Bisphenol A (BPA) exposure during the perinatal and postnatal periods increases the susceptibility to disease over the life cycle. However, information on the BPA delivered to fetuses or infants via ...the placenta and breastfeeding is limited. We determined the BPA exposure levels in various bodily fluids and tissues of pregnant women and described fetus and infant exposures to BPA based on associations and BPA ratios in mother–neonate paired samples. Maternal serum, urine, placenta, breast milk, cord serum, and neonatal urine samples were collected from 318 mother–neonate pairs at six university hospitals in Korea. BPA levels were detected using liquid chromatography tandem mass spectrometry. The ratios of the BPA levels in the other sample types to the levels in maternal serum were calculated. BPA was detected in 79.5–100% of the maternal and fetal samples. The median BPA concentration in the samples decreased in the order of neonatal urine (4.75ng/mL), maternal urine (2.86ng/mL), cord serum (1.71ng/mL), maternal serum (1.56ng/mL), breast milk (0.74ng/mL), and the placenta (0.53ng/g). We estimated the ratios of BPA levels in the other sample types to those in maternal serum. The median (95th percentile) cord serum-to-maternal serum ratio was 1.12 (15.2) for 160 mother–fetal pairs, in which BPA was detected in both samples. The placenta-, maternal urine-, neonatal urine-, and breast milk-to-maternal serum ratios were 0.28 (5.31), 1.79 (29.9), 1.98 (28.2), and 0.51 (10.5), respectively. In addition, the median (95th percentile) cord serum-to-placenta ratio was 4.03 (45.8), and the neonatal urine-to-cord serum ratio was 1.95 (25.6). The 95th percentile values were 14–20-fold greater than the medians. Urine contained the highest BPA concentrations, followed by serum, breast milk, and the placenta. The variations of BPA ratio show individual differences in the amounts of BPA delivered from mother to fetus.
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•Not enough data on tissue distribution of BPA in mother‑neonate (or fetus) pair•The order of BPA concentrations in examined tissue or bio-samples are urine in mother and neonates>cord serum>maternal serum>breast milk>placenta.•BPA in cord serum, significantly associated with in maternal serum and urine but not in others.•The variations of BPA ratio show individual differences in the amounts of BPA delivered from mother to fetus.
Psoriasis is a chronic inflammatory disorder characterized by pathogenic hyperproliferation of keratinocytes and immune dysregulation. Currently, objective evaluation tools reflecting the severity of ...psoriasis are insufficient. MicroRNAs in extracellular vesicles (EV miRNAs) have been shown to be potential biomarkers for various inflammatory diseases. Our objective was to investigate the possibility of plasma-derived EV miRNAs as a marker for the psoriasis disease severity.
EVs were extracted from the plasma of 63 patients with psoriasis and 12 with Behçet's disease. We performed next-generation sequencing of the plasma-derived EV miRNAs from the psoriasis patients. Real-time quantitative reverse transcription polymerase chain reaction (qRT-PCR) was used to validate the level of EV miRNA expression. In situ hybridization was used to discern the anatomical location of miRNAs. qRT-PCR, western blotting, and cell counting kits (CCKs) were used to investigate IGF-1 signaling in cells transfected with miRNA mimics.
We identified 19 differentially expressed EV miRNAs and validated the top three up-and down-regulated EV miRNAs. Among these, miR-625-3p was significantly increased in patients with severe psoriasis in both plasma and skin and most accurately distinguished moderate-to-severe psoriasis from mild-to-moderate psoriasis. It was produced and secreted by keratinocytes upon stimulation. We also observed a significant intensification of IGF-1 signalling and increased cell numbers in the miR-625-3p mimic transfected cells.
We propose keratinocyte-derived EV miR-625-3p as a novel and reliable biomarker for estimating the severity of psoriasis. This biomarker could objectively evaluate the severity of psoriasis in the clinical setting and might serve as a potential therapeutic target. Trial registration None.
Lay Summary Behçet disease (BD) is a multisystem vasculitis (inflammation of the blood vessels) of unknown origin that commonly results in oral and genital ulcers, uveitis (eye inflammation) and skin ...lesions. BD is most prevalent in people from the Mediterranean to East Asia, affecting 0.4% of people in this area. Most lesions go away with time, but more severe forms that involve the cardiovascular and neurological systems can lead to death. It is estimated that people with BD have 1.4 times the risk of dying than the general population. Using large insurance databases in Korea, we investigated the risk of death in people with BD versus age- and sex-matched controls (i.e. people without the disease) from the general population. We found that patients with BD had a 28% greater risk of death than controls over 11.9 years of follow-up, with the highest risk being in first year after diagnosis. Top causes of death in people with BD included cancer, and cardiovascular, gastrointestinal, neurological, genitourinary, respiratory and infectious disease. Further analyses of the data showed that the risk of death in BD is affected by age and sex. In particular, younger patients were more susceptible to death as a result of cardiovascular disease and women were more susceptible to dying of gastrointestinal disease. Our study suggests that there could be an increased risk of death within the first year of being diagnosed with BD and highlights how BD is a systemic disease (i.e. the involvement of any internal organ system could lead to an increase in mortality). Finally, there were unique patterns of cause-specific deaths across subgroups of people with BD.
This study aimed to determine the factors associated with nursing professionalism among Korean nursing students. This cross‐sectional study was carried out using a convenient sample comprising 247 ...students enrolled in a four‐year Bachelor of Science Nursing program from September 6–27, 2021. A self‐reported structured questionnaire was employed to explore the relationships among ego‐resilience, self‐leadership, clinical learning environment, academic satisfaction, clinical competency, and nursing professionalism by utilizing structural equation modeling. The modified model exhibited good fit indices. Learning‐related factors, including clinical learning environments, academic satisfaction, and clinical competency, directly affected nursing professionalism. Self‐leadership and the clinical learning environment were indirectly associated with nursing professionalism via both academic satisfaction and clinical competency. Regarding ego‐resilience, it only indirectly affected nursing professionalism via academic satisfaction. Creating a student‐centered learning environment may be vital to improve students' major and clinical performance, thereby boosting nursing professionalism. Furthermore, nurse educators should consider individual psychological aspects of students when designing the nursing curriculum to foster nursing professionalism. Longitudinal studies are needed to determine if our model is available to explain the development of professionalism among nursing students.
Postmarketing surveillance is conducted to establish drug safety and effectiveness under real‐world practice. We aimed to validate the effectiveness and safety of ustekinumab in the treatment of ...adult Korean patients with plaque psoriasis under real‐world practice. This was a prospective, observational, and multi‐center study. Subjects aged 18 years or older who were treated with ustekinumab for plaque psoriasis were enrolled. We enrolled 977 patients; 654 (66.9%) were men, with mean body surface area (BSA, ± standard deviation) of 27.0 ± 18.3% and mean psoriasis area severity index (PASI) score of 18.1 ± 9.7. The effectiveness analysis was performed in 581 patients who had at least one follow‐up assessment and met treatment criteria per local label and reimbursement guidelines. Of these patients, 287 had effectiveness data for visit 6 at 53.7 ± 2.1 weeks. At visit 6, 91.6% (263/287), 51.2% (147/287), and 9.4% (27/287) patients achieved PASI 75, 90, and 100 responses, respectively. Adverse events (AEs) occurred in 112 of the 977 (11.5%) patients with an incidence rate of 21.5 per 100 patient‐years (PYs). Serious AEs occurred in eight (0.8%) patients with an incidence rate of 1.2 per 100 PYs. The estimated 1‐year drug survival rate was 87.7%. The multiple logistic regression analysis showed that higher baseline PASI score and no prior biologic exposure were significant predictors for PASI 90 response at visit 6. Ustekinumab was effective and safe, and displayed a high survival rate in the treatment of adult Korean patients with plaque psoriasis in real‐world practice.
ABSTRACT
While long‐distance running has important health benefits, chronic elevation of blood pressure during exercise might induce cardiac events and sudden death. This study aimed to investigate ...characteristics of exercise and incidence of abnormal exercise electrocardiography findings in long‐distance runners with exercise‐induced hypertension. Long‐distance runners (n = 606) underwent a questionnaire survey, history taking, and exercise stress testing, and they were classified into the non‐exercise‐induced (n = 268) and exercise‐induced (n = 338) hypertension groups. Exercise‐induced hypertension was defined as systolic blood pressure ≥210 mm Hg during maximal exercise. Abnormal electrocardiogram response (AER) were defined as abnormal electrocardiography findings, such as arrhythmias or ST‐segment changes, during exercise stress testing. There were no differences in general and exercise‐related characteristics between the non‐exercise‐induced and exercise‐induced hypertension groups. The AER group (AERg, n = 37) had a significantly longer training history and total exercise time than the non‐AER group (non‐AERg, n = 569) (p < .05). Atrial arrhythmias and ST‐segment depression were more prevalent in the exercise‐induced hypertension group than in the non‐exercise‐induced hypertension group (atrial arrhythmias: 5% 17/338 vs. 1.9% 5/268; ST‐segment depression: 2.7% 9/338 vs. .4% 1/268; p < .05). The incidence of AER was significantly higher in the exercise‐induced hypertension group (n = 30, 8.8%) than in the non‐exercise‐induced hypertension group (n = 7, 2.6%) (p < .05). This study showed that long‐distance runners with AER had a longer training history and total exercise time than those without AER, and the exercise‐induced hypertension group had a higher rate of AER.
•This article examines promoting and hindering factors of fan’s instant sponsorship (FIS).•The term FIS is proposed after reviewing five comparable concepts.•Perceived value of FIS, affection to ...creators, and vulnerability to creators’ inducements positively affect FIS.•Vulnerability to creators’ inducements was the only variable that influenced the amount of sponsorship.•Implications for the field of contents creation are discussed.
This article aims to understand fan’s instant sponsorship (FIS), focusing on promoting and hindering factors. FIS refers to viewers’ occasional activities that pay for items through various methods, usually in the form of cyber money, to content creators on personal broadcasting platforms. We base our use of this term on a review of comparable concepts, such as charitable donations, corporate sponsorships, crowdfunding, Pay-What-You-Want pricing, and fan tributes. Based on each concept’s predictors, we conducted a pilot study of items that are likely to influence FIS and then administered an online survey. According to the results, we extracted four promoting factors (the need for recognition, perceived value of FIS, affection for creators, vulnerability to creators’ inducement) and three hindering factors (perceived subjective norms, perceived inconvenience in payment, perceived lack of affordability). Among them, perceived value of FIS, affection for creators, and vulnerability to creators’ inducements positively affect the intention to sponsor continuously, despite the negative effect of perceived subjective norms. Vulnerability to creators’ inducements were the only variable that influenced the amount of sponsorship. The cases of affection to creators and the intention to sponsor continuously revealed the moderating effect of time spent on live-streaming content. We discuss the implications of the results for the field of contents creation and the related subjects.
Behçet's disease (BD) is a systemic inflammatory disease that involves various organs. The clinical manifestation-based diagnosis of BD is a time-consuming process, which makes it difficult to ...distinguish from patients with similar symptoms. Moreover, an authentic biomarker has not been developed for accurate diagnosis yet. Our current study investigated the unique metabolic signatures of BD and explored biomarkers for precise diagnosis based on an untargeted metabolomic approach.
Integrative metabolomic and lipidomic profiling was performed on plasma samples of BD patients (n = 40), healthy controls (HCs, n = 18), and disease controls (DCs, n = 17) using GC-TOF MS and LC-Orbitrap MS. Additionally, the lipid profiles of 66 peripheral blood mononuclear cells (PBMCs) were analyzed from 29 BD patients, 18 HCs, and 19 DCs.
Plasma metabolic dysfunction in BD was determined in carbohydrate, hydroxy fatty acid, and polyunsaturated fatty acid metabolisms. A plasma biomarker panel with 13 compounds was constructed, which simultaneously distinguished BD from HC and DC (AUCs ranged from 0.810 to 0.966). Dysregulated PBMC metabolome was signatured by a significant elevation in lysophosphatidylcholines (LPCs) and ether-linked lysophosphatidylethanolamines (EtherLPEs). Ten PBMC-derived lipid composites showed good discrimination power (AUCs ranged from 0.900 to 0.973). Correlation analysis revealed a potential association between disease activity and the metabolites of plasma and PBMC, including sphingosine-1 phosphate and EtherLPE 18:2.
We identified metabolic biomarkers from plasma PBMC, which selectively discriminated BD from healthy control and patients with similar symptoms (recurrent mouth ulcers with/without genital ulcers). The strong correlation was determined between the BD activity and the lipid molecules. These findings may lead to the development for diagnostic and prognostic biomarkers based on a better understanding of the BD pathomechanism.
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