Purpose: This study examined how parenting behaviors and child self-esteem mediate the relationship between maternal attitudes toward corporal punishment and peer violence perpetration by children. The analysis focused on mothers with adverse childhood experiences (ACEs). Specifically, the study tested both parallel mediation (positive and harsh parenting behaviors) and serial mediation involving child self-esteem. Methods: This study conducted a secondary data analysis using the 2018 nationwide survey administered by the Korea Institute for Health and Social Affairs. The sample consisted of 1,097 mothers, each of whom reported at least one ACE. Data were analyzed using IBM SPSS Statistics ver. 26.0 and the PROCESS macro Model 80. Maternal attitudes toward corporal punishment were specified as the independent variable. Positive and harsh parenting behaviors were included as parallel mediators, child self-esteem was modeled as a serial mediator, and peer violence perpetration was treated as the dependent variable. The significance of indirect effects was evaluated using bootstrapping with 5,000 resamples drawn from the original dataset, with bias-corrected 95% confidence intervals. Results: Maternal attitudes toward corporal punishment were significantly associated with harsh parenting behaviors. These behaviors, in turn, had a negative impact on child self-esteem and contributed to greater perpetration of peer violence. The indirect effects were statistically significant based on bias-corrected 95% confidence intervals derived from the bootstrapped sampling distribution. Positive parenting behaviors did not exhibit any significant mediating effects. Conclusion Tolerant attitudes toward corporal punishment may increase peer violence among children by encouraging harsh parenting and lowering self-esteem. These findings suggest that mitigating harsh parenting and enhancing child self-esteem may help mitigate peer violence. Accordingly, tailored parenting education is recommended for mothers with ACEs.

Objective: The incidence of psychiatric illnesses might be higher in individuals people living with human immunodeficiency virus (PLWH) than in individuals without human immunodeficiency virus (HIV). We aimed to investigate whether PLWH had different risks of psychiatric morbidities in comparison to non-HIV-infected individuals. Methods: This study included all PLWH in South Korea between January 1, 2017 and December 31, 2017. The control group, which had never been diagnosed with HIV, was selected using a 1:10 stratified random sampling technique, considering age and sex. The endpoint of this study was new diagnosis of psychiatric morbidities which were diagnosed from January 1, 2018 to December 31, 2022. Results: After conducting a 1:5 propensity score (PS) matching process, the final analysis comprised a group of 17,815 PLWH and 78,021 control subjects. In the PS-matched cohort, the incidence rate of psychiatric morbidity in PLWH was 5,677.7 per 100,000 per year, whereas that in the controls was 4,926.3 per 100,000 per year. In Cox regression in the PS-matched cohort, PLWH showed 17% (hazard ratio, 1.17; 95% confidence interval, 1.14–1.21; p<0.001) higher risk of psychiatric morbidity than controls. Specifically, PLWH showed higher risk of depression, mania, bipolar disorder, insomnia disorder, substance use disorder, and schizophrenia compared to controls. Conclusion PLWH had a greater likelihood of experiencing psychiatric morbidities compared to those without HIV in South Korea. Our research findings indicate the importance of public health policy in addressing the declining mental health of individuals living with HIV.

Alport syndrome, a rare genetic disorder affecting around 1 in 50,000 individuals, primarily presents as microscopic hematuria and chronic kidney disease (CKD) with associated extrarenal complications. The Alport syndrome results from mutations in COL4A3, COL4A4, and COL4A5 genes, disrupting the formation of the α3–α4–α5 chain in the collagen IV network. The etiology involves X chromosome- related, autosomal dominant, autosomal recessive, and digenic inheritance patterns. The disease primarily manifests as kidney involvement, featuring persistent hematuria, proteinuria, and a progressive decline in renal function. Hearing loss, ocular abnormalities, and extrarenal manifestations further contribute to its complexity. Genotype-phenotype correlations are relatively evident, with distinct presentations in X-linked, autosomal recessive, and autosomal dominant cases. Diagnosis relies on urinalysis, histologic examination, and genetic testing with advancements in next-generation sequencing aiding identification. Although no specific treatment exists, early diagnosis improves outcomes, emphasizing the importance of genetic testing for prognosis and familial screening. The purpose of this review is to advance knowledge and enhance understanding of Alport syndrome.

The impact of baseline estimated glomerular filtration rate (eGFR) on the risk of adverse outcomes according to metabolic parameter variabilities in chronic kidney disease has rarely been investigated. Methods: We conducted a retrospective nationwide cohort study using the National Health Insurance System data in Korea from 2007 to 2013 to identify individuals with three or more health screenings. The metabolic components variability was defined as intraindividual variability between measurements using the variability independent of the mean. The metabolic variability score was defined as the total number of high-variability metabolic components. Multivariable-adjusted Cox regression analysis was conducted to evaluate the risks of all-cause mortality, myocardial infarction, and ischemic stroke. Results: During a mean follow-up of 6.0 ± 0.7 years, 223,531 deaths, 107,140 myocardial infarctions, and 116,182 ischemic strokes were identified in 9,971,562 patients. Low eGFR categories and higher metabolic variability scores were associated with a higher risk of adverse outcomes. The degree of association between metabolic variability and adverse outcomes was significantly larger in those with low eGFR categories than in those with preserved eGFR (p for interaction < 0.001). Representatively, those with high metabolic variability in the eGFR of <15 mL/min/1.73 m2 group showed a prominently higher risk for all-cause mortality (adjusted hazard ratio [aHR], 5.28; 95% confidence interval [CI], 4.02–6.94) when the degree was compared to the findings in those with preserved (eGFR of ≥60 mL/min/1.73 m2) kidney function (aHR, 2.55; 95% CI, 2.41–2.69). Conclusion: The degree of adverse association between metabolic variability and poor prognosis is accentuated in patients with impaired kidney function.

Chronic kidney disease (CKD) patients are hospitalized for various conditions. Hospitalization increases the readmission rate and mortality rate, seriously deteriorating patients’ quality of life. Consequently, it is crucial to analyze the reasons for hospitalization in CKD patients from a broader perspective according to CKD grade. Methods: This is a prospective cohort study of CKD patients entitled the KoreaN cohort study for Outcomes in patients With Chronic Kidney Disease (KNOW-CKD). A total of 2,238 patients were examined, and the reasons for hospitalization were classified into 16 disease categories. The incidence rate ratio (IRR) according to CKD stage was compared using negative bimodal regression analysis. Results: The all-cause hospitalization incidence was 184.96 per 1,000 person-years. The most common reason for hospitalization was circulatory system disease, followed by infection and digestive system disease. Among hospitalizations for acute kidney injury, endocrine-nutrition-metabolic–related illness, blood-related disease, and diseases of the nervous system and sensory organs, IRR increased as CKD grade advanced. The incidence of ophthalmologic surgery during hospitalization increased according to the CKD stage. The IRR of KNOW-CKD patients was 6.19 (95% confidence interval, 5.92–6.48; p < 0.001) compared with the general population. Conclusion: This in-depth analysis of hospitalizations among CKD patients confirmed that CKD patients were hospitalized for various reasons, such as metabolic, ophthalmic, and hematologic diseases. Early detection and intervention regarding causative diseases of CKD are important to reduce the hospitalization burden and improve patients’ quality of life.

Early-onset diabetes mellitus has a significant lifetime burden and is associated with higher morbidity and mortality. Since insulin resistance is one of the mechanisms of podocyte injury, we aimed to evaluate the effect of albuminuria on newly developed early-onset type 2 diabetes mellitus (T2DM). Methods: We screened 6,891,399 subjects aged ≥20 and <40 years without a history of prediabetes or diabetes from the Korean National Health Insurance Service database between 2009 and 2012. A multivariate Cox proportional hazard model was used to identify the impact of albuminuria on early-onset T2DM. Results: Among a total of 5,383,779 subjects, 62,148 subjects (1.2%) developed early-onset diabetes over 7.3 ± 1.2 years. Albuminuria was significantly associated with early-onset T2DM (adjusted hazard ratio [aHR], 1.62; 95% confidence interval [CI], 1.55–1.70) after adjustment for age, sex, anthropometric data, physical exercise status, serum glucose, and total cholesterol. The risk of early-onset T2DM increased more in subjects with more components of metabolic syndrome (MetS). Among each component of MetS, hypertriglyceridemia was prominently associated with early-onset T2DM (aHR, 2.02; 95% CI, 1.81–2.25) in subjects with albuminuria. Conclusion: Dipstick albuminuria was significantly associated with early-onset T2DM in young adult populations. Close monitoring of albuminuria is warranted for disease risk modification, especially in subjects with MetS.

Oxidative stress contributes to the onset of chronic diseases in various organs, including muscles. Morroniside, a type of iridoid glycoside contained in Cornus officinalis, is reported to have advantages as a natural compound that prevents various diseases.However, the question of whether this phytochemical exerts any inhibitory effect against oxidative stress in muscle cells has not been well reported. Therefore, the current study aimed to evaluate whether morroniside can protect against oxidative damage induced by hydrogen peroxide (H 2O2) in murine C2C12 myoblasts. Our results demonstrate that morroniside pretreatment was able to inhibit cytotoxicity while suppressing H2O2-induced DNA damage and apoptosis. Morroniside also significantly improved the antioxidant capacity in H2O2-challenged C2C12 cells by blocking the production of cellular reactive oxygen species and mitochondrial superoxide and increasing glutathione production. In addition, H2O2-induced mitochondrial damage and endoplasmic reticulum (ER) stress were effectively attenuated by morroniside pretreatment, inhibiting cytoplasmic leakage of cytochrome c and expression of ER stress-related proteins. Furthermore, morroniside neutralized H2O2-mediated calcium (Ca2+ ) overload in mitochondria and mitigated the expression of calpains, cytosolic Ca2+ -dependent proteases. Collectively, these findings demonstrate that morroniside protected against mitochondrial impairment and Ca2+ -mediated ER stress by minimizing oxidative stress, thereby inhibiting H2O2-induced cytotoxicity in C2C12 myoblasts.