BACKGROUND/OBJECTIVES: Estrogen regulates certain biological functions, including bone health, maintenance of skin components, and cardiovascular and brain protection. Estrogen deficiency manifests as hot flashes, wrinkles, skin dryness, reduced bone mineral density (BMD), sleep disorders, and cardiovascular diseases. This study aimed to investigate the effects of aerobic exercise combined with ferulic acid (FA) in ovariectomized rats.MATERIALS/METHODS: Female Sprague–Dawley rats were classified into control (N), ovariectomy (OV), ovariectomy and exercise (OV+EX), and ovariectomy and exercise with ferulic acid (OV+EX+F) groups. Following ovariectomy at 22 weeks of age, the rats were tower climbing exercise at gradually increase the load (3 days/week for 12 weeks) with or without FA (5 g/kg diet) administration. RESULTS: Estrogen deficiency in female rats (OV group) resulted in increased body weight, increased blood triglyceride (TG) levels, and decreased BMD following ovariectomy.Interestingly, compared with the rats in the OV group, the rats in the OV+EX+F group exhibited reduced body weight and blood TG levels and maintained BMD following ovariectomy, similar to those in the N group. Histological analysis of the skin of estrogen-deficient rats (OV group) revealed significantly decreased skin thickness with fewer dermal cells and distorted subcutaneous fat layers, similar to the aging phenotype. Interestingly, the rats in the OV+EX+F group exhibited rescued skin phenotypes compared with those in the OV and OV+EX groups. The skin of rats from all groups was analyzed for the expression of DNA damage and repair proteins. The OV+EX+F and OV+EX groups exhibited enhanced protein levels of pCHK1 (S345), an initiator of DNA repair signaling, and p53, indicating increased cellular DNA damage because of ovariectomy and ultimately an underlying DNA repair process. CONCLUSION Exercise with FA had beneficial effects on lipid profiles, BMD, and skin remodeling during menopause.

Objective: To investigate the effects of methylphenidate and atomoxetine treatment on motor coordination in children with attention-deficit/hyperactivity disorder (ADHD). Methods: In this single-site, open-label, naturalistic follow-up study, 157 children (7.6±1.4 years; 139 males) with ADHD were recruited between March 2015 and May 2020 from the Department of Psychiatry, Asan Medical Center, and treated for 12 weeks with methylphenidate (n=48) or atomoxetine (n=109). Children completed the Advanced Test of Attention (ATA), and caregivers completed the ADHD Rating Scale (ARS) questionnaire and Developmental Coordination Disorder Questionnaire (DCDQ) at baseline and at 12 weeks. Paired t-tests, a mixed-effects model, and linear regression were used to compare treatment groups and assess factors influencing motor coordination changes. Results: Methylphenidate and atomoxetine resulted in significant improvement in DCDQ fine motor/handwriting, general coordination, and total scores over 12 weeks. Fine motor/handwriting had a significant main effect for time (F1=16.64, p<0.001, η2=0.097); however, the interaction effect between group and time was not significant (F1=0.24, p=0.625, η2=0.002). Changes in parent-reported ARS inattention scores (β=-0.174, p=0.029) and auditory commission errors of ATA (β=0.191, p=0.022) were significantly associated with changes in fine motor/handwriting. Additionally, changes in parent-reported ARS inattention scores (β=-0.177, p=0.034) and rater-reported ARS inattention scores (β=-0.198, p=0.017) were significant predictors of improvements in general coordination in separate models. Conclusion Methylphenidate and atomoxetine had a positive effect on motor coordination in children with ADHD. Improvement in motor coordination was associated with ADHD symptom improvement.

Objective: Stigma influences perceptions of mental illness and novel diseases like coronavirus disease-2019 (COVID-19), often impeding healthcare access despite advancements in medical treatment. This study compares the stigma associated with COVID-19 and mental illness to identify factors that could help reduce stigma. Methods: An online survey was conducted in May 2023 among 1,500 participants aged 19 to 65 in South Korea, using a panel from Embrain, an online survey service. The survey assessed stigma and distress related to COVID-19 and mental illness using a validated questionnaire. It collected demographic and clinical data, evaluated COVID-19-related stigma, fear, and knowledge, and measured prejudice and attitudes toward psychiatric treatment. Personality traits were assessed using the Big Five Inventory (BFI)-10. Factors significantly associated with stigma scores were entered into linear regression analysis. Results: COVID-19-related stigma scores were significantly negatively correlated with knowledge of COVID-19 and positively correlated with fear of infection and age. Individuals with a history of COVID-19 infection had significantly lower scores on COVID-19-related stigma. Similarly, mental illness stigma was negatively correlated with knowledge of psychiatric treatment and positively correlated with age, as well as conscientiousness and neuroticism in the BFI. Personal experience with individuals with mental illness was associated with significantly lower stigma scores. Conclusion This study suggests that the mechanism-making stigma was similar in cases of traditional mental illness and a novel infectious disease. Both cognitive and experiential factors influence stigma. Educating the public about the disease and enabling interactions with affected individuals emerge as effective strategies for stigma reduction.

Background: Colorectal carcinomas (CRCs) with caudal-type homeobox 2 (CDX2) loss are recognized to pursue an aggressive behavior but tend to be accompanied by a high density of tumor-infiltrating lymphocytes (TILs). However, little is known about whether there is an interplay between CDX2 loss and TIL density in the survival of patients with CRC. Methods: Stage III CRC tissues were assessed for CDX2 loss using immunohistochemistry and analyzed for their densities of CD8 TILs in both intraepithelial (iTILs) and stromal areas using a machine learning-based analytic method. Results: CDX2 loss was significantly associated with a higher density of CD8 TILs in both intraepithelial and stromal areas. Both CDX2 loss and a high CD8 iTIL density were found to be prognostic parameters and showed hazard ratios of 2.314 (1.050–5.100) and 0.378 (0.175–0.817), respectively, for cancer-specific survival. A subset of CRCs with retained CDX2 expression and a high density of CD8 iTILs showed the best clinical outcome (hazard ratio of 0.138 [0.023–0.826]), whereas a subset with CDX2 loss and a high density of CD8 iTILs exhibited the worst clinical outcome (15.781 [3.939–63.230]). Conclusions Altogether, a high density of CD8 iTILs did not make a difference in the survival of patients with CRC with CDX2 loss. The combination of CDX2 expression and intraepithelial CD8 TIL density was an independent prognostic marker in adjuvant chemotherapy-treated patients with stage III CRC.

Objective: This study investigated how educational levels modify the relationship between the standard deviation of NN intervals (SDNN) of heart rate variability and the development of post-traumatic stress disorder (PTSD). Methods: Participants with physical injuries were enrolled from a trauma center and monitored over two years. Initial assessments included SDNN and educational attainment, along with socio-demographic and clinical variables. PTSD diagnoses were made at 3, 6, 12, and 24 months post-injury using the Clinician-Administered PTSD Scale for DSM-5.Logistic regression analyses were conducted. Results: Of the 538 participants, 58 (10.8%) developed PTSD during the follow-up period. A significant interaction effect was observed: lower SDNN was significantly linked to PTSD in individuals with higher education, but not in those with lower education. Conclusion The study identified education-dependent associations between SDNN and PTSD development, emphasizing the importance of tailored PTSD prevention strategies that consider both SDNN and educational levels.

Background: Intellectual disability (ID) may be associated with an increased risk of diabetes mellitus (DM). However, evidence from longitudinal studies is scarce, particularly in Asian populations. Methods: This retrospective cohort study used representative linked data from the Korea National Disability Registration System and the National Health Insurance Service database. Adults (≥20 years) who received a national health examination in 2009 (3,385 individuals with ID and 3,463,604 individuals without ID) were included and followed until 2020. ID was identified using legal registration information. Incident DM was defined by prescription records with relevant diagnostic codes. Multivariable-adjusted Cox proportional hazards regression models were used to estimate the adjusted hazard ratio (aHR) and 95% confidence interval (CI) for DM risks in individuals with ID compared to those without ID. Results: Over a mean follow-up of 9.8 years, incident DM occurred in 302 (8.9%) individuals with ID and 299,156 (8.4%) individuals without ID. Having ID was associated with increased DM risk (aHR, 1.38; 95% CI, 1.23 to 1.55). Sensitivity analysis confirmed a higher DM risk in individuals with ID (aHR, 1.39; 95% CI, 1.24 to 1.56) than those with other disabilities (aHR, 1.11; 95% CI, 1.10 to 1.13) or no disability (reference). Stratified analysis showed higher DM risk in non-hypertensive subjects (aHR, 1.63; 95% CI, 1.43 to 1.86) compared to hypertensive subjects (aHR, 1.00; 95% CI, 0.80 to 1.26; P for interaction <0.001). Conclusion Adults with ID have an increased risk of developing DM, highlighting the need for targeted public health strategies to promote DM prevention in this population.

BACKGROUND/OBJECTIVES: Estrogen regulates certain biological functions, including bone health, maintenance of skin components, and cardiovascular and brain protection. Estrogen deficiency manifests as hot flashes, wrinkles, skin dryness, reduced bone mineral density (BMD), sleep disorders, and cardiovascular diseases. This study aimed to investigate the effects of aerobic exercise combined with ferulic acid (FA) in ovariectomized rats.MATERIALS/METHODS: Female Sprague–Dawley rats were classified into control (N), ovariectomy (OV), ovariectomy and exercise (OV+EX), and ovariectomy and exercise with ferulic acid (OV+EX+F) groups. Following ovariectomy at 22 weeks of age, the rats were tower climbing exercise at gradually increase the load (3 days/week for 12 weeks) with or without FA (5 g/kg diet) administration. RESULTS: Estrogen deficiency in female rats (OV group) resulted in increased body weight, increased blood triglyceride (TG) levels, and decreased BMD following ovariectomy.Interestingly, compared with the rats in the OV group, the rats in the OV+EX+F group exhibited reduced body weight and blood TG levels and maintained BMD following ovariectomy, similar to those in the N group. Histological analysis of the skin of estrogen-deficient rats (OV group) revealed significantly decreased skin thickness with fewer dermal cells and distorted subcutaneous fat layers, similar to the aging phenotype. Interestingly, the rats in the OV+EX+F group exhibited rescued skin phenotypes compared with those in the OV and OV+EX groups. The skin of rats from all groups was analyzed for the expression of DNA damage and repair proteins. The OV+EX+F and OV+EX groups exhibited enhanced protein levels of pCHK1 (S345), an initiator of DNA repair signaling, and p53, indicating increased cellular DNA damage because of ovariectomy and ultimately an underlying DNA repair process. CONCLUSION Exercise with FA had beneficial effects on lipid profiles, BMD, and skin remodeling during menopause.

Objective: To investigate the effects of methylphenidate and atomoxetine treatment on motor coordination in children with attention-deficit/hyperactivity disorder (ADHD). Methods: In this single-site, open-label, naturalistic follow-up study, 157 children (7.6±1.4 years; 139 males) with ADHD were recruited between March 2015 and May 2020 from the Department of Psychiatry, Asan Medical Center, and treated for 12 weeks with methylphenidate (n=48) or atomoxetine (n=109). Children completed the Advanced Test of Attention (ATA), and caregivers completed the ADHD Rating Scale (ARS) questionnaire and Developmental Coordination Disorder Questionnaire (DCDQ) at baseline and at 12 weeks. Paired t-tests, a mixed-effects model, and linear regression were used to compare treatment groups and assess factors influencing motor coordination changes. Results: Methylphenidate and atomoxetine resulted in significant improvement in DCDQ fine motor/handwriting, general coordination, and total scores over 12 weeks. Fine motor/handwriting had a significant main effect for time (F1=16.64, p<0.001, η2=0.097); however, the interaction effect between group and time was not significant (F1=0.24, p=0.625, η2=0.002). Changes in parent-reported ARS inattention scores (β=-0.174, p=0.029) and auditory commission errors of ATA (β=0.191, p=0.022) were significantly associated with changes in fine motor/handwriting. Additionally, changes in parent-reported ARS inattention scores (β=-0.177, p=0.034) and rater-reported ARS inattention scores (β=-0.198, p=0.017) were significant predictors of improvements in general coordination in separate models. Conclusion Methylphenidate and atomoxetine had a positive effect on motor coordination in children with ADHD. Improvement in motor coordination was associated with ADHD symptom improvement.

Objective: Stigma influences perceptions of mental illness and novel diseases like coronavirus disease-2019 (COVID-19), often impeding healthcare access despite advancements in medical treatment. This study compares the stigma associated with COVID-19 and mental illness to identify factors that could help reduce stigma. Methods: An online survey was conducted in May 2023 among 1,500 participants aged 19 to 65 in South Korea, using a panel from Embrain, an online survey service. The survey assessed stigma and distress related to COVID-19 and mental illness using a validated questionnaire. It collected demographic and clinical data, evaluated COVID-19-related stigma, fear, and knowledge, and measured prejudice and attitudes toward psychiatric treatment. Personality traits were assessed using the Big Five Inventory (BFI)-10. Factors significantly associated with stigma scores were entered into linear regression analysis. Results: COVID-19-related stigma scores were significantly negatively correlated with knowledge of COVID-19 and positively correlated with fear of infection and age. Individuals with a history of COVID-19 infection had significantly lower scores on COVID-19-related stigma. Similarly, mental illness stigma was negatively correlated with knowledge of psychiatric treatment and positively correlated with age, as well as conscientiousness and neuroticism in the BFI. Personal experience with individuals with mental illness was associated with significantly lower stigma scores. Conclusion This study suggests that the mechanism-making stigma was similar in cases of traditional mental illness and a novel infectious disease. Both cognitive and experiential factors influence stigma. Educating the public about the disease and enabling interactions with affected individuals emerge as effective strategies for stigma reduction.

BACKGROUND/OBJECTIVES: Estrogen regulates certain biological functions, including bone health, maintenance of skin components, and cardiovascular and brain protection. Estrogen deficiency manifests as hot flashes, wrinkles, skin dryness, reduced bone mineral density (BMD), sleep disorders, and cardiovascular diseases. This study aimed to investigate the effects of aerobic exercise combined with ferulic acid (FA) in ovariectomized rats.MATERIALS/METHODS: Female Sprague–Dawley rats were classified into control (N), ovariectomy (OV), ovariectomy and exercise (OV+EX), and ovariectomy and exercise with ferulic acid (OV+EX+F) groups. Following ovariectomy at 22 weeks of age, the rats were tower climbing exercise at gradually increase the load (3 days/week for 12 weeks) with or without FA (5 g/kg diet) administration. RESULTS: Estrogen deficiency in female rats (OV group) resulted in increased body weight, increased blood triglyceride (TG) levels, and decreased BMD following ovariectomy.Interestingly, compared with the rats in the OV group, the rats in the OV+EX+F group exhibited reduced body weight and blood TG levels and maintained BMD following ovariectomy, similar to those in the N group. Histological analysis of the skin of estrogen-deficient rats (OV group) revealed significantly decreased skin thickness with fewer dermal cells and distorted subcutaneous fat layers, similar to the aging phenotype. Interestingly, the rats in the OV+EX+F group exhibited rescued skin phenotypes compared with those in the OV and OV+EX groups. The skin of rats from all groups was analyzed for the expression of DNA damage and repair proteins. The OV+EX+F and OV+EX groups exhibited enhanced protein levels of pCHK1 (S345), an initiator of DNA repair signaling, and p53, indicating increased cellular DNA damage because of ovariectomy and ultimately an underlying DNA repair process. CONCLUSION Exercise with FA had beneficial effects on lipid profiles, BMD, and skin remodeling during menopause.