Heart failure (HF) is a major cause of mortality and morbidity in South Korea, imposing substantial physical, emotional, and financial burdens on patients and society. Despite the high burden of symptom and complex care needs of HF patients, palliative care and hospice services remain underutilized in South Korea due to cultural, institutional, and knowledge-related barriers. This position statement from the Korean Society of Heart Failure emphasizes the need for integrating palliative and hospice care into HF management to improve quality of life and support holistic care for patients and their families. By clarifying the role of palliative care in HF and proposing practical referral criteria, this position statement aims to bridge the gap between HF and palliative care services in South Korea, ultimately improving patient-centered outcomes and aligning treatment with the goals and values of HF patients.

The global increase in livestock production has correspondingly intensified farm odors due to harmful bacteria, reduced immunity, and disease progression. In this study, we treated feces with Biomagic-Enzyme complex for 4 months to understand the relationship between farm odor, immunity against common viral diseases, immune cytokines, and changes in the microbiota. A gas meter (MultiRAE) was used to measure ammonia (NH3) and hydrogen sulfide (H2S) while odor intensity and offensiveness were characterized by the non-objective scaling method. A complete blood count was performed and plasma was obtained after blood centrifugation at 3,000 rpm for 20 minutes. The cytokine profile was evaluated using commercial kits. Microbial DNA was extracted and purified from fecal samples to analyze the microbiota. Microbial DNA and viral RNA/DNA were obtained from fecal samples and amplified to determine the expression of transmissible gastroenteritis virus (TGEV), porcine reproductive and respiratory syndrome (PRRS), and porcine circovirus type 2 (PCV2). Our results indicated that Biomagic reduced odor nuisance by decreasing ammonia levels, resulting in faint and fairly offensive odor intensity. After the enzyme treatment, Escherichia coli populations significantly reduced across all 3 farms. In contrast, beneficial Lactobacillus spp. levels remained stable, indicating the enzyme selectively targeted harmful bacteria while preserving beneficial ones. The beneficial Lachnospiraceae, Spirochaetaceae, and Bacteroidaceae were found to be higher in the third month of treatment. TGEV was not detected, while PRRS and non-pathogenic PCV2 showed a positive infection rate. In conclusion, Biomagic reduced ammonia, prevented viral infection from pig farms, and improved gut-beneficial bacteria and microbiota.

The global increase in livestock production has correspondingly intensified farm odors due to harmful bacteria, reduced immunity, and disease progression. In this study, we treated feces with Biomagic-Enzyme complex for 4 months to understand the relationship between farm odor, immunity against common viral diseases, immune cytokines, and changes in the microbiota. A gas meter (MultiRAE) was used to measure ammonia (NH3) and hydrogen sulfide (H2S) while odor intensity and offensiveness were characterized by the non-objective scaling method. A complete blood count was performed and plasma was obtained after blood centrifugation at 3,000 rpm for 20 minutes. The cytokine profile was evaluated using commercial kits. Microbial DNA was extracted and purified from fecal samples to analyze the microbiota. Microbial DNA and viral RNA/DNA were obtained from fecal samples and amplified to determine the expression of transmissible gastroenteritis virus (TGEV), porcine reproductive and respiratory syndrome (PRRS), and porcine circovirus type 2 (PCV2). Our results indicated that Biomagic reduced odor nuisance by decreasing ammonia levels, resulting in faint and fairly offensive odor intensity. After the enzyme treatment, Escherichia coli populations significantly reduced across all 3 farms. In contrast, beneficial Lactobacillus spp. levels remained stable, indicating the enzyme selectively targeted harmful bacteria while preserving beneficial ones. The beneficial Lachnospiraceae, Spirochaetaceae, and Bacteroidaceae were found to be higher in the third month of treatment. TGEV was not detected, while PRRS and non-pathogenic PCV2 showed a positive infection rate. In conclusion, Biomagic reduced ammonia, prevented viral infection from pig farms, and improved gut-beneficial bacteria and microbiota.

Background: The US Food and Drug Administration (FDA) and European Medicines Agency (EMA) approved empagliflozin for reducing cardiovascular mortality and heart failure (HF) hospitalization in patients with both HF with reduced ejection fraction (HFrEF) and HF with preserved ejection fraction (HFpEF). However, limited data are available on the generalizability of empagliflozin to clinical practice. Therefore, we evaluated real-world eligibility and potential cost-effectiveness based on a nationwide prospective HF registry. Methods: A total of 3,108 HFrEF and 2,070 HFpEF patients from the Korean Acute Heart Failure (KorAHF) registry were analyzed. Eligibility was estimated by inclusion and exclusion criteria of EMPagliflozin outcomE tRial in Patients With chrOnic heaRt Failure With Reduced Ejection Fraction (EMPEROR-Reduced) and EMPagliflozin outcomE tRial in Patients With chrOnic heaRt Failure With Preserved Ejection Fraction (EMPEROR-Preserved) trials and by FDA & EMA label criteria. The cost-utility analysis was done using a Markov model to project the lifetime medical cost and quality-adjusted life year (QALY). Results: Among the KorAHF patients, 91.4% met FDA & EMA label criteria, while 44.7% met the clinical trial criteria. The incremental cost-effectiveness ratio of empagliflozin was calculated at US$6,764 per QALY in the overall population, which is far below a threshold of US$18,182 per QALY. The cost-effectiveness benefit was more evident in patients with HFrEF (US$5,012 per QALY) than HFpEF (US$8,971 per QALY). Conclusion There is a large discrepancy in real-world eligibility for empagliflozin between FDA & EMA labels and clinical trial criteria. Empagliflozin is cost-effective in HF patients regardless of ejection fraction in South Korea health care setting. The efficacy and safety of empagliflozin in real-world HF patients should be further investigated for a broader range of clinical applications.

The global increase in livestock production has correspondingly intensified farm odors due to harmful bacteria, reduced immunity, and disease progression. In this study, we treated feces with Biomagic-Enzyme complex for 4 months to understand the relationship between farm odor, immunity against common viral diseases, immune cytokines, and changes in the microbiota. A gas meter (MultiRAE) was used to measure ammonia (NH3) and hydrogen sulfide (H2S) while odor intensity and offensiveness were characterized by the non-objective scaling method. A complete blood count was performed and plasma was obtained after blood centrifugation at 3,000 rpm for 20 minutes. The cytokine profile was evaluated using commercial kits. Microbial DNA was extracted and purified from fecal samples to analyze the microbiota. Microbial DNA and viral RNA/DNA were obtained from fecal samples and amplified to determine the expression of transmissible gastroenteritis virus (TGEV), porcine reproductive and respiratory syndrome (PRRS), and porcine circovirus type 2 (PCV2). Our results indicated that Biomagic reduced odor nuisance by decreasing ammonia levels, resulting in faint and fairly offensive odor intensity. After the enzyme treatment, Escherichia coli populations significantly reduced across all 3 farms. In contrast, beneficial Lactobacillus spp. levels remained stable, indicating the enzyme selectively targeted harmful bacteria while preserving beneficial ones. The beneficial Lachnospiraceae, Spirochaetaceae, and Bacteroidaceae were found to be higher in the third month of treatment. TGEV was not detected, while PRRS and non-pathogenic PCV2 showed a positive infection rate. In conclusion, Biomagic reduced ammonia, prevented viral infection from pig farms, and improved gut-beneficial bacteria and microbiota.

The global increase in livestock production has correspondingly intensified farm odors due to harmful bacteria, reduced immunity, and disease progression. In this study, we treated feces with Biomagic-Enzyme complex for 4 months to understand the relationship between farm odor, immunity against common viral diseases, immune cytokines, and changes in the microbiota. A gas meter (MultiRAE) was used to measure ammonia (NH3) and hydrogen sulfide (H2S) while odor intensity and offensiveness were characterized by the non-objective scaling method. A complete blood count was performed and plasma was obtained after blood centrifugation at 3,000 rpm for 20 minutes. The cytokine profile was evaluated using commercial kits. Microbial DNA was extracted and purified from fecal samples to analyze the microbiota. Microbial DNA and viral RNA/DNA were obtained from fecal samples and amplified to determine the expression of transmissible gastroenteritis virus (TGEV), porcine reproductive and respiratory syndrome (PRRS), and porcine circovirus type 2 (PCV2). Our results indicated that Biomagic reduced odor nuisance by decreasing ammonia levels, resulting in faint and fairly offensive odor intensity. After the enzyme treatment, Escherichia coli populations significantly reduced across all 3 farms. In contrast, beneficial Lactobacillus spp. levels remained stable, indicating the enzyme selectively targeted harmful bacteria while preserving beneficial ones. The beneficial Lachnospiraceae, Spirochaetaceae, and Bacteroidaceae were found to be higher in the third month of treatment. TGEV was not detected, while PRRS and non-pathogenic PCV2 showed a positive infection rate. In conclusion, Biomagic reduced ammonia, prevented viral infection from pig farms, and improved gut-beneficial bacteria and microbiota.

The global increase in livestock production has correspondingly intensified farm odors due to harmful bacteria, reduced immunity, and disease progression. In this study, we treated feces with Biomagic-Enzyme complex for 4 months to understand the relationship between farm odor, immunity against common viral diseases, immune cytokines, and changes in the microbiota. A gas meter (MultiRAE) was used to measure ammonia (NH3) and hydrogen sulfide (H2S) while odor intensity and offensiveness were characterized by the non-objective scaling method. A complete blood count was performed and plasma was obtained after blood centrifugation at 3,000 rpm for 20 minutes. The cytokine profile was evaluated using commercial kits. Microbial DNA was extracted and purified from fecal samples to analyze the microbiota. Microbial DNA and viral RNA/DNA were obtained from fecal samples and amplified to determine the expression of transmissible gastroenteritis virus (TGEV), porcine reproductive and respiratory syndrome (PRRS), and porcine circovirus type 2 (PCV2). Our results indicated that Biomagic reduced odor nuisance by decreasing ammonia levels, resulting in faint and fairly offensive odor intensity. After the enzyme treatment, Escherichia coli populations significantly reduced across all 3 farms. In contrast, beneficial Lactobacillus spp. levels remained stable, indicating the enzyme selectively targeted harmful bacteria while preserving beneficial ones. The beneficial Lachnospiraceae, Spirochaetaceae, and Bacteroidaceae were found to be higher in the third month of treatment. TGEV was not detected, while PRRS and non-pathogenic PCV2 showed a positive infection rate. In conclusion, Biomagic reduced ammonia, prevented viral infection from pig farms, and improved gut-beneficial bacteria and microbiota.