OBJECTIVES: We aimed to assess the impact of obesity on mortality in middle-aged Koreans using data from a Health Examinees study. METHODS: We used data from the participants who had complete information on body size and gave informed consent for the linkage of their data with the national death certificate data. Cox proportional hazard model was used to estimate the hazard ratios and 95% confidence intervals (CIs) of body mass index (BMI) and waist-to-hip ratio (WHR) for all-cause, cardiovascular, and cancer mortality. RESULTS: A total of 115,961 participants were included in the study. The results showed a U-shaped association between BMI and mortality, indicating that both males and females with BMIs of less than 21.0 kg/m2 and greater than or equal to 30.0 kg/m2 are at increased risk. The results showed that males with a BMI of less than 18.5 kg/m² had a significantly higher risk of all-cause mortality (adjusted hazard ratio [aHR], 2.24; 95% CI, 1.73 to 2.91) and cardiovascular mortality (aHR, 2.27; 95% CI, 1.23 to 4.20). Similarly, males with a WHR of less than 0.80 (aHR, 1.38; 95% CI, 1.08 to 1.77), 0.90 to less than 0.95 (aHR, 1.15; 95% CI, 1.02 to 1.29), and greater than or equal to 0.95 (aHR, 1.28; 95% CI, 1.11 to 1.47) showed an increased risk of all-cause mortality. In females, a BMI of less than 18.0 kg/m2 was linked to a higher risk of cardiovascular mortality (aHR, 2.67; 95% CI, 1.13 to 6.33). CONCLUSIONS Being underweight was associated with an increased risk of mortality in both sexes, and the lowest risk of death was found in males who were slightly overweight with a BMI of 23.0-25.0 kg/m2.

OBJECTIVES: We aimed to assess the impact of obesity on mortality in middle-aged Koreans using data from a Health Examinees study. METHODS: We used data from the participants who had complete information on body size and gave informed consent for the linkage of their data with the national death certificate data. Cox proportional hazard model was used to estimate the hazard ratios and 95% confidence intervals (CIs) of body mass index (BMI) and waist-to-hip ratio (WHR) for all-cause, cardiovascular, and cancer mortality. RESULTS: A total of 115,961 participants were included in the study. The results showed a U-shaped association between BMI and mortality, indicating that both males and females with BMIs of less than 21.0 kg/m2 and greater than or equal to 30.0 kg/m2 are at increased risk. The results showed that males with a BMI of less than 18.5 kg/m² had a significantly higher risk of all-cause mortality (adjusted hazard ratio [aHR], 2.24; 95% CI, 1.73 to 2.91) and cardiovascular mortality (aHR, 2.27; 95% CI, 1.23 to 4.20). Similarly, males with a WHR of less than 0.80 (aHR, 1.38; 95% CI, 1.08 to 1.77), 0.90 to less than 0.95 (aHR, 1.15; 95% CI, 1.02 to 1.29), and greater than or equal to 0.95 (aHR, 1.28; 95% CI, 1.11 to 1.47) showed an increased risk of all-cause mortality. In females, a BMI of less than 18.0 kg/m2 was linked to a higher risk of cardiovascular mortality (aHR, 2.67; 95% CI, 1.13 to 6.33). CONCLUSIONS Being underweight was associated with an increased risk of mortality in both sexes, and the lowest risk of death was found in males who were slightly overweight with a BMI of 23.0-25.0 kg/m2.

OBJECTIVES: We aimed to assess the impact of obesity on mortality in middle-aged Koreans using data from a Health Examinees study. METHODS: We used data from the participants who had complete information on body size and gave informed consent for the linkage of their data with the national death certificate data. Cox proportional hazard model was used to estimate the hazard ratios and 95% confidence intervals (CIs) of body mass index (BMI) and waist-to-hip ratio (WHR) for all-cause, cardiovascular, and cancer mortality. RESULTS: A total of 115,961 participants were included in the study. The results showed a U-shaped association between BMI and mortality, indicating that both males and females with BMIs of less than 21.0 kg/m2 and greater than or equal to 30.0 kg/m2 are at increased risk. The results showed that males with a BMI of less than 18.5 kg/m² had a significantly higher risk of all-cause mortality (adjusted hazard ratio [aHR], 2.24; 95% CI, 1.73 to 2.91) and cardiovascular mortality (aHR, 2.27; 95% CI, 1.23 to 4.20). Similarly, males with a WHR of less than 0.80 (aHR, 1.38; 95% CI, 1.08 to 1.77), 0.90 to less than 0.95 (aHR, 1.15; 95% CI, 1.02 to 1.29), and greater than or equal to 0.95 (aHR, 1.28; 95% CI, 1.11 to 1.47) showed an increased risk of all-cause mortality. In females, a BMI of less than 18.0 kg/m2 was linked to a higher risk of cardiovascular mortality (aHR, 2.67; 95% CI, 1.13 to 6.33). CONCLUSIONS Being underweight was associated with an increased risk of mortality in both sexes, and the lowest risk of death was found in males who were slightly overweight with a BMI of 23.0-25.0 kg/m2.

OBJECTIVES: We aimed to assess the impact of obesity on mortality in middle-aged Koreans using data from a Health Examinees study. METHODS: We used data from the participants who had complete information on body size and gave informed consent for the linkage of their data with the national death certificate data. Cox proportional hazard model was used to estimate the hazard ratios and 95% confidence intervals (CIs) of body mass index (BMI) and waist-to-hip ratio (WHR) for all-cause, cardiovascular, and cancer mortality. RESULTS: A total of 115,961 participants were included in the study. The results showed a U-shaped association between BMI and mortality, indicating that both males and females with BMIs of less than 21.0 kg/m2 and greater than or equal to 30.0 kg/m2 are at increased risk. The results showed that males with a BMI of less than 18.5 kg/m² had a significantly higher risk of all-cause mortality (adjusted hazard ratio [aHR], 2.24; 95% CI, 1.73 to 2.91) and cardiovascular mortality (aHR, 2.27; 95% CI, 1.23 to 4.20). Similarly, males with a WHR of less than 0.80 (aHR, 1.38; 95% CI, 1.08 to 1.77), 0.90 to less than 0.95 (aHR, 1.15; 95% CI, 1.02 to 1.29), and greater than or equal to 0.95 (aHR, 1.28; 95% CI, 1.11 to 1.47) showed an increased risk of all-cause mortality. In females, a BMI of less than 18.0 kg/m2 was linked to a higher risk of cardiovascular mortality (aHR, 2.67; 95% CI, 1.13 to 6.33). CONCLUSIONS Being underweight was associated with an increased risk of mortality in both sexes, and the lowest risk of death was found in males who were slightly overweight with a BMI of 23.0-25.0 kg/m2.

Objective: This study aimed to establish normal reference values for PV indices (PV/Ao ratio and PV diameter) in cats and determine the usefulness of these for predicting symptomatic EHPSS. Methods: This study included 95 dogs and 114 cats that underwent abdominal CT. The canine normal (CN) group included dogs without EHPSS. The cats were classified into feline normal (FN, 88/114), feline asymptomatic (FA, 16/114), and feline symptomatic (FS, 10/114) groups.The PV and Ao diameters were measured in axial cross-sections. Results: The group FN had a higher PV/Ao ratio than the group CN (p < 0.001). Within the feline groups, the PV indices were in the order FN > FA > FS (both p < 0.001). The mean PV diameter and PV/Ao ratio for group FN were 5.23 ± 0.77 mm and 1.46 ± 0.19, respectively. The cutoff values between groups FN and FS were 4.115 mm for PV diameter (sensitivity, 100%; specificity, 97.7%) and 1.170 for PV/Ao ratio (90%, 92.1%). The cutoff values between group FA and FS were 3.835 mm (90%, 93.8%) and 1.010 (70%, 100%), respectively. Conclusions and Relevance: The results demonstrated significant differences in PV indices between dogs and cats. In cats, the PV/Ao ratio demonstrated high diagnostic performance for symptomatic EHPSS. The PV diameter also performed well, in contrast to dogs.

The depth of double-lumen endobronchial tube (DLT) is reportedly known tobe directly proportional to height and several height-based recommendations have beensuggested. This retrospective study was designed to find out the difference between calculated depths using height-based formulae and realistic depths in clinical practice of DLTplacement by analyzing pooled data from patients intubated with left-sided DLT.Methods: The electronic medical records of adults, intubated with DLT from February 2018to December 2020, were reviewed. Data retrieved included age, sex, height, weight, andsize and depth of DLT. The finally documented DLT depth (depth final, DF) was comparedwith the calculated depths, and the relationship between height and DF was also evaluated.A questionnaire on endobronchial intubation method was sent to anesthesiologists.Results: A total of 503 out of 575 electronic records of consecutive patients were analyzed.Although the relationship between height and DF was shown to have significant correlation(Spearman’s rho = 0.63, P < 0.001), DF was shown to be significantly greater than calculated depths (P < 0.001). Despite 57.1% of anesthesiologists have knowledge of clinical recommendations to anticipate size and depth of DLT, no one routinely utilizes those recommendations.Conclusions: Anesthesiologists tend to place DLTs in a deeper position than expected whendepths are calculated using height-based recommendations. Although such discrepanciesmay not be clinically meaningful, efforts are needed to standardize the methods of endobronchial intubation to prevent potential complications associated with malposition.

Background: Recent studies suggest that MEK1/2 inhibitors, including binimetinib, significantly improve malignant melanoma (MM) patient survival. Growing evidence suggests that phytochemicals, especially curcumin, can overcome drug resistance in cancer cells through a variety of mechanisms. Objective: This study aims to examine curcumin’s efficacy in vitro combined with binimetinib in human MM cells. Methods: We used 2D monolayer and 3D spheroid human epidermal melanocyte culture models, HEMn-MP (human epidermal melanocytes, neonatal, moderately pigmented), and two human MM cell lines, G361 and SK-MEL-2, to evaluate cell viability, proliferation, migration, death, and reactive oxygen species (ROS) production following single therapy treatment, with either curcumin or binimetinib, or a combination of both. Results: Compared to MM cells treated with single therapy, those with combination therapy showed significantly decreased cell viability and increased ROS production. We observed apoptosis following both single and combination therapies. However only those who had had combination therapy had necroptosis. Conclusion Collectively, our data demonstrates that curcumin exerts significant synergistic anticancer effects on MM cells by inducing ROS and necroptosis when combined with binimetinib. Therefore, a strategy of adding curcumin to conventional anticancer agents holds promise for treating MM.

Background: Melanoma is one of the most aggressive and metastatic skin cancers. Although overexpression of Dock180 and Elmo1 has been identified in various cancers, including glioma, ovarian cancer, and breast cancer, their expression and functions in melanoma remain unknown. Objective: This study aims to confirm the expression of Dock180 and Elmo1, their underlying mechanisms, and roles in melanoma. Methods: Both immunohistochemical staining and Western blotting were used to confirm expression of Dock180 and Elmo1 in human melanoma. To identify roles of Dock180 and Elmo1 in cell survival, apoptosis and migration, downregulation of Dock180 or Elmo1 in melanoma cells with small interfering RNA (siRNA) was performed. Results: We identified overexpression of Dock180 and Elmo1 in human melanoma compared to normal skin ex vivo. Inhibition of Dock180 or Elmo1 following siRNA in melanoma cells reduced cell viability and increased apoptosis as supported by increased proportion of cells with Annexin V-PE (+) staining and sub-G0/G1 peak in cell cycle analysis. Moreover, inhibition of Dock180 or Elmo1 regulated apoptosis-related proteins, showing downregulation of Bcl-2, caspase-3, and PARP and upregulation of Bax, PUMA, cleaved caspase-3, and cleaved PARP. Furthermore, knockdown of Dock180 and Elmo1 in melanoma cells reduced cell migration and changed cellular signaling pathways including ERK and AKT. Vemurafenib decreased cell viability in concentration-dependent manner, while transfection with Dock180- or Elmo1-specific siRNA in melanoma cells significantly reduced cell viability. Conclusion Our results suggest that both Dock180 and Elmo1 may be associated with cancer progression, and can be potential targets for treatment of melanoma.

Objectives: In the era of the Fourth Industrial Revolution, where an ecosystem is being developed to enhance the quality of healthcare services by applying information and communication technologies, systematic and sustainable data management is essential for medical institutions. In this study, we assessed the data management status and emerging concerns of three medical institutions, while also examining future directions for seamless data management. Methods: To evaluate the data management status, we examined data types, capacities, infrastructure, backup methods, and related organizations. We also discussed challenges, such as resource and infrastructure issues, problems related to government regulations, and considerations for future data management. Results: Hospitals are grappling with the increasing data storage space and a shortage of management personnel due to costs and project termination, which necessitates countermeasures and support. Data management regulations on the destruction or maintenance of medical records are needed, and institutional consideration for secondary utilization such as long-term treatment or research is required. Government-level guidelines for facilitating hospital data sharing and mobile patient services should be developed. Additionally, hospital executives at the organizational level need to make efforts to facilitate the clinical validation of artificial intelligence software. Conclusions This analysis of the current status and emerging issues of data management reveals potential solutions and sets the stage for future organizational and policy directions. If medical big data is systematically managed, accumulated over time, and strategically monetized, it has the potential to create new value.