health status factors are associated with the awareness and treatment status of hypertension. Data were analyzed from 13 180 adults with hypertension in a nationally representative sample collected from 2007 to 2015 through the Korean National Health and Nutrition Examination Survey. Among hypertensive Korean adults, only 65.2% were aware of their condition and being treated with antihypertensive medications. Younger age was identified as an important barrier to diagnosis and treatment of hypertension. Although there were slight differences between participants aged <65 and ≥65 years, higher risks of being untreated or being unaware of having hypertension were also associated with male gender, lower education levels, unhealthy behaviors, and a better health conditions. We suggest that aggressive interventions to improve the awareness, treatment, and/or control of hypertension should be applied to young and middle-aged people who are vulnerable to hypertension management. [ABSTRACT FROM AUTHOR]

Despite concerns to their increasing contribution to ecological and human exposure, the atmospheric levels of poly- and perfluoroalkyl substances (PFASs) have been determined mainly in Europe and North America. This study presents the indoor and outdoor air concentrations of volatile PFASs [fluorotelomer alcohols (FTOHs), and perfluoroalkyl sulfonamides/sulfonamidoethanols/sulfonamide ethyl acetate (FOSAs/FOSEs/FOSEA)] for the first time in Korean cities. In contrast to the good agreement observed for indoor FTOHs levels in Korea and Europea/North America, FOSAs/FOSEs levels were 10–100-fold lower in Korean indoor air, representing a cultural difference of indoor source. Korean outdoor air contained higher PFAS levels than indoor air, and additionally showed different PFAS composition profile from indoor air. Thus, indoor air would not likely be a main contributor to atmospheric PFAS contamination in Korea, in contrast to western countries. Inhalation exposure of volatile PFASs was estimated to be a minor contributor to PFOA and PFOS exposure in Korea. [Copyright &y& Elsevier]

Simple Summary: Hanwoo cattle is considered one of the most economically important species and sources of nutrition for Koreans. Thus, both the reproductive performance and growth traits play an important role in the continuous development and productivity of Hanwoo farming. Therefore, to improve beef production and the profitability of Hanwoo farming, estimations of genetic parameters for birth weight (BW) and weaning weight (WW) and their relationship with age at first calving (AFC) and gestation length (GL) are necessary to understand and improve their responses to selection. Thus, this study estimated the variance components, heritability estimates of birth weight (BW) and weaning weight (WW) and their genetic and phenotypic relationship to age at first calving (AFC), and gestation length (GL). Results revealed a moderate and high heritability estimate for BW and WW, which suggests a sluggish and rapid response of these traits to selection, respectively. The moderate and high genetic correlation between BW and reproductive traits (AFC and GL) revealed that the selection of a heavier BW might result in a longer AFC and GL. Although the genetic correlation for BW and AFC was moderate and positive, the phenotypic correlation of close to zero may indicate that the phenotypic expression for these traits is likely to be influenced by the genotype-environment interaction (GxE). Moreover, the genetic and phenotypic correlation between WW and reproductive traits (AFC and GL) indicates that the selection of a heavier WW may not influence the AFC and GL of Hanwoo cow. These estimated genetic parameters and correlations for the studied traits can be utilized for genetic breeding programs of Hanwoo cattle. Hanwoo is one of the most economically important animal species in Korea due to its significant contribution to nutrition. However, the current selection index only focuses to improve carcass traits of Hanwoo. Thus, this study aimed to estimate the genetic parameters of birth weight (BW) and weaning weight (WW) and their genetic and phenotypic relationship to the age at first calving (AFC) and gestation length (GL) of Hanwoo. The genetic parameters for birth weight (BW) and weaning weight (WW) were estimated using the data obtained from 52,173 and 35,800 Hanwoo calves born from February 1998 to March 2017, respectively. Further, these data were used to determine their genetic and phenotypic correlation to age at first calving (AFC) and gestation length (GL). The heritability estimates of BW and WW and correlation coefficients were obtained using the average information restricted maximum likelihood (AIREML) procedure, fit in single and two-trait linear animal models. The estimated direct heritability for BW and WW was moderate (0.22 ± 0.02) and high (0.51 ± 0.03), respectively, while the maternal heritability for both traits was 0.12 ± 0.01 and 0.17 ± 0.01, respectively. The genetic correlation of BW and reproductive traits (AFC and GL) showed a moderate and high positive correlation coefficient of 0.33 ± 0.06 and 0.53 ± 0.02, respectively, while close to zero and low positive phenotypic correlations of 0.06 ± 0.01 and 0.21 ± 0.06 were also observed between the correlated traits, respectively. For the correlation analysis between WW and AFC, both the genetic and phenotypic correlation showed close to zero values of 0.04 ± 0.06 and −0.01 ± 0.01, respectively. Meanwhile, the genetic and phenotypic correlation between WW and GL showed low and negative correlations of −0.09 ± 0.06 and −0.09 ± 0.01, respectively. These obtained estimated variances for BW and WW and their corresponding genetic and phenotypic correlation to AFC and GL can be used as information for genetic improvement and subsequent economic improvement of Hanwoo farming. [ABSTRACT FROM AUTHOR]

Hanwoo, is the most popular native beef cattle in South Korea. Due to its extensive popularity, research is ongoing to enhance its carcass quality and marbling traits. In this study we conducted a haplotype-based genome-wide association study (GWAS) by constructing haplotype blocks by three methods: number of single nucleotide polymorphisms (SNPs) in a haplotype block (nsnp), length of genomic region in kb (Len) and linkage disequilibrium (LD). Significant haplotype blocks and genes associated with them were identified for carcass traits such as BFT (back fat thickness), EMA (eye Muscle area), CWT (carcass weight) and MS (marbling score). Gene-set enrichment analysis and functional annotation of genes in the significantly-associated loci revealed candidate genes, including PLCB1 and PLCB4 present on BTA13, coding for phospholipases, which might be important candidates for increasing fat deposition due to their role in lipid metabolism and adipogenesis. CEL (carboxyl ester lipase), a bile-salt activated lipase, responsible for lipid catabolic process was also identified within the significantly-associated haplotype block on BTA11. The results were validated in a different Hanwoo population. The genes and pathways identified in this study may serve as good candidates for improving carcass traits in Hanwoo cattle. [ABSTRACT FROM AUTHOR]

Simple summary: In this study, RNA-Seq data between liver tissues of Hanhyup chicken maintained in Korea and Kyrgyzstan was compared. We then investigated the candidate genes involved in response to environmental changes such as altitude, humidity, temperature etc. We found that 315 genes were differentially expressed genes (DEGs) in the Kyrgyz environment, out of which 174 and 141 were up- and down-regulated respectively. GO and KEGG pathway enriched between the two climatic conditions have been investigated. The identified candidate DEGs and enriched pathways may involve in the acclimatization of Hanhyup chicken to the Kyrgyz environment. RNA sequencing was used to profile the liver transcriptome of a Korean commercial chicken (Hanhyup) at two different environments (Korea and Kyrgyzstan) to investigate their role during acclimatization into different climatic conditions. Ten samples from each location were analyzed to identify candidate genes that respond to environmental changes such as altitude, humidity, temperature, etc. Sequencing reads were preprocessed, aligned with the reference genome, assembled and expressions were estimated through bioinformatics approaches. At a false discovery rate (FDR) <0.05 and fold change (FC) ≥2, we found 315 genes were DE. Out of 315 DE genes, 174 and 141 were up- and down-regulated respectively in the Kyrgyz environment. Gene ontology (GO) enrichment analysis showed that the differentially expressed genes (DEGs) were associated with energy metabolism such as pyruvate and lactate metabolic processes, and glycerol catabolic process. Similarly, KEGG pathway analysis indicated pyruvate metabolism, glycolysis/gluconeogenesis, biosynthesis, citrate cycles were differentially enriched in the Kyrgyz environment. DEGs like TSKU, VTG1, SGK, CDK2, etc. in such pathways are highly involved in the adaptation of organisms into diverse climatic conditions. Our investigation may serve as a resource for the chicken industry, especially in exporting Hanhyup chicken from Korea to other countries. [ABSTRACT FROM AUTHOR]

Simple Summary: Genetic parameters play an important role in designing a breeding program. Many software and methods are used to estimate genetic parameters in livestock population. Multi-trait models are efficiently used these days for productive traits, reproductive traits, milk traits, etc. These models are more useful in the case of low heritability trait and with missing phenotypes. In this study, Hanwoo cattle, an indigenous breed from South Korea, is studied for four carcass traits (back fat thickness, carcass weight, eye muscle area, and marbling score). Single-trait and multi-trait models are constructed using BLUPF90 software to estimate variance components. In addition, the effect of genetic correlations among traits is scrutinized in multi-trait models for these traits. Hanwoo breed is preferred in South Korea because of the high standards in marbling and the palatability of its meat. Numerous studies have been conducted and are ongoing to increase the meat production and quality in this beef population. The aim of this study was to estimate and compare genetic parameters for carcass traits using BLUPF90 software. Four models were constructed, single trait pedigree model (STPM), single-trait genomic model (STGM), multi-trait pedigree model (MTPM), and multi-trait genomic model (MTGM), using the pedigree, phenotype, and genomic information of 7991 Hanwoo cattle. Four carcass traits were evaluated: Back fat thickness (BFT), carcass weight (CWT), eye muscle area (EMA), and marbling score (MS). Heritability estimates of 0.40 and 0.41 for BFT, 0.33 and 0.34 for CWT, 0.36 and 0.37 for EMA, and 0.35 and 0.38 for MS were obtained for the single-trait pedigree model and the multi-trait pedigree model, respectively, in Hanwoo. Further, the genomic model showed more improved results compared to the pedigree model, with heritability of 0.39 (CWT), 0.39 (EMA), and 0.46 (MS), except for 0.39 (BFT), which may be due to random events. Utilization of genomic information in the form of single nucleotide polymorphisms (SNPs) has allowed more capturing of the variance from the traits improving the variance components. [ABSTRACT FROM AUTHOR]

Background: Septic shock is a life-threatening condition with underlying circulatory and cellular/metabolic abnormalities. Vitamin C and thiamine are potential candidates for adjunctive therapy; they are expected to improve outcomes based on recent experimental and clinical research. The aim of the Ascorbic Acid and Thiamine Effect in Septic Shock (ATESS) trial is to evaluate the effects of early combination therapy with intravenous vitamin C and thiamine on recovery from organ failure in patients with septic shock.Methods: This study is a randomized, double-blind, placebo-controlled, multicentre trial in adult patients with septic shock recruited from six emergency departments in South Korea. Patients will be randomly allocated into the treatment or control group (1:1 ratio), and we will recruit 116 septic shock patients (58 per group). For the treatment group, vitamin C (50 mg/kg) and thiamine (200 mg) will be mixed in 50 ml of 0.9% saline and administered intravenously every 12 h for a total of 48 h. For the placebo group, an identical volume of 0.9% saline will be administered in the same manner. The primary outcome is the delta Sequential Organ Failure Assessment (SOFA) score (ΔSOFA = initial SOFA at enrolment - follow-up SOFA after 72 h).Discussion: This trial will provide valuable evidence about the effectiveness of vitamin C and thiamine therapy for septic shock. If effective, this therapy might improve survival and become one of the main therapeutic adjuncts for patients with septic shock.Trial Registration: ClinicalTrials.gov, NCT03756220 . Registered on 5 December 2018. [ABSTRACT FROM AUTHOR]

In this study, we monitored the newly added Stockholm Convention persistent organic pollutants (POPs) HCHs, PeCBz, endosulfans, chlordecone, PBDEs, PBBs and PFCs in industrial, urban, and agricultural soils in South Korea, in order to evaluate their distributions and potential sources. These POPs were widely distributed throughout South Korea, and their concentrations and distributions were affected by land use, reflecting their sources. The overall concentrations of HCHs, PeCBz, endosulfans, PBDEs, and PFCs in soils were in the range of ND (non-detectable)–0.358ng/g (average±standard deviation: 0.060±0.080ng/g), ND–0.531ng/g (0.083±0.133ng/g), 0.058–8.42ng/g (2.19±2.43ng/g), 0.004–4.78ng/g (0.68±1.06ng/g), and ND–1.62ng/g (0.50±0.46ng/g), respectively. Agricultural soils showed the highest concentration of endosulfan, which was the most recently used pesticide monitored in this study. On the other hand, industrial soils contained the highest concentrations of PeCBz, PBDEs, and PFCs, which were mainly introduced to environment via the industrial activities. [ABSTRACT FROM AUTHOR]

• Single-trait and multi-trait ssGBLUP were evaluated using imputed HD genotypes for carcass traits in Hanwoo cattle. • Increasing the marker density from 50 K to HD SNP genotypes resulted in a small improvement in prediction accuracy for carcass traits. • The additional gain on the accuracy of genomic prediction when using multi-trait model is small and limited to some traits. This study aimed to evaluate the accuracy of genomic prediction using single-trait and multi-trait single-step genomic best linear unbiased prediction (ssGBLUP) based on 50 K SNP chip dataset and imputed high-density (HD) genotypes for various carcass traits in commercial Hanwoo population such as backfat thickness (BFT), carcass weight (CWT), rib eye area (REA), and marbling score (MS). Analyses involved phenotypes from 18,269 animals born between April 2006 and June 2017 from different commercial herds in South Korea as well as genomic information from 16,892 animals genotyped using customized Hanwoo 50 K SNP chip and imputed to HD genotypes. Cross-validation was performed on 3,041 animals in the validation population born from November 2016 to June 2017. The results showed that HD genotypes led to a marginal increase in prediction accuracies (0.6 to 2%) than 50 K genotypes for BFT, REA, and MS, while no improvement was noted for CWT. Compared to the single-trait model, the use of multi-trait model based on 50 K or HD genotypes produced only a small improvement in prediction accuracies (1.2 to 2%) for BFT and REA but without improvement for CWT. For MS, the accuracy of genomic prediction using the multi-trait model based on 50 K or HD genotype datasets was slightly lower than the single-trait model. Generally, inflation of predictions increased using the HD genotypes and multi-trait model. Therefore, we recommend the use of 50 K genotypes and single-trait model in the estimation of genomic breeding values for carcass traits in commercial Hanwoo population. [ABSTRACT FROM AUTHOR]