Relationships of walking activity with depressed mood and suicidal ideation among the middle-aged Korean population: a nationwide cross-sectional study.

Introduction: The suicide rate of middle-aged adults has increased rapidly, which is a significant public health concern. A depressed mood and suicidal ideation are significant risk factors for suicide, and non-pharmacological interventions such as exercise therapy have been suggested as potential treatments. Walking is a feasible and accessible form of exercise therapy for middle-aged adults. Methods: We conducted a study based on the Seventh Korea National Health and Nutrition Examination Survey (2016-2018) data of 6,886 general middle-aged adults in South Korea to investigate the relationships of walking exercise with depressed mood and suicidal ideation. Multiple logistic regression analysis was used to adjust for confounding variables. Sampling weights were applied to obtain estimates for the general Korean population. Results: Participants who walked ≥5 days per week had a significantly lower odds ratio (OR) for depressed mood [OR = 0.625, 95% confidence interval (CI): 0.424-0.921, p = 0.018] and suicidal ideation (OR = 0.252, 95% CI: 0.125-0.507, p < 0.001) compared to those who never walked, regardless of the duration of exercise. The same results were obtained for males after stratifying the data by sex and suicidal ideation was associated with walking in females. Conclusion: Regular walking exercise was associated with diminished mental health problems in middle-aged adults. Light walks may serve as a useful starting point for patients with serious mental health issues, such as suicidal ideation.

Dexamethasone therapy prevents delayed neuropsychiatric sequelae after carbon monoxide poisoning: a prospective registry-based study.

BACKGROUND: Delayed neuropsychiatric sequelae are major complications of carbon monoxide poisoning; carbon monoxide triggers brain oxidation and inflammation. Corticosteroids such as dexamethasone modulate neurological damage after carbon monoxide poisoning through anti-inflammatory actions and immune response inhibition. However, it is not known whether corticosteroids prevent delayed neuropsychiatric sequelae. We thus studied whether dexamethasone reduced the incidence of delayed neuropsychiatric sequelae. METHODS: This registry-based study enrolled patients with carbon monoxide poisoning treated in a Korean tertiary care hospital from March 1st, 2020 to November 30th, 2021. Data of patients were prospectively collected during the study period, and retrospectively analyzed. One group received intravenous dexamethasone. We performed multivariable logistic regression analysis to identify factors associated with delayed neuropsychiatric sequelae. RESULTS: A total of 128 patients were enrolled, of which 99 patients received dexamethasone therapy and 29 patients did not. The incidences of delayed neuropsychiatric sequelae in the dexamethasone and non-dexamethasone groups were 16.2% and 37.9%, respectively. Multivariable logistic regression analysis revealed that dexamethasone use (odds ratio = 0.122, 95% confidence interval 0.031-0.489) and a higher Glasgow Coma Scale (odds ratio = 0.818, 95% confidence interval 0.682-0.981) was associated with a lower incidence of delayed neuropsychiatric sequelae. CONCLUSION: Early dexamethasone treatment was significantly associated with a decreased incidence of delayed neuropsychiatric sequelae. A higher Glasgow Coma Scale at presentation also was associated with a lower incidence of delayed neuropsychiatric sequelae.

Relationship between body mass index and risk of delirium in an intensive care unit.

OBJECTIVE: Delirium in the intensive care unit (ICU) is a common and critical condition that leads to poor prognosis in older patients, but the association between body mass index (BMI) and the incidence of delirium remains unclear. METHODS: We retrospectively analyzed 5,622 patients admitted to the ICU of a tertiary referral hospital between 2013 and 2022. We collected sociodemographic data, vital signs, laboratory results, and delirium scale scores. We subdivided the patients into four categories: underweight (<18.5 kg/m2), normal weight (18.5-22.9 kg/m2), overweight (23-24.9 kg/m2), and obese (>25 kg/m2). The primary outcome was the incidence of delirium according to the BMI categories. We performed multivariable logistic regression analysis, adjusted for sex, age, past smoking and alcohol history, benzodiazepine use, and laboratory abnormalities. RESULTS: Among the 5,622 patients in the ICU (mean age, 72.9 years; male, 60.1%; mean BMI, 24.2 kg/m2), the incidence of delirium was 19.0% (1,069 patients). The mean modified incidence of delirium was higher among underweight patients (odds ratio [OR]=1.51, confidence interval [CI]=1.07-2.12, p = 0.02) than among normal-weight patients. Overweight and obese status were not independently associated with delirium (OR=0.90, CI=0.70-1.17, p = 0.43; OR= 0.97; CI=0.77-1.21, p = 0.78, respectively). The area under the receiver-operating characteristic curve of the multivariable logistic regression model was 0.71 (95% CI=0.69-0.73). CONCLUSIONS: Underweight status is an independent risk factor for delirium in the ICU. Additional caution is required when evaluating underweight patients for delirium. Obese or overweight status are not associated with delirium, providing evidence for the obesity paradox.

The Effect of Suicide Prevention Education on Attitudes Toward Suicide in Police Officers.

OBJECTIVE: This study investigated the effect of suicide prevention education on attitudes toward suicide among police officers. METHODS: We used an anonymous questionnaire for 518 officers and surveyed the demographic profiles and examined attitudes toward suicide utilizing the Attitudes Towards Suicide Scale (ATTS) (1=totally agree, 5=totally disagree). Our study divided participants into two groups, based on whether or not they had received suicide prevention education, and examined the differences in attitudes toward suicide between the groups. RESULTS: Of the total population, 247 (47.7%) officers had received suicide prevention education. The education group thought suicide as a predictable matter, disagreeing significantly more with the ATTS factor 'suicide is unpredictable' (3.36 vs. 3.35; p=0.001) compared with the no education group. Also, the education group more perceived suicide as a cry for help and at the same time disagreed more with the notion 'suicidal thoughts will never disappear' (2.08 vs. 2.26; p=0.025, 3.2 vs. 3.05; p=0.035, respectively). CONCLUSION: Officers with experience in suicide prevention education showed more positive attitude toward suicide and suicide prevention. These findings suggest a need to organize more opportunities of suicide prevention educations, such as making the training mandatory for police officers.

Working hours are closely associated with depressive mood and suicidal ideation in Korean adults: a nationwide cross-sectional study.

Long working hours have been presumed to negatively influence health. However, evidence is lacking regarding any associations of working hours with depressive mood or suicidal ideation. We investigated the relationships of working hours with depressive mood and suicidal ideation in a representative sample of the Korean general population. We analyzed data collected by the Korea National Health and Nutrition Examination Surveys VI and VII (2013-2018). Depressive mood and suicidal ideation were identified through self-reporting. We divided participants into four groups according to weekly working hours: 30-40, 41-50, 51-60, and > 60 h/week. Sampling weights were applied to obtain estimates for the general Korean population. We analyzed 14,625 participants, of whom 5383 (36.8%), 4656 (31.8%), 2553 (17.5%), and 2033 (13.9%) worked 30-40, 41-50, 51-60, and > 60 h/week, respectively. In these groups, 3.6%, 4.4%, 5.2%, and 6.3% of the participants reported depressive mood, while 1.8%, 1.9%, 2.2%, and 3.6% reported suicidal ideation. In multiple regression analyses, compared with the 30-40 h/week group, the adjusted odds ratios of the 41-50, 51-60, and > 60 h/week groups for depressive mood were 1.35 (1.08-1.69), 1.5 (1.14-1.97), and 1.6 (1.19-2.14). A similar trend was evident for suicidal ideation (odds ratios 1.16 [0.82-1.63], 1.48 [0.99-2.21], and 2.29 [1.53-3.42]). Long working hours are significantly associated with depressive mood and suicidal ideation.

Sleep Duration Is Closely Associated with Suicidal Ideation and Suicide Attempt in Korean Adults: A Nationwide Cross-Sectional Study.

INTRODUCTION: Suicidal ideation and suicide attempts are major risk factors for suicidal death, and sleep problems are associated with an increased risk for mental disorders. We investigated the relationship between sleep duration and suicidal ideation and suicide attempts in a representative sample of the Korean general population from a nationwide survey. METHODS: We analyzed data collected from the Korea National Health and Nutrition Examination Survey VI and VII (2013-2018). Suicidal ideation was identified via self-report, and we accessed suicide attempt history. Sleep duration was divided into three categories: short sleep duration (SSD) (≤5 h), normal sleep duration (NSD) (>5 and <9 h), and long sleep duration (LSD) (≥9 h). Sampling weights were applied to obtain estimates for the general Korean population. RESULTS: Overall, 4015 (12.0%), 25,609 (76.5%), and 3857 (11.5%) participants were in the SSD, NSD, and LSD groups, respectively. Among these groups, 7.2%, 2.8%, and 3.3% reported suicidal ideation; while 1.2%, 0.4%, and 0.7% reported a history of suicide attempts. Multiple regression analyses revealed that SSD was significantly more strongly associated with suicidal ideation (adjusted odds ratio (AOR) 1.46, p < 0.001) and attempts (AOR 2.05, p = 0.003) than NSD. No association was found between LSD and suicidal ideation/attempts. CONCLUSION: Sleep duration is significantly associated with suicidal behavior, and SSD was particularly closely related with an increased risk for suicidal ideation and suicide attempt. Clinicians should carefully consider sleep duration in suicidal patients.

Neuron-specific enolase level as a predictor of neurological outcome in near-hanging patients: A retrospective multicenter study.

OBJECTIVES: Neuron-specific enolase (NSE) is frequently used to predict neurological outcomes in patients with hypoxic brain injury. Hanging can cause hypoxic brain damage, and survivors can suffer from neurological deficits that may impair daily activities. Here, we investigated the utility of the initial serum NSE level as a predictor of neurological outcomes in near-hanging patients with decreased consciousness. METHODS: This retrospective multicenter study was conducted in patients who visited the emergency department due to near-hanging injury from October 2013 to February 2019 at three university hospitals in Korea. They were divided into two groups according to the presence of out-of-hospital cardiac arrest. The neurological outcome was determined using the Cerebral Performance Category (CPC) measured at the time of discharge. Multivariate analysis was performed to determine whether initial serum NSE is an independent predictor of neurological outcome. RESULTS: Of the 70 patients included in the study, 44 showed a poor neurological outcome (CPC score = 3-5). Among the 52 patients with cardiac arrest, only 10 (19.2%) were discharged with good neurological outcome (CPC score = 1-2). In the whole cohort, a high serum NSE level was a significant predictor of poor neurological outcome (odds ratio [OR], 1.343; 95% confidence interval [CI], 1.003-1.800, p = 0.048). Among the patients with cardiac arrest, a high serum NSE level was a significant predictor of poor neurological outcome (OR, 1.138; 95% CI, 1.009-1.284, p = 0.036). CONCLUSIONS: In near-hanging patients, a high initial serum NSE level is an independent predictor of poor neurological outcome.

A novel graft preparation technique of the quadriceps tendon for arthroscopic double-bundle anterior cruciate ligament reconstruction.

Surgical reconstruction is a general approach for an anterior cruciate ligament rupture. Techniques have evolved from single-bundle to double-bundle reconstruction to restore the 2 anatomically and functionally different bundles as much as possible. However, there is controversy regarding which method yields superior clinical outcomes. The purpose of this article is to introduce our new graft preparation method, which will potentially address the limitations of currently available double-bundle anterior cruciate ligament reconstruction procedures using the quadriceps tendon. The proximal portion of the graft is preserved in our method, instead of completely being split into 2 distinct graft bundles as previously suggested. We believe that the preserved portion can act as a biofunctional "safety circuit" in case of overloading and also help some synergistic actions of the 2 bundles.

Use of the quadriceps tendon in arthroscopic acetabular labral reconstruction: potential and benefits as an autograft option.

The acetabular labrum serves many integral functions within the hip joint. As a result, novel surgical techniques that aim to preserve or reconstruct the labrum have entered the spotlight. We have performed labral reconstruction using the quadriceps tendon as an autograft for a patient with a moderate labral defect. The purpose of this report is to propose this novel donor site as a viable alternative for labral reconstruction using an autograft; the potential benefits over currently popular methods are discussed.

Soy soluble polysaccharide induces apoptosis in HCT­116 human colon cancer cells via reactive oxygen species generation.

Previous studies have suggested that soy sauce contains specific bioactive components and various biological activities of soy sauce have been observed. Soy soluble polysaccharide (SSPS), a predominant bioactive compound in soy sauce, has numerous pharmacological actions, including anti­inflammatory and immunomodulating activities. In the current study, the apoptotic effects of SSPS were investigated in HCT­116 human colon cancer cells. Treatment with SSPS significantly inhibited cell growth in a concentration­dependent manner by inducing apoptosis but not necrosis. This induction was associated with the generation of reactive oxygen species (ROS), mitochondrial dysfunction, activation of caspases and cleavage of the poly (ADP­ribose) polymerase protein. Induction of apoptotic cell death of HCT­116 cells by SSPS showed a correlation with the downregulation of members of the inhibitor of apoptosis protein family, including X­linked inhibitor of apoptosis protein and antiapoptotic Bcl­2, and upregulation of Bax and Bad. Administration of N­acetyl­L­cysteine, a scavenger of ROS, significantly decreased SSPS­induced apoptosis. These results indicate a critical role of signaling cascades involving a ROS­mediated caspase pathway in the anticancer effects of SSPS.

Piceatannol inhibits mast cell-mediated allergic inflammation.

Piceatannol is a phenolic stilbenoid and a metabolite of resveratrol which is found in red wine. Piceatannol (PIC) commonly exhibits anti-inflammatory, antiplatelet and antiproliferative activity. In the present study, the anti-allergic and anti-inflammatory mechanisms of PIC were investigated by examining the effects of PIC on pro­inflammatory cytokine release and phosphorylation of mitogen-activated protein (MAP) kinases (ERK, JNK and p38) in a human mast cell line. PIC dose-dependently inhibited compound 48/80-induced systemic anaphylaxis and immunoglobulin E-mediated local allergic reactions. PIC reduced the immunoglobulin E (IgE)-mediated local allergic reaction and attenuated histamine release from rat peritoneal mast cells. Histamine and ß-hexosaminidase release was markedly decreased dose-dependently by PIC treatment in RBL-2H3 cells. PIC treatments of HMC-1 cells definitely reduced mRNA expression and the release of the pro­inflammatory cytokines, tumor necrosis factor-α and interleukin-8. MAP kinase phosphorylation was also strongly decreased dose-dependently following PIC treatment. PIC regulated the production of cytokines and histamine in phorbol 12-myristate 13-acetate plus A23187-stimulated mast cells. Thus, PIC may alleviate allergic inflammation and may be a useful therapeutic agent for allergic diseases.

Manganese (II) induces chemical hypoxia by inhibiting HIF-prolyl hydroxylase: implication in manganese-induced pulmonary inflammation.

Manganese (II), a transition metal, causes pulmonary inflammation upon environmental or occupational inhalation in excess. We investigated a potential molecular mechanism underlying manganese-induced pulmonary inflammation. Manganese (II) delayed HIF-1alpha protein disappearance, which occurred by inhibiting HIF-prolyl hydroxylase (HPH), the key enzyme for HIF-1alpha hydroxylation and subsequent von Hippel-Lindau(VHL)-dependent HIF-1alpha degradation. HPH inhibition by manganese (II) was neutralized significantly by elevated dose of iron. Consistent with this, the induction of cellular HIF-1alpha protein by manganese (II) was abolished by pretreatment with iron. Manganese (II) induced the HIF-1 target gene involved in pulmonary inflammation, vascular endothelial growth factor (VEGF), in lung carcinoma cell lines.The induction of VEGF was dependent on HIF-1. Manganese-induced VEGF promoted tube formation of HUVEC. Taken together, these data suggest that HIF-1 may be a potential mediator of manganese-induced pulmonary inflammation.