Purpose: High-cost novel therapies for multiple myeloma (MM) require evaluation of efficacy and cost-effectiveness. Materials and Methods: This study developed a methodology to assess cost-effectiveness using nationwide data from 11,450 newly diagnosed MM patients. A novel algorithm was applied to identify lines of therapy (LoT). Results: The number of newly diagnosed MM patients increased significantly, from 873 in 2010 to 1,464 in 2019 (p < 0.001). Advancing LoT was associated with shorter time to next treatment (TTNT) and overall survival (OS) (p < 0.001), while all-cause medical costs increased with each LoT (p < 0.001). Bortezomib-melphalan-prednisolone was the most common frontline regimen for transplant-ineligible patients (29.2%), while bortezomib-thalidomide-dexamethasone was most used for transplant-eligible patients (11.3%). Daratumumab monotherapy demonstrated superior second TTNT (7.8 vs. 5.2 months) and OS (8.5 vs. 5.3 months) compared to standard care in heavily treated MM patients, with statistical significance maintained after cost adjustment. For subsequent therapies following daratumumab, a methodology was developed to estimate required medical costs using the incremental cost-effectiveness ratio (ICER): Expected cost ($)=ICER×(Expected life expectancy–0.567)+35,601. Conclusion This study provides a novel cost-effectiveness framework linking treatment efficacy and real-world costs, supporting predictions of societal costs for future MM therapies.

Aromadendrin is a phenolic compound with various biological effects such as anti-inflammatory properties. However, its protective effects against acute lung injury (ALI) remain unclear. Therefore, this study aimed to explore the ameliorative effects of aromadendrin in an experimental model of lipopolysaccharide (LPS)-induced ALI. In vitro analysis revealed a notable increase in the levels of cytokine/chemokine formation, nuclear factor kappa B (NF-κB) activation, and myeloid differentiation primary response 88 (MyD88)/toll-like receptor (TLR4) expression in LPS-stimulated BEAS-2B lung epithelial cell lines that was ameliorated by aromadendrin pretreatment. In LPS-induced ALI mice, the remarkable upregulation of immune cells and IL-1β/IL-6/TNF-α levels in the bronchoalveolar lavage fluid and inducible nitric oxide synthase/cyclooxygenase-2/CD68 expression in lung was decreased by the oral administration of aromadendrin. Histological analysis revealed the presence of cells in the lungs of ALI mice, which was alleviated by aromadendrin. In addition, aromadendrin ameliorated lung edema. This in vivo effect of aromadendrin was accompanied by its inhibitory effect on LPS-induced NF-κB activation, MyD88/TLR4 expression, and signal transducer and activator of transcription 3 activation. Furthermore, aromadendrin increased the expression of heme oxygenase-1/ NAD(P)H quinone dehydrogenase 1 in the lungs of ALI mice. In summary, the in vitro and in vivo studies demonstrated that aromadendrin ameliorated endotoxin-induced pulmonary inflammation by suppressing cytokine formation and NF-κB activation, suggesting that aromadendrin could be a useful adjuvant in the treatment of ALI.

This study evaluated the effectiveness of an obesity program developed to solve ‘obesity’, which was selected as the top priority for urgent improvement among the dietary problems of elementary school students in Busan. The program aimed to practice four health rules every day (sleep early, eat two vegetables with each meal, reduce sugary snacks, and exercise for 30 minutes every day). The participants were trained to practice the four rules online in real time every day for three weeks, and their performance in nutrition education tasks was monitored using Padlet. The anthropometric measurements showed no change in the overall average weight before and after participating in the program, but all students grew in height (z=–6.978, P＜0.001), and the number of obese students decreased significantly (z=–3.317, P＜0.001). This obesity program was effective in improving height growth and obesity in elementary school students. In terms of dietary changes, after participating in the program, the frequency of vegetable consumption increased significantly (z= –4.849, P＜0.001), the frequency of sweet snack consumption decreased significantly (z=–4.298, P＜0.001), and the bedtime improved (z=–1.000). Therefore, the non-face-to-face, self-directed obesity program developed in this study is expected to reduce the workload of nutrition teachers carrying a heavy workload such as meal service and nutrition classes, and can be used as an efficient nutrition counseling program.

This study was undertaken to analyze the growth, nutritional, and dietary risk factors of elementary school students belonging to the Busan Metropolitan City Office of Education and provide the basic data needed to develop an underweight and obesity prevention program. In 2021, BMI and Dietary Screening Test (DST) data of 4,046 children surveyed by the Nutrition Education Experience Center’s “Diagnosis System” of the Busan Regional Office of Education were analyzed. The DST consists of 36 questions about lifestyle habits, meal quality, meal regularity, snack quality, and eating behavior. Of the children included, 6.8% were underweight, 65.4% were normal weight, 13.4% were overweight, and 14.4% were obese. Children in the obesity group had shorter sleep and meal times (P＜0.001), lower vegetable and fruit consumption frequencies (P＜0.001), higher fast food consumption frequencies (P＜0.001), higher rates of skipping meals (P＜0.01) and breakfast (P＜0.001), and more frequently used smartphones and watched TV during meals (P＜0.001). The underweight group had the highest scores for all eating development factors but more frequently had chewing and swallowing difficulties (P＜0.001). The study confirms underweightedness and obesity are present different problems and indicates that nutrition teachers should conduct accurate studies on the eating habits and behaviors of obese and underweight students and provide individually tailored nutritional counseling.