Four soluble factors—putrescine, glucosamine, nicotinamide, and signal transducer and activator of transcription 3 (STAT3) inhibitor BP-1-102—were shown to differentiate bone marrow mononucleated cells (BMNCs) into functional insulin-producing cells (IPCs) in vitro. Transplantation of these IPCs improved hyperglycemia in diabetic mice. However, the role of endogenous BMNC regeneration in this effect was unclear. This study aimed to evaluate the effect of these factors on in vivo BMNC differentiation into IPCs in diabetic mice. Mice were orally administered the factors for 5 days, twice at 2-week intervals, and monitored for 45–55 days. Glucose tolerance, glucose-stimulated insulin secretion, and pancreatic insulin content were measured. Chimeric mice harboring BMNCs from insulin promoter luciferase/green fluorescent protein (GFP) transgenic mice were used to track endogenous BMNC fate. These factors lowered blood glucose levels, improved glucose tolerance, and enhanced insulin secretion. Immunostaining confirmed IPCs in the pancreas, showing the potential of these factors to induce β-cell regeneration and improve diabetes treatment.

Background: Cumulative evidence consistently shows that anthropometric and body composition measurements are strongly linked to the risk of incident diabetes, typically based on baseline measurements. This study aims to assess whether repeated measurements enhance the prediction of diabetes risk beyond baseline assessments alone. Methods: We utilized data from a 16-year population-based follow-up cohort within the Korean Genome and Epidemiology Study, comprising 6,030 individuals aged 40 to 69 years at baseline. We included eight indices: a body shape index (ABSI), body adiposity index (BAI), waist circumference (WC), body mass index (BMI), waist-to-hip ratio (WHR), weight-adjusted skeletal muscle index (SMI), percent body fat, and fat-to-muscle ratio. The effect of these measurements for incident diabetes was estimated using Harrell’s C-indexes and hazard ratios with 95% confidence intervals, employing time-dependent Cox proportional hazard models. Results: Over the 16-year follow-up, 939 new diabetes cases were identified (cumulative incidence, 15.6%). The median number of indicator measurements per participant was eight. The basic model, including 10 features (sex, age, education levels, physical activity, alcohol intake, current smoking, total energy intake, dietary diversity score, and log-transformed C-reactive protein levels, and quartiles of unweighted genetic risk score at baseline), yielded a Harrell’s C-index of 0.610. The highest C-index in repeated measurements was for WC (0.668) across the general population, weight-adjusted SMI in men, and WHR in women. However, except for ABSI and BAI, the diabetes predictive power of the other indicators was comparable. Additionally, repeated measurements of WC, BMI, and WHR in women were found to contribute to improved discrimination compared to baseline measurements, but not in men. Conclusion Utilizing repeated measurements of general and central adiposity to predict diabetes may be helpful in predicting hidden risks, especially in women.

OBJECTIVES: Low handgrip strength (HGS) in children and adolescents might be associated with the risk of metabolic syndrome (MetS) and insulin resistance. This study prospectively evaluated the association between HGS in childhood and MetS in adolescence. METHODS: Based on data from the Ewha Birth and Growth Study, this study analyzed HGS at ages 7 to 9 and metabolic indices at ages 13 to 15. In total, 219 participants were analyzed. The risk of MetS was evaluated using the continuous metabolic syndrome score (cMetS), and insulin resistance was assessed using fasting blood insulin and homeostasis model assessment of insulin resistance (HOMA-IR). Relative HGS in childhood was determined by dividing HGS by body weight and categorized as sex-specific quartiles. RESULTS: This study found an inverse association between relative HGS levels in childhood and MetS and insulin resistance in adolescence. For each 1-group increase in relative HGS quartiles, cMetS (standarard [Std] β=-0.64, p<0.01), HOMA-IR (Std β=-0.21, p<0.01), and fasting blood insulin (Std β=-0.21, p<0.01) all decreased on average. These associations remained significant even after adjusting for confounding factors. CONCLUSIONS Our study showed a prospective association between HGS in childhood and the risk of MetS and insulin resistance in adolescence. It provides significant epidemiological evidence, emphasizing the importance of efforts to increase muscle strength from a young age to mitigate the risk of MetS and insulin resistance in adolescence.

Purpose: This study aimed to develop a graded prognostic assessment (GPA) model integrating genomic characteristics for elderly patients with glioblastoma (eGBM), and to compare the efficacy of different radiotherapy schedules. Materials and Methods: This multi-institutional retrospective study included patients aged ≥ 65 years who underwent surgical resection followed by radiotherapy with or without temozolomide (TMZ) for newly diagnosed eGBM. Based on the significant factors identified in the multivariate analysis for overall survival (OS), the molecular GPA for eGBM (eGBM-molGPA) was established. Results: A total of 334 and 239 patients who underwent conventionally fractionated radiotherapy (CFRT) and hypofractionated radiotherapy (HFRT) were included, respectively, with 86% of patients receiving TMZ-based chemoradiation. With a median follow-up of 17.4 months (range, 3.3 to 149.9 months), the median OS was 18.7 months for CFRT+TMZ group, 15.1 months for HFRT+TMZ group, and 10.4 months for radiotherapy alone group (CFRT+TMZ vs. HFRT+TMZ: hazard ratio [HR], 1.52; p < 0.001 and CFRT+TMZ vs. radiotherapy alone: HR, 2.52; p < 0.001). In a combined analysis with the NOA-08 and Nordic trials, CFRT+TMZ group exhibited the highest survival rates among all treatment groups. The eGBM-molGPA, which integrated four clinical and three molecular parameters, stratified patients into low-, intermediate-, and high-risk groups. CFRT+TMZ significantly improved OS compared to HFRT+TMZ or radiotherapy alone in the low-risk (p=0.023) and intermediate-risk groups (p < 0.001). However, in the high-risk group, there was no significant difference in OS between treatment options (p=0.770). Conclusion CFRT+TMZ may be more effective than HFRT+TMZ or radiotherapy alone for selected eGBM patients. The novel eGBM-molGPA model can guide treatment selection for this patient population.

Objective: Several miRNAs have been identified as differentially expressed in patients with poor ovarian response (POR) compared to those with normal responses. This study aims to assess the potential of serum miR-329-3p as a biomarker for diagnosing POR. Methods: We conducted a Kyoto Encyclopedia of Genes and Genomes (KEGG) pathway analysis to confirm the target genes of miR-329-3p. KGN cells were transfected with both miR-329-3p mimic and inhibitor to assess the differential expression of these target genes. In accordance with the Bologna criteria, we enrolled 16 control patients and 16 patients with POR. We collected patient samples, including serum from day 2 and the human chorionic gonadotropin (hCG) day, as well as granulosa and cumulus cells, to validate the expression of miR-329-3p using quantitative real-time polymerase chain reaction. Results: KEGG pathway analysis revealed that miR-329-3p targeted adenylyl cyclase 9 (ADCY9) and protein kinase A subunit beta (PRKACB), both of which are involved in ovarian steroidogenesis. In KGN cells treated with a miR-329-3p mimic, ADCY9 and PRKACB expression levels were significantly reduced (p<0.05). Elevated levels of miR-329-3p suppressed aromatase expression and 17β-estradiol production by modulating ADCY9 and PRKACB in KGN cells. These effects were also observed in POR patients. Follicle-stimulating hormone receptor (FSHR) expression was diminished in the granulosa cells of POR patients. On day 2, on hCG day, and in granulosa cells, miR-329-3p exhibited high expression levels in the serum of POR patients. Conclusion miR-329-3p exhibited increased expression in granulosa cells and in the sera of POR patients. Consequently, we propose that miR-329-3p may be a potential biomarker for the diagnosis of POR.

This study examined the KHEI (Korean Healthy Eating Index) in elderly men and women according to their income level using the National Health and Nutrition Survey (2020∼2021) data. The income level was classified into lower, lower middle, upper middle, and upper groups according to the household income quartiles. The significant differences between the KHEI score and three subcategories (adequacy, moderation, energy balance) scores according to the income level showed the same pattern in the elderly total, men and women. Regarding the individual item, the score for the intake of meat, fish, eggs, legumes, total fruit, fresh fruit, total vegetables, and vegetables excluding kimchi and pickled vegetables were significantly lower in the lower income group in total elderly, men and women than in the other groups (P＜0.001). Among the items that showed differences between elderly men and women, the ‘regular breakfast’ score was lowest in the upper-income group of elderly men and the ‘mixed grains intake’ score was lowest in the lower-income group of elderly men. These results can be used to help develop nutrition policies and national nutritional interventions for the elderly population according to the income level.

Purpose: To identify US findings suggestive of malignancy in thyroid nodules with follicular lesions of undetermined significance (FLUS) or follicular neoplasm (FN) on fine-needle aspiration cytology (FNAC) and evaluate the diagnostic performance. Materials and Methods: Seventy FLUS (n = 57) or FN (n = 13) nodules on FNAC that underwent surgical excision between February 2018 and November 2020 were selected. US findings were retrospectively reviewed. Orientation, margin, echogenicity, calcification, additional findings of the rim, echogenicity, heterogeneity of the solid portion, and the ratio of anterior posterior diameter to lateral diameter (criteria) were assessed. The diagnostic performances of US findings, criteria, and the Korean Society of Thyroid Radiology Thyroid Imaging Reporting and Data System (K-TIRADS) were evaluated using logistic regression analysis. Results: Microcalcification, homogeneous solid echotexture, and thickened rims were suggestive of malignancy. Our criteria showed a highest area under the ROC curve (AUC) value of 0.771, sensitivity of 97.14%, accuracy of 77.14%, positive predictive value of 93.33%, negative predictive value of 95.24%, and specificity of 97.14%. The criteria showed a significantly higher AUC value than K-TIRADS. Conclusion US findings of homogenous solid portions, thick rims, and microcalcifications suggested malignancy in nodules with FLUS or FN on FNAC. These additional US findings could improve the diagnostic performance of K-TIRADS.

Objectives: To investigate the relationship between self-rating of subjective oral health, oral hygiene behaviors, and objective oral health status, and to identify factors that determine self-rating for subjective oral health. Methods: This retrospective study examined data from 1,128 patients who underwent panoramic radiography and oral examination based on national health checkups between 2009 and 2015. Oral hygiene behavior was validated using a questionnaire, and the presence of oral diseases was validated through oral examination and panoramic radiographs. The effect of oral hygiene behaviors on the presence of oral diseases or dental treatment was evaluated using univariate regression analysis. Oral hygiene behaviors and the prevalence of oral disease were compared, according to selfrated subjective oral health, using the chi-square test. Factors affecting self-rating of subjective oral health were determined using multivariate regression analysis. Results: Patients who brushed their teeth less than three times per day had a higher risk of dental caries, periodontitis, and missing teeth (P<0.05). The percentage of patients performing oral hygiene behaviors differed significantly according to the self-rating of subjective oral health. The factors affecting the self-rating of subjective oral health were pain and the presence of restored teeth.The presence of gingivitis, periodontitis, and the number of dental caries had no significant effect on the self-rating of oral health. Conclusions Self-rating of oral health was determined by treatment experience rather than objective oral health status and it affected oral hygiene behavior.

Background: While the clinical course of radiation-induced meningioma (RIM) is considered to be more aggressive than that of sporadic meningioma (SM), the genetic predisposition for RIM is not established well. The present study aimed to analyze the clinical and genetic characteristics of RIMs to increase understanding of the tumorigenesis and prognosis of RIMs. Methods: We investigated a database of 24 patients who met the RIM criteria between January 2000 and April 2023. Genetic analysis through next-generation sequencing with a targeted gene panel was performed on 10 RIM samples. Clinical, radiological, and pathological parameters were evaluated with genetic analyses. Results: The median ages for receiving radiotherapy (RT) and RIM diagnosis were 8.0 and 27.5 years, respectively, with an interval of 17.5 years between RT and RIM diagnosis. RIMs tended to develop in non-skull bases and multifocal locations. Most primary pathologies included germ cell tumors and medulloblastoma. The tumor growth rate was 3.83 cm 3 per year, and the median doubling time was 0.8 years. All patients underwent surgical resection of RIMs. The histological grade of RIMs was World Health Organization grade 1 (64%) or 2 (36%). RIMs showed higher incidences in young-age (63%), high-dose (75%), and extendedfield (79%) RT groups. The recurrence rate was 21%. Genetic analysis revealed NF2 one copy loss in 90% of the patients, with truncating NF2 mutations and additional copy number aberrations in grade 2 RIMs. TERT promoter mutation and CDKN2A/B deletion were not identified. Notably, loss of H3K27me3 was identified in 26% of RIMs. H3K27me3 loss was associated with a higher prevalence of grade 2 RIMs (67%) and high recurrence rates (33%). Conclusion The study reveals a higher prevalence of high-grade tumors among RIMs with more rapid growth and higher recurrences than SMs. Genetically, RIMs are primarily associated with NF-2 alterations with chromosomal abnormalities in grade 2 tumors, along with a higher proportion of H3K27me3 loss.

Objectives: To investigate the relationship between self-rating of subjective oral health, oral hygiene behaviors, and objective oral health status, and to identify factors that determine self-rating for subjective oral health. Methods: This retrospective study examined data from 1,128 patients who underwent panoramic radiography and oral examination based on national health checkups between 2009 and 2015. Oral hygiene behavior was validated using a questionnaire, and the presence of oral diseases was validated through oral examination and panoramic radiographs. The effect of oral hygiene behaviors on the presence of oral diseases or dental treatment was evaluated using univariate regression analysis. Oral hygiene behaviors and the prevalence of oral disease were compared, according to selfrated subjective oral health, using the chi-square test. Factors affecting self-rating of subjective oral health were determined using multivariate regression analysis. Results: Patients who brushed their teeth less than three times per day had a higher risk of dental caries, periodontitis, and missing teeth (P<0.05). The percentage of patients performing oral hygiene behaviors differed significantly according to the self-rating of subjective oral health. The factors affecting the self-rating of subjective oral health were pain and the presence of restored teeth.The presence of gingivitis, periodontitis, and the number of dental caries had no significant effect on the self-rating of oral health. Conclusions Self-rating of oral health was determined by treatment experience rather than objective oral health status and it affected oral hygiene behavior.