Background: The management of sexually transmitted infections (STIs) at the national level is necessary for the health and well-being of individuals in society. The purpose of this study was to propose a redesign of the STI surveillance system by collecting opinions from experts. Methods: After the major STIs were reviewed, 1) gonorrhea, 2) chancroid, 3) Mycoplasma genitalium infection, and 4) trichomoniasis were selected as diseases requiring a redesign of the surveillance system through the Delphi method, a technique for solving problems by collecting opinions from experts. The expert panel was selected from experts on STIs (n = 17) and included members of the Korean Association of Urogenital Tract Infection and Inflammation, the Korean Society of Infectious Diseases, and the 3rd advisory committee on STIs. Results: The experts agreed upon the exclusion of surveillance for chancroid on the basis of the low incidence, with an agreement rate of 83%. The experts agreed upon the inclusion of M. genitalium in the surveillance system, with a high agreement rate of 88%. However, there was disagreement among the experts on whether to include trichomoniasis in the surveillance system and whether to switch to a mandatory surveillance system for gonorrhea. Conclusion Although a consensus was not reached in some of the surveys in this study, it involved the collection of various expert opinions. Therefore, policies should be promoted with a prioritized focus on items with high agreement, but items for which no consensus was reached need to be reviewed in greater depth through additional research and investigation.

Background: and Purpose Treatments for neuromyelitis optica spectrum disorder (NMOSD) such as eculizumab, ravulizumab, satralizumab, and inebilizumab have significantly advanced relapse prevention, but they remain expensive. Rituximab is an off-label yet popular alternative that offers a cost-effective solution, but its real-world efficacy needs better quantification for guiding the application of newer approved NMOSD treatments (ANTs). This study aimed to determine real-world rituximab failure rates to anticipate the demand for ANTs and aid in resource allocation. Methods: We conducted a nationwide retrospective study involving 605 aquaporin-4-antibody-positive NMOSD patients from 22 centers in South Korea that assessed the efficacy and safety of rituximab over a median follow-up of 47 months. Results: The 605 patients treated with rituximab included 525 (87%) who received continuous therapy throughout the follow-up period (median=47 months, interquartile range=15–87 months). During this period, 117 patients (19%) experienced at least 1 relapse. Notably, 68 of these patients (11% of the total cohort) experienced multiple relapses or at least 1 severe relapse.Additionally, 2% of the patients discontinued rituximab due to adverse events, which included severe infusion reactions, neutropenia, and infections. Conclusions This study has confirmed the efficacy of rituximab in treating NMOSD, as evidenced by an 87% continuation rate among patients over a 4-year follow-up period. Nevertheless, the occurrence of at least one relapse in 19% of the cohort, including 11% who experienced multiple or severe relapses, and a 2% discontinuation rate due to adverse events highlight the urgent need for alternative therapeutic options.

Purpose: This study aimed to examine the mediating effects of posttraumatic stress and depression on the relationship between perceived stress and suicidality, and to explore the moderating and moderated mediating effects of resilience in this relationship. Methods: This secondary data analysis utilized data from the 2023 G metropolitan city mental health survey, which included 1,000 participants. The analysis was conducted using SPSS/WIN 25.0 and the PROCESS macro 4.3, with significant values of resilience identified using the Johnson- Neyman method. Results: Posttraumatic stress and depression were found to mediate the effect of perceived stress on suicidality. Additionally, resilience moderated the relationships between perceived stress and posttraumatic stress, as well as between posttraumatic stress and depression. Furthermore, resilience had a moderated mediating effect on the relationship between stress and suicidality. Specifically, when resilience levels were between 84.14 and 84.90, posttraumatic stress did not significantly affect depression, and the dual mediating effect of posttraumatic stress and depression on the relationship between stress and suicidality was not observed. Conclusion The findings suggest that developing resilience training programs may be essential for suicide prevention, even in contexts of severe stress or trauma.

Background: and Purpose Treatments for neuromyelitis optica spectrum disorder (NMOSD) such as eculizumab, ravulizumab, satralizumab, and inebilizumab have significantly advanced relapse prevention, but they remain expensive. Rituximab is an off-label yet popular alternative that offers a cost-effective solution, but its real-world efficacy needs better quantification for guiding the application of newer approved NMOSD treatments (ANTs). This study aimed to determine real-world rituximab failure rates to anticipate the demand for ANTs and aid in resource allocation. Methods: We conducted a nationwide retrospective study involving 605 aquaporin-4-antibody-positive NMOSD patients from 22 centers in South Korea that assessed the efficacy and safety of rituximab over a median follow-up of 47 months. Results: The 605 patients treated with rituximab included 525 (87%) who received continuous therapy throughout the follow-up period (median=47 months, interquartile range=15–87 months). During this period, 117 patients (19%) experienced at least 1 relapse. Notably, 68 of these patients (11% of the total cohort) experienced multiple relapses or at least 1 severe relapse.Additionally, 2% of the patients discontinued rituximab due to adverse events, which included severe infusion reactions, neutropenia, and infections. Conclusions This study has confirmed the efficacy of rituximab in treating NMOSD, as evidenced by an 87% continuation rate among patients over a 4-year follow-up period. Nevertheless, the occurrence of at least one relapse in 19% of the cohort, including 11% who experienced multiple or severe relapses, and a 2% discontinuation rate due to adverse events highlight the urgent need for alternative therapeutic options.

Purpose: This study aimed to examine the mediating effects of posttraumatic stress and depression on the relationship between perceived stress and suicidality, and to explore the moderating and moderated mediating effects of resilience in this relationship. Methods: This secondary data analysis utilized data from the 2023 G metropolitan city mental health survey, which included 1,000 participants. The analysis was conducted using SPSS/WIN 25.0 and the PROCESS macro 4.3, with significant values of resilience identified using the Johnson- Neyman method. Results: Posttraumatic stress and depression were found to mediate the effect of perceived stress on suicidality. Additionally, resilience moderated the relationships between perceived stress and posttraumatic stress, as well as between posttraumatic stress and depression. Furthermore, resilience had a moderated mediating effect on the relationship between stress and suicidality. Specifically, when resilience levels were between 84.14 and 84.90, posttraumatic stress did not significantly affect depression, and the dual mediating effect of posttraumatic stress and depression on the relationship between stress and suicidality was not observed. Conclusion The findings suggest that developing resilience training programs may be essential for suicide prevention, even in contexts of severe stress or trauma.

Background: and Purpose Treatments for neuromyelitis optica spectrum disorder (NMOSD) such as eculizumab, ravulizumab, satralizumab, and inebilizumab have significantly advanced relapse prevention, but they remain expensive. Rituximab is an off-label yet popular alternative that offers a cost-effective solution, but its real-world efficacy needs better quantification for guiding the application of newer approved NMOSD treatments (ANTs). This study aimed to determine real-world rituximab failure rates to anticipate the demand for ANTs and aid in resource allocation. Methods: We conducted a nationwide retrospective study involving 605 aquaporin-4-antibody-positive NMOSD patients from 22 centers in South Korea that assessed the efficacy and safety of rituximab over a median follow-up of 47 months. Results: The 605 patients treated with rituximab included 525 (87%) who received continuous therapy throughout the follow-up period (median=47 months, interquartile range=15–87 months). During this period, 117 patients (19%) experienced at least 1 relapse. Notably, 68 of these patients (11% of the total cohort) experienced multiple relapses or at least 1 severe relapse.Additionally, 2% of the patients discontinued rituximab due to adverse events, which included severe infusion reactions, neutropenia, and infections. Conclusions This study has confirmed the efficacy of rituximab in treating NMOSD, as evidenced by an 87% continuation rate among patients over a 4-year follow-up period. Nevertheless, the occurrence of at least one relapse in 19% of the cohort, including 11% who experienced multiple or severe relapses, and a 2% discontinuation rate due to adverse events highlight the urgent need for alternative therapeutic options.

Purpose: This study aimed to examine the mediating effects of posttraumatic stress and depression on the relationship between perceived stress and suicidality, and to explore the moderating and moderated mediating effects of resilience in this relationship. Methods: This secondary data analysis utilized data from the 2023 G metropolitan city mental health survey, which included 1,000 participants. The analysis was conducted using SPSS/WIN 25.0 and the PROCESS macro 4.3, with significant values of resilience identified using the Johnson- Neyman method. Results: Posttraumatic stress and depression were found to mediate the effect of perceived stress on suicidality. Additionally, resilience moderated the relationships between perceived stress and posttraumatic stress, as well as between posttraumatic stress and depression. Furthermore, resilience had a moderated mediating effect on the relationship between stress and suicidality. Specifically, when resilience levels were between 84.14 and 84.90, posttraumatic stress did not significantly affect depression, and the dual mediating effect of posttraumatic stress and depression on the relationship between stress and suicidality was not observed. Conclusion The findings suggest that developing resilience training programs may be essential for suicide prevention, even in contexts of severe stress or trauma.

Purpose: This study aimed to examine the mediating effects of posttraumatic stress and depression on the relationship between perceived stress and suicidality, and to explore the moderating and moderated mediating effects of resilience in this relationship. Methods: This secondary data analysis utilized data from the 2023 G metropolitan city mental health survey, which included 1,000 participants. The analysis was conducted using SPSS/WIN 25.0 and the PROCESS macro 4.3, with significant values of resilience identified using the Johnson- Neyman method. Results: Posttraumatic stress and depression were found to mediate the effect of perceived stress on suicidality. Additionally, resilience moderated the relationships between perceived stress and posttraumatic stress, as well as between posttraumatic stress and depression. Furthermore, resilience had a moderated mediating effect on the relationship between stress and suicidality. Specifically, when resilience levels were between 84.14 and 84.90, posttraumatic stress did not significantly affect depression, and the dual mediating effect of posttraumatic stress and depression on the relationship between stress and suicidality was not observed. Conclusion The findings suggest that developing resilience training programs may be essential for suicide prevention, even in contexts of severe stress or trauma.

Hemophagocytic lymphohistiocytosis (HLH) is a rare, life-threatening hematological disorder characterized by uncontrolled activation of CD8+ T and natural killer cells, leading to a cytokine storm and severe organ dysfunction. Although secondary HLH related to autoimmune diseases usually demonstrates a good treatment response to immunosuppressive therapy for underlying conditions, there is no consensus regarding the treatment in case of unresponsiveness to the treatment. Herein, we present a case of HLH that was unresponsive to high-dose glucocorticoid and cyclosporine treatment in a patient with newly diagnosed systemic lupus erythematosus. The patient’s clinical features and laboratory abnormalities rapidly improved with ruxolitinib, an oral Janus kinase 1 and 2 (JAK1/2) inhibitor. This result suggests that blocking JAK-STAT pathway may be a potential treatment option in patients with refractory HLH secondary to autoimmune diseases.

Purpose: To investigate urine microbiome differences among healthy women, women with recurrent uncomplicated cystitis (rUC), and those with sporadic/single uncomplicated cystitis (sUC) to challenge traditional beliefs about origins of these infections. Materials and Methods: Patients who underwent both conventional urine culture and next-generation sequencing (NGS) of urine were retrospectively reviewed. Symptom-free women with normal urinalysis results as a control group were also studied. Samples were collected via transurethral catheterization. Results: In the control group, urine microbiome was detected on NGS in 83.3%, with Lactobacillus and Prevotella being the most abundant genera. The sensitivity of urine NGS was significantly higher than that of conventional urine culture in both the sUC group (91.2% vs. 32.4%) and the rUC group (82.4% vs. 16.4%). In urine NGS results, Enterobacterales, Prevotella, and Escherichia/ Shigella were additionally found in the sUC group, while the recurrent urinary tract infection (rUTI)/rUC group exhibited the presence of Lactobacillus, Prevotella, Enterobacterales, Escherichia/Shigella, and Propionibacterium. Moreover, distinct patterns of urine NGS were observed based on menopausal status and ingestion of antibiotics or probiotics prior to NGS test sampling. Conclusions Urine microbiomes in control, sUC, and rUTI/rUC groups exhibited distinct characteristics. Notably, sUC and rUC might represent entirely separate pathological processes, given their distinct urine microbiomes. Consequently, the use of urine NGS might be essential to enhancing sensitivity compared to conventional urine culture in both sUC and rUTI/rUC groups.