Daejeon University

ObjectiveObesity is a major modifiable risk factor for cardiovascular disease. We evaluated whether multi-organ dysfunction trajectories for major adverse cardiovascular events (MACE) using clinically defined obesity classification improves risk discrimination compared with BMI-based categories.MethodsWe analyzed 457,675 UK Biobank participants. BMI-based categories were defined using ethnicity-specific thresholds. Clinically defined obesity was classified as no, preclinical (excess adiposity without organ dysfunction), or clinical obesity (excess adiposity with ≥1 obesity-related organ dysfunction). Organ dysfunction trajectories were constructed over consecutive 2-year periods beginning 2 years after baseline: (1) status (no, period 1 only, period 2 only, persistent organ dysfunctions) and (2) change (no, increase, decrease, persistent organ dysfunctions). Incident MACE was defined as a composite of ischemic heart disease, stroke, and fatal cardiovascular disease. Participants were followed until the first occurrence of incident MACE, death, 10 years after the index date, or the end of follow up, whichever came first. Cox models estimated adjusted hazard ratio (aHR).ResultsAcross status trajectories, MACE risk increased in a graded response from no dysfunction to persistent dysfunction under both obesity definitions. Within trajectories, clinical obesity showed the highest risk under the clinically defined definition (clinical vs no obesity: no dysfunction aHR 2.03, 95% CI 1.96–2.11; persistent dysfunction aHR 1.61, 95% CI 1.30–2.01), whereas underweight showed the highest risk under BMI categories (underweight vs normal: no dysfunction aHR 1.83, 95% CI 1.62–2.07; persistent dysfunction aHR 2.19, 95% CI 1.32–3.63). The 10-year cumulative incidence of MACE within persistent dysfunction increased monotonically across clinically defined categories (~24% in clinical obesity), while BMI-based categories peaked in the overweight (~20%).ConclusionsMulti-organ dysfunction trajectories were strongly associated with incident MACE, having persistent dysfunction as the highest risk. Clinically defined obesity provided more monotonic, graded risk across trajectories than BMI, which were susceptible to reverse causation. Incorporating clinical obesity definitions with longitudinal dysfunction assessment may improve cardiovascular risk stratification.

Depression, a mood disorder characterized by persistent negative emotions and impaired functioning, is associated with dysregulation of the hypothalamic-pituitary-adrenal (HPA) axis and glucocorticoid receptor (GR) dysfunction. Aurantii Fructus Immaturus (AFI), the immature fruit of Citrus aurantium Linné, has been used in East Asian herbal medicine, and neohesperidin (NHD), a principal constituent of AFI, has been studied for its antidepressant properties. This study aimed to elucidate the mechanisms underlying the antidepressant effects of NHD, focusing on its ability to enhance GR expression and activity, thereby normalizing HPA axis function and mitigating neuroinflammation. AFI extract and its component NHD ameliorated depression-like behaviors in chronic restraint stress mice with normalized plasma corticosterone (CORT) levels. Moreover, NHD treatment reduced hippocampal expression of proinflammatory cytokine genes (TNFA, IL6, IL1A, and IL1B) while enhancing GR expression, particularly the NR3C1 exon 17 and 110 variants homologous to human GR variants implicated in depression. In cultured cells, NHD not only reversed CORT-induced neurite atrophy in N2a cells but also suppressed lipopolysaccharide-induced cytokine release in BV2 microglia. Notably, gene silencing of the GR via siRNA abrogated these neuritogenic and antineuroinflammatory effects, demonstrating that NHD exerts its antidepressant and neuroinflammation-suppressive actions in a GR-dependent manner. These findings suggest a promising therapeutic potential for AFI and NHD in stress-related depressive disorders, offering a multi-target approach that addresses both stress response and neuroinflammation through modulation of GR expression.

Prior research consistently reports differences in mental health outcomes among adolescents between intact and non-intact families, highlighting the need to address these disparities. This study aims to investigate the moderating effect of advisers (counselors, teachers, or friends) on the mental health of adolescents from non-intact families. We conducted a cross-sectional study using data from the 2017 Korea Youth Risk Behavior Web-Based Survey, a large, representative nationwide sample of adolescents. We included 61,572 middle and high school students living with at least one parent, categorizing them into five groups: biological parents, single parent (only father or mother), stepfather-biological mother, and biological father-stepmother. We assessed mental health outcomes (poor self-rated health status, self-rated unhappiness, depressive mood, suicidal consideration, suicidal planning, and suicidal attempt) using self-reported measures and evaluated the presence of advisers providing emotional support. Multivariate-adjusted logistic regression analyses were performed to examine associations between family structure and mental health outcomes, and to assess the moderating effect of advisers. Compared to adolescents living with both biological parents, those from non-intact families exhibited significantly higher odds of poor mental health outcomes. While adviser presence was associated with lower odds of adverse outcomes across most family structures, formal tests of interaction were not statistically significant. Our findings suggest that family structure is associated with adolescent mental health, and that adviser presence is generally linked to more favorable outcomes. Although formal interaction tests did not demonstrate statistically significant moderation, the consistent patterns observed across groups highlight the potential value of adviser support. These findings should be interpreted with caution, yet they underscore the importance of promoting access to trusted advisers as a practical strategy to support adolescents, particularly those from non-intact families.

Managed Aquifer Recharge (MAR) has been increasingly recognized as a sustainable groundwater management strategy, but its operational sustainability is often constrained by clogging. This study evaluated clogging mechanisms at a field-scale MAR test site in Hongseong, Korea, by integrating injection tests, physicochemical analyses, thermodynamic modeling, and mineralogical characterization. During approximately 2.7 months of injection, injectivity remained generally stable and no severe clogging was observed, although partial declines occurred under prolonged quasi-steady conditions. Pre-treatment of recharge water substantially improved the Modified Fouling Index from 104.4 to 18.3 s/L2, yielding clogging velocities of 0.007–0.039 m/year near the well screen, indicative of slow clogging progression. Turbidity and fine particles (1–3 μm) were markedly reduced by pre-treatment, though localized mobilization of fines occurred in coarser sediments. Concentrations of Na+, K+, Cl−, and HCO3− decreased due to dilution, whereas and NO3− temporarily increased from nitrate input before declining through denitrification. SAR values (≤ 0.82) and sodium percentages (≤ 35.7