Search Results (630)

Objective: This study aimed to investigate the impact of depression and anxiety disorders on mortality in women diagnosed with gynecologic cancers, utilizing nationwide retrospective cohort data. Methods: Data from the Korean National Health Insurance Service (NHIS) database, covering women diagnosed with cervical, endometrial, or ovarian cancers between 2007 and 2014, were analyzed. Women diagnosed with depression or anxiety disorders within one year after cancer diagnosis were identified and compared with a control group comprising patients with gynecologic cancers who did not develop either disorder during the same post-diagnosis period. Mortality was evaluated as the primary outcome. Results: Of 85,327 women analyzed, 784 (0.9%) were diagnosed with depression or anxiety disorders. Patients with depression or anxiety exhibited significantly higher mortality (38.4% vs. 29.9%; p < 0.001). Multivariate analysis indicated that depression significantly increased mortality risk (OR 1.46, 95% CI 1.27–1.66), whereas anxiety alone showed no significant effect (OR 0.97, 95% CI 0.74–1.27). Combined depression and anxiety showed the highest mortality risk (OR 1.47, 95% CI 1.31–1.65). Conclusions: Depression and anxiety disorders are significant predictors of increased mortality in women with gynecologic cancers, emphasizing the necessity for integrated mental health assessment and interventions in oncologic care to improve both survival and quality of life. Full article

Recurrent pregnancy loss (RPL) is defined as the occurrence of two or more pregnancy losses before 20 weeks of gestation. RPL is a common medical condition among reproductive-age women, with approximately 23 million cases reported annually worldwide. Up to 5% of pregnant women may experience two or more consecutive pregnancy losses. Previous studies have investigated risk factors for RPL, including maternal age, uterine pathology, genetic anomalies, infectious agents, endocrine disorders, thrombophilia, and immune dysfunction. However, RPL is a disease caused by a complex interaction of genetic factors, environmental factors (e.g., diet, lifestyle, and stress), epigenetic factors, and the immune system. In addition, due to the lack of research on genetics research related to RPL, the etiology remains unclear in up to 50% of cases. Platelets play a critical role in pregnancy maintenance. This study examined the associations of platelet receptor and ligand gene variants, including integrin subunit beta 3 (ITGB3) rs2317676 A > G, rs3809865 A > T; fibrinogen gamma chain (FGG) rs1049636 T > C, rs2066865 T > C; glycoprotein 1b subunit alpha (GP1BA) rs2243093 T > C, rs6065 C > T; platelet endothelial cell adhesion molecule 1 (PECAM1) rs2812 C > T; and platelet endothelial aggregation receptor 1 (PEAR1) rs822442 C > A, rs12137505 G > A, with RPL prevalence. In total, 389 RPL patients and 375 healthy controls (all Korean women) were enrolled. Genotyping of each single nucleotide polymorphism was performed using polymerase chain reaction–restriction fragment length polymorphism and the TaqMan genotyping assay. All samples were collected with approval from the Institutional Review Board at Bundang CHA Medical Center. The ITGB3 rs3809865 A > T genotype was strongly associated with RPL prevalence (pregnancy loss [PL] ≥ 2: adjusted odds ratio [AOR] = 2.505, 95% confidence interval [CI] = 1.262–4.969, p = 0.009; PL ≥ 3: AOR = 3.255, 95% CI = 1.551–6.830, p = 0.002; PL ≥ 4: AOR = 3.613, 95% CI = 1.403–9.307, p = 0.008). The FGG rs1049636 T > C polymorphism was associated with a decreased risk in women who had three or more pregnancy losses (PL ≥ 3: AOR = 0.673, 95% CI = 0.460–0.987, p = 0.043; PL ≥ 4: AOR = 0.556, 95% CI = 0.310–0.997, p = 0.049). These findings indicate significant associations of the ITGB3 rs3809865 A > T and FGG rs1049636 T > C polymorphisms with RPL, suggesting that platelet function influences RPL in Korean women. Full article

Lung cancer is one of the most common cancers and the leading cause of cancer-related death worldwide. Despite advancements, the overall survival rate for lung cancer remains between 10% and 20% in most countries. However, recent progress in diagnostic tools and therapeutic strategies has led to meaningful improvements in survival outcomes, highlighting the growing importance of personalized management based on accurate disease assessment. ¹⁸F-fluorodeoxyglucose positron emission tomography/computed tomography (FDG PET/CT) has become essential in the management of lung cancer, serving as a key imaging modality for initial diagnosis, staging, treatment response assessment, and follow-up evaluation. Recent developments in radiomics and artificial intelligence (AI), including machine learning and deep learning, have revolutionized the analysis of complex imaging data, enhancing the diagnostic and predictive capabilities of FDG PET/CT in lung cancer. However, the limitations of FDG, including its low specificity for malignancy, have driven the development of novel oncologic radiotracers. One such target is fibroblast activation protein (FAP), a type II transmembrane glycoprotein that is overexpressed in activated cancer-associated fibroblasts within the tumor microenvironment of various epithelial cancers. As a result, FAP-targeted radiopharmaceuticals represent a novel theranostic approach, offering the potential to integrate PET imaging with radioligand therapy (RLT). In this review, we provide a comprehensive overview of FDG PET/CT in lung cancer, along with recent advances in AI. Additionally, we discuss FAP-targeted radiopharmaceuticals for PET imaging and their potential application in RLT for the personalized management of lung cancer. Full article

Background: Percutaneous epidural neuroplasty (PEN) and related adhesiolysis procedures are widely used for managing chronic spinal pain. Although generally safe, complications—ranging from minor to life-threatening—have been reported. This review aimed to estimate the incidence and characteristics of complications following PEN and to evaluate the medical rationale for post-procedural inpatient monitoring. Methods: We systematically searched PubMed, Embase, and the Cochrane Library for studies published from January 2000 to April 2025 reporting complications associated with PEN. We performed a random-effects meta-analysis on five eligible cohort studies to estimate the pooled complication rate and evaluated heterogeneity. Risk of bias was assessed using the Newcastle–Ottawa Scale. Results: Five cohort studies (n = 1740) were included in the meta-analysis, with a pooled complication rate of 9.0% (95% CI: 4.8–13.1%, I² = 97.5%). A total of 133 complications were identified from cohort studies and case reports. Mechanical and neurological complications were most common. Serious complications, including hematoma, meningitis, and cardiopulmonary arrest, were concentrated within the first 6 h post-procedure. Conclusions: This meta-analysis highlights a quantifiable risk of complications associated with PEN. Our findings support structured inpatient monitoring during the immediate post-procedural period to enhance safety and outcomes. Full article

Objectives: This study assessed the effectiveness of a cognitive behavioral therapy (CBT)-based fine dust education program, grounded in the Health Belief Model (HBM), on elementary students’ fine dust knowledge, related behaviors, and mental health (depression, anxiety, stress, sleep quality). Methods: From September to November 2024, 95 students (grades 4–6) living near a coal-fired power plant in midwestern South Korea were assigned to either an intervention group (n = 44) or a control group (n = 51). The intervention group completed a three-session CBT-based education program; the control group received stress management education. Assessments were conducted at weeks 1, 2, 4, and 8 using standardized mental health and behavior scales (PHQ: Patient Health Questionnaire, GAD: Generalized Anxiety Disorder Assessment, PSS: Perceived Stress Scale, ISI: Insomnia Severity Index). Results: A chi-square test was conducted to compare pre- and post-test changes in knowledge and behavior related to PM2.5. The intervention group showed significant improvements in seven fine dust-related knowledge and behavior items (e.g., PM2.5 awareness rose from 33.3% to 75.0%; p < 0.05). The control group showed limited gains. Regarding mental health, based on a mixed-design ANCOVA, anxiety scores significantly declined over time in the intervention group, with group and interaction effects also significant (p < 0.05). Depression scores showed time effects, but group and interaction effects were not significant. No significant changes were observed for stress, sleep, or group × PM2.5 interactions. Conclusions: The CBT-based education program effectively enhanced fine dust knowledge, health behaviors, and reduced anxiety among students. It presents a promising, evidence-based strategy to promote environmental and mental health in school-aged children. Full article

Background/Objectives: Delayed gastric emptying (DGE) is a well-known complication of laparoscopic pylorus-preserving gastrectomy (LPPG). Patients who underwent LPPG in the KLASS-04 trial, which was a multicenter prospective randomized control trial comparing LPPG and laparoscopic distal gastrectomy (LDG), showed an unneglectable incidence of long-term DGE compared to patients who underwent LDG. This study aimed to identify the multifactorial risk factors associated with DGE and to analyze the quality of life (QoL) of patients with DGE following LPPG. Methods: DGE was defined as “nearly normal diet residue” at least once in the endoscopic follow-up at 1, 2, and 3 years after the surgery. Clinicopathological features, surgical outcomes, and QoL were compared between the DGE and non-DGE groups. Results: DGE was observed in 21/124 patients (16.3%) who underwent LPPG. Patients without previous abdominal surgery had a higher incidence of DGE in the univariate (32% vs. 4.8%, p = 0.011) and logistic regression analyses (odds ratio: 0.106, 95% confidence interval: 0.014–0.824, p = 0.032). Patients with DGE reported more symptoms of nausea and vomiting (p = 0.004), constipation (p = 0.04), and a dry mouth (p = 0.005). Conclusions: Despite the strict protocol used to avoid well-known risk factors for DGE, such as damage to the hepatic branch of the vagus nerve, infrapyloric artery and vein, and short antral cuff, the LPPG group of the KLASS-04 trial exhibited a considerable incidence of DGE. No clinicopathological or surgical factors, other than the absence of a previous surgical history, were identified as multifactorial risk factors for DGE. However, DGE had a negative impact on the QoL of patients. Full article

Opuntia humifusa (commonly known as Cheon-nyun-cho) has traditionally been used for its antioxidant, laxative, and immune-boosting properties, but its potential prebiotic activity remains largely unexplored. In this study, we evaluated the prebiotic potential of O. humifusa leaf and fruit extracts by assessing their effects on the growth of four Lactobacillus spp. strains. Among them, Lactobacillus paracasei KCTC 12576 exhibited the most pronounced response to the extracts and was therefore selected for further investigation. Comparative analysis demonstrated that ethanol extracts were more effective than water extracts, and leaf extracts outperformed fruit extracts in enhancing bacterial viability. Notably, the ethanol extract of O. humifusa leaves showed the strongest stimulatory effect on L. paracasei KCTC 12576 growth. Based on extraction optimization studies, 60% ethanol was identified as the most effective solvent for obtaining bioactive compounds. HPLC analysis revealed the presence of isorhamnetin 3-O-β-D-(6-O-α-L-rhamnosyl)glucoside (1) as a major flavonol glycoside in the extract. A robust and validated HPLC method was established for quantification of this compound (0.33 mg/g in the 60% ethanol extract of the leaves), supporting the standardization of the extract. These findings suggest that O. humifusa leaf extract, particularly the 60% ethanol extract, may serve as a promising natural prebiotic ingredient for use in functional foods or synbiotic formulations. Full article

Donepezil (DPZ) is an Alzheimer’s disease (AD) drug that promotes cholinergic neurotransmission and exhibits excellent acetylcholinesterase (AChE) selectivity. The current oral formulations of DPZ demonstrate decreased bioavailability, attributed to limited drug permeability across the blood–brain barrier (BBB). In order to overcome these limitations, various dosage forms aimed at delivering DPZ have been explored. This discussion will focus on the nose-to-brain (N2B) delivery system, which represents the most promising approach for brain drug delivery. Intranasal (IN) drug delivery is a suitable system for directly delivering drugs to the brain, as it bypasses the BBB and avoids the first-pass effect, thereby targeting the central nervous system (CNS). Currently developed formulations include lipid-based, solid particle-based, solution-based, gel-based, and film-based types, and a systematic review of the N2B research related to these formulations has been conducted. According to the in vivo results, the brain drug concentration 15 min after IN administration was more than twice as high those from other routes of administration, and the direct delivery ratio of the N2B system improved to 80.32%. The research findings collectively suggest low toxicity and high therapeutic efficacy for AD. This review examines drug formulations and delivery methods optimized for the N2B delivery of DPZ, focusing on technologies that enhance mucosal residence time and bioavailability while discussing recent advancements in the field. Full article

The objective of this study was to improve measurement accuracy in the evaluation of autonomous agricultural tractor performance by addressing external disturbances, such as sensor installation errors, vibrations, and heading-induced bias that occur during the measurement of the conventional rear three-point hitch (Rear 3-Point) system. To mitigate these disturbances, the measurement point was relocated to the cab, where external interference is comparatively minimal. However, in compliance with the ISO 12188 standard, the Rear 3-Point system must be used as the reference measurement point. Therefore, its coordinates were indirectly estimated using an extended Kalman filter (EKF) and artificial intelligence (AI)-based techniques. A hybrid model was developed in which a transformer-based AI model was trained using the Rear 3-Point coordinates predicted by EKF as the ground truth. While traditional time-series models, such as LSTM and GRU, show limitations in predicting nonlinear data, the application of an attention mechanism was found to enhance prediction performance by effectively learning temporal dependencies and vibration patterns. The experimental results show that the EKF-based estimation achieved a precision of RMSE 1.6 mm, a maximum error of 12.6 mm, and a maximum standard deviation of 3.9 mm compared to actual measurements. From the perspective of experimental design, the proposed hybrid model was able to predict the trajectory of the autonomous agricultural tractor with significantly reduced external disturbances when compared to the actual measured Rear 3-Point coordinates, while also complying with the ISO 12188 standard. These findings suggest that the proposed approach provides an effective and integrated solution for developing high-precision autonomous agricultural systems. Full article

Recurrent pregnancy loss (RPL) is defined as the occurrence of two or more consecutive pregnancy losses before 20 weeks of gestation, encompassing both embryonic and fetal losses. Although previous studies have provided substantial insights into RPL, the causes in many cases remain unexplained. This lack of information has prompted continued investigation into various risk factors, including those identified through next-generation sequencing (NGS). In the present study, whole-exome sequencing (WES) was used to identify genes potentially associated with RPL and infertility, which may serve as novel biomarkers. Confirmation of the association between these genetic variants and RPL may help to develop functional biomarkers for early diagnosis. The findings revealed that the PCSK5 rs1110222 G > A polymorphism was significantly associated with a reduced risk of RPL. In contrast, the MUC2 rs10902088 C > T polymorphism was associated with an increased risk of RPL among women with more than four pregnancy losses. Notably, the A-T allele combination of PCSK5 rs1110222 G > A and MUC2 rs10902088 C > T showed a significant association with a decreased risk of RPL relative to the G-C combination. In conclusion, this study confirms that the PCSK5 rs1110222 G > A and MUC2 rs10902088 C > T polymorphisms are genetically associated with the prevalence of RPL in Korean women. Full article

This study evaluated the therapeutic potential of 70% ethanol extracts from six medicinal plants (Chenopodium album, Cassia tora, Cudrania tricuspidata, Dioscorea polystachya, Lonicera japonica, Solidago virgaurea subsp. gigantea) through their antibacterial, antioxidant, cytotoxic, and immunomodulatory activities, targeting applications in aquaculture. All extracts exhibited potent antibacterial activity (MIC ≤ 10 μg/mL) against Aeromonas spp. and Photobacterium damselae subsp. damselae, but limited efficacy against Streptococcus parauberis. C. tricuspidata (CTR) and C. tora (CTO) demonstrated superior antioxidant activity (IC₅₀ = 1292 μg/mL and IC₅₀ = 227 μg/mL, respectively), correlating with high polyphenol content (1498 and 1409 mg GAE/g). CTR displayed significant concentration-dependent cytotoxicity (IC₅₀ = 904.2 μg/mL), while C. album (CA) promoted cell proliferation (132.3% viability). In LPS-stimulated CHSE-214 cells, D. polystachya (DP) induced the highest IL-8 expression (207-fold), followed by Chenopodium album (CA) (194-fold IL-8, 49-fold TNF-α) and CTR (245-fold RIPK2), activating NF-κB, MAPK, and NOD-like receptor pathways critical for teleost immunity. Lonicera japonica (LJ) suppressed TNF-α (0.4-fold) and IRF1 (0.3-fold), indicating anti-inflammatory potential, while S. virgaurea subsp. gigantea (SV) showed biphasic TNF-α modulation (79-fold at 10 μg/mL, 5-fold at 100 μg/mL). These diverse bioactivities, particularly the robust immunomodulatory effects, highlight the promise of these extracts as natural therapeutic agents for fish health management in aquaculture. Full article

The widespread application of pesticides in agriculture has raised increasing concerns regarding their ecological impact, particularly in aquatic environments. Among these, α-cypermethrin, a highly active isomeric form of cypermethrin, has been extensively used due to its potent insecticidal efficacy and low mammalian toxicity. However, its toxicity to non-target aquatic organisms remains insufficiently understood at the metabolic level. In this study, a targeted metabolomics approach was employed to investigate the biochemical effects of α-cypermethrin in adult zebrafish. Acute toxicity was first determined to establish sublethal exposure concentrations (0.15 µg/L and 1.5 µg/L), followed by a 48 h exposure under a controlled flow-through system. GC-MS/MS-based analysis quantified 395 metabolites, and multivariate statistical models (principal component analysis (PCA) and partial least square-discriminant analysis (PLS-DA)) revealed clear dose-dependent metabolic alterations at two time points. Pathway analysis identified disruptions in glycolysis, glycerolipid metabolism, amino acid turnover, and glutathione pathways. Notably, glutamate depletion and associated reductions in GABA (4-Aminobutanoate) and TCA (Tricarboxylic acid) cycle intermediates suggest oxidative stress-induced metabolic bottlenecks. These results provide mechanistic insights into α-cypermethrin-induced toxicity and demonstrate the utility of metabolite-level biomarkers for environmental monitoring. This study contributes to a systems-level understanding of how sublethal pesticide exposure affects vertebrate metabolism, offering a basis for improved ecological risk assessment and pesticide regulation. Full article

Background: Obstructive sleep apnea (OSA) has been associated with adverse oral function outcomes, yet its association with oral function remains underexplored. This study aims to analyze the association between OSA and oral function problems, and whether these relationships are more pronounced among socioeconomically disadvantaged groups. Methods: Data were derived from the 2022–2023 Korea National Health and Nutrition Examination Survey (KNHANES), including 6349 participants aged 40 and above. OSA risk was assessed using the STOP-Bang questionnaire. Oral function was evaluated through chewing discomfort, speaking discomfort, and dental pain. Complex sample logistic regression was performed, adjusting for demographic, socioeconomic, and health-related covariates. Stratified analyses were conducted to examine whether the association differed across socioeconomic groups. Result: High OSA risk was significantly associated with chewing discomfort (OR: 1.365, 95% CI: 1.121–1.662), speaking discomfort (OR: 1.534, 95% CI: 1.126–2.082), and dental pain (OR: 1.198, 95% CI: 1.006–1.431). Stratified analyses showed stronger associations in low education or income groups. For instance, those in the lowest income group were over five times more likely to report speaking discomfort (OR = 5.207, 95% CI: 2.365–11.462) than those in the highest. Conclusions: OSA risk is significantly associated with impaired oral function, particularly among socioeconomically disadvantaged groups. These findings underscore the need for integrated public health approaches that address both sleep and oral health disparities. Full article

Pedicularis hallaisanensis is a strictly biennial, hemiparasitic herb endemic to Republic of Korea and listed as an endangered species. Its populations are limited to high-altitude habitats, with recent surveys confirming survival only in Gayasan. This study aimed to assess the population size and ecological traits of P. hallaisanensis to inform conservation strategies. We established 23 quadrats at 1400–1410 m above sea level and collected microhabitat data (air temperature, soil moisture, electroconductivity, vegetation cover, and species richness) from 2022 to 2024. Flora composition and pollinator species were surveyed, with bumblebees (Bombus ignitus, B. hypocrita sapporoensis) identified as the most frequent pollinators. General linear mixed models and Pearson’s correlation analysis showed a strong positive relationship between species richness and population size and between vegetation cover and stem height. The study area’s average temperature was 6.3 °C below Republic of Korea’s national average, suggesting that climate change could disrupt the microclimatic conditions necessary for this species’ survival. The findings highlight the importance of maintaining plant diversity and controlling invasive woody species to sustain P. hallaisanensis populations. Targeted conservation measures, including habitat management and ex situ propagation, are recommended to safeguard this vulnerable species. Full article

This study aimed to validate the usefulness of the Simplified Computerized Comprehensive Learning Ability Screening Test (SCLST) in schools and homes, to facilitate early detection and intervention for children with reading disorder (RD), math disorder (MD), or attention-deficit hyperactivity disorder (ADHD). Participants included 207 children and adolescents diagnosed with ADHD, RD, or MD and the healthy control group that was matched 1:1 by gender, age, and educational years. Higher rates of omission errors, commission errors, and standard deviation of response times were observed in the ADHD group (p < 0.001) in the SCLST-ADHD. The accuracy rates of the SCLST-RD and SCLST-MD were lower in the RD (p < 0.001) and MD group (p < 0.01), respectively. The mean response times were higher in the MD group (p < 0.001). In addition, the optimal sensitivity and specificity values were 84.6% and 88.5%, and the positive and negative predictive values were 88.0% and 85.2%, respectively, in the SCLST-ADHD. In the SCLTS-RD, the sensitivity and specificity values were 81.1% and 85.6%, and the positive and negative predictive values were 84.9% and 81.9%, respectively. In the SCLST-MD, the sensitivity and specificity values were 97.4% and 76.9%, and the positive and negative predictive values were 80.9% and 96.8%, respectively. Thus, by supporting timely assessment and intervention, this tool can support clinicians and educators in early-stage learning disabilities screening and reduce long-term psychosocial impairments. Full article