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Jung YM, Lee SM, Oh S, Lyoo SH, Park CW, Lee SD, Park JS, Jun JK. The concordance rate of non-chromosomal congenital malformations in twins based on zygosity: a retrospective cohort study. BJOG 2020; 128:857-864. [PMID: 32783284 DOI: 10.1111/1471-0528.16463] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/31/2020] [Indexed: 11/29/2022]
Abstract
OBJECTIVE To examine the concordance rate of non-chromosomal congenital malformations in twin pairs based on zygosity. DESIGN Retrospective cohort study. SETTING A tertiary hospital in Korea. POPULATION Twin pairs born at Seoul National University Hospital between 2001 and 2019. METHODS Congenital malformations were diagnosed by postnatal workups of neonates or autopsy in cases of stillborn infants. Zygosity was confirmed by sex, chorionicity and DNA analysis. MAIN OUTCOME MEASURES Concordance rate of congenital malformations in twin pairs based on zygosity. RESULTS In total, 3386 twin pairs were included. The risk of a congenital malformation in the index twin increased significantly if the co-twin had the congenital malformation, and the concordance rate was higher in monozygotic (MZ) than in dizygotic (DZ) twins (37.04 versus 16.77, P < 0.001). An increased risk of a congenital malformation in the presence of the same congenital malformation in the co-twin was observed only for malformations of the nervous system, eye/ear/face/neck, circulatory system, cleft lip/palate, genital organs, urinary system and musculoskeletal system. Significantly higher concordance rates in MZ than in DZ twin pairs were observed only for the nervous system (40.00 versus 0.00, P < 0.001), circulatory system (32.97 versus 19.74, P = 0.021), cleft lip/palate (44.44 versus 0.00, P = 0.017) and urinary system (22.22 versus 0.00, P = 0.004), whereas significant differences were not found for the genital organs or musculoskeletal system. CONCLUSIONS Monozygotic twins had higher concordance rates than DZ twins only in specific organ systems. It may be speculated that nervous system, circulatory system, cleft lip/palate and urinary system are primarily genetically affected. TWEETABLE ABSTRACT Monozygotic twins had higher concordance rates than dizygotic twins only in specific organ systems.
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Park S, Byun S, Kim J, Yang B, Oh S. Treatment of Molar Incisor Malformation and the short term follow-up: Case reports. EUROPEAN JOURNAL OF PAEDIATRIC DENTISTRY 2020; 21:238-242. [PMID: 32893659 DOI: 10.23804/ejpd.2020.21.03.15] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
BACKGROUND Molar Incisor Malformation (MIM) or Molar Root Incisor malformation (MRIM) is a recently discovered root malformation with constricted pulp and abnormally located furcation presented in permanent first molars and sometimes incisors. CASE REPORT Two cases that feature MIM are presented with the description of the characteristic tooth form, clinical/radiographic examination, medical history, the supposed aetiology, treatment procedure and results at the 2-year follow-up. Conservative endodontic treatment was performed in both cases, furcation perforation and canal perforation were filled with MTA (Mineral Trioxide Aggregate), and a good prognosis was observed after 2 years of follow-up. Furthermore, recommended treatment options are discussed to provide a more appropriate treatment for the patients. CONCLUSION Patients with MIM need to be treated at the right time to avoid severe infection and other problems. Early diagnosis with appropriate treatment is more likely to lead to a more favourable prognosis.
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Yoo S, Oh S, Yun J, Kwon O, Suh J, Park J, Choo M, Cho M, Jeong H, Won S, Son H. Optimal high-density lipoprotein cholesterol level for decreasing benign prostatic hyperplasia in men not taking statin medication: A historical cohort study. EUR UROL SUPPL 2020. [DOI: 10.1016/s2666-1683(20)33357-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022] Open
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Yun B, Maburutse BE, Kang M, Park MR, Park DJ, Kim Y, Oh S. Short communication: Dietary bovine milk-derived exosomes improve bone health in an osteoporosis-induced mouse model. J Dairy Sci 2020; 103:7752-7760. [PMID: 32622594 DOI: 10.3168/jds.2019-17501] [Citation(s) in RCA: 54] [Impact Index Per Article: 13.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2019] [Accepted: 04/14/2020] [Indexed: 12/13/2022]
Abstract
Osteoporosis is a systemic skeletal disease characterized by low bone mass and micro-architectural deterioration of bone tissue, with a consequent increase in bone fragility and fracture susceptibility. In an aged society with increased life expectancy, the incidence rate of osteoporosis is also rapidly increasing. Inadequate nutrition may negatively influence bone metabolism. Recently, many studies have investigated the functionality of milk-derived exosomes, which play important roles in cell-to-cell communication. However, there are few reports of how milk-derived exosomes influence osteoblast proliferation and differentiation. Here, we determined whether bovine colostrum-derived exosomes promote anti-osteoporosis in vitro and in vivo. Tartrate-resistant acid phosphatase-stained cells were significantly inhibited in Raw264.7 cells treated with exosomes, indicating reduced osteoclast differentiation. We induced osteoporosis in mice using glucocorticoid pellets after orally administering exosomes for 2 mo. Interestingly, the bone mineral density of exosome-fed mouse groups was significantly improved compared with the glucocorticoid-induced osteoporosis group without exosome treatment. In addition, Lactobacillus were decreased in the gut microbiota community of osteoporosis-induced mice, but the gut microbiota community composition was effectively restored by exosome intake. Taken together, we propose that exosomes isolated from bovine colostrum could be a potential candidate for osteoporosis prevention, bone remodeling improvement, and inhibition of bone resorption. To our knowledge, this is the first time that a protective effect of milk exosomes against osteoporosis has been demonstrated in vivo. Our results strongly suggest that bovine colostrum exosomes might be used as a prophylaxis to prevent the onset of osteoporosis. Indeed, our results offer promising alternative strategies in the nutritional management of age-related bone complications.
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Di Pietro P, Adhlakha N, Piccirilli F, Di Gaspare A, Moon J, Oh S, Di Mitri S, Spampinati S, Perucchi A, Lupi S. Terahertz Tuning of Dirac Plasmons in Bi_{2}Se_{3} Topological Insulator. PHYSICAL REVIEW LETTERS 2020; 124:226403. [PMID: 32567905 DOI: 10.1103/physrevlett.124.226403] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/21/2019] [Accepted: 05/15/2020] [Indexed: 06/11/2023]
Abstract
Light can be strongly confined in subwavelength spatial regions through the interaction with plasmons, the collective electronic modes appearing in metals and semiconductors. This confinement, which is particularly important in the terahertz spectral region, amplifies light-matter interaction and provides a powerful mechanism for efficiently generating nonlinear optical phenomena. These effects are particularly relevant in graphene and topological insulators, where massless Dirac fermions show a naturally nonlinear optical behavior in the terahertz range. The strong interaction scenario has been considered so far from the point of view of light. In this Letter, we investigate instead the effect of strong interaction on the plasmon itself. In particular, we will show that Dirac plasmons in Bi_{2}Se_{3} topological insulator are strongly renormalized when excited by high-intensity terahertz radiation by displaying a huge red-shift down to 60% of its characteristic frequency. This opens the road towards tunable terahertz nonlinear optical devices based on topological insulators.
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Lee M, Lee K, Lee H, Kim N, Jeon J, Jeon S, Oh S, Kim S, Kim S, Lee Y. 0455 Role of Interaction Between Anterior Insula Response to Sleep-Related Pictures and Stress Levels on Sleep Disturbance. Sleep 2020. [DOI: 10.1093/sleep/zsaa056.452] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Introduction
Literature suggests that stress may play an important role in sleep disturbance. Individuals with higher stress levels often showed hyperarousal to stressful events, possibly leading to sleep disturbance. Hyperarousal is also one of features of stress-related sleep disturbance. Here, we examined the extent to which stress levels interact with neural activity in response to sleep-related information to predict sleep disturbance.
Methods
Forty eight healthy adults (26 females, age = 35.7 ± 10.5) without sleep disorders based on nocturnal polysomnography participated in this study. They were viewing sleep-related pictures (e.g., bedroom and sunset) and non-sleep related, neutral pictures (e.g., kitchen and landscape) during fMRI scanning. They also completed questionnaires assessing stress levels and sleep disturbance using Life Experience Survey (LES) and Pittsburgh Sleep Quality Index (PSQI), respectively. Activity in response to sleep-related pictures compared to neutral pictures was extracted from our region-of-interest (ROI), the anterior insula, and entered into our moderation models. The SPSS macro PROCESS (Hayes, 2013) was used to conduct moderation analyses. Given a significant correlation between age and PSQI scores, age was included as a covariate.
Results
Our moderation analyses showed that interactions between stress levels and anterior insula response to sleep-related pictures significantly predicted sleep disturbance. Simple slope analyses showed that at higher anterior insula response, higher stress levels were associated with greater sleep disturbance, but at lower anterior insula response, stress was not significantly associated with sleep disturbance. These results indicate that individuals with high levels of stress were more likely to experience sleep disturbance if they showed greater anterior insula response to sleep-related pictures (i.e., hyperarousal in response to sleep-related information).
Conclusion
The current findings suggest that interactions between stress levels and neural substrates of hyperarousal, particularly the anterior insula, may play a critical role in sleep disturbance.
Support
Brain Research Program through the National Research Foundation of Korea funded by the Ministry of Science, ICT & Future Planning (Study No.: 2016M3C7A1904338 and NRF-2018R1D1A1B07049704).
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Lee K, Lee H, Jeon J, Jeon S, Kim N, Oh S, Lee M, Kim S, Lee Y. 0064 Heightened Neural Responses to Negative Words in Shift Workers Using the Stroop Task. Sleep 2020. [DOI: 10.1093/sleep/zsaa056.062] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Introduction
Shift work is known to have a negative impact on a wide range of health problems such as sleep disturbance, cognitive impairment, and emotional disorders (e.g., anxiety and depression). It is important to understand underlying mechanisms for negative impact of shift work on health problems. This study aimed to investigate psychological and neural mechanisms associated with shift work.
Methods
Thirty six shift workers (28 females, age = 29.9 ± 7.4) and 35 non-shift workers (20 females, age = 30.5 ± 5.5) participated in this study. They were performing the word Stroop task during fMRI scanning. This task included sleep-related words and negative words to investigate neural substrates associated with sleep-related information and emotional information processing. Neutral words were included as control stimuli. The participants also completed questionnaires assessing sleep-related problems such as Pittsburgh Sleep Quality Index (PSQI) and Epworth Sleepiness Scale, and emotion-related problems such as Beck Depression Inventory and Beck Anxiety Inventory. Two-sample t-tests were conducted to find group differences in self-report measures and neural response to sleep-related words and negative words compared to neutral words.
Results
Relative to non-shift workers, shift workers showed greater sleep disturbance (i.e., higher PSQI), but they did not show any evidence of emotion-related problems. Shift workers also demonstrated greater neural response to negative words (vs. neutral words) in several prefrontal regions (e.g., dorsal anterior cingulate cortex and dorsolateral prefrontal cortex), anterior insula and caudate compared to non-shift workers. However, shift workers did not show significantly different neural response to sleep-related words (vs. neutral words) compared to non-shift workers.
Conclusion
The result from this study provides supporting evidence that shift work is associated with subjective sleep disturbance. Shift workers’ heightened neural response to negative information may reflect their increased sensitivity to negative information, that may contribute to sleep disturbance.
Support
Brain Research Program through the National Research Foundation of Korea funded by the Ministry of Science, ICT & Future Planning (Study No.: 2016M3C7A1904338 and NRF-2018R1D1A1B07049704).
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Adam J, Adamczyk L, Adams JR, Adkins JK, Agakishiev G, Aggarwal MM, Ahammed Z, Alekseev I, Anderson DM, Aparin A, Aschenauer EC, Ashraf MU, Atetalla FG, Attri A, Averichev GS, Bairathi V, Barish K, Behera A, Bellwied R, Bhasin A, Bielcik J, Bielcikova J, Bland LC, Bordyuzhin IG, Brandenburg JD, Brandin AV, Butterworth J, Caines H, Calderón de la Barca Sánchez M, Cebra D, Chakaberia I, Chaloupka P, Chan BK, Chang FH, Chang Z, Chankova-Bunzarova N, Chatterjee A, Chen D, Chen JH, Chen X, Chen Z, Cheng J, Cherney M, Chevalier M, Choudhury S, Christie W, Crawford HJ, Csanád M, Daugherity M, Dedovich TG, Deppner IM, Derevschikov AA, Didenko L, Dong X, Drachenberg JL, Dunlop JC, Edmonds T, Elsey N, Engelage J, Eppley G, Esha R, Esumi S, Evdokimov O, Ewigleben J, Eyser O, Fatemi R, Fazio S, Federic P, Fedorisin J, Feng CJ, Feng Y, Filip P, Finch E, Fisyak Y, Francisco A, Fulek L, Gagliardi CA, Galatyuk T, Geurts F, Gibson A, Gopal K, Grosnick D, Guryn W, Hamad AI, Hamed A, Harris JW, He W, He X, Heppelmann S, Heppelmann S, Herrmann N, Hoffman E, Holub L, Hong Y, Horvat S, Hu Y, Huang HZ, Huang SL, Huang T, Huang X, Humanic TJ, Huo P, Igo G, Isenhower D, Jacobs WW, Jena C, Jentsch A, Ji Y, Jia J, Jiang K, Jowzaee S, Ju X, Judd EG, Kabana S, Kabir ML, Kagamaster S, Kalinkin D, Kang K, Kapukchyan D, Kauder K, Ke HW, Keane D, Kechechyan A, Kelsey M, Khyzhniak YV, Kikoła DP, Kim C, Kimelman B, Kincses D, Kinghorn TA, Kisel I, Kiselev A, Kisiel A, Kocan M, Kochenda L, Kosarzewski LK, Kramarik L, Kravtsov P, Krueger K, Kulathunga Mudiyanselage N, Kumar L, Kunnawalkam Elayavalli R, Kwasizur JH, Lacey R, Lan S, Landgraf JM, Lauret J, Lebedev A, Lednicky R, Lee JH, Leung YH, Li C, Li W, Li W, Li X, Li Y, Liang Y, Licenik R, Lin T, Lin Y, Lisa MA, Liu F, Liu H, Liu P, Liu P, Liu T, Liu X, Liu Y, Liu Z, Ljubicic T, Llope WJ, Longacre RS, Lukow NS, Luo S, Luo X, Ma GL, Ma L, Ma R, Ma YG, Magdy N, Majka R, Mallick D, Margetis S, Markert C, Matis HS, Mazer JA, Minaev NG, Mioduszewski S, Mohanty B, Mooney I, Moravcova Z, Morozov DA, Nagy M, Nam JD, Nasim M, Nayak K, Neff D, Nelson JM, Nemes DB, Nie M, Nigmatkulov G, Niida T, Nogach LV, Nonaka T, Odyniec G, Ogawa A, Oh S, Okorokov VA, Page BS, Pak R, Pandav A, Panebratsev Y, Pawlik B, Pawlowska D, Pei H, Perkins C, Pinsky L, Pintér RL, Pluta J, Porter J, Posik M, Pruthi NK, Przybycien M, Putschke J, Qiu H, Quintero A, Radhakrishnan SK, Ramachandran S, Ray RL, Reed R, Ritter HG, Roberts JB, Rogachevskiy OV, Romero JL, Ruan L, Rusnak J, Sahoo NR, Sako H, Salur S, Sandweiss J, Sato S, Schmidke WB, Schmitz N, Schweid BR, Seck F, Seger J, Sergeeva M, Seto R, Seyboth P, Shah N, Shahaliev E, Shanmuganathan PV, Shao M, Shen F, Shen WQ, Shi SS, Shou QY, Sichtermann EP, Sikora R, Simko M, Singh J, Singha S, Smirnov N, Solyst W, Sorensen P, Spinka HM, Srivastava B, Stanislaus TDS, Stefaniak M, Stewart DJ, Strikhanov M, Stringfellow B, Suaide AAP, Sumbera M, Summa B, Sun XM, Sun Y, Sun Y, Surrow B, Svirida DN, Szymanski P, Tang AH, Tang Z, Taranenko A, Tarnowsky T, Thomas JH, Timmins AR, Tlusty D, Tokarev M, Tomkiel CA, Trentalange S, Tribble RE, Tribedy P, Tripathy SK, Tsai OD, Tu Z, Ullrich T, Underwood DG, Upsal I, Van Buren G, Vanek J, Vasiliev AN, Vassiliev I, Videbæk F, Vokal S, Voloshin SA, Wang F, Wang G, Wang JS, Wang P, Wang Y, Wang Y, Wang Z, Webb JC, Weidenkaff PC, Wen L, Westfall GD, Wieman H, Wissink SW, Witt R, Wu Y, Xiao ZG, Xie G, Xie W, Xu H, Xu N, Xu QH, Xu YF, Xu Y, Xu Z, Xu Z, Yang C, Yang Q, Yang S, Yang Y, Yang Z, Ye Z, Ye Z, Yi L, Yip K, Zbroszczyk H, Zha W, Zhang D, Zhang S, Zhang S, Zhang XP, Zhang Y, Zhang ZJ, Zhang Z, Zhao J, Zhong C, Zhou C, Zhu X, Zhu Z, Zurek M, Zyzak M. First Measurement of Λ_{c} Baryon Production in Au+Au Collisions at sqrt[s_{NN}]=200 GeV. PHYSICAL REVIEW LETTERS 2020; 124:172301. [PMID: 32412276 DOI: 10.1103/physrevlett.124.172301] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/01/2019] [Revised: 02/24/2020] [Accepted: 03/27/2020] [Indexed: 06/11/2023]
Abstract
We report on the first measurement of the charmed baryon Λ_{c}^{±} production at midrapidity (|y|<1) in Au+Au collisions at sqrt[s_{NN}]=200 GeV collected by the STAR experiment at the Relativistic Heavy Ion Collider. The Λ_{c}/D^{0} [denoting (Λ_{c}^{+}+Λ_{c}^{-})/(D^{0}+D[over ¯]^{0})] yield ratio is measured to be 1.08±0.16 (stat)±0.26 (sys) in the 0%-20% most central Au+Au collisions for the transverse momentum (p_{T}) range 3<p_{T}<6 GeV/c. This is significantly larger than the pythia model calculations for p+p collisions. The measured Λ_{c}/D^{0} ratio, as a function of p_{T} and collision centrality, is comparable to the baryon-to-meson ratios for light and strange hadrons in Au+Au collisions. Model calculations including coalescence hadronization for charmed baryon and meson formation reproduce the features of our measured Λ_{c}/D^{0} ratio.
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Jo I, Kim H, Oh S, Kim H. Transient receptor potential vanilloid 2 mediates the inhibitory effect of far-infrared irradiation on adipogenic differentiation of tonsil-derived mesenchymal stem cells. Cytotherapy 2020. [DOI: 10.1016/j.jcyt.2020.03.149] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
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Jo S, Jang C, Oh S, Jo I. Basic fibroblast growth factor-induced cholinergic neuronal differentiation of tonsil-derived mesenchymal stem cells. Cytotherapy 2020. [DOI: 10.1016/j.jcyt.2020.03.148] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
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Lee A, You L, Harris L, Oh S, Fisher-Heffernan R, Brennan K, de Lange C, Huber L, Karrow N. Effect of algae or fish oil supplementation and porcine maternal stress on the adrenal transcriptome of male offspring fed a low-quality protein diet. Brain Behav Immun Health 2020; 4:100058. [PMID: 34589844 PMCID: PMC8474508 DOI: 10.1016/j.bbih.2020.100058] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2019] [Accepted: 03/03/2020] [Indexed: 11/18/2022] Open
Abstract
Offspring adrenal function may be negatively affected in utero by maternal stressors such as microbial infection. Maternal supplementation with immunomodulatory compounds such as omega-3 polyunsaturated fatty acids (n-3 PUFA) may help minimize the adverse effects of maternal stress on fetal hypothalamic-pituitary-adrenal development and improve offspring health. Presently, n-3 PUFA sources are primarily fish-based, but n-3 PUFA microalgae (AL) may be an alternative. Previously, it was determined that maternal AL or fish oil (FO) supplementation to sows, in addition to maternal stress induced by Escherichia coli lipopolysaccharide (LPS) challenge appeared to have a greater influence on the stress response of male offspring compared to females. To further elaborate on these findings, this study assessed the effects of maternal AL or FO supplementation combined with a maternal LPS challenge on adrenal gene expression in male offspring fed a nursery diet containing low-quality protein sources. Forty-eight sows were fed gestation diets starting on gestation day (gd) 75 containing either 3.12% AL, 3.1% FO, or a control diet containing 1.89% corn oil. On gd 112, half the sows in each treatment were administered 10 μg/kg LPS i.m. Piglets were weaned at 21 days of age onto a common low-quality plant-based protein diet, and one week after weaning, four piglets per sow were administered 40 μg/kg LPS i.m. Two hours later, the piglets were euthanized to obtain adrenal tissue, and total RNA was extracted to carry out transcriptome analysis using the Affymetrix GeneChip WT Plus assay and subsequent validation by real-time PCR. Analysis revealed that adrenal steroidogenesis, fatty acid metabolism and immune function were significantly influenced by maternal diet and stress. Increased expression of immune-related genes including lymphocyte antigen 96, TLR-2 and NF-κB suggests that maternal AL supplementation may increase offspring sensitivity to inflammation after weaning. Decreased expression of lymphocyte antigen 96 in male offspring from sows receiving maternal LPS challenge also suggests a possible role of maternal stress in diminishing the offspring immune response to immune stress challenge. Increased expression of the genes encoding the 11BHSD2 enzyme in offspring from sows fed FO may also reduce the magnitude of the stress response. These data provide insight to the immune and metabolic mechanisms that may be influenced by maternal diet and stress. Expression of adrenal steroidogenesis genes were influenced by maternal treatment. Expression of lipid metabolism genes and immune function genes were enriched. Maternal algae supplementation may increase offspring sensitivity to inflammation. Maternal stress may reduce the offspring immune response to immune challenges. Maternal fish oil supplementation may reduce the offspring stress response.
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Liu B, Lisberg A, Salehi-Rad R, Lee J, Tran L, Krysan K, Li R, Lim R, Dumitras C, Jing Z, Abtin F, Suh R, Genshaft S, Oh S, Aberle D, Winter L, Sharma S, Elashoff D, Garon E, Dubinett S. A33 Phase I Trial of in Situ Vaccination with Autologous CCL21-Modified Dendritic Cells (CCL21-DC) Combined with Pembrolizumab for Advanced NSCLC. J Thorac Oncol 2020. [DOI: 10.1016/j.jtho.2019.12.062] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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Lee HJ, Choi EK, Park JB, Han KD, Oh S. Tooth Loss Predicts Myocardial Infarction, Heart Failure, Stroke, and Death. J Dent Res 2020; 98:164-170. [PMID: 30782090 DOI: 10.1177/0022034518814829] [Citation(s) in RCA: 70] [Impact Index Per Article: 17.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023] Open
Abstract
We investigated whether oral health, represented by missing teeth, was associated with an increased risk of cardiovascular disease, including myocardial infarction (MI), heart failure (HF), stroke, and all-cause mortality. Subjects who underwent routine dental examinations and health checkups provided by the Korean National Health Insurance from 2007 to 2008 ( n = 4,440,970) were followed up for incident MI, HF, stroke, and death until 2016. During follow-up of 7.56 y, 68,063 (1.5%) subjects died, and 31,868 (0.7%) were admitted for MI, 22,637 (0.5%) for HF, and 30,941 (0.7%) for stroke. Cardiovascular events and mortality increased in proportion to tooth loss. Tooth loss was an independent risk factor for cardiovascular events after multivariable analysis adjusted for cardiovascular risk, behavioral, and income factors. Each missing tooth was associated with an approximately 1% increase in MI (HR, 1.010; 95% CI, 1.007 to 1.014), 1.5% increase in HF (HR, 1.016; 95% CI, 1.013 to 1.019) and stroke (HR, 1.015; 95% CI, 1.012 to 1.018), and 2% increase in mortality (HR, 1.022; 95% CI, 1.020 to 1.023). Having ≥5 missing teeth substantially increased risk for cardiovascular outcomes, and even a small number of missing teeth (1 to 4) was associated with an increased risk for MI, stroke, and death. This association was consistent in subgroup analyses and especially strong among the younger subjects (age <65 y) and those with periodontitis. In this large Korean nationwide cohort study, we found that tooth loss showed a dose-dependent association with incident MI, HF, ischemic stroke, and all-cause death and was a good predictor of cardiovascular outcome. In clinical practice, the number of missing teeth can aid physicians in discriminating patients with a higher cardiovascular risk.
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Yoo S, Suh J, Park J, Cho S, Jeong H, Son H, Oh S, Paick J, Cho M. 329 Does Preoperative Bladder Compliance Affect Long-term Functional Outcomes after Laser Prostatectomy? J Sex Med 2020. [DOI: 10.1016/j.jsxm.2019.11.149] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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Moon K, Lim S, Park J, Sung C, Oh S, Woo J, Lee J, Hwang H. RRAM-based synapse devices for neuromorphic systems. Faraday Discuss 2019; 213:421-451. [PMID: 30426118 DOI: 10.1039/c8fd00127h] [Citation(s) in RCA: 54] [Impact Index Per Article: 10.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Abstract
Hardware artificial neural network (ANN) systems with high density synapse array devices can perform massive parallel computing for pattern recognition with low power consumption. To implement a neuromorphic system with on-chip training capability, we need to develop an ideal synapse device with various device requirements, such as scalability, MLC characteristics, low power operation, data retention, and symmetric/linear conductance changes under potentiation/depression modes. Although various devices have been proposed for synapse applications, they have limitations for application in neuromorphic systems. In this paper, we will cover various RRAM synapse devices, such as filamentary switching RRAM (HfOx, TaOx, Cu-CBRAM) and analog RRAM devices, based on interface resistive switching (Pr0.7Ca0.3MnOx and TiOx) and ferroelectric polarization (HfZrOx). By optimizing potentiation/depression conditions, we could improve the conductance linearity and MLC characteristics of filamentary synapse devices. Interface RRAM has better MLC characteristics with limited retention and conductance linearity. By controlling the reactivity of metal electrodes and the oxygen concentration in oxides, we can modulate the synapse characteristics. Metal-Ferroelectric-Insulator-Semiconductor (MFIS) FET devices exhibit good retention characteristics and analog memory characteristics due to polarization. Based on various synapse device characteristics, we have estimated the pattern recognition accuracy of MNIST handwritten digits and CIFAR-10 datasets. We have confirmed that synapse device characteristics directly affect the pattern recognition accuracy of ANNs. In order to simultaneously satisfy all the requirements of synapse devices, it is necessary to develop new technology capable of controlling the movement of oxygen vacancies and metal ions at the atomic scale. Considering the limited synapse characteristics of current 2-terminal RRAM devices, hardware ANNs capable of only off-chip training can be constructed by optimizing the current RRAM devices by limiting the bit number. A 3-terminal synapse device or a device based on a new operation principle should be developed as an alternative for on-chip training applications.
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Adam J, Adamczyk L, Adams JR, Adkins JK, Agakishiev G, Aggarwal MM, Ahammed Z, Alekseev I, Anderson DM, Aoyama R, Aparin A, Aschenauer EC, Ashraf MU, Atetalla FG, Attri A, Averichev GS, Bairathi V, Barish K, Bassill AJ, Behera A, Bellwied R, Bhasin A, Bhati AK, Bielcik J, Bielcikova J, Bland LC, Bordyuzhin IG, Brandenburg JD, Brandin AV, Bryslawskyj J, Bunzarov I, Butterworth J, Caines H, Calderón de la Barca Sánchez M, Cebra D, Chakaberia I, Chaloupka P, Chan BK, Chang FH, Chang Z, Chankova-Bunzarova N, Chatterjee A, Chattopadhyay S, Chen JH, Chen X, Cheng J, Cherney M, Christie W, Contin G, Crawford HJ, Csanád M, Das S, Dedovich TG, Deppner IM, Derevschikov AA, Didenko L, Dilks C, Dong X, Drachenberg JL, Dunlop JC, Edmonds T, Elsey N, Engelage J, Eppley G, Esha R, Esumi S, Evdokimov O, Ewigleben J, Eyser O, Fatemi R, Fazio S, Federic P, Fedorisin J, Feng Y, Filip P, Finch E, Fisyak Y, Fulek L, Gagliardi CA, Galatyuk T, Geurts F, Gibson A, Gopal K, Greiner L, Grosnick D, Gupta A, Guryn W, Hamad AI, Hamed A, Harris JW, He L, Heppelmann S, Heppelmann S, Herrmann N, Holub L, Hong Y, Horvat S, Huang B, Huang HZ, Huang SL, Huang T, Huang X, Humanic TJ, Huo P, Igo G, Jacobs WW, Jena C, Jentsch A, Ji Y, Jia J, Jiang K, Jowzaee S, Ju X, Judd EG, Kabana S, Kagamaster S, Kalinkin D, Kang K, Kapukchyan D, Kauder K, Ke HW, Keane D, Kechechyan A, Kelsey M, Khyzhniak YV, Kikoła DP, Kim C, Kinghorn TA, Kisel I, Kisiel A, Kocan M, Kochenda L, Kosarzewski LK, Kramarik L, Kravtsov P, Krueger K, Kulathunga Mudiyanselage N, Kumar L, Kunnawalkam Elayavalli R, Kwasizur JH, Lacey R, Landgraf JM, Lauret J, Lebedev A, Lednicky R, Lee JH, Li C, Li W, Li W, Li X, Li Y, Liang Y, Licenik R, Lin T, Lipiec A, Lisa MA, Liu F, Liu H, Liu P, Liu P, Liu T, Liu X, Liu Y, Liu Z, Ljubicic T, Llope WJ, Lomnitz M, Longacre RS, Luo S, Luo X, Ma GL, Ma L, Ma R, Ma YG, Magdy N, Majka R, Mallick D, Margetis S, Markert C, Matis HS, Matonoha O, Mazer JA, Meehan K, Mei JC, Minaev NG, Mioduszewski S, Mishra D, Mohanty B, Mondal MM, Mooney I, Moravcova Z, Morozov DA, Nasim M, Nayak K, Nelson JM, Nemes DB, Nie M, Nigmatkulov G, Niida T, Nogach LV, Nonaka T, Odyniec G, Ogawa A, Oh S, Okorokov VA, Page BS, Pak R, Panebratsev Y, Pawlik B, Pawlowska D, Pei H, Perkins C, Pintér RL, Pluta J, Porter J, Posik M, Pruthi NK, Przybycien M, Putschke J, Quintero A, Radhakrishnan SK, Ramachandran S, Ray RL, Reed R, Ritter HG, Roberts JB, Rogachevskiy OV, Romero JL, Ruan L, Rusnak J, Rusnakova O, Sahoo NR, Sahu PK, Salur S, Sandweiss J, Schambach J, Schmidke WB, Schmitz N, Schweid BR, Seck F, Seger J, Sergeeva M, Seto R, Seyboth P, Shah N, Shahaliev E, Shanmuganathan PV, Shao M, Shen F, Shen WQ, Shi SS, Shou QY, Sichtermann EP, Siejka S, Sikora R, Simko M, Singh J, Singha S, Smirnov D, Smirnov N, Solyst W, Sorensen P, Spinka HM, Srivastava B, Stanislaus TDS, Stefaniak M, Stewart DJ, Strikhanov M, Stringfellow B, Suaide AAP, Sugiura T, Sumbera M, Summa B, Sun XM, Sun Y, Sun Y, Surrow B, Svirida DN, Szelezniak MA, Szymanski P, Tang AH, Tang Z, Taranenko A, Tarnowsky T, Tawfik A, Thomas JH, Timmins AR, Tlusty D, Tokarev M, Tomkiel CA, Trentalange S, Tribble RE, Tribedy P, Tripathy SK, Tsai OD, Tu B, Tu Z, Ullrich T, Underwood DG, Upsal I, Van Buren G, Vanek J, Vasiliev AN, Vassiliev I, Videbæk F, Vokal S, Voloshin SA, Wang F, Wang G, Wang P, Wang Y, Wang Y, Webb JC, Wen L, Westfall GD, Wieman H, Wissink SW, Witt R, Wu Y, Xiao ZG, Xie G, Xie W, Xu H, Xu N, Xu QH, Xu YF, Xu Z, Yang C, Yang Q, Yang S, Yang Y, Yang Z, Ye Z, Ye Z, Yi L, Yip K, Zbroszczyk H, Zha W, Zhang D, Zhang L, Zhang S, Zhang S, Zhang XP, Zhang Y, Zhang Z, Zhao J, Zhong C, Zhou C, Zhu X, Zhu Z, Zurek M, Zyzak M. First Observation of the Directed Flow of D^{0} and D^{0}[over ¯] in Au+Au Collisions at sqrt[s_{NN}]=200 GeV. PHYSICAL REVIEW LETTERS 2019; 123:162301. [PMID: 31702332 DOI: 10.1103/physrevlett.123.162301] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/06/2019] [Revised: 08/09/2019] [Indexed: 06/10/2023]
Abstract
We report the first measurement of rapidity-odd directed flow (v_{1}) for D^{0} and D^{0}[over ¯] mesons at midrapidity (|y|<0.8) in Au+Au collisions at sqrt[s_{NN}]=200 GeV using the STAR detector at the Relativistic Heavy Ion Collider. In 10-80% Au+Au collisions, the slope of the v_{1} rapidity dependence (dv_{1}/dy), averaged over D^{0} and D^{0}[over ¯] mesons, is -0.080±0.017(stat)±0.016(syst) for transverse momentum p_{T} above 1.5 GeV/c. The absolute value of D^{0} meson dv_{1}/dy is about 25 times larger than that for charged kaons, with 3.4σ significance. These data give a unique insight into the initial tilt of the produced matter, and offer constraints on the geometric and transport parameters of the hot QCD medium created in relativistic heavy-ion collisions.
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Lee H, Lee SR, Choi EK, Han KD, Oh S. P1884Low lipid levels and high variability correlate with the risk of new-onset atrial fibrillation. Eur Heart J 2019. [DOI: 10.1093/eurheartj/ehz748.0632] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Background
High levels of lipids and lipid variability are established risk factors for atherosclerotic cardiovascular disease. We investigated their roles in the development of atrial fibrillation (AF). This is the largest cohort study yet on the association between lipid levels and AF, and the first study on the association between lipid variability and AF.
Methods
A nationwide population-based cohort of 3,828,652 adults (mean age 43.9 years) from the Korean National Health Insurance Service database without prevalent AF, not on lipid-lowering medication, and with at least 3 measurements of each lipid parameter at 1–2 year intervals over a 4-year period were included. Total cholesterol (TC), low-density lipoprotein cholesterol (LDL-C), high-density lipoprotein cholesterol (HDL-C), and triglycerides (TG) were measured, and lipid variability was calculated using variability independent of mean. The cohort was divided into quartiles by baseline lipid levels and lipid variability, and followed up for incident AF.
Results
During median 3.4 years of follow-up, AF was newly diagnosed in 13,240 (0.35%). AF development was inversely associated with TC and LDL-C levels (for top vs. bottom quartile; TC, hazard ratio [HR] 0.76, 95% confidence interval [95% CI] 0.72–0.80); LDL-C, HR 0.78, 95% CI 0.74–0.82) in both sexes, and with TG levels in men (HR 0.85, 95% CI 0.80–0.90). Meanwhile, AF development was associated with higher LDL-C and HDL-C variability (for top vs. bottom quartile; LDL-C, HR 1.16, 95% CI 1.10–1.22; HDL-C, HR 1.08, 95% CI 1.03–1.14) in both sexes, and with TC variability in men (HR 1.16, 95% CI 1.10–1.22).
Conclusions
Lower cholesterol levels (TC, LDL-C) and higher cholesterol variability (LDL-C, HDL-C) were associated with higher risk for AF. Low TG levels and high TC variability were also associated with AF incidence in men. These findings support the “cholesterol paradox” in AF, and suggest that cholesterol variability is also a risk factor for AF development.
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93
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Okada S, Hattori A, Matsunaga T, Takamochi K, Oh S, Inoue M, Suzuki K. P1.17-10 Prediction of Visceral Pleural Invasion in c-N0 Non-Small Cell Lung Cancer. J Thorac Oncol 2019. [DOI: 10.1016/j.jtho.2019.08.1284] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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94
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Watanabe Y, Takamochi K, Oh S, Suzuki K. EP1.08-02 Surgical Indication for Postoperative Regional Lymph Node Oligo-Recurrence in Non-Small Cell Lung Cancer. J Thorac Oncol 2019. [DOI: 10.1016/j.jtho.2019.08.2191] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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95
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Choi EK, Lee SR, Han KD, Oh S. P3776Blood pressure variability and incidence of new-onset atrial fibrillation. Eur Heart J 2019. [DOI: 10.1093/eurheartj/ehz745.0626] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Background
Visit-to-visit blood pressure (BP) variability is a known risk factor for stroke, but the association between BP variability and atrial fibrillation (AF) incidence is uncertain. We sought to evaluate the association between BP variability and incident AF.
Methods
We identified 8,063,922 subjects (mean age 48 years; 59% men) who had ≥3 health checkups provided by the Korean National Health Insurance Corporation between 2004 and 2010. Systolic and diastolic BP variability was defined as variability independence of the mean (VIM). VIM was divided into four groups and high variability of BP was defined as the highest quartile values. The primary end point was new-onset atrial fibrillation.
Results
During a mean 7 years of follow-up, 140,086 subjects were newly diagnosed with AF (2.53 per 1000 person-years). High variation in BP was associated with an increase in the risk of AF (SBP: hazard ratio [HR], 1.060; 95% confidence interval [CI], 1.044–1.075, DBP: HR, 1.066; 95% CI, 1.050–1.082) compared with subjects with lowest quartile of BP. Among subjects with high variation both in SBP and DBP, the risk of AF was 7.6% higher than subjects without high variation in SBP and DBP. The risk of high BP variation on new-onset AF was more obvious in high-risk patients. The association of high BP variability with AF was being stronger for high-risk subjects who were older (≥65 years), with diabetes, or with CKD compared with subjects who were younger, without diabetes, or without CKD.
Conclusions
Fluctuation in SBP and DBP was associated with higher incidence of AF, especially in high-risk subjects, independent of traditional AF risk factors.
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Hattori A, Takamochi K, Oh S, Suzuki K. P2.17-03 Surgical Outcomes of Repeated Anatomical Pulmonary Resection for the Ipsilateral Second Lung Cancers. J Thorac Oncol 2019. [DOI: 10.1016/j.jtho.2019.08.1914] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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97
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Lee H, Choi EK, Han KD, Oh S. P1871Bodyweight variability and atrial fibrillation development. Eur Heart J 2019. [DOI: 10.1093/eurheartj/ehz748.0621] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Background
Bodyweight fluctuation is a risk factor for cardiovascular events and death. We investigated whether bodyweight variability is also a risk factor for atrial fibrillation (AF) development.
Methods
A nationwide population-based cohort of 8,091,401 adults from the Korean National Health Insurance Service database without previous history of AF and with at least 3 measurements of bodyweight over a 5-year period was followed up for incident AF. Intra-individual bodyweight variability was calculated using variability independent of mean, and high bodyweight variability was defined as the quartile with highest bodyweight variability (Q4) with Q1–3 as reference.
Results
During median 8.1 years of follow-up, AF was newly diagnosed in 158,347 (2.0%). Increasing bodyweight variability was associated with AF development after adjustment for baseline bodyweight, height, age, sex, lifestyle factors and comorbidities: each increase of 1-SD in bodyweight variability was associated with 5% increased risk of AF development (hazard ratio [HR] 1.05, 95% confidence interval [CI] 1.04–1.05), and subjects with highest bodyweight variability (Q4) showed 14% increased risk of AF development compared to those in the quartile with lowest bodyweight variability (HR 1.14, 95% CI 1.12–1.15).
When the cohort was grouped by body mass index (BMI) into underweight, normal weight, overweight, obese (Figure 1A), subjects with high bodyweight variability showed a shallow U-shaped relationship of BMI with AF incidence, with the highest incidence rate of AF in the underweight group. On the other hand, subjects with reference bodyweight variability showed a proportional increase of AF incidence with BMI, with the highest AF incidence in the obese group. High bodyweight variability was significantly associated with AF development in all BMI groups except in the very obese (BMI≥30) in multivariable analysis, and this association was stronger in subjects with lower bodyweight. In underweight subjects, high bodyweight variability was associated with 16% increased risk of AF development (HR 1.16, 95% CI 1.08–1.24). Obese subjects with high bodyweight variability compared to those with reference variability showed lower crude AF incidence rates, but after multivariable analysis, AF risk was increased (obese stage I) or comparable (obese stage II).
When the cohort was grouped by total bodyweight change (Figure 1B), subjects with high bodyweight variability showed higher AF incidence and elevated AF risk on multivariable analysis in all weight change groups. Subjects with overall weight loss (≥-5%) and high bodyweight variability showed the highest AF incidence and AF risk (HR 1.12, 95% CI 1.09–1.15).
Figure 1
Conclusions
Fluctuation in bodyweight was independently associated with higher risk of AF development. The association of high bodyweight variability with AF development was especially stronger in subjects with lower bodyweight, and in subjects with overall weight loss (≥-5%)
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Choi EK, Lee SR, Lee SR, Kwon S, Kwon S, Han KD, Han KD, Jung JH, Jung JH, Oh S, Oh S, Lip GYH, Lip GYH. P4782Direct comparison of dabigatran, apixaban, rivaroxaban and edoxaban for effectiveness and safety among patients with non-valvular atrial fibrillation. Eur Heart J 2019. [DOI: 10.1093/eurheartj/ehz745.1158] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Background
Although the prescription of non-vitamin K antagonist oral anticoagulants (NOACs) in patients with non-valvular atrial fibrillation (AF) has been rapidly increasing in Asian countries since their introduction, limited evidence exists on the effectiveness and safety of warfarin and all 4 available NOACs from current clinical practice in the Asian population. We aimed to evaluate comparative effectiveness and safety of warfarin and all 4 available NOACs
Methods
We studied a retrospective observational cohort of oral anticoagulant (OAC) naïve non-valvular AF patients treated with warfarin or NOACs (rivaroxaban, dabigatran, apixaban, or edoxaban) from January 2015 to December 2017, based on the Korean Health Insurance Review and Assessment database. For the comparisons, warfarin to 4 NOACs and NOAC to NOAC comparison cohorts were balanced using inverse probability of treatment weighting (IPTW). Ischemic stroke, intracranial hemorrhage (ICH), gastrointestinal bleeding (GIB), major bleeding (MB) and a composite clinical outcome were evaluated.
Results
A total of 116,804 patients were included (25,420 with warfarin, 35,965 with rivaroxaban, 17,745 with dabigatran, 22,177 with apixaban, and 15,496 with edoxaban). Patients treated with warfarin were younger (mean age 67 years) compared to NOAC users (71 to 73 years) and had lower mean CHA2DS2-VASc score (3.18) than the NOAC groups (3.58 to 3.76). Among the NOAC users, patients prescribed apixaban were older (mean age 73 years) than other NOAC groups (71 to 72 years), had higher mean CHA2DS2-VASc score (3.76) than others (3.55 to 3.63) and higher burden of comorbidities. More than half of patients were prescribed reduced dose regimes. After IPTW, all baseline covariates were well balanced across 5 treatment groups. Compared with warfarin, all NOACs were associated with lower risks of ischemic stroke, ICH, GIB, MB and composite outcome (Figure A). Apixaban and edoxaban showed a lower rate of ischemic stroke compared with rivaroxaban and dabigatran (Figure B). Apixaban, dabigatran and edoxaban had a lower rate of GIB and MB compared with rivaroxaban. The composite clinical outcome was non-significantly different for apixaban vs edoxaban.
Conclusions
In this large contemporary observational Asian cohort, all 4 NOACs were associated with lower rates of ischemic stroke and major bleeding compared to warfarin. Differences in clinical outcomes between NOACs may give useful guidance for physicians to choose drugs to fit their particular patient clinical profile.
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Lim HE, Ahn J, Han SJ, Shim J, Kim YH, Choi EK, Oh S, Shin SY, Lip GYH. P1026Risk factors for the occurrence of stroke after atrial fibrillation ablation. Eur Heart J 2019. [DOI: 10.1093/eurheartj/ehz747.0617] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Background
Risk factors for the occurrence of embolic stroke (ES) after atrial fibrillation (AF) ablation have not been fully elucidated. Our aim was to assess incidence of ES during long-term follow-up following AF ablation and to identify predicting factors associated with post-ablation ES.
Methods
We enrolled patients who experienced ES after AF ablation and body mass index-matched controls from AF ablation registries. Epicardial adipose tissue (EAT) was assessed using multislice computed tomography prior to ablation.
Results
A total of 3,464 patients who underwent AF ablation were recruited. During a mean follow-up of 47.2 months, ES occurred in 47 patients (1.36%) with a mean CHA2DS2-VAS score of 2.15 and overall incidence of ES was 0.34 per 100 patients/year. Compared with control group (n=190), ES group had more higher prior thromboembolic event and AF recurrence rates, larger LA size, lower creatinine clearance rate (CCr), and greater total and periatrial EAT volumes although no differences in AF type, CHA2DS2-VASc score, ablation extent, and anti-thrombotics use were found. On multivariate regression analysis, a prior history of thromboembolism, CCr, and periatrial EAT volume were independently associated with ES occurrence after AF ablation.
Cox regression analysis Risk factor Univariate Multivariate HR (95% CI) p value HR (95% CI) p value Age 1.017 (0.984–1.051) 0.31 Prior thromboembolism 2.488 (1.134–5.460) 0.023 2.916 (1.178–7.219) 0.021 CHA2DS2-VASc score 1.139 (0.899–1.445) 0.282 CCr 0.984 (0.970–0.999) 0.038 0.982 (0.996–0.998) 0.029 LA diameter (mm) 1.070 (1.012–1.130) 0.017 1.072 (0.999–1.150) 0.054 EAT_total (ml) 1.020 (1.010–1.029) <0.001 1.008 (0.993–1.023) 0.297 EAT_periatrial (ml) 1.085 (1.045–1.126) <0.001 1.065 (1.005–1.128) 0.032 PVI + additional ablation 0.846 (0.460–1.557) 0.592 No anticoagulant use 0.651 (0.346–1.226) 0.184 Recurrence 2.011 (1.007–4.013) 0.048 1.240 (0.551–2.793) 0.603 CCr, creatinine clearance rate; EAT, epicardial adipose tissue; LA, left atrium; PVI, pulmonary vein isolation.
K-M curve for stroke-free survival
Conclusions
Incidence of ES after AF ablation was lower than expected rate based on CHA2DS2-VASc score even though anticoagulants use was limited. Periatrial EAT volume, a prior thromboembolism event, and CCr were independent factors in predicting ES irrespective of AF recurrence and CHA2DS2-VASc score in patients who underwent AF ablation.
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Choi EK, Lee SR, Han KD, Jung JH, Oh S, Lip GYH. P4769Optimal rivaroxaban dose in Asian patients with atrial fibrillation and normal or mildly impaired renal function. Eur Heart J 2019. [DOI: 10.1093/eurheartj/ehz745.1145] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Abstract
Background
Although rivaroxaban 15 mg was only given to patients with creatinine clearance (CrCl) <50mL/min in the pivotal clinical trial, this dose has been commonly prescribed in Asian patients with non-valvular atrial fibrillation (AF) regardless of renal function. There is a paucity of information regarding the clinical outcomes of rivaroxaban 15 mg compared to rivaroxaban 20 mg in patients with CrCl ≥50mL/min. This study aimed to examine the effectiveness and safety of two doses of rivaroxaban in Asian patients with AF and CrCl ≥50mL/min.
Methods
Using the Korean National Health Insurance Service database, patients with AF and normal or mildly impaired renal function (CrCl ≥50mL/min) and naïve to rivaroxaban or warfarin were included from January 2014 to December 2016. Three separate 1:1 propensity score-matched cohorts were conducted: rivaroxaban 20 mg (R20) vs. warfarin (n=15,584), rivaroxaban 15 mg (R15) vs. warfarin (n=11,554), and R20 vs. R15 (n=10,392). Hazard ratios (HRs) for ischemic stroke, intracranial hemorrhage (ICH), gastrointestinal (GI) bleeding, major bleeding, all-cause death, and composite clinical outcome were analyzed.
Results
Among the pooled total study population, mean age was 66.9±10.9 years, 62.2% were male, mean CHA2DS2-VASc score was 3.16±1.79, and mean CrCl was 83.6±42.0 mL/min (median 78.4 mL/min, IQR 67.7–91.0 mL/min). A substantial proportion (42.6%) of patients with CrCl ≥50 mL/min were prescribed off-label R15 for stroke prevention in the Korean AF population. Compared to warfarin, both R20 and R15 showed significantly lower risk for ischemic stroke, major bleeding (mainly through reduction of ICH), and all-cause death (Figure). Overall, both R20 and R15 had better results for the composite clinical outcome compared to warfarin (HR: 0.617, 95% CI: 0.550–0.691 for R20, and HR: 0.759, 95% CI: 0.675–0.853 for R15). Compared to off-label R15, on-label R20 showed a nonsignificant trend toward lower risks of ischemic stroke, hospitalization for GI bleeding, hospitalization for major bleeding, and all-cause death. Overall, on-label R20 had better results for the composite clinical outcome compared to off-label R15 in patients with CrCl ≥50 mL/min (HR: 0.852, 95% CI: 0.735–0.988). This benefit was consistently observed in patients aged ≥80 years and those <50 kg. In patients with CrCl 50–60 mL/min, R20 showed a nonsignificant trend toward a higher risk of hospitalization for major bleeding compared to R15 (HR: 1.828, 95% CI 0.994–3.452).
Conclusions
Among Asians with AF and CrCl ≥50mL/min, both R20 and R15 were associated with reduced risk of ischemic stroke, ICH, major bleeding, and all-cause death without significantly increased risk of GI bleeding compared with warfarin. In patients with CrCl ≥50mL/min, on-label R20 showed better results for the composite clinical outcome compared to off-label R15.
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