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Purpose: The relationship between the number of chronic diseases and oral health problems is unclear. We sought to determine whether the number of chronic diseases and multimorbidity have an association with oral health problems in Korean adults. Materials and Methods: Data from 23,246 adults aged ≥ 19 years, who participated in the Korea National Health and Nutrition Examination Survey from 2016 to 2019, were considered for our analyses. Participants with either masticatory or speech problems were defined as the oral health problems group. Individuals who reported having had dental treatment in the last year were defined as the dental treatment group. We used multivariable logistic regression analyses to calculate odds ratios (ORs) and 95% confidence intervals (CIs). Results: The proportions of oral health problems and dental treatment were higher in participants with multimorbidity than in those without multimorbidity (all p < 0.001). Moreover, ORs of oral health problems demonstrated a tendency to increase with the number of chronic diseases, even after adjustment (p for trend < 0.001). Compared to the participants without multimorbidity, the risk of having oral health problems increased by 25% (OR: 1.25, 95% CI: 1.12–1.39), and that of receiving dental treatment increased by 23% (OR: 1.23, 95% CI: 1.13–1.34) in patients with multimorbidity. Conclusion: The risk of oral health problems and dental treatment increased in association with the number of chronic diseases in Korean adults. The authors emphasise the risks and importance of oral health in a large population affected by multiple chronic diseases. [ABSTRACT FROM AUTHOR]

This study investigated sex differences in the age-varying trends of depressive symptoms, substance use, and their relationships throughout the adult lifespan. Using a nationwide sample from South Korea, this study aimed to confirm existing patterns and identify unique characteristics specific to the South Korean context. Time-Varying Effect Modeling (TVEM) was applied to data from 17,484 participants (9987 women and 7497 men) in the Korea National Health and Nutrition Examination Survey. Consistent with global trends, the results revealed a higher prevalence of depressive symptoms among women and a greater prevalence of substance use among men. However, the findings also illuminated unique patterns within the South Korean context. Substance use among South Korean men peaked during their 40s, whereas South Korean women consistently exhibited lower rates of substance use. Additionally, a stronger association between depressive symptoms and substance use was identified in women compared to men. The study used cross-sectional data, limiting the analysis of temporal dynamics between depressive symptoms and substance use. Additionally, TVEM cannot distinguish between aging and cohort effects. Furthermore, the assessments of depressive symptoms and substance use were based on self-report. Finally, the study did not include adolescents or sex and gender minorities in its sample. These results emphasize the need for targeted interventions, particularly among women in their 20s and older adulthood, where there is a heightened co-occurrence of depressive symptoms and substance use. These findings also highlight the importance of sex- and culture-sensitive approaches tailored to the South Korean context. • Depressive symptoms were more prevalent among South Korean women. • Substance use was more prevalent among South Korean men. • A stronger association was observed in South Korean women. [ABSTRACT FROM AUTHOR]

Depression has emerged as a modifiable risk factor for cardiovascular disease (CVD). However, evidence on whether depressive symptoms measured using a self-report questionnaire are associated with CVD incidence is scarce. Therefore, we aimed to investigate the association between depressive symptoms and CVD risk using data from national health examinations and insurance claim records. This retrospective cohort study included participants who underwent the Korean National Screening Program for Transitional Ages at age 66 years between 2007 and 2017. The presence of depressive symptoms was defined as affirmative responses to any of three questions (loss of activities and interests, worthlessness, and hopelessness) selected from the Geriatric Depression Scale. Incident composite CVD event included myocardial infarction, stroke, heart failure, and CVD death. The association between depressive symptoms and CVD risk was evaluated using hazard ratios (HRs) and 95 % confidence intervals (CIs) estimated with Cox proportional hazards models. Among 88,765 participants (48.5 % women) aged 66 years, 4036 incident CVD events occurred during a mean follow-up of 6.8 years. Participants with depressive symptoms had a significantly higher risk of CVD than those without depressive symptoms (adjusted HR = 1.16 [95 % CI: 1.07–1.24]). The three individual depressive symptoms showed similar associations with CVD risk (loss of activities and interests, adjusted HR = 1.17 [95 % CI: 1.08–1.26]; worthlessness, 1.15 [1.03–1.29]; hopelessness, 1.13 [1.01–1.26]). The study was limited to participants aged 66 years. Despite extensive adjustment for potential confounders and multiple sensitivity analyses, residual confounding and reverse causality could not be ruled out. The presence of depressive symptoms was associated with an increased risk of CVD. Screening for depressive symptoms in the general population may effectively mitigate the burden of CVD. • In the homogeneous Korean population aged 66 years, 18.2 % had depressive symptoms. • Three depressive symptom items were associated with an increased CVD risk. • Adults with depressive symptoms had a 16 % higher CVD risk than others. [ABSTRACT FROM AUTHOR]

Multiple genes might interact to determine the age at onset of bipolar disorder. We investigated gene-gene interactions related to age at onset of bipolar disorder in the Korean population, using genome-wide association study (GWAS) data. The study population consisted of 303 patients with bipolar disorder. First, the top 1000 significant single-nucleotide polymorphisms (SNPs) associated with age at onset of bipolar disorder were selected through single SNP analysis by simple linear regression. Subsequently, the QMDR method was used to find gene-gene interactions. The best 10 SNPs from simple regression were located in chromosome 1, 2, 3, 10, 11, 14, 19, and 21. Only five SNPs were found in several genes, such as FOXN3 , KIAA1217 , OPCML , CAMSAP2 , and PTPRS. On QMDR analyses, five pairs of SNPs showed significant interactions with a CVC exceeding 1/5 in a two-locus model. The best interaction was found for the pair of rs60830549 and rs12952733 (CVC = 1/5, P < 1E−07). In three-locus models, four combinations of SNPs showed significant associations with age at onset, with a CVC of >1/5. The best three-locus combination was rs60830549, rs12952733, and rs12952733 (CVC = 2/5, P < 1E−6). The SNPs showing significant interactions were located in the KIAA1217 , RBFOX3 , SDK2 , CYP19A1 , NTM , SMYD3 , and RBFOX1 genes. Our analysis confirmed genetic interactions influencing the age of onset for bipolar disorder and identified several potential candidate genes. Further exploration of the functions of these promising genes, which may have multiple roles within the neuronal network, is necessary. • Genetic interactions are crucial for the sub-phenotype of psychiatric disorder. • Age at onset of bipolar disorder was influenced by gene-gene interactions. • The SNPs showing significant interactions were located in the KIAA1217 , RBFOX3 , SDK2 , CYP19A1 , NTM , SMYD3 , and RBFOX1 genes. [ABSTRACT FROM AUTHOR]

ABSTRACT Background Aims Methods Results Conclusion Rosacea, a chronic inflammatory skin condition, is marked by enduring redness, visible blood vessels, and inflammatory eruptions in facial areas. Managing rosacea remains a persistent challenge for dermatologists, especially in cases unresponsive to conventional treatments. Injectable poly‐d,l‐lactic acid (PDLLA) has shown promise in treating erythema and telangiectasia associated with rosacea in addition to age‐related concerns. Employing Mirajet, a laser‐induced microjet system, for administering PDLLA is a novel and promising treatment for rosacea.We aimed to evaluate the efficacy and safety of injectable PDLLA delivered via a needle‐free microjet system for managing rosacea.Four Korean women with persistent and refractory rosacea received five monthly sessions of PDLLA needle‐free injections. Clinical assessments were conducted using the Clinician's Erythema Assessment and Patient's Self‐Assessment (PSA) at baseline, 4 weeks post‐treatment, and 22 weeks post‐final treatment. Adverse events were monitored throughout the study period.At 4 weeks post‐treatment, both Clinician's Erythema Assessment and PSA scores indicated significant improvements in erythema that were sustained up to the 22‐week follow‐up. Patients reported high satisfaction with resolution of redness and improved skin texture. Mild swelling, redness, and petechiae were observed post‐treatment but resolved spontaneously. No product‐related adverse events were noted during the study period.Injectable PDLLA delivered via laser‐induced microjet injection demonstrated promising efficacy in improving rosacea symptoms and skin quality for up to 22 weeks without significant adverse effects. Larger randomized controlled trials are needed to confirm these findings and evaluate long‐term safety and sustainability of outcomes. [ABSTRACT FROM AUTHOR]

Background: Pathogenic variants of MYH7, which encodes the beta-myosin heavy chain protein, are major causes of dilated and hypertrophic cardiomyopathy. Methods: In this study, we used whole-genome sequencing data to identify MYH7 variants in 397 patients with various cardiomyopathy subtypes who were participating in the National Project of Bio Big Data pilot study in Korea. We also performed in silico analyses to predict the pathogenicity of the novel variants, comparing them to known pathogenic missense variants. Results: We identified 27 MYH7 variants in 41 unrelated patients with cardiomyopathy, consisting of 20 previously known pathogenic/likely pathogenic variants, 2 variants of uncertain significance, and 5 novel variants. Notably, the pathogenic variants predominantly clustered within the myosin motor domain of MYH7. We confirmed that the novel identified variants could be pathogenic, as indicated by high prediction scores in the in silico analyses, including SIFT, Mutation Assessor, PROVEAN, PolyPhen-2, CADD, REVEL, MetaLR, MetaRNN, and MetaSVM. Furthermore, we assessed their damaging effects on protein dynamics and stability using DynaMut2 and Missense3D tools. Conclusions: Overall, our study identified the distribution of MYH7 variants among patients with cardiomyopathy in Korea, offering new insights for improved diagnosis by enriching the data on the pathogenicity of novel variants using in silico tools and evaluating the function and structural stability of the MYH7 protein. [ABSTRACT FROM AUTHOR]

Network analysis has become a crucial tool in genetic research, enabling the exploration of associations between genes and diseases. Its utility extends beyond genetics to include the assessment of environmental factors. Unipartite network analysis is commonly used in genomics to visualize initial insights and relationships among variables. Syndromic diseases, such as metabolic syndrome, are characterized by the simultaneous occurrence of various signs, symptoms, and clinicopathological features. Metabolic syndrome encompasses hypertension, diabetes, obesity, and dyslipidemia, and both genetic and environmental factors contribute to its development. Given that relevant data often consist of distinct sets of variables, a more intuitive visualization method is needed. This study applied multipartite network analysis as an effective method to understand the associations among genetic, environmental, and disease components in syndromic diseases. We considered three distinct variable sets: genetic factors, environmental factors, and disease components. The process involved projecting a tripartite network onto a two-mode bipartite network and then simplifying it into a one-mode network. This approach facilitated the visualization of relationships among factors across different sets and within individual sets. To transition from multipartite to unipartite networks, we suggest both sequential and concurrent projection methods. Data from the Korean Association Resource (KARE) project were utilized, including 352,228 SNPs from 8840 individuals, alongside information on environmental factors such as lifestyle, dietary, and socioeconomic factors. The single-SNP analysis step filtered SNPs, supplemented by reference SNPs reported in a genome-wide association study catalog. The resulting network patterns differed significantly by sex: demographic factors and fat intake were crucial for women, while alcohol consumption was central for men. Indirect relationships were identified through projected bipartite networks, revealing that SNPs such as rs4244457, rs2156552, and rs10899345 had lifestyle interactions on metabolic components. Our approach offers several advantages: it simplifies the visualization of complex relationships among different datasets, identifies environmental interactions, and provides insights into SNP clusters sharing common environmental factors and metabolic components. This framework provides a comprehensive approach to elucidate the mechanisms underlying complex diseases like metabolic syndrome. [ABSTRACT FROM AUTHOR]

Introduction: Metabolic syndrome is a chronic disease associated with multiple comorbidities. Over the last few years, machine learning techniques have been used to predict metabolic syndrome. However, studies incorporating demographic, clinical, laboratory, dietary, and genetic factors to predict the incidence of metabolic syndrome in Koreans are limited. In the present study, we propose a genome-wide polygenic risk score for the prediction of metabolic syndrome, along with other factors, to improve the prediction accuracy of metabolic syndrome. Methods: We developed 7 machine learning-based models and used Cox multivariable regression, deep neural network (DNN), support vector machine (SVM), stochastic gradient descent (SGD), random forest (RAF), Naïve Bayes (NBA) classifier, and AdaBoost (ADB) to predict the incidence of metabolic syndrome at year 14 using the dataset from the Korean Genome and Epidemiology Study (KoGES) Ansan and Ansung. Results: Of the 5440 patients, 2,120 were considered to have new-onset metabolic syndrome. The AUC values of model, which included sex, age, alcohol intake, energy intake, marital status, education status, income status, smoking status, dried laver intake, and genome-wide polygenic risk score (gPRS) Z-score based on 344,447 SNPs (p-value < 1.0), were the highest for RAF (0.994 [95% CI 0.985, 1.000]) and ADB (0.994 [95% CI 0.986, 1.000]). Conclusions: Incorporating both gPRS and demographic, clinical, laboratory, and seaweed data led to enhanced metabolic syndrome risk prediction by capturing the distinct etiologies of metabolic syndrome development. The RAF- and ADB-based models predicted metabolic syndrome more accurately than the NBA-based model for the Korean population. [ABSTRACT FROM AUTHOR]

Objective Background Methods Results Conclusion To describe exploratory endpoints from a previous phase 2b/3 placebo‐controlled trial conducted in Japan and Korea, specifically investigating the effect of fremanezumab or placebo on migraine‐associated symptoms and acute headache medication use in patients with episodic migraine (EM).EM is associated with non‐head pain symptoms, including nausea, vomiting, photophobia, or phonophobia, which contribute substantially to the disease burden, healthcare resource utilization, and impaired quality of life. Current EM treatments include a mix of nonspecific/migraine‐specific acute headache medications, but medication overuse can induce headaches and progression from EM to chronic migraine (CM). In multiple phase 2b/3 trials, the monoclonal antibody fremanezumab significantly reduced the average number of monthly migraine days experienced by patients with EM/CM compared with placebo.This was a prespecified analysis of exploratory endpoints in a multicenter, randomized, double‐blind, placebo‐controlled, phase 2b/3 trial conducted in Japanese and Korean patients with EM (NCT03303092). Patients were randomized to receive fremanezumab, either monthly or quarterly, or matching placebo, administered subcutaneously at 4‐week/28‐day (“monthly”) intervals to maintain blinding. Exploratory endpoints reported here were the mean change from baseline in the number of days/month with (i) the use of any acute headache medication, (ii) the use of any migraine‐specific acute headache medication, (iii) nausea or vomiting, and (iv) photophobia and phonophobia.Overall, 357 Japanese and Korean patients with EM received either monthly (n = 121) or quarterly (n = 119) fremanezumab or placebo (n = 117). Compared with placebo, fremanezumab administered monthly or quarterly was associated with a significant reduction from baseline in the average number of days/month with acute headache medication use over three months (difference vs. placebo −2.81 [95% confidence interval (CI) −3.52, −2.11]; p < 0.001 and −2.79 [95% CI −3.50, −2.08]; p < 0.001, respectively). Similar findings were observed in the monthly average number of days with migraine‐specific acute headache medications (difference vs. placebo with monthly and quarterly fremanezumab, −2.63 [95% CI −3.31, −1.95] for both; p < 0.001), the average number of days/month with nausea or vomiting (difference vs. placebo −1.09 [95% CI −1.60, −0.58]; p < 0.001 for monthly fremanezumab and −1.37 [95% CI −1.88, −0.86]; p < 0.001 for quarterly fremanezumab), and the average number of days with photophobia and phonophobia (difference vs. placebo −1.22 [95% CI −1.80, −0.65]; p < 0.001 and −1.64 [95% CI −2.22, −1.06]; p < 0.001, respectively).Monthly and quarterly administered fremanezumab effectively prevented EM in Japanese and Korean patients. Fremanezumab also improved other disease aspects including the need for acute headache medications and the frequency of migraine‐associated symptoms. [ABSTRACT FROM AUTHOR]

Objectives This study aimed to examine age, period, and cohort effects contributing to the prevalence of diabetes and hypertension among older Koreans. Additionally, it sought to investigate how sociodemographic characteristics interact with period and cohort effects to influence the disease prevalence. Methods Using the 2004–2020 data from the National Survey of Older Koreans, a nationally representative sample of older adults aged 65 or older, hierarchical age–period–cohort cross-classified random effects models (HAPC-CCREMs) were employed to estimate separate age, period, and cohort components of the recent trends in diabetes and hypertension. Sociodemographic characteristics were tested for their interactions with period and cohort effects. Results Significant period effects were observed, indicating a steady increase in the likelihood of being diagnosed with diabetes and hypertension over time. Age effects revealed a quadratic trend, with disease risks generally increasing with age, but the rate of increase diminishing at older ages. Cohort effects exhibited an inverted U-shaped pattern, with higher risks observed in the 1930s and early 1940s cohorts compared to earlier and later cohorts. Gender and educational attainment emerged as significant moderators. Women than men born in the early 1930s exhibited higher risks of diabetes and hypertension, whereas individuals with lower educational attainment showed a steadily increasing risk of hypertension over time. Discussion The results underscore the complex interplay of age, period, and cohort effects in shaping disease prevalence among older Koreans. Our findings highlight the importance of considering historical context and sociodemographic factors in understanding disease trends and designing targeted interventions to mitigate health disparities. [ABSTRACT FROM AUTHOR]

Recent events on the Korean Peninsula have heightened tensions to what may be their most dangerous level since the 1950–53 Korean War. The breakdown of the 2018 Comprehensive Military Agreement and North Korea's abandonment of its longstanding unification policy have marked significant shifts in inter-Korean relations, amid a realignment of regional powers into opposing alliances. A historical survey of Korean reunification efforts reveals the cross-cutting implications of recent diplomatic and military developments, while an analysis of the derailed inter-Korean peace process—particularly after the failed 2019 Hanoi summit between North Korea and the United States—highlights lost opportunities for regional integration and peaceful interconnection. [ABSTRACT FROM AUTHOR]

Despite the negative health impact of multiple risk-taking behaviors (RTBs), there is a lack of understanding of adolescents who are more prone to multiple RTBs. This study aimed to identify sociodemographic, mental, and physical health variables associated with increased susceptibility to multiple RTBs in each sex. Cross-sectional data from the 2020 and 2021 Korea Youth Risk Behavior Web-based Survey was used. A total of 106,979 Korean adolescents (55,460 men and 51,519 women) were assessed on five RTBs (alcohol use, smoking, sexual intercourse, illicit substance use, no seat belt wearing). In comparison to no RTB group, odds ratios of the relevant covariate factors were calculated in one RTB or multiple RTBs groups. Male and female adolescents engaging in multiple RTBs were 6.4% and 3.8%, respectively. Increasing age, low subjective socioeconomic status, and living in rural areas were associated with multiple RTBs regardless of sex. All mental health variables except anxiety were associated with multiple RTBs in both sexes. Physical inactivity and obesity were associated with decreased odds of multiple RTBs in both sexes. This study identifies diverse factors associated with multiple RTBs of Korean adolescents and demonstrates existing sex differences. Age and mental health status are the most critical factors that distinguish multiple risk-taking groups from those involved in one or no RTB. • Adolescents' risk-taking behaviors include alcohol use, smoking, sexual intercourse, drug use, and not wearing seatbelts. • Identifying teens vulnerable to multiple risk-taking behaviors is important for promoting overall health of adolescents. • Poor mental health status and late teens are significant risk factors for multiple risk-taking behaviors. • Subtle sex differences in anxiety and living arrangements are significant only for female adolescents' risk-taking. [ABSTRACT FROM AUTHOR]

General strain theory (GST) maintains that the likelihood of individuals engaging in deviant behaviors as a coping mechanism for negative emotions is conditioned by one's propensity for criminal coping. However, only a few previous studies, which suffered from limitations in measuring the propensity for criminal coping, have examined the conditioning proposition on this propensity within the framework of the GST. To address this research gap, using a nationally representative sample of South Korean adolescents, this study employs moderated-mediation analysis to examine the moderating role of the propensity of criminal coping in the link between negative emotions and delinquent behaviors from a GST perspective. First, exposure to strains directly/indirectly affects involvement in delinquent behavior. Also, results revealed that negative emotions (i.e. anger and depression) partially mediated the effect of strains on engagement in delinquency. In addition, the effect of anger and depression on engagement in delinquent behaviors is significantly moderated by adolescents' propensity for criminal coping. Results reveal the significant role of the propensity for criminal coping in connecting negative emotions and delinquent behaviors. Based on findings, theoretical and practical implications were discussed. [ABSTRACT FROM AUTHOR]

This study analyzed data from the Korea Welfare Panel Study to identify changing patterns in social exclusion among South Korean youth and determine the influencing factors. The study examined 345 youth from 2012 to 2021. A fuzzy set theory and growth mixture model was used to measure social exclusion and identify patterns and the associated factors during this timeframe. The main findings are as follows. First, the social exclusion gap among South Korean youth that emerged a decade ago has continued, with high, middle, and low levels of exclusion identified. Second, the analysis revealed that looking at the demographics, being female, having less education and lower personal and household income increased the likelihood of falling into a relatively higher level of social exclusion. Based on the results, policy recommendations are suggested to mitigate the social exclusion gap among Korean youth. [ABSTRACT FROM AUTHOR]

Background: Transient receptor potential vanilloid 1 (TRPV1) is associated with skin sensitivity and mainly activated by capsaicin and heat. Interestingly, troxerutin can inhibit TRPV1 activation. However, its efficacy in reducing skin sensitivity remains undetermined. Aims: We evaluated the efficacy of troxerutin in alleviating skin sensitivity using clinical tests and in vitro experiments. Methods: For the in vitro experiment, HaCaT keratinocytes were pretreated with different concentrations of troxerutin, followed by incubation with 50 μM capsaicin for 1, 24, or 48 h. The gene and protein expressions of four inflammatory cytokines involved in skin irritation were determined. Among 35 Korean women with sensitive skin recruited for the clinical trial, 13 were involved in assessing the immediate soothing effects of 0.1% and 0.0095% troxerutin following capsaicin irritation, whereas 22 participated in evaluating the preventive soothing effect of 10% and 1% troxerutin over 4 weeks against capsaicin‐ and heat‐induced irritation. We evaluated the soothing rate using skin redness, visual analog scale, and high temperature sensitive index as evaluation indices. Results: Troxerutin inhibited the mRNA and protein expressions of cytokines in capsaicin‐treated keratinocytes. In the clinical study, 0.1% and 0.0095% troxerutin promptly alleviated capsaicin‐induced skin redness, whereas 10% troxerutin notably decreased both the visual analog scale and high temperature sensitive index for capsaicin‐ and heat‐related irritation. However, 1% troxerutin was only effective in reducing the visual analog scale in response to capsaicin irritation. Conclusions: Troxerutin can inhibit TRPV1 activation in clinical and in vitro tests. [ABSTRACT FROM AUTHOR]

Purpose: In high-risk non-muscle-invasive bladder cancer (NMIBC), intravesical Bacillus Calmette-Guérin (BCG) is the standard adjuvant therapy post-transurethral resection of bladder tumor (TURBT). Intravesical gemcitabine, used as an alternative or second-line therapy amid BCG shortages, lacks outcome studies in the Korean population. Materials and Methods: Patients who received weekly intravesical gemcitabine for 6 weeks after TURBT from 2019 to 2022 were retrospectively investigated. Based on the American Urological Association risk classification, patients with high- or very high-risk NMIBC who refused cystectomy were included. Maintenance treatment was performed depending on their risk. Recurrence was defined as histologic confirmation on subsequent cystoscopic biopsies or TURBT. Disease free survival (DFS) was evaluated by the Kaplan-Meier method. Results: The study included 60 patients, comprising 45 high-risk (group 1) patients with a median age of 76 years and 15 very high-risk (group 2) patients with a median age of 68 years. Among them, 28 patients had previously received intravesical BCG. Over a median follow-up of 22 months, recurrence occurred in 31 patients in group 1 and 11 in group 2. The DFS rates of the highrisk group and the very high-risk group were 57.8% versus 40% at 1 year, 20.7% versus 21.3% at 2 years and 20.7% versus 21.3% at 3 years, respectively (p=0.831). Tis stage (p=0.042) and prostatic urethra invasion (p=0.028) were significant predictors of DFS. Cancer-specific mortality rates were 2.2% in group 1 and 6.7% in group 2 (p=0.441). Conclusions: Similar DFS outcome between high-risk and very high-risk patients were observed based on short-term results in Korea. This finding is crucial for clinical practice; however, studies analyzing more patients and long-term outcomes are needed. [ABSTRACT FROM AUTHOR]

At the 2020 Tokyo Summer Olympics, South Korean archer An San received national attention for her short hair, when anti-feminists accused An of being a feminist. The anti-feminists' online assaults made national headlines and evoked a strong feminist countermovement. In this paper, we ground this incident in the context of Korean nationalism and its relation to sport, and South Korean feminist movements. Using social media and news sources as our data, we analyze the meanings of women athletes' hair length and styles, revealed in the case of An San. We explore meanings of hair in Korean women's elite sport, and within the context of the tal-corset feminist movement. We argue that the An incident sheds light on the complex interplay between nationalism, feminist movements, and physical cultures of hair, and see the An incident as one that drew increasing public attention and support for the feminist movement in South Korea. [ABSTRACT FROM AUTHOR]

Purpose: This study aims to understand the reasons for individuals switching from traditional banks to Internet-only banks and examine how switching intentions differ between Generation X and Generation Z. Notably, Generation Z, being digital natives, exhibits distinct characteristics compared to Generation X, who often referred to as digital immigrants. Given the technology-driven nature of Internet-only banks, a multi-group analysis between these two generations was conducted. Design/methodology/approach: This study utilizes Bansal's push–pull–mooring model as a framework to analyze switching intention. The study collected survey data from 383 Korean participants, consisting of 198 participants from Generation Z and 185 participants from Generation X. Findings: The findings indicate that low satisfaction and discomfort are factors that push people to leave traditional banks. Specifically, Generation Z shows a significantly higher inclination to leave traditional banks due to discomfort. On the other hand, relative advantage, compatibility, observability and trialability are factors that pull people to switch to Internet-only banks. Generation X is more likely to consider adopting Internet-only banks when compatibility is high and complexity is low. Originality/value: This study is the first to explore unique motivators for Generation Z, such as their discomfort with interpersonal interactions in the retail banking sector. These findings challenge earlier research emphasizing human interaction's importance in technology adoption, offering insights into their future adoption of contactless services. [ABSTRACT FROM AUTHOR]

This longitudinal case study describes a male Korean English teacher's identity development during two years of compulsory military service. An investment and imagined communities framework undergirded the thematic analysis of emails, mobile messaging, and casual conversations. Three recursive themes emerged: English user, researcher, and hyeong (older brother) identities. The findings indicated the following: Jung's English user identity was manifested in the role of someone who was occasionally asked to perform the task of translating for the U.S. and Korean Armies. His researcher identity reflected his eagerness for further study and interest in academic issues, which was sustained through his interactions with colleagues in the academic community and military comrades. His hyeong identity, the counselor, emerged in response to military colleagues' requests for advice on English learning and the importance of English in Korean society. This study shows the need for increased attention to this under-researched population. [ABSTRACT FROM AUTHOR]

Pulmonary function is influenced by factors such as age, sex, height, and weight. This study investigated the relationship between obesity, body composition, and pulmonary function measures (forced expiratory volume in one second [FEV1], forced vital capacity [FVC], and the FEV1-to-FVC ratio) of Korean adults aged 40 years and older. Using the fifth Korea national health and nutrition examination survey in 2010 and 2011, multiple regression analyses were performed to identify factors associated with pulmonary function, stratified by sex. Independent variables were waist circumference (WC) and an additional measure of obesity/muscularity (weight in model 1, body mass index [BMI] in model 2, and fat-free mass index [FFMI] in model 3). Among 3918 adults, the mean FFMI was 17.7 and 15.0 kg/m2 for men and women, respectively. Weight and BMI were positively associated with only FEV1 (B = 0.003 and B = 0.006, respectively, p < 0.01) and the FEV1-to-FVC ratio (B = 0.001, p < 0.01) in women. FFMI was positively associated with FEV1 and FVC in both sexes (B = 0.019, p < 0.05 for FEV1 and B = 0.020, p < 0.01 for FVC in men; B = 0.025, p < 0.0001 for FEV1 and B = 0.022, p < 0.0001 for FVC in women). WC was inversely associated with FEV1 and FVC in men and FEV1 in women, respectively. Weight and BMI behaved as indicators of body size based on their positive associations with pulmonary function. In conclusion, FFMI can be an important and consistent predictor of pulmonary function in both men and women. [ABSTRACT FROM AUTHOR]

Background: Happiness is a cognitive and emotional evaluation of one's life, and the upward approach affects satisfaction and happiness throughout life. Because nursing students must experience medical settings closely related to COVID-19 infection through clinical practice, they are vulnerable to exposure to infection and academic stress, and are also sensitive to personal life satisfaction and happiness. In this study, Korean nursing students who experienced the COVID-19 pandemic during the COVID-19 endemic era were divided into nursing students infected with COVID-19 and non-infected nursing students. By identifying the effects of college life adaptation, leisure satisfaction from club activities, and family health on happiness, which are individual sub-factors of happiness, we intend to provide basic data for the development of intervention programs for promoting their happiness. Methods: Data were collected from October 4, 2023 to November 15, 2023. The subjects were 343 students enrolled in five nursing schools in four major cities (D, G, K, and Y) in Korea. Data were analyzed using descriptive statistics, t-test, one-way ANOVA, Pearson's correlation coefficients. Results: For COVID+ students, happiness was significantly affected by adaptation to campus life and family strengths. This model had r2 = 0.401; i.e., it explained 40.1% of the variability in happiness. For COVID0 students, happiness was significantly affected by adaptation to campus life and subjective health status, with r2 = 0.346. Conclusions: These results indicate the necessity of developing a happiness-promotion program for nursing students. [ABSTRACT FROM AUTHOR]

Background: Serum bone turnover markers offer limited insight into metabolic activity at the individual vertebra level in osteoporosis. This study introduces a novel image-derived bone turnover marker for individual vertebrae to address this limitation, utilizing volumetric density-adjusted quantitative bone single-photon emission computed tomography/computed tomography (SPECT/CT) with [99mTc]Tc-DPD. This retrospective study included 177 lumbar vertebrae from 55 postmenopausal South Korean women. The mean standardized uptake value (SUVmean, g/cm3) and volumetric bone mineral density (vBMD, mg/cm3) were determined within a 2-cm³ volume of interest in the trabecular portion of each vertebra using quantitative SPECT and CT. The density-adjusted mean standardized uptake value (dSUVmean) was calculated by dividing the SUVmean by the vBMD and multiplying by 1,000. Results: SUVmean correlated positively with vBMD (r = 0.60, p < 0.001). Conversely, dSUVmean correlated negatively with vBMD (ρ = −0.66, p < 0.001), highlighting the inverse relationship between bone mass and turnover after density adjustment of SUVmean. Patients with major osteoporotic fractures had lower vBMD (62.5 ± 29.4 vs. 92.3 ± 27.4 mg/cm³, p = 0.001) but higher dSUVmean (100.8 ± 60.7 vs. 62.6 ± 17.5, p = 0.001) compared to those without fractures, reinforcing the association between fracture prevalence, low bone mass, and high bone turnover. Conclusion: Volumetric density-adjusted quantitative bone SPECT/CT offers a novel image-derived bone turnover marker for assessing bone turnover in osteoporosis. This method provides a precise assessment of fragility at the individual vertebra level, which may enhance personalized osteoporosis management. [ABSTRACT FROM AUTHOR]

Background: A sub-analysis of the Korean population in the LIBERTY ASTHMA QUEST trial (NCT02414854) revealed that dupilumab effectively treated severe uncontrolled asthma. This study aimed to assess the cost-effectiveness of add-on therapy with dupilumab to background therapy in patients ≥ 12 years of age with uncontrolled severe asthma compared to that of background therapy in South Korea. Methods: The cost-effectiveness analysis was conducted using a Markov model over a lifetime from the Korean healthcare system perspective. Clinical efficacy and utility weights were obtained from post-hoc analyses of the Korean population in the QUEST trial. Data on the costs and treatment setting of exacerbation in a real-world setting were retrospectively collected using the administrative medical database from a single tertiary hospital. Results: The base-case results indicated that add-on dupilumab therapy increases costs ($112,924 for add-on dupilumab versus $29,545 for background therapy alone). However, add-on dupilumab increased quality-adjusted life years (QALYs, 8.03 versus 3.93, respectively), with fewer events of severe exacerbations per patient compared to using the background therapy alone (17.920 versus 19.911, respectively). The incremental cost-effectiveness ratio was $20,325 per QALY. Various sensitivity analyses supported the robustness of the base-case results. Probabilistic sensitivity analysis showed that the probability of add-on dupilumab being cost-effective was 87% at a threshold willingness-to-pay of $26,718 (KRW 35 million) per QALY gained. Conclusions: Dupilumab is cost-effective for adolescents and adults with uncontrolled severe asthma in South Korea. Our study provides evidence to support clinicians and policymakers in making informed decisions for severe asthma management. [ABSTRACT FROM AUTHOR]

ABSTRACT The study by Monocello et al. presents findings from a cultural model analysis providing support for culturally bounded understandings of weight and shape and body ideals, and identifying factors that vary across culturally anchored weight categories. In this commentary, we highlight the value of utilizing emic perspectives and employing cultural models in research focused on body image and disordered eating, and the usefulness of these empirical data among Korean men who constitute an underrepresented group in the eating disorders literature. In addition, methodological and contextual aspects that warrant consideration in the interpretation of the results are highlighted. Finally, directions for future research are presented focused on body image and disordered eating among Korean men, as well as leveraging cultural models more broadly in the field. We hope that the study by Monocello and colleagues will stimulate additional research that centers the perspectives of underrepresented groups in ways that elevate and honor their experiences and help to shift the field away from a White‐centered perspective. [ABSTRACT FROM AUTHOR]

This study presents a model of automatic speech recognition (ASR) that is designed to diagnose pronunciation issues in children with speech sound disorders (SSDs) to replace manual transcriptions in clinical procedures. Because ASR models trained for general purposes mainly predict input speech into standard spelling words, well-known high-performance ASR models are not suitable for evaluating pronunciation in children with SSDs. We fine-tuned the wav2vec2.0 XLS-R model to recognise words as they are pronounced by children, rather than converting the speech into their standard spelling words. The model was fine-tuned with a speech dataset of 137 children with SSDs pronouncing 73 Korean words that are selected for actual clinical diagnosis. The model’s Phoneme Error Rate (PER) was only 10% when its predictions of children’s pronunciations were compared to human annotations of pronunciations as heard. In contrast, despite its robust performance on general tasks, the state-of-the-art ASR model Whisper showed limitations in recognising the speech of children with SSDs, with a PER of approximately 50%. While the model still requires improvement in terms of the recognition of unclear pronunciation, this study demonstrates that ASR models can streamline complex pronunciation error diagnostic procedures in clinical fields. [ABSTRACT FROM AUTHOR]

Hip pain is a prevalent degenerative joint symptoms, imposing a significant global health burden. Hip pain is experiencing an increase in incidences in Korea due to its aging society, and the social burden of hip pain continues to rise as the hip joint is crucial for gait and balance. This study assessed the epidemiology of hip pain in Korea using data from the fifth version of Korea National Health and Nutrition Examination Survey (KNHANES V-5). The research analyzed data from 8,898,044 Koreans to evaluate the prevalence and characteristics of hip pain and abnormal hip X-ray. Variables encompassed medical, demographic, mental, social, and musculoskeletal factors. Descriptive analysis and propensity score matching analyses unveiled characteristics of Koreans experiencing hip pain or showing abnormal hip x-ray. The study provides insights into the epidemiology of hip pain in the entire Korean population, and further suggesting the effective management of hip pain. [ABSTRACT FROM AUTHOR]

Background: Tofacitinib is an oral Janus kinase inhibitor for the treatment of ulcerative colitis (UC). We aimed to identify the safety and effectiveness of tofacitinib in patients with UC in routine clinical settings in Korea. Methods: This open-label, observational, prospective, post-marketing surveillance study was conducted at 22 hospitals in the Republic of Korea. Patients with moderate to severe active UC who received tofacitinib were included and followed up for up to 52 weeks. Tofacitinib was administered at a dosage of 10 mg twice daily for at least 8 weeks, followed by 5 or 10 mg twice daily at the investigator's discretion based on clinical evaluation according to the approved Korean label. Safety including adverse events (AEs) and effectiveness including clinical remission, clinical response, and endoscopic mucosal healing were evaluated. Safety analysis set was defined as all patients registered for this study who received at least one dose of tofacitinib according to the approved Korean label and followed up for safety data. Effectiveness analysis set included patients in the safety analysis set who were evaluated for overall effectiveness assessment and excluded patients who had received tofacitinib less than 8 weeks. Results: A total of 110 patients were enrolled, of whom 106 patients were included in the safety population. The median duration of treatment was 370 days and the treatment duration ranged from 16 to 684 days for the safety population. AEs occurred in 42 patients (39.6%). Serious AEs (SAEs) occurred in 7 patients (6.6%) and of them, there were 2 cases of serious infections. These serious infections were reported as Adverse Event of Special Interest (AESI) in this study and no other AESI were reported. There were no cases of death during the study period. Clinical remission rates were 40.0%, 46.7%, 57.6%, and 55.1% at 8, 16, 24, and 52 weeks, and clinical response rates were 77.8%, 87.9%, 56.6%, and 81.4% at each visit, respectively. Endoscopic mucosal healing rates were 58.7% at 16 weeks and 46.2% at 52 weeks. Conclusion: Tofacitinib was effective in Korean patients with moderate to severe active UC and the safety findings were consistent with the known safety profile of tofacitinib. Summary: This study confirmed the safety and effectiveness of tofacitinib in Korean patients with moderate to severe active UC in routine clinical settings. Trial registration: This study is registered in the ClinicalTrials.gov under the identifier NCT04071405, registered on 28 August 2019. [ABSTRACT FROM AUTHOR]

Background: Obesity has been suggested to be associated with the coronavirus disease 2019 (COVID-19); however, it is unclear whether obesity or metabolic abnormalities accompanied by obesity have a stronger association with COVID-19 risk. Methods: This study used the Korea Disease Control and Prevention Agency database, which includes information about the COVID-19 diagnosis and mortality dates of the entire Korean population between October 2020 and December 2021 (for diagnosis) or March 2022 (for mortality). A total of 24,310,283 adults were included and classified into four metabolic obesity phenotypes: (1) metabolically healthy and normal weight (MHNW), (2) metabolically unhealthy and normal weight (MUNW), (3) metabolically healthy and obese (MHO), and (4) metabolically unhealthy and obese (MUO). COVID-19 mortality and severity were compared according to metabolic obesity phenotypes in the total population and in each age group (20–<50 years, 50–<70 years, and ≥ 70 years). Additionally, major adverse cardiovascular events (MACE) after COVID-19 infection were compared according to metabolic obesity phenotypes. Results: A total of 3, 956, 807 participants (16.3%) were diagnosed with COVID-19 during the study period. Among them, metabolically unhealthy subjects had higher mortality rates than metabolically healthy subjects (0.81% for MUNW, 0.40% for MUO, 0.23% for MHNW, and 0.19% for MHO). The rates of severe hospitalized disease were also higher in metabolically unhealthy subjects than in healthy subjects (0.59% for MUNW, 0.55% for MUO, 0.19% for MHNW, and 0.31% for MHO). In the subgroup analyses by age, similar trends were observed in subjects aged 20–50 and 50–70 years, respectively. Additionally, the incidence of total MACE was increased in metabolically unhealthy individuals. Conclusions: The study shows that metabolic health is more strongly associated with COVID-19 mortality and severity than obesity, particularly in adults aged < 70 years. [ABSTRACT FROM AUTHOR]

Objective Materials and Methods Results Conclusions Dental implants are a considerable financial burden for elderly people and their caregivers. This study aimed to calculate the estimated economic costs of dental implants on the Korean older population.The economic costs of dental implants for adults aged 75 years and older were estimated from a societal perspective, considering both direct and indirect expenditures. We used data from the Korean National Health Insurance Service for the period 2015–2018 to estimate the medical costs. Noninsured medical costs were estimated from research on medical expenses by the National Health Insurance Review and Assessment Service. Indirect costs related to transportation fees and time loss were obtained. The Cochran Armitage trend test was performed to examine the trend of the economic burden of dental implants.The estimated economic costs showed from 2015 to 2018 (total costs: $26.54–55.66 million, total costs after discount: $17.11–39.56 million). Direct costs, including insured and noninsured medical costs, represented from $25.81 to $47.03 million. Indirect costs, including transportation and time costs, ranged from $0.73 to $1.63 million. The impact of the total dental implant costs was 0.0018%–0.0034% of the Korean annual gross domestic product and 1.03%–1.59% of the annual total costs of dental care benefits.The estimated economic burden of dental implants significantly increased from 2015 to 2018 in older South Korean adults. These results will provide a foundation and guidance for further health economic studies on the burden of dental implants in the elderly population. [ABSTRACT FROM AUTHOR]

Background: Lymphangioleiomyomatosis (LAM) is a rare multisystemic disorder characterized by the proliferation of abnormal smooth muscle-like cells. Although serum vascular endothelial growth factor-D (VEGF-D) is currently used as a diagnostic biomarker for LAM, its diagnostic value in Korean patients is unclear. Objectives: To evaluate the diagnostic value of serum VEGF-D for LAM in Korean patients. Design: A multicenter prospective cohort study Methods: Serum samples were prospectively collected from five medical institutions, from patients with LAM (n = 40) and controls (n = 24; healthy participants = 3, other cystic lung diseases = 13, idiopathic pulmonary fibrosis = 4, idiopathic nonspecific interstitial pneumonia = 4). Serum VEGF-D levels were measured using the enzyme-linked immunosorbent assay, and the diagnostic value was evaluated using receiver operating characteristic (ROC) curve analysis. Results: The mean age of patients with LAM was 44.5 years, and all were female (controls: 47.8 years; female: 70.8%, p < 0.001). The serum VEGF-D levels were significantly higher in patients with LAM than those in the control group (median: 708.9 pg/mL vs 325.3 pg/mL, p < 0.001). In the ROC curve analysis, serum VEGF-D levels showed good predicting performance for LAM diagnosis (area under the curve = 0.918) with an optimal cut-off value of 432.7 pg/mL (sensitivity = 85.0%, specificity = 87.5%). When 800 pg/mL was used as the cut-off value, the specificity of serum VEGF-D for LAM diagnosis increased to 100.0%. Conclusion: Our results suggest that serum VEGF-D may be a useful biomarker for diagnosing LAM in Korean patients, similar to previous reports. Plain Language Summary: Blood test for diagnosis of lymphangioleiomyomatosis in Korea: role of vascular endothelial growth factor-D In this study, we discuss a blood test to diagnose a rare lung disease, called lymphangioleiomyomatosis (LAM). LAM primarily affects women, especially during their childbearing years, and can cause serious lung problems such as damage and cyst (air-filled sac) formation. The blood test looks for a special protein in the blood, called vascular endothelial growth factor-D (VEGF-D). If someone has a lot of this protein, it usually means that they have LAM. We have found that when VEGF-D levels are high, the test can effectively separate LAM from other lung diseases. We also found that raising this threshold to higher levels made it much more likely to correctly distinguish a group of people who do not have the disease from patients with LAM. Our study is important because it's the first to show the usefulness of blood VEGF-D testing in Korean LAM patients, and because it suggests an easier and less inconvenient way for physicians to diagnose LAM in Koreans. Our findings are an important step in improving the management of Korean patients with LAM. [ABSTRACT FROM AUTHOR]

Socioeconomic status (SES) has a considerable impact on cardiovascular health (CVH), which may differ by sex. We aimed to investigate sex-specific socioeconomic disparities in CVH among 31,141 individuals aged 25–64 years who participated in the cross-sectional 2007–2017 Korea National Health and Nutrition Survey (KNHANES) and the Life's Simple 7 metrics were used to define ideal CVH. Latent class analysis was used to estimate overall SES patterns. Logistic regression models were used to estimate sex-specific odds ratios (ORs) and 95% confidence interval (95% CI) for the likelihood of ideal CVH across SES classes, with the highest SES as the reference group. Four SES classes were identified: (1) low class with low education and material property (2.4%), (2) lower-medium class (10.1%) and (3) higher-medium class (43.7%) with increasing material affluence, and (4) high class with highest education and income (43.8%). Lower SES was associated with decreased ideal CVH among women; compared to their high SES counterparts, women with lowest SES were least likely to achieve ideal overall CVH (OR: 0.55, 95%CI: 0.43–0.71). Similar SES gradients in ideal overall CVH for men were also observed but it was less clear (OR (95%CI) for lowest SES: 0.83, 0.51–1.34). Low SES was associated with poorer achievement of ideal CVH with some sex-heterogeneities. Interventions that equalize the distribution of power and resources and targeted sex-specific approaches to empower low socioeconomic subgroups are warranted to prevent the transition from ideal to suboptimal cardiovascular health and to close socioeconomic disparities in CVH among Korean adults. [ABSTRACT FROM AUTHOR]

Epidemiological studies in some populations showed that dietary intake of fish may be inversely associated with depression, but large studies in Korean population are limited. Thus, we investigated the association between fish consumption and depression, considering the serving size of fish, in Korean adults. This study was based on the data from the Korea National Health and Nutrition Examination Survey (2013−2021), which is a large nationally representative study of Korean population. Fish consumption was assessed with a 24-hour dietary recall, and physician-diagnosed depression status was assessed using questionnaires from the health interview survey. Multivariable logistic regression models adjusting for demographic, lifestyle, and dietary factors were used to calculate odds ratios (OR) and 95 % confidence intervals (CI) for depression. A total of 31,632 adults aged 19–64 years were included in the analysis. After adjusting for covariates, highest fish consumption (≥4 servings/week) was significantly associated with 26 % lower odds of depression compared to the lowest fish consumption (<1 servings/week) (OR 0.74; 95 % CI, 0.60–0.92, P for trend = 0.007). A similar inverse association was found in female adults (OR 0.76; 95 % CI, 0.59–0.97, P for trend = 0.018), but no significant association was found in male adults (OR 0.75; 95 % CI, 0.49–1.15, P for trend = 0.223). Since KNHANES is a cross-sectional study, it is difficult to evaluate the causal relationship between fish consumption and depression risk. This study results suggest that high fish consumption is associated with lower risk of depression in Korean adults, especially in female adults. • Using large, national data of Korean adults, we found an association between fish consumption and depression risk. • High fish consumption was associated with lower risk of depression in Korean adults, especially in females. • No significant association was found in male adults, which needs further studies. [ABSTRACT FROM AUTHOR]

Temperament and character are useful in risk assessment and therapy of individuals in the anxiety-depression spectrum but understudied in South Korea. The study aimed to identify the temperament and character features associated with anxiety and/or depression in individuals with clinical disorders and in the general population. A representative sample of 1384 Korean adults over 18 years old (58 % female) were assessed with the Beck Depression Inventory (BDI), State-Trait Anxiety Inventory (STAI), and Temperament and Character Inventory (TCI). Multivariate analyses, including structural equation modeling and complex systems analysis, evaluated how personality influenced risk and resilience for anxiety and/or depression. The three groups with anxiety and/or depression were strongly distinguished by temperament and character: (i) In AD (n = 58), Harm Avoidance and Reward Dependence were higher than in DD, and Self-directedness was higher than in AD+DD; (ii) In DD (n = 90), Persistence, Self-Directedness and Cooperativeness were higher than in AD+DD; and (iii) In AD+DD (n = 101), Harm Avoidance was highest and Persistence and Self-directedness were lowest (i.e., they were lowest in Resilience). Structural equation models confirmed these risk relations with strong character development reducing the adverse effects of emotional hyperreactivity from extreme temperaments. Self-reports were measured only at one point in time, requiring collateral experimental data to support causal interpretation. Interactions of temperament and character are strongly predictive of risk and resilience to anxiety and/or depression by regulating both positive and negative affect. Character mediates the adverse effects of extreme temperaments on affect. • Harm Avoidance increases anxiety & depression, and Self-directedness reduces both. • Reward Dependence tends to increase depression, and Cooperativeness reduces it. • Resilience is a complex adaptive system regulating positive and negative affect. • Resilience strongly predicts lower levels of anxiety and/or depression. • Overall, character mediates the adverse effects of extreme temperaments on affect. [ABSTRACT FROM AUTHOR]

Opportunistic osteoporosis screening using deep learning (DL) analysis of low-dose chest CT (LDCT) scans is a potentially promising approach for the early diagnosis of this condition. We explored bone mineral density (BMD) profiles across all adult ages and prevalence of osteoporosis using LDCT with DL in a Korean population. This retrospective study included 1915 participants from two hospitals who underwent LDCT during general health checkups between 2018 and 2021. Trabecular volumetric BMD of L1-2 was automatically calculated using DL and categorized according to the American College of Radiology quantitative computed tomography diagnostic criteria. BMD decreased with age in both men and women. Women had a higher peak BMD in their twenties, but lower BMD than men after 50. Among adults aged 50 and older, the prevalence of osteoporosis and osteopenia was 26.3% and 42.0%, respectively. Osteoporosis prevalence was 18.0% in men and 34.9% in women, increasing with age. Compared to previous data obtained using dual-energy X-ray absorptiometry, the prevalence of osteoporosis, particularly in men, was more than double. The automated opportunistic BMD measurements using LDCT can effectively predict osteoporosis for opportunistic screening and identify high-risk patients. Patients undergoing lung cancer screening may especially profit from this procedure requiring no additional imaging or radiation exposure. [ABSTRACT FROM AUTHOR]

Insulin resistance is closely associated with metabolic diseases such as type 2 diabetes and cardiovascular disease, and the resting heart rate (RHR) is an important marker of the autonomic nervous system's status. This study aimed to investigate the association between the RHR and the homeostatic model assessment of insulin resistance (HOMA-IR) in Korean adults. Using data from the 2019 Korea National Health and Nutrition Examination Survey (KNHANES 2019), we analyzed 6118 adults and classified the participants into four groups based on their RHR (≤67, 68–71, 72–79, and ≥80 beats/min [bpm]). Logistic regression analysis considering demographic, lifestyle, and biochemical factors revealed that the odds of having a HOMA-IR of 2.5 or higher were significantly increased in the higher RHR groups. Specifically, compared to the ≤67 bpm group, the 68–71, 72–79, and ≥80 bpm groups had increased odds of 1.277, 1.599, and 1.919 times, respectively. These results are expected to contribute to the development of strategies for the early diagnosis and management of metabolic diseases through the RHR, and further research is needed to deepen the understanding of the physiological mechanisms of this relationship, including the management of the RHR through lifestyle modification and regular exercise and the effect of reducing insulin resistance. [ABSTRACT FROM AUTHOR]

Introduction: With rapid advancements in natural language processing (NLP), predicting personality using this technology has become a significant research interest. In personality prediction, exploring appropriate questions that elicit natural language is particularly important because questions determine the context of responses. This study aimed to predict levels of neuroticism--a core psychological trait known to predict various psychological outcomes--using responses to a series of open-ended questions developed based on the fivefactor model of personality. This study examined the model's accuracy and explored the influence of item content in predicting neuroticism. Methods: A total of 425 Korean adults were recruited and responded to 18 openended questions about their personalities, along with the measurement of the Five-Factor Model traits. In total, 30,576 Korean sentences were collected. To develop the prediction models, the pre-trained language model KoBERT was used. Accuracy, F1 Score, Precision, and Recall were calculated as evaluation metrics. Results: The results showed that items inquiring about social comparison, unintended harm, and negative feelings performed better in predicting neuroticism than other items. For predicting depressivity, items related to negative feelings, social comparison, and emotions showed superior performance. For dependency, items related to unintended harm, social dominance, and negative feelings were the most predictive. Discussion: We identified items that performed better at neuroticism prediction than others. Prediction models developed based on open-ended questions that theoretically aligned with neuroticism exhibited superior predictive performance. [ABSTRACT FROM AUTHOR]

Height is known to be a classically heritable trait controlled by complex polygenic factors. Numerous height-associated genetic variants across the genome have been identified so far. It is also a representative of externally visible characteristics (EVC) for predicting appearance in forensic science. When biological evidence at a crime scene is deficient in identifying an individual, the examination of forensic DNA phenotyping using some genetic variants could be considered. In this study, we aimed to predict 'height', a representative forensic phenotype, by using a small number of genetic variants when short tandem repeat (STR) analysis is hard with insufficient biological samples. Our results not only replicated previous genetic signals but also indicated an upward trend in polygenic score (PGS) with increasing height in the validation and replication stages for both genders. These results demonstrate that the established SNP sets in this study could be used for height estimation in the Korean population. Specifically, since the PGS model constructed in this study targets only a small number of SNPs, it contributes to enabling forensic DNA phenotyping even at crime scenes with a minimal amount of biological evidence. To the best of our knowledge, this was the first study to evaluate a PGS model for height estimation in the Korean population using GWAS signals. Our study offers insight into the polygenic effect of height in East Asians, incorporating genetic variants from non-Asian populations. [ABSTRACT FROM AUTHOR]

The maximization-well-being relationship has been extensively studied at the person level, but rarely at the day level. Based on an event reconstruction method, daily data from 200 South Korean adults across 14 days were obtained to examine associations between maximization dimensions (i.e. maximization goal and strategy) and well-being, and the moderating effects of choice domains and characteristics. Results of multilevel analyses indicated that at the day level, maximization goal was significantly associated with well-being, while maximization strategy was not. Choice domain moderated the relationship between maximization goal and well-being; significant positive associations were shown in time use and life decisions but not in consumer goods. Finally, choice irreversibility was the only significant moderator among choice characteristics; it strengthened the positive association between maximization goal and well-being and weakened the negative association between maximization strategy and well-being. Theoretical implications, study limitations and future directions for research are discussed. [ABSTRACT FROM AUTHOR]

A randomized, active-controlled, double-blind, first-in-human, phase 1 study was conducted in healthy Korean adults to evaluate the safety, tolerability, and immunogenicity of EuNmCV-5, a new pentavalent meningococcal vaccine targeting serogroups A, C, W, X, and Y. Sixty participants randomly received a single dose of either EuNmCV-5 or MenACWY-CRM, a quadrivalent vaccine containing serogroups A, C, W, and Y. Safety was assessed through monitoring anaphylactic reactions, adverse events for 28 days, and serious adverse events over 180 days. Immunogenicity was assessed via rabbit complement-dependent serum bactericidal antibody (rSBA) assay. EuNmCV-5 was safe, well-tolerated, and elicited a substantial antibody titer increase. The seroprotection rates exceeded 96.7%, and the seroconversion rates were over 85% for all the targeted serogroups. It showed higher seroconversion rates against serogroups A and C (p = 0.0016 and 0.0237, respectively) and elicited a substantial increase in GMT for all targeted serogroups compared to the MenACWY-CRM. ClinicalTrials.gov identifier: NCT05739292. [ABSTRACT FROM AUTHOR]

This study hypothesizes that self-control and opportunity variables affect heterogeneity in developmental trajectories of bullying victimization. Using data from a follow-up study of 2,351 Korean adolescents, the study incorporates a latent class growth analysis approach to identify subgroups, each with a unique pattern of the trajectories. The model yields three subgroups of bullying victims: the early-onset and decreaser, the increaser and late-peak, and the normative groups. Results suggest that, compared to the normative group, the early-onset and decreasing group members manifest lower levels of self-control and engage in a greater range of delinquent behaviors. Also, the impact of low self-control on group membership was attenuated after controlling for those opportunity variables, indicating a partially mediating relationship. Social guardianship variables distinguished normative groups from other victim groups. Further, members of the increaser and late-peak group were more likely than the early-onset and decreaser group members to engage in cyber deviance over the long-term. [ABSTRACT FROM AUTHOR]

This article, published in the Australasian Journal of Dermatology, explores the clinical and dermoscopic features of onychomatricoma in Korean patients. Onychomatricoma is a rare benign tumor that originates from the nail matrix. The study analyzed ten patients with pathologically confirmed onychomatricoma and found that the most common clinical findings were increased nail thickness and xanthonychia. Dermoscopic examination revealed patterns such as localized nail thickening and multiple cavities at the free edge. The study also identified four distinct types of onychomatricoma based on clinical and dermoscopic findings. The article concludes by acknowledging the limitations of the study and the need for further research on the morphologic characteristics of onychomatricoma in different ethnicities. [Extracted from the article]

The COVID-19 pandemic had a detrimental impact on adolescent mental health, but few studies have explicitly compared adolescents' mental health across countries, nor have they explored how different uses of media by adolescents in different countries may serve as protective or detrimental factors. To explore these associations, we use data collected from 958 South Korean adolescents and 1,253 United States (U.S.) adolescents in spring 2022 (ages 14–18). U.S. adolescents scored higher on anxiety and loneliness, relative to South Korean adolescents, and U.S. adolescents' social media use frequency related positively to these variables. Conversely, South Korean adolescents' social media use frequency was not related to anxiety or depression, and was negatively related to loneliness. Thus, social media use appears to relate detrimentally to U.S. adolescents' mental health but relates in a more protective way to South Korean adolescents' mental health. We discuss differential social media use and country differences to contextualize these findings. [ABSTRACT FROM AUTHOR]

Background/Objectives: Obstructive sleep apnea (OSA) impairs quality of life (QoL). However, its disease burden in the general population remains unknown. We aimed to investigate the association between OSA and health-related QoL in the general Korean population. Methods: This study analyzed cross-sectional datasets of adults (≥40 years) in the Korean National Health and Nutrition Examination Survey 2019–2021. QoL was assessed using the 3-level EuroQoL 5-dimension component (EQ-5D-3L). The high risk of OSA was determined using the STOP-Bang questionnaire (score ≥ 3). Demographic and clinical factors were included in linear regression analyses to identify the factors associated with EQ-5D-3L. Results: Of the 8966 total participants, 6792 (75.8%) and 2174 (24.2%) were classified as having a low risk and high risk of OSA, respectively. The high risk OSA group showed significantly lower QoL scores when compared with the low risk OSA group (0.939 ± 0.003 vs. 0.951 ± 0.002, p < 0.001). However, the mean difference was within the minimal clinically important difference (MCID) of EQ-5D-3L. Only females exceeded the MCID for the EQ-5D-3L. Elderly females with a high risk of OSA showed the lowest QoL. The regression coefficient of high risk OSA in the multivariate model was −0.018 (95% CI: −0.025–−0.01, p < 0.001). Patient demographics and comorbidities also showed significant associations with the EQ-5D-3L. Their regression coefficient was higher than that of high risk OSA. Conclusions: The impact of high risk OSA on QoL manifested differently according to age and sex. The impact of comorbidities on QoL was greater than that of high risk OSA, highlighting the important role of comorbidities and the need for their adjustment in the assessment of QoL. [ABSTRACT FROM AUTHOR]

Since March 2020, South Korea has implemented social distancing measures to reduce the spread of the coronavirus disease (COVID-19). These policies resulted in significant changes in the lifestyle of Korean adults, including spending more time indoors and experiencing increased sedentary time during the pandemic. This study aimed to investigate the combined influence of sedentary lifestyle and the COVID-19 pandemic on obesity rates among adults residing in South Korea. Data were obtained from the 2018–2020 Korea National Health and Nutrition Examination Survey (KNHANES). Multiple logistic regression was used to analyze the synergistic effects of a sedentary lifestyle and COVID-19 on obesity. The prevalence of sedentary lifestyles among the participants increased from 30.4% pre-COVID-19 to 36.6% during the pandemic. Furthermore, the obesity rates were raised independently by COVID-19 (OR: 1.16, 95% CI 1.04–1.30) and by a sedentary lifestyle (OR = 1.17, 95% CI 1.04–1.31). A synergistic effect of a sedentary lifestyle and COVID-19 on obesity was identified (OR: 1.57, 95% CI 1.30–1.85). COVID-19 and a sedentary lifestyle significantly increased the risk of obesity in South Korean adults. Moreover, the combined synergistic effects of these risk factors were too substantial to be disregarded by merely summing their individual effects on obesity. [ABSTRACT FROM AUTHOR]

This study aimed to examine pathways from child abuse to school adjustment and the roles of self-control and academic stress on the link among North Korean adolescent refugees living in South Korea and native South Korean adolescents. A total of 610 students (adolescents from South Korea = 325 and adolescents from North Korea = 285) living in South Korea, from juniors in middle schools to seniors in high schools, were interviewed in 2017. Multigroup structural equation modeling was used to examine differences in the country of origin on the pathways from abuse to school adjustment via self-control and academic stress. North Korean adolescent refugees were less likely to adjust to their school life than South Korean adolescents. Academic stress was found as a significant mediator between self-control and school adjustment in both South Korean and North Korean adolescents. Child abuse was associated with self-control of South Korean adolescents. Childhood abuse from parents can have an overall influence on individual characteristics and school life for adolescents. By paying attention to this process, comprehensive solutions are urgently required not only to intervene in the problem of abusive parenting behaviors but also to block the path of the expanding negative consequences among both groups of adolescents. [ABSTRACT FROM AUTHOR]

Despite growing interest in the preventive effects of statins, as lipid-lowering agents, on migraine attacks, comprehensive nationwide studies comparing migraine likelihood between statin users and controls are lacking. Our nested case–control study within the Korean National Health Insurance Service-Health Screening Cohort (2002–2019) investigated this association using 38,957 migraine patients and 155,828 controls, considering migraine subtypes (with/without aura) and statin types (lipophilic vs. hydrophilic). Using propensity score matching and adjusting for confounders, statin use was linked to reduced migraine likelihood overall (odds ratio (OR) 0.93), particularly for migraines with aura (OR 0.75) and without aura (OR 0.94). Lipophilic statins were effective for both subtypes, while hydrophilic statins mainly reduced the likelihood of migraines without aura. Subgroup analyses showed consistent benefits across demographics, but varied effectiveness based on weight, smoking, alcohol use, hemoglobin levels, and dyslipidemia history. In summary, this nationwide cohort study suggests that statin use may reduce migraine likelihood among Korean adults across diverse demographics and clinical profiles, but varied effectiveness based on certain lifestyle and comorbidity factors underscores the importance of considering individual patient profiles when assessing the potential benefits of statin therapy for migraine prevention. [ABSTRACT FROM AUTHOR]

Congenital central hypoventilation syndrome (CCHS) is a rare genetic disorder characterized by hypoventilation due to impaired breathing control by the central nervous system and other symptoms of autonomic dysfunction. Mutations in paired-like homeobox 2 B (PHOX2B) are responsible for most cases of CCHS. Patients with CCHS have various phenotypes and severities, making the diagnosis difficult. This study aimed to present a comprehensive single-center experience of patients with CCHS, including key clinical features, treatment strategies, and outcomes. A retrospective chart review was performed for patients diagnosed with CCHS between January 2001 and July 2023 at Seoul National University Children's Hospital. Finally, we selected 24 patients and collected their demographic data, genotypes, ventilation methods, and clinical features related to autonomic dysfunction. The relationship between the clinical manifestations and genotypes was also examined. All patients used home ventilators, and tracheostomy was performed in 87.5% of patients. Fifteen (62.5%) patients had constipation and nine (37.5%) were diagnosed with Hirschsprung disease. Arrhythmia, endocrine dysfunction, and subclinical hypothyroidism were present in nine (37.5%), six patients (25.0%), and two patients (16.7%), respectively. A significant number of patients exhibited neurodevelopmental delays (19 patients, 79.2%). There was a correlation between the phenotype and genotype of PHOX2B in patients with CCHS. (r = 0.71, p < 0.001). Conclusion: There was a positive correlation between paired-like homeobox 2 B mutations (especially the number of GCN repeats in the polyalanine repeat mutations sequence) and clinical manifestations. This study also demonstrated how initial treatment for hypoventilation affects neurodevelopmental outcomes in patients with CCHS. What is Known: • Congenital central hypoventilation syndrome is a rare genetic disorder characterized by hypoventilation and dysfunction of autonomic nervous system. • The disease-defining gene of CCHS isPHOX2Bgene – most of the cases have heterozygous PARMs and the number of GCN triplets varies among the patients(20/24 – 20/33). What is New: • We have noted in the Korean patients with CCHS that there is a correlation between genotype (number of GCN repeats) and severity of phenotype. • National support for rare diseases allowed for a prompter diagnosis of patients with CCHS in Korean population. [ABSTRACT FROM AUTHOR]

Bisphenol A (BPA) exposure primarily occurs through dietary intake. This study aimed to estimate the extent of dietary BPA exposure among Koreans. A thorough literature search was conducted to establish a BPA content database encompassing common foods consumed in Korea, including various food raw materials and processed food products. Dietary exposure levels were estimated by integrating the constructed BPA database with comprehensive nationwide 24 h-dietary recall datasets. The finding revealed that dietary BPA exposure was low for most Koreans, with a mean of 14.5 ng/kg bw/day, but was higher for preschool-age children (over 23 ng). Canned foods accounted for 9–36% of the total dietary exposure of the highest dietary exposure groups; while across all age groups, a considerable amount was derived from canned tuna, contribution of canned fruits and canned coffee (milk-containing) was high for preschool-age children and adults, respectively. Notably, for adults, a substantial proportion also stemmed from beer packaged in cans. While diet contributed over 80% of aggregate exposure for most age groups, preschool-age children experienced 60% exposure through diet due to additional exposure from indoor dust. Even at the high exposure scenario, aggregate BPA exposure levels remained lower than the current tolerable daily intake (TDI) set by the Korean agency (20 μg/kg bw/day). Nevertheless, most Koreans were exposed to BPA levels surpassing the strictest TDI (0.2 ng/kg bw/day) set by the European Food Safety Authority. [ABSTRACT FROM AUTHOR]

Objective: This study aimed to investigate the long-term effects and functional outcomes of androgen suppression therapy using leuprorelin among Korean patients with spinal and bulbar muscular atrophy (SBMA). Methods: This observational study enrolled patients with genetically confirmed SBMA who provided informed consent. Leuprorelin was administered via subcutaneous injection every 12 weeks. The primary outcome measure was the change in total Spinal and Bulbar Muscular Atrophy Functional Rating Scale (SBMAFRS) scores. Results: A total of 48 SBMA patients were evaluated in this study. Among them, 39 patients underwent androgen suppression therapy over a 3-year period. The total SBMAFRS score decreased from 41.72 ± 5.55 to 36.74 ± 7.74 (p < 0.001) in patients who completed their treatment. The subgroup with a baseline SBMAFRS score of ≥ 42 had a significantly lower decline in SBMAFRS score than did those with a baseline SBMAFRS score of ≤ 41. We determined that at a baseline, SBMAFRS cutoff value of 41.5 could predict good prognosis, with a corresponding area under the curve of 0.689. Conclusion: Despite androgen suppression therapy, all enrolled participants exhibited a decrease in the overall SBMAFRS score. However, those with a baseline SBMAFRS of ≥ 42 showed a mild decrease in scores, indicating a more favorable prognosis. These findings suggest that a higher baseline motor function was a key prognostic indicator in SBMA treatment and that initiating early leuprorelin treatment in patients with high baseline function may lead to good clinical outcomes. [ABSTRACT FROM AUTHOR]

Objective: This study aimed to investigate the association of hormone replacement therapy (HRT) use, type, duration and age of commencement with myocardial infarction (MI) and stroke in postmenopausal Korean women. Methods: This nested case–control study used data from the National Health Insurance Service database to analyze 2017 data from women aged ≥50 years and diagnosed with natural menopause between 2004 and 2007. Among 356,160 eligible women, 36,446 used HRT for ≥1 year and 319,714 did not (controls). These two groups were matched 1:1 for statistical analysis. Type and duration were categorized into three categories. Results: Women who started estrogen–progestogen therapy (EPT) or estrogen therapy (ET) in their 50s, or EPT or tibolone in their ≥60s exhibited a lower stroke risk than controls. MI risk was lower among women who used tibolone – regardless of duration – or EPT or ET for 1–3 years than among controls. Stroke risk was lower with tibolone use for ≥5 years or with EPT or ET use for 1–3 years or ≥5 years than non-users. Conclusion: Our study may support the beneficial effect of HRT by showing that Korean postmenopausal women who used HRT at a relatively younger and healthier age had a relative benefit for MI and stroke. [ABSTRACT FROM AUTHOR]