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The use of neoadjuvant chemotherapy (NAC) as a first-line therapy for advanced high-grade serous ovarian carcinoma (HGSOC) has increased. However, several studies have reported NAC-induced platinum resistance. This study aimed to evaluate the predictive impact of clinical factors on chemotherapy response score (CRS) and to select patients who would respond well to NAC. This multicenter retrospective (study included patients treated between January 2016 and December 2021). International Federation of Gynecology and Obstetrics stage IIIC and IV HGSOC patients were eligible. Institutionally strict complete resectability criteria were used in the present study. Pathological slides were scored according to the CRS criteria. Among 172 patients with HGSOC, 87 (50.6%) had stage IIIC disease and 85 (49.4%) had stage IV disease. And 35 (20.4%) had CRS1, 103 patients were CRS2 (59.9%), and 34 patients were CRS3 (19.7%). Compared with CRS1, simultaneous metastases to distant lymph nodes and solid organs confirmed by imaging were associated with a 75% reduction in CRS2 (odds ratio = 0.25; 95% confidence interval: 0.09-0.70; P = .008). And breast cancer susceptibility gene 1/2 mutation was positively (odds ratio = 8.41; 95% confidence interval: 2.25-31.52; P = .002) associated with CRS3 compared to CRS1. Patients with CRS3 had significantly longer progression-free survival (PFS), with median PFS of 9.8, 14.8, and 27.0 months for CRS of 1, 2, and 3, respectively (P < .001). Overall survival was also prolonged in patients with CRS3 (P < .001). Germline breast cancer susceptibility gene 1/2 mutation was a predictor of CRS3 and a good prognostic factor for the survival rate. Simultaneous metastasis to distant lymph nodes and solid organs is a predictor of CRS1. CRS inversely correlated with PFS and overall survival., Competing Interests: The authors have no conflicts of interest to disclose., (Copyright © 2024 the Author(s). Published by Wolters Kluwer Health, Inc.)

Background: No standard treatment guidelines have been established for postpartum hemorrhage (PPH). We aimed to assess the differences in outcomes and prognoses between patients with PPH who underwent surgical and non-surgical treatment., Methods: This retrospective study included 230 patients diagnosed with PPH at two referral hospitals between August 2013 and October 2023. The patients were divided into non-surgical (group 1, n = 159) and surgical intervention groups (group 2, n = 71). A subgroup analysis was performed by dividing the surgical intervention group into immediate (n = 45) and delayed surgical intervention groups (n = 26)., Results: Initial lactic acid levels and shock index were significantly higher in group 2 (2.85 ± 1.37 vs. 4.54 ± 3.63 mmol/L, p = 0.001, and 0.83 ± 0.26 vs. 1.10 ± 0.51, p < 0.001, respectively). Conversely, initial heart rate and body temperature were significantly lower in group 2 (92.5 ± 21.0 vs. 109.0 ± 28.1 beat/min, p < 0.001, and 37.3 ± 0.8 °C vs. 37.0 ± 0.9 °C, p = 0.011, respectively). Logistic regression analysis identified low initial body temperature, high lactic acid level, and shock index as independent predictors of surgical intervention (p = 0.029, p = 0.027, and p = 0.049, respectively). Regarding the causes of PPH, tone was significantly more prevalent in group 1 (57.2% vs. 35.2%, p = 0.002), whereas trauma was significantly more prevalent in group 2 (24.5% vs. 39.4%, p = 0.030). Group 2 had worse overall outcomes and prognoses than group 1. The subgroup analysis showed significantly higher rates of uterine atony combined with other causes, hysterectomy, and disseminated intravascular coagulopathy in the delayed surgical intervention group than the immediate surgical intervention group (42.2% vs. 69.2%, p = 0.027; 51.1% vs. 73.1%, p = 0.049; and 17.8% vs. 46.2%, p = 0.018, respectively)., Conclusions: Patients with PPH presenting with increased lactic acid levels and shock index and decreased body temperature may be surgical candidates. Additionally, immediate surgical intervention in patients with uterine atony combined with other causes of PPH could improve prognosis and reduce postoperative complications., (© 2024. The Author(s).)

Background/objectives: We investigated the association of plant and animal protein intake with grip strength in Koreans aged ≥ 50 yrs., Subjects/methods: The data was collected from 3,610 men and 4,691 women (≥ 50 yrs) from the 2016-2018 Korea National Health and Nutrition Examination Survey. We calculated the total energy intake, and the intake of animal and plant protein and collected dietary data using 1-day 24-h dietary recalls. Low grip strength (LGS) was defined as the lowest quintile (men: up to 26.8 kg, women: up to 15.7 kg). The association of protein intake with grip strength was examined using Pearson's correlation and multiple linear regression analysis., Results: The results proved that participants with LGS had lower daily energy, protein and fat intake, and percent energy from protein than those with normal or high grip strength ( P < 0.0001). Total energy intake, animal protein, and plant protein were positively associated with grip strength. A higher intake of total plant protein ( P for trend = 0.004 for men, 0.05 for women) and legumes, nuts, and seeds (LNS) protein ( P for trend = 0.01 for men, 0.02 for women) was significantly associated with a lower prevalence of LGS. However, non-LNS plant protein intake was not associated with LGS ( P for trend = 0.10 for men, 0.15 for women). In women, a higher total animal protein intake was significantly associated with decreased LGS ( P for trend = 0.03)., Conclusions: Higher total plant protein and LNS protein intake are negatively associated with LGS., Competing Interests: Conflict of Interest: The authors declare no potential conflicts of interests., (©2023 The Korean Nutrition Society and the Korean Society of Community Nutrition.)

Objectives: The association between long sleep duration and mortality is frequently attributed to the confounding influence of comorbidities. Nevertheless, past efforts to account for comorbidities have yielded inconsistent outcomes. The objective of this study was to evaluate this relationship using a large prospective cohort in Korea., Methods: The study included 114 205 participants from the Health Examinees Study, who were followed for a median of 9.1 years. A composite comorbidity score was developed to summarize the effects of 21 diseases. Using Cox proportional hazards regression, hazard ratios (HRs) and 95% confidence intervals (CIs) for all-cause, cancer, and cardiovascular mortality associated with sleep duration were estimated. These estimates were adjusted for socio-demographic factors, lifestyle factors, body mass index, and comorbidity score. Additionally, a stratified analysis by subgroups with and without comorbidities was conducted., Results: Throughout the follow-up period, 2675 deaths were recorded. After all adjustments, an association was observed between a sleep duration of 8 hours or more and all-cause mortality (HR, 1.10; 95% CI, 1.01 to 1.20). However, no such association was detected in the stratified analysis for the subgroups based on comorbidity status., Conclusions: Long sleep duration was found to be associated with all-cause mortality among Koreans, even after adjusting for comorbidities. Additional studies are required to explore the mechanism underlying the association between sleep duration and major causes of mortality.

Background: Previous studies suggested that metabolic syndrome (MetS) might create a pro-cancer environment and increase cancer incidence. However, evidence on the risk of gastric cancer (GC) was limited. This study aimed to evaluate the association between MetS and its components and GC in the Korean population., Methods: Included were 108,397 individuals who participated in the large-scale prospective cohort study, the Health Examinees-Gem study during 2004-2017. The multivariable Cox proportional was used to estimate hazard ratios (HRs) and 95% confidence intervals (CIs) on the association between MetS and its components with GC risk. Age was used as the time scale in the analyses. The stratified analysis was performed to determine the joint effect of lifestyle factors and MetS on GC risk in different groups., Results: During the mean follow-up of 9.1 years, 759 cases of newly diagnosed cancer (408 men and 351 women) were identified. Overall, participants with MetS had a 26% increased risk of GC than those without MetS (HR 1.26; 95% CI 1.07-1.47); the risk increased with the number of MetS components (p for trend 0.01). Hypertriglyceridemia, low HDL-cholesterol, and hyperglycemia were independently associated with the risk of GC. The potential joint effect of MetS and current smokers (p for interaction 0.02) and obesity (BMI ≥ 25.0) (p for interaction 0.03) in GC., Conclusions: In this prospective cohort study, we found that MetS were associated with an increased risk of GC in the Korean population. Our findings suggest that MetS may be a potentially modifiable risk factor for GC risk., (© 2023. The Author(s) under exclusive licence to The International Gastric Cancer Association and The Japanese Gastric Cancer Association.)

Background: Epidemiological findings on the association between soybean product consumption and gastric cancer risk remain inconsistent. We evaluated the relationship between soybean product consumption and the risk of gastric cancer in a prospective cohort study in Korea., Methods: This prospective cohort study included a total of 139,267 participants aged 40-69 years from the Health Examinees-Gem (HEXA-G) study between 2004 and 2013. Information on cancer diagnosis was retrieved from the Korea Central Cancer Registry until 31 December 2018. Multivariate hazard ratios (HRs) and 95% of confidence intervals (CIs) for the risk of gastric cancer according to the consumption of soybean products were estimated using Cox proportional hazards models., Results: A total of 767 incident cases of gastric cancer occurred over an average follow-up period of 9.21 years. We found that men who consumed two servings per week had 37% lower risk of gastric cancer compared with who consume those who almost never consumed (HR for tofu consumption of more than two servings/week vs. almost never consumed was 0.63 (95% CI 0.45, 0.89); p for trend = 0.04). Among men with a BMI of less than 25 kg/m 2 , increased consumption of soybean paste (p for trend = 0.02) and tofu (HR 0.51 (95% CI 0.32, 0.82 for more than two servings/week vs. almost never consumed); p for trend = 0.01) was associated with decreased risk of gastric cancer., Conclusion: Our results suggest that a high consumption of soybean products has a protective effect against gastric cancer., (© 2023. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany.)

Background & Aims: We conducted a systematic review and meta-analysis of current evidence for the association between food groups, dietary patterns, and breast cancer risk among the Asian population., Methods: This systematic review and meta-analysis followed the Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) guidelines. We performed a systematic literature search up to December 2022 in English in the PubMed, Web of Science, Embase, and Cochrane databases. Risk ratios (RRs) with 95% confidence intervals (CIs) were extracted as effect sizes. Publication bias was estimated by two different funnel plot methods., Results: We collected the data from 15 cohort studies and 34 case-control studies meeting the search criteria. The meta-analysis found that the consumption of fruits and, likewise, vegetables were associated with a 29% lower risk of breast cancer, respectively [RR = 0.71 (0.55, 0.93); RR = 0.71 (0.53, 0.95)]. By contrast, no significance was found between meat, soy foods, and green tea consumption and breast cancer risk (P > 0.05). However, soy protein and isoflavone intake could lower breast cancer risk by 35% and 32%, respectively [RR = 0.65 (0.51, 0.83); RR = 0.68 (0.55, 0.82)]. As for the dietary pattern, high adherence to a healthy dietary pattern and, similarly, to a healthy eating index was associated with a 38% and 51% reduction in breast cancer risk, respectively [RR = 0.62 (0.44, 0.88; RR = 0.49 (0.27, 0.87)], while high adherence to an unhealthy dietary pattern was associated with a 44% increased risk [RR = 1.44 (1.06, 1.96)]. Considering alcohol consumption, a 75% increased risk of breast cancer was found [RR = 1.75 (1.33, 2.30)]., Conclusion: The present meta-analysis found that high intakes of fruits, vegetables, soy protein, and soy isoflavone significantly reduced the risk of breast cancer, while high intake of alcohol had a significantly increased risk. Meat, soy food, and green tea consumption were not significantly associated with breast cancer risk. Considering dietary patterns, high adherence to a healthy eating index and a healthy dietary pattern may reduce breast cancer risk. Conversely, adherence to unhealthy dietary patterns may increase breast cancer risk. However, further studies are needed to confirm the associations between dietary patterns and breast cancer in the Asian population., (Copyright © 2023 Elsevier Ltd and European Society for Clinical Nutrition and Metabolism. All rights reserved.)

Objectives: The purpose of this study was to explore the association between adherence to 2 cancer prevention recommendations and cancer risk., Methods: In total, 104,386 individuals aged 40-69 years old who were recruited between 2004 and 2013 in the Health Examinees-Gem study were included. Adherence scores were constructed based on 8 items from the World Cancer Research Fund/American Institute for Cancer Research (WCRF/AICR) cancer prevention recommendations, including body weight, physical activity, diet, alcohol consumption and breastfeeding, and on 6 items from the Korean cancer prevention guidelines (smoking status, eating vegetables and fruits, salty foods, alcohol intake, physical activity, and body weight). A Cox proportional hazards model was used to estimate the associations between adherence scores and the risk of total and 5 major cancers., Results: The multivariable hazard ratio (HR) for total cancer with the high adherence score versus the lowest score (4.25-7.00 vs. 0.00-3.25) for the WCRF/AICR guidelines was 0.91 (95% confidence interval [CI], 0.82 to 1.00) in men. A reduced breast cancer risk was observed among women with the highest score. Men within the highest category of the Korean cancer prevention guideline score (3.25-6.00) had an HR of 0.80 (95% CI, 0.73 to 0.88) for developing total cancer compared to men within the lowest score (0.00-2.50). The higher adherence group among men showed lower risks of developing stomach, colorectal, and lung cancers., Conclusions: Adhering to guidelines for cancer prevention can help to reduce the risk of developing cancer in Korean men. The association might differ by cancer type and gender.

Coffee and green tea may affect colorectal physiology and contain many bioactive components, such as polyphenol and caffeine, which have antioxidant and anti-carcinogenic activities. However, the association between coffee and green tea consumption and the risk of colorectal cancer (CRC) has been inconclusive. This study examined the association between coffee and green tea consumption and the risk of CRC in a large-scale prospective cohort study in Korea. Data from the Health Examinees study from 2004 to 2013 were analyzed, and 114,243 participants (39,380 men and 74,863 women) aged 40-79 years were included in the final analysis. A Cox proportional hazards regression model using age at time scale was used to estimate hazard ratios (HRs) and 95% confidence intervals (CIs) of coffee and green tea consumption for the risk of CRC by sex. In both men and women, no significant association was found between coffee and green tea consumption and the risk of CRC. Among women, there was a significant increase in the risk of colon cancer (HR, 1.66; 95% CI, 1.13-2.44) in the black coffee drinker group. Our findings suggest that consumption of coffee and green tea may not be associated with the CRC incidence in Korea; instead, the association may differ depending on cancer subsites and coffee types., Competing Interests: CONFLICTS OF INTEREST No potential conflicts of interest were disclosed., (Copyright © 2022 Korean Society of Cancer Prevention.)

Background/objectives: The aim of this study was to examine the validity and reproducibility of a food frequency questionnaire (FFQ) developed in Korea for breast cancer survivors., Subjects/methods: Ninety-nine breast cancer survivors who completed an FFQ twice and three 3-day dietary records (DRs) between 2016-2017 were included. Energy and 14 nutrient intakes were calculated from FFQs and DRs. To determine the validity of the FFQ, energy-adjusted de-attenuated Pearson correlations between two FFQ assessments and the average of the three 3-day DRs were calculated, and to determine reproducibility, energy-adjusted Pearson correlations and degrees of agreement were calculated between the first and second FFQ assessments., Results: Correlation coefficients of validity ranged from 0.29 (protein) to 0.47 (fat) (median value = 0.36) for the FFQ assessment and from 0.20 (riboflavin) to 0.53 (calcium) (median value = 0.37) for the second. Correlation coefficients of reproducibility ranged from 0.22 (sodium) to 0.62 (carbohydrate) (median value = 0.36). Regarding FFQ reproducibilities, percentage classifications of exact agreements for energy-adjusted nutrients ranged from 27.3% (sodium) and 45.5% (fat). A median 76.8% of participants were classified into the same or adjacent quartiles, while a median of 5.6% of participants were classified in extreme quartiles. Bland-Atman plots for the majority of data points of three macronutrients, calcium and vitamins A and C fell within limits of agreement., Conclusions: These results indicated that the newly developed FFQ for Korean breast cancer survivors has acceptable validity and reproducibility as compared with three 3-day DRs collected over a one-year period., Competing Interests: Conflict of Interest: The authors declare no potential conflicts of interests., (©2022 The Korean Nutrition Society and the Korean Society of Community Nutrition.)

The COVID 19 pandemic is far from over, and vaccines remain important tool for fighting the disease. As the preventive effects of the COVID-19 vaccine emerges, it is likely that the perception of importance and safety of vaccines have a positive effect on the acceptance of other vaccines. However, it is still unclear how COVID-19 pandemic has affected the general vaccination perception and acceptance. Therefore, the objective of this study was to investigate the impact of the COVID-19 pandemic on the perception of HPV vaccination. This study involved an offline survey of 161 women aged between 20 and 49 years who visited the gynecologic clinic at Chung-nam National University Sejong Hospital from January 2021 to June 2021. The questionnaire consists of items related to experience and knowledge of COVID-19 and HPV viruses, as well as attitudes toward HPV vaccination. Knowledge about COVID-19 virus and HPV correlated positively with their experiences (P = .011 and P = .045, respectively). Positive attitude was increased, and negative attitude was reduced toward HPV vaccination in the COVID-19 pandemic era. Participants stated that accurate information and cost reduction about HPV vaccine was needed to increase the HPV vaccination rate. During the COVID-19 pandemic era, positive attitudes towards HPV vaccination have tended to increase. To increase the HPV vaccination rate, public efforts are needed for further information and cost reduction., Competing Interests: The authors have no funding and conflicts of interest to disclose., (Copyright © 2022 the Author(s). Published by Wolters Kluwer Health, Inc.)

Epidemiological evidence suggests that hypertension is associated with breast cancer risk. However, previous studies disregard blood pressure components in the healthy population. We aimed to examine the relationship between systolic and diastolic blood pressure and breast cancer risk in a Korean population-based prospective cohort. A total of 73,031 women from the Health Examinees Gem Study were followed from baseline (2004 to 2013) through 2018. Systolic and diastolic blood pressure were measured by trainee physicians at baseline recruitment and then categorized based on the international guidelines for clinical hypertension. Associations between systolic and diastolic blood pressure with overall breast cancer and stratified by premenopausal and postmenopausal status were evaluated using adjusted multivariable Cox proportional hazard regression. A total of 858 breast cancer cases were recorded for a median follow-up period of 9 years. Compared with the normal DBP category (< 85 mmHg), the normal-high category was positively associated with breast cancer risk in postmenopausal women (85-89 mmHg, HR 1.73 95% CI 1.28-2.33), but not in premenopausal women (85-89 mmHg, HR 0.87 95% CI 0.56-1.35). Similar results were found when all cases of self-reported hypertension were excluded. Results for SBP did not show a significant association with breast cancer risk. The association between DBP and breast cancer suggests DBP could be an important factor in cancer prevention, especially for women after menopause. Our study provides a first detailed approach to understanding the importance of diastolic blood pressure for breast cancer prevention and warrants further investigation., (© 2022. The Author(s).)

To evaluate the efficacy and safety of a gonadotropin-releasing hormone (GnRH) agonist for treating large-sized submucosal leiomyoma before hysteroscopic myomectomy. The data were retrospectively collected from patients who underwent a hysteroscopic myomectomy for a submucosal leiomyoma >3.5 cm in size from January 2009 to December 2018. The patients were divided into the GnRH group and the control group according to whether they were pretreated before surgery. A total of 61 patients were included in the study, 31 in the GnRH agonist group and 30 in the control group. At diagnosis, the maximum leiomyoma diameter was similar between the 2 groups (4.67 ± 0.6 cm in the GnRH agonist group vs 3.82 ± 0.6 cm in the control group, P = .061). After pretreatment with the GnRH agonist, the maximum diameter was significantly smaller in the GnRH agonist group compared to the control group (3.82 ± 0.6 vs 4.33 ± 0.8 cm, respectively, P = .004). The leiomyoma volume in the GnRH agonist group decreased by 55.6%, from 41.68 ± 15.7 to 23.19 ± 10.4 cm3, which led to significant differences in leiomyoma volume between the 2 groups (23.19 ± 10.4 cm3 in the GnRH agonist group vs 33.22 ± 24.7 cm3 in the control group, P = .042). The GnRH agonist group showed a shorter operation time (37.7 vs 43.9 minutes, P = .040) and less uterine distention media was used (6800 vs 9373.3 mL, P = .037) compared to the control group. Postoperative complications such as estimated blood loss, remnant leiomyoma, and recurrence were similar between the 2 groups. Treatment with a GnRH agonist before hysteroscopic myomectomy for large submucosal leiomyoma might decrease the volume of the leiomyoma, reduce operation time, and the amount of uterine-distension media used without surgical complications., Competing Interests: The authors have no conflicts of interest to disclose., (Copyright © 2022 the Author(s). Published by Wolters Kluwer Health, Inc.)

Background: The role of serum 25-hydroxyvitamin D [25(OH)D] levels in the development of sarcopenia in non-alcoholic fatty liver disease (NAFLD) remains controversial. We investigated the association between vitamin D levels, occurrence of sarcopenia, NAFLD, and sarcopenia in NAFLD in adults aged >50 years. Methods: This study used data pertaining to 5396 adults aged >50 years (1870 men and 3526 women) from the 2008-2011 Korea National Health and Nutrition Examination Survey. Appendicular skeletal muscle mass adjusted by weight (ASM/Wt) was used to diagnose sarcopenia, and NAFLD was diagnosed using the NAFLD fat score. Results: The lowest quintile of serum 25(OH)D level (4.85-15.26 ng/mL) was associated with an increased occurrence of sarcopenia [odds ratio (OR) 2.65; 95% confidence interval (CI) 1.64-4.27], NAFLD (OR 1.82; 95% CI 1.19-2.96), and sarcopenia in NAFLD (OR 2.25; 95% CI 1.26-4.03) in men. In women, sarcopenia (OR 1.80; 95% CI 1.29-2.51) was also significantly associated with serum vitamin D levels, whereas high levels of vitamin D were not significantly related to NAFLD. Conclusions: Serum vitamin D levels are associated with sarcopenia, NAFLD, and sarcopenia in NAFLD. Vitamin D level can be a useful marker of sarcopenia and NAFLD, especially in men.

Objective: Epidemiological studies indicate that alcohol increases gastric cancer (GC) risk, yet most studies have focused on heavy alcohol intake, leaving other factors understudied. A comprehensive investigation of the effects of the frequency and amount of alcohol intake may help elucidate the GC risk associated with drinking behavior., Methods: The Health Examinees-Gem (HEXA-G) study, a community-based large-scale prospective cohort study, enrolled Korean adults 40-69 years of age between the years 2004 and 2013. Incident GC cases were identified through linkage to Korea Central Cancer Registry data until December 31, 2017. Self-reported questionnaires were used to survey alcohol consumption-related factors (duration, frequency, amount, and type of alcoholic beverages). The frequency and amount of alcohol consumption were combined to explore GC risk according to 4 drinking patterns: "infrequent-light", "frequent-light", "infrequent-heavy", and "frequent-heavy". We used Cox proportional hazard models to estimate the adjusted hazard ratios (HRs) and 95% confidence intervals (CIs), and investigate the relationship between alcohol intake and GC incidence., Results: A total of 128,218 participants were included in the analysis. During an average follow-up period of 8.6 years, 462 men and 385 women were diagnosed with GC. In men, current drinkers showed a 31% greater risk of GC than non-drinkers (HR 1.31, 95% CI 1.03-1.66), whereas no significant association was observed in women. In men, GC risk was associated with a higher frequency ( P trend 0.02) and dose of ethanol intake in grams ( P trend 0.03). In men, the "frequent-light" (≥5 times/week and <40 g ethanol/day) drinking pattern was associated with a 46% greater risk of GC (HR 1.46, 95% CI 1.02-2.07) than the "infrequent-light" pattern (<5 times/week and <40 g ethanol/day)., Conclusions: This study suggests that frequent intake of alcohol, even in low quantities per session, increases GC risk. Further research is warranted to evaluate the relationship between alcohol and GC in detail., Competing Interests: No potential conflicts of interest are disclosed., (Copyright © 2022 Cancer Biology & Medicine.)

Emerging evidence has indicated a possible link between obesity in early life with subsequent cancer risks, but its association with gastric cancer remains unknown. This study aimed to investigate the association of obesity at ages 18-20 and 35 with the later risk of gastric cancer among the Korean population. Included were 122,724 individuals who participated in the large-scale prospective cohort study, the Health Examinees-Gem (HEXA-G) study, during 2004-2017. Multivariable Cox proportional hazards models were used to estimate hazard ratios (HR) and 95% confidence intervals (CI) for gastric cancer risk associated with body mass index (BMI) at ages 18-20 and 35 years. During a mean follow-up period of 8.6±2.1 years, a total 927 gastric cancer cases (531 men and 396 women) were identified. When compared to normal BMI (18.5-23.0 kg/m2), obesity (BMI ≥30 kg/m2) at age 35 was significantly associated with increased risk of gastric cancer later in life among total participants (HR 1.94, 95% CI 1.26-2.97, p 0.01). When analyzed separately by sex, obesity at 35 years of age was significantly associated with increased risk of gastric cancer among both men (HR 1.79, 95% CI 1.02-3.13, p 0.05) and women (HR 2.35, 95% CI 1.21-4.60, p 0.02). No significant associations were found for obesity at late adolescence in both men and women. Our findings suggest that obesity in early adulthood may be associated with an increased risk of gastric cancer. The results may aid in understanding the etiology of GC in a population with a divergent trend of gastric cancer., Competing Interests: The authors have declared that no competing interests exist.

Background: The association between sarcopenia and protein intake has been well studied. However, limited data are available on the association between sarcopenia and protein intake in people with nonalcoholic fatty liver disease (NAFLD). This study aimed to investigate the association between protein intake and sarcopenia among elderly participants with NAFLD using the Korea National Health and Nutrition Examination Survey (KNHANES). Methods: Data of 4179 participants (1576 men and 2603 women, age ≥60 years) who participated in the KNHANES during 2008-2011 were obtained. Sarcopenia was defined as appendicular skeletal muscle mass/wt (%) of 1 standard deviation below the gender-specific mean for healthy adults and NAFLD as liver fat score using the fatty liver prediction models. According to their daily protein intake, participants were grouped into the high protein intake group (>1.2 g/kg/day), middle protein intake group (0.8-1.2 g/kg/day), and low protein intake group (<0.8 g/kg/day). Generalized linear models and logistic regression models were used. Results: The overall prevalence of sarcopenia in participants with NAFLD was 16.53%. Compared with the highest protein intake group, the low protein intake group had a significantly higher risk of sarcopenia (adjustment odds ratio = 1.707; 95% confidence interval = 1.009-2.886). In the fully adjusted model, the highest protein intake group had significantly lower levels of insulin, total body fat, vitamin B, and fat intake, whereas muscle proportions, energy, carbohydrates, vitamin A, and vitamin C intake of high protein intake participants were significantly higher than other groups. Conclusion: The prevalence of sarcopenia and sarcopenia-related factors were significantly lower in NAFLD elderly participants with high protein intake. These results suggest that high protein intake can help prevent and manage sarcopenia in people with NAFLD.

Background: It is still uncertain whether food insecurity increases the risk of metabolic syndrome. Recent reports from the United States and developing countries have shown conflicting results on this issue. This study aimed to investigate the association between food security status and metabolic syndrome in Korean adults. Methods: We performed a nationwide population study using data for 18,782 adults obtained from the 2012 to 2015 Korean National Health and Nutrition Examination Surveys. The 18-item Food Security Survey Module was utilized to assess household food security status. We used multiple logistic regression models to determine the association between food security status and metabolic syndrome. Results: The overall prevalence of food insecurity was 8.2% and that of metabolic syndrome was 27.3%. The prevalences of metabolic syndrome were 26.2%, 32.3%, 30.2%, and 28.8% in the high, marginal, low, and very low food security groups, respectively. Food-insecure participants (participants in the low food security and very low food security groups) were significantly more likely to be female, divorced/widowed/separated, and current smokers compared to food-secure participants. Food-insecure participants also had lower incomes, lower education attainments, and lower physical activities ( P  < 0.05). Compared with the high food security group, the marginal (odds ratio [OR]: 1.34, 95% confidence interval [95% CI]: 1.19-1.50, P  < 0.001) and low food security groups (OR: 1.22, 95% CI: 1.04-1.42, P  = 0.01) had increased odds of metabolic syndrome in the unadjusted models. However, after controlling for covariates, including age, sex, marital status, education attainment, household income, smoking, alcohol intake, and physical activity, neither marginal food security (adjusted odds ratio [aOR]: 1.02, 95% CI: 0.87-1.19, P  = 0.86) nor low food security (aOR: 0.88, 95% CI: 0.71-1.08, P  = 0.22) was significantly associated with an increased risk of metabolic syndrome. Conclusions: Contrary to a prior report from the United States, food security status was not significantly associated with the risk of metabolic syndrome in Korean adults.

Although a number of studies explain the association between dietary patterns, which take into account that foods are eaten in combination, and breast cancer risk, the findings are inconsistent. We examined the association between dietary patterns and multi-grain rice intake, and the risk of breast cancer in a large-scale prospective cohort study in Korean women. A total of 93,306 women aged 40-69 years from the Health Examinees-Gem (HEXA-G) study (2004 and 2013) were included. We obtained Information on cancer diagnosis via linkage to the Korea Central Cancer Registry. Factor analysis was conducted to obtain dietary patterns, and Cox proportional models were used to estimate the hazard ratios (HRs) and 95% confidence intervals (95% CI) for breast cancer risk. For 494,490 person-years, 359 new cases of breast cancer occurred. We identified three major dietary patterns, that explained 23.9% of the total variance based on daily total food intake (g/day) from 37 food groups: the meat dietary pattern (higher intake of bread and red meat), the white rice dietary pattern (higher intake of white rice and lower intake of multi-grain rice), and the other pattern. Women who had higher white rice dietary pattern scores had a 35% higher risk of breast cancer, than did women with lower white rice dietary pattern scores (multivariable HR 1.35; 95% CI 1.00-1.84 for the highest vs. lowest quartile of the white rice dietary pattern scores, p for trend = 0.0384). We found that women who consumed three or more servings of multi-grain rice per day had 33% lower risk of breast cancer than did those who consumed one or less multi-grain rice serving per day among women under 50 years of age (multivariable HR 0.67; 95% CI 0.45-0.99, p for trend = 0.0204). Our study suggests that a multi-grain rice diet may be associated with lower risk of breast cancer in Korean women.

Background: While both food insecurity and depression have been reported to be closely related to sex and marital status, the impact of sex and marital status on the prevalence of perceived depression in association with food security status has not been evaluated., Materials & Methods: We performed a nationwide population study using data for 19,866 adults obtained from the 2012-2015 Korean National Health and Nutrition Examination Surveys. Household food insecurity status was evaluated using the 18-item Food Security Survey Module. Perceived depression was measured using one item questionnaire or the 9-item Patient Health Questionnaire (PHQ-9). We cross-sectionally analyzed associations between perceived depression and variables, including socio-demographic factors and food security status. The prevalence of perceived depression was compared according to sex, marital status, and food security status. We applied survey sampling weights in all analyses., Results: The overall prevalence of perceived depression was 10.5%. Prevalence rates of perceived depression in the high food security group, marginal food security group, low food security group, and very low food security group were 8.9%, 13.6%, 19.7%, and 35.0%, respectively (P < 0.001). Of total participants, 1.8% were categorized as having both perceived depression and food insecurity. After adjusting for confounding covariates, female sex (adjusted odds ratio [aOR]; 2.37), never married (aOR; 1.37), divorced/widowed/separated (aOR; 1.50), low food security (aOR; 1.72), and very low food security (aOR; 3.65) were associated with increased risk of perceived depression. Men with very low food security and divorced/widowed/separated status were most likely to have perceived depression (53.2%), followed by women with very low food security and divorced/widowed/separated status (48.7%), women with very low food security and married status (42.0%), and women with low food security and divorced/widowed/separated status (33.3%)., Conclusions: Female sex and marital status of divorced/widowed/separated were strongly associated with perceived depression. These two factors and food insecurity synergistically contributed to perceived depression., Competing Interests: The authors have declared that no competing interests exist.

Background: Soybean food consumption has been considered as a possible way to lower incidence of cardiometabolic syndrome (CMS) among Asians. However, results from studies investigating its efficacy on CMS in Asians have been inconsistent., Methods: We analyzed the association between soybean intake frequency and prevalence of CMS based on data from the Korea National Health and Nutrition Examination Survey 2007 to 2011. Data of 9,287 women aged 20 to 64 years were analyzed. Food frequency questionnaire was used to assess soybean food consumption frequency. General linear model and multivariable logistic regression model were used to examine the association of soybean intake quintile with CMS and its risk factors. Least square means of metabolic factors mostly showed no significant relevance except liver indexes., Results: Compared to participants in the 1st quintile (<2 times/week of soybean food), odds ratios (OR) for CMS and abdominal obesity (AO) in the 4th quintile (8.5 times/week17 times/week and CMS varied depending on soybean food items., Competing Interests: No potential conflict of interest relevant to this article was reported., (Copyright © 2020 Korean Diabetes Association.)

Epidemiologic studies regarding breast cancer risk related to milk consumption remain controversial. The aim of this study was to evaluate the association between milk consumption and the risk for breast cancer. A total of 93,306 participants, aged 40-69 years, were included in the prospective cohort study in the Health Examinees-Gem (HEXA-G) study between 2004 and 2013. Dietary intake was assessed using a validated food frequency questionnaire. Information on cancer diagnosis in the eligible cohort was retrieved from the Korea Central Cancer Registry through 31 December 2014. The Cox proportional hazards model was used to estimate multivariate hazard ratios (HRs) and 95% confidence intervals (CIs). A total of 359 breast cancer cases were observed over a median follow-up period of 6.3 years. Milk consumption was not associated with decreased risk for breast cancer in the total population ( p for trend = 0.0687). In women under 50 years of age, however, milk consumption was inversely associated with breast cancer risk. In the comparison between highest (≥1 serving/day) and lowest (<1 serving/week) intake categories of milk, the multivariate HR (95% CI) was 0.58 (0.35-0.97, p for trend = 0.0195)) among women under 50 years of age. In conclusion, our findings show that milk consumption in Korean women aged 50 or younger is associated with a decreased risk for breast cancer, when compared to those who never or rarely consumed milk. Further studies need to be conducted to assess this relationship and confirm these results.

An efficient transition-metal-free protocol for the hydroboration of aldehydes and ketones (reduction) was developed. The hydroboration of a wide range of aldehydes and ketones with pinacolborane (HBpin) under the K 2 CO 3 catalyst has been studied. The reaction system is practical and reliable and proceeds under extremely mild and operationally simple conditions. No prior preparation of the complex metal catalyst was required, and hydroboration occurred stoichiometrically. Further, the chemoselective reduction of aldehydes over ketones was carried out. Moreover, we demonstrated the use of K 2 CO 3 as an efficient catalyst for the hydroboration of alkenes. The operational simplicity, inexpensive and transition-metal-free catalyst, and the applicability to gram-scale synthesis strengthen its potential applications for hydroboration (reduction) at an industrial scale., Competing Interests: The authors declare no competing financial interest., (Copyright © 2019 American Chemical Society.)

Here we developed a highly efficient alkene hydroboration protocol, showing that various alkyl boronates can be smoothly obtained in good yields by reacting alkenes with pinacolborane (HBpin) in the presence of 5 mol% lithium diisobutyl- tert -butoxyaluminum hydride. The coordination of aluminate ions with lithium cations allowed for effective hydride transfer during hydroboration, and the obtained boronate ester was further used for C-C coupling, trifluoroboronate salt formation, and oxidation to alcohol., Competing Interests: There are no conflicts to declare., (This journal is © The Royal Society of Chemistry.)

We identified demographic, lifestyle, and clinical factors associated with vitamin D status among breast cancer survivors. The vitamin D prediction model may be a useful surrogate of circulating 25-hydroxvitamin D (25(OH)D) concentrations when this measure was not available. We included a total of 216 Korean breast cancer survivors aged 21-79 years who had been diagnosed with stage I to III primary breast cancer and had breast cancer surgery at least 6 months before enrolment. We used linear and logistic regressions to identify determinants for the plasma 25(OH)D concentrations and vitamin D insufficiency (plasma 25(OH)D concentration < 50 nmol/L). We observed that 48.85% of breast cancer survivors had a plasma 25(OH)D concentration less than 50 nmol/L. We identified the following determinants for plasma 25(OH)D concentrations: time since diagnosis (β = -0.005 for 1 month increment), supplementary vitamin D intake (β = 0.06 for 10 μg/day increment), season of the blood draw (β = 0.35 for summer; β = 0.32 for fall; β = 0.26 for winter vs. spring), smoking status (β = 0.28 for former vs. never), use of any supplement (β = -0.35 for non-use vs. use), and the parity number (β = -0.30 for three or more vs. one) were associated with the plasma 25(OH)D concentrations. In addition to the aforementioned variables, body mass index (BMI) was associated with the prevalence of vitamin D insufficiency. We identified the determinants for the plasma 25(OH)D concentrations among Korean breast cancer survivors. Future studies are needed to investigate the role of vitamin D in the progression of breast cancer among Korean breast cancer survivors., Competing Interests: All authors declare that there are no competing interests.

Background: The effect of the addition of hydroxypropyl methylcellulose (HPMC) on the textural properties of low-fat tofu was investigated. Three fat levels (240, 100 and 30 g kg -1 ) were used to make tofu, which were identified as C (full-fat tofu), L1 and L2. HPMC (5 g kg -1 ) was added to soymilk to prepare control and low-fat tofu, designated as CH, L1H and L2H., Results: Soymilk with a lower fat level had a lower viscosity: 143 (C), 100 (L1) and 42 (L2) cP. The addition of HPMC increased the viscosity of all types of soymilk, particularly in L2H (107 cP). With fat reduction, tofu syneresis increased from 19% (C) to 29% (L2), although syneresis of L2H recovered to 19%, which is similar to high-fat control tofu. Decreased fat resulted in a lower firmness in L2 (0.67 N) compared to control (0.78 N). Firmness increased to 1.08 N in L2H tofu, whereas the firmness of CH tofu was 0.63 N. All types of tofu showed a denser, well-connected and cross-linking structure when HPMC was added, especially in L2H tofu., Conclusion: HPMC improved the texture of the low-fat tofu by creating a harder texture and reducing syneresis. HPMC is an effective fat replacer for lower fat soymilk. © 2017 Society of Chemical Industry., (© 2017 Society of Chemical Industry.)

Background: The quality of life for breast cancer survivors has become increasingly important because of their high survival rate and prolonged life expectancy. The purpose of this study was to examine the association of physical activity following diagnosis and health-related quality of life (HRQOL) in breast cancer survivors., Methods: We conducted a cross-sectional study of breast cancer survivors. A total of 231 women aged 21-78 years who had been diagnosed with stages I to III breast cancer and had breast cancer surgery at least 6 months prior were recruited from three hospitals between September 2012 and April 2015 and were included in this study. We asked participants about their HRQOL and engagement in physical activity using structured questionnaires. We examined the association between HRQOL levels and physical activity using a generalized linear model., Results: Breast cancer survivors in the high physical activity group (3rd tertile) were more likely to have lower scores for fatigue (p for trend = 0.001) and pain (p for trend = 0.02) and higher scores for sexual function (p for trend = 0.007) than those in the low physical activity group (1st tertile). When we stratified participants by stage, we found increasing scores for physical functioning (p for trend =0.01) and decreasing scores for fatigue (p for trend = 0.02) with increasing levels of physical activity in breast cancer survivors with stage I breast cancer. In survivors with stages II and III, we found statistically significant associations with fatigue (p for trend = 0.02) and sexual functioning (p for trend = 0.001)., Conclusions: In conclusion, engagement in physical activity was related to better health-related quality of life among breast cancer survivors. Our findings may warrant further prospective and intervention studies to support the benefit of physical activity in improving the quality of life and survival of Korean breast cancer survivors.

Diet may play an important role in breast cancer recurrence or survival, and therefore assessment of long-term diet among breast cancer survivors is important in breast cancer survivorship research. Given that the diet of breast cancer survivors may differ from that of the general population, the use of a FFQ specific to this group may be needed. The objective of this study was to develop a FFQ for breast cancer survivors, the most commonly used tool to measure long-term dietary patterns in nutritional epidemiological studies. We collected information on the foods and amounts of foods consumed using 3-d dietary records from a total of 192 women who had been diagnosed with stage I-III breast cancers and had undergone breast cancer surgery at least 6 months before the baseline study. A total of 1254 foods and dishes consumed were re-grouped by the similarity of the main ingredients and/or serving units, and several dishes commonly consumed among the Korean population were added. After we performed contribution analyses and variability analyses to detect between-person variation for selected nutrients, we listed a total of 123 foods and dishes for the FFQ specific to breast cancer survivors. Our breast cancer survivor-specific FFQ can be used to estimate long-term dietary intake and to examine its association with breast cancer prognosis in epidemiological studies of breast cancer in Korea.

Liquid electrolytes composed of lithium salt in a mixture of organic solvents have been widely used for lithium-ion batteries. However, the high flammability of the organic solvents can lead to thermal runaway and explosions if the system is accidentally subjected to a short circuit or experiences local overheating. In this work, a cross-linked composite gel polymer electrolyte was prepared and applied to lithium-ion polymer cells as a safer and more reliable electrolyte. Mesoporous SiO2 nanoparticles containing reactive methacrylate groups as cross-linking sites were synthesized and dispersed into the fibrous polyacrylonitrile membrane. They directly reacted with gel electrolyte precursors containing tri(ethylene glycol) diacrylate, resulting in the formation of a cross-linked composite gel polymer electrolyte with high ionic conductivity and favorable interfacial characteristics. The mesoporous SiO2 particles also served as HF scavengers to reduce the HF content in the electrolyte at high temperature. As a result, the cycling performance of the lithium-ion polymer cells with cross-linked composite gel polymer electrolytes employing methacrylate-functionalized mesoporous SiO2 nanoparticles was remarkably improved at elevated temperatures.

The enhanced stability of lithium metal is vital to the development of high energy density lithium batteries due to its higher specific capacity and low redox potential. Herein, we demonstrate that nitrogen and sulfur codoped graphene (NSG) nanosheets coated on a polyethylene separator stabilized the lithium electrode in lithium metal batteries by effectively suppressing dendrite growth and maintaining a uniform ionic flux on the metal surface. The ultrathin layer of NSG nanosheets also improved the dimensional stability of the polymer separator at elevated temperatures. In addition, the enhanced interfacial interaction between the NSG-coated separator and lithium metal via electrostatic attraction released the surface tension of lithium metal and suppressed the initiation of dendrite growth on lithium metal. As a result, the electrochemical performance of a lithium metal cell composed of a LiNi0.8Co0.15Al0.05O2 positive electrode with an NSG-coated separator was remarkably improved as compared to the cell with an uncoated polyethylene separator.

We demonstrate the effectiveness of dual-layer coating of cathode active materials for improving the cycling performance and thermal stability of lithium-ion cells. Layered nickel-rich LiNi0.6Co0.2Mn0.2O2 cathode material was synthesized and double-layer coated with alumina nanoparticles and poly(3,4-ethylenedioxythiophene)-co-poly(ethylene glycol). The lithium-ion cells assembled with a graphite negative electrode and a double-layer-coated LiNi0.6Co0.2Mn0.2O2 positive electrode exhibited high discharge capacity, good cycling stability, and improved rate capability. The protective double layer formed on the surface of LiNi0.6Co0.2Mn0.2O2 materials effectively inhibited the dissolution of Ni, Co, and Mn metals from cathode active materials and improved thermal stability by suppressing direct contact between electrolyte solution and delithiated Li(1-x)Ni0.6Co0.2Mn0.2O2 materials. This effective design strategy can be adopted to enhance the cycling performance and thermal stability of other layered nickel-rich cathode materials used in lithium-ion batteries.

Background: Tofu made from low-fat soy flour is a nutritional food for consumers and economically benefits the food processor. However, low-fat tofu has poor textural quality, especially insufficient firmness. Stepwise heating (heating at 75 °C, followed by holding at 95 °C) of full-fat soymilk increases gel properties. Therefore we evaluated the two-step heating of low-fat soymilk to improve tofu texture., Results: The denaturation enthalpy and temperature of β-conglycinin and glycinin were higher in low-fat tofu compared to high-fat tofu. The viscosity of low-fat soymilk and texture of tofu by one-step heating were weaker than full-fat soymilk and tofu. However, the two-step heating increased free sulfhydryl groups and viscosity of low-fat soymilk to a value higher or similar to conventional soymilk. The syneresis of low-fat tofu was reduced about 30% and hardness was higher (131.0 N) by the two-step process compared to one-step heating of full-fat tofu (101.4 N) by the one-step process. The microstructure of low-fat tofu became finer, denser and more homogeneous by the two-step heat process., Conclusion: Low-fat tofu produced by denaturing the two major soy proteins separately had improved textural qualities similar to full-fat tofu as a result of increased hydrophobic interactions between denatured protein molecules., (© 2014 Society of Chemical Industry.)

Objective: To explore a) the relationship between parents'/guardians' dental anxiety and oral health literacy and b) those between these variables and background and oral health-related characteristics., Methods: Survey data were collected from 187 parents/guardians (81% female; average age 37 years). Dental anxiety was measured with the Dental Anxiety Scale - Revised (DAS-R) and oral health literacy with the Rapid Estimate of Adult Literacy in Dentistry (REALD-30). Children's dental charts were reviewed to collect information about their dental treatment., Results: DAS-R and REALD-30 scores were correlated (r = -0.22; P = 0.003). A multivariate regression model with DAS-R score as the dependent variable showed that the DAS-R score has a significant multivariate association with REALD-30, oral health, income, and presence of fillings., Conclusions: Dental anxiety and oral health literacy are related. However, DAS score has a significant multivariate association with the four variables REALD-30 score, oral health, income, and presence of fillings. These findings show that among socioeconomically disadvantaged patients, the contributors to poor oral health are interrelated and multidetermined and include poor oral health literacy and dental anxiety. The public health message is that in order to improve the overall oral health of socioeconomically disadvantaged patients, public health stakeholders need to consider how to communicate with these patients effectively and how to reduce dental anxiety. Gaining a better understanding of how to communicate with parents a) at an appropriate literacy level and b) in a way that it reduces dental anxiety is therefore crucial., (© 2013 American Association of Public Health Dentistry.)

LiNi0.6Co0.2Mn0.2O2 cathode materials were surface-modified by coating with a dual conductive poly(3,4-ethylenedioxythiophene)-co-poly(ethylene glycol) (PEDOT-co-PEG) copolymer, and their resulting electrochemical properties were investigated. The surface-modified LiNi0.6Co0.2Mn0.2O2 cathode material exhibited a high discharge capacity and good high rate performance due to enhanced transport of Li(+) ions as well as electrons. The presence of a protective conducting polymer layer formed on the cathode also suppressed the growth of a resistive layer and inhibited the dissolution of transition metals from the active cathode materials, which resulted in more stable cycling characteristics than the pristine LiNi0.6Co0.2Mn0.2O2 cathode material at 55 (o)C.

There are various causes to a low level of consciousness in patients in the intensive care unit. Neurological injury, infection, and metabolic disarray are considered as some of the causes. A 39 year-old female patient was transferred to our hospital with septic shock due to ascending colon perforation. The patient had previously received ovarian cancer surgery and a cycle of chemotherapy at another hospital. Emergent operation for colon perforation was successful. After the operation, she was treated in the intensive care unit for infectious and pulmonary complications. She suddenly showed deterioration in her level of consciousness and had a generalized seizure. At the time of her seizure, she had severe hyperammonemia. Brain CT showed severe cerebral edema that was absent in the CT scan taken 2 days before. Continuous renal replacement therapy was conducted but was ineffective in lowering the level of serum ammonia and the patient subsequently died.

Background: Gabapentin is a safe and well-tolerated anticonvulsant with a wide therapeutic index, and it is used for neuropathic pain. The aim of this study was to compare previous dosing methods with the administration of four different doses of gabapentin while maintaining the same maximum daily dose for the safe administration of high doses of the medication., Methods: THE SUBJECTS WERE OUTPATIENTS WITH VARIOUS NEUROPATHIC PAIN SYNDROMES, WITH AT LEAST TWO OF THE FOLLOWING SYMPTOMS: allodynia, burning pain, shooting pain, or hyperalgesia. The TID group received equal doses of gabapentin 3 times per day, while the QID group received 4 different doses of gabapentin per day. The pain score, frequency of breakthrough pain (BTP), severity and the duration of pain, sleep disturbance due to nocturnal pain, and adverse effects were recorded each day., Results: The average daily pain score and sleep disturbance were significantly reduced in the QID group between days 3 and 10 of the experiment. The adverse effects of the medication were also reduced in the QID group. However, the frequency of BTP and severity and duration of pain were not significantly different between two groups., Conclusions: Administration of 4 different doses of gabapentin during the initial titration in outpatients with neuropathic pain resulted in a significant reduction in awakening from breakthrough pain and a reduction in the adverse effects of the medication.

A hybrid composite membrane is prepared by coating nano-sized Al2O3 powder (13 and 50 nm) and poly(vinylidene fluoride-co-hexafluoropropene) (P(VdF-co-HFP)) binder on both sides of polyethylene separator. The composite membrane shows better thermal stability and improved wettability for organic liquid electrolyte than polyethylene separator, due to the presence of heat-resistant Al2O3 particles with high-surface area in the coating layer. By using the composite membrane, the lithium-ion cells composed of carbon anode and LiNi1/3Co1/3Mn1/3O2 cathode are assembled and their cycling performances are evaluated. The cells assembled with the composite membranes are proven to have better capacity retention than the cell prepared with polyethylene separator, due to the enhanced ability to retain the electrolyte solution in the cell. The cell assembled with the composite membrane containing 13 nm-sized Al2O3 particles has an initial discharge capacity of 173.2 mA h g(-1) with good capacity retention.

Thymidine nucleotides are required for faithful DNA synthesis and repair, and their de novo biosynthesis is regulated by serine hydroxymethyltransferase 1 (SHMT1). The SHMT1 transcript contains a heavy chain ferritin, heterogeneous nuclear ribonucleoprotein H2, and CUG-binding protein 1-responsive internal ribosome entry site (IRES) that regulates SHMT1 translation. In this study a non-lethal dose of UVC is shown to increase SHMT1 IRES activity and protein levels in four different cell lines. The mechanism for the UV-induced activation of the SHMT1 IRES involves an increase in heavy chain ferritin and heterogeneous nuclear ribonucleoprotein H2 expression and the translocation of CUG-binding protein 1 from the nucleus to the cytoplasm. The UV-induced increase in SHMT1 translation is accompanied by an increase in the small ubiquitin-like modifier-dependent nuclear localization of the de novo thymidylate biosynthesis pathway and a decrease in DNA strand breaks, indicating a role for SHMT1 and nuclear folate metabolism in DNA repair.

A critical feature of Mycobacterium tuberculosis, the causative agent of human tuberculosis (TB), is its ability to survive and multiply within macrophages, making these host cells an ideal niche for persisting microbes. Killing the intracellular tubercle bacilli is a key requirement for efficient tuberculosis treatment, yet identifying potent inhibitors has been hampered by labor-intensive techniques and lack of validated targets. Here, we present the development of a phenotypic cell-based assay that uses automated confocal fluorescence microscopy for high throughput screening of chemicals that interfere with the replication of M. tuberculosis within macrophages. Screening a library of 57,000 small molecules led to the identification of 135 active compounds with potent intracellular anti-mycobacterial efficacy and no host cell toxicity. Among these, the dinitrobenzamide derivatives (DNB) showed high activity against M. tuberculosis, including extensively drug resistant (XDR) strains. More importantly, we demonstrate that incubation of M. tuberculosis with DNB inhibited the formation of both lipoarabinomannan and arabinogalactan, attributable to the inhibition of decaprenyl-phospho-arabinose synthesis catalyzed by the decaprenyl-phosphoribose 2' epimerase DprE1/DprE2. Inhibition of this new target will likely contribute to new therapeutic solutions against emerging XDR-TB. Beyond validating the high throughput/content screening approach, our results open new avenues for finding the next generation of antimicrobials.

Tanikolide seco-acid 2 and tanikolide dimer 3, the latter a novel and selective SIRT2 inhibitor, were isolated from the Madagascar marine cyanobacterium Lyngbya majuscula. The structure of 2, isolated as the pure R enantiomer, was elucidated by X-ray experiment in conjunction with NMR and optical rotation data, whereas the depside molecular structure of 3 was initially thought to be a meso compound as established by NMR, MS, and chiral HPLC analyses. Subsequent total synthesis of the three tanikolide dimer stereoisomers 4, 5, and ent-5, followed by chiral GC-MS comparisons with the natural product, showed it to be exclusively the R,R-isomer 5. Tanikolide dimer 3 (= 5) inhibited SIRT2 with an IC(50) = 176 nM in one assay format and 2.4 microM in another. Stereochemical determination of symmetrical dimers such as compound 3 pose intriguing and subtle questions in structure elucidation and, as shown in the current work, are perhaps best answered in conjunction with total synthesis.

The total synthesis of (-)-amphidinolide E was accomplished by following a synthetic scheme that incorporates the labile C2 stereocenter at a very late stage. The oxolane unit was prepared by beta-alkoxyacrylate radical cyclization. The enyne metathesis reaction was employed for the synthesis of the side chain. The Kocienski-Julia reaction was used for the union of the two major fragments, and the Kita macrolactonization protocol was used for macrolide synthesis.