Validity and Reliability of POM-Checker for Measuring Shoulder Range of Motion in Healthy Participants: A Pilot Single-Center Comparative Study

BACKGROUND

The aim of this study was to compare shoulder movement measurements between a Kinect-based markerless ROM assessment device (POM-Checker) and a 3D motion capture analysis system (BTS SMART DX-400).

METHODS

This was a single-visit clinical trial designed to evaluate the validity and reliability of the POM-Checker. The primary outcome was to assess the equivalence between two measurement devices within the same set of participants, aiming to evaluate the validity of the POM-Checker compared to the gold standard device (3D Motion Analysis System). As this was a pilot study, six participants were included.

RESULTS

The intraclass correlation coefficient (ICC) and the corresponding 95% confidence intervals (CIs) were used to assess the reproducibility of the measurements. Among the 18 movements analyzed, 16 exhibited ICC values of >0.75, indicating excellent reproducibility.

CONCLUSION

The results showed that the POM-checker is reliable and validated to measure the range of motion of the shoulder joint.

Low-Loss Pogo Pin Probe Card with a Coupling Isolation Structure up to 50 GHz

A design for a millimeter wave RF probe card that removes resonance is proposed. The designed probe card optimizes the position of the ground surface and the signal pogo pins to resolve the resonance and signal loss issues that occur when connecting a dielectric socket and a PCB. At millimeter wave frequencies, the height of the dielectric socket and pogo pin matches the length of half a wavelength, allowing the socket to act as a resonator. When the leakage signal from the PCB line is coupled to the 2.9 mm high socket with pogo pins, resonance at a frequency of 28 GHz is generated. The probe card uses the ground plane as a shielding structure to minimize this resonance and radiation loss. The importance of the signal pin location is verified via measurements in order to address the discontinuity caused by field polarity switching. A probe card fabricated using the proposed technique exhibits an insertion loss performance of -8 dB up to 50 GHz and eliminates resonance. A signal with an insertion loss of -3.1 dB can be transmitted to a system-on-chip in a practical chip test.

Quality Characteristics and Acceptance Intention for Healthcare Kiosks: Perception of Elders from South Korea Based on the Extended Technology Acceptance Model

This study aimed to perform a path analysis to understand the effects of quality characteristics on perceived usefulness, perceived ease to use, involvement, and acceptance intention of healthcare kiosks in elderly using the extended technology acceptance model. We performed structural equation modeling (SEM) with data from 300 elderly. The following results were obtained. Firstly, elderly's perceived quality characteristics of healthcare kiosks had a partial positive effect on perceived usefulness. Secondly, elderly's perceived quality characteristics of healthcare kiosks had a partial positive effect on perceived ease to use. Thirdly, elderly's perceived ease to use healthcare kiosks had a partial positive effect on perceived usefulness. In addition, elderly's perceived usefulness of healthcare kiosks had a positive effect on acceptance intention. Lastly, elderly's perceived ease to use healthcare kiosks had a positive effect on acceptance intention.

AB1279 POOR QUALITY OF LIFE AND REDUCED WORK PRODUCTIVITY IN EUROPEAN PATIENTS WITH DERMATOMYOSITIS AND POLYMYOSITIS: FINDINGS FROM A SYSTEMATIC LITERATURE REVIEW

Background

Dermatomyositis (DM) and polymyositis (PM) are rare heterogenous systemic autoimmune disorders of the skin, muscles, and other organs with few effective treatment options available. They are described as devastating diseases but the full impact on patients’ lives in Europe is not well understood.

Objectives

To systematically review and summarize evidence on humanistic burden of disease in patients with DM and PM in Europe to better understand patient-relevant aspects of disease and key domains of life impacted by DM and PM in the European setting.

Methods

A systematic literature review (SLR) was conducted in MEDLINE and Embase databases to identify studies in children and adults with DM and PM, published in the English language between Jan 1, 2011, and Apr 28, 2021. Only primary studies enrolling 10 or more patients were included, irrespective of country or region. Each eligible article was independently reviewed by two reviewers. The title and study abstracts were reviewed to assess eligibility for full-text review. The topics of interest were clinical, humanistic, and economic burden of disease, as well as current management and unmet needs in DM and PM. Information on geographic scope was extracted from the papers of included studies. The current abstract summarizes SLR results on humanistic burden of DM and PM in European patients.

Results

A total of 2,967 non-duplicated publications were retrieved from medical databases and analyzed against pre-defined study selection criteria. There were 2,574 records excluded at title and abstract screening. Remaining 393 records were analyzed in the full text with 208 papers considered relevant. Additional 21 papers were identified from searching reference list of relevant studies and conference proceedings. In total, 222 studies described in 229 publications were included in data abstraction. Among 43 studies conducted across 14 European countries, 12 studies evaluated health-related quality of life (HRQoL) and work productivity in patients with DM and PM. In 6 studies, patients received standard of care therapy. Six studies enrolled adults with DM and PM and 6 were conducted in patients with juvenile onset of DM. There were 6 cross-sectional analyses, 4 longitudinal cohort studies, 2 case-control studies, with sample size ranging from 11 to 246 patients. Adults with DM and PM had significantly worse HRQoL across multiple domains of 36-Item Short Form Survey (SF-36) compared to controls from general population, with a strong negative impact of muscle weakness on physical functioning. Patients reported high difficulties in performing leisure time activities, moving around and work as indicated by median scores of 4-5 points in a 7-point Myositis Activity Profile (MAP). Reduced grip force in DM and PM adults was significantly associated with worse performance in domestic activities in the MAP assessment (p<0.05). In women with DM and PM, poor grip force additionally impacted vitality and mental health as measured by SF-36 (p<0.05). There were no associations between grip force and any SF-36 domain in men. Approximately 60% of adult patients rated their ability to work as “poor” or “less good” according to the Work Ability Index, 68% of patients had more than one week of sick leave in the past year, and 20.8% of them were permanently not able to work for at least 2 years. Children and adolescents with DM had impaired physical and psychosocial functioning compared to healthy norms with 40% of individuals showing increased emotional distress requiring in-depth psychological assessment.

Conclusion

European patients with DM and PM experience a muscle weakness that has a detrimental impact on HRQoL, daily activities and ability to work. Similar disease impact on HRQoL was reported in patients in North America. These findings suggest a need for a novel therapy that will restore physical functioning in patients with DM and PM.

Disclosure of Interests

Jens Schmidt Speakers bureau: Euroimmun, CSL Behring, Consultant of: Alnylam, Argenx, Biotest, CSL Behring, Kezar Life Sciences, LFB, Novartis, Octapharma, UCB, Grant/research support from: CSL Behring, Novartis, Konrad Pisarczyk Consultant of: Kezar Life Sciences, Richard Leff Shareholder of: Kezar Life Sciences, Consultant of: Kezar Life Sciences, Kiruthi Palaniswamy Shareholder of: Kezar Life Sciences, Employee of: Kezar Life Sciences, Eunmi Park Shareholder of: Kezar Life Sciences, Employee of: Kezar Life Sciences, Li Long Shareholder of: Kezar Life Sciences, Employee of: Kezar Life Sciences

AB1277 POOR LONG-TERM OUTCOMES AND SUBSTANTIAL BURDEN OF COMORBIDITIES IN EUROPEAN PATIENTS WITH DERMATOMYOSITIS/POLYMYOSITIS: RESULTS FROM A SYSTEMATIC LITERATURE REVIEW

Background

Dermatomyositis (DM) and polymyositis (PM) are rare heterogenous systemic autoimmune disorders of the skin, muscles and other organs that may have a devastating impact on patients’ lives. Despite various therapies used in clinical practice, a notable proportion of patients seem not to achieve sustainable remission. There is a need to better understand long-term outcomes and comorbidities in patients with DM/PM in Europe.

Objectives

To systematically review and summarize evidence on clinical burden of disease in patients with DM/PM in Europe.

Methods

A systematic literature review (SLR) was conducted in MEDLINE and Embase databases to identify studies in children and adults with DM/PM, published in the English language between 2011 and 2021. Primary studies enrolling 10 or more patients were included, irrespective of country or region. Each eligible article was independently reviewed by two reviewers. The title and study abstracts were reviewed to assess eligibility for full-text review. The current abstract summarizes SLR results on the long-term outcomes and comorbidities in patients with DM/PM in Europe.

Results

A total of 2,967 non-duplicated publications were retrieved from medical databases and analyzed against pre-defined study selection criteria. There were 2,574 records excluded at title and abstract screening. Remaining 393 records were analyzed in the full text with 208 papers considered relevant. Additional 21 papers were identified from searching reference list of relevant studies and conference proceedings. In total, 222 studies (229 publications) were included in data abstraction. Among 43 studies conducted across 14 European countries, 23 studies evaluated long-term outcomes of disease and burden of comorbidities. There were 14 longitudinal cohort studies, 7 cross-sectional analyses and 2 case-control studies. Only 29-44% of DM/PM adults achieved remission. Between 38% and 62% of adults with DM/PM required at least 3 different medications, suggesting inadequate response to initial and subsequent regimens. During a mean follow-up of 13.9 years, 69% patients with JDM had polycyclic or chronic disease characterized by periods of remission and recurrence or by permanently active disease for more than 2 years after diagnosis. A notable proportion of children (60.4%) showed evidence of damage in at least one body organ and 13-20% of patients had complications such as calcinosis, lipodystrophy, or muscle atrophy. Adults with DM/PM often suffered from interstitial lung disease (16-66%), serious infections leading to hospitalization or death (21-26.7%), and cardiovascular disorders (CVDs) (19-71%). Compared to age and gender matched controls without DM, patients with DM had 16-times higher risk of venous thromboembolism (HR=16.44, 95% CI: 7.54-35.86). Incidence of coronary heart disease, hemorrhagic stroke, or ischemic stroke during 10-year follow-up was approximately 1.5- to 2-times higher in DM/PM adults relative to general population. Multiple studies reported high rates of any malignancy in DM adults (7.5-33%) and in PM adults (8-11.7%). During approximately 24,000 patient-years of follow-up, adults with DM/PM had more than 4-times higher incidence of lung cancer compared to general population that also was one of the highest incidences among multiple other autoimmune diseases. Long-term prognosis in DM/PM was poor with 20-year survival below 70%. The most common causes of deaths were pulmonary-related, malignancies, and cardiac complications. Mortality due to lung cancer was more than 4-times higher than in general population (standardized mortality ratio=4.17, 95% CI: 3.03-5.60).

Conclusion

European patients with DM/PM suffer from substantial burden of comorbidities including serious infections, malignancies and CVDs that lead to poor long-term outcomes. A notable proportion of adult and juvenile patients do not achieve sustainable remission or experience relapse indicating high unmet need.

Disclosure of Interests

Jiří Vencovský Speakers bureau: Abbvie, Biogen, Boehringer, Eli Lilly, Gilead, MSD, Novartis, Pfizer, Roche, Sanofi, UCB, Werfen, Consultant of: Abbvie, Argenx, Boehringer, Eli Lilly, Gilead, Octapharma, Pfizer, UCB, Grant/research support from: Abbvie, Konrad Pisarczyk Consultant of: Kezar Life Sciences, Richard Leff Shareholder of: Kezar Life Sciences, Consultant of: Kezar Life Sciences, Eunmi Park Shareholder of: Kezar Life Sciences, Employee of: Kezar Life Sciences, Kiruthi Palaniswamy Shareholder of: Kezar Life Sciences, Employee of: Kezar Life Sciences, Li Long Shareholder of: Kezar Life Sciences, Employee of: Kezar Life Sciences.

Development of postbiotics by whey bioconversion with Enterococcus faecalis M157 KACC81148BP and Lactococcus lactis CAU2013 KACC81152BP for treating periodontal disease and improving gut health

This study developed postbiotics with whey bioconversion product produced by Enterococcus faecalis M157 KACC 81148BP, and mixed whey bioconversion products produced by E. faecalis M157 KACC 81148BP and Lactococcus lactis ssp. lactis CAU2013 KACC 81152BP to alleviate periodontitis (PD) and to improve gut health. The powdered whey bioconversion product (EF) produced by E. faecalis M157 KACC 81148BP, mixed whey bioconversion products (EF+LL) from E. faecalis M157 KACC 81148BP and L. lactis CAU2013 KACC 81152BP, and phosphate-buffered saline (PBS; control) were administered orally to PD-induced rats for 8 wk. Infiltration of inflammatory cells and epithelial proliferation in periodontal tissue were found in control, but the lesions were reduced in PD+EF group (administration of EF to PD-induced rats), and no lesions were observed in PD+EF+LL group (administration of EF+LL to PD-induced rats). The bone loss volumes in PD+EF and PD+EF+LL groups were lower than in control. Cytokine production levels related to inflammation were lower and antioxidative stress markers were higher in PD+EF and PD+EF+LL groups than in control for both periodontal tissue and gut. The ratios of Lactobacillus spp. in gut microbiome of PD+EF and PD+EF+LL groups were higher than in control. These results indicate that the whey bioconversion product produced by E. faecalis M157 KACC 81148BP, and mixed whey bioconversion products produced by E. faecalis M157 KACC 81148BP and L. lactis CAU2013 KACC 81152BP are effective on relieving periodontitis and improving the gut health.

P–205 Epothilone D as an actin cytoskeleton stabilizer improved mitochondria bioenergenesis and blastocyst formation of mouse preimplantation embryo

Study question

What is primary factor of bioenergetics product activity between microtubule instability and the functional activity of mitochondria in embryo?

Summary answer

The actin cytoskeleton instability is presumably the primary cause for the bioenergenesis of mitochondrial function to the preimplantation embryo development.

What is known already

Mitochondria are cellular organelles dynamically moving and morphological changes. It provides for homeostatic energy to the cell. The dynamic property of the mitochondria is associated with the microtubule network in the cell. However, the stability of the microtubule was clearly identified for preimplantation embryo development.

Study design, size, duration

This study is designed to assess the ATP productivity of the mitochondria, and specifically to observe what its primary factor is in terms of providing microtubule stability in mammalian cells. Additionally, we investigated the relationship between blastocyst formation and actin cytoskeleton stabilization by EpD with 2-cell mice.

Participants/materials, setting, methods

We prepared the microtubule stability regulation model with the HEK293 cell line by using the microtubule stabilizer as an Epothilone D (EpD). Then we analyzed the metabolic activity of the cells through oxidative phosphorylation (OXP) ratios analysis. Also, we performed confocal live imaging to observe mitochondria morphology depending on the cells’ microtubule. Next, we treated EpD to 2-cell culture media for the analysis of blastocyst development ratios.

Main results and the role of chance

EpD significantly increased fusion form. Also, EpD enhance bioenergy ratios like OXP in the mitochondria and functional activity related marker, like mTOR compared with the control. These results suggest that microtubule stabilization enhances mitochondrial metabolism by increasing oxygen consumption. Also, EpD in 2-cell culture media led to a significant increase in the speed of development and 50% higher hatched out blastocyst formation ratios compared to the control group.

Limitations, reasons for caution

This study had limited animal experiments. For the next study, we are planning with an aim to improve the quality and development ratios of human embryos by EpD.

Wider implications of the findings: Microtubule stabilizer has a possibility to recover the mitochondria’s functional activity in the preimplantation embryo development. Mitochondrial functional activity along the actin cytoskeleton may play a pivotal role in determining the embryo quality and development ratios for archive pregnancy.

Trial registration number

non-clinical trials

Fermented milk with Lactobacillus curvatus SMFM2016-NK alleviates periodontal and gut inflammation, and alters oral and gut microbiota

This study aimed to analyze the effect of milk fermented with Lactobacillus curvatus SMFM2016-NK on periodontal diseases and gut health in a rat model. To improve the effect of Lb. curvatus SMFM2016-NK-fermented milk administration for relieving periodontitis, the periodontitis rat models were treated with the following for 4 wk: 10% skim milk (normal), periodontitis + 10% skim milk (negative control), periodontitis + Lactobacillus rhamnosus GG-fermented milk (positive control), and periodontitis + Lb. curvatus SMFM2016-NK-fermented milk (PD+LCFM). Transcriptional analysis of inflammatory cytokines [tumor necrosis factor α (TNF-α), IL-1β, IL-6, and IL-10] was performed via quantitative reverse-transcription PCR. The changes in the oral and gut microbiomes after administering Lb. curvatus SMFM2016-NK-fermented milk were analyzed with metagenomics sequencing using DNA extracted from the oral gingival tissues and feces from the cecum of the rat models. After treatment with Lb. curvatus SMFM2016-NK-fermented milk, the relative gene expression levels of TNFA and IL1B in the gingiva decreased in the PD+LCFM group compared with those in the negative control group. In the oral microbiome, the proportion of the phylum Proteobacteria in the PD+LCFM group was lower than that in the negative control after treatment with Lb. curvatus SMFM2016-NK-fermented milk. For the effect in the gut, the relative gene expression levels of inflammatory cytokines in the colon between the normal and negative control groups were not different; however, the expression levels of TNFA and IL1B in the PD+LCFM and positive control groups, respectively, were lower than those in the negative control group. The composition and diversity of the gut microbiome differed among normal, periodontitis, and Lb. curvatus SMFM2016-NK-fermented milk treatment groups. These results indicate that Lb. curvatus SMFM2016-NK-fermented milk could alleviate periodontal and gut inflammation and change oral and gut microbiota.

Neurological involvement and MRI brain findings in an adult with hemolytic uremic syndrome: A case report

Hemolytic uremic syndrome is a frequent complication of shiga toxin producing Escherichia coli in pediatric population. It rarely affects adults with extremely rare neurological manifestation. We present a case of hemolytic uremic syndrome in a 64-year-old male who presented with a bloody diarrhea 30 minutes after eating an expired meat sandwich. Shiga-toxin producing Escherichia coli O157:H7 was confirmed as the causative agent. The patient developed neurological manifestations with persistent encephalopathy that ultimately leads to his death after 22 days of hospitalization. Magnetic resonance imaging findings was significant for signal changes in the thalami, tectum, insulae, and central pons, impressive of hemolytic uremic syndrome.

0268 Development of an Integrated Model of Sleep Deprivation in Adolescence

Introduction

Sleep deprivation is a consistently and widely concerning problem among adolescents. Although a few models have been proposed to explain the relationships and pathways through which factors influence sleep in adolescents, there are lack of theoretical models that apply both biological and behavioral factors that contribute to sleep deprivation across the trajectory of adolescent development. The current study proposes an integrated model that draws upon constructs from several influential theories with an aim to re-conceptualize factors associated with sleep deprivation as a chronic and cyclic problem that emerges from biological and behavioral changes in youth.

Methods

The Two Process Model of Sleep Regulation, Spielman’s 3p model, the theory of planned behavior, dual systems model, and sleep health framework are used to develop an integrated model of factors that lead to sleep deprivation in adolescents.

Results

The resulting integrated model highlights the importance of adolescent’s inherent nature of delayed sleep phase at pubertal onset (two process model); increased reward-seeking that precedes the structural maturation of their cognitive control and emotions (dual systems model); and their attitudes/perceptions towards sleep (theory of planned behavior), which is often geared toward not prioritizing sleep. Sleep health framework adequately frames the pattern of sleep-wakefulness in adolescents using a multidimensional approach of sleep. Moreover, the new model presents contextual factors (Spielman’s 3p model) and the way that these constructs interact in order to maintain a vicious cycle of insufficient sleep which leads to chronic sleep deprivation.

Conclusion

The current model portrays a wide-ranging view of mechanisms underlying sleep deprivation among adolescence by integrating both biological and behavioral aspects. The model is proposed to encourage researchers to explore these conceptual elements of biological and neurobiological changes, and behavioral problems in order to operationalize relevant measures to relate the concepts to sleep deprivation and subsequent health outcomes in adolescents.

Support

None

Deep CT to MR Synthesis Using Paired and Unpaired Data

Magnetic resonance (MR) imaging plays a highly important role in radiotherapy treatment planning for the segmentation of tumor volumes and organs. However, the use of MR is limited, owing to its high cost and the increased use of metal implants for patients. This study is aimed towards patients who are contraindicated owing to claustrophobia and cardiac pacemakers, and many scenarios in which only computed tomography (CT) images are available, such as emergencies, situations lacking an MR scanner, and situations in which the cost of obtaining an MR scan is prohibitive. From medical practice, our approach can be adopted as a screening method by radiologists to observe abnormal anatomical lesions in certain diseases that are difficult to diagnose by CT. The proposed approach can estimate an MR image based on a CT image using paired and unpaired training data. In contrast to existing synthetic methods for medical imaging, which depend on sparse pairwise-aligned data or plentiful unpaired data, the proposed approach alleviates the rigid registration of paired training, and overcomes the context-misalignment problem of unpaired training. A generative adversarial network was trained to transform two-dimensional (2D) brain CT image slices into 2D brain MR image slices, combining the adversarial, dual cycle-consistent, and voxel-wise losses. Qualitative and quantitative comparisons against independent paired and unpaired training methods demonstrated the superiority of our approach.

A new treatment for presumed corneal epithelial inclusion cyst in a shih-tzu dog

An 8-year-old female shih-tzu was assessed for a 3-year history of yellow intrastromal material in the right eye. Slit-lamp biomicroscopy showed a yellow lesion in the upper half of the cornea, superficial corneal neovascularisation and oedema with negative fluorescein staining in the right eye. Ultrasound biomicroscopy revealed a nearly anechoic cystic space surrounded by hyperechoic oedematous cornea separating the stroma at three-quarters of the corneal depth. Two partial-thickness corneal incisions were performed around the lesion under topical anaesthesia. After cytology and culture sampling, intrastromal flushing was performed. A yellow viscous necrotic tissue was identified with no microorganism or evidence of tumour formation. Antibiotics, anti-inflammatories and a bandage contact lens were applied. Ultrasound biomicroscopy confirmed no recurrence 8 days later. Corneal neovascularisation and oedema gradually resolved through a 2-week follow-up. There was no recurrence in the subsequent 8 months.

Proactive text messaging (GetReady2Quit) and nicotine replacement therapy to promote smoking cessation among smokers in primary care: A pilot randomized trial protocol

INTRODUCTION

Most smokers see a physician each year, but few use any assistance when they try to quit. Text messaging programs improve smoking cessation in community and school settings; however, their efficacy in a primary care setting is unclear. The current trial assesses the feasibility and preliminary clinical outcomes of text messaging and mailed nicotine replacement therapy (NRT) among smokers in primary care.

METHODS

In this single-center pilot randomized trial, eligible smokers in primary care are offered brief advice by phone and randomly assigned to one of four interventions: (1) Brief advice only, (2) text messages targeted to primary care patients and tailored to quit readiness, (3) a 2-week supply of nicotine patches and/or lozenges (NRT), and (4) both text messaging and NRT. Randomization is stratified by practice and intention to quit. The text messages (up to 5/day) encourage those not ready to quit to practice a quit attempt, assist those with a quit date through a quit attempt, and promote NRT use. The 2-week supply of NRT is mailed to patients' homes.

RESULTS

Feasibility outcomes include recruitment rates, study retention, and treatment adherence. Clinical outcomes are assessed at 1, 2, 6, and 12-weeks post-enrollment. The primary outcome is ≥1self-reported quit attempt(s). Secondary clinical outcomes include self-reported past 7- and 30-day abstinence, days not smoked, NRT adherence, and exhaled carbon monoxide.

CONCLUSIONS

This pilot assesses text messaging plus NRT, as a proactively offered intervention for smoking cessation support in smokers receiving primary care and will inform full-scale randomized trial planning.

TRIAL REGISTRATION

ClinicalTrials.govNCT03174158.

A Longitudinal Follow-up Study on Factors Associated With Smoking Relapse Among Adolescent Quitline Users in Korea

Background: Smoking among adolescent is one of the biggest alarming issues in tobacco control. Although smoking cessation interventions for adolescents have been implemented, 92% would be relapsed within one year. However, the information on factors associated with smoking relapse is insufficient among adolescents, although it looks necessary for understanding smoking behaviors of adolescents and applying more effective intervention program for them. Korea is one of the country having the highest adolescent smoking prevalence (9.6% in boys and 2.7% in girls aged 19 years or less) and in lack of information on smoking behaviors and factors associated with relapse or successful quit. Telephone-based cessation service (hereafter Quitline) has been available since 2006 regarding the confidentiality and accessibility of adolescent smokers and it has followed-up abstinence of users with intensive counseling for 1 year. Therefore, analysis on the adolescent smokers who used Quitline might be meaningful to understand adolescents' cessation behaviors and factors associated with. Aim: To identify the factors associated with smoking relapse among adolescent Quitline users in Korea. Methods: 2141 (1370 boys and 394 girls) adolescent smokers who registered at Quitline in Korea from January 2007 to December 2017 and attempted quit were included in the current study. The baseline information on sociodemographic characteristics, smoking and other health behaviors, nicotine dependency, and motivational factors for quit were collected. Cessation outcome and reason of relapse were identified during the 1 year follow-up of each individual. Multivariate logistic regression was performed to identify associated factors of smoking relapse. Results: The analysis on the data are undergoing and the result would be suggested in the conference with the further analysis. Conclusion: It will be suggested in the conference.

An Ecological Study on the Risk of Gastric Cancer With Helicobacter Pylori Prevalence and Other Potential Cofactors in Korea

Background: Korea has a high incidence of gastric cancer and a high prevalence of Helicobacter pylori infection. Observation of prevalence trends and determination of risk factors for gastric cancer are important to establish health policies to prevent and reduce the burden of disease. Currently, there is no evidence of complete correlation between prevalence of H. pylori infection and the occurrence of gastric cancer. Several explanations have been proposed for the paradox of high prevalence of infection and low gastric cancer incidence in certain places, including diet and salt consumption, genetic susceptibility, other infections, aflatoxin-contaminated food, and the interaction of all these factors, but none of them has been clearly established. Aim: To explore the potential effects of prevalence of H. pylori infection and other risk factors on gastric cancer incidence in Korea. Methods: Information on gastric cancer incidence, prevalence of H. pylori infection, and the risk factors for gastric cancer were evaluated from nationally representative data - the Korean National Cancer Registry, nationwide routine health check-up surveillance system, and National Health and Nutrition Survey, respectively. Secular trends of H. pylori infection prevalence and age-standardized incidence rates for gastric cancer by region were examined. Furthermore, trends of income level, education level, marital status, number of family members, smoking status, drinking status, obesity, diabetes, hypertension, dyslipidemia, and age-standardized incidence rates for gastric cancer by region were examined. Results: Gastric cancer incidence showed a decreasing trend from 2011 to 2015; 50.6%–44.4% for men and 22.1%–17.0% for women. The prevalence of H. pylori infection also showed a decreasing trend; from 66.9% in 1998%–54.4% in 2011. In Korea, areas with high prevalence of H. pylori infection also showed high gastric cancer incidence. However, the Chungcheong area showed relatively low prevalence of H. pylori infection, but had the highest gastric cancer incidence in Korea. Other factors which showed similar effects on gastric cancer incidence, like H. pylori infection were large family size (4 or more family members), low income, low education, and obesity. The effect of introduction of 'National Cancer Screening Program' will be evaluated in the final outcome. Conclusion: The results of this study indicated that significant regional differences exist between trends in H. pylori infection prevalence and gastric cancer incidence in Korea. Also, the possibility of lack of association between H. pylori prevalence and the incidence of gastric cancer are suggested. Overall, this study suggests the need for further research to explore potential factors accounting for regional differences in gastric cancer incidence in Korea.

Elastostatic reversibility in thermally formed bulk metallic glasses: nanobeam diffraction fluctuation electron microscopy

The unparalleled shaping ability of bulk metallic glasses can revolutionize commercial products having multi-length scale features with a processing time of several minutes. Despite the widespread shaping ability of these polymer-like multicomponent alloys, thermoplastic forming (TPF) can severely degrade the intrinsic properties, particularly when complex stress states are activated. The present work emphasizes the importance of elastostatic loading (ESL) which not only fully reverses deteriorated room temperature plasticity originating under TPF or post-cryostatic conditions, but also activates a rejuvenation mechanism by rendering an extended resistance against strain softening. Furthermore, the reduction in the supercooled liquid region and crystallization enthalpy measured by differential scanning calorimetry are found to be temporary, and can be fully reversed to the initial condition. HRTEM imaging of the samples are performed with an imaging spherical aberration corrector. Individual nanobeam diffraction patterns obtained by the fluctuation electron microscopy (FEM) measurements are acquired using a scanning transmission electron microscope with a probe size of 1.2 nm from a 10 × 10 raster, yielding 100 diffraction patterns. The normalized variance of a series of nanodiffraction patterns of the post-elastostatically loaded sample reveals a height decrease in the first broad peak of normalized intensity variance V(k) suggesting modifications in the medium-range structural order which in turn dramatically restores the mechanical and thermal properties. Overall, the combination of TPF and post-ESL treatment in advanced glassy metals can open a new avenue for ultra-high mechanical and thermal performance micro- and nanomechanical devices for biosensors, MOSFETs and robotics.

The association between season of birth, age at onset, and clozapine use in schizophrenia

OBJECTIVE

This study aimed to determine whether the rate of clozapine use, an indicator of refractoriness in schizophrenia, is associated with the season of birth and age at onset in patients with schizophrenia based on nationwide data.

METHODS

Patients with schizophrenia (n = 114 749) who received prescriptions for antipsychotic medication between 2008 and 2014 were retrospectively identified from the Korean National Health Insurance Service database. The study population was divided into three groups based on their age at the onset of schizophrenia (early, middle, and late onset). We assessed differences in the month of birth between patients and the general population. In addition, the cumulative clozapine use was calculated.

RESULTS

Compared to the late-onset schizophrenia group, the early- and middle-onset groups showed a higher probability of birth during the winter season. In addition, the early-onset group showed the highest cumulative clozapine use rate. In the middle-onset group, the initiation of clozapine use was significantly earlier for patients born in winter compared to those born in summer.

CONCLUSION

Our results indicate that the age at onset is an important factor in predicting the prognosis of schizophrenia patients. The season of birth also affects the prognosis, but with less robustness. Specifically, it appears that early disease onset and winter birth might be associated with poor outcomes in Korean patients with schizophrenia.

Gq-activated fibroblasts induce cardiomyocyte action potential prolongation and automaticity in a three-dimensional microtissue environment

Cardiac fibroblasts (CFs) are known to regulate cardiomyocyte (CM) function in vivo and in two-dimensional in vitro cultures. This study examined the effect of CF activation on the regulation of CM electrical activity in a three-dimensional (3-D) microtissue environment. Using a scaffold-free 3-D platform with interspersed neonatal rat ventricular CMs and CFs, G_q-mediated signaling was selectively enhanced in CFs by Gα_q adenoviral infection before coseeding with CMs in nonadhesive hydrogels. After 3 days, the microtissues were analyzed by signaling assay, histological staining, quantitative PCR, Western blots, optical mapping with voltage- or Ca²⁺-sensitive dyes, and microelectrode recordings of CF resting membrane potential (RMP_CF). Enhanced G_q signaling in CFs increased microtissue size and profibrotic and prohypertrophic markers. Expression of constitutively active Gα_q in CFs prolonged CM action potential duration (by 33%) and rise time (by 31%), prolonged Ca²⁺ transient duration (by 98%) and rise time (by 65%), and caused abnormal electrical activity based on depolarization-induced automaticity. Constitutive G_q activation in CFs also depolarized RMP_CF from -33 to -20 mV and increased connexin 43 and connexin 45 expression. Computational modeling confers that elevated RMP_CF and increased cell-cell coupling between CMs and CFs in a 3-D environment could lead to automaticity. In conclusion, our data demonstrate that CF activation alone is capable of altering action potential and Ca²⁺ transient characteristics of CMs, leading to proarrhythmic electrical activity. Our results also emphasize the importance of a 3-D environment where cell-cell interactions are prevalent, underscoring that CF activation in 3-D tissue plays a significant role in modulating CM electrophysiology and arrhythmias.NEW & NOTEWORTHY In a three-dimensional microtissue model, which lowers baseline activation of cardiac fibroblasts but enables cell-cell, paracrine, and cell-extracellular matrix interactions, we demonstrate that selective cardiac fibroblast activation by enhanced G_q signaling, a pathophysiological trigger in the diseased heart, modulates cardiomyocyte electrical activity, leading to proarrhythmogenic automaticity.