Background: Atherogenic dyslipidemia, which is frequently associated with type 2 diabetes (T2D) and insulin resistance, contributes to the development of vascular complications. Statin therapy is the primary approach to dyslipidemia management in T2D, however, the role of non-statin therapy remains unclear. Ezetimibe reduces cholesterol burden by inhibiting intestinal cholesterol absorption. Fibrates lower triglyceride levels and increase high-density lipoprotein cholesterol (HDL-C) levels via peroxisome proliferator- activated receptor alpha agonism. Therefore, when combined, these drugs effectively lower non-HDL-C levels. Despite this, few clinical trials have specifically targeted non-HDL-C, and the efficacy of triple combination therapies, including statins, ezetimibe, and fibrates, has yet to be determined. Methods: This is a multicenter, prospective, randomized, open-label, active-comparator controlled trial involving 3,958 eligible participants with T2D, cardiovascular risk factors, and elevated non-HDL-C (≥100 mg/dL). Participants, already on moderate-intensity statins, will be randomly assigned to either Ezefeno (ezetimibe/fenofibrate) addition or statin dose-escalation. The primary end point is the development of a composite of major adverse cardiovascular and diabetic microvascular events over 48 months. Conclusion This trial aims to assess whether combining statins, ezetimibe, and fenofibrate is as effective as, or possibly superior to, statin monotherapy intensification in lowering cardiovascular and microvascular disease risk for patients with T2D. This could propose a novel therapeutic approach for managing dyslipidemia in T2D.

BACKGROUND/OBJECTIVES: Perceived diet quality (PDQ) has been suggested as an easy-touse dietary assessment tool. However, its practicality and efficiency are still questionable.This study aimed to gauge the utility of PDQ as an alternative dietary assessment tool among Korean adults by examining PDQ and its associated factors. SUBJECTS/METHODS: An online survey was conducted on 514 Korean adults aged 19 to 64 years in October 2022. PDQ was assessed using a 5-point Likert scale, and participants were categorized into healthy, fair, or unhealthy PDQ groups. The participants were asked about the perceived importance of nutrients and food groups for health and the extent to which they considered these factors in their usual diets using a 5-point Likert scale. A multivariate linear regression model was used to identify the factors associated with PDQ. RESULTS: About 26.7% of participants rated their diets as healthy, while 63.2% rated them as fair and 10.1% rated them as unhealthy. Participants with a healthy PDQ rated perceived importance and consideration of nutrients and food groups higher than the fair or unhealthy PDQ groups. A healthier PDQ was associated with the male gender, an older age, being normal or underweight, having better subjective health, lower use of alcohol, being physically active, having a high interest in healthy diets, and a higher perception of the importance of nutrients and food groups for health. CONCLUSION The PDQ could serve as a simple and rapid screening tool for identifying individuals at risk of poor diets.

Purpose: This study examined the characteristics of dietary information acquisition and perceptions on the Dietary Reference Intakes for Koreans (KDRIs) and related guidelines, the Food Balance Wheel and Target Pattern, focusing on the differences according to gender and experience of acquiring dietary information. Methods: Five hundred and fourteen Korean adults aged 19–64 years participated in an online survey and were categorized according to gender and whether they had experience acquiring dietary information. The differences in the general characteristics, dietary behaviors, and perceptions of KDRIs and related guidelines were analyzed using χ 2 tests. Results: Among the participants, 68.1% reported having experience acquiring dietary information, with a higher proportion of women (76.2%) than men (60.1%). Women with such experiences were older, more physically active, experienced in diet management, and showed greater interest in healthy eating and dietary information (p < 0.05 for all). Men with experience also had more diet management experience and showed higher interest in healthy eating and dietary information (p < 0.05 for all). Dietary information was acquired primarily from the Internet, followed by mass media, online video platforms, and social media. The major inconvenience in using dietary information was the lack of tailored content and insufficient detail. The awareness of KDRIs and related guidelines was higher among those with experience in acquiring dietary information. On the other hand, understanding and applicability of these guidelines showed no significant differences across groups. Conclusion This study found that the proportion of individuals acquiring nutrition information varied according to gender and lifestyle behaviors. Most participants acquired information primarily through the Internet. The awareness of KDRIs and related guidelines was higher among those with experience in acquiring dietary information. These findings suggest that the strategies for providing nutrition information should consider the characteristics of Korean adults to improve effectiveness.

BACKGROUND/OBJECTIVES: Perceived diet quality (PDQ) has been suggested as an easy-touse dietary assessment tool. However, its practicality and efficiency are still questionable.This study aimed to gauge the utility of PDQ as an alternative dietary assessment tool among Korean adults by examining PDQ and its associated factors. SUBJECTS/METHODS: An online survey was conducted on 514 Korean adults aged 19 to 64 years in October 2022. PDQ was assessed using a 5-point Likert scale, and participants were categorized into healthy, fair, or unhealthy PDQ groups. The participants were asked about the perceived importance of nutrients and food groups for health and the extent to which they considered these factors in their usual diets using a 5-point Likert scale. A multivariate linear regression model was used to identify the factors associated with PDQ. RESULTS: About 26.7% of participants rated their diets as healthy, while 63.2% rated them as fair and 10.1% rated them as unhealthy. Participants with a healthy PDQ rated perceived importance and consideration of nutrients and food groups higher than the fair or unhealthy PDQ groups. A healthier PDQ was associated with the male gender, an older age, being normal or underweight, having better subjective health, lower use of alcohol, being physically active, having a high interest in healthy diets, and a higher perception of the importance of nutrients and food groups for health. CONCLUSION The PDQ could serve as a simple and rapid screening tool for identifying individuals at risk of poor diets.

Purpose: In men with metastatic castration-resistant prostate cancer (mCRPC), new bone lesions are sometimes not properly categorized through a confirmatory bone scan, and clinical significance of the test itself remains unclear. This study aimed to demonstrate the performance rate of confirmatory bone scans in a real-world setting and their prognostic impact in enzalutamide-treated mCRPC. Materials and Methods: Patients who received oral enzalutamide for mCRPC during 2014-2017 at 14 tertiary centers in Korea were included. Patients lacking imaging assessment data or insufficient drug exposure were excluded. The primary outcome was overall survival (OS). Secondary outcomes included performance rate of confirmatory bone scans in a real-world setting. Kaplan-Meier analysis and multivariate Cox regression analysis were performed. Results: Overall, 520 patients with mCRPC were enrolled (240 [26.2%] chemotherapy-naïve and 280 [53.2%] after chemotherapy). Among 352 responders, 92 patients (26.1%) showed new bone lesions in their early bone scan. Confirmatory bone scan was performed in 41 patients (44.6%), and it was associated with prolonged OS in the entire population (median, 30.9 vs. 19.7 months; p < 0.001), as well as in the chemotherapy-naïve (median, 47.2 vs. 20.5 months; p=0.011) and post-chemotherapy sub-groups (median, 25.5 vs. 18.0 months; p=0.006). Multivariate Cox regression showed that confirmatory bone scan performance was an independent prognostic factor for OS (hazard ratio 0.35, 95% confidence interval, 0.18 to 0.69; p=0.002). Conclusion Confirmatory bone scan performance was associated with prolonged OS. Thus, the premature discontinuation of enzalutamide without confirmatory bone scans should be discouraged.

Emergency department (ED) triage systems are used to classify the severity and urgency of emergency patients, and Korean medical institutions use the Korean Triage and Acuity Scale (KTAS). During the COVID-19 pandemic, appropriate treatment for emergency patients was delayed due to various circumstances, such as overcrowding of EDs, lack of medical workforce resources, and increased workload on medical staff. The purpose of this study was to evaluate the accuracy of the KTAS in predicting the urgency of emergency patients during the COVID-19 pandemic. Methods This study retrospectively reviewed patients who were treated in the ED during the pandemic period from January 2020 to June 2021. Patients were divided into COVID-19–screening negative (SN) and COVID-19–screening positive (SP) groups. We compared the predictability of the KTAS for urgent patients between the two groups. Results From a total of 107,480 patients, 62,776 patients (58.4%) were included in the SN group and 44,704 (41.6%) were included in the SP group. The odds ratios for severity variables at each KTAS level revealed a more evident discriminatory power of the KTAS for severity variables in the SN group (P<0.001). The predictability of the KTAS for severity variables was higher in the SN group than in the SP group (area under the curve, P<0.001). Conclusion During the pandemic, the KTAS had low accuracy in predicting patients in critical condition in the ED. Therefore, in future pandemic periods, supplementation of the current ED triage system should be considered in order to accurately classify the severity of patients.

Purpose: This study examined the characteristics of dietary information acquisition and perceptions on the Dietary Reference Intakes for Koreans (KDRIs) and related guidelines, the Food Balance Wheel and Target Pattern, focusing on the differences according to gender and experience of acquiring dietary information. Methods: Five hundred and fourteen Korean adults aged 19–64 years participated in an online survey and were categorized according to gender and whether they had experience acquiring dietary information. The differences in the general characteristics, dietary behaviors, and perceptions of KDRIs and related guidelines were analyzed using χ 2 tests. Results: Among the participants, 68.1% reported having experience acquiring dietary information, with a higher proportion of women (76.2%) than men (60.1%). Women with such experiences were older, more physically active, experienced in diet management, and showed greater interest in healthy eating and dietary information (p < 0.05 for all). Men with experience also had more diet management experience and showed higher interest in healthy eating and dietary information (p < 0.05 for all). Dietary information was acquired primarily from the Internet, followed by mass media, online video platforms, and social media. The major inconvenience in using dietary information was the lack of tailored content and insufficient detail. The awareness of KDRIs and related guidelines was higher among those with experience in acquiring dietary information. On the other hand, understanding and applicability of these guidelines showed no significant differences across groups. Conclusion This study found that the proportion of individuals acquiring nutrition information varied according to gender and lifestyle behaviors. Most participants acquired information primarily through the Internet. The awareness of KDRIs and related guidelines was higher among those with experience in acquiring dietary information. These findings suggest that the strategies for providing nutrition information should consider the characteristics of Korean adults to improve effectiveness.

BACKGROUND/OBJECTIVES: Perceived diet quality (PDQ) has been suggested as an easy-touse dietary assessment tool. However, its practicality and efficiency are still questionable.This study aimed to gauge the utility of PDQ as an alternative dietary assessment tool among Korean adults by examining PDQ and its associated factors. SUBJECTS/METHODS: An online survey was conducted on 514 Korean adults aged 19 to 64 years in October 2022. PDQ was assessed using a 5-point Likert scale, and participants were categorized into healthy, fair, or unhealthy PDQ groups. The participants were asked about the perceived importance of nutrients and food groups for health and the extent to which they considered these factors in their usual diets using a 5-point Likert scale. A multivariate linear regression model was used to identify the factors associated with PDQ. RESULTS: About 26.7% of participants rated their diets as healthy, while 63.2% rated them as fair and 10.1% rated them as unhealthy. Participants with a healthy PDQ rated perceived importance and consideration of nutrients and food groups higher than the fair or unhealthy PDQ groups. A healthier PDQ was associated with the male gender, an older age, being normal or underweight, having better subjective health, lower use of alcohol, being physically active, having a high interest in healthy diets, and a higher perception of the importance of nutrients and food groups for health. CONCLUSION The PDQ could serve as a simple and rapid screening tool for identifying individuals at risk of poor diets.

Purpose: This study developed the evaluation components and criteria for the Korean Healthy Diet (KHD) and assessed the current compliance of Koreans. Methods: The study reviewed domestic and international dietary guidelines and literature and conducted an online survey of 514 Korean adults to understand their nutritional perceptions, specifically the perceived importance of health and incorporation into usual diet. Data from the Korea National Health and Nutrition Examination Survey (KNHANES) were used to investigate food and nutrient intake patterns and examine the relationship between intake and metabolic syndrome (MetS). Based on these data, the components and criteria for a KHD were established by sex and age, and adherence was assessed. Results: The KHD evaluation included 13 dietary components: carbohydrates, sugar, fiber, protein, total fat, saturated fat, sodium, calcium, mixed grains, meat·fish·eggs·beans, vegetables, fruits, and dairy products. Applying the selected components and criteria to data from the KNHANES (2019-2021), the average KHD adherence score for Korean adults was 5.465 ± 0.023 out of a maximum score of 13. The score significantly increased with age (4.766 ± 0.044 for 19-29 years; 5.276±0.032 for 30-49 years; 6.109 ± 0.033 for 50-64 years), and women (5.642 ± 0.028) had higher scores than men (5.284 ± 0.030) (p < 0.05). Furthermore, the total score significantly differed between those with MetS (5.518 ± 0.045) and those without (5.568 ± 0.026) after adjusted for sex and age (p < 0.05). When scoring the dietary components, sugar (0.852 ± 0.004) and proteins (0.881 ± 0.004) scored relatively higher in the association with MetS, whereas calcium (0.148 ± 0.004) and mixed grains (0.225 ± 0.005) scored relatively lower. Conclusions The KHD evaluation criteria could be used as a tool for screening and monitoring the overall diet quality of Koreans.