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Analyzing Usage of the Metaverse by Associations of Patients With Prostate Cancer During the 2023 Blue Ribbon Campaign: Cross-Sectional Survey Study
No full textBACKGROUND: It is important to explain early diagnosis and treatment plans to patients of prostate cancer due to the different stages that diagnosis is made at and the corresponding stage-specific treatment options, as well as the varying prognoses depending on the choices made. Although various studies have implemented metaverse-based interventions across diverse clinical settings for medical education, there is a lack of publications addressing the implementation and validation of patient education using this technology. OBJECTIVE: This study explored the potential of the metaverse as an educational and informational tool for prostate cancer. We measured and analyzed participants' satisfaction and perceptions following a metaverse-based prostate cancer awareness campaign. We also evaluated the feasibility and potential effectiveness of the metaverse as a platform for hosting a virtual patient association and delivering health education. METHODS: The study was conducted via a questionnaire administered from September 15 to October 20, 2023, during the Blue Ribbon Campaign organized by the Korean Urological Association and the Korean Society of Urological Oncology. The postevent questionnaire was designed to assess the effectiveness of using the metaverse to increase awareness of prostate cancer. A total of 119 participants, including patients, caregivers, and members of the general population, completed the survey within the metaverse space and assessed their satisfaction and perceived awareness using a 5-point Likert scale. RESULTS: The mean educational satisfaction score was 4.17 (SD 0.65), the mean psychological satisfaction score was 4.06 (SD 0.70), the mean overall satisfaction score was 4.12 (SD 0.72), and the mean awareness score was 4.09 (SD 0.72) out of a possible 5 points. Among responses rated 4 or higher ("agree" or "strongly agree"), 82.8% (394/476) were in the educational aspect, 76.6% (365/476) in psychological satisfaction, 81% (289/357) in overall satisfaction, and 80.4% (287/357) in awareness. Statistical analysis revealed significant differences in psychological (median 4.0, IQR 3.50-4.63, vs median 4.50, IQR 4.0-4.56) and overall (median 4.0, IQR 3.67-4.83, vs median 4.33, IQR 4.0-4.67) aspects between the general population group and patients and caregivers (median 4.0, IQR 3.33-4.33, vs median 4.67, IQR 4.0-4.67). CONCLUSIONS: The findings suggest that the metaverse holds promise as a platform for health care education and patient support, offering accessible and engaging experiences for patients, caregivers, and members of the general population. Our approach demonstrated a positive influence on participants' satisfaction and perceived awareness, highlighting its potential to enhance health communication and patient engagement. Despite these encouraging results, limitations, such as the sample being skewed toward younger participants and reliance on self-reported data, underscore the need for more rigorous and multidimensional assessment strategies. Future studies should incorporate objective knowledge assessments, behavioral follow-ups, and qualitative methods to better evaluate the intervention's effectiveness. This study provides early evidence that metaverse-based interventions can support disease awareness and promote preventive health behaviors, contributing to the ongoing evolution of digital health education
Cryopreservation of Bulk-Produced Primary Rat Oligodendrocyte Progenitor Cells
No full textPrimary oligodendrocyte cultures are a crucial driving force for in vitro research on oligodendrocytes (OLs) and myelin. Various methods are available to obtain oligodendrocyte lineage cells, primarily from neonatal rodent brains or human induced pluripotent stem cells (iPSCs). In this protocol, we describe a step-by-step procedure for detaching and cryopreserving primary rat oligodendrocyte progenitor cells (OPCs), followed by the thawing, proliferation, and differentiation of the cryopreserved OPCs. After freezing in a serum-free cryopreservation medium, the OPCs can be preserved at -80 °C for up to two months without notable changes in viability, proliferation, or differentiation into mature OLs. Cryopreserved OPCs can be differentiated into mature OLs with robust myelin processes and the capacity to wrap around neuron-mimicking structures. Combined with the author’s method for primary OL culture, which allows for bulk production of OPCs, OPC cryopreservation may substantially improve the efficiency of in vitro OL research
Relationship between multiple unemployment spells and cardiovascular disease mortality in South Korean workers
No full textBACKGROUND: It is necessary to explore the health problems of vulnerable workers who experience repeated unemployment spells. The number of unemployment spells should be considered in the relationship between unemployment and cardiovascular disease (CVD) mortality. Using nationwide data, we aimed to investigate the relationship between unemployment and CVD mortality and examine whether this effect varies depending on the number of unemployment spells. METHODS: Using data from Statistics Korea and employment insurance databases from 2018 to 2019, we identified an average of 1387 CVD deaths per year among 7.76 million workers who had at least one employment record prior to their death. The number of unemployment spells was calculated based on the employment history over the past 5 years. Crude mortality rates per 100 000 individuals and age-standardised mortality rates (SMRs) and sex-SMRs were calculated. RESULTS: The crude mortality rate due to CVD was 17.9 per 100 000 individuals among workers. Workers with one unemployment spell in the past 5 years had a significantly higher SMR than those without (2.01; 95% CI 1.87 to 2.16). Additionally, as unemployment spells increased, the SMR increased. The impact was more substantial among older workers than among younger workers. These findings remained consistent when CVD was divided into ischaemic heart disease and cerebrovascular disease. CONCLUSION: Repeated unemployment spells may be a risk factor for increased CVD mortality. These findings underscore the vulnerability of individuals facing repeated unemployment spells, highlighting the necessity for economic as well as health and psychological support
Global, regional, and national prevalence of child and adolescent overweight and obesity, 1990–2021, with forecasts to 2050: a forecasting study for the Global Burden of Disease Study 2021
No full textBACKGROUND: Despite the well documented consequences of obesity during childhood and adolescence and future risks of excess body mass on non-communicable diseases in adulthood, coordinated global action on excess body mass in early life is still insufficient. Inconsistent measurement and reporting are a barrier to specific targets, resource allocation, and interventions. In this Article we report current estimates of overweight and obesity across childhood and adolescence, progress over time, and forecasts to inform specific actions. METHODS: Using established methodology from the Global Burden of Diseases, Injuries, and Risk Factors Study 2021, we modelled overweight and obesity across childhood and adolescence from 1990 to 2021, and then forecasted to 2050. Primary data for our models included 1321 unique measured and self-reported anthropometric data sources from 180 countries and territories from survey microdata, reports, and published literature. These data were used to estimate age-standardised global, regional, and national overweight prevalence and obesity prevalence (separately) for children and young adolescents (aged 5-14 years, typically in school and cared for by child health services) and older adolescents (aged 15-24 years, increasingly out of school and cared for by adult services) by sex for 204 countries and territories from 1990 to 2021. Prevalence estimates from 1990 to 2021 were generated using spatiotemporal Gaussian process regression models, which leveraged temporal and spatial correlation in epidemiological trends to ensure comparability of results across time and geography. Prevalence forecasts from 2022 to 2050 were generated using a generalised ensemble modelling approach assuming continuation of current trends. For every age-sex-location population across time (1990-2050), we estimated obesity (vs overweight) predominance using the log ratio of obesity percentage to overweight percentage. FINDINGS: Between 1990 and 2021, the combined prevalence of overweight and obesity in children and adolescents doubled, and that of obesity alone tripled. By 2021, 93.1 million (95% uncertainty interval 89.6-96.6) individuals aged 5-14 years and 80.6 million (78.2-83.3) aged 15-24 years had obesity. At the super-region level in 2021, the prevalence of overweight and of obesity was highest in north Africa and the Middle East (eg, United Arab Emirates and Kuwait), and the greatest increase from 1990 to 2021 was seen in southeast Asia, east Asia, and Oceania (eg, Taiwan [province of China], Maldives, and China). By 2021, for females in both age groups, many countries in Australasia (eg, Australia) and in high-income North America (eg, Canada) had already transitioned to obesity predominance, as had males and females in a number of countries in north Africa and the Middle East (eg, United Arab Emirates and Qatar) and Oceania (eg, Cook Islands and American Samoa). From 2022 to 2050, global increases in overweight (not obesity) prevalence are forecasted to stabilise, yet the increase in the absolute proportion of the global population with obesity is forecasted to be greater than between 1990 and 2021, with substantial increases forecast between 2022 and 2030, which continue between 2031 and 2050. By 2050, super-region obesity prevalence is forecasted to remain highest in north Africa and the Middle East (eg, United Arab Emirates and Kuwait), and forecasted increases in obesity are still expected to be largest across southeast Asia, east Asia, and Oceania (eg, Timor-Leste and North Korea), but also in south Asia (eg, Nepal and Bangladesh). Compared with those aged 15-24 years, in most super-regions (except Latin America and the Caribbean and the high-income super-region) a greater proportion of those aged 5-14 years are forecasted to have obesity than overweight by 2050. Globally, 15.6% (12.7-17.2) of those aged 5-14 years are forecasted to have obesity by 2050 (186 million [141-221]), compared with 14.2% (11.4-15.7) of those aged 15-24 years (175 million [136-203]). We forecasted that by 2050, there will be more young males (aged 5-14 years) living with obesity (16.5% [13.3-18.3]) than overweight (12.9% [12.2-13.6]); while for females (aged 5-24 years) and older males (aged 15-24 years), overweight will remain more prevalent than obesity. At a regional level, the following populations are forecast to have transitioned to obesity (vs overweight) predominance before 2041-50: children and adolescents (males and females aged 5-24 years) in north Africa and the Middle East and Tropical Latin America; males aged 5-14 years in east Asia, central and southern sub-Saharan Africa, and central Latin America; females aged 5-14 years in Australasia; females aged 15-24 years in Australasia, high-income North America, and southern sub-Saharan Africa; and males aged 15-24 years in high-income North America. INTERPRETATION: Both overweight and obesity increased substantially in every world region between 1990 and 2021, suggesting that current approaches to curbing increases in overweight and obesity have failed a generation of children and adolescents. Beyond 2021, overweight during childhood and adolescence is forecast to stabilise due to further increases in the population who have obesity. Increases in obesity are expected to continue for all populations in all world regions. Because substantial change is forecasted to occur between 2022 and 2030, immediate actions are needed to address this public health crisis. FUNDING: Bill & Melinda Gates Foundation and Australian National Health and Medical Research Council
Transcriptional Landscape and Biomarker Discovery for Endoplasmic Reticulum Stress in Alzheimer’s Disease: An Ex Vivo Study Using Patients-Derived Dermal Fibroblasts
No full textOBJECTIVE: Numerous studies have identified various risk factors associated with Alzheimer's disease (AD). However, the experimental limitations of disease modeling make it challenging to directly interpret their effects. These limitations include constraints of postmortem samples, animal experiments, and challenges associated with brain tissue studies. Ex vivo experiments effectively address these issues by enabling patient-specific identification and highlighting potential biomarkers. This study aimed to characterize the transcriptional profile of fibroblasts derived from patients with AD in response to endoplasmic reticulum (ER) stress and propose potential biomarkers. METHODS: We utilized an ex vivo platform to identify genes differentially responsive to ER stress. The transcriptional feature of fibroblasts in both healthy controls (n=22) and patients with AD (n=20) was analyzed using bulk RNA sequencing. The cytotoxicity of the selected target gene was evaluated through knockdown experiments. RESULTS: A total of 468 differentially expressed genes (DEGs) were identified. Gene ontology and pathway enrichment analysis revealed that 210 DEGs, which were less responsive in AD, are involved in lipid-related terms and pathways. By narrowing down AD-related genes, we identified 49 highly reliable AD-associated genes. The most significant gene, DCTN2, exhibited a fold change that positively correlated with cognitive function and negatively correlated with blood-based biomarkers (pTau217, amyloid beta 42/40 ratio), aligning with the amyloid/Tau/neurodegeneration research criteria for AD. Additionally, the knockdown of DCTN2 in glial cell lines resulted in increased cell toxicity and apoptosis. CONCLUSION: Identifying differentially responsive genes in ex vivo experiments not only provides insights into the pathology of AD but also offers potential biomarkers for disease diagnosis
Eligibility for Lecanemab Treatment in the Republic of Korea: Real-World Data From Memory Clinics
No full textBACKGROUND AND PURPOSE: We aimed to determine the proportion of Korean patients with early Alzheimer's disease (AD) who are eligible to receive lecanemab based on the United States Appropriate Use Recommendations (US AUR), and also identify the barriers to this treatment. METHODS: We retrospectively enrolled 6,132 patients with amnestic mild cognitive impairment or mild amnestic dementia at 13 hospitals from June 2023 to May 2024. Among them, 2,058 patients underwent amyloid positron emission tomography (PET) and 1,199 (58.3%) of these patients were amyloid-positive on PET. We excluded 732 patients who did not undergo brain magnetic resonance imaging between June 2023 and May 2024. Finally, 467 patients were included in the present study. RESULTS: When applying the criteria of the US AUR, approximately 50% of patients with early AD were eligible to receive lecanemab treatment. Among the 467 included patients, 36.8% did not meet the inclusion criterion of a Mini-Mental State Examination (MMSE) score of >/=22. CONCLUSIONS: Eligibility for lecanemab treatment was not restricted to Korean patients with early AD except for those with an MMSE score of >/=22. The MMSE criteria should therefore be reconsidered in areas with a higher proportion of older people, who tend to have lower levels of education
Guidelines for the Treatment of Laryngeal Cancer from the Korean Society of Head and Neck Surgery
No full textOBJECTIVES: Effective treatment of laryngeal cancer requires clinical decision-making that balances survival outcomes with the preservation of essential functions, such as voice and swallowing. This study, led by the Clinical Practice Guideline Committee of the Korean Society of Head and Neck Surgery, aims to establish evidence-based recommendations to guide surgeons in optimizing treatment decisions for patients with laryngeal cancer. METHODS: A literature search was performed in the PubMed, Embase, Cochrane Library, and KoreaMed databases by a literature search expert and subsequently reviewed by a panel of 39 committee experts. The Grading of Recommendations, Assessment, Development, and Evaluation (GRADE) method was employed to assess the quality of evidence and develop and report the recommendations. The strength of each recommendation reflects the guideline panel's confidence that the benefits of an intervention outweigh its risks for the target population. After drafting the guidelines, Delphi questionnaires were distributed to members of the Korean Society of Head and Neck Surgery and an external reviewer panel. RESULTS: In total, 15 evidence-based recommendations are provided, addressing six critical aspects of laryngeal cancer treatment: early-stage treatment, treatment of locally advanced cancer, neck management, adjuvant therapy, swallowing rehabilitation, and salvage treatment for recurrent tumors. CONCLUSION: The guidelines provide evidence-based, validated recommendations to support clinicians in making optimal treatment decisions for laryngeal cancer
기능성 소화불량증의 기능의학적 접근: 뇌-장축 불균형 1예와 위산저하증 2예
No full textFunctional dyspepsia is a common gastrointestinal disorder typically treated with proton pump inhibitors or gastrointestinal motility agents. However, these treatments can sometimes be ineffective or even worsen symptoms. Therefore, it may be more beneficial to identify and address the root causes of the symptoms rather than relying solely on standard treatments. Addressing the root issues of functional dyspepsia can be more effective than merely using gastrointestinal medications. First, gastrointestinal symptoms may arise from hormonal imbalances, autonomic nervous system dysfunctions, and neurotransmitter imbalances, all of which indicate imbalances of brain-gut axis. Correcting these imbalances can significantly alleviate symptoms. Second, a comprehensive approach to functional medicine in gastrointestinal health should include not only hyperacidity and hypersensitivity but also conditions like hypochlorhydria, along with associated nutritional deficiencies and small intestinal bacterial overgrowth. Integrating clinical nutritional treatments alongside these considerations can further enhance symptom relief. This paper reviewed the related literature and reported three related cases.기능성 소화불량증은 흔한 소화기질환으로, 일반적으로 프로톤펌프억제제나 위장관 운동 촉진제를 사용하여 치료한다. 그러나 이러한 치료가 효과가 없거나 악화시키는 경우가 있어, 일괄적 치료보다는 증상의 근본 원인을 찾아 해결하는 것이 도움이 될 수 있다. 즉 직접적인 위장관약물 사용보다는 기능성 소화불량증의 원인을 해결하는 것이 중요하다. 첫째, 대표적으로 뇌-장축 불균형에 해당하는 호르몬 이상, 자율신경계 불균형, 신경전달물질 불균형이 위장관 증상을 유발할 수 있으므로 이에 대한 불균형을 해결하는 것이 증상완화에 도움이 될 수 있다. 둘째, 위장관계 불균형을 고려할 때, 위산 과다 및 과민성뿐만 아니라 위산저하증에 대한 고려와 이와 동반된 영양결핍 문제, 그리고 소장내 세균과증식도 함께 고려해야한다. 이를 고려하여 임상영양치료를 병행할 경우 환자들의 증상완화에 더욱 효과적일 수 있다. 본고는 이와 관련한 문헌리뷰를 고찰하며 관련한 증례 3가지를 보고하였다
HepScope: CNN-based single-cell discrimination of malignant hepatocytes
Get PDFHepatocellular carcinoma (HCC) presents a major health issue worldwide. This study introduces the HepScope gene set, developed through a hybrid approach that utilizes single-cell RNA sequencing (scRNA-seq), spatial transcriptomics (stRNA-seq), bulk RNA-seq, and proteomics data, along with the adaptation of Convolutional Neural Network (CNN) techniques. Comprising 113 genes significantly upregulated in malignant hepatocytes, HepScope gene set includes 77 genes unique to this set compared to other HCC-related gene sets. Unlike existing solutions, HepScope gene set demonstrated superior discriminatory power in distinguishing malignant from non-malignant hepatocytes, as validated by Seurat's module score, outperforming five other gene sets across multiple datasets. A 1D-CNN model, specifically adapted for the HepScope gene set, achieved superior accuracy (0.71), AUROC (0.82), and F1 score (0.85) compared to models trained on other gene sets, underscoring its enhanced predictive precision and robustness. Rigorous cross-validation and benchmarking against alternative models confirmed HepScope’s consistent performance. Additionally, we evaluated the prognostic capability of the HepScope gene set across two independent cohorts, demonstrating that the HepScope-based risk score is a strong independent predictor of overall and disease-free survival, making it a valuable tool for patient prognosis. Collectively, our findings position HepScope as a promising gene set for both diagnostic and prognostic applications in HCC, highlighting its potential in precision medicine for HCC and offering insights into personalized therapy development
Effects of 4G Long-Term Evolution Electromagnetic Fields on Thyroid Hormone Dysfunction and Behavioral Changes in Adolescent Male Mice
Get PDFRadiofrequency electromagnetic fields (RF-EMFs) can penetrate tissues and potentially influence endocrine and brain development. Despite increased mobile phone use among children and adolescents, the long-term effects of RF-EMF exposure on brain and endocrine development remain unclear. This study investigated the effects of long-term evolution band (LTE) EMF exposure on thyroid hormone levels, crucial for metabolism, growth, and development. Four-week-old male mice (C57BL/6) were exposed to LTE EMF (whole-body average specific absorption rate [SAR] 4 W/kg) or a positive control (lead; Pb, 300 ppm in drinking water) for 4 weeks. Subsequently, the mice underwent behavioral tests including open field, marble burying, and nest building. Blood pituitary and thyroid hormone levels, and thyroid hormone-regulating genes within the hypothalamus–pituitary–thyroid (HPT) axis were analyzed. LTE exposure increased T3 levels, while Pb exposure elevated T3 and T4 and decreased ACTH levels. The LTE EMF group showed no gene expression alterations in the thyroid and pituitary glands, but hypothalamic Dio2 and Dio3 expressions were significantly reduced compared to that in the sham-exposed group. Pb exposure altered the hypothalamic mRNA levels of Oatp1c1 and Trh, pituitary mRNA of Trhr, and Tpo and Tg expression in the thyroid. In conclusion, LTE EMF exposure altered hypothalamic Dio2 and Dio3 expression, potentially impacting the HPT axis function. Further research is needed to explore RF-EMF’s impacts on the endocrine system