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Background: Calcitonin gene-related peptide monoclonal antibodies (CGRP mAbs) are a breakthrough migraine treatment, but long-term compliance under limited public insurance coverage has not been well known. This study explores one-year treatment patterns and outcomes of CGRP mAbs using real-world data. Methods: This multicenter retrospective study included migraine patients treated with CGRP monoclonal antibodies (CGRP mAbs) from July 2022 to June 2023. Treatment discontinuation was defined as a gap of over 60 days between injections. Among patients with 12 months of follow-up, adherence was measured using the Proportion of Days Covered (PDC), calculated as the ratio of days covered to the follow-up duration, with PDC ≥ 80% indicating good adherence. Efficacy was also assessed, defined as a ≥50% reduction in monthly headache days and acute medication use. Results: The study included 140 patients (mean age 44.6 ± 12.1 years; 82.9% female). Migraine without aura was predominant (93.6%), and 65.0% had chronic migraine. CGRP mAbs discontinuation occurred in 71.4% of patients, primarily due to headache improvement (22.9%) or lack of efficacy (15.0%). Among 81 patients with 12 months of follow-up, good adherence was observed in 40.7% of patients. Among these patients, 60.6% achieved a ≥50% reduction in monthly headache days, and 51.9% showed a ≥50% reduction in monthly acute medication use. Conclusions: More than two-thirds of patients discontinued the CGRP mAb within 1 year, so these findings emphasize the need for strategies to improve adherence and optimize follow-up plans to enhance patient support.

Abstract Background Chronic migraine (CM) is associated with severe psychological symptoms and disabilities. Information on the relationship between stress and the outcomes of acute CM treatment is limited. Methods We evaluated the clinical presentation and stress levels of patients with CM who visited the neurology departments of 14 hospitals between September and December 2015. The patients were divided into stress and reference groups on the basis of the Korean version of the Brief Encounter Psychosocial Instrument (BEPSI-K). Quality of life was evaluated using EuroQol Five Dimension Questionnaire Three-Level. The Migraine Assessment of Current Therapy questionnaire was used to assess the outcomes of acute treatment. Results This study included 186 CM patients. On the basis of the BEPSI-K score, 79 and 107 patients were assigned to the stress and reference groups, respectively. The stress group had more patients with poor outcomes of acute treatment than the reference group (67.1% vs 40.2%, P < 0.001). In a multivariate analysis, female gender (odds ratio [OR] = 3.266, 95% confidence interval [CI] = 1.172–9.103, P = 0.024), the number of headache-free days per month (OR = 0.932, 95% CI = 0.883–0.985, P = 0.012), and BEPSI-K score (OR = 1.667, 95% CI = 1.051–2.643, P = 0.030) predicted poor outcomes of acute treatment. Conclusions High levels of stress were reported by 42.5% of patients with CM. The association between stress and the outcomes of acute treatment suggests that stress is an important clinical variable for improving the management of CM.

Mobile health (mHealth) holds promise for enhancing patient care, yet attrition in its use remains a major barrier. Low retention rates limit its potential impact, while barriers to accessing or adopting mHealth vary across populations and countries. These differences in utilization of mHealth may exacerbate health inequalities, contributing to the digital health divide. We aimed to conduct a systematic review and meta-analysis to investigate the factors associated with inequalities in mHealth utilization across different implementation phases, including access, adoption, adherence, and maintenance. This systematic review and meta-analysis analyzed mHealth research from 2000 to May 30, 2024, using databases, including PubMed, Web of Science, MEDLINE, and ProQuest. Eligible studies included smartphones, mHealth apps, wearables, and inequality indicators across 4 mHealth phases: access, adoption, adherence, and maintenance. Excluded studies were nonpeer-reviewed, opinion-based, or not in English. Extracted data included study characteristics, target populations, health outcomes, and inequality factors like age, gender, socioeconomic status, and digital literacy. Factors were categorized using a digital health equity framework (biological, behavioral, sociocultural, digital, health care system, and physical domains). Meta-analyses were performed using a random-effects model for factors reported in at least three studies, with heterogeneity assessed by the I² statistic. Among 1990 studies, 62 studies met the inclusion criteria, and 30 studies underwent meta-analysis. The phases of mHealth utilization were access (n=23, 37%), adoption (n=47, 76%), adherence (n=9, 15%), and maintenance (n=2, 3%). Meta-analysis showed older age was negatively associated with mHealth adoption (odds ratio [OR] 0.47, 95% CI 0.23-0.93), while higher education and income were positively associated in both access and adoption phases. Employment showed significant associations in the access phase (OR 1.49, 95% CI 1.08-2.05), whereas comorbidities (OR 1.39, 95% CI 1.03-1.86) and private insurance (OR 1.63, 95% CI 1.07-2.48) were significantly associated with adoption of mHealth. Women (OR 1.24, 95% CI 1.06-1.45) and physically active individuals (OR 1.64, 95% CI 1.07-2.50) were more likely to adopt mHealth. The conceptual framework outlined in this study highlights the multifaceted nature of mHealth utilization across all the phases of mHealth engagement. To address these inequalities, tailored and personalized interventions are required at each phase of mHealth utilization. Targeted efforts can enhance digital access for older and low-income adults while promoting engagement through education, insurance support, and healthy behaviors, thereby promoting equitable and effective mHealth use. By recognizing the interconnectedness of these domains, policy makers and health care stakeholders can design interventions that not only address the phase-specific barriers but also bridge broader inequalities in health care access and engagement.

Background: Atherosclerosis is a systemic disease. Many ischemic stroke patients may have concomitant coronary artery disease (CAD). Detection and treatment of preclinical CAD in stroke patients may improve long-term outcome and survival because CAD is a major cause of death during follow-up in stroke patients. However, association between coronary and cerebral artery atherosclerosis in stroke patients has not fully been investigated. This study aimed at examining the frequency and high-risk groups of CAD in ischemic stroke patients. Methods: Consecutive patients who were admitted due to acute ischemic stroke between July 2006 and June 2010 were prospectively enrolled in this study. A total of 1,304 patients who underwent MSCT coronary angiography and cerebral angiography were included in this study. By using 64-multislice computed tomography coronary angiography, we investigated the frequency of CAD and association between coronary and cerebral artery atherosclerosis in terms of location and burden (severity and extent) in stroke patients. We also sought to identify high-risk groups for CAD among stroke patients. Results: The frequency of significant (≧50%) CAD was 32.3% and the frequency of any degree of CAD was 70.1%. Diabetes mellitus, serum levels of total cholesterol, high-density lipoprotein cholesterol and triglyceride, and significant stenosis of the extracranial carotid, intracranial vertebral and basilar arteries were independently associated with CAD. However, no association was found between CAD and significant stenosis of the anterior, middle and posterior cerebral arteries. The association between CAD and cerebral atherosclerosis was stronger with increased severity and extent of cerebral atherosclerosis. When compared to patients with <2 risk factors and without significant cerebral atherosclerosis, those with multiple (≧2) risk factors and atherosclerosis in both the carotid and the vertebrobasilar arteries had very high risks of CAD [odds ratio (OR) 8.36; 95% confidence interval (CI) 4.15–16.87]. The risk was also high in patients with multiple risk factors and atherosclerosis in either the carotid or the vertebrobasilar artery (OR 4.13; 95% CI 2.62–6.51), and in those with <2 risk factors but atherosclerosis in both the carotid and the vertebrobasilar arteries (OR 3.40; 95% CI 1.22–9.47). Conclusions: A substantial portion of stroke patients had preclinical CAD, and there was a clear relationship between coronary and cerebral artery atherosclerosis in terms of location and burden. The risk of CAD was particularly high in stroke patients with multiple risk factors and atherosclerosis of the carotid and/or vertebrobasilar arteries.

Background: Embolic infarctions from the heart are known to cause multiple scattered infarct lesions as well as single, large territorial infarctions. However, it remains unknown which factors contribute to these different infarction patterns in patients with potential cardiac sources of embolism (PCSE). Methods: We examined 388 ischemic stroke patients with a high-risk PCSE using diffusion-weighted imaging. Infarction patterns were categorized into a single large lesion, a single small lesion, confluent and additional lesions, or small scattered lesions. The relationships between infarction patterns and clinical and hematologic parameters were investigated. Results: Of the 388 patients, a single large lesion was detected in 139 (35.8%), a single small lesion in 29 (7.5%), confluent and additional lesions in 171 (44.1%), and small scattered lesions in 49 (12.7%). Prior use of antiplatelet agents and anticoagulant were associated with the pattern of small scattered lesions and a single small lesion, respectively. Additionally, higher white blood cell counts were associated with confluent and additional lesions. The type of high-risk PCSE was not related to a specific infarction pattern. Conclusions: These results suggest that platelet function and inflammatory processes may directly affect the thrombus formation in the cardiac chamber.

The snow enhancement experiments, carried out by injecting AgI and water vapor into orographically enhanced clouds （fog）, have been conducted to confirm Li and Pitter＇s forced condensation process in a natural situation. Nine ground-based experiments have been conducted at Daegwallyeong in the Taebaek Mountains for the easterly foggy days from January-February 2006. We then obtained the optimized conditions for the Daegwallyeong region as follows： the small seeding rate （1.04 g min-1） of AgI for the easterly cold fog with the high humidity of Gangneung. Additional experiments are needed to statistically estimate the snowfall increment caused by the small AgI seeding into the orographical fog （cloud） over the Taeback Mountains.

There has been a tremendous amount of research in the past decade to optimize the mechanical properties and degradation behavior of the biodegradable Mg alloy for orthopedic implant. Despite the feasibility of degrading implant, the lack of fundamental understanding about biocompatibility and underlying bone formation mechanism is currently limiting the use in clinical applications. Herein, we report the result of long-term clinical study and systematic investigation of bone formation mechanism of the biodegradable Mg-5wt%Ca-1wt%Zn alloy implant through simultaneous observation of changes in element composition and crystallinity within degrading interface at hierarchical levels. Controlled degradation of Mg-5wt%Ca-1wt%Zn alloy results in the formation of biomimicking calcification matrix at the degrading interface to initiate the bone formation process. This process facilitates early bone healing and allows the complete replacement of biodegradable Mg implant by the new bone within 1 y of implantation, as demonstrated in 53 cases of successful long-term clinical study.

Two-dimensional stacks of dissimilar hexagonal monolayers exhibit unusual electronic, photonic and photovoltaic responses that arise from substantial interlayer excitations. Interband excitation phenomena in individual hexagonal monolayer occur in states at band edges (valleys) in the hexagonal momentum space; therefore, low-energy interlayer excitation in the hexagonal monolayer stacks can be directed by the two-dimensional rotational degree of each monolayer crystal. However, this rotation-dependent excitation is largely unknown, due to lack in control over the relative monolayer rotations, thereby leading to momentum-mismatched interlayer excitations. Here, we report that light absorption and emission in MoS 2 /WS 2 monolayer stacks can be tunable from indirect- to direct-gap transitions in both spectral and dynamic characteristics, when the constituent monolayer crystals are coherently stacked without in-plane rotation misfit. Our study suggests that the interlayer rotational attributes determine tunable interlayer excitation as a new set of basis for investigating optical phenomena in a two-dimensional hexagonal monolayer system. Single atomic layers of transition metal dichalcogenides have outstanding electrical and optical properties. Here, the authors show that light absorption and emission from stacks of different transition metal dichalcogenide monolayers can be tuned by rotating the crystals.

An extreme heatwave, in terms of intensity and duration, is projected to occur at the end of the 21st century (2071–2100) over the whole of East Asia. The projection is calculated using daily maximum temperature data of 25 km horizontal resolution produced by 12 general circulation model-regional climate model chains participating in the CORDEX-East Asia Phase 2 project. An ‘extreme’ heatwave is defined as one in which the heatwave magnitude (HWM), which is the accumulated daily intensity of a heatwave during the heatwave period, is higher than the 95th percentile of the HWM for the reference period (1981–2005). In historical simulations, heatwaves have occurred mainly from April to June in India, in April and May in Indochina, from June to August in China and Mongolia, and in July and August in the Korean Peninsula and Japan; most heatwaves last three to four days. In India and Indochina, long-lasting and intense heatwaves occur more often than in other regions. In future, heatwave intensity will increase, the average duration of heatwaves will be approximately two to three weeks, and the heatwave season will be lengthened. Therefore, extreme heatwaves will occur more frequently and strongly. Under two representative concentration pathway scenarios (RCP2.6 and RCP8.5) and two shared socioeconomic pathway scenarios (SSP1-2.6 and SSP5-8.5), the proportion of extreme heatwaves to all heatwave events will increase from 5.0% (historical) to 8.0%, 20.8%, 19.3%, and 36.3%, and the HWM of the extreme heatwave will be 1.4, 3.5, 3.0, and 9.0 times stronger, respectively. The main reason for the increase in the HWM of extreme heatwaves is the increased duration rather than the daily intensity of the heatwaves. In East Asia, the temporal and regional disparities of heatwave damage will be much more prominent as extreme heatwaves become stronger and more frequent in these regions and during the periods that are more affected by heatwaves in the present day.

This study investigated the effects of a thin aluminum oxynitride (AlOxNy) gate insulator on the electrical characteristics of AlGaN/GaN-on-SiC metal-insulator-semiconductor high electron mobility transistors (MIS-HEMTs). The fabricated AlGaN/GaN-on-SiC MIS-HEMTs exhibited a significant reduction in gate leakage and off-state drain currents in comparison with the conventional Schottky-gate HEMTs, thus enhancing the breakdown voltage. The effects of gate recess were also investigated while using recessed MIS-HEMT configuration. The Johnson’s figures of merit (= fT × BVgd) for the fabricated MIS-HEMTs were found to be in the range of 5.57 to 10.76 THz·V, which is the state-of-the-art values for GaN-based HEMTs without a field plate. Various characterization methods were used to investigate the quality of the MIS and the recessed MIS interface.