Background: The effects of propofol, a commonly used intravenous anesthetic, on the breast cancer tumor microenvironment are not well understood. This study examined the influence of propofol on natural killer group 2, member D (NKG2D) ligand expression, matrix metalloproteinase (MMP)-mediated immune evasion, and natural killer (NK) cell-mediated cytotoxicity in breast cancer cells. Methods: We studied three human breast cancer cell lines representing distinct receptor subtypes: MCF-7 (estrogen receptor - and progesterone receptor-positive), MDA-MB-453 (human epidermal growth factor receptor 2-positive), and HCC-70 (triple-negative). Cells were treated with propofol at concentrations of 0 μg/ml (control; C), 4 μg/ml (P4), or 8 μg/ml (P8). Assessments included mRNA and protein expression of NKG2D ligands, NK cell cytotoxicity, protein levels of MMP-1 and MMP-2, and concentrations of soluble NKG2D ligands. Results: In MCF-7 and HCC-70 cell lines, propofol upregulated the mRNA and protein expression of NKG2D ligands in a dose-dependent manner, enhancing NK cell-mediated lysis. In contrast, in MDA-MB-453 cell lines, propofol downregulated the mRNA and protein expression of NKG2D ligands, resulting in diminished NK cell-mediated lysis. Across all receptor subtypes, propofol did not affect the expression of MMP-1 or MMP-2 or the concentration of soluble NKG2D ligands. Conclusions Our results demonstrate that propofol exerts receptor subtype-dependent effects on NK cell-mediated immunosurveillance in breast cancer cell lines, potentially mediated by changes in the transcription of NKG2D ligands rather than by alterations in MMP expression or their proteolytic activity.

Background: Although excessive physical activity (PA) does not always confer additional health benefits, there is a paucity of studies that have quantitatively examined the doseresponse relationship between PA and type 2 diabetes. Therefore, this study investigated the relationship between the type 2 diabetes prevalence and intensity, frequency, and metabolic equivalent of task (MET) score of PA in a large population sample. Methods: We conducted a nationwide cross-sectional analysis examining sociodemographic variables, PA habits, and type 2 diabetes prevalence in 2,428,448 participants included in the Korea Community Health Survey. The non-linear association between MET score and odds ratios (ORs) for type 2 diabetes prevalence was plotted using a weighted generalized additive model. Categorical analysis was used to examine the joint association of moderate-intensity PA (MPA) and vigorous-intensity PA (VPA), and the influence of PA frequency. Results: MET score and diabetes prevalence revealed a non-linear association with the nadir at 1,028 MET-min/week, beyond which ORs increased with additional PA. Joint analysis of MPA and VPA showed the lowest OR of 0.79 (95% confidence interval, 0.75–0.84) for those engaging in 300–600 MET-min/week of MPA and > 600 MET-min/week of VPA concurrently, corresponding with World Health Organization recommendations. Additionally, both “weekend warriors” and “regularly active” individuals showed lower ORs compared to the inactive, although no significant difference was noted between the active groups. Conclusion In a large South Korean sample, higher PA is not always associated with a lower prevalence of type 2 diabetes, as the association follows a non-linear pattern; differences existed across sociodemographic variables. Considering the joint association, an adequate combination of MPA and VPA is recommended. The frequency of PA does not significantly influence the type 2 diabetes prevalence.

Background: Although excessive physical activity (PA) does not always confer additional health benefits, there is a paucity of studies that have quantitatively examined the doseresponse relationship between PA and type 2 diabetes. Therefore, this study investigated the relationship between the type 2 diabetes prevalence and intensity, frequency, and metabolic equivalent of task (MET) score of PA in a large population sample. Methods: We conducted a nationwide cross-sectional analysis examining sociodemographic variables, PA habits, and type 2 diabetes prevalence in 2,428,448 participants included in the Korea Community Health Survey. The non-linear association between MET score and odds ratios (ORs) for type 2 diabetes prevalence was plotted using a weighted generalized additive model. Categorical analysis was used to examine the joint association of moderate-intensity PA (MPA) and vigorous-intensity PA (VPA), and the influence of PA frequency. Results: MET score and diabetes prevalence revealed a non-linear association with the nadir at 1,028 MET-min/week, beyond which ORs increased with additional PA. Joint analysis of MPA and VPA showed the lowest OR of 0.79 (95% confidence interval, 0.75–0.84) for those engaging in 300–600 MET-min/week of MPA and > 600 MET-min/week of VPA concurrently, corresponding with World Health Organization recommendations. Additionally, both “weekend warriors” and “regularly active” individuals showed lower ORs compared to the inactive, although no significant difference was noted between the active groups. Conclusion In a large South Korean sample, higher PA is not always associated with a lower prevalence of type 2 diabetes, as the association follows a non-linear pattern; differences existed across sociodemographic variables. Considering the joint association, an adequate combination of MPA and VPA is recommended. The frequency of PA does not significantly influence the type 2 diabetes prevalence.

Background: Although excessive physical activity (PA) does not always confer additional health benefits, there is a paucity of studies that have quantitatively examined the doseresponse relationship between PA and type 2 diabetes. Therefore, this study investigated the relationship between the type 2 diabetes prevalence and intensity, frequency, and metabolic equivalent of task (MET) score of PA in a large population sample. Methods: We conducted a nationwide cross-sectional analysis examining sociodemographic variables, PA habits, and type 2 diabetes prevalence in 2,428,448 participants included in the Korea Community Health Survey. The non-linear association between MET score and odds ratios (ORs) for type 2 diabetes prevalence was plotted using a weighted generalized additive model. Categorical analysis was used to examine the joint association of moderate-intensity PA (MPA) and vigorous-intensity PA (VPA), and the influence of PA frequency. Results: MET score and diabetes prevalence revealed a non-linear association with the nadir at 1,028 MET-min/week, beyond which ORs increased with additional PA. Joint analysis of MPA and VPA showed the lowest OR of 0.79 (95% confidence interval, 0.75–0.84) for those engaging in 300–600 MET-min/week of MPA and > 600 MET-min/week of VPA concurrently, corresponding with World Health Organization recommendations. Additionally, both “weekend warriors” and “regularly active” individuals showed lower ORs compared to the inactive, although no significant difference was noted between the active groups. Conclusion In a large South Korean sample, higher PA is not always associated with a lower prevalence of type 2 diabetes, as the association follows a non-linear pattern; differences existed across sociodemographic variables. Considering the joint association, an adequate combination of MPA and VPA is recommended. The frequency of PA does not significantly influence the type 2 diabetes prevalence.

Background: Although excessive physical activity (PA) does not always confer additional health benefits, there is a paucity of studies that have quantitatively examined the doseresponse relationship between PA and type 2 diabetes. Therefore, this study investigated the relationship between the type 2 diabetes prevalence and intensity, frequency, and metabolic equivalent of task (MET) score of PA in a large population sample. Methods: We conducted a nationwide cross-sectional analysis examining sociodemographic variables, PA habits, and type 2 diabetes prevalence in 2,428,448 participants included in the Korea Community Health Survey. The non-linear association between MET score and odds ratios (ORs) for type 2 diabetes prevalence was plotted using a weighted generalized additive model. Categorical analysis was used to examine the joint association of moderate-intensity PA (MPA) and vigorous-intensity PA (VPA), and the influence of PA frequency. Results: MET score and diabetes prevalence revealed a non-linear association with the nadir at 1,028 MET-min/week, beyond which ORs increased with additional PA. Joint analysis of MPA and VPA showed the lowest OR of 0.79 (95% confidence interval, 0.75–0.84) for those engaging in 300–600 MET-min/week of MPA and > 600 MET-min/week of VPA concurrently, corresponding with World Health Organization recommendations. Additionally, both “weekend warriors” and “regularly active” individuals showed lower ORs compared to the inactive, although no significant difference was noted between the active groups. Conclusion In a large South Korean sample, higher PA is not always associated with a lower prevalence of type 2 diabetes, as the association follows a non-linear pattern; differences existed across sociodemographic variables. Considering the joint association, an adequate combination of MPA and VPA is recommended. The frequency of PA does not significantly influence the type 2 diabetes prevalence.

OBJECTIVE: Despite the global decrease in influenza infections during the coronavirus disease 2019 (COVID-19) pandemic, seasonal influenza remains a significant health issue. South Korea, known for its robust pandemic response and high influenza vaccination rates, offers a unique context for examining changes in vaccination trends during the pandemic. Using nationally representative data, we aimed to understand the impact of the pandemic on influenza vaccination behavior over a 12-year period and to identify vulnerable groups. METHODS: We analyzed influenza vaccination rates in South Korea between 2011-2022, focusing on pandemic-related impacts. The data of 2,426,139 adults (≥ 19 years) from the Korea Community Health Survey were used to assess demographic and sociological factors influencing vaccination behaviors. RESULTS: We observed an increase in influenza vaccination rates during the pre-COVID-19 period from 2011-2013 (weighted prevalence: 46.68% [95% confidence interval ( CI): 46.55-46.82]) to 2017-2019 (weighted prevalence: 52.50% [95% CI: 52.38-52.63]). However, a significant decline was observed in 2022, the late-COVID-19 pandemic period (weighted prevalence: 55.78% [95% CI: 55.56-56.01]), compared with the mid-pandemic period in 2021 (weighted prevalence: 59.12% [95% CI: 58.91-59.32]), particularly among populations traditionally prioritized for influenza vaccination, including older adults (≥ 65 years) and patients with chronic diseases and low educational and income levels. CONCLUSION The influenza vaccination rate in South Korea was significantly affected by the COVID-19 pandemic, showing a notable decrease among vulnerable demographic groups. This suggests the need for targeted public health strategies to address vaccine hesitancy and improve vaccination rates, particularly among high-risk populations.
Humans ; Republic of Korea/epidemiology* ; COVID-19/epidemiology* ; Adult ; Middle Aged ; Influenza Vaccines/administration & dosage* ; Male ; Female ; Influenza, Human/epidemiology* ; Aged ; Vaccination/statistics & numerical data* ; Young Adult ; Pandemics ; SARS-CoV-2

Background: Liver disease causes over two million deaths annually worldwide, comprising approximately 4% of all global fatalities. We aimed to analyze liver disease-related mortality trends from 1990 to 2021 using the World Health Organization (WHO) Mortality Database and forecast global liver disease-related mortality rates up to 2050. Methods: This study examined age-standardized liver disease-related death rates from 1990 to 2021, employing data from the WHO Mortality Database across 112 countries across five continents. The rates over time were calculated using a locally weighted scatter plot smoother curve, with weights assigned based on the population of each country. Furthermore, this study projected liver disease-related mortality rates up to 2050 using a Bayesian age-periodcohort (BAPC) model. Additionally, a decomposition analysis was conducted to discern influencing factors such as population growth, aging, and epidemiological changes. Results: The estimated global age-standardized liver disease-related mortality rates surged significantly from 1990 to 2021 across 112 countries, rising from 103.4 deaths per 1,000,000 people (95% confidence interval [CI], 88.16, 118.74) in 1990 to 173.0 deaths per 1,000,000 people (95% CI, 155.15, 190.95) in 2021. This upward trend was particularly pronounced in low- and middle-income countries, in Africa, and in populations aged 65 years and older.Moreover, age-standardized liver disease-related mortality rates were correlated with a lower Human Development Index (P < 0.001) and sociodemographic index (P = 0.001). According to the BAPC model, the projected trend indicated a sustained and substantial decline in liver disease-related mortality rates, with an estimated decrease from 185.08 deaths per 1,000,000 people (95% CI, 179.79, 190.63) in 2021 to 156.29 (112.32, 214.77) in 2050. From 1990 to 2021, age-standardized liver disease-related deaths surged primarily due to epidemiological changes, whereas from 1990 to 2050, the impact of population aging and growth became the primary contributing factors to the overall increase. Conclusion Global age-standardized liver disease-related mortality has increased significantly and continues to emerge as a crucial global public health issue. Further investigation into liver disease-related mortality rates in Africa is needed, and updating policies is necessary to effectively manage the global burden of liver disease.

BACKGROUND/OBJECTIVES: The increasing prevalence of overweight and obesity has become a significant global burden, with more than 40% of the global adult population attempting to lose weight. Previous studies on the impact of weight-control methods on mental health, especially among adolescents, are limited. Thus, this study aimed to investigate the association between various weight-control methods and depression among adolescents, with the goal of informing healthier weight management decisions and promoting effective methods. SUBJECTS/METHODS: This nationwide study utilized data from the Korea Youth Risk Behavior Web-based Survey, including a sample of 418,254 adolescents collected over 12yrs (2007–2019). We conducted a weighted complex sample analysis to compare depression rates associated with specific weight-control methods, including exercise, fasting (≥ 24 h), eating less, taking prescriptionon-prescription weight-loss medication, taking laxatives or diuretics, vomiting, one-food diet, taking oriental medicine, and diet foods. RESULTS: Of the 418,254 participants, 45.96% (192,246) were male. Among male participants, fasting (≥ 24 h; weighted odds ratio [wOR], 1.43; 95% confidence interval [CI], 1.36–1.51) and vomiting (wOR, 1.49; 95% CI, 1.35–1.66) were associated with an increased risk of depression. Among female participants, prescribed (wOR, 0.82; 95% CI, 0.74–0.90) and non-prescribed (wOR, 0.89; 95% CI, 0.82–0.97) weight-loss medication reduced the risk of depression. However, fasting (≥ 24 h; wOR, 1.47; 95% CI, 1.41–1.52) vomiting (wOR, 1.45;95% CI, 1.36–1.55) significantly increased the risk of depression. CONCLUSION The risk of depression varies depending on the weight-control method, with a consistent trend observed across both sexes. Methods such as vomiting, fasting, taking oriental medicine for weight loss, and consuming diet foods increased the risk of depression, while weight-loss medications were associated with reduced depression symptoms in females. These findings highlight the need for further research on weightcontrol medications and policies that support effective weight management while reducing depressive effects.

Background: Spinal anesthesia-induced hypotension (SAH) frequently occurs in older patients, many of whom have mild left ventricular (LV) diastolic dysfunction, often asymptomatic at rest. This study investigated the association between preoperative echocardiographic measurements and SAH in older patients with mild LV diastolic dysfunction. Methods: We conducted a retrospective observational study using data from electronic medical records. The patients ≥ 65 years old who underwent spinal anesthesia for urologic surgery between January 2016 and December 2017 and whose preoperative echocardiography within 6 months before surgery revealed grade I LV diastolic dysfunction were recruited. SAH was investigated using the anesthesia records. Logistic regression and receiver operating characteristic (ROC) curve analyses were performed. Results: A total of 163 patients were analyzed. SAH and significant SAH developed in 55 (33.7%) patients. The mitral inflow E velocity was an independent risk factor for SAH (odds ratio [OR], 0.886; 95% confidence interval [CI], 0.845–0.929; P < 0.001). The area under the ROC curve for mitral inflow E velocity to predict SAH was 0.819 (95% CI, 0.752–0.875; P < 0.001). If mitral inflow E velocity was ≤ 60 cm/s, SAH was predicted with a sensitivity of 83.6% and specificity of 70.4%. Conclusions The preoperative mitral inflow E velocity demonstrated the greatest predictability of SAH in older patients with mild LV diastolic dysfunction. This may assist in identifying patients at high risk of SAH and guiding preventive strategies in the future.

Background: Liver disease causes over two million deaths annually worldwide, comprising approximately 4% of all global fatalities. We aimed to analyze liver disease-related mortality trends from 1990 to 2021 using the World Health Organization (WHO) Mortality Database and forecast global liver disease-related mortality rates up to 2050. Methods: This study examined age-standardized liver disease-related death rates from 1990 to 2021, employing data from the WHO Mortality Database across 112 countries across five continents. The rates over time were calculated using a locally weighted scatter plot smoother curve, with weights assigned based on the population of each country. Furthermore, this study projected liver disease-related mortality rates up to 2050 using a Bayesian age-periodcohort (BAPC) model. Additionally, a decomposition analysis was conducted to discern influencing factors such as population growth, aging, and epidemiological changes. Results: The estimated global age-standardized liver disease-related mortality rates surged significantly from 1990 to 2021 across 112 countries, rising from 103.4 deaths per 1,000,000 people (95% confidence interval [CI], 88.16, 118.74) in 1990 to 173.0 deaths per 1,000,000 people (95% CI, 155.15, 190.95) in 2021. This upward trend was particularly pronounced in low- and middle-income countries, in Africa, and in populations aged 65 years and older.Moreover, age-standardized liver disease-related mortality rates were correlated with a lower Human Development Index (P < 0.001) and sociodemographic index (P = 0.001). According to the BAPC model, the projected trend indicated a sustained and substantial decline in liver disease-related mortality rates, with an estimated decrease from 185.08 deaths per 1,000,000 people (95% CI, 179.79, 190.63) in 2021 to 156.29 (112.32, 214.77) in 2050. From 1990 to 2021, age-standardized liver disease-related deaths surged primarily due to epidemiological changes, whereas from 1990 to 2050, the impact of population aging and growth became the primary contributing factors to the overall increase. Conclusion Global age-standardized liver disease-related mortality has increased significantly and continues to emerge as a crucial global public health issue. Further investigation into liver disease-related mortality rates in Africa is needed, and updating policies is necessary to effectively manage the global burden of liver disease.