Objectives: Smoking causes 8 million deaths annually and significant socioeconomic burdens. Despite several therapies, cessation rates remain low due to nicotine’s addictive properties and withdrawal symptoms. This study evaluates the efficacy of transcutaneous auricular vagus nerve stimulation (taVNS) in reducing nicotine dependence and improving psychological states. Methods: This pilot study enrolled 23 adult smokers aged 19 to 65 years with the Fagerström Test for Nicotine Dependence (FTND) scores over 4 and daily cigarette consumption exceeding 10. Participants were randomized into treatment and control groups. The treatment group received personalized taVNS stimulation targeting the auricular branch of the vagus nerve, applied for 30 minutes, three times daily, for four weeks. The control group received a low-level fixed-current stimulation. Outcomes, including the FTND, cigarettes per day (CPD), the Patient Health Questionnaire-9 (PHQ-9), the Generalized Anxiety Disorder-7 (GAD-7), and the Insomnia Severity Index (ISI), were assessed at baseline, 2 weeks, and 4 weeks. Statistical analyses included the Mann–Whitney U-test and Wilcoxon signed-rank test. Results: The treatment group showed significant reductions in the FTND (2.0 points at 2 weeks, p<0.05; 3.0 points at 4 weeks, p<0.05) and CPD (1.0 fewer cigarette at 2 weeks, p<0.05; 2.0 fewer cigarettes at 4 weeks, p<0.05). Additionally, the PHQ-9 scores decreased significantly in the treatment group (3.0 points at 2 weeks, p<0.05; no further improvement at 4 weeks). However, the GAD-7 and the ISI scores showed no statistically significant changes in either group. The control group exhibited slight improvements in the FTND and the CPD, possibly due to placebo effects or motivation induced by study participation. Conclusions This study highlights taVNS as a promising non-invasive treatment for smoking cessation, effective in reducing nicotine dependence and improving depressive symptoms. However, its effects on anxiety and sleep quality remain unclear. Larger studies are needed to confirm its efficacy and explore optimal parameters and underlying mechanisms.

Objectives: Smoking causes 8 million deaths annually and significant socioeconomic burdens. Despite several therapies, cessation rates remain low due to nicotine’s addictive properties and withdrawal symptoms. This study evaluates the efficacy of transcutaneous auricular vagus nerve stimulation (taVNS) in reducing nicotine dependence and improving psychological states. Methods: This pilot study enrolled 23 adult smokers aged 19 to 65 years with the Fagerström Test for Nicotine Dependence (FTND) scores over 4 and daily cigarette consumption exceeding 10. Participants were randomized into treatment and control groups. The treatment group received personalized taVNS stimulation targeting the auricular branch of the vagus nerve, applied for 30 minutes, three times daily, for four weeks. The control group received a low-level fixed-current stimulation. Outcomes, including the FTND, cigarettes per day (CPD), the Patient Health Questionnaire-9 (PHQ-9), the Generalized Anxiety Disorder-7 (GAD-7), and the Insomnia Severity Index (ISI), were assessed at baseline, 2 weeks, and 4 weeks. Statistical analyses included the Mann–Whitney U-test and Wilcoxon signed-rank test. Results: The treatment group showed significant reductions in the FTND (2.0 points at 2 weeks, p<0.05; 3.0 points at 4 weeks, p<0.05) and CPD (1.0 fewer cigarette at 2 weeks, p<0.05; 2.0 fewer cigarettes at 4 weeks, p<0.05). Additionally, the PHQ-9 scores decreased significantly in the treatment group (3.0 points at 2 weeks, p<0.05; no further improvement at 4 weeks). However, the GAD-7 and the ISI scores showed no statistically significant changes in either group. The control group exhibited slight improvements in the FTND and the CPD, possibly due to placebo effects or motivation induced by study participation. Conclusions This study highlights taVNS as a promising non-invasive treatment for smoking cessation, effective in reducing nicotine dependence and improving depressive symptoms. However, its effects on anxiety and sleep quality remain unclear. Larger studies are needed to confirm its efficacy and explore optimal parameters and underlying mechanisms.

Objectives: Smoking causes 8 million deaths annually and significant socioeconomic burdens. Despite several therapies, cessation rates remain low due to nicotine’s addictive properties and withdrawal symptoms. This study evaluates the efficacy of transcutaneous auricular vagus nerve stimulation (taVNS) in reducing nicotine dependence and improving psychological states. Methods: This pilot study enrolled 23 adult smokers aged 19 to 65 years with the Fagerström Test for Nicotine Dependence (FTND) scores over 4 and daily cigarette consumption exceeding 10. Participants were randomized into treatment and control groups. The treatment group received personalized taVNS stimulation targeting the auricular branch of the vagus nerve, applied for 30 minutes, three times daily, for four weeks. The control group received a low-level fixed-current stimulation. Outcomes, including the FTND, cigarettes per day (CPD), the Patient Health Questionnaire-9 (PHQ-9), the Generalized Anxiety Disorder-7 (GAD-7), and the Insomnia Severity Index (ISI), were assessed at baseline, 2 weeks, and 4 weeks. Statistical analyses included the Mann–Whitney U-test and Wilcoxon signed-rank test. Results: The treatment group showed significant reductions in the FTND (2.0 points at 2 weeks, p<0.05; 3.0 points at 4 weeks, p<0.05) and CPD (1.0 fewer cigarette at 2 weeks, p<0.05; 2.0 fewer cigarettes at 4 weeks, p<0.05). Additionally, the PHQ-9 scores decreased significantly in the treatment group (3.0 points at 2 weeks, p<0.05; no further improvement at 4 weeks). However, the GAD-7 and the ISI scores showed no statistically significant changes in either group. The control group exhibited slight improvements in the FTND and the CPD, possibly due to placebo effects or motivation induced by study participation. Conclusions This study highlights taVNS as a promising non-invasive treatment for smoking cessation, effective in reducing nicotine dependence and improving depressive symptoms. However, its effects on anxiety and sleep quality remain unclear. Larger studies are needed to confirm its efficacy and explore optimal parameters and underlying mechanisms.

Objectives: Smoking causes 8 million deaths annually and significant socioeconomic burdens. Despite several therapies, cessation rates remain low due to nicotine’s addictive properties and withdrawal symptoms. This study evaluates the efficacy of transcutaneous auricular vagus nerve stimulation (taVNS) in reducing nicotine dependence and improving psychological states. Methods: This pilot study enrolled 23 adult smokers aged 19 to 65 years with the Fagerström Test for Nicotine Dependence (FTND) scores over 4 and daily cigarette consumption exceeding 10. Participants were randomized into treatment and control groups. The treatment group received personalized taVNS stimulation targeting the auricular branch of the vagus nerve, applied for 30 minutes, three times daily, for four weeks. The control group received a low-level fixed-current stimulation. Outcomes, including the FTND, cigarettes per day (CPD), the Patient Health Questionnaire-9 (PHQ-9), the Generalized Anxiety Disorder-7 (GAD-7), and the Insomnia Severity Index (ISI), were assessed at baseline, 2 weeks, and 4 weeks. Statistical analyses included the Mann–Whitney U-test and Wilcoxon signed-rank test. Results: The treatment group showed significant reductions in the FTND (2.0 points at 2 weeks, p<0.05; 3.0 points at 4 weeks, p<0.05) and CPD (1.0 fewer cigarette at 2 weeks, p<0.05; 2.0 fewer cigarettes at 4 weeks, p<0.05). Additionally, the PHQ-9 scores decreased significantly in the treatment group (3.0 points at 2 weeks, p<0.05; no further improvement at 4 weeks). However, the GAD-7 and the ISI scores showed no statistically significant changes in either group. The control group exhibited slight improvements in the FTND and the CPD, possibly due to placebo effects or motivation induced by study participation. Conclusions This study highlights taVNS as a promising non-invasive treatment for smoking cessation, effective in reducing nicotine dependence and improving depressive symptoms. However, its effects on anxiety and sleep quality remain unclear. Larger studies are needed to confirm its efficacy and explore optimal parameters and underlying mechanisms.

Background: Although menopause is considered a risk factor for depression, no association has been established between the risk of suicidal ideation and age at menopause. This study aimed to evaluate the association between age at menopause and suicidal ideation in middleaged menopausal Korean women. Methods: This cross-sectional study used data from the Korea National Health and Nutrition Examination Survey (2013–2018). Women aged 40–65 years were divided into the following three categories: primary ovarian insufficiency (POI), early menopause, and menopause, according to age at natural menopause (< 40, 40–45, and > 45 years, respectively). Depressive symptoms were assessed using the Patient Health Questionnaire-9 (PHQ-9). Results: Among 2,232 menopausal women, 25 (1.1%) experienced POI and 114 (5.1%) experienced early menopause. The PHQ-9 items that pertained to low self-esteem and suicidal ideation scored higher in women with POI than in those who experienced menopause after 45 years of age. The prevalence of suicidal ideation differed significantly according to age at menopause (POI, 30.0%; early menopause, 12.7%; menopause, 8.0%; P = 0.016). Logistic regression analysis revealed that POI was significantly associated with suicidal ideation after the adjustment for age, body mass index, and education, household income, and walking levels (odds ratio, 4.2; 95% confidence interval, 1.0–17.7). Conclusion Korean middle-aged women with POI were more likely to have suicidal ideation than those who experienced menopause at 45 years or above, despite not being diagnosed with major depressive disorder.

Background: Hematocrit is usually measured from venous blood collected by invasive venipuncture. This study was performed to determine hematocrit accurately and precisely using minimally invasive volumetric absorptive microsampling (VAMS) technique.Such technique is to be applied to determining hematocrit in various clinical settings for the care, including therapeutic drug monitoring, of neonatal or epileptic patients, or patients with high risk of infection or bleeding. Methods: The study was performed using 31 VAMS samples obtained from 21 pancreatic cancer patients. Hematocrit was determined using the values of potassium concentrations obtained from blood in VAMS tips (HctVAMS ). HctVAMS was compared with hematocrit measured from blood collected by venipuncture (HctVP ). The accuracy and precision of HctVAMS in comparison to HctVP were evaluated using BlandAltman plot, Deming regression and mountain plot. Results: Bland-Altman plot displayed a random scattering pattern of the differences between HctVAMS and HctVP with the mean bias of −0.010 and the 95% limit of agreement ranging from −0.063 to 0.044.Deming regression for HctVAMS and HctVP line demonstrated very small proportional and constant biases of 1.04 and −0.003, respectively. Mountain plot exhibited a narrow and symmetrical distribution of the differences with their median of −0.011 and central 95% range from −0.049 to 0.033. Conclusion Hematocrit was accurately and precisely determined using less invasive VAMS technique. Such technique appears to be applicable to determining hematocrit in situations that venipuncture is not favorable or possible.

Acute pericarditis may be caused by a variety of disorders. Most cases of acute pericarditis without any initial apparent cause are idiopathic, although presumably viral in origin. While staphylococcus aureus, streptococcus pneumonias and streptococcus pyogens were the predominant organisms recovered prior to 1950, gram negative bacilli, anaerobic bacteria and fungus were recovered after 1950. These changes of the etiologic diversity of acute pericarditis were related to the development and advances of cardiac surgery, antibiotics, chemotherapy for cancer and immunosuppressive treatments. It is important for the therapy of acute bacterial pericarditis to establish the proper regimen of antibiotics and to drain pericardial effusion, if needed. We report a case of acute pericarditis, caused by Klebsiella pneumoniae, an uncommon pathogen that caused purulent pericarditis with cardiac tamponade.
Anti-Bacterial Agents ; Bacteria, Anaerobic ; Cardiac Tamponade ; Drug Therapy ; Fungi ; Klebsiella pneumoniae* ; Klebsiella* ; Pericardial Effusion ; Pericarditis* ; Pneumonia ; Staphylococcus aureus ; Streptococcus ; Thoracic Surgery

Objective: To evaluate the diagnostic performance of a deep learning algorithm for the automated detection of developmental dysplasia of the hip (DDH) on anteroposterior (AP) radiographs. Materials and Methods: Of 2601 hip AP radiographs, 5076 cropped unilateral hip joint images were used to construct a dataset that was further divided into training (80%), validation (10%), or test sets (10%). Three radiologists were asked to label the hip images as normal or DDH. To investigate the diagnostic performance of the deep learning algorithm, we calculated the receiver operating characteristics (ROC), precision-recall curve (PRC) plots, sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) and compared them with the performance of radiologists with different levels of experience. Results: The area under the ROC plot generated by the deep learning algorithm and radiologists was 0.988 and 0.988–0.919, respectively. The area under the PRC plot generated by the deep learning algorithm and radiologists was 0.973 and 0.618– 0.958, respectively. The sensitivity, specificity, PPV, and NPV of the proposed deep learning algorithm were 98.0, 98.1, 84.5, and 99.8%, respectively. There was no significant difference in the diagnosis of DDH by the algorithm and the radiologist with experience in pediatric radiology (p = 0.180). However, the proposed model showed higher sensitivity, specificity, and PPV, compared to the radiologist without experience in pediatric radiology (p < 0.001). Conclusion The proposed deep learning algorithm provided an accurate diagnosis of DDH on hip radiographs, which was comparable to the diagnosis by an experienced radiologist.

Objective: To evaluate the diagnostic performance of a deep learning algorithm for the automated detection of developmental dysplasia of the hip (DDH) on anteroposterior (AP) radiographs. Materials and Methods: Of 2601 hip AP radiographs, 5076 cropped unilateral hip joint images were used to construct a dataset that was further divided into training (80%), validation (10%), or test sets (10%). Three radiologists were asked to label the hip images as normal or DDH. To investigate the diagnostic performance of the deep learning algorithm, we calculated the receiver operating characteristics (ROC), precision-recall curve (PRC) plots, sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) and compared them with the performance of radiologists with different levels of experience. Results: The area under the ROC plot generated by the deep learning algorithm and radiologists was 0.988 and 0.988–0.919, respectively. The area under the PRC plot generated by the deep learning algorithm and radiologists was 0.973 and 0.618– 0.958, respectively. The sensitivity, specificity, PPV, and NPV of the proposed deep learning algorithm were 98.0, 98.1, 84.5, and 99.8%, respectively. There was no significant difference in the diagnosis of DDH by the algorithm and the radiologist with experience in pediatric radiology (p = 0.180). However, the proposed model showed higher sensitivity, specificity, and PPV, compared to the radiologist without experience in pediatric radiology (p < 0.001). Conclusion The proposed deep learning algorithm provided an accurate diagnosis of DDH on hip radiographs, which was comparable to the diagnosis by an experienced radiologist.

Background: To investigate the relationship between polycystic ovary syndrome (PCOS) in Korean women and childhood growth and obesity of their offspring. Methods: This longitudinal case-control study using the Korean National Health Insurance claims database and the National Health Screening Program for Infants and Children database included women who delivered singletons between January 2007 and December 2008. Offspring’s body mass index (BMI) measurements taken between 42 and 80 months of age were compared according to a maternal history of PCOS. Results: Among a total of 131,805 participants, 1,213 women had a history of PCOS and 130,592 women did not. Female offspring aged 66–80 months born to women with PCOS had significantly higher BMI than those born to women without PCOS; there was no significant difference in that of male offspring regardless of maternal PCOS. In the generalized estimating equation and multivariable logistic regression analyses, the female offspring born to women with PCOS had a significantly higher risk of obesity during the age of 42–54 and 66–80 months (odds ratio [OR], 1.6; 95% confidence interval [CI], 1.09–2.21 and OR, 1.5; 95% CI, 1.05–2.15, respectively), than those born to women without PCOS, after adjusting for several confounding factors. Conclusion Maternal PCOS is independently associated with an increased incidence of childhood obesity in female offspring among Korean women. Women with PCOS should consider the risk of early childhood obesity in their daughters, even if they maintain a healthy weight themselves.