This nationwide population-based cohort study aimed to investigate the impact of systemic anti-inflammatory treatment on the major adverse cardiovascular events (MACE) risk in patients with psoriasis ...from January 2006 to December 2018, using a database provided by the Korean National Health Insurance Service. Patients were grouped based on the following treatment modalities: biologics, phototherapy, methotrexate, cyclosporine, and mixed conventional systemic agents. Patients who had not received any systemic treatment were assigned to the control cohort. The incidence of MACE per 1000 person-year was 3.5, 9.3, 12.1, 28.4, 39.5, and 14.5 in the biologic, phototherapy, methotrexate, cyclosporine, mixed conventional systemic agents, and control cohorts, respectively. During the 36-month follow-up, the cumulative incidence of MACE in the phototherapy and biologic cohorts remained lower than that of other treatment modalities. Cyclosporine (hazard ratio (HR) = 2.11, 95% confidence interval (CI) = 1.64-2.71) and mixed conventional systemic agents (HR = 2.57, 95% CI = 2.05-3.22) treatments were associated with increased MACE risk. Methotrexate treatment was not associated with MACE. Our finding demonstrates that treatment modalities may affect cardiovascular comorbidities in patients with psoriasis. Thus, an appropriate combination of anti-psoriatic therapies should be considered to manage patients with high cardiovascular risk.IRB approval status: Waiver decision was obtained by the institutional review board, Konkuk University Hospital, Seoul, Republic of Korea (KUH1120107).
This study evaluated the incidence of colorectal cancer (CRC) according to the number of metabolic syndrome (MetS) components.
Using health checkup and insurance claims data of 6,365,409 subjects, ...the occurrence of CRC according to stage of MetS by sex was determined from the date of the health checkup in 2009 until December 31, 2018.
Cumulative incidence rates (CIR) of CRC in men and women was 3.9 and 2.8 per 1000 (p < 0.001), respectively. CIR of CRC for the normal, pre-MetS, and MetS groups in men was 2.6, 3.9, and 5.5 per 1000 (p < 0.001) and CIR in women was 2.1, 2.9, and 4.5 per 1000 (p < 0.001), respectively. Compared with the normal group, the hazard ratio (HR) of CRC for the pre-MetS group was 1.25 (95% CI 1.17-1.33) in men and 1.09 (95% CI 1.02-1.17) in women, and the HR of CRC for the MetS group was 1.54 (95% CI 1.43-1.65) in men and 1.39 (95% CI 1.26-1.53) in women after adjustment.
We found that MetS is a risk factor for CRC in this study. Therefore, the prevention and active management of MetS would contribute to the prevention of CRC.
Inter-hospital transfer (IHT) and primary percutaneous coronary intervention (PCI) are preferred over onsite thrombolysis when provided expeditiously. On the other hand, its benefit has not been ...evaluated in a real-world situation. This study examined the effects of IHT on the short- and long-term mortality in patients with acute myocardial infarction (AMI) and compared the reperfusion treatments and resources between the referring and receiving hospitals.
Patients newly diagnosed with AMI and admitted to hospital were selected from the national health insurance database from 2004 to 2018. The 30-day and one-year mortality in the transferred and non-transferred patients were estimated and compared using stabilized inverse probability of treatment weighting to account for confounding bias.
Of the 258,291 participants, 10,158 were transferred to one or more hospitals. IHT was more likely to occur to older or more comorbid people, patients in rural areas, and those whose insurance was medical aid. The 30-day and one-year mortality of the non-IHT group was 9.7% and 15.8%, respectively, whereas the figure was 11.4% and 20.5% in the IHT group. After balancing the baseline characteristics, the transferred patients were 1.12 (95% CI: 1.06-1.20) and 1.25 (95% CI: 1.20-1.31) times more likely to die during the subsequent 30 days and one year, respectively, than those treated solely at the presenting hospital. In ST-segment elevation myocardial infarction (STEMI), the hazard ratios of the 30-day and 1-year mortality were 1.14 (95% CI: 0.97-1.35) and 1.31 (95% CI: 1.15-1.49) in the transferred patients after balancing cardiogenic shock and cardiac arrest. On-site thrombolysis was rarely performed in the referring hospitals.
Patients transferred for the treatment of AMI experienced higher short- and long-term mortality. Therefore, onsite thrombolysis and the estimated time delay to PCI should be considered in regional hospitals to reduce mortality with the organization of STEMI treatment networks.
ObjectiveIschaemic stroke incidence is on the decline globally, but the trend in South Korea is unknown. In this study, the 10-year incidence trends of first-ever ischaemic stroke in South Korea were ...evaluated.Design, setting and participantsThe National Health Insurance Services medical claim data were used to construct 10 annual cohorts of adults aged 20 years and older, who had not been diagnosed with stroke, to find out the incidence trends of first-ever ischaemic stroke from 2010 to 2019.Outcome measuresThe primary outcomes were crude and age-adjusted incidence rates for 10 years. Crude incidence rates of the age groups and incidence age statistics were calculated. For comparison among the income groups, age-adjusted incidence rates were used. Incidence rates in all the groups were analysed separately by sex.ResultsAge-standardised incidence rates of ischaemic stroke per 100 000 were 101.0 in men, and 67.6 in women in 2010; and 92.2 in men, and 55.0 in women in 2019. By age group, there was a decrease in women over 40 years of age, and men over 60 years of age. The relative difference in stroke incidence rates between medical aid beneficiaries and the highest income group increased from 1.5 to 1.87 over 10 years.ConclusionsAge-standardised incidence rate of ischaemic stroke has decreased from 2010 to 2019 for both man and women. The incidence rate was stable in the younger age groups and decreased in the older age groups, and the disparities between income groups have widened over the past decade. Stroke prevention strategies are needed for the younger age group and the low-income group. Further research is needed to study the risk factors contributing to the incidence of ischaemic stroke in different groups.
The Korean Demilitarized Zone (DMZ) was established in 1953 during the cessation of the Korean War, which divided the Korean Peninsula into North and South Korea. The DMZ is a representative ...biodiversity resource because it limits human activities. The current status of faunal diversity in adjacent areas of the DMZ was investigated in five regions at 91 sites from 2015 to 2019. A total of 19,562 individuals were collected and identified, including 81 species, 19 families, and 11 orders. Zacco koreanus was the most abundant fish species (relative abundance of 21.9%), while other key species were Zacco platypus (18.2%), Rhynchocypris oxycephalus (5.2%), Rhynchocypris steindachneri (4.9%), and Pungtungia herzi (3.7%). Notably, twenty-nige endemic and seven Red Data Book species were recorded, and three exotic species, Carassius cuvieri, Micropterus salmoides, and Lepomis macrochirus were found at five sites. Human activities and disturbances were found at 34.0% of all sampling sites, and the highest disturbance factors were river dredging and agricultural use (seven sites), sewage (five sites), and fisheries and development (two sites). We recommend that the governments of South and North Korea collaboratively manage the DMZ to protect ecological diversity and maintain its status as a symbol of peace.
In this paper, we propose an adaptive quantization method that can easily transfer the weights, which are trained in software network with floating point operation, to the real synaptic devices in ...hardware-based neural networks and maintain high performance. An n-type gated Schottky diode is investigated as a synaptic device, and the conductance behavior of this device is modeled successfully. Max value normalization and <inline-formula> <tex-math notation="LaTeX">3\sigma </tex-math></inline-formula> normalization are applied to the weights trained with an accuracy of 98.29% on fully connected neural network (<inline-formula> <tex-math notation="LaTeX">784\times 256\times10 </tex-math></inline-formula>) using software network. Then, the weights are quantized using the adaptive quantization method and can be transferred by adjusting the number of identical pulses applied to the synaptic devices. After applying the adaptive quantization method, accuracy rates of 98.09% and 97.20% in MNIST classification are obtained for both max value normalization and <inline-formula> <tex-math notation="LaTeX">3\sigma </tex-math></inline-formula> normalization, respectively. The proposed quantization method works well even when there is nonideality of synaptic devices such as nonlinearity of conductance behavior, limited conductance levels, and variation of conductance.
Hardware-based spiking neural networks (SNNs) inspired by a biological nervous system are regarded as an innovative computing system with very low power consumption and massively parallel operation. ...To train the SNNs with supervision, we propose an efficient on-chip training scheme approximating backpropagation algorithm suitable for hardware implementation. We show that the accuracy of the proposed scheme for SNNs is close to that of conventional artificial neural networks, by using stochastic characteristics of neurons. In a hardware configuration, gated Schottky diodes (GSDs) are used as synaptic devices, which have a saturated current with respect to the input voltage. We design the SNN system by adopting the proposed on-chip training scheme with the GSDs which can update their conductance in parallel to speed up the overall system. The performance of on-chip training SNN system is validated through MNIST data set classification based on network size and total time step. The SNN systems achieve accuracy of 97.83% with 1 hidden layer, and 98.44% with 4 hidden layers in fully connected neural networks. We then evaluate the effect of nonlinearity and asymmetry of conductance response for long-term potentiation (LTP) and long-term depression (LTD) on the performance of the on-chip training SNN system. In addition, the impact of device variations on the performance of the on-chip training SNN system is evaluated.
In higher vertebrates, helper and cytotoxic T cells, referred to as CD4 and CD8 T lymphocytes, respectively, are mainly associated with adaptive immunity. The adaptive immune system in teleosts ...involves T cells equivalent to those found in mammals. We previously generated monoclonal antibodies (mAbs) against olive flounder (
) CD4 T cells, CD4-1 and CD4-2, and used these to describe the olive flounder's CD4 Tcell response during a viral infection. In the present study, we successfully produced mAbs against CD8 T lymphocytes and their specificities were confirmed using immuno-blotting, immunofluorescence staining, flow cytometry analysis andreverse transcription polymerase chain reaction (RT-PCR). The results showed that these mAbs are specific for CD8 T lymphocytes. We also investigated variations in CD4 and CD8 T cells populations, and analyzed the expression of immune-related genes expressed by these cells in fish infected with nervous necrosis virus or immunized with thymus dependent and independent antigens. We found that both CD4 and CD8 T lymphocyte populations significantly increased in these fish and Th1-related genes were up-regulated compared to the control group. Collectively, these findings suggest that the CD4 and CD8 T lymphocytes in olive flounder are similar to the helper and cytotoxic T cells found in mammals, and Th1 and cytotoxic immune responses are primarily involved in the early adaptive immune response against extracellular antigens.
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