Background: This study examined gender differences in occupational stress, depressive symptoms, and suicidal ideation by considering the potential moderating effect of grit on Korean employees. Methods: A total of 11,369 participants (7,735 men and 3,634 women) aged 19–65 years, employed across 18 private companies and local government organizations in Korea, completed questionnaires including the Short Grit Scale, Korean Occupational Stress Scale, and Center for Epidemiologic Studies Depression Scale between April 2020 and March 2022.Suicidal ideation was assessed based on its presence or absence. Mediation and moderation analyses were performed using the Statistical Package for the Social Sciences PROCESS macro. Results: Depressive symptoms partially mediated the relationship between occupational stress and suicidal ideation in male employees, whereas depressive symptoms fully mediated the relationship in female employees. Grit moderated the relationship between depressive symptoms and suicidal ideation in male employees but not in female employees.Furthermore, the moderated mediating effect of grit in male employees on the relationship between occupational stress and suicidal ideation provided less protection in cases of severe depression. The cross-sectional design does not allow for causal inferences. Conclusion These findings contribute to understanding of the gender differences in the impact of depressive symptoms on the relationship between occupational stress and suicidal ideation, as well as the protective effect of grit. These findings highlight the need for genderspecific approaches to prevent suicidal ideation among employees.

Background: This study examined gender differences in occupational stress, depressive symptoms, and suicidal ideation by considering the potential moderating effect of grit on Korean employees. Methods: A total of 11,369 participants (7,735 men and 3,634 women) aged 19–65 years, employed across 18 private companies and local government organizations in Korea, completed questionnaires including the Short Grit Scale, Korean Occupational Stress Scale, and Center for Epidemiologic Studies Depression Scale between April 2020 and March 2022.Suicidal ideation was assessed based on its presence or absence. Mediation and moderation analyses were performed using the Statistical Package for the Social Sciences PROCESS macro. Results: Depressive symptoms partially mediated the relationship between occupational stress and suicidal ideation in male employees, whereas depressive symptoms fully mediated the relationship in female employees. Grit moderated the relationship between depressive symptoms and suicidal ideation in male employees but not in female employees.Furthermore, the moderated mediating effect of grit in male employees on the relationship between occupational stress and suicidal ideation provided less protection in cases of severe depression. The cross-sectional design does not allow for causal inferences. Conclusion These findings contribute to understanding of the gender differences in the impact of depressive symptoms on the relationship between occupational stress and suicidal ideation, as well as the protective effect of grit. These findings highlight the need for genderspecific approaches to prevent suicidal ideation among employees.

Background: This study examined gender differences in occupational stress, depressive symptoms, and suicidal ideation by considering the potential moderating effect of grit on Korean employees. Methods: A total of 11,369 participants (7,735 men and 3,634 women) aged 19–65 years, employed across 18 private companies and local government organizations in Korea, completed questionnaires including the Short Grit Scale, Korean Occupational Stress Scale, and Center for Epidemiologic Studies Depression Scale between April 2020 and March 2022.Suicidal ideation was assessed based on its presence or absence. Mediation and moderation analyses were performed using the Statistical Package for the Social Sciences PROCESS macro. Results: Depressive symptoms partially mediated the relationship between occupational stress and suicidal ideation in male employees, whereas depressive symptoms fully mediated the relationship in female employees. Grit moderated the relationship between depressive symptoms and suicidal ideation in male employees but not in female employees.Furthermore, the moderated mediating effect of grit in male employees on the relationship between occupational stress and suicidal ideation provided less protection in cases of severe depression. The cross-sectional design does not allow for causal inferences. Conclusion These findings contribute to understanding of the gender differences in the impact of depressive symptoms on the relationship between occupational stress and suicidal ideation, as well as the protective effect of grit. These findings highlight the need for genderspecific approaches to prevent suicidal ideation among employees.

Background: This study examined gender differences in occupational stress, depressive symptoms, and suicidal ideation by considering the potential moderating effect of grit on Korean employees. Methods: A total of 11,369 participants (7,735 men and 3,634 women) aged 19–65 years, employed across 18 private companies and local government organizations in Korea, completed questionnaires including the Short Grit Scale, Korean Occupational Stress Scale, and Center for Epidemiologic Studies Depression Scale between April 2020 and March 2022.Suicidal ideation was assessed based on its presence or absence. Mediation and moderation analyses were performed using the Statistical Package for the Social Sciences PROCESS macro. Results: Depressive symptoms partially mediated the relationship between occupational stress and suicidal ideation in male employees, whereas depressive symptoms fully mediated the relationship in female employees. Grit moderated the relationship between depressive symptoms and suicidal ideation in male employees but not in female employees.Furthermore, the moderated mediating effect of grit in male employees on the relationship between occupational stress and suicidal ideation provided less protection in cases of severe depression. The cross-sectional design does not allow for causal inferences. Conclusion These findings contribute to understanding of the gender differences in the impact of depressive symptoms on the relationship between occupational stress and suicidal ideation, as well as the protective effect of grit. These findings highlight the need for genderspecific approaches to prevent suicidal ideation among employees.

Factor V (FV) deficiency is a coagulation disorder (congenital or acquired). Unlike congenital FV deficiency, mixing tests for prothrombin time and activated partial thromboplastin time are not corrected in acquired FV cases. A 79-year-old male was admitted to the intensive care unit after an emergency operation due to gastric ulcer perforation. While receiving antibiotic treatment for septic shock, the coagulation profile began to show prolongation of prothrombin time and activated partial thromboplastin time. FV deficiency (< 1%) following meropenem administration was diagnosed . The patient did not show spontaneous bleeding or bleeding tendency. With fresh frozen plasma transfusion, steroid administration, and discontinuation of meropenem, the blood coagulation profile test result was normalized 20 days after diagnosis. His follow-up FV level increased to 78.7%. Although abnormalities in coagulation profiles are common in sepsis patients, in our patient, timely recognition and hematological consultation allowed early diagnosis and proper management of FV deficiency.

Background: Currently, non-vitamin K-antagonist oral anticoagulant (NOAC) monotherapy has been suggested as the optimal antithrombotic therapy for atrial fibrillation (AF) beyond one year after coronary revascularization. The aim of this study was to compare the outcomes between NOAC monotherapy and NOAC plus antiplatelet combination therapy using realworld data. Methods: Between 2015 and 2020, patients with AF who had received NOACs beyond one year after coronary revascularization were enrolled from Korean national insurance data. We emulated a pragmatic sequence of trials between the NOAC monotherapy and the antiplatelet combination therapy followed by propensity score matching. The primary endpoint was major adverse cardiac and cerebrovascular events (MACCEs), a composite of all-cause death, myocardial infarction, and stroke. Results: Among 206,407 person-trials from 4,465 individuals, we compared 3,275 pairs of the monotherapy and the matched combination therapy. During a median follow-up of 1.24 years, the incidence rate of MACCE was 19.4% and 20.0% per patient-year in the monotherapy group and the antiplatelet combination group, respectively (hazard ratio [HR], 0.96; 95% confidence interval [CI], 0.88–1.05; P = 0.422). Compared with the antiplatelet combination group, the monotherapy group had a significantly lower incidence rate of major bleeding, defined as intracranial bleeding or gastrointestinal bleeding requiring hospitalization (2.8% vs. 3.6% per patient-year; HR, 0.78; 95% CI, 0.62–0.97; P = 0.024). Conclusion As an antithrombotic therapy for AF beyond one year after coronary revascularization, NOAC monotherapy was associated with a similar risk of MACCE and a lower risk of major bleeding compared to NOAC plus antiplatelet combination therapy.

Continuous renal replacement therapy (CRRT) has become the standard modality of renal replacement therapy (RRT) in critically ill patients. However, consensus is lacking regarding the criteria for discontinuing CRRT. Here we validated the usefulness of the prediction model for successful discontinuation of CRRT in a multicenter retrospective cohort. Methods: One temporal cohort and four external cohorts included 1,517 patients with acute kidney injury who underwent CRRT for >2 days from 2018 to 2020. The model was composed of four variables: urine output, blood urea nitrogen, serum potassium, and mean arterial pressure. Successful discontinuation of CRRT was defined as the absence of an RRT requirement for 7 days thereafter. Results: The area under the receiver operating characteristic curve (AUROC) was 0.74 (95% confidence interval, 0.71–0.76). The probabilities of successful discontinuation were approximately 17%, 35%, and 70% in the low-score, intermediate-score, and highscore groups, respectively. The model performance was good in four cohorts (AUROC, 0.73–0.75) but poor in one cohort (AUROC, 0.56). In one cohort with poor performance, attending physicians primarily controlled CRRT prescription and discontinuation, while in the other four cohorts, nephrologists determined all important steps in CRRT operation, including screening for CRRT discontinuation. Conclusion: The overall performance of our prediction model using four simple variables for successful discontinuation of CRRT was good, except for one cohort where nephrologists did not actively engage in CRRT operation. These results suggest the need for active engagement of nephrologists and protocolized management for CRRT discontinuation.

Tuberous sclerosis is a genetic disorder that affects every organ system, has a diverse presentation and progression, and can be life threatening. The authors encountered a case of a choking death caused by a fragment of rice cake. The deceased was an inmate of a social welfare institution due to mental retardation. The deceased was a 60-year-old male, 170 cm in height, and weighed 74 kg. Autopsy revealed multiple tubercles on the face, undigested food material, including rice cake, in the stomach, cardiomegaly (460 g) with mild coronary atherosclerosis, fatty infiltration into the myocardium, severe pulmonary congestion and edema with froth in the bronchus, and a yellowishbrown mass in each kidney. The brain showed firmness of the cortex in the parietal lobe and blurring of the white-grey matter interface. Histologically, the kidney masses were consistent with angiomyolipoma, and the brain lesion revealed abnormal neurons and astrocytes with a ballooned appearance and glassy cytoplasm, suggestive of tuberous sclerosis. Fatty infiltration and focal interstitial fibrosis were observed in the heart. Toxicology results were negative. The authors determined that the autopsy findings were consistent with tuberous sclerosis and that it may have been the cause of mental retardation, which served as an indirect cause of choking.

Background: s: Fimasartan is the most recently developed, potent, and long-acting angiotensin II receptor blocker (ARB). However, data are limited regarding treatment effects of fimasartan in patients with heart failure. Methods: Between 2010 and 2016, patients who underwent coronary revascularization for myocardial infarction (MI) with heart failure and prescription of ARB at hospital discharge were enrolled from the Korean nationwide medical insurance data. Clinical outcomes were compared between patients receiving fimasartan and those receiving other ARBs (candesartan, valsartan, losartan, telmisartan, olmesartan, and irbesartan). The primary outcome was a composite of all-cause death, recurrent MI, hospitalization for heart failure, and stroke. Results: Of 2,802 eligible patients, fimasartan was prescribed to 124 patients (4.4%). During a median follow-up of 2.2 years (interquartile range, 1.0–3.9), 613 events of the primary outcome occurred. There was no significant difference in the primary outcome between patients receiving fimasartan and those receiving other ARBs (adjusted hazard ratio [HR], 0.82; 95% confidence interval [CI], 0.46–1.45). Compared with patients receiving other ARBs, those receiving fimasartan had comparable incidence of all-cause death (adjusted HR, 0.70; 95% CI, 0.30–1.63), recurrent MI (adjusted HR, 1.28; 95% CI, 0.49–3.34), hospitalization for heart failure (adjusted HR, 0.70; 95% CI, 0.27–1.84), and stroke (adjusted HR, 0.59; 95% CI, 0.18–1.96). Conclusion In this nationwide cohort, fimasartan, compared with other ARBs, had comparable treatment effects for a composite of all-cause death, recurrent MI, hospitalization for heart failure, and stroke in patients with heart failure after MI.

The number of migrant workers is increasing worldwide every year, and their number and role in Korean society is also increasing. However, the poor conditions faced by migrant workers often become a social issue, and it is not uncommon for them to be the subject of forensic autopsies. This study aimed to investigate the current status of medicolegal autopsy on migrant workers in Korea. We collected data of medicolegal autopsies on migrant workers conducted in Korea from 2016 to 2020 by requesting data from the institutions performing medicolegal autopsy. We calculated the autopsy rate and analyzed manner of death and cause of death. The medicolegal autopsy rate for foreign deaths was 16.4%, which was more than five times higher than the autopsy rate for Korean deaths. By manner of death, 43.7% were natural death, 6.4% were homicides, 8.5% were suicides, 23.6% were accidental deaths, 2.7% were undetermined unnatural deaths and 15.0% were unknown. These results showed a high rate of homicide, accidental death, and unknown death compared to Korean. And the proportion of industrial accident deaths and sudden manhood death syndrome were high. Through this study, it was confirmed that medicolegal autopsies are performed at a relatively high frequency when migrant workers die, and the characteristics related to the deaths of migrant workers were identified.