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Purpose Little has been determined regarding the association between patients’ and families’ illness understanding and preferences for medical care. We aimed to evaluate the association of illness understanding with advance care planning (ACP) and preferences for end-of-life care, such as aggressive care, early palliative care (EPC), and hospice care, among advanced cancer patients and their family caregivers. Methods Patients were recruited for a prospective cohort study at outpatient and inpatient facilities in nine university hospitals in Korea (n = 150), and their primary family caregivers were also asked to participate (n = 101). Data on ACP and end-of-life care preferences were collected only at baseline in the cohort study with optional questions and were used to analyze these study results. Results Patients with illness understanding were more likely to have documented physician orders for life-sustaining treatment (POLSTs) (adjusted odds ratio [aOR] of 4.94) and to have discussed ACP with their families (aOR 2.15) than those who did not. Being expected to live for several months, they were unlikely to prefer active treatment. Caregivers understanding patients’ illness were more likely to write advance directives (ADs) and to discuss ACP; furthermore, they had already discussed ACP with family members. They did not prefer active treatment or life-sustaining treatments when their family members were expected to die within a few weeks. There was no significant association between illness understanding and preferences for EPC. Conclusion Accurately recognizing an incurable disease is associated with preferences for more ACP and less aggressive care but not with preferences for EPC or hospice care among both advanced cancer patients and their family caregivers.

Recent advances in passive acoustic monitoring (PAM) have markedly improved the ability to study marine soundscapes by enabling long-term, non-invasive monitoring of biological sounds across large spatial and temporal scales. Among aquatic organisms, fish are primary contributors to biophony, producing sounds associated with feeding, reproduction, and social behavior. However, the majority of previous research has focused on individual vocalizations, with limited attention to collective acoustic phenomena such as fish choruses. This study quantitatively analyzes choruses produced by the small yellow croaker (Larimichthys polyactis), an ecologically and commercially important species in the Northwest Pacific Ocean. Using power spectral density (PSD) analysis, we examined long-term underwater recordings from a sea cage containing approximately 2000 adult small yellow croakers. The choruses were centered around ~600 Hz and exhibited sound pressure levels 15–20 dB higher at night than during the day. These findings highlight the ecological relevance of fish choruses and support their potential use as indicators of biological activity. This study lays the foundation for incorporating fish choruses into soundscape-based PAM frameworks to enhance biodiversity and habitat monitoring.

The increasing use of water-based drilling muds in offshore oil and gas operations has raised concerns about potential ecological risks of their primary components, such as bentonite, on marine organisms. To date, the biological effects of bentonite on benthic species remain poorly understood. This study aimed to evaluate the physiological and oxidative stress responses of Pacific abalone (Haliotis discus hannai) exposed to varying concentrations (20–3000 mg/L) of bentonite over a 10-day period. Short-term exposure (up to 7 days) to bentonite did not result in significant mortality across treatment groups; however, partial mortality was observed in the highest concentration group (3000 mg/L) on day 8. Biochemical analyses revealed elevated levels of hydrogen peroxide and malondialdehyde, particularly in higher concentration groups, indicating oxidative stress. Antioxidant enzyme activities showed concentration- and time-dependent changes, with early activation followed by suppression under prolonged exposure. Total antioxidant capacity also declined over time in high-concentration groups. These findings indicate that while bentonite may not be acutely lethal to abalone, it can trigger sublethal oxidative stress responses, particularly under chronic exposure conditions, underscoring the importance of evaluating long-term physiological impacts of suspended drilling particulates and the need for research on a wider range of marine species.

The Yeongsan River estuary is experiencing increased concentrations of nutrient and organic matter due to its estuary bank (sea dike). The opening of floodgates at the estuary bank leads to a substantial inflow of freshwater into the saltwater zone, thereby resulting in water quality changes. Our study evaluated spatiotemporal variations in nutrient limitation in the freshwater and saltwater zones in the Yeongsan River estuary, which is expected to fluctuate with the changing seasons. We utilized the N:P ratio to evaluate the potential nutrient limitation and conducted bioassay experiments to directly assess actual nutrient limitation. The N:P ratio showed that P was the limiting nutrient in both the long-term (2004–2008) and during our field investigation. However, the bioassay experiment revealed that in the freshwater zone, P was limited in spring and winter (p < 0.05), while no nutrient was limited in summer and fall. In the saltwater zone, we observed P limitation in spring and winter (p < 0.05) and N limitation in fall (p < 0.05), whereas no nutrient limitation was observed in the summer. These results demonstrate that actual nutrient limitation, which directly influences phytoplankton growth, varies spatiotemporally in response to freshwater discharge in the Yeongsan River estuary.

Non-palpable, volumetric splenomegaly at diagnosis was evaluated using computed tomography in patients with essential thrombocythemia (ET) and prefibrotic/early primary myelofibrosis (pre-PMF) based on 2016 World Health Organization guidelines. Each patient’s spleen volume was adjusted for their age and body surface area. The degree of splenomegaly was classified as no, borderline volumetric, overt volumetric, or palpable splenomegaly. Seventy-six patients with ET (median age, 62.5 years) and 19 patients with pre-PMF (median age, 65 years) were followed up for a median of 2.4 years (range 0.1–17.6 years) and 4.2 years (range 0.2–19.6 years), respectively. Spleen volume was significantly greater in pre-PMF patients than in ET patients (377.9 ± 92.2 cm3 vs. 224.9 ± 115.2 cm3, P < 0.001). No, borderline volumetric, overt volumetric, and palpable splenomegaly were found in 42 (55.3%), 24 (31.6%), 10 (13.2%), and 0 (0%) patients with ET, respectively, and in 0 (0%), 8 (42.1%), 19 (52.6%), and 1 (5.2%) patient with pre-PMF, respectively (P < 0.001). Volumetric splenomegaly did not affect thrombosis-free survival in patients with ET or those with pre-PMF. This study indicates that all patients with pre-PMF present with splenomegaly, whereas half of the patients with ET have a normal-sized spleen at diagnosis.

Gallbladder carcinoma (GBC) exhibits poor prognosis due to local recurrence, metastasis, and resistance to targeted therapies. Using clinicopathological analyses of GBC patients along with molecular in vitro and tumor in vivo analysis of GBC cells, we showed that reduction of Dsg2 expression was highly associated with higher T stage, more perineural, and lymphatic invasion. Dsg2-depleted GBC cells exhibited significantly enhanced proliferation, migration, and invasiveness in vitro and tumor growth and metastasis in vivo through Src-mediated signaling activation. Interestingly, Dsg2 binding inhibited Src activation, whereas its loss activated cSrc-mediated EGFR plasma membrane clearance and cytoplasmic localization, which was associated with acquired EGFR-targeted therapy resistance and decreased overall survival. Inhibition of Src activity by dasatinib enhanced therapeutic response to anti-EGFR therapy. Dsg2 status can help stratify predicted patient response to anti-EGFR therapy and Src inhibition could be a promising strategy to improve the clinical efficacy of EGFR-targeted therapy.

Marine environments provide a unique opportunity to blend offshore wind energy production and marine fishery activities as complementary technologies. This study investigated the morphological characteristics (length and weight) and biomass yield of seaweed (Undaria pinnatifida) in a model marine environment with mariculture within an offshore wind farm in southwestern Korea. The mean lengths in the first cultivation trials of U. pinnatifida sporophytes increased from 1.8 ± 0.1 cm in November 2021 to 120–170 cm in March 2022 (density, 39.8 plants m−1; final wet weight, 98.6–249.1 g (mean 146.8 ± 20.4 g, n = 20 ind.); yield 5842 g m−1). Further, for the second cultivation trial, the length of the sporophytes increased from 1.5 ± 0.1 cm in November 2021 to 120–150 cm in April 2022 (density, 49.3 plants m−1; final wet weight, 83.0–251.6 g (mean 155.7 ± 19.0 g; n = 20 ind.); yield, 7676 g m−1), and, owing to the increase in water temperature and light intensity due to seasonal changes around the offshore wind power farm, the second cultivation trials showed signs of chlorosis. Considering the environment, we judged seaweed growth to be normal. Therefore, when applying this model to grow U. pinnatifida, seasonal temperature changes, the purpose of the product, and the nutritional status of the open-sea area should be considered. These results may improve seaweed farming in offshore wind farms in the future.

The walleye pollock, Gadus chalcogrammus (Pallas, 1814), is one of the most commercially and ecologically valuable species in the Northwestern Pacific. However, combined pressures of overfishing and environmental changes have led to a substantial decline in its production in Japan and Russia since the 1990s, and a collapse in Korea since the 2000s. The objective of this study was to comprehensively examine its genetic diversity and population structure with an extensive sampling effort of 16 populations across the Northwestern Pacific including South Korea, Japan, and Russia. A multiplex PCR assay composed of seven microsatellite markers revealed a moderate level of observed heterozygosity (Ho = 0.369–0.599), which is lower than that reported in previous studies of this species. All loci were highly polymorphic, with the mean PIC ranging from 0.608 to 0.793. The structure of the 16 populations was characterized by heterozygote deficiency, a modest effective allele number (Ne = 4.551–7.969), low genetic differentiation (FST = 0.000–0.054), a weak population structure, a genetic admixture, and no significant correlation between the genetic and geographic distance. These characteristics are typical of pelagic marine species with large population sizes due to a consistent gene flow among populations when there are no physical boundaries in the open ocean. The seasonal and country-specific genetic structure indicated that G. chalcogrammus populations in the Northwestern Pacific region should be managed as a single management unit. The findings from this study provide critical information for future genetic monitoring, conservation management, and the development of strategies aimed at restoring the populations of this species.

Background Post-transplantation cyclophosphamide (PTCy) and anti-thymocyte globulin (ATG) are common prophylactic strategies for graft-versus-host disease (GVHD) after haploidentical hematopoietic stem cell transplantation (haplo-HSCT). Interleukin (IL)-6 is a surrogate marker for cytokine release syndrome (CRS) and acute GVHD. Method The clinical outcomes and complications of haplo-HSCT with PTCy plus ATG versus PTCy monotherapy were compared according to serum IL-6 levels at Chungnam National University Hospital (Daejeon, South Korea) from January 2019 to February 2023. Results Forty patients who underwent haplo-HSCT were analyzed. A significant difference in IL-6 levels was observed between the PTCy plus ATG and PTCy alone groups (7.47 ± 10.55 vs. 117.65 ± 127.67; p  = 0.003). More patients in the PTCy plus ATG group had a CRS grade of 0 than in the PTCy alone group ( p  < 0.001). Serum IL-6 levels were associated with grades II–IV acute GVHD (r = 0.547, p  < 0.001). The cumulative incidence (CI) of grades II–IV acute GVHD was significantly higher in the PTCy alone group (67.9% vs. 4.8%; p  < 0.001). No significant difference in the CI for chronic GVHD was detected between the PTCy plus ATG and PTCy alone groups (72.1% vs. 82.0%; p  = 0.730). The CI of 1-year non-relapse mortality was significantly higher in the PTCy alone group than in the PTCy plus ATG group (42.2% vs. 15.9%; p  = 0.022). The 1-year overall survival (OS) was significantly better in the PTCy plus ATG group (75.9% vs. 35.3%; p  = 0.011). The 1-year GVHD-free, relapse-free survival rate was 29.4% in the PTCy alone group and 54.0% in the PTCy plus ATG group ( p  = 0.038). Conclusion Serum IL-6 levels were higher in the PTCy alone group than in the PTCy plus ATG group. The addition of ATG before stem cell infusion affected IL-6 levels and reduced the incidences of CRS and grade II–IV acute GVHD in haplo-HSCT patients. This study suggests that PTCy plus ATG as GVHD prophylaxis in haplo-HSCT is beneficial in terms of clinical outcomes and complications of HSCT.

Cutaneous T-cell lymphomas (CTCLs) are a group of T-cell lymphomas with low incidence. Due to their indolent characteristics, treatment strategies have not yet been established for advanced CTCLs. In this study, relative incidence of CTCLs in Asia was estimated and the therapeutic outcomes presented based on various treatments currently used in clinics for advanced CTCLs. As part of a prospective registry study of peripheral T-cell lymphoma (PTCL) conducted across Asia, including Korea, China, Taiwan, Singapore, Malaysia, and Indonesia, subgroup analysis was performed for patients with CTCLs. Among 486 patients with PTCL, 37 with CTCL (7.6%) were identified between April 2016 and February 2019. Primary cutaneous ALK-negative anaplastic large cell lymphoma (ALCL, 35.1%) was the most common subtype. With a median follow-up period of 32.1 months, median progression-free survival (PFS) was 53.5 months (95% CI 0.0–122.5), and overall survival was not reached. 14 patients (48.2%) underwent subsequent treatment after the first relapse, but the response rate was 20% with a PFS of 2.2 months (95% CI 0.3–4.0). Six patients received autologous stem cell transplantation (auto-SCT). However, auto-SCT did not result in better outcomes. Additional studies are needed on standard care treatment of advanced or refractory and relapsed CTCLs.