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A Mobile App for Comprehensive Symptom Management in People With Parkinson’s Disease: A Pilot Usability Study

imageThere is an increasing need for highly accessible health management platforms for comprehensive symptoms of Parkinson disease. Mobile apps encompassing nonmotor symptoms have been rarely developed since these symptoms are often subjective and difficult to reflect what individuals actually experience. The study developed an app for comprehensive symptom management and evaluated its usability and feasibility. A single-group repeated measurement experimental design was used. Twenty-two participants used the app for 6 weeks. Monitoring of nonmotor symptoms, games to address motor symptoms, and medication management were incorporated in the app. Quantitative outcomes were self-assessed through an online questionnaire, and one-on-one telephone interviews were conducted to understand the user's point of view. The successful experience of self-monitoring had improved participants' self-efficacy (Z = −3.634, P

Post‐acute COVID‐19 syndrome in previously hospitalized patients

Abstract

Introduction

With the prolongation of the COVID-19 pandemic, more individuals are experiencing sequelae after COVID-19 infection, also known as post-acute COVID-19 syndrome (PCS). The aims of this study were to describe the prevalence and characteristics of PCS symptoms such as fatigue, anxiety, and depression and to compare these symptoms according to participant characteristics in patients who had been previously hospitalized due to COVID-19.

Design

A descriptive cross-sectional study design was used.

Methods

We included 114 individuals who had been hospitalized for COVID-19 and were discharged from the hospital at least 4 weeks before. Symptoms were assessed using the Fatigue Severity Scale, the Hospital Anxiety-Depression Scale, and the PCS symptom questionnaire developed by the authors. We used descriptive statistics, the Student's t-test, the Wilcoxon rank-sum test, and the Kruskal–Wallis test for statistical analyses.

Results

The most prevalent symptoms were anxiety (66.7%), fatigue (64.0%), headache (57.9%), and concentration or memory difficulties (57.9%). Concentration or memory difficulties and sleep disturbances had the highest mean frequency. Concentration or memory difficulties were rated with the highest mean severity, and cough, loss of taste, and muscle and joint pain had the highest mean distress scores. Female participants, individuals hospitalized for more than 2 weeks, individuals discharged more than 9 months ago, unvaccinated patients, and those who tried at least one symptom relief method reported higher symptom distress.

Conclusion

The findings of this investigation into the frequency, severity, and distress of symptoms shed light on the identification of post-COVID symptoms in detail. To objectively evaluate and comprehend the symptom trajectories of PCS, prospective studies about the development of symptom assessment tools and studies with a longitudinal design should be conducted.

Clinical Relevance

A substantial number of respondents reported numerous symptoms and expressed symptom distress; therefore, the development of nursing interventions and treatments to alleviate PCS symptoms is crucial.

Daily life activities of young adults with obesity living in highly accessible and compact urban environments in Seoul, South Korea: a spatiotemporal qualitative study protocol

Por: Kim · D. H. · Lee · E. H. L. · Jeong · J. Y. · Lee · J. · Yoo · S.
Introduction

Amid the growing global concern about obesity, young adults in South Korea are particularly affected, with 30.8% of people aged 19–34 classified as obese. Given the urban-centric lifestyle of Korean youth, understanding the relationship between daily life activities and the urban environment holds great promise for effective interventions. This study aims to explore the daily life activities of young adults with obesity in Seoul, a city known for its highly accessible and compact environment. The research questions explore the interaction between daily life activities and the neighbourhood environment and consider weight management in an urban context.

Methods and analysis

This study uses an extended qualitative geographic information system approach to explore a district in Seoul with a highly accessible and compact urban environment. The sample comprises young adults with obesity (aged 19–34) residing in the study area, with recruitment targeting up to 51 participants for data saturation. A qualitative, multimethod approach combines descriptive and spatiotemporal data collection. Descriptive data are being collected, including in-depth interviews and photographs of daily food consumption. Spatial data collection involves field observations, cognitive mapping and mobile Global Positioning System tracking. Temporal data is gathered through participants drawing round timetables, detailing their daily schedules. Data analysis will entail thematic analysis of the interview data and content analysis of the spatiotemporal data. For the integrated analysis, pattern finding will be used to synthesise the data.

Ethics and dissemination

This study was approved by the institutional review board of Seoul National University on 11 July 2022. Data collection and curation are currently underway, and the results of the analysis will be shared with the scientific community at international conferences and peer-reviewed journals. We are planning an open seminar to share our research findings with relevant policy-makers, community organisations and health professionals.

Understanding global research trends in the control and prevention of infectious diseases for children: Insights from text mining and topic modeling

Abstract

Introduction

The emergence of novel infectious diseases has amplified the urgent need for effective prevention strategies, especially ones targeting vulnerable populations such as children. Factors such as the high incidence of both emerging and existing infectious diseases, delays in vaccinations, and routine exposure in communal settings heighten children's susceptibility to infections. Despite this pressing need, a comprehensive exploration of research trends in this domain remains lacking. This study aims to address this gap by employing text mining and modeling techniques to conduct a comprehensive analysis of the existing literature, thereby identifying emerging research trends in infectious disease prevention among children.

Methods

A cross-sectional text mining approach was adopted, focusing on journal articles published between January 1, 2003, and August 31, 2022. These articles, related to infectious disease prevention in children, were sourced from databases such as PubMed, CINAHL, MEDLINE (Ovid), Scopus, and Korean RISS. The data underwent preprocessing using the Natural Language Toolkit (NLTK) in Python, with a semantic network analysis and topic modeling conducted using R software.

Results

The final dataset comprised 509 journal articles extracted from multiple databases. The study began with a word frequency analysis to pinpoint relevant themes, subsequently visualized through a word cloud. Dominant terms encompassed “vaccination,” “adolescent,” “infant,” “parent,” “family,” “school,” “country,” “household,” “community,” “HIV,” “HPV,” “COVID-19,” “influenza,” and “diarrhea.” The semantic analysis identified “age” as a key term across infection, control, and intervention discussions. Notably, the relationship between “hand” and “handwashing” was prominent, especially in educational contexts linked with “school” and “absence.” Latent Dirichlet Allocation (LDA) topic modeling further delineated seven topics related to infectious disease prevention for children, encompassing (1) educational programs, (2) vaccination efforts, (3) family-level responses, (4) care for immunocompromised individuals, (5) country-specific responses, (6) school-based strategies, and (7) persistent threats from established infectious diseases.

Conclusion

The study emphasizes the indispensable role of personalized interventions tailored for various child demographics, highlighting the pivotal contributions of both parental guidance and school participation.

Clinical Relevance

The study provides insights into the complex public health challenges associated with preventing and managing infectious diseases in children. The insights derived could inform the formulation of evidence-based public health policies, steering practical interventions and fostering interdisciplinary synergy for holistic prevention strategies.

Neural processing of prototypicality and simplicity of product design in forming design preferences

by Erin Cho, Shin-Ae Yoon, Hae-Jeong Park

The current study investigates the neural correlates when processing prototypicality and simplicity—affecting the preference of product design. Despite its significance, not much is known about how our brain processes these visual qualities of design when forming design preferences. We posit that, although fluency is the perceptual judgment accounting for the positive effects of both prototypicality and simplicity on design preference, the neural substrates for the fluency judgment associated with prototypicality would differ from those associated with simplicity. To investigate these issues, we conducted an fMRI study of preference decisions for actual product designs with different levels of prototypicality and simplicity. The results show a significant functional gradient between the preference processing of simplicity and prototypicality–i.e., involvement of the early ventral stream of visual information processing for simplicity evaluation but recruitment of the late ventral stream and parietal-frontal brain regions for prototypicality evaluation. The interaction between the simplicity and prototypicality evaluations was found in the extrastriate cortex in the right hemisphere. The segregated brain involvements suggest that the fluency judgment for prototypicality and simplicity contribute to preference choice in different levels of cognitive hierarchy in the perceptual mechanism of the design preference.

Expectations and concerns about transitioning to face-to-face learning among Korean nursing students: A mixed methods study

by Hyeongsuk Lee, Hye Jin Yoo

Owing to the coronavirus disease pandemic, nursing education materials were developed for online use. However, as nursing involves working with human beings, the experience of face-to-face learning is important. This study investigated the learning satisfaction and anxiety experienced by nursing students based on their learning methods, expectations, and concerns about transitioning entirely to face-to-face learning. Using a mixed-methods design, 120 and 14 third- and fourth-year nursing students in Korea completed an online survey and individual interviews, respectively. Data were collected from July to August 2022 to assess nursing students’ learning satisfaction, anxiety, expectations, and concerns based on their learning method. Learning satisfaction was 3.96±0.68 out of 5; the students who experienced “online lectures only” had significantly higher overall satisfaction (F = 3.22, p = .002), nursing lectures satisfaction (F = 2.01, p = .046), and nursing practicum satisfaction (F = 2.19, p = .031). Anxiety was measured using the Generalized Anxiety Disorder-7 tool and was evaluated at the “minimal level,” with an average score of 3.46 ± 4.80 out of 21. From the qualitative results obtained through interviews, we derived three categories and nine subcategories. These categories include: the burden of unfamiliar learning situations that are difficult to predict, considerations about face-to-face learning needed to improve learning satisfaction, and the turning point that offsets the sense of deprivation during college life. The qualitative results provided evidence for determining specific goals for face-to-face learning that reflected the opinions of nursing students. To successfully transition to face-to-face learning, it is essential to consider a combination of student efforts, professors’ attention, and university-level support to develop a learning approach that combines the strengths of both online and face-to-face learning. Maximizing the benefits of online learning, such as integrating face-to-face and online learning through repetitive reviews of recorded videos of face-to-face sessions at their own time, can effectively reduce students’ burdens and anxiety and increase their learning satisfaction.

Spousal support, parent–nurse partnership and caregiver burden among parents of children with chronic diseases: A cross‐sectional study

Abstract

Aim

To examine the effects of spousal support and parent–nurse partnership on caregiver burden of parents of children with chronic disease.

Background

With the trend of increasing the global number of children with chronic diseases, the parental caregiver burden has become increasingly prevalent.

Design

Cross-sectional study.

Methods

The study participants included 115 parents of children diagnosed with chronic disease at a general hospital in South Korea. The study duration was 4 June 2021–30 April 2022. Self-reported measures included the parent–nurse partnership scale, the Korean version of the Parenting Alliance Inventory and the family caregiver burden scale. T-tests, ANOVA, Pearson's correlation coefficients and hierarchical linear multiple regression were conducted using IBM SPSS version 26.0. This study followed STROBE guideline.

Results

Parental caregiver burden was significantly negatively associated with spousal support and parent–nurse partnership. Factors significantly influencing caregiver burden were parental alcohol consumption; child's inherited metabolic disease, cardiovascular disease, disease relating to haematological tumours or kidney disease diagnosis; child's health perceived as poor by parents; child's dependency perceived as high by parents; hospitalization recency; and low spousal support. These factors accounted for 65% of caregiver burden.

Conclusion

Parental caregiver burden was related to spousal support and parent–nurse partnership, but the primary factor affecting caregiver burden was spousal support.

Relevance to clinical practice

The results highlighted the role of healthcare professionals in educating parents of children with chronic diseases to facilitate spousal support and have implications for nursing and community-based interventions to reduce parental caregiver burden. Furthermore, they underlined that policymakers and other stakeholders should pay attention to the parental caregiver burden through government-based, family-centered strategies.

Patient or public contribution

Parents of children with chronic disease were recruited to perform the self-administered survey in the phase of data collection.

Efficacy of preoperative lymphoscintigraphy in predicting surgical outcomes of lymphaticovenous anastomosis in lower extremity lymphedema: Clinical correlations in gynecological cancer-related lymphedema

by Min Young Yoo, Kyong-Je Woo, Seo Young Kang, Byung Seok Moon, Bom Sahn Kim, Hai-Jeon Yoon

Background

Lymphaticovenous anastomosis (LVA) is a promising microsurgical treatment for lower extremity lymphedema (LEL). Lymphoscintigraphy effectively assesses lower limb lymphatic systems before LVA, but its role in predicting the therapeutic outcomes of LVA is indeterminate. In this study we investigate the efficacy of preoperative lymphoscintigraphy using clinical findings to predict outcomes in gynecological cancer-related LEL patients who underwent LVA.

Methods

A retrospective review was conducted on consecutive gynecological cancer patients with LEL who had undergone LVA between June 2018 and June 2021. The therapeutic efficacy was assessed by measuring the change rate of the lower extremity lymphedema index (LELi) six months after surgery. Clinical data and lymphoscintigraphic findings were analyzed to assess therapeutic efficacy of LVA.

Results

Out of the 60 evaluated legs, 83.3% of the legs showed improved results after LVA. Univariable linear regression analysis revealed that higher preoperative LELi, and ovarian cancer were associated with superior LELi change rate (LC rate). Absence of dermal backflow (DBF) on lymphoscintigraphy was associated with inferior LC rate. Multivariable linear regression analysis identified ovarian cancer and higher preoperative LELi were independently correlated with favorable outcomes, while the absence of DBF was independently correlated with inferior outcomes.

Conclusion

The results of this study emphasizes the effectiveness of preoperative lymphoscintigraphy, preoperative LELi, and primary malignancy as predictors of LVA outcomes in gynecological cancer-related LEL patients.

Disparities of health expenditure associated with the experience of admission in long-term care hospital among patients with colorectal cancer in South Korea: A generalized estimating equation

by Woo-Ri Lee, Noorhee Son, Ki-Bong Yoo, Kyu-Tae Han

With rising concerns about the functional role of long-term care hospitals in the Korean medical system, this study aimed to observe the experience of admission in the long-term care hospitals and their association with medical expenditures among patients with colorectal cancer, and to investigate disparities among vulnerable populations. Data were obtained from the National Health Insurance Senior Cohort Database in South Korea for the period 2008–2019. With 6,305 patients newly diagnosed with colorectal cancer between 2008 and 2015, we conducted a regression analysis using the Generalized Estimating Equation model with gamma distribution to investigate the association between health expenditure and the experience of long-term care hospitals. We also explored the interaction effect of disability or income, followed by subgroup analysis. Among patients who received care at long-term care hospitals, the health expenditure within one year and five years after the incidence of colorectal cancer was found to be higher than in those who did not receive such care. It was observed that the low-income and disabled groups experienced higher disparities in health expenditure. The rise in health expenditure highlights importance for functional improvement, aligning with these initial purpose of long-term care hospitals to address the growing healthcare needs of the elderly population and ensure efficient healthcare spending, of long-term care hospitals. To achieve this original intent, it is imperative for government initiatives to focus on reducing quality gaps in long-term care hospital services and addressing cost disparities among individuals with cancer, including those with disabilities or low-income.

Providing a comprehensive approach to oil well blowout risk assessment

by Mostafa Satiarvand, Neda Orak, Katayoon Varshosaz, Elham Mobarak Hassan, Mahboobeh Cheraghi

Drilling is one of the most dangerous activities in the oil and gas process industries. Therefore, a holistic approach was presented to prevent and control risks and reduce the uncertainty of blowouts, kick scenarios, and control layers based on the Fuzzy Bayesian Network (FBN). Four independent protection layers (IPLs) were used to evaluate the blowout outcome, and the failure probabilities of IPL1 and IPL2 were calculated with Fault Tree Analysis (FTA). Then, different events were transferred to the Bayesian Network (BN) in GeNIe software, and updated the probabilities. The Fuzzy Fault Tree (FFT) results reveal that the failure probabilities for IPL1 and IPL2 amount to 8.94×10−4 and 4.97×10−21, respectively. Also, the blowout probability results based on FFT were larger than FBN. According to FBN, the probability of the kick event was equal to 6.60×10−34. Sensitivity analysis showed that X1 (Mud volume/flow change) had the highest degree of importance in the blowout of oil wells. The results of this study can be used in both a preventive and reactive approach. Deductive and inductive reasoning, the dynamic nature and conditional dependencies, and causal relationships between events can make the model more realistic.

Changes in life satisfaction among middle-aged adults living alone over a 12-year span

by Jaehee Yoon, Jeewuan Kim, Joohyun Chung, Heesook Son

This secondary analysis used data collected for the Korean Longitudinal Study of Aging from 2006 to 2018 to examine changes in life satisfaction among middle-aged adults living alone in South Korea. Individuals who were over 45 years of age, lived alone at the time of the first data collection wave, and responded at least twice to the survey over the 12-year study period were included in the final linear mixed model (N = 124). Life satisfaction increased for those who had increased assets, were widowed, and had more frequent contact with acquaintances (i.e., once a month and once a week compared with once a year). Life satisfaction decreased as the number of chronic illnesses increased for underweight individuals compared with normal weight or overweight individuals and for depressed versus non-depressed individuals. This study’s findings indicate that increased social support is beneficial for middle-aged marginalized individuals, including those who are economically disadvantaged, have few social interactions, are underweight, and have chronic illnesses.

Ischaemic stroke in patients with diabetes requiring urgent procedures during the COVID-19 pandemic in South Korea: a retrospective, nationwide, population-based cohort study using data from the National Emergency Department Information System

Por: Park · M. J. · Hwang · J. · Ahn · J. · Park · S. J. · Song · E. · Jang · A. · Choi · K. M. · Baik · S. H. · Yoo · H. J.
Objectives

The COVID-19 pandemic resulted in suboptimal care for ischaemic stroke. Patients with diabetes mellitus (DM), a high-risk group for stroke, had compromised routine care during the pandemic, which increases the chance of stroke. We examined influence of the COVID-19 pandemic on the management of ischaemic stroke in patients with DM in South Korea.

Design

Retrospective, nationwide, population-based cohort study.

Setting

Data from the National Emergency Department Information System.

Participants

We analysed 11 734 patients diagnosed with acute ischaemic stroke who underwent intravenous thrombolysis or endovascular thrombectomy between 2019 (the reference year) and 2020 (the pandemic year). Among them, 1014 subjects with DM were analysed separately.

Outcome measures

The frequency of emergency department (ED) visits, time from symptom onset to ED, from ED visit to admission and in-hospital mortality were compared between two periods in the overall population and in patients with DM.

Results

During the pandemic, the incidence of ischaemic stroke requiring urgent procedures increased by 7.57% in total and by 9.03% in patients with DM. Time delay from symptom onset to ED (reference vs pandemic, total: 1.50 vs 1.55 hours; p

Conclusions

During the COVID-19 pandemic, the incidence of ischaemic stroke requiring urgent procedures increased, and older patients with DM showed a higher ICU admission rate. However, the pandemic was not associated with an increased in-hospital stroke mortality.

Test negative case-control study of COVID-19 vaccine effectiveness for symptomatic SARS-CoV-2 infection among healthcare workers: Zambia, 2021-2022

Por: Mweso · O. · Simwanza · J. · Malambo · W. · Banda · D. · Fwoloshi · S. · Sinyange · N. · Yoo · Y. M. · Feldstein · L. R. · Kapina · M. · Mulenga · L. B. · Liwewe · M. M. · Musonda · K. · Kapata · N. · Mwansa · F. D. · Agolory · S. · Bobo · P. · Hines · J. · Chilengi · R.
Objectives

The study aim was to evaluate vaccine effectiveness (VE) of COVID-19 vaccines in preventing symptomatic COVID-19 among healthcare workers (HCWs) in Zambia. We sought to answer the question, ‘What is the vaccine effectiveness of a complete schedule of the SARS-CoV-2 vaccine in preventing symptomatic COVID-19 among HCWs in Zambia?’

Design/setting

We conducted a test-negative case–control study among HCWs across different levels of health facilities in Zambia offering point of care testing for COVID-19 from May 2021 to March 2022.

Participants

1767 participants entered the study and completed it. Cases were HCWs with laboratory-confirmed SARS-CoV-2 and controls were HCWs who tested SARS-CoV-2 negative. Consented HCWs with documented history of vaccination for COVID-19 (vaccinated HCWs only) were included in the study. HCWs with unknown test results and unknown vaccination status, were excluded.

Primary and secondary outcome measures

The primary outcome was VE among symptomatic HCWs. Secondary outcomes were VE by: SARS-CoV-2 variant strains based on the predominant variant circulating in Zambia (Delta during May 2021 to November 2021 and Omicron during December 2021 to March 2022), duration since vaccination and vaccine product.

Results

We recruited 1145 symptomatic HCWs. The median age was 30 years (IQR: 26–38) and 789 (68.9%) were women. Two hundred and eighty-two (24.6%) were fully vaccinated. The median time to full vaccination was 102 days (IQR: 56–144). VE against symptomatic SARS-CoV-2 infection was 72.7% (95% CI: 61.9% to 80.7%) for fully vaccinated participants. VE was 79.4% (95% CI: 58.2% to 90.7%) during the Delta period and 37.5% (95% CI: –7.0% to 63.3%) during the Omicron period.

Conclusions

COVID-19 vaccines were effective in reducing symptomatic SARS-CoV-2 among Zambian HCWs when the Delta variant was circulating but not when Omicron was circulating. This could be related to immune evasive characteristics and/or waning immunity. These findings support accelerating COVID-19 booster dosing with bivalent vaccines as part of the vaccination programme to reduce COVID-19 in Zambia.

Application of Skyline software for detecting prohibited substances in doping control analysis

by Hyeon-Jeong Lee, Mijin Jeon, Yoondam Seo, Inseon Kang, Wooyeon Jeong, Junghyun Son, Eugene C. Yi, Hophil Min

As the number of prohibited drugs has been progressively increasing and analytical methods for detecting such substances are renewed continuously for doping control, the need for more sensitive and accurate doping analysis has increased. To address the urgent need for high throughput and accurate analysis, liquid chromatography with tandem mass spectrometry is actively utilized in case of most of the newly designated prohibited substances. However, because all mass spectrometer vendors provide data processing software that is incapable of handling other instrumental data, it is difficult to cover all doping analysis procedures, from method development to result reporting, on one platform. Skyline is an open-source and vendor-neutral software program invented for the method development and data processing of targeted proteomics. Recently, the utilization of Skyline has been expanding for the quantitative analysis of small molecules and lipids. Herein, we demonstrated Skyline as a simple platform for unifying overall doping control, including the optimization of analytical methods, monitoring of data quality, discovery of suspected doping samples, and validation of analytical methods for detecting newly prohibited substances. For method optimization, we selected the optimal collision energies for 339 prohibited substances. Notably, 195 substances exhibited a signal intensity increase of >110% compared with the signal intensity of the original collision energy. All data related to method validation and quantitative analysis were efficiently visualized, extracted, or calculated using Skyline. Moreover, a comparison of the time consumed and the number of suspicious samples screened in the initial test procedure highlighted the advantages of using Skyline over the commercially available software TraceFinder in doping control.

A genome-wide and candidate gene association study of preterm birth in Korean pregnant women

by Young Min Hur, Jae Young Yoo, Young Ah You, Sunwha Park, Soo Min Kim, Gain Lee, Young Ju Kim

Preterm birth (PTB) refers to delivery before 37 weeks of gestation. Premature neonates exhibit higher neonatal morbidity and mortality rates than term neonates; therefore, it is crucial to predict and prevent PTB. Advancements enable the prediction and prevention of PTB using genetic approaches, especially by investigating its correlation with single nucleotide polymorphisms (SNPs). We aimed to identify impactive and relevant SNPs for the prediction of PTB via whole–genome sequencing analyses of the blood of 31 pregnant women with PTB (n = 13) and term birth (n = 18) who visited the Ewha Womans University Mokdong Hospital from November 1, 2018 to February 29, 2020. A genome-wide association study was performed using PLINK 1.9 software and 256 SNPs were selected and traced through protein-protein interactions. Moreover, a validation study by genotyping was performed on 60 other participants (preterm birth, n = 30; term birth, n = 30) for 25 SNPs related to ion channel binding and receptor complex pathways. Odds ratios were calculated using additive, dominant, and recessive genetic models. The risk of PTB in women with the AG allele of rs2485579 (gene name: RYR2) was significantly 4.82-fold increase, and the risk of PTB in women with the AG allele of rs7903957 (gene name: TBX5) was significantly 0.25-fold reduce. Our results suggest that rs2485579 (in RYR2) can be a genetic marker of PTB, which is considered through the association with abnormal cytoplasmic Ca2+ concentration and dysfunctional uterine contraction due to differences of RYR2 in the sarcoplasmic reticulum.

The genes significantly associated with an improved prognosis and long-term survival of glioblastoma

by Hong Gyu Yoon, Jin Hwan Cheong, Je Il Ryu, Yu Deok Won, Kyueng-Whan Min, Myung-Hoon Han

Background and purpose

Glioblastoma multiforme (GBM) is the most devastating brain tumor with less than 5% of patients surviving 5 years following diagnosis. Many studies have focused on the genetics of GBM with the aim of improving the prognosis of GBM patients. We investigated specific genes whose expressions are significantly related to both the length of the overall survival and the progression-free survival in patients with GBM.

Methods

We obtained data for 12,042 gene mRNA expressions in 525 GBM tissues from the Cancer Genome Atlas (TCGA) database. Among those genes, we identified independent genes significantly associated with the prognosis of GBM. Receiver operating characteristic (ROC) curve analysis was performed to determine the genes significant for predicting the long-term survival of patients with GBM. Bioinformatics analysis was also performed for the significant genes.

Results

We identified 33 independent genes whose expressions were significantly associated with the prognosis of 525 patients with GBM. Among them, the expressions of five genes were independently associated with an improved prognosis of GBM, and the expressions of 28 genes were independently related to a poorer prognosis of GBM. The expressions of the ADAM22, ATP5C1, RAC3, SHANK1, AEBP1, C1RL, CHL1, CHST2, EFEMP2, and PGCP genes were either positively or negatively related to the long-term survival of GBM patients.

Conclusions

Using a large-scale and open database, we found genes significantly associated with both the prognosis and long-term survival of patients with GBM. We believe that our findings may contribute to improving the understanding of the mechanisms underlying GBM.

Clinical efficacy of inhaled corticosteroids in patients with coronavirus disease 2019: A living review and meta-analysis

by Su-Yeon Yu, Miyoung Choi, Seungeun Ryoo, Chelim Cheong, Kyungmin Huh, Young Kyung Yoon, Su Jin Jeong

Inhaled corticosteroids are known to be relatively safe for long-term use in inflammatory respiratory diseases and it has been repurposed as one of the potential therapies for outpatients with coronavirus disease 2019 (COVID-19). However, inhaled corticosteroids have not been accepted for COVID-19 as a standard therapy because of its lack of proven benefits. Therefore, this study aimed to evaluate the effectiveness of inhaled corticosteroids in patients with COVID-19. Randomized controlled trials comparing the efficacy of inhaled corticosteroid treatment in patients with COVID-19 were identified through literature electronic database searches up to March 10, 2023. Meta-analyses were conducted for predefined outcomes, and the certainty of evidence was graded using the grading of recommendations, assessment, development, and evaluation approach. Overall, seven trials (eight articles) were included in this systematic review. Compared with usual care, inhaled corticosteroids was associated with significantly improved clinical recovery at 7 and 14 days in patients with COVID-19. In subgroup analysis, only budesonide showed significant efficacy in clinical recovery, whereas no significant benefit was observed for ciclesonide. Moreover, inhaled corticosteroids use was not significantly associated with all-cause hospitalization, all-cause mortality, admission to intensive care unit, or the use of mechanical ventilation. Our systematic review used evidence with very low to moderate certainty. Although based on limited evidence, our results suggest that inhaled corticosteroids treatment, especially budesonide, improves the clinical recovery of patients with COVID-19. More trials and meta-analyses are needed to assess the efficacy of inhaled corticosteroids for COVID-19 treatment.

CTIVA: Censored time interval variable analysis

by Insoo Kim, Junhee Seok, Yoojoong Kim

Traditionally, datasets with multiple censored time-to-events have not been utilized in multivariate analysis because of their high level of complexity. In this paper, we propose the Censored Time Interval Analysis (CTIVA) method to address this issue. It estimates the joint probability distribution of actual event times in the censored dataset by implementing a statistical probability density estimation technique on the dataset. Based on the acquired event time, CTIVA investigates variables correlated with the interval time of events via statistical tests. The proposed method handles both categorical and continuous variables simultaneously—thus, it is suitable for application on real-world censored time-to-event datasets, which include both categorical and continuous variables. CTIVA outperforms traditional censored time-to-event data handling methods by 5% on simulation data. The average area under the curve (AUC) of the proposed method on the simulation dataset exceeds 0.9 under various conditions. Further, CTIVA yields novel results on National Sample Cohort Demo (NSCD) and proteasome inhibitor bortezomib dataset, a real-world censored time-to-event dataset of medical history of beneficiaries provided by the National Health Insurance Sharing Service (NHISS) and National Center for Biotechnology Information (NCBI). We believe that the development of CTIVA is a milestone in the investigation of variables correlated with interval time of events in presence of censoring.

Impact of caregiver relationship on self‐care in patients with Parkinson's disease: A cross‐sectional study using Riegel's theory of self‐care of chronic illness

Abstract

Aims

To explore how the characteristics of patients and caregivers affect self-care in patients with Parkinson's disease (PD).

Design

A multicentre cross-sectional study.

Method

We followed the STROBE checklist. Parkinson's disease patients aged 50 years and older and their caregivers were recruited from two tertiary hospitals and the Korean Parkinson's Disease Association website. Patient characteristics, including social support, relationship quality with caregivers, self-care efficacy and self-care, were analysed. Caregiver characteristics were also evaluated, including caregiving duration, social support, relationship quality with patients, contribution to patients' self-care efficacy and contribution to patients' self-care.

Results

The characteristics of patients and caregivers (103 pairs) were hierarchically regressed into patient self-care domains (maintenance, monitoring and management). Most patients and caregivers gave a self-care efficacy and self-care management rating of moderate. In three regression models, patient self-care efficacy was positively related to three domains of patient self-care. Self-care maintenance decreased as patients' disease duration increased. Self-care monitoring was positively related to the education level of patients and caregiving duration. Self-care management showed an inverse relationship with caregiving duration and a positive relationship with caregiver contribution.

Conclusion

Self-care efficacy was important in promoting PD patients' self-care maintenance, monitoring and management. The contributions of caregivers were also critical in increasing PD patients' self-care management.

Implications for the profession and patient care

To increase patients' self-care efficacy and self-care, educational interventions containing information about the disease, symptom management, and problem-solving should be implemented. Since caregivers are deeply involved in patients' self-care, educational interventions for caregivers should also be provided.

Impact

This study closed the literature gap by examining the self-care efficacy and self-care of Korean PD patients. Findings demonstrated the importance of caregiver roles on patients' self-care and health.

Patient or public contribution

Two tertiary hospitals and the Korean Parkinson's Disease Association assisted during the recruitment process.

Eight‐year trajectories and predictors of cognitive function in community‐dwelling Korean older adults with cardiovascular diseases

Abstract

Purpose

This study aims to identify longitudinal patterns and predictors of cognitive function trajectories among Korean older adults with cardiovascular diseases.

Design

This study is a longitudinal panel analysis based on secondary data. Data from the the Korean Longitudinal Study of Ageing (KLoSA) were used for analysis.

Methods

The KLoSA is a representative panel survey of older Koreans. We analyzed responses from 301 participants aged ≥65 years who completed the same survey more than three times out of five waves between 2012 and 2020.

Findings

Latent class growth modeling identified two trajectories of cognitive function in older people with cardiovascular diseases: “low and declining” (n = 81, 26.9%) and “high and declining” (n = 220, 73.1%). Participants in “the low and declining trajectory group” were more likely to have a low educational level, weak handgrip strength, depression, and low social participation at baseline than those in “the high and declining trajectory group.”

Conclusions

Our results indicate a need to develop community-based tailored interventions for improving handgrip strength, mental health, and social participation in delaying cognitive decline in older people with cardiovascular diseases considering their educational level.

Clinical Relevance

Healthcare providers should be more concerned about older people with a weaker handgrip, depression, and low social activities as a high-risk group for cognitive decline over time in cardiovascular care. Therefore, it is necessary to evaluate them early with standardized tools and make subsequent strategies for the older population with cardiovascular diseases.

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