Validity and reliability of the Korean version of the Digital Burnout Scale.

Objectives: To investigate the factor structure and verify the validity and reliability of the Korean version of the Digital Burnout Scale (DBS) among Generation Z university students. Methodology: The World Health Organization guidelines were employed in the forward and back translation, synthesis, cross-cultural adaptation, and pre-survey phases to result in the Korean version of the DBS. The Korean version was then used to collect data from 330 university students online. Construct, convergent, discriminant, and concurrent validity, and internal consistency were assessed. Findings: The Korean version of the DBS had three subscales (digital aging, digital deprivation, and emotional exhaustion) and included 24 items. The results of the confirmatory factor analysis indicated adequate model fit indices. Convergent, discriminant, and concurrent validity were satisfactory. The Cronbach's ⍺ for the overall scale was 0.95. Conclusion: The Korean version of the DBS has good reliability and validity and can be used as a tool to assess the level of risk of digital burnout and provide appropriate support and intervention. Implications: The Korean version of the DBS will serve as a framework for developing healthy digital education by grasping individual characteristics. Longitudinal research is recommended to identify factors that cause digital usage and burnout for various age groups.

Dynamic Assessment of Modified Quick Sequential Organ Failure Assessment in Acutely Deteriorated Patients with Chronic Liver Disease.

Background/Aims: Quick sequential organ failure assessment (qSOFA) has been suggested to identify those who have poor outcomes in patients with suspected infection. We aimed to evaluate the ability of the modified qSOFA (m-qSOFA) to identify high-risk patients in acutely deteriorated patients with chronic liver disease (CLD), especially acute-on-chronic liver failure (ACLF). Methods: We used the data of both Korean Acute-on-Chronic Liver Failure (KACLiF) and Asian Pacific Association for the Study of the Liver ACLF Research Consortium (AARC) cohorts. qSOFA was modified by replacing the Glasgow Coma Scale with hepatic encephalopathy, and m-qSOFA≥2 was considered high. Results: Patients with high m-qSOFA had a significantly lower 1-month transplant-free survival (TFS) in both cohorts and higher organ failure development in KACLiF than patients with low m-qSOFA (Ps<0.05). Subgroup analysis by ACLF showed that patients with high m-qSOFA had lower TFS than patients with low m-qSOFA. m-qSOFA was an independent prognostic factor (hazard ratios (HR)=2.604, 95% confidence interval (CI) 1.353-5.013, P=0.004 in KACLiF and HR=1.904, 95% CI 1.484-2.442, P<0.001 in AARC). The patients with low m-qSOFA at baseline but high m-qSOFA on the 7th day had a significantly lower 1-month TFS than the patients with high m-qSOFA at baseline but low m-qSOFA on the 7th day (52.6% vs. 89.4%, P<0.001 in KACLiF and 26.9% vs. 61.5%, P<0.001 in AARC). Conclusion: Baseline and dynamic changes in m-qSOFA were useful to identify patients with a high risk of organ failure development and short-term mortality among CLD patients with acute deterioration.

Twenty Years of Progress and the Way Forward: Immunization Registry Information System in Korea.

The National Immunization Program in The Republic of Korea offers mandatory and free vaccinations to children under 12, regulated by the Infectious Disease Prevention and Control Act. Tracking vaccination coverage is crucial for population protection and public health strategies. Since 2002, the Immunization Registry Information System (IRIS) has been used nationwide to capture vaccination data. This study reviewed documents related to IRIS's establishment and development. The Republic of Korea legally supports IRIS's construction and data collection, integrating vaccination data with the Ministry of the Interior and Safety's resident registration to minimize errors. This collaboration also facilitates cost reimbursement and digital registration, promoting wider vaccination coverage. IRIS manages expense claims once vaccination details are logged, and authorized medical institutions can access these records in real-time. Since 2015, the Korea Disease Control and Prevention Agency has been compiling annual data on national vaccination coverage. IRIS also sends automated reminders in 12 languages, reports adverse effects, and issues vaccination certificates. However, IRIS lacks integration between vaccine and disease registries, unlike countries such as England, Denmark, and the Netherlands. Improving integration capabilities could enhance IRIS's support for public health through an integrated information system.

Lagerstroemia macrocarpa extract inhibits Th2-mediated STAT6 signaling pathway in human keratinocytes.

In this study, we examined physiological functions as a key material to develop cosmeceuticals using extracts of Lagerstroemia macrocarpa Wall. Ex Kurz (L. macrocarpa). Initially, the L. macrocarpa extract was treated by different concentration and antioxidant assay (DPPH and ABTS) were performed to measure free radical scavenging ability. In the cytotoxicity experiment, the extract was treated into human epidermal keratinocytes with different concentrations to measure cytotoxicity. We found that the extract induces differentiation markers such as keratin (KRT)1, KRT2, KRT9, KRT10 in keratinocytes. Furthermore, the extract significantly induces involucrin (IVL), loricrin (LOR), claudin1 (CLDN1), and filaggrin (FLG) expression, suggesting that it may enhance skin barrier functions. Especially, the extract restored FLG expression inhibited by interleukin (IL)-4/IL-13 in in vitro atopic dermatitis-like model. Therefore, we expect L. macrocarpa extract will be an effective material to develop the therapeutic and cosmeceutical of atopic dermatitis.

The experience of good mentoring focused on overcoming turnover intention among millennial nurses.

Introduction: Millennials are emerging as a prominent demographic in the nursing workforce. It is necessary to create an environment that harmonizes the advantages of each generation in a nursing workforce in which various generations coexist. As the importance of mentoring programs for millennial nurses grows, it is believed that the effectiveness of mentoring to support millennial nurses can be enhanced by identifying the attributes of good mentors as perceived by nurses. This study aimed to explore the attributes of good mentors according to millennial nurses in the nursing workforce with a focus on overcoming turnover intention problems. Methods: Four focus group interviews were conducted to collect data, which were subsequently analyzed using Braun and Clarke's thematic analysis method. A descriptive qualitative design involving 22 millennial nurses employed at a tertiary hospital, Hospital A, in Seoul, Republic of Korea was utilized. Results and discussion: Four themes emerged from the analysis: the concept of a significant others, the presence of a driving force to endure, the importance of a guide to a harmonious life, and the value of a partner for growth. The participants themselves identified these themes. To prevent turnover intention among millennial nurses, mentors should employ diverse strategies, and institutional supports are crucial. Furthermore, since it is unrealistic to expect all ideal mentor characteristics to be present in one person, mentor development education is also necessary. This information is valuable for designing mentor development programs and for establishing a solid framework for effective mentoring programs.

Associations of anxiety and fatigue with hazardous occupational conditions of Korean nurses in early pregnancy: A cross-sectional study.

AIM: To identify occupational conditions associated with anxiety and fatigue among Korean nurses in early pregnancy. BACKGROUND: Pregnant nurses, like non-pregnant hospital nurses, are exposed to dangerous and stressful work environments, which can affect fatigue and anxiety. DESIGN AND METHODS: This cross-sectional study enrolled 1490 nurses who participated in the early pregnancy module in the Korea Nurses' Health Study between 2014 and 2020. Hierarchical linear regression analyses were employed to identify the factors associated with anxiety and fatigue among nurses in early pregnancy. RESULTS: One-fifth of participants were working night shifts, and more than two-thirds were working overtime. When using antineoplastic drugs and disinfectants, the rate of use of protective equipment varied depending on the size of the hospital. Working overtime and lifting heavy objects were associated with increased anxiety and fatigue among nurses. CONCLUSION: Overtime work was associated with both anxiety and fatigue among pregnant nurses. Pregnant hospital nurses were exposed to both night shift and overtime work. Therefore, hospital managers should improve hazardous working environments to protect the health of nurses in early pregnancy and their fetuses.

Development of an Acute Pain Assessment Tool for Patients in Post-anesthesia Care Units.

BACKGROUND: Post-operative pain is a common form of acute pain. Objective pain assessment in post-anesthesia care units after surgery is useful regardless of the patient's condition. AIMS: This study aimed to develop and evaluate an acute pain assessment tool for patients in post-anesthesia care units. DESIGN: This was a cross-sectional observational study comprising two stages: scale development and psychometric evaluation. SETTINGS:  . PARTICIPANTS/SUBJECTS:  . METHODS: Scale items were developed based on a literature review and content validity by experts. The validity and interrater reliability of the pain scale were evaluated using data from 218 patients admitted to the post-anesthesia care unit at a university hospital. A receiver operating characteristic curve was used to identify the sensitivity and specificity for determining the cutoff point for acute pain. RESULTS: We developed an objective acute pain scale, called the APA5, which ranges from 0-10 and comprises behavioral (facial and verbal expressions and body movement) and physiological (changes in heart rate and blood pressure) responses. The APA5 is valid and reliable for assessing acute pain in the recovery room. Sensitivity and specificity were acceptable when the cutoff was 2 out of 10 points. CONCLUSIONS: The APA5 is an easy and simple tool for measuring pain in patients in post-anesthesia care units who have difficulties with self-reporting.

Validity and reliability of the Korean version of the gender-friendliness barriers in nursing programs scale.

Introduction: The gender-friendliness barriers in nursing programs (GFB-NP) were used to measure perceived gender affinity among male nursing students in nursing education programs. Originally developed in Taiwan, this scale has not been used in Korea. The purpose of this study is to confirm the reliability and validity of the GFB-NP scale for Korean male nursing students. Methods: A convenience sample of male nursing students enrolled in the 1st to 4th year of nursing departments at five four-year universities located in three cities in Korea was used in the study. To confirm the validity and factor structure of the scale, both exploratory factor analysis and confirmatory factor analysis were employed. Results: The results support a four-factor structure: Professional acquisition opportunity, peer interaction, sociocultural prejudice, and gender role attitude. We confirmed that the Korean version of the GFB-NP is an appropriate tool for measuring the gender-friendliness educational environment perceived by male nursing students in nursing education. Discussion: The GFB-NP will serve as a framework for developing counseling and management strategies to help male nursing students successfully adapt to school life within the nursing education curriculum. Research with a longitudinal study design is recommended to investigate the progression of school adaptation through undergraduate program courses.

Development of a scintillator-based optical soft x-ray (OSXR) diagnostic system for KSTAR tokamak.

We have developed a new scintillator-based optical soft x-ray (OSXR) diagnostic system for KSTAR. By utilizing fiber optic faceplates, mm-size lens arrays, and fiber bundles, we have successfully constructed a novel optical system for scintillator-based soft x-ray detection to overcome the limited vacuum-port conditions in KSTAR. P47 (Y2SiO5), which has a fast rise (∼7 ns) and decay (∼100 ns) time sufficient for detecting plasma instabilities observed in the kHz-MHz spectral range, was selected as the scintillator material for the KSTAR OSXR system. Scintillation toward each detection channel is collected by the lens arrays coupled to optical fiber cores, which are connected to the photodetector system. Initial results obtained during the 2022 KSTAR experimental campaign support the validity of the OSXR data through the consistency of OSXR measurement results with other diagnostics. We also observe that the OSXR system can capture magnetohydrodynamic activities, such as sawtooth oscillations, and provide valuable information for disruption mitigation studies using shattered pellet injection.

Quality assessment of systematic reviews with meta-analysis in undergraduate nursing education.

BACKGROUND: Little attention has been given to the methodological quality of meta-analyses in nursing education. This warrants further improvements in meta-analyses in nursing education. OBJECTIVE: This study aimed to assess the methodological quality of meta-analysis in the field of undergraduate nursing education. DESIGN: This was a methodological study to review the methodological quality of systematic reviews (SRs) with meta-analysis. METHODS: Exhaustive literature searches were performed using five comprehensive databases. Between 1994 and 2022, 11,827 studies were identified, and 41 full-text articles met the inclusion criteria. Two researchers extracted data using A Measurement Tool to Assess Systematic Reviews (AMSTAR)-2. The Chi-square test was conducted to make comparisons before and after 2017, the year AMSTAR-2 was released. RESULTS: A comprehensive literature retrieval strategy, inclusion and exclusion criteria, literature selection, and data extraction were observed in nursing education more than in other disciplines. Improvements to be made include pre-specifying the protocol, providing a list of excluded studies with their exclusion reasons, reporting the source of funding for the included studies, assessing and discussing the potential impact of risk of bias, as well as investigating and discussing publication bias and its impact. CONCLUSIONS: The number of SRs with meta-analyses in nursing education is increasing. This warrants efforts to improve the quality of research. In addition, guidelines for reporting SRs in the field of nursing education should be constantly updated.

Patient safety interprofessional education program using medical error scenarios for undergraduate nursing and medical students in Korea.

Interprofessional education (IPE) for patient safety is becoming increasingly important worldwide. However, Korea lacks a systematic approach toward patient safety, despite the high demand for teamwork and patient communication education. This study aims to determine the effectiveness of a patient safety IPE program using medical error scenarios. The program was developed to enhance patient safety motivation and interprofessional learning attitudes among medical and nursing students, and evaluate the design of the program and students' satisfaction levels. The program comprises two modules, each consisting of lectures, team-based case analysis, role-play, and high-fidelity simulation activities. This study followed a quasi-experimental pre-post test design to determine program outcomes. An online survey for the Readiness for Interprofessional Learning Scale (RIPLS), patient safety motivation, program design evaluation, and program satisfaction was conducted before and after the program. Data were analyzed using descriptive statistics, paired sample t-tests, and Pearson's correlation. The pre-post RIPLS and patient safety results were significant (t = -5.21, p < .001;t = -3.20, p = .002). The results of the medical scenario examination of the patient safety IPE program showed improved motivation for patient safety among students, and contributed to the improvement of IPE learning attitudes by improving team work and collaboration.

The SpACE-CCM: A facile and versatile cell culture medium-based biosensor for detection of SARS-CoV-2 spike-ACE2 interaction.

The COVID-19 pandemic is an ongoing global public health threat. COVID-19 is caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection, and binding of the SARS-CoV-2 spike to its receptor, angiotensin-converting enzyme 2 (ACE2), on host cells is critical for viral infection. Here, we developed a luminescent biosensor that readily detects interactions of the spike receptor-binding domain (RBD) and ACE2 in cell culture medium ('SpACE-CCM'), which was based on bimolecular complementation of the split nanoluciferase-fused spike RBD and ectodomain of ACE2 and further engineered to be efficiently secreted from cells by adding a heterologous secretory signal peptide (SSP). Screening of various SSPs identified 'interferon-α+alanine-aspartate' as the SSP that induced the highest activity. The SpACE-CCM biosensor was validated by observing a marked reduction of the activity caused by interaction-defective mutations or in the presence of neutralizing antibodies, recombinant decoy proteins, or peptides. Importantly, the SpACE-CCM biosensor responded well in assay-validating conditions compared with conventional cell lysate-based NanoLuc Binary Technology, indicating its advantage. We further demonstrated the biosensor's versatility by quantitatively detecting neutralizing activity in blood samples from COVID-19 patients and vaccinated individuals, discovering a small molecule interfering with the spike RBD-ACE2 interaction through high-throughput screening, and assessing the cross-reactivity of neutralizing antibodies against SARS-CoV-2 variants. Because the SpACE-CCM is a facile and rapid one-step reaction biosensor that aptly recapitulates the native spike-ACE2 interaction, it would be advantageous in many experimental and clinical applications associated with this interaction.

Quercetin Attenuates the Production of Pro-Inflammatory Cytokines in H292 Human Lung Epithelial Cells Infected with Pseudomonas aeruginosa by Modulating ExoS Production.

The type three secretion system (T3SS) is a major virulence system of Pseudomonas aeruginosa (P. aeruginosa). The effector protein Exotoxin S (ExoS) produced by P. aeruginosa is secreted into the host cells via the T3SS. For the purpose of an experiment on inhibitors with regard to ExoS secretion, we developed a sandwich-type enzyme-linked immunosorbent assay (ELISA) system. Quercetin was selected because it has a prominent ExoS inhibition effect and also is known to have anti-inflammatory and antioxidant effects on mammalian cells. In this study, we investigated the effects of quercetin on the expression and secretion of ExoS using ELISA and Western blot analysis methods. The results showed that the secretion of ExoS was significantly decreased by 10 and 20 µM of quercetin. Also, popB, popD, pscF, and pcrV which are composed of the T3SS needle, are reduced by quercetin at the mRNA level. We also confirmed the inhibitory effect of quercetin on cytokines (IL-6, IL-1ß, and IL-18) in P. aeruginosa-infected H292 cells by real-time polymerase chain reaction (PCR) and ELISA. Collectively, quercetin inhibits the secretion of ExoS by reducing both ExoS production and the expression of the needle protein of T3SS. Furthermore, these results suggest that quercetin has the potential to be used as an anti-toxic treatment for the inflammatory disease caused by P. aeruginosa infection.

Serum S100B Levels in Patients with Liver Cirrhosis and Hepatic Encephalopathy.

Hepatic encephalopathy (HE) is one of the main complications of liver cirrhosis (LC) and is classified into minimal hepatic encephalopathy (MHE) and overt hepatic encephalopathy (overt HE). S100B is expressed mainly in astrocytes and other glial cells, and S100B has been reported to be associated with various neurological disorders. The present study aimed to investigate the diagnostic ability of serum S100B to discriminate the grade of HE and the parameters correlated with serum S100B levels. Additionally, we investigated whether serum S100B levels can be used to predict 1-year mortality in cirrhotic patients. In total, 95 cirrhotic patients were consecutively enrolled and divided into the following three groups: (i) without any types of HEs; (ii) with MHE; and (iii) with overt HE. The diagnosis of MHE was made by the Mini-Mental State Examination (MMSE) and Psychometric Hepatic Encephalopathy Score (PHES). Among the three groups, there were no significant differences in serum S100B levels regardless of HE severity. The clinical parameters correlated with serum S100B levels were age, serum bilirubin, and creatinine levels. The Model for End-Stage Liver Disease (MELD) score showed a significant positive correlation with serum S100B levels. The relationship between serum S100B levels and MELD score was maintained in 48 patients without any type of HE. Additionally, hyperammonemia, low cholesterol levels, and the combination of serum S100B levels ≥ 35 pg/mL with MELD score ≥ 13 were factors for predicting 1- year mortality. In conclusion, serum S100B level was not useful for differentiating the severity of HE. However, we found that serum S100B levels can be affected by age, serum bilirubin, and creatinine in cirrhotic patients and are associated with MELD scores. Additionally, serum S100B levels showed the possibility of predicting 1-year mortality in cirrhotic patients. These findings suggest that serum S100B levels may reflect liver dysfunction and prognosis in liver disease.

A Double-Blind, Randomized, Placebo-Controlled, Phase II Clinical Study To Evaluate the Efficacy and Safety of Camostat Mesylate (DWJ1248) in Adult Patients with Mild to Moderate COVID-19.

Although several antiviral agents have become available for coronavirus disease 2019 (COVID-19) treatment, oral drugs are still limited. Camostat mesylate, an orally bioavailable serine protease inhibitor, has been used to treat chronic pancreatitis in South Korea, and it has an in vitro inhibitory potential against severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). This study was a double-blind, randomized, placebo-controlled, multicenter, phase 2 clinical trial in mild to moderate COVID-19 patients. We randomly assigned patients to receive either camostat mesylate (DWJ1248) or placebo orally for 14 days. The primary endpoint was time to clinical improvement of subject symptoms within 14 days, measured using a subjective 4-point Likert scale. Three hundred forty-two patients were randomized. The primary endpoint was nonsignificant, where the median times to clinical improvement were 7 and 8 days in the camostat mesylate group and the placebo group, respectively (hazard ratio [HR] = 1.09; 95% confidence interval [CI], 0.84 to 1.43; P = 0.50). A post hoc analysis showed that the difference was greatest at day 7, without reaching significance. In the high-risk group, the proportions of patients with clinical improvement up to 7 days were 45.8% (50/109) in the camostat group and 38.4% (40/104) in the placebo group (odds ratio [OR] = 1.33; 95% CI, 0.77 to 2.31; P = 0.31); the ordinal scale score at day 7 improved in 20.0% (18/90) of the camostat group and 13.3% (12/90) of the placebo group (OR = 1.68; 95% CI, 0.75 to 3.78; P = 0.21). Adverse events were similar in the two groups. Camostat mesylate was safe in the treatment of COVID-19. Although this study did not show clinical benefit in patients with mild to moderate COVID-19, further clinical studies for high-risk patients are needed. (This trial was registered with ClinicalTrials.gov under registration no. NCT04521296).

Role of alcohol media literacy in alcohol use among children and adolescents: a systematic review.

Enhancing alcohol media literacy (AML) is a critical strategy to attenuate negative effects of alcohol-related media messages. We aimed to systematically review previous studies on AML in children and adolescents. Through database and hand searches, we identified four non-experimental and 13 experimental studies. From the 17 studies, we extracted data on theoretical framework, AML measures, intervention contents and main findings. Our review revealed the following. First, nine and four studies used a single theory and at least two theories, respectively. The most frequently used theory was the Message Interpretation Process model. Second, 13 studies assessed AML using participant self-reporting or evaluators' ratings of participant performance, but no study reported validities of AML measures. Eight studies assessed tobacco or general media literacy as well as AML. Third, all experimental studies used three to five media literacy core concepts proposed by the Center for Media Literacy in AML interventions. Finally, all non-experimental studies found strong cross-sectional associations between higher AML and improved drinking outcomes; all experimental studies found strong intervention effects, such as an increase in AML or improvement in drinking outcomes. In addition, intervention effects differed across participants' gender and drinking experiences. Given our review, health professionals should implement strategies to enhance children and adolescents' AML. Future research should investigate (i) causal inferences in non-experimental studies, (ii) long-term intervention effects in experimental studies and (iii) differences in intervention effects across participants' characteristics, while using solid theoretical frameworks and multidimensional AML concepts.

Currently, alcohol consumption and great exposure to alcohol-related media messages in youth are significant public health concerns. After systematically reviewing non-experimental studies on alcohol media literacy (AML) in children and adolescents, we found that high AML levels were associated with improved drinking-related characteristics: a decrease in positive alcohol expectancies, intention to drink and risk of alcohol consumption. Additionally, we found that AML education targeting children and adolescents was effective in enhancing AML and improving the aforementioned drinking-related characteristics. Given our findings, we strongly recommend providing AML education to children and adolescents in order to attenuate negative effects of alcohol-related media messages on drinking-related characteristics.

Insight into the Economic Effects of a Severe Korean PRRSV1 Outbreak in a Farrow-to-Nursery Farm.

Porcine reproductive and respiratory syndrome (PRRS) is a disease that has inflicted economic losses in the swine industry. The causative agent, porcine reproductive and respiratory syndrome virus (PRRSV), is known to have a high genetic diversity which leads to heterogeneous pathogenicity. To date, the impact of PRRS outbreaks on swine production and the economy of the swine industry in South Korea has been rarely reported. In this study, we compare the reproductive performance in the breeding-farrowing phase and growth performance in the nursery phase, in two 27-week periods, one before and one after a PRRSV1 outbreak on a 650-sow farrow-to-nursery farm caused by a Korean PRRSV1 isolate which was genetically distinct from vaccine strains or other global strains. The reproductive performance of sows and the growth performance of nursery pigs were compared using row data consisting of 1907 mating records, 1648 farrowing records, and 17,129 weaning records from 32 breeding batches. The following variables were significantly different between the pre-PRRS outbreak period and the post-PRRS outbreak period: the farrowing rate (−7.1%, p < 0.0001), the abortion rate (+3.9%, p < 0.0001), the return rate (+2.9%, p = 0.0250), weaning to estrus interval days (+1.9 days, p < 0.0001), total piglets born (−1.2 pigs/litter, p < 0.0001), piglets born alive (−2.2 pigs/litter, p < 0.0001), weaned piglets (−2.7 pigs/litter, p < 0.0001), pre-weaning mortality (+7.4%, p < 0.0001), weaning weight (−0.9 kg/pig, p = 0.0015), the mortality rate (+2.8%, p < 0.0001), average daily gain (−69.8 g/d, p < 0.0001), and the feed conversion ratio (+0.26, p = 0.0036). Economic losses for a period of 27 weeks after a PRRS outbreak were calculated at KRW 99,378 (USD 82.8) per mated female for the breeding-farrowing phase, KRW 8,968 (USD 7.5) per pig for the nursery growth phase, and KRW 245,174 (USD 204.3) per sow in the post-outbreak period. In conclusion, the farrow-to-nursery farm in our study suffered extensive production and economic losses as a result of a PRRSV1 outbreak.

Comparison of 6-Month and Prolonged Dual Antiplatelet Therapy after Percutaneous Coronary Intervention with Biodegradable Polymer Everolimus-Eluting Stent.

Background: The optimal duration of dual antiplatelet therapy (DAPT) after biodegradable-polymer (BP) everolimus-eluting stent (EES) implantation remains uncertain. Methods: This study analyzed 793 patients who underwent percutaneous coronary intervention (PCI) with BP-EES in 10 cardiovascular centers in Korea between July 2016 and January 2018. Using the prescription data at 6 months post-PCI, we divided these patients into two groups, namely, short-DAPT and prolonged-DAPT groups, which underwent DAPT for 6 and > 6 months of PCI, respectively. The primary endpoint, which included mortality, myocardial infarction, or target-vessel revascularization at 2 years, was compared by propensity score (PS) matching between the two groups. Results: Out of the 793 patients, 283 matched pairs were identified by PS matching. Out of this matched population, 405 (71.6%) patients had an acute coronary syndrome. The primary endpoint did not differ in 2 years between the short-DAPT and prolonged-DAPT groups (7.5% vs. 8.3%; hazard ratio, 0.87; 95% confidential interval, 0.47-1.60; P = 0.648). Likewise, no difference was found regarding mortality, cardiac mortality, myocardial infarction, target-lesion failure, target-vessel failure, and bleeding events defined by the Bleeding Academic Research Consortium and Thrombolysis In the Myocardial Infarction classification. Meanwhile, one patient in the short-DAPT group had definite stent thrombosis at 364 days post-PCI. Subgroup analysis showed that several anatomical and procedural factors were not significantly related to DAPT duration. Most patients (77.4%) in both groups were prescribed clopidogrel at discharge. Conclusions: In real-world patients undergoing PCI with BP-EES, the ischemic and bleeding endpoints demonstrated no difference between 6-month and prolonged (>6 months) DAPT.

Platelet-to-White Blood Cell Ratio: A Feasible Biomarker for Pyogenic Liver Abscess.

The platelet-to-white blood cell ratio (PWR) has been reported to predict the severity of patients with various diseases. However, no previous studies have assessed the use of the PWR as a prognostic marker for pyogenic liver abscesses (PLA). This observational retrospective study was performed between January 2008 and December 2017, including 833 patients with PLA from multiple centers. The enrolled patients, on average, had a PWR of 17.05, and 416 patients had a PWR lower than 17.05. A total of 260 patients (31.2%) with PLA showed complications of metastatic infection, pleural effusion and abscess rupture. A low PWR level was identified as a strong risk factor for metastatic infection and pleural effusion. The low PWR group also had a longer hospital stay. In the multivariate analysis, old age, anemia, albumin and CRP levels and unidentified pathogens were significant factors for low PWR levels. A low PWR, old age, male sex, abscess size, albumin, ALP and unidentified causative pathogens showed significant associations with a hospital stay longer than 28 days. As a result, PLA patients presenting with a low PWR were shown to have more complications and a poor prognosis. Considering its cost-effectiveness, PWR could be a novel biomarker used to predict a prognosis of PLA.