Objectives: This qualitative study explores the perspectives of dental hygienists and examines factors influencing payment structures in a community home-based oral health care intervention program. Methods: Focus group interviews were conducted on October 26, 2023, in a quiet study room over 120 minutes. Intervention providers who participated in the older adults medical care integration support program were included in this study. Their ages ranged from 25 to 57 years, with experience in home-based oral healthcare spanning from 1.5 to 5 years. Voice recordings of the interviews were transcribed using Clova Note and Naver’s AI transcription tool. Subsequently, the ‘Word Cloud Generator 3.7’ program was employed to extract, visualize, and analyze frequently mentioned words and key concepts from the responses. Results Semantic analysis identified 61 significant keywords and 10 subcategories, categorized into four main themes: ‘oral health challenges in the elderly,’ ‘work system of home-based dental hygienists,’ ‘needs and realities of home-based oral care,’ and ‘payment and compensation frameworks.’ Conclusions: To address the demands of a super-aging society, it is imperative to establish a standardized oral healthcare cost system for home-based interventions, supported by clear laws and regulations.

Objectives: This qualitative study explores the perspectives of dental hygienists and examines factors influencing payment structures in a community home-based oral health care intervention program. Methods: Focus group interviews were conducted on October 26, 2023, in a quiet study room over 120 minutes. Intervention providers who participated in the older adults medical care integration support program were included in this study. Their ages ranged from 25 to 57 years, with experience in home-based oral healthcare spanning from 1.5 to 5 years. Voice recordings of the interviews were transcribed using Clova Note and Naver’s AI transcription tool. Subsequently, the ‘Word Cloud Generator 3.7’ program was employed to extract, visualize, and analyze frequently mentioned words and key concepts from the responses. Results Semantic analysis identified 61 significant keywords and 10 subcategories, categorized into four main themes: ‘oral health challenges in the elderly,’ ‘work system of home-based dental hygienists,’ ‘needs and realities of home-based oral care,’ and ‘payment and compensation frameworks.’ Conclusions: To address the demands of a super-aging society, it is imperative to establish a standardized oral healthcare cost system for home-based interventions, supported by clear laws and regulations.

Objectives: This qualitative study explores the perspectives of dental hygienists and examines factors influencing payment structures in a community home-based oral health care intervention program. Methods: Focus group interviews were conducted on October 26, 2023, in a quiet study room over 120 minutes. Intervention providers who participated in the older adults medical care integration support program were included in this study. Their ages ranged from 25 to 57 years, with experience in home-based oral healthcare spanning from 1.5 to 5 years. Voice recordings of the interviews were transcribed using Clova Note and Naver’s AI transcription tool. Subsequently, the ‘Word Cloud Generator 3.7’ program was employed to extract, visualize, and analyze frequently mentioned words and key concepts from the responses. Results Semantic analysis identified 61 significant keywords and 10 subcategories, categorized into four main themes: ‘oral health challenges in the elderly,’ ‘work system of home-based dental hygienists,’ ‘needs and realities of home-based oral care,’ and ‘payment and compensation frameworks.’ Conclusions: To address the demands of a super-aging society, it is imperative to establish a standardized oral healthcare cost system for home-based interventions, supported by clear laws and regulations.

Objectives: This qualitative study explores the perspectives of dental hygienists and examines factors influencing payment structures in a community home-based oral health care intervention program. Methods: Focus group interviews were conducted on October 26, 2023, in a quiet study room over 120 minutes. Intervention providers who participated in the older adults medical care integration support program were included in this study. Their ages ranged from 25 to 57 years, with experience in home-based oral healthcare spanning from 1.5 to 5 years. Voice recordings of the interviews were transcribed using Clova Note and Naver’s AI transcription tool. Subsequently, the ‘Word Cloud Generator 3.7’ program was employed to extract, visualize, and analyze frequently mentioned words and key concepts from the responses. Results Semantic analysis identified 61 significant keywords and 10 subcategories, categorized into four main themes: ‘oral health challenges in the elderly,’ ‘work system of home-based dental hygienists,’ ‘needs and realities of home-based oral care,’ and ‘payment and compensation frameworks.’ Conclusions: To address the demands of a super-aging society, it is imperative to establish a standardized oral healthcare cost system for home-based interventions, supported by clear laws and regulations.

Objective: Giant cell arteritis (GCA) is a large-vessel vasculitis that primarily affects elderly individuals. However, data regarding Korean patients with GCA are scarce owing to its extremely low prevalence in East Asia. This study aimed to investigate the clinical characteristics of Korean patients with GCA and their outcomes, focusing on relapse. Methods: The medical records of 27 patients with GCA treated at three tertiary hospitals between 2007 and 2022 were retrospectively reviewed. Results: Seventeen (63.0%) patients were females, and the median age at diagnosis was 75 years. Large vessel involvement (LVI) was detected in 12 (44.4%) patients, and polymyalgia rheumatica (PMR) was present in 14 (51.9%) patients. Twelve (44.4%) patients had fever at onset. The presence of LVI or concurrent PMR at diagnosis was associated with a longer time to normalization of the C-reactive protein level (p=0.039) or erythrocyte sedimentation rate (p=0.034). During follow-up (median: 33.8 months), four (14.8%) patients experienced relapse. Kaplan-Meier analyses showed that relapse was associated with visual loss (p=0.008) and the absence of fever (p=0.004) at onset, but not with LVI or concurrent PMR. Conclusion Concurrent PMR and LVI were observed in approximately half of Korean patients with GCA, and the elapsed time to normalization of inflammatory markers in these patients was longer. The relapse rate in Korean GCA is lower than that in Western countries, and afebrile patients or patients with vision loss at onset have a higher risk of relapse, suggesting that physicians should carefully monitor patients with these characteristics.

Objective: This study was performed to evaluate the efficacy and safety of lurasidone (160 mg/day) compared to quetiapine XR (QXR; 600 mg/day) in the treatment of acutely psychotic patients with schizophrenia. Methods: Patients were randomly assigned to 6 weeks of double-blind treatment with lurasidone 160 mg/day (n=105) or QXR 600 mg/day (n=105). Primary efficacy measure was the change from baseline to week 6 in Positive and Negative Syndrome Scale (PANSS) total score and Clinical Global Impressions severity (CGI-S) score. Adverse events, body measurements, and laboratory parameters were assessed. Results: Lurasidone demonstrated non-inferiority to QXR on the PANSS total score. Adjusted mean±standard error change at week 6 on the PANSS total score was -26.42±2.02 and -27.33±2.01 in the lurasidone and QXR group, respectively. The mean difference score was -0.91 (95% confidence interval -6.35–4.53). The lurasidone group showed a greater reduction in PANSS total and negative subscale on week 1 and a greater reduction in end-point CGI-S score compared to the QXR group. Body weight, body mass index, and waist circumference in the lurasidone group were reduced, with significantly lower mean change compared to QXR. Endpoint changes in glucose, cholesterol, triglycerides, and low-density lipoprotein levels were also significantly lower. The most common adverse drug reactions with lurasidone were akathisia and nausea. Conclusion Lurasidone 160 mg/day was found to be non-inferior to QXR 600 mg/day in the treatment of schizophrenia with comparable efficacy and tolerability. Adverse effects of lurasidone were generally tolerable, and beneficial effects on metabolic parameters can be expected.

OBJECTIVES: This study investigated whether Janus kinase inhibitors (JAKis) raise the risk of cardiovascular disease (CVD), venous thromboembolism (VTE), and cancer in patients with rheumatoid arthritis (RA). METHODS: We conducted a real-world retrospective observational study using data obtained from the Korean National Health Insurance Service database. Two data sets were analyzed: tumor necrosis factor inhibitor (TNFi)/JAKi-naive RA patients (set 1) and all RA patients who used TNFis or JAKis (set 2). The incidence rate ratios (IRRs) and hazard ratios (HRs) for acute myocardial infarction (AMI), stroke, cardiovascular (CV)-related mortality, major adverse cardiovascular events (MACE), VTE, arterial thromboembolism (ATE), cancer, and all-cause mortality were compared between the JAKi and TNFi groups. RESULTS: Set 1 included 1,596 RA patients (JAKi group: 645; TNFi group: 951), and set 2 included 11,765 RA patients (JAKi group: 2,498; TNFi group: 9,267). No adverse events (AEs) showed significantly higher IRRs in the JAKi groups than in the TNFi groups of sets 1 and 2. The HRs for MACE in the JAKi groups of sets 1 and 2 were 0.59 (95% confidence [CI], 0.35 to 0.99) and 0.80 (95% CI, 0.67 to 0.97), respectively. The JAKi group of set 2 showed a significantly higher risk of all-cause mortality (HR, 1.71; 95% CI, 1.32 to 2.20), but the other AEs did not demonstrate increased risks in the JAKi groups. CONCLUSIONS In this study, JAKis did not increase the risk of AMI, stroke, CV-related mortality, MACE, VTE, ATE, or cancer in Korean RA patients relative to TNFis.

Purpose: The fusion of early (E) and late diastolic filling (A) on mitral inflow Doppler, even in the absence of tachycardia, is often found during assessment of left ventricular (LV) diastolic function. We evaluated the echocardiographic characteristics and clinical implications of premature E-A fusion of uncertain cause in the absence of tachycardia. Materials and Methods: We identified 1014 subjects who showed E-A fusion and normal LV ejection fraction (LVEF) between January 2019 and June 2021 at two tertiary hospitals. Among these, 105 (10.4%) subjects showed premature E-A fusion at heart rates less than 100 beats per minute (bpm). The conventional echocardiographic parameters and LV global longitudinal strain (GLS) were compared with 1:1 age-, sex-, and heart rate-matched controls without E-A fusion. Results: The premature E-A fusion group had a heart rate of 96.4±3.7 bpm. Only 4 (3.8%) subjects were classified as having LV diastolic dysfunction according to current guidelines. The group showed prolonged isovolumic relaxation time (107.2±25.3 msec vs. 61.6±15.6 msec, p<0.001), increased Tei index (0.76±0.19 vs. 0.48±0.10, p<0.001), lower LVEF (63.8±7.0% vs. 67.3±5.6%, p<0.001) and lower absolute LV GLS (|LV GLS|) (17.0±4.2% vs. 19.7±3.3%, p<0.001) than controls. As the E-A fusion occurred at lower heart rate, the |LV GLS| was also lower (p for trend=0.002). Conclusion Premature E-A fusion at heart rates less than 100 bpm is associated with subclinical LV dysfunction. Time-based indices and LV GLS are helpful for evaluating this easily overlooked population.

no abstract available.

In cryptogenic stroke patients, early detection of new-onset atrial fibrillation (AF) and recurrent stroke is required to prevent poor clinical outcomes. Therefore, we investigated the predictors of new-onset AF and recurrent stroke in cryptogenic stroke patients without previously diagnosed AF. In total, 390 patients who were diagnosed with stroke and non-sustained atrial tachycardia (NSAT) on 24-hour Holter monitoring were followed up to assess new-onset AF and recurrent stroke. The 5-year event-free survival as well as the predictors of recurrent stroke or new-onset AF were investigated. Based on receiver operating characteristic analysis, frequent premature atrial contractions (PACs) were defined as PACs >44 beats/day. The median follow-up period was 35 months. The composite event rate was 11.5%. In Kaplan-Meier analysis, the 5-year cumulative incidence of composite events was higher in cryptogenic stroke patients with frequent PACs than in those without frequent PACs. Multivariate analysis revealed that current smoking, increased left atrial volume index, and frequent PACs were poor prognostic predictors of composite event, and frequent PACs were an independent poor prognostic factor of new-onset AF in cryptogenic stroke patients. Therefore, frequent PACs might be associated with poor clinical outcomes (new-onset AF and recurrent stroke) in cryptogenic stroke patients with concomitant NSAT.