Adherence to general medical checkup and cancer screening guidelines according to self-reported smoking status: Korea National Health and Nutrition Examination Survey (KNHANES) 2010-2012

Association between physical activity and health-related quality of life in middle-aged and elderly individuals with musculoskeletal disorders: Findings from a national cross-sectional study in Korea

PURPOSE

This study aimed to identify the association between physical activity and health-related quality of life (HRQoL) in middle-aged and elderly individuals with musculoskeletal disorders.

METHODS

This study used data from the 2016-2020 Korea National Health and Nutrition Examination Survey (KNHANES). We included only those over 40 years of age diagnosed with one or more of the following: osteoarthritis, rheumatism, and osteoporosis. In total, 4,731 participants (783 men and 3,948 women) were included as the study population. Multiple logistic regression analysis was performed to examine the association between physical activity and HRQoL.

RESULTS

In the case of middle-aged and elderly individuals with musculoskeletal disorders, the likelihood of HRQoL worsening was significantly lower for those who regularly engaged in physical activity compared with that of those who did not engage in physical activity at all (men: OR 0.58, 95% CI 0.37-0.90; women: OR 0.64, 95% CI 0.53-0.79). Stratified analysis by the type and intensity of physical activity revealed that the possibility of poor HRQoL was lowest when leisure-related moderate-intensity physical activities were performed (men: OR 0.44, 95% CI 0.22-0.89; Women: OR 0.50, 95% CI 0.36-0.69).

CONCLUSIONS

Our findings suggest that engaging in regular physical activity contributes to preventing exacerbation of HRQoL, even if the individual suffers from musculoskeletal disorders. It is necessary to provide an appropriate type and intensity of physical activity in consideration of the patients' pain and severity.

Preparation and Biocompatibility Study of Contrast-Enhanced Hernia Mesh Material

BACKGROUND

Meshes play a crucial role in hernia repair. However, the displacement of mesh inevitably leads to various associated complications. This process is difficult to be traced by conventional imaging means. The purpose of this study is to create a contrast-enhanced material with high-density property that can be detected by computed tomography (CT).

METHODS

The contrast-enhanced monofilament was manufactured from barium sulfate nanoparticles and medical polypropylene (PP/Ba). To characterize the composite, stress tensile tests and scanning electron microscopy (SEM) was performed. Toxicity and biocompatibility of PP/Ba materials was verified by in vitro cellular assays. Meanwhile, the inflammatory response was tested by protein adsorption assay. In addition, an animal model was established to demonstrate the long-term radiographic effect of the composite material in vivo. Subsequent pathological tests confirmed its in vivo compatibility.

RESULTS

The SEM revealed that the main component of the monofilament is carbon. In vitro cell experiments demonstrated that novel material does not affect cell activity and proliferation. Protein adsorption assays indicated that the contrast-enhanced material does not cause additional inflammatory responses. In addition, in vivo experiments illustrated that PP/Ba mesh can be detected by CT and has good in vivo compatibility.

CONCLUSION

These results highlight the excellent biocompatibility of the contrast-enhanced material, which is suitable for human abdominal wall tissue engineering.

Lymphocyte Inhibition by the Salamander-Killing Chytrid Fungus, Batrachochytrium salamandrivorans

Amphibian populations have been declining around the world for more than five decades, and the losses continue. Although causes are complex, major contributors to these declines are two chytrid fungi, Batrachochytrium dendrobatidis and Batrachochytrium salamandrivorans, which both cause the disease termed chytridiomycosis. Previously, we showed that B. dendrobatidis impedes amphibian defenses by directly inhibiting lymphocytes in vitro and in vivo by release of soluble metabolites, including kynurenine (KYN), methylthioadenosine (MTA), and spermidine (SPD). Here, we show that B. salamandrivorans cells and cell-free supernatants also inhibit amphibian lymphocytes as well as a human T cell line. As we have shown for B. dendrobatidis, high-performance liquid chromatography (HPLC) and mass spectrometry revealed that KYN, MTA, and SPD are key metabolites found in the B. salamandrivorans supernatants. Production of inhibitory factors by B. salamandrivorans is limited to mature zoosporangia and can occur over a range of temperatures between 16°C and 26°C. Taken together, these results suggest that both pathogenic Batrachochytrium fungi have evolved similar mechanisms to inhibit lymphocytes in order to evade clearance by the amphibian immune system.

Association between Physical Exercise and Glycated Hemoglobin Levels in Korean Patients Diagnosed with Diabetes

This study aimed to identify the association between physical exercise and glycated hemoglobin (HbA1c) levels in Korean patients diagnosed with diabetes. Data from the 2015−2019 Korea National Health and Nutrition Examination Survey were used. In total, 2559 participants were included (1286 males and 1273 females). Multiple logistic regression analysis was conducted to examine the effect of physical exercise on controlled HbA1c levels among diabetic patients. In Korean male patients with diabetes, performance of physical exercise, including walking and resistance exercises, was associated with controlled HbA1c levels < 6.5% (odds ratio (OR), 1.85; 95% confidence interval (CI), 1.17−2.92). In males, performing resistance exercise for ≥5 days a week, without walking exercise, had a significant association with HbA1c levels (OR, 1.75; 95% CI, 1.15−2.65). HbA1c levels were more likely to be controlled when both walking and resistance exercises were performed for ≥5 days a week in both sexes (males: OR, 1.74; 95% CI, 1.04−2.93 and females: OR, 2.59; 95% CI, 1.09−6.15). This study found that resistance exercise may contribute to the management of HbA1c levels among Korean patients with diabetes. Promoting resistance exercise performance can be beneficial for improving the condition of patients with diabetes.

Cost Utility Analysis of a Pilot Study for the Korean Lung Cancer Screening Project

Purpose

The aim of this study was to evaluate the cost utility of a pilot study of Korean Lung Cancer Screening Project.

Materials and Methods

We constructed a Markov model consisting of 26 states based on the natural history of lung cancer according to the Surveillance, Epidemiology, and End Results summary stage (localized, regional, distant). In the base case, people aged 55–74 years were under consideration for annual screening. Costs and quality-adjusted life years were simulated to calculate the incremental cost utility ratio. Sensitivity analyses were performed on the uncertainty associated with screening target ages, stage distribution, cost, utility, mortality, screening duration, and discount rate.

Results

The base case (US$25,383 per quality-adjusted life year gained) was cost-effective compared to the scenario of no screening and acceptable considering a willingness-to-pay threshold of US$27,000 per quality-adjusted life years gained. In terms of the target age of screening, the age between 60 and 74 years was the most cost-effective. Lung cancer screening was still cost-effective in the sensitivity analyses on the cost for treatment, utility, mortality, screening duration, and less than 5% discount rates, although the result was sensitive to a rise in positive rates or variation of stage distribution.

Conclusion

Our results showed the cost-effectiveness of annual low-dose computed tomography screening for lung cancer in high-risk populations.

Disparities in Colorectal Cancer Screening Practices in a Midwest Urban Safety-Net Healthcare System

AIMS

Although colorectal cancer screening (CRC) using stool-based test is well-studied, evidence on fecal immunochemical test (FIT) patterns in a safety-net healthcare system utilizing opportunistic screening is limited. We studied the FIT completion rates and adenoma detection rate (ADR) of positive FIT-colonoscopy (FIT-C) in an urban safety-net system.

METHODS

We performed a retrospective cross-sectional chart review on individuals ≥ 50 years who underwent CRC screening using FIT or screening colonoscopy, 09/01/2017-08/30/2018. Demographic differences in FIT completion were studied; ADR of FIT-C was compared to that of screening colonoscopy.

RESULTS

Among 13,427 individuals with FIT ordered, 7248 (54%) completed the stool test and 230 (48%) followed up a positive FIT with colonoscopy. Increasing age (OR 1.01, CI 1.01-1.02), non-Hispanic Blacks (OR 0.87, CI 0.80-0.95, p = 0.002), current smokers (OR 0.84, CI 0.77-0.92, p < 0.0001), those with Medicaid (OR 0.86, CI 0.77-0.96, p = 0.006), commercial insurance (OR 0.85, CI 0.78-0.94, p = 0.002), CCI score ≥ 3 (OR 0.82, CI 0.74-0.91, p < 0.0001), orders by family medicine providers (OR 0.87, CI 0.81-0.94, p < 0.0001) were associated with lower completion of stool test. Individuals from low median household income cities had lower follow-up of positive FIT, OR 0.43, CI 0.21-0.86, p = 0.017. ADR of FIT-C was higher than that of screening colonoscopy.

CONCLUSION

Adherence to CRC screening is low in safety-net systems employing opportunistic screening. Understanding demographic differences may allow providers to formulate targeted strategies in high-risk vulnerable groups.

Public opinion on implementing the National Lung Cancer Screening Program in Korea

Background

Lung cancer screening for high-risk population using low-dose computed tomography is a valid strategy to reduce lung cancer mortality. This study investigated public opinions toward the initiation and participation in the National Lung Cancer Screening Program (NLCSP) launched in Korea.

Methods

In this cross-sectional analysis of the 2018 Korean National Cancer Screening Survey, we analyzed the responses related to lung cancer screening. Eligible participants for NLCSP are aged 55‒74 years with at least 30 pack-years of smoking history. We compared public opinions on implementing lung cancer screening according to smoking status and eligibility for NLCSP.

Results

Among 3,495 respondents, 205 (5.9%) were eligible for screening. Most of the respondents (71.2%) agreed with implementing NLCSP. Agreement rates were relatively lower in never smokers (66.2%) and higher in former (80.8%) and current smokers (82.3%). Factors associated with agreement included the presence of private health insurance [odds ratio (OR) 1.36, 95% confidence interval (CI), 1.04–1.78], regular health checkup (OR 2.10, 95% CI, 1.72–2.57), and smoking history (former, OR 1.66, 95% CI, 1.09–2.55; current, OR 1.97, 95% CI, 1.45–2.67). Preference of the screening facilities showed that quality was considered more important than accessibility (46.9% vs. 31.9%). Furthermore, people were more affirmative (75.5%) towards receiving mandatory smoking cessation counseling included in NLCSP.

Conclusions

Public agreement and active participation of the eligible population are key factors in the successful implementation of NLCSP. Our data would be a valuable resource in building appropriate strategies to maximize the benefits of nationwide lung cancer screening.