AIM:To evaluate long-term visual field(VF)prediction using K-means clustering in patients with primary open angle glaucoma(POAG).METHODS:Patients who underwent 24-2 VF tests≥10 were included in this study.Using 52 to...AIM:To evaluate long-term visual field(VF)prediction using K-means clustering in patients with primary open angle glaucoma(POAG).METHODS:Patients who underwent 24-2 VF tests≥10 were included in this study.Using 52 total deviation values(TDVs)from the first 10 VF tests of the training dataset,VF points were clustered into several regions using the hierarchical ordered partitioning and collapsing hybrid(HOPACH)and K-means clustering.Based on the clustering results,a linear regression analysis was applied to each clustered region of the testing dataset to predict the TDVs of the 10th VF test.Three to nine VF tests were used to predict the 10th VF test,and the prediction errors(root mean square error,RMSE)of each clustering method and pointwise linear regression(PLR)were compared.RESULTS:The training group consisted of 228 patients(mean age,54.20±14.38y;123 males and 105 females),and the testing group included 81 patients(mean age,54.88±15.22y;43 males and 38 females).All subjects were diagnosed with POAG.Fifty-two VF points were clustered into 11 and nine regions using HOPACH and K-means clustering,respectively.K-means clustering had a lower prediction error than PLR when n=1:3 and 1:4(both P≤0.003).The prediction errors of K-means clustering were lower than those of HOPACH in all sections(n=1:4 to 1:9;all P≤0.011),except for n=1:3(P=0.680).PLR outperformed K-means clustering only when n=1:8 and 1:9(both P≤0.020).CONCLUSION:K-means clustering can predict longterm VF test results more accurately in patients with POAG with limited VF data.展开更多
BACKGROUND Clinical guidelines for early extubation after liver transplantation remain lacking,with significant variations in the rates of early extubation across transplantation centers.AIM To identify clinical facto...BACKGROUND Clinical guidelines for early extubation after liver transplantation remain lacking,with significant variations in the rates of early extubation across transplantation centers.AIM To identify clinical factors,including the use of epidural analgesia,associated with early extubation in living-donor liver transplantation(LDLT).METHODS The medical records of LDLT recipients were analyzed in this study,categorizing them based on extubation timing as delayed(leaving the operating room without extubation)or early(tracheal tube removed immediately after surgery).A multivariate binary logistic regression analysis was performed.Subgroup analysis was conducted,excluding patients contraindicated for epidural analgesia owing to significant coagulopathy.RESULTS Total of 159 patients,93(58.5%)underwent early extubation.Relevant clinical factors of early extubation were shorter anhepatic time[adjusted odds ratio(OR)=0.439,95%confidence interval(CI):0.232-0.831;P=0.011],absence of high-dose vasoactive drug use at the end of surgery(OR=0.235,95%CI:0.106-0.519;P<0.001),and the use of epidural analgesia(OR=15.730,95%CI:1.919-128.919;P=0.010).In a subgroup analysis of 67 patients,epidural analgesia remained a relevant clinical factor for early extubation(adjusted OR=19.381,95%CI:2.15-174.433;P=0.008).CONCLUSION Shorter anhepatic time,absence of high-dose vasoactive drug use at the end of surgery,and the use of epidural analgesia are relevant clinical factors of early extubation following LDLT.展开更多
Neurons are highly polarized,morphologically asymmetric,and functionally compartmentalized cells that contain long axons extending from the cell body.For this reason,their maintenance relies on spatiotemporal regulati...Neurons are highly polarized,morphologically asymmetric,and functionally compartmentalized cells that contain long axons extending from the cell body.For this reason,their maintenance relies on spatiotemporal regulation of organelle distribution between the somatodendritic and axonal domains.Although some organelles,such as mitochondria and smooth endoplasmic reticulum,are widely distributed throughout the neuron,others are segregated to either the somatodendritic or axonal compartment.For example,Golgi outposts and acidified lysosomes are predominantly present in the somatodendritic domain and rarely distributed along the axon,whereas newly formed autophagosomes and synaptic vesicles are mainly distributed in the distal axon(Britt et al.,2016).展开更多
Polystyrene nanoparticles pose significant toxicological risks to aquatic ecosystems,yet their impact on zebrafish(Danio rerio)embryonic development,particularly erythropoiesis,remains underexplored.This study used si...Polystyrene nanoparticles pose significant toxicological risks to aquatic ecosystems,yet their impact on zebrafish(Danio rerio)embryonic development,particularly erythropoiesis,remains underexplored.This study used single-cell RNA sequencing to comprehensively evaluate the effects of polystyrene nanoparticle exposure on erythropoiesis in zebrafish embryos.In vivo validation experiments corroborated the transcriptomic findings,revealing that polystyrene nanoparticle exposure disrupted erythrocyte differentiation,as evidenced by the decrease in mature erythrocytes and concomitant increase in immature erythrocytes.Additionally,impaired heme synthesis further contributed to the diminished erythrocyte population.These findings underscore the toxic effects of polystyrene nanoparticles on hematopoietic processes,highlighting their potential to compromise organismal health in aquatic environments.展开更多
This study compares the microstructural evolution,dynamic recrystallization(DRX)behavior,tensile properties,and age-hardenability between the newly developed high-speed-extrudable BA56 alloy and those of the widely re...This study compares the microstructural evolution,dynamic recrystallization(DRX)behavior,tensile properties,and age-hardenability between the newly developed high-speed-extrudable BA56 alloy and those of the widely recognized AZ31 alloy in industry.Unlike the AZ31 alloy,which retains partially unrecrystallized grains,the high-speed-extruded BA56 alloy demonstrates a coarser but entirely recrystallized and more homogeneous microstructure.The fine-grained structure and abundant Mg_(3)Bi_(2) particles in the BA56 extrusion billet significantly enhance its DRX behavior,thus enabling rapid and complete recrystallization during extrusion.The BA56 alloy contains band-like fragmented Mg_(3)Bi_(2) particles and numerous fine Mg_(3)Bi_(2) particles distributed throughout the material,in contrast to the sparse Al_(8)Mn_(5) particles in the AZ31 alloy.These features contribute to superior mechanical properties of the BA56 alloy,which achieves tensile yield and ultimate tensile strengths of 205 and 292 MPa,respectively,compared to 196 and 270 MPa for the AZ31 alloy.The superior strength of the BA56 alloy,even with its coarser grain size,can be explained by its elevated Hall-Petch constant and the strengthening contribution from the fine Mg_(3)Bi_(2) particles.Additionally,the BA56 alloy demonstrates significant age-hardenability,achieving a 22%enhancement in hardness following T5 aging,attributed to the precipitation of nanoscale Mg_(3)Bi_(2) and Mg_(17)Al_(12) phases.By contrast,the AZ31 alloy shows minimal hardening due to the absence of precipitate formation during aging.These findings suggest that the BA56 alloy is a promising candidate for the production of extruded Mg components requiring a combination of high productivity,superior mechanical performance,and wide-ranging process adaptability.展开更多
BACKGROUND Intramuscular corticosteroid injection may cause adverse effects such as dermal and/or subcutaneous atrophy,alopecia,hypopigmentation,and hyperpigmentation.Although cutaneous atrophy can spontaneously resol...BACKGROUND Intramuscular corticosteroid injection may cause adverse effects such as dermal and/or subcutaneous atrophy,alopecia,hypopigmentation,and hyperpigmentation.Although cutaneous atrophy can spontaneously resolve,several treatment options have been suggested for this condition.CASE SUMMARY In this paper,we report a case of corticosteroid injection induced lipoatrophy treated with autologous whole blood(AWB)injection,as the condition had been unresponsive to fractional laser therapy.A 29-year-old female patient visited the dermatology clinic complaining of skin depression on her right buttock area,which had appeared six months earlier.There had been only subtle improvement at the margins after fractional CO_(2) laser treatment;therefore,after obtaining informed consent from the patient,AWB treatment was initiated.One month after the first AWB injection,the size and depth of the lesion had noticeably improved,and a slight improvement was also observed in discoloration.CONCLUSION Close observation is the initial treatment of choice for steroid induced skin atrophy;however,for patients in need of immediate cosmetic improvement,AWB injection may be a safe and cost-effective alternative.展开更多
BACKGROUND Although obesity is a well-established contributor to surgical risks,evidence regarding the specific outcomes of laparoscopic cholecystectomy(LC)in obese patients remains scarce.AIM To assess clinicopatholo...BACKGROUND Although obesity is a well-established contributor to surgical risks,evidence regarding the specific outcomes of laparoscopic cholecystectomy(LC)in obese patients remains scarce.AIM To assess clinicopathologic differences and 1-year outcomes following elective LC in patients with obesity and gallstone disease.METHODS This retrospective study analyzed data from 65 patients who underwent elective LC for gallstone disease between January 2020 and May 2022,with outcomes assessed at the 1-year follow-up.Patients were categorized as obese(body mass index≥25 kg/m^(2))or non-obese(body mass index<25 kg/m^(2)),and comparisons were made across preoperative laboratory values,intraoperative parameters,and patient-reported outcomes.RESULTS The obese group had significantly higher American Society of Anesthesiologists scores,higher glycated hemoglobin levels,and lower vitamin D levels than the non-obese group.Elevated triglycerides were more frequent in the obese group,whereas higher high-density lipoprotein levels were more common in the nonobese group.Intraoperative and postoperative outcomes did not differ between the groups.At the 1-year follow-up,24.6%of patients reported post-cholecystectomy symptoms,with no group differences.CONCLUSION Obese patients had higher American Society of Anesthesiologists scores,lower vitamin D,and elevated triglycerides preoperatively,but these differences did not significantly affect intraoperative findings or 1-year postoperative outcomes compared to non-obese patients.展开更多
BACKGROUND Primary splenic lesions are rare and often detected incidentally through imaging,biopsy,or autopsy,typically without distinct clinical symptoms.Although imaging can help differentiate benign from malignant ...BACKGROUND Primary splenic lesions are rare and often detected incidentally through imaging,biopsy,or autopsy,typically without distinct clinical symptoms.Although imaging can help differentiate benign from malignant lesions,splenic hamartomas,and angiosarcomas may exhibit overlapping features,making diagnosis challenging.This report presents a case of splenic hamartoma suspected to be an angiosarcoma based on preoperative imaging.Splenic hamartomas that mimic angiosarcomas are exceedingly rare.CASE SUMMARY A 33-year-old male presented to the Department of Emergency with frank red blood hematemesis and a 1-week history of epigastric pain.On arrival,he was alert and hemodynamically stable.Contrast-enhanced abdominal computed tomography revealed splenomegaly with significant engorgement of the portal and splenic veins,along with a diffuse nodular splenic lesion measuring 8.2 cm×6.2 cm.Following esophageal varix ligation,abdominal magnetic resonance imaging demonstrated iso-to high-signal intensity within the splenic mass and multiple hypervascular lesions in the right hepatic lobe,raising suspicion for splenic an-giosarcoma with hepatic metastases.18F-fluorodeoxyglucose positron emission tomography-computed tomography showed diffusely mild increased metabolic activity in the spleen.The patient subsequently underwent splenectomy and liver biopsy.Histopathological examination revealed chronic inflammation in the liver,and the splenic lesion was confirmed to be a splenic hamartoma.The patient successfully returned to work and remains in good health.CONCLUSION This rare case of splenic hamartoma mimicking angiosarcoma highlights the importance of differential diagnosis in managing splenic tumors.展开更多
Coronavirus disease 2019(COVID-19)has had a substantial global health impact,with over 765 million confirmed cases and nearly 7 million deaths.[1]In South Korea,stringent lockdown policy heavily restricted the daily a...Coronavirus disease 2019(COVID-19)has had a substantial global health impact,with over 765 million confirmed cases and nearly 7 million deaths.[1]In South Korea,stringent lockdown policy heavily restricted the daily activities for over two years,resulting in widespread public health issues.展开更多
In this editorial,I discuss the article by Wang et al,published in the World Journal of Diabetes,which explores jejunoileal side-to-side anastomosis as a novel surgical intervention for type 2 diabetes mellitus(T2DM)....In this editorial,I discuss the article by Wang et al,published in the World Journal of Diabetes,which explores jejunoileal side-to-side anastomosis as a novel surgical intervention for type 2 diabetes mellitus(T2DM).T2DM,often associated with obesity,remains a global health challenge,as sustained remission is difficult to achieve with conventional pharmacological therapy.Jejunoileal anastomosis offers a promising alternative,particularly for patients with normal or relatively high body mass index,and addresses the unique challenges posed by diverse patient populations.This procedure preserves gastric anatomy while simultaneously improving metabolic parameters,such as glycemic control,lipid profiles,and pancreaticβ-cell function.Unlike traditional metabolic surgeries that involve permanent anatomical alterations,this approach provides advantages such as reversibility,shorter operative times,and minimal nutritional complications,making it appealing to patients for whom conventional bariatric surgery is unsuitable.Advances in gut hormone physiology and incretin modulation support these findings.This innovative approach represents a potential paradigm shift in T2DM treatment,offering insights into the evolving role of surgical interventions in metabolic regulation.While early findings show promising diabetes remission rates and metabolic improvements at six months post-surgery,further studies with longer follow-up periods and broader patient cohorts are required.展开更多
Tailoring 1D nanotubes with refined interfacial interactions and optimized adsorption sites presents a highly promising yet challenging strategy for advancing Na/Li-ion batteries(SIBs/LIBs).Herein,the intertwined yard...Tailoring 1D nanotubes with refined interfacial interactions and optimized adsorption sites presents a highly promising yet challenging strategy for advancing Na/Li-ion batteries(SIBs/LIBs).Herein,the intertwined yardlong bean-like Fe_(9)Ni_(9)S_(16)/FeS heterostructures with sulfur vacancies encapsulated in N-doped carbon nanotubes(3 N-Fe_(9)Ni_(9)S_(16)/FeS-3@CNTs)are controllably synthesized through Fe/Ni-catalyzed pyrolysis of dicyandiamide followed by sulfidation strategies.1D nanotubes with robust outer walls and internal cavity structures shorten the diffusion paths of ions/electrons and buffer volume expansion and aggregation of active materials.The Fe_(9)Ni_(9)S_(16)/FeS heterostructure provides a powerful driving force for charge transfer by forming built-in electric fields,optimizing ion adsorption,while the Fe_(9)Ni_(9)S_(16)features a wider interlayer spacing that allows for frequent Na+/Li+insertion and extraction,thereby enhancing the reaction kinetics within the electrode.Driven by these synergistic factors,the 3 N-Fe_(9)Ni_(9)S_(16)/FeS-3@CNTs demonstrates remarkable electrochemical performance,achieving a substantial reversible capacity of up to 682.1mA h g^(−1)for SIBs at 0.1 A g^(−1)and 782.7 mA h g^(−1)for LIBs at 0.5 A g−1,alongside exceptional cycling stability in SIBs,maintaining 78.7%of its capacity after 1500 cycles at 1 A g^(−1)coupling with the ether-based electrolyte.Employing various electrochemical analyses in conjunction with ex-situ characterization techniques and Density Functional Theory(DFT)calculations,the storage mechanisms and phase transition processes are investigated,elucidating the structure-composition-performance relationships.This work paves the way for a new strategy in designing advanced materials with engineered heterostructures and controllable defects for energy conversion and storage devices.展开更多
BACKGROUND Tinnitus is a common condition in otolaryngology;however,its pathophysiolo-gical mechanisms remain incompletely elucidated.Recent efforts have focused on improving individual treatment efficacy by combining...BACKGROUND Tinnitus is a common condition in otolaryngology;however,its pathophysiolo-gical mechanisms remain incompletely elucidated.Recent efforts have focused on improving individual treatment efficacy by combining different treatment app-roaches.Therefore,this study aimed to reveal the efficacy of Korean medicine(KM)combination therapy in treating chronic tinnitus unresponsive to conven-tional Western treatments.CASE SUMMARY A 35-year-old female patient with over 10 years of left-sided tinnitus,accom-panied by left eye twitching,headache,neck pain,and premenstrual syndrome,was diagnosed with liver qi stagnation.She underwent 11 sessions involving acupuncture-related treatments and Chuna therapy as part of KM treatment.From the 9th session onward,temporomandibular joint balancing therapy was incorporated.Following the treatment,tinnitus,headache,and neck pain resol-ved,while other symptoms improved,as reflected in the rating scores(tinnitus handicap inventory:68 to 0,headache impact test-6:64 to 36,neck disability in-dex:21 to 0).Significant improvement in tinnitus,headache,and neck pain was observed after just two KM treatment sessions;intermittent tinnitus ceased entirely after the 9th session,and improvements were maintained at the 2-month follow-up.CONCLUSION In conclusion,personalized treatment with a combination and modification of various KM therapies based on individual pattern diagnosis effectively alleviated daily life discomfort in a patient with chronic tinnitus,unresponsive to conventional treatments.This led to a rapid resolution of symptoms within a relatively short timeframe.展开更多
Dear Editor,Myelin oligodendrocyte glycoprotein(MOG)is a minor component of myelin,expressed on the external surface of oligodendrocytes in the central nervous system(CNS)[1].Anti-MOG antibodies(MOG-ab)have been impli...Dear Editor,Myelin oligodendrocyte glycoprotein(MOG)is a minor component of myelin,expressed on the external surface of oligodendrocytes in the central nervous system(CNS)[1].Anti-MOG antibodies(MOG-ab)have been implicated in the demyelinating process and are considered unique biomarkers for a group of heterogeneous autoimmune inflammatory CNS diseases known as MOG-associated disorder(MOGAD)[1].MOGAD can present with a range of clinical manifestations,including optic neuritis,transverse myelitis,acute disseminating encephalomyelitis,and brainstem or cerebral encephalitis[1].Optic neuritis is the most common clinical feature of MOGAD in adults,typically manifesting as steroid-sensitive,recurrent,bilateral optic neuritis with optic disc swelling[1].展开更多
BACKGROUND Balloon-assisted enteroscopy with a specialized overtube has improved the success of endoscopic retrograde cholangiopancreatography(ERCP)in patients with surgically altered anatomy(SAA).However,direct compa...BACKGROUND Balloon-assisted enteroscopy with a specialized overtube has improved the success of endoscopic retrograde cholangiopancreatography(ERCP)in patients with surgically altered anatomy(SAA).However,direct comparative data between double-balloon enteroscopy(DBE)and single-balloon enteroscopy(SBE)remain limited.AIM To compare the ERCP-related outcomes between DBE and SBE in patients with SAA.METHODS We retrospectively reviewed the medical records of 1042 patients with SAA who underwent ERCP.After propensity score matching for age and sex,494 patients were included,with 247 patients in each of the SBE and DBE groups.RESULTS The success rates of intubation,cannulation,completion of intended ERCP,and adverse events were similar between the DBE and SBE groups(94.3%vs 96.4%,P=0.393;89.5%vs 93.5%,P=0.147;88.3%vs 92.7%,P=0.125;10.5%vs 14.6%,P=0.222,respectively).However,the SBE group had significantly longer intubation and procedure times than the DBE group(23.5±22.3 minutes vs 14.1±13.5 minutes,P<0.001;65.2±37.9 minutes vs 31.0±18.5 minutes,P<0.001).Preserved gastric anatomy and Roux-en-Y reconstruction were independently associated with intubation failure(odds ratio=3.18,95%confidence interval:1.30-8.31;odds ratio=8.65,95%confidence interval:1.71-157.60,respectively).CONCLUSION DBE and SBE showed comparable clinical success and safety profiles in ERCP for patients with SAA,although SBE required significantly longer procedure times.DBE could provide procedural efficiency benefits in cases where an extended procedure duration is expected.Furthermore,a preserved gastric anatomy and Roux-en-Y reconstruction were identified as independent risk factors for intubation failure.展开更多
The use of abrasive waterjets(AWJs)for rock drilling offers advantages in urbanized areas,locations that are vulnerable to damage,and piling operations.However,the overall operational cost of AWJ systems remains high ...The use of abrasive waterjets(AWJs)for rock drilling offers advantages in urbanized areas,locations that are vulnerable to damage,and piling operations.However,the overall operational cost of AWJ systems remains high compared to that of conventional drilling methods,which constrains the long-term industrial application of AWJs.For instance,the abrasive costs account for over 60%of the total process cost,but the recycling of abrasives remaining after drilling could significantly reduce machining costs.In this study,the post-impact characteristics of abrasives were explored,aiming to enhance their recyclability.The physical properties and particle distribution of used abrasives vary depending on the jet energy,ultimately affecting their recyclability and recycling rate.The particle properties of used abrasives(particle size distribution,particle shape,and mean particle size)were compared under different waterjet energy variables(standoff distance(SOD)and water pressure)and test conditions(dry and underwater).Furthermore,the collision stages of the abrasive particles within a waterjet system were classified and analyzed.The results revealed that abrasive fragmentation predominantly occurred due to internal collisions within the mixing chamber.In addition,an attempt was made to optimize the waterjet parameters for an economical and efficient operation.The findings of this study could contribute to enhancing the cost-effectiveness of AWJ systems for rock drilling applications.展开更多
AIM:To report the demographic and systemic characteristics of patients,clinical progression of endophthalmitis,and the efficacy of various treatment strategies,with a focus on identifying key factors for preserving vi...AIM:To report the demographic and systemic characteristics of patients,clinical progression of endophthalmitis,and the efficacy of various treatment strategies,with a focus on identifying key factors for preserving vision in eyes with endogenous endophthalmitis due to Klebsiella pneumoniae(K.pneumoniae)liver abscess.METHODS:In this single-center,retrospective case series of 18 patients with endogenous endophthalmitis due to K.pneumoniae liver abscess were analyzed.Ophthalmologic features of endophthalmitis at early,intermediate and advanced stages were obtained from eyes with endophthalmitis of different severities.Prompt vitrectomy was considered primarily for all eyes except for very early endophthalmitis.Intravitreal injections of antibiotics were performed in eyes with endophthalmitis in the very early stages and in eyes where vitrectomy was not available,and additional control of infection was needed after vitrectomy.Evisceration was performed in eyes with corneoscleral perforation,advanced endophthalmitis,perforation with preseptal or orbital cellulitis,uncontrolled infection,or severe pain with no vision.RESULTS:Mean(±standard deviation)age of the 18 patients with endophthalmitis was 64.5±12.2(range:32-84)y,and 14 patients(77.8%)were males.Endophthalmitis tended to involve the retinal parenchyma first and then progressed into the vitreous cavity and anterior segments.However,it presented a tendency to cause massive subretinal abscesses even after vitrectomy with silicone oil tamponade.Very high intraocular pressure with new vessels on the iris(41.7%)were also commonly observed.Although all but three patients had systemic disease such as diabetes or hypertension,visual prognosis after treatment did not appear to depend significantly on underlying comorbidities.A final best-corrected visual acuity better than 20/60 was achieved only when lesions were detected very early,with relatively good initial visual acuity,likely reflecting lower bacterial inoculation in the eye.CONCLUSION:Detection of early endophthalmitis lesions appears to be the only way to preserve good vision in patients with K.pneumoniae liver abscesses.Therefore,proper guidelines for ophthalmologic screening remain to be established for subjects at a high risk of endophthalmitis.展开更多
Background:Patients with cancer are confronted not only with physical changes and pain but also with significant psychological challenges,including distress,anxiety,and depression,as a consequence of their diagnosis a...Background:Patients with cancer are confronted not only with physical changes and pain but also with significant psychological challenges,including distress,anxiety,and depression,as a consequence of their diagnosis and treatment.This study aimed to identify the factors influencing anxiety or depression in patientswith cancer,examine the relationship between the duration since cancer diagnosis and psychological state,and explore the association between these factors and the use of Korean medicine(KM).Methods:This study utilized data from the 2018 Korea Health Panel spanning 2008 to 2018.The analysis focused on adult participants(aged 19 and above)diagnosed with cancer who responded to their psychological state(i.e.,anxiety or depression)and the duration since their cancer diagnosis.The dependent variables were the presence of anxiety or depression and the utilization of KM.Descriptive statistics and multiple logistic regression analysis were used to investigate factors influencing these variables.Results:A total of 773 participants were included in the final analysis,of whom 214 reported prior KM experience.Multiple logistic regression analysis indicated that the likelihood of experiencing anxiety or depression decreased as the duration since cancer diagnosis increased.Factors associated with anxiety or depression in patients with cancer included sex(odds ratio[OR]=2.06),number of chronic diseases(OR=1.17),Charlson Comorbidity Index score(CCI score of 2:OR=1.60),and EQ-5D(EuroQol Five Dimensions Questionnaire)index(OR<0.001).Cancer patients without anxiety or depression were more likely to use KM if they had been diagnosed within three years,were female(OR=2.11),and had a higher number of chronic conditions(OR=1.20).In contrast,patients with anxiety or depression were more likely to utilizeKMif theyhadbeendiagnosed formore thanfive years(OR=6.30)and resided in urban areas.Conclusions:The results suggest that patterns of KM utilization among patients with cancer are associated with their psychological state.Future research should focus on identifying direct correlations between psychological factors and KM use in patients with cancer.展开更多
This study assessed the connectedness between oil shocks and industry stock indexes in the United States(US).We consider the normal and extreme conditions across different frequency horizons,and the quantile time–fre...This study assessed the connectedness between oil shocks and industry stock indexes in the United States(US).We consider the normal and extreme conditions across different frequency horizons,and the quantile time–frequency connectedness method is used to determine the tail risk contagion under different frequency horizons.Our results reveal that the short-term frequency connectedness significantly exceeds the long-term frequency connectedness.We also indicate that the connectedness in the lower and upper quantiles is greater than at the conditional mean.Importantly,oil risk shock is the biggest net transmitter of shocks to the US sectors in normal and extreme conditions,highlighting that oil risk shocks cause substantial variations in US sector stock returns in the short,medium,and long term.Finally,QAR(3)model demonstrates the significant impact of oil risk shocks on US sector stock returns during extreme and normal conditions.Therefore,our study underscores the role of asymmetry in the reaction of US sector stock returns to oil-related shocks,and we suggest that policies aimed at overcoming the adverse effects of oil shocks on stock markets and promoting financial stability should incorporate asymmetric features.展开更多
We examine technology ETF and uncertainty index(VIX,GVZ,and OVZ)spillover dynamics and quantile frequency interconnectedness across market states.This study is the first to use quantile-frequency spillover,quadruple w...We examine technology ETF and uncertainty index(VIX,GVZ,and OVZ)spillover dynamics and quantile frequency interconnectedness across market states.This study is the first to use quantile-frequency spillover,quadruple wavelet coherence,and wavelet quantile correlation methodologies to facilitate these analyses.The total connectedness index value is 70%,which is much higher in both the upper and lower quantiles.Under normal market conditions,short-term connectedness significantly exceeds long-term connectedness.Levels of ETF-uncertainty indicator connectedness increase under extreme market conditions;most technology ETFs are net spillover transmitters and uncertainty indices net spillover receivers,indicating the contagion risk of ETF investments.We show that while greater ETF-uncertainty index connectedness may benefit portfolio diversification,large fluctuations in technology EFTs can result in financial instability due to high market volatility.In the long term,the joint effects of uncertainty indices on ETFs are significant,with negative correlations between ETFs and uncertainties at different frequencies,supporting the potential role of uncertainty indices in hedging technology ETF portfolio risks.Dynamic portfolio rebalancing,scenario analysis,and stress testing may help to manage the effects of high connectedness.展开更多
基金Supported by the Korea Health Technology R&D Project through the Korea Health Industry Development Institute(KHIDI),the Ministry of Health&Welfare,Republic of Korea(No.RS-2020-KH088726)the Patient-Centered Clinical Research Coordinating Center(PACEN),the Ministry of Health and Welfare,Republic of Korea(No.HC19C0276)the National Research Foundation of Korea(NRF),the Korea Government(MSIT)(No.RS-2023-00247504).
文摘AIM:To evaluate long-term visual field(VF)prediction using K-means clustering in patients with primary open angle glaucoma(POAG).METHODS:Patients who underwent 24-2 VF tests≥10 were included in this study.Using 52 total deviation values(TDVs)from the first 10 VF tests of the training dataset,VF points were clustered into several regions using the hierarchical ordered partitioning and collapsing hybrid(HOPACH)and K-means clustering.Based on the clustering results,a linear regression analysis was applied to each clustered region of the testing dataset to predict the TDVs of the 10th VF test.Three to nine VF tests were used to predict the 10th VF test,and the prediction errors(root mean square error,RMSE)of each clustering method and pointwise linear regression(PLR)were compared.RESULTS:The training group consisted of 228 patients(mean age,54.20±14.38y;123 males and 105 females),and the testing group included 81 patients(mean age,54.88±15.22y;43 males and 38 females).All subjects were diagnosed with POAG.Fifty-two VF points were clustered into 11 and nine regions using HOPACH and K-means clustering,respectively.K-means clustering had a lower prediction error than PLR when n=1:3 and 1:4(both P≤0.003).The prediction errors of K-means clustering were lower than those of HOPACH in all sections(n=1:4 to 1:9;all P≤0.011),except for n=1:3(P=0.680).PLR outperformed K-means clustering only when n=1:8 and 1:9(both P≤0.020).CONCLUSION:K-means clustering can predict longterm VF test results more accurately in patients with POAG with limited VF data.
文摘BACKGROUND Clinical guidelines for early extubation after liver transplantation remain lacking,with significant variations in the rates of early extubation across transplantation centers.AIM To identify clinical factors,including the use of epidural analgesia,associated with early extubation in living-donor liver transplantation(LDLT).METHODS The medical records of LDLT recipients were analyzed in this study,categorizing them based on extubation timing as delayed(leaving the operating room without extubation)or early(tracheal tube removed immediately after surgery).A multivariate binary logistic regression analysis was performed.Subgroup analysis was conducted,excluding patients contraindicated for epidural analgesia owing to significant coagulopathy.RESULTS Total of 159 patients,93(58.5%)underwent early extubation.Relevant clinical factors of early extubation were shorter anhepatic time[adjusted odds ratio(OR)=0.439,95%confidence interval(CI):0.232-0.831;P=0.011],absence of high-dose vasoactive drug use at the end of surgery(OR=0.235,95%CI:0.106-0.519;P<0.001),and the use of epidural analgesia(OR=15.730,95%CI:1.919-128.919;P=0.010).In a subgroup analysis of 67 patients,epidural analgesia remained a relevant clinical factor for early extubation(adjusted OR=19.381,95%CI:2.15-174.433;P=0.008).CONCLUSION Shorter anhepatic time,absence of high-dose vasoactive drug use at the end of surgery,and the use of epidural analgesia are relevant clinical factors of early extubation following LDLT.
基金supported by the Merkin PNNR Center(23-DF/C2/261)(to HS).
文摘Neurons are highly polarized,morphologically asymmetric,and functionally compartmentalized cells that contain long axons extending from the cell body.For this reason,their maintenance relies on spatiotemporal regulation of organelle distribution between the somatodendritic and axonal domains.Although some organelles,such as mitochondria and smooth endoplasmic reticulum,are widely distributed throughout the neuron,others are segregated to either the somatodendritic or axonal compartment.For example,Golgi outposts and acidified lysosomes are predominantly present in the somatodendritic domain and rarely distributed along the axon,whereas newly formed autophagosomes and synaptic vesicles are mainly distributed in the distal axon(Britt et al.,2016).
基金supported by the Institute for Basic Science (IBS-R022-D1)Global Learning&Academic Research Institution for Master’s/Ph D students and Post-Doc Program of the National Research Foundation of Korea Grant funded by the Ministry of Education (RS-2023-00301938)+1 种基金National Research Foundation of Korea Grant funded by the Korean government (RS-2024-00406152,MSIT)Additional financial support was provided by the 2024 Post-Doc Development Program of Pusan National University,Korea Medical Institute,and KREONET。
文摘Polystyrene nanoparticles pose significant toxicological risks to aquatic ecosystems,yet their impact on zebrafish(Danio rerio)embryonic development,particularly erythropoiesis,remains underexplored.This study used single-cell RNA sequencing to comprehensively evaluate the effects of polystyrene nanoparticle exposure on erythropoiesis in zebrafish embryos.In vivo validation experiments corroborated the transcriptomic findings,revealing that polystyrene nanoparticle exposure disrupted erythrocyte differentiation,as evidenced by the decrease in mature erythrocytes and concomitant increase in immature erythrocytes.Additionally,impaired heme synthesis further contributed to the diminished erythrocyte population.These findings underscore the toxic effects of polystyrene nanoparticles on hematopoietic processes,highlighting their potential to compromise organismal health in aquatic environments.
基金supported by the National Research Foundation of Korea(NRF)grants funded by the Korea government(MSIT)(Nos.RS-2024–00351052 and RS-2024–00450561).
文摘This study compares the microstructural evolution,dynamic recrystallization(DRX)behavior,tensile properties,and age-hardenability between the newly developed high-speed-extrudable BA56 alloy and those of the widely recognized AZ31 alloy in industry.Unlike the AZ31 alloy,which retains partially unrecrystallized grains,the high-speed-extruded BA56 alloy demonstrates a coarser but entirely recrystallized and more homogeneous microstructure.The fine-grained structure and abundant Mg_(3)Bi_(2) particles in the BA56 extrusion billet significantly enhance its DRX behavior,thus enabling rapid and complete recrystallization during extrusion.The BA56 alloy contains band-like fragmented Mg_(3)Bi_(2) particles and numerous fine Mg_(3)Bi_(2) particles distributed throughout the material,in contrast to the sparse Al_(8)Mn_(5) particles in the AZ31 alloy.These features contribute to superior mechanical properties of the BA56 alloy,which achieves tensile yield and ultimate tensile strengths of 205 and 292 MPa,respectively,compared to 196 and 270 MPa for the AZ31 alloy.The superior strength of the BA56 alloy,even with its coarser grain size,can be explained by its elevated Hall-Petch constant and the strengthening contribution from the fine Mg_(3)Bi_(2) particles.Additionally,the BA56 alloy demonstrates significant age-hardenability,achieving a 22%enhancement in hardness following T5 aging,attributed to the precipitation of nanoscale Mg_(3)Bi_(2) and Mg_(17)Al_(12) phases.By contrast,the AZ31 alloy shows minimal hardening due to the absence of precipitate formation during aging.These findings suggest that the BA56 alloy is a promising candidate for the production of extruded Mg components requiring a combination of high productivity,superior mechanical performance,and wide-ranging process adaptability.
基金Supported by The New Faculty Research Grant of Pusan National University,2023The Research Grant of the Chungbuk National University in 2023.
文摘BACKGROUND Intramuscular corticosteroid injection may cause adverse effects such as dermal and/or subcutaneous atrophy,alopecia,hypopigmentation,and hyperpigmentation.Although cutaneous atrophy can spontaneously resolve,several treatment options have been suggested for this condition.CASE SUMMARY In this paper,we report a case of corticosteroid injection induced lipoatrophy treated with autologous whole blood(AWB)injection,as the condition had been unresponsive to fractional laser therapy.A 29-year-old female patient visited the dermatology clinic complaining of skin depression on her right buttock area,which had appeared six months earlier.There had been only subtle improvement at the margins after fractional CO_(2) laser treatment;therefore,after obtaining informed consent from the patient,AWB treatment was initiated.One month after the first AWB injection,the size and depth of the lesion had noticeably improved,and a slight improvement was also observed in discoloration.CONCLUSION Close observation is the initial treatment of choice for steroid induced skin atrophy;however,for patients in need of immediate cosmetic improvement,AWB injection may be a safe and cost-effective alternative.
基金Supported by Biomedical Research Institute Grant from Pusan National University Hospital,No.202500360001.
文摘BACKGROUND Although obesity is a well-established contributor to surgical risks,evidence regarding the specific outcomes of laparoscopic cholecystectomy(LC)in obese patients remains scarce.AIM To assess clinicopathologic differences and 1-year outcomes following elective LC in patients with obesity and gallstone disease.METHODS This retrospective study analyzed data from 65 patients who underwent elective LC for gallstone disease between January 2020 and May 2022,with outcomes assessed at the 1-year follow-up.Patients were categorized as obese(body mass index≥25 kg/m^(2))or non-obese(body mass index<25 kg/m^(2)),and comparisons were made across preoperative laboratory values,intraoperative parameters,and patient-reported outcomes.RESULTS The obese group had significantly higher American Society of Anesthesiologists scores,higher glycated hemoglobin levels,and lower vitamin D levels than the non-obese group.Elevated triglycerides were more frequent in the obese group,whereas higher high-density lipoprotein levels were more common in the nonobese group.Intraoperative and postoperative outcomes did not differ between the groups.At the 1-year follow-up,24.6%of patients reported post-cholecystectomy symptoms,with no group differences.CONCLUSION Obese patients had higher American Society of Anesthesiologists scores,lower vitamin D,and elevated triglycerides preoperatively,but these differences did not significantly affect intraoperative findings or 1-year postoperative outcomes compared to non-obese patients.
基金Supported by Clinical Research Grant from Pusan National University Hospital in 2024.
文摘BACKGROUND Primary splenic lesions are rare and often detected incidentally through imaging,biopsy,or autopsy,typically without distinct clinical symptoms.Although imaging can help differentiate benign from malignant lesions,splenic hamartomas,and angiosarcomas may exhibit overlapping features,making diagnosis challenging.This report presents a case of splenic hamartoma suspected to be an angiosarcoma based on preoperative imaging.Splenic hamartomas that mimic angiosarcomas are exceedingly rare.CASE SUMMARY A 33-year-old male presented to the Department of Emergency with frank red blood hematemesis and a 1-week history of epigastric pain.On arrival,he was alert and hemodynamically stable.Contrast-enhanced abdominal computed tomography revealed splenomegaly with significant engorgement of the portal and splenic veins,along with a diffuse nodular splenic lesion measuring 8.2 cm×6.2 cm.Following esophageal varix ligation,abdominal magnetic resonance imaging demonstrated iso-to high-signal intensity within the splenic mass and multiple hypervascular lesions in the right hepatic lobe,raising suspicion for splenic an-giosarcoma with hepatic metastases.18F-fluorodeoxyglucose positron emission tomography-computed tomography showed diffusely mild increased metabolic activity in the spleen.The patient subsequently underwent splenectomy and liver biopsy.Histopathological examination revealed chronic inflammation in the liver,and the splenic lesion was confirmed to be a splenic hamartoma.The patient successfully returned to work and remains in good health.CONCLUSION This rare case of splenic hamartoma mimicking angiosarcoma highlights the importance of differential diagnosis in managing splenic tumors.
基金supported by the Convergence Medical Institute of Technology Policy Research Project(CMIT PRP 2022-03)at Pusan National University Hospital.
文摘Coronavirus disease 2019(COVID-19)has had a substantial global health impact,with over 765 million confirmed cases and nearly 7 million deaths.[1]In South Korea,stringent lockdown policy heavily restricted the daily activities for over two years,resulting in widespread public health issues.
文摘In this editorial,I discuss the article by Wang et al,published in the World Journal of Diabetes,which explores jejunoileal side-to-side anastomosis as a novel surgical intervention for type 2 diabetes mellitus(T2DM).T2DM,often associated with obesity,remains a global health challenge,as sustained remission is difficult to achieve with conventional pharmacological therapy.Jejunoileal anastomosis offers a promising alternative,particularly for patients with normal or relatively high body mass index,and addresses the unique challenges posed by diverse patient populations.This procedure preserves gastric anatomy while simultaneously improving metabolic parameters,such as glycemic control,lipid profiles,and pancreaticβ-cell function.Unlike traditional metabolic surgeries that involve permanent anatomical alterations,this approach provides advantages such as reversibility,shorter operative times,and minimal nutritional complications,making it appealing to patients for whom conventional bariatric surgery is unsuitable.Advances in gut hormone physiology and incretin modulation support these findings.This innovative approach represents a potential paradigm shift in T2DM treatment,offering insights into the evolving role of surgical interventions in metabolic regulation.While early findings show promising diabetes remission rates and metabolic improvements at six months post-surgery,further studies with longer follow-up periods and broader patient cohorts are required.
基金supported by the program of National Research Foundation of Korea(NRF)funded by the Ministry of Science,ICT and Future planning(grant number 2022R1A4A1034312,2023R1A2C1007413)by the Commercialization Promotion Agency for R&D Outcomes(COMPA)grant funded by the Korean Government(Ministery of Science and ICT)(RS-2023-00304764)。
文摘Tailoring 1D nanotubes with refined interfacial interactions and optimized adsorption sites presents a highly promising yet challenging strategy for advancing Na/Li-ion batteries(SIBs/LIBs).Herein,the intertwined yardlong bean-like Fe_(9)Ni_(9)S_(16)/FeS heterostructures with sulfur vacancies encapsulated in N-doped carbon nanotubes(3 N-Fe_(9)Ni_(9)S_(16)/FeS-3@CNTs)are controllably synthesized through Fe/Ni-catalyzed pyrolysis of dicyandiamide followed by sulfidation strategies.1D nanotubes with robust outer walls and internal cavity structures shorten the diffusion paths of ions/electrons and buffer volume expansion and aggregation of active materials.The Fe_(9)Ni_(9)S_(16)/FeS heterostructure provides a powerful driving force for charge transfer by forming built-in electric fields,optimizing ion adsorption,while the Fe_(9)Ni_(9)S_(16)features a wider interlayer spacing that allows for frequent Na+/Li+insertion and extraction,thereby enhancing the reaction kinetics within the electrode.Driven by these synergistic factors,the 3 N-Fe_(9)Ni_(9)S_(16)/FeS-3@CNTs demonstrates remarkable electrochemical performance,achieving a substantial reversible capacity of up to 682.1mA h g^(−1)for SIBs at 0.1 A g^(−1)and 782.7 mA h g^(−1)for LIBs at 0.5 A g−1,alongside exceptional cycling stability in SIBs,maintaining 78.7%of its capacity after 1500 cycles at 1 A g^(−1)coupling with the ether-based electrolyte.Employing various electrochemical analyses in conjunction with ex-situ characterization techniques and Density Functional Theory(DFT)calculations,the storage mechanisms and phase transition processes are investigated,elucidating the structure-composition-performance relationships.This work paves the way for a new strategy in designing advanced materials with engineered heterostructures and controllable defects for energy conversion and storage devices.
文摘BACKGROUND Tinnitus is a common condition in otolaryngology;however,its pathophysiolo-gical mechanisms remain incompletely elucidated.Recent efforts have focused on improving individual treatment efficacy by combining different treatment app-roaches.Therefore,this study aimed to reveal the efficacy of Korean medicine(KM)combination therapy in treating chronic tinnitus unresponsive to conven-tional Western treatments.CASE SUMMARY A 35-year-old female patient with over 10 years of left-sided tinnitus,accom-panied by left eye twitching,headache,neck pain,and premenstrual syndrome,was diagnosed with liver qi stagnation.She underwent 11 sessions involving acupuncture-related treatments and Chuna therapy as part of KM treatment.From the 9th session onward,temporomandibular joint balancing therapy was incorporated.Following the treatment,tinnitus,headache,and neck pain resol-ved,while other symptoms improved,as reflected in the rating scores(tinnitus handicap inventory:68 to 0,headache impact test-6:64 to 36,neck disability in-dex:21 to 0).Significant improvement in tinnitus,headache,and neck pain was observed after just two KM treatment sessions;intermittent tinnitus ceased entirely after the 9th session,and improvements were maintained at the 2-month follow-up.CONCLUSION In conclusion,personalized treatment with a combination and modification of various KM therapies based on individual pattern diagnosis effectively alleviated daily life discomfort in a patient with chronic tinnitus,unresponsive to conventional treatments.This led to a rapid resolution of symptoms within a relatively short timeframe.
文摘Dear Editor,Myelin oligodendrocyte glycoprotein(MOG)is a minor component of myelin,expressed on the external surface of oligodendrocytes in the central nervous system(CNS)[1].Anti-MOG antibodies(MOG-ab)have been implicated in the demyelinating process and are considered unique biomarkers for a group of heterogeneous autoimmune inflammatory CNS diseases known as MOG-associated disorder(MOGAD)[1].MOGAD can present with a range of clinical manifestations,including optic neuritis,transverse myelitis,acute disseminating encephalomyelitis,and brainstem or cerebral encephalitis[1].Optic neuritis is the most common clinical feature of MOGAD in adults,typically manifesting as steroid-sensitive,recurrent,bilateral optic neuritis with optic disc swelling[1].
基金Supported by National Research Foundation of Korea,No.RS-2022-NRO71822Hallym University Medical Center Research Fund(Mighty Hallym,4.0).
文摘BACKGROUND Balloon-assisted enteroscopy with a specialized overtube has improved the success of endoscopic retrograde cholangiopancreatography(ERCP)in patients with surgically altered anatomy(SAA).However,direct comparative data between double-balloon enteroscopy(DBE)and single-balloon enteroscopy(SBE)remain limited.AIM To compare the ERCP-related outcomes between DBE and SBE in patients with SAA.METHODS We retrospectively reviewed the medical records of 1042 patients with SAA who underwent ERCP.After propensity score matching for age and sex,494 patients were included,with 247 patients in each of the SBE and DBE groups.RESULTS The success rates of intubation,cannulation,completion of intended ERCP,and adverse events were similar between the DBE and SBE groups(94.3%vs 96.4%,P=0.393;89.5%vs 93.5%,P=0.147;88.3%vs 92.7%,P=0.125;10.5%vs 14.6%,P=0.222,respectively).However,the SBE group had significantly longer intubation and procedure times than the DBE group(23.5±22.3 minutes vs 14.1±13.5 minutes,P<0.001;65.2±37.9 minutes vs 31.0±18.5 minutes,P<0.001).Preserved gastric anatomy and Roux-en-Y reconstruction were independently associated with intubation failure(odds ratio=3.18,95%confidence interval:1.30-8.31;odds ratio=8.65,95%confidence interval:1.71-157.60,respectively).CONCLUSION DBE and SBE showed comparable clinical success and safety profiles in ERCP for patients with SAA,although SBE required significantly longer procedure times.DBE could provide procedural efficiency benefits in cases where an extended procedure duration is expected.Furthermore,a preserved gastric anatomy and Roux-en-Y reconstruction were identified as independent risk factors for intubation failure.
基金supported by the Korea Agency for Infrastructure Technology Advancement(KAIA)grant funded by the Ministry of Land,Infrastructure and Transport(Grant No.RS-2023-00245334)。
文摘The use of abrasive waterjets(AWJs)for rock drilling offers advantages in urbanized areas,locations that are vulnerable to damage,and piling operations.However,the overall operational cost of AWJ systems remains high compared to that of conventional drilling methods,which constrains the long-term industrial application of AWJs.For instance,the abrasive costs account for over 60%of the total process cost,but the recycling of abrasives remaining after drilling could significantly reduce machining costs.In this study,the post-impact characteristics of abrasives were explored,aiming to enhance their recyclability.The physical properties and particle distribution of used abrasives vary depending on the jet energy,ultimately affecting their recyclability and recycling rate.The particle properties of used abrasives(particle size distribution,particle shape,and mean particle size)were compared under different waterjet energy variables(standoff distance(SOD)and water pressure)and test conditions(dry and underwater).Furthermore,the collision stages of the abrasive particles within a waterjet system were classified and analyzed.The results revealed that abrasive fragmentation predominantly occurred due to internal collisions within the mixing chamber.In addition,an attempt was made to optimize the waterjet parameters for an economical and efficient operation.The findings of this study could contribute to enhancing the cost-effectiveness of AWJ systems for rock drilling applications.
文摘AIM:To report the demographic and systemic characteristics of patients,clinical progression of endophthalmitis,and the efficacy of various treatment strategies,with a focus on identifying key factors for preserving vision in eyes with endogenous endophthalmitis due to Klebsiella pneumoniae(K.pneumoniae)liver abscess.METHODS:In this single-center,retrospective case series of 18 patients with endogenous endophthalmitis due to K.pneumoniae liver abscess were analyzed.Ophthalmologic features of endophthalmitis at early,intermediate and advanced stages were obtained from eyes with endophthalmitis of different severities.Prompt vitrectomy was considered primarily for all eyes except for very early endophthalmitis.Intravitreal injections of antibiotics were performed in eyes with endophthalmitis in the very early stages and in eyes where vitrectomy was not available,and additional control of infection was needed after vitrectomy.Evisceration was performed in eyes with corneoscleral perforation,advanced endophthalmitis,perforation with preseptal or orbital cellulitis,uncontrolled infection,or severe pain with no vision.RESULTS:Mean(±standard deviation)age of the 18 patients with endophthalmitis was 64.5±12.2(range:32-84)y,and 14 patients(77.8%)were males.Endophthalmitis tended to involve the retinal parenchyma first and then progressed into the vitreous cavity and anterior segments.However,it presented a tendency to cause massive subretinal abscesses even after vitrectomy with silicone oil tamponade.Very high intraocular pressure with new vessels on the iris(41.7%)were also commonly observed.Although all but three patients had systemic disease such as diabetes or hypertension,visual prognosis after treatment did not appear to depend significantly on underlying comorbidities.A final best-corrected visual acuity better than 20/60 was achieved only when lesions were detected very early,with relatively good initial visual acuity,likely reflecting lower bacterial inoculation in the eye.CONCLUSION:Detection of early endophthalmitis lesions appears to be the only way to preserve good vision in patients with K.pneumoniae liver abscesses.Therefore,proper guidelines for ophthalmologic screening remain to be established for subjects at a high risk of endophthalmitis.
基金supported by a grant of the R&D Project through the Korea Health Industry Development Institute(KHIDI),funded by the Ministry of Health&Welfare,Republic of Korea(grant number:RS-2023-KH139376).
文摘Background:Patients with cancer are confronted not only with physical changes and pain but also with significant psychological challenges,including distress,anxiety,and depression,as a consequence of their diagnosis and treatment.This study aimed to identify the factors influencing anxiety or depression in patientswith cancer,examine the relationship between the duration since cancer diagnosis and psychological state,and explore the association between these factors and the use of Korean medicine(KM).Methods:This study utilized data from the 2018 Korea Health Panel spanning 2008 to 2018.The analysis focused on adult participants(aged 19 and above)diagnosed with cancer who responded to their psychological state(i.e.,anxiety or depression)and the duration since their cancer diagnosis.The dependent variables were the presence of anxiety or depression and the utilization of KM.Descriptive statistics and multiple logistic regression analysis were used to investigate factors influencing these variables.Results:A total of 773 participants were included in the final analysis,of whom 214 reported prior KM experience.Multiple logistic regression analysis indicated that the likelihood of experiencing anxiety or depression decreased as the duration since cancer diagnosis increased.Factors associated with anxiety or depression in patients with cancer included sex(odds ratio[OR]=2.06),number of chronic diseases(OR=1.17),Charlson Comorbidity Index score(CCI score of 2:OR=1.60),and EQ-5D(EuroQol Five Dimensions Questionnaire)index(OR<0.001).Cancer patients without anxiety or depression were more likely to use KM if they had been diagnosed within three years,were female(OR=2.11),and had a higher number of chronic conditions(OR=1.20).In contrast,patients with anxiety or depression were more likely to utilizeKMif theyhadbeendiagnosed formore thanfive years(OR=6.30)and resided in urban areas.Conclusions:The results suggest that patterns of KM utilization among patients with cancer are associated with their psychological state.Future research should focus on identifying direct correlations between psychological factors and KM use in patients with cancer.
基金supported by the Ministry of Education of the Republic of Korea and the National Research Foundation of Korea(NRF-2024S1A5A2A01028034).
文摘This study assessed the connectedness between oil shocks and industry stock indexes in the United States(US).We consider the normal and extreme conditions across different frequency horizons,and the quantile time–frequency connectedness method is used to determine the tail risk contagion under different frequency horizons.Our results reveal that the short-term frequency connectedness significantly exceeds the long-term frequency connectedness.We also indicate that the connectedness in the lower and upper quantiles is greater than at the conditional mean.Importantly,oil risk shock is the biggest net transmitter of shocks to the US sectors in normal and extreme conditions,highlighting that oil risk shocks cause substantial variations in US sector stock returns in the short,medium,and long term.Finally,QAR(3)model demonstrates the significant impact of oil risk shocks on US sector stock returns during extreme and normal conditions.Therefore,our study underscores the role of asymmetry in the reaction of US sector stock returns to oil-related shocks,and we suggest that policies aimed at overcoming the adverse effects of oil shocks on stock markets and promoting financial stability should incorporate asymmetric features.
基金supported by the Ministry of Education of the Republic of Korea and the National Research Foundation of Korea(NRF-2024S1A5A2A01028034).
文摘We examine technology ETF and uncertainty index(VIX,GVZ,and OVZ)spillover dynamics and quantile frequency interconnectedness across market states.This study is the first to use quantile-frequency spillover,quadruple wavelet coherence,and wavelet quantile correlation methodologies to facilitate these analyses.The total connectedness index value is 70%,which is much higher in both the upper and lower quantiles.Under normal market conditions,short-term connectedness significantly exceeds long-term connectedness.Levels of ETF-uncertainty indicator connectedness increase under extreme market conditions;most technology ETFs are net spillover transmitters and uncertainty indices net spillover receivers,indicating the contagion risk of ETF investments.We show that while greater ETF-uncertainty index connectedness may benefit portfolio diversification,large fluctuations in technology EFTs can result in financial instability due to high market volatility.In the long term,the joint effects of uncertainty indices on ETFs are significant,with negative correlations between ETFs and uncertainties at different frequencies,supporting the potential role of uncertainty indices in hedging technology ETF portfolio risks.Dynamic portfolio rebalancing,scenario analysis,and stress testing may help to manage the effects of high connectedness.
