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The aim of this study was to analyze the regional factors affecting the prevalence of hypertension in Korea using regional hypertension prevalence data. Data from the National Statistical Portal for the past 5 years (2018–2022) were collected and used as indicators of hypertension prevalence and regional variables in 229 regions. The correlation between hypertension prevalence and regional factors was investigated, and spatial statistical techniques such as spatial autocorrelation analysis, hotspot analysis, and geographically weighted regression analysis were performed to identify the spatial dependence of hypertension prevalence, hotspot and coldspot regions, and regional factors affecting regional hypertension prevalence. Regional factors influencing hotspots and coldspots were current smoking, high-risk drinking, obesity prevalence, and number of medical institutions per 100,000. The results of this study suggest that differentiated hypertension prevalence management strategies are needed according to hotspots and coldspots. In the future, this study is expected to be useful as basic data for health business policies to promote national and local health.

Objectives To analyze the characteristics of hospital injured patients and the factors that affect treatment results. Methods We used the data from the Korea National Hospital Discharge In-depth Injury Survey from 2019 to 2021 of the Korea Disease Control and Prevention Agency (KDCA), 18,037 people who experienced hospital injury accidents were analyzed. In a retrospective cross-sectional study, general characteristics and injury-related characteristics of patients with hospital-acquired injuries were collected. The data were analyzed using chi-square test and logistic regression analysis of complex sampling design. The significance of all statistical analyses was verified at the p-value (<0.05) level. Results Variables that significantly affected the death of patients with hospital injuries were gender, age, route of admission, type of hospital injury, principal diagnosis, and length of stay (p < 0.05). The risk of death was 3.174 times (95% confidence interval: 2.376–4.238) higher when neoplasm was the principal diagnosis compared to cases with principal diagnosis of other systems. Conclusions It is necessary to do patient safety education to help medical personnel be more aware of groups of patients who had a high risk of death from hospital damage, such as male and elderly patients, patients who admitted through the emergency room, and patients whose principal diagnosis was neoplasm, circulatory system, or respiratory system disease.

Background Autoimmune hepatitis (AIH), primary biliary cholangitis (PBC), and primary sclerosing cholangitis (PSC) are all immune-mediated chronic inflammatory liver diseases. Autoimmune liver diseases are rare, making identification and treatment difficult. To improve clinical outcomes and enhance patient quality of life, we performed an epidemiological study of autoimmune liver diseases based on real-world comprehensive data. Results We used National Health Insurance Service claims data in Korea from 2005 to 2019. Patients were identified using the International Classification of Disease 10th Revision code, and rare intractable disease codes assigned according to the strict diagnostic criteria. In the AIH cohort, 8,572 (83.9%) were females and the mean age at diagnosis was 56.3 ± 14.3 years. PBC also showed female dominance (83.3%) and the mean age was 57.8 ± 12.6 years. Patients with PSC showed no sex predominance and had a mean age of 57.8 ± 21.5 years. During the study period, there were 10,212, 6,784, and 888 AIH, PBC, and PSC patients, respectively. The prevalence of AIH, PBC, and PSC in 2019 were 18.4, 11.8, and 1.5 per 100,000 population, while the corresponding incidences were 2.3, 1.4, and 0.3 per 100,000 population, respectively. Analysis of sex-age-standardized data showed that the annual prevalence of these diseases is increasing. The 10-year survival rates were 89.8%, 74.9%, and 73.4% for AIH, PBC, and PSC, respectively. Conclusions The number of patients with autoimmune liver disease in South Korea is increasing over time. Further research on autoimmune liver disease is needed to fulfill unmet clinical needs.

Objectives This study aims to develop a deep learning-based classification model for early detection of dementia using a wearable device that can measure the electrical conductivity of the skin, temperature, and movement as factors related to dementia, interlocking them with an application, and analyzing the collected data. Methods This study was conducted on 18 elderly individuals (5 males, 13 females) aged 65 years or older who consented to the study. The Korean Mini-Mental State Examination survey for cognitive function tests was conducted by well-trained researchers. The subjects were first grouped into high- or low-risk group for dementia based on their Korean Mini-Mental State Examination score. Data obtained by wearable devices of each subject were then used for the classification of the high- and low-risk groups of dementia through a smart healthcare-based system implementing a deep neural network with scaled principal component analysis. The correlation coefficients between the Korean Mini-Mental State Examination score and the featured data were also investigated. Results Our study showed that the proposed system using a deep neural network with scaled principal component analysis was effective in detecting individuals at high risk for dementia with up to 99% accuracy and which performance was better compared with commonly used classification algorithms. In addition, it was found that the electrical conductivity of skin had the closest correlation with the results of the Korean Mini-Mental State Examination score among data collected through wearable devices in this study. Conclusions Our proposed system can contribute to effective early detection of dementia for the elderly, using a non-invasive and easy-to-wear wearable device and classification algorithms with a simple cognitive function test. In the future, we intend to have more subjects participate in the experiment, to include more relevant variables in the wearable device, and to analyze the effectiveness of the smart healthcare-based dementia classification system over the long term.

Few large-scale studies have investigated factors associated with the development of hepatocellular carcinoma (HCC) in patients with autoimmune hepatitis (AIH). This study aimed to determine the risk of HCC in AIH patients and associated risk factors, focusing on metabolic dysfunction-associated steatotic liver disease (MASLD). We analyzed the claims data from the Korean National Health Insurance Service from 2007 to 2020. The study included 7,382 patients with AIH and a control group of 58,538 age- and sex-matched individuals, at a ratio of 1:8. We compared the incidence rates of HCC between these groups and investigated the risk factors of HCC. During a median follow-up of 5.9 years, 160 AIH patients were diagnosed with HCC, resulting in an incidence rate of 3.60 per 1,000 person-years. The matched controls exhibited an incidence rate of 0.48 per 1,000 person-years. After adjustment, AIH patients had a 4.85-fold heightened risk of HCC compared to the control group. Within the AIH cohort, the presence of coexisting MASLD further elevated the risk of HCC, along with other factors such as older age, male sex, and decompensated liver cirrhosis, as observed in a two-year landmark analysis. The presence of concurrent extrahepatic autoimmune diseases did not affect the prognosis, while glucocorticoid treatment was associated with a decreased risk of HCC. Patients with AIH had an increased risk of HCC compared to matched controls, particularly those with coexisting MASLD. In addition to appropriate medical treatment, proactive interventions and lifestyle modifications for concurrent MASLD are recommended for these patients.

Few large-scale studies have been published regarding the association between autoimmune hepatitis (AIH) and risk of osteoporotic fracture. This study aimed to determine the risk of developing an osteoporotic fracture in patients with AIH. We used claims data from the Korean National Health Insurance Service between 2007 and 2020. Patients with AIH (n = 7,062) were matched with controls (n = 28,122) based on age, sex, and duration of follow-up using a ratio of 1:4. Osteoporotic fractures included fractures of the vertebrae, hip, distal radius, and proximal humerus. The incidence rate (IR) and IR ratio of osteoporotic fracture were compared between the 2 groups, and their associated factors were evaluated. During a median follow-up period of 5.4 years, 712 osteoporotic fractures occurred in patients with AIH with an IR of 17.5 per 1,000 person-years. Patients with AIH had a significantly higher risk of osteoporotic fractures than matched controls, with an IR ratio of 1.24 (95% confidence intervals, 1.10-1.39, P < 0.01) in the multivariable analysis. Female sex, older age, history of stroke, presence of cirrhosis, and use of glucocorticoids were associated with an increased risk of osteoporotic fractures. In the 2-year landmark analysis, longer duration of glucocorticoid exposure was associated with an incremental increased risk of osteoporotic fracture. Patients with AIH had an increased risk of osteoporotic fracture compared with controls. The presence of cirrhosis and long-term use of glucocorticoids further adversely affected osteoporotic fracture in patients with AIH.

Prolonged therapy using nucleos(t)ide analogs (NUC) is inevitable in patients with chronic hepatitis B (CHB) infection, but its long-term impact on Parkinson’s disease (PD) risk remains unclear. This study evaluated the association between NUC therapy and PD incidence in a nationwide CHB cohort. The study population comprised the National Health Insurance Service claims database from January 1, 2013, to December 31, 2013, only included treatment naïve CHB patients and those without previously diagnosed with PD. Participants were followed until PD diagnosis or study completion. The primary outcome was PD incidence, comparing patients who initiated NUC therapy at cohort entry with those who did not. Over the 7.9-year study period, the incidence rate of PD in NUC-treated patients was 1.48 per 1000 persons, compared to 1.95 per 1000 persons in the untreated group. In an adjusted competing risk model, the 3-year follow-up showed a statistically significant reduction in risk (hazard ratio [HR]: 0.61; 95% confidence interval [CI] 0.39–0.97). In the propensity score-matched cohort of 18,365 pairs, the cumulative incidence during 2–4 years of follow-up was significantly lower in the NUC-treated group compared to the untreated group. However, no statistically significant difference in cumulative PD incidence was observed between the groups at the early or late stages of the follow-up period. NUC therapy initially reduced PD incidence, but this protective effect diminished over time, indicating a time-varying effect. Regular PD screening may be needed for long-term NUC users.

Background We hypothesized that portal vein tumor thrombosis (PVTT) in hepatocellular carcinoma (HCC) increases portal pressure and causes esophageal varices and variceal bleedings. We examined the incidence of high-risk varices and variceal bleeding and determined the indications for variceal screening and prophylaxis. Methods This study included 1709 asymptomatic patients without any prior history of variceal hemorrhage or endoscopic prophylaxis who underwent upper endoscopy within 30 days before or after initial anti-HCC treatment. Of these patients, 206 had PVTT, and after 1:2 individual matching, 161 of them were matched with 309 patients without PVTT. High-risk varices were defined as large/medium varices or small varices with red-color signs and variceal bleeding. Bleeding rates from the varices were compared between matched pairs. Risk factors for variceal bleeding in the entire set of patients with PVTT were also explored. Results In the matched-pair analysis, the proportion of high-risk varices at screening (23.0% vs. 13.3%; P  = 0.003) and the cumulative rate of variceal bleeding (4.5% vs. 0.4% at 1 year; P  = 0.009) were significantly greater in the PVTT group. Prolonged prothrombin time, lower platelet count, presence of extrahepatic metastasis, and Vp4 PVTT were independent risk factors related to high-risk varices in the total set of 206 patients with PVTT (Adjusted odds ratios [95% CIs], 1.662 [1.151–2.401]; 0.985 [0.978–0.993]; 4.240 [1.783–10.084]; and 3.345 [1.457–7.680], respectively; Ps < 0.05). During a median follow-up of 43.2 months, 10 patients with PVTT experienced variceal bleeding episodes, 9 of whom (90%) had high-risk varices. Presence of high-risk varices and sorafenib use for HCC treatment were significant predictors of variceal bleeding in the complete set of patients with PVTT (Adjusted hazard ratios [95% CIs], 26.432 [3.230–216.289]; and 5.676 [1.273–25.300], respectively; Ps < 0.05). Conclusions PVTT in HCC appears to increase the likelihood of high-risk varices and variceal bleeding. In HCC patients with PVTT, endoscopic prevention could be considered, at least in high-risk variceal carriers taking sorafenib.

Surface modification—altering geometric structures or surface energy—is a key factor in improving liquid resistance/repellency on a solid surface. In particular, roughness from geometric structures provides void spaces that enhance energy barriers in nanofibers that a liquid droplet should overcome to penetrate, thus preventing the transition of a liquid drop from the Cassie–Baxter state to Wenzel state. In this work, the design of a geometric structure that performs highly in liquid resistance/repellency was proposed by extending the Cassie–Baxter model into cellulose acetate (CA) nanofibers, entrapping SiO2 nanoparticles, and examining the impact of void spaces created by the entrapped SiO2 into nanofibers in prediction and experiment. The extended Cassie–Baxter equation was simplified using H*, which is characterized by Tnp. The prediction and measurement of the apparent contact angle θnf in CA-SiO2 nanofabrics showed good agreement, and the results emphasized the role of void space in improving liquid resistance/repellency while minimizing chemical treatments for altering surface energy and geometric structure.Graphic abstract