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Obesity is a global public health concern, often co-occurring in patients with severe mental illnesses. The impact of psychotropic drugs-induced weight gain is augmenting the disease burden and healthcare expenditure. However, predictors of psychotropic drug-induced weight gain and the efficacy of anti-obesity drugs remain underexplored. This study aims to develop a machine learning algorithm to predict both psychotropic drugs-induced weight gain and metabolic changes, and the potential of anti-obesity drugs. We plan to enroll 300 patients with severe mental illnesses, including schizophrenia, bipolar disorder, and major depressive disorder. In Phase 1, the study will predict weight gain and metabolic changes after the psychotropic treatment. Data on demographics, lifestyle, medical history, psychological factors, anthropometrics, and laboratory results will be collected at baseline and re-evaluated 24 weeks post-treatment. Participants classified as obese (body mass index ≥ 25 kg/m²) or overweight (body mass index of 23–24.9 kg/m²) at the 24-week follow-up will proceed to Phase 2, which focuses on predicting the promise of anti-obesity drugs. The study participants will receive anti-obesity medications for 24 weeks, and the same variables from Phase 1 will be reassessed. A machine learning model will be developed to predict both psychotropic drug-induced weight gain and anti-obesity medications that will be effective. The algorithm will be tailored to each patient to guide clinicians in personalizing psychiatric and obesity treatment plans. The clinical trial is registered with the Clinical Research Information Service, part of the WHO International Clinical Trials Registry Platform (approval number: KCT0009769).

Background Ambient fine particulate matter is a rising concern for global public health. It was recently suggested that exposure to fine particulate matter may contribute to the development of diabetes and dyslipidaemia. This study aims to examine the potential associations of ambient particulate matter exposure with changes in fasting glucose and lipid profiles in Koreans. Method We used the data from the National Health Insurance Service–National Sample Cohort (NHIS-NSC), a nationwide database representative of the Korean population. A total of 85,869 individuals aged ≥20 years were included. Multiple regression analyses were conducted to assess the associations between exposure to particulate matter and changes in fasting glucose and lipid profiles at 2-year intervals after adjusting for confounders. Results Significant associations were observed between an increase in interquartile range for particulate matter < 2.5 μm in diameter (PM 2.5 ) and elevated levels of fasting glucose and low-density lipoprotein cholesterol ( p for trend = 0.015 and 0.010, respectively), while no association for particulate matter sized 2.5–10 μm in diameter (PM 10–2.5 ) was noted after adjusting for the other covariates. Sub-group analyses showed stronger associations in individuals who were older (≥60 years) or physically inactive. Conclusions Fine particulate matter exposure affects worsening fasting glucose and low-density lipoprotein cholesterol levels, with no evidence of an association for coarse particulate matter.

In the current study, we aimed to examine the association between knee pain and diet quality in women aged ≥ 50 years using data from the Korea National Health and Nutrition Examination Survey. This was a population-based, cross-sectional study. Diet quality was assessed using the Diet Quality Index-International (DQI-I), and knee pain and osteoarthritis were self-reported. A multivariate logistic regression model was used to adjust for age, body mass index, household income, marital status, education, occupation, smoking status, hazardous alcohol use, regular physical activity, menopause, and chronic diseases, including hypertension, diabetes, dyslipidemia, osteoarthritis, and depression. A total of 3,881 women were included in this study, and the prevalence of knee pain was 25.4%. The intakes of total energy, protein, and fat were lower in women with knee pain than in those without (all P < 0.01), while the carbohydrate intake was higher (P = 0.01). No significant differences were noted in the scores for variety, overall balance, and moderation components, except for the item of total fat intake, between the DQI-I scores for women with and without knee pain, after adjusting for age. Women without knee pain showed higher scores in several items of the adequacy component (P < 0.05) than did women with knee pain. The total DQI-I scores were lower in women with knee pain than in women without knee pain, after adjusting for covariates, including osteoarthritis (OR = 0.985, 95% CI = 0.973–0.997, P = 0.01). Knee pain independent of osteoarthritis was associated with poor diet quality in community-dwelling women aged ≥ 50 years.

Background Potentially inappropriate medications (PIMs) are prevalent in older adults with dementia and subsequent falls or fall-related injuries. The present study determined the risk of falls or fall-related injuries associated with PIM use in older adults with dementia. Methods The National Health Insurance Service-Elderly Cohort Database 2.0 (NHIS-ECDB 2.0) was used for this self-controlled case series (SCCS) study. This study included 1430 participants who went through exposure and non-exposure periods of PIM application among patients with dementia and experienced outcome events of falls or fall-related injuries between January 2016 and December 2019. The incidence of falls or fall-related injuries during the exposure and post-exposure periods was compared with that during the non-exposure period. Beers Criteria were used to define PIMs in patients with dementia. Negative binomial regression was conducted. The incidence rate ratio (IRR) was used to determine the risk of falls or fall-related injuries. Results During the exposure periods in which falls or fall-related injuries occurred, the mean number of PIMs among patients with dementia was 3.76 (SD = 2.99), and the most commonly used PIMs among patients with dementia were first-generation antihistamines ( n  = 283; 59.1%). Compared to the non-exposure period, the adjusted IRR during the exposure period was 1.57 (95% CI = 1.39–1.76). The risk of falls or fall-related injuries was increased when PIM use in patients with dementia was initiated (1–14 days: IRR = 2.76, 95% CI = 2.31–3.28; 15–28 days: IRR = 1.95, 95% CI = 1.48–2.56; ≥ 29 days: IRR = 1.17, 95% CI = 1.01–1.35). Especially, an increased risk of falls or fall-related injuries was associated with greater PIM use among patients with dementia. Conclusion Among older adults with dementia, PIMs significantly increase the risk of falls and fall-related injuries. Therefore, strategies should be developed to manage PIM prescriptions in patients with dementia to prevent falls.

Background Archaea are one of the least-studied members of the gut-dwelling autochthonous microbiota. Few studies have reported the dominance of methanogens in the archaeal microbiome (archaeome) of the human gut, although limited information regarding the diversity and abundance of other archaeal phylotypes is available. Results We surveyed the archaeome of faecal samples collected from 897 East Asian subjects living in South Korea. In total, 42.47% faecal samples were positive for archaeal colonisation; these were subsequently subjected to archaeal 16S rRNA gene deep sequencing and real-time quantitative polymerase chain reaction-based abundance estimation. The mean archaeal relative abundance was 10.24 ± 4.58% of the total bacterial and archaeal abundance. We observed extensive colonisation of haloarchaea (95.54%) in the archaea-positive faecal samples, with 9.63% mean relative abundance in archaeal communities. Haloarchaea were relatively more abundant than methanogens in some samples. The presence of haloarchaea was also verified by fluorescence in situ hybridisation analysis. Owing to large inter-individual variations, we categorised the human gut archaeome into four archaeal enterotypes. Conclusions The study demonstrated that the human gut archaeome is indigenous, responsive, and functional, expanding our understanding of the archaeal signature in the gut of human individuals. C2ZBUs6SCY_qq35PWZmhrc Video Abstract

Background As Korea’s population ages, understanding factors that influence health-related quality of life (HRQoL) in middle-aged and older adults is crucial. Methods This study investigated how medication adherence and ego-resiliency mediate the relationship between internet literacy and HRQoL in middle-aged and older adults in South Korean. A total of 197 participants aged 40 or older, working in companies or volunteer groups, were recruited. Mediation effects were examined using Hayes’ PROCESS macro (Model 4). Results Internet literacy was significantly related to medication adherence (r = .423), ego-resiliency (r = .417), and HRQoL (r = .378). Both medication adherence and ego-resiliency positively correlated with HRQoL (r = .408 and r = .413, respectively). Ego-resiliency and medication adherence fully mediated the relationship between internet literacy and HRQoL (ß=0.003, ß=0.005). Conclusions Medication adherence and ego-resiliency mediate the link between internet literacy and HRQoL. Middle and older adults need continuous internet literacy education and ego-resiliency training to enhance HRQoL. Additionally, medication adherence may be relevant even for those not currently taking prescribed medications, as it reflects broader health behaviors.

Skipping meals is a poor eating behaviour known to result in poor diet quality and health outcomes. Nevertheless, it has become increasingly common over the past few decades in many countries. This study aimed to examine the potential association between the use of workplace foodservices and skipping meals among Korean adult workers using data from the Korea National Health and Nutrition Examination Survey 2016–2018, a nationwide cross-sectional survey of a representative Korean population. A total of 5,137 workers aged 20–64 years were included. Dietary assessment was conducted using a 24-hour dietary recall. In total, 41.2% participants skipped one meal or more per day. The percentage of workers who skipped meals was 43.1±1.0% among participants who did not use workplace foodservices compared to 31.8±1.9% among those who did (P<0.01). Skipping meals was significantly associated with not using workplace foodservices, after adjusting for other confounders including sociodemographic variables, health-related variables, and meal procurement source (odds ratio = 3.4; 95% confidence interval = 2.6–4.4; P<0.01). We found a significant association between using workplace foodservices and reduced skipping meals in Korean adult workers. This study suggests the importance of the provision of workplace foodservices for workers to potentially reduce poor eating behaviours such as skipping meals.

Background DNA extraction is an important factor influencing the microbiome profile in fecal samples. Considering that the QIAamp DNA Stool Mini Kit, one of the most commonly used DNA extraction kits, is no longer manufactured, this study aimed to investigate whether a new commercially available kit, the QIAamp PowerFecal Pro DNA Kit, yields comparable microbiome profiles with those previously obtained using the QIAamp DNA Stool Mini Kit. Results We extracted DNA from fecal samples of 10 individuals using three protocols (protocol P of the QIAamp PowerFecal Pro DNA Kit, and protocols SB and S of the QIAamp DNA Stool Mini Kit with and without an additional bead-beating step, respectively) in triplicate. Ninety extracted DNA samples were subjected to 16S rRNA gene sequencing. DNA quality measured by 260/280 absorbance ratios was found to be optimal in protocol P. Additionally, the DNA quantity and microbiome diversity obtained using protocol P were significantly higher than those of protocol S, however, did not differ significantly from those of protocol SB. Based on the overall microbiome profiles, variations between protocol P and protocol SB or S were significantly less than between-individual variations. Furthermore, most genera were not differentially abundant in protocol P compared to the other protocols, and the number of differentially abundant genera, as well as the degree of fold-changes were smaller between protocols P and SB than between protocols P and S. Conclusions The QIAamp PowerFecal Pro DNA Kit exhibited microbiome analysis results that were comparable with those of the QIAamp DNA Stool Mini Kit with a bead-beating step. These results will prove useful for researchers investigating the gut microbiome in selecting an alternative protocol to the widely used but discontinued kit.

Purpose Several observational studies have shown contradictory results regarding the association between sunlight exposure and the risk of malignant lymphoma. Thus, we aimed to systematically determine the association between sunlight exposure and lymphoid malignancy risk through a meta-analysis. Methods A thorough search of four electronic databases (PubMed, Embase, Web of Science, and Scopus) was performed to identify eligible studies until 13 August 2020. A random-effects model was used to calculate risk estimates of sunlight exposure. The main outcome measure was the risk of lymphoid malignancy subtypes with odds ratios (ORs) and 95% confidence intervals (CIs) according to various forms of solar ultraviolet radiation. Results In total, 17 case–control studies and 9 cohort studies including 216,285 non-Hodgkin lymphoma (NHL) and 23,017 Hodgkin’s lymphoma (HL) patients were included in the final analysis. Personal sunlight exposure was significantly associated with a decreased risk of HL (OR 0.77; 95% CI 0.68–0.87) and NHL (OR 0.81; 95% CI 0.71–0.92), including all subtypes except T-cell lymphoma. Ambient sunlight exposure at residence was associated with a reduced risk of HL (OR 0.88; 95% CI 0.81–0.95) and all NHL subtypes (OR 0.84; 95% CI 0.73–0.96), except for chronic lymphocytic leukemia/small lymphocytic lymphoma. As the number of sunburns and sunbaths increased, the risk of NHL tended to decrease. Conclusion While there was an observed protective effect both from case–control and prospective studies, substantial heterogeneity was found in the current study. Thus, more evidence is required to confirm that promoting sunlight exposure can prevent the development of lymphoid neoplasia.

PurposeSeveral observational studies have presented conflicting results on the association between the use of proton pump inhibitors (PPIs) or histamine H2 receptor antagonist (H2RA) and the risk of coronavirus disease 2019 (COVID-19). This systematic review and meta-analysis aimed to examine this association.MethodsIn July 2021, PubMed, Embase, Cochrane Central Register of Controlled Trials, and Web of Science were searched for articles investigating the relationship between the two main acid suppressants and COVID-19. Studies showing the effect estimates as hazard ratio (HR) for severe outcomes or incidence of COVID-19 were evaluated using a random-effects model.ResultsA total of 15 retrospective cohort studies with 18,109 COVID-19 cases were included in the current meta-analysis. PPI use was significantly associated with severe outcomes of COVID-19 (hazard ratio [HR] = 1.53; 95% confidence interval [CI]: 1.20–1.95) but not with the incidence of COVID-19, whereas H2RA use was significantly associated with decreased incidence (HR = 0.86, 95% CI: 0.76–0.97). For subgroup analyses of PPIs, increased severe outcomes of COVID-19 were observed in < 60 years, active use, in-hospital use, and Asians. For subgroup analyses of H2RAs, decreased severe outcomes of COVID-19 were observed in > 60 years, while in-hospital use and use in Asia were associated with higher disease severity.ConclusionsClose observation can be considered for COVID-19 patients who use PPIs to prevent severe outcomes. However, caution should be taken because of substantial heterogeneity and plausible protopathic bias.