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Background: Despite the effectiveness of cardiac rehabilitation (CR), the actual participation rate in CR is low. While home-based CR offers a viable alternative, it faces challenges in participation due to factors such as a lack of self-motivation and fear of exercising without supervision. Utilizing a mobile healthcare application (app) during counseling may be an effective strategy for patients. Therefore, the aim of this study was to assess whether 6 weeks of home-based CR with exercise readjustment using a mobile app is an effective therapy for patients with acute myocardial infarction (AMI). Methods: Post-AMI patients eligible for home-based CR were randomized into the intervention group (CR-Mobile) and the control group, which followed the usual home-based CR protocol (CR-Usual). Both groups participated in a 6-week home-based CR program, with exercise readjustment and encouragement carried out every 2 weeks. The CR-Mobile group was supervised using data recorded in the mobile app, while the CR-Usual group was supervised via phone consultations. The primary outcome measured was maximal oxygen consumption (VO2max). Results: Within-group comparisons showed significant improvements in VO2max (PCR-Mobile = 0.011 vs. PCR-Usual = 0.020) and METs (PCR-Mobile = 0.011 vs. PCR-Usual = 0.011) for both groups. Conclusions: These findings suggest that a 6-week home-based CR program with exercise readjustment using a mobile app can potentially enhance exercise capacity as effectively as verbal supervision. [ABSTRACT FROM AUTHOR]

Diffuse axonal injury (DAI) following sudden acceleration and deceleration can lead to cognitive function decline. Various treatments have been proposed. Repetitive transcranial magnetic stimulation (rTMS), a non-invasive stimulation technique, is a potential treatment for enhancing neuroplasticity in cases of brain injury. The therapeutic efficacy of rTMS on cognitive function remains unconfirmed. This study investigated the effects of rTMS and the underlying molecular biomechanisms using a rat model of DAI. Sprague–Dawley rats (n = 18) were randomly divided into two groups: one receiving rTMS after DAI and the other without brain stimulation. All rats were subjected to sudden acceleration and deceleration using a DAI modeling machine to induce damage. MRI was performed to confirm the DAI lesion. The experimental group received rTMS at a frequency of 1 Hz over the frontal cortex for 10 min daily for five days. To assess spatial memory, we conducted the Morris water maze (MWM) test one day post-brain damage and one day after the five-day intervention. A video tracking system recorded the escape latency. After post-MWM tests, all rats were euthanized, and their brain tissues, particularly from the hippocampus, were collected for immunohistochemistry and western blot analyses. The escape latency showed no difference on the MWM test after DAI, but a significant difference was observed after rTMS between the two groups. Immunohistochemistry and western blot analyses indicated increased expression of BDNF, VEGF, and MAP2 in the hippocampal brain tissue of the DAI-T group. In conclusion, rTMS improved cognitive function in the DAI rat model. The increased expression of BDNF, VEGF, and MAP2 in the DAI-T group supports the potential use of rTMS in treating cognitive impairments associated with DAI. [ABSTRACT FROM AUTHOR]

Thinking about macroscopic phenomena in terms of models based on the idea of microscopic particles (i.e., the particulate theory of matter) is one of the important goals for student learning in chemistry around the world. However, previous research suggests that students do not easily understand phenomena from a particle perspective, although such a perspective has many concrete aspects that ought to assist learners of chemistry. More than the textbooks of other countries, Korean chemistry texts tend to include colorful inscriptions. How, we might ask, do such inscriptions help learners of chemistry? The purpose of this study is to investigate the function and structure of chemical inscriptions in middle school science textbooks by drawing on a semiotic framework. We develop the concept of "chemi (stry)-semiotics" to unveil the work of reading required to understand chemical inscriptions in the way their authors intended them to be understood. The study began with the assumption that different kinds and functions (structure) of inscriptions constitute different "signs" that are available as sense-making resources in the learning process. We show that the difficulty in understanding the particulate nature of matter may result from the different processes of semiosis (interpretation and meaning making) between inscriptions depicting macroscopic and models based on microscopic particles.

The percentage of patients undergoing cardiac rehabilitation programs (CRP) is very low (30–40%), and hospitals providing CRP are either insufficient or lacking, even in countries with advanced medical care; therefore, this study aims to investigate the barriers, as well as compare the differences between hospitals, with or without CRP. We conducted a survey, in which the questionnaire was distributed through post or email to 607 specialists who work at 164 hospitals performing percutaneous coronary interventions (PCI). The results were as follows: (1) of the 164 hospitals, 132 responded (response rate: 80.5%). While all 47 hospitals with CRP responded (100%), from among the 117 hospitals without CRP, 85 responded (72.7%). (2) Of the 607 specialists, 227 responded (response rate: 36.9%). The response rates according to specialties were as follows: cardiologists (28.9%), cardiac surgeons (24.5%), and physiatrists (64.1%). (3) While the specialists at hospitals with CRP identified patient referral, transportation, and cost as the major barriers, for those at hospitals without CRP, all items were considered barriers, especially the items related to equipment, space, workforce, and budget as being more serious barriers. Therefore, in order to actively promote CRP, it is suggested that governments consider the customized support system according to the performance of CRPs. [ABSTRACT FROM AUTHOR]

Background: The effect of combined repetitive transcranial magnetic stimulation (rTMS) and scalp acupuncture stimulation (SAS) on middle cerebral artery occlusion (MCAO) mice has not yet been reported. The regulation of gene expression after combined stimulation remains unclear. Objective: To analyze gene expression patterns through ribonucleic acid (RNA) sequencing. Methods: Thirty-six 8-weeks-old C57BL/6J male mice weighing 50–60 grams were used for this experiment. The MCAO was induced with 60-min occlusion and subsequent reperfusion of the middle cerebral artery. Experimental mice were randomly assigned to four groups, with nine mice in each group, as follows: control group (no treatment), SAS group (10 minutes SAS), rTMS group (1 Hz rTMS), and combined group (1 Hz rTMS and SAS). Stimulation was performed from the 3rd day to the 7th day after the induction of MCAO. All mice were sacrificed, and brain tissues were taken from the motor area of the MCAO lesion. We analyzed their gene expression profiles using RNA sequencing technology. Results: After stimulation, the grip strength increased in the SAS and rTMS group compared to the control and combined group. The nuclear factor kappa-light-chain-enhancer of activated B cells (NFκB) was the key up-regulated protein in the SAS group while src homologus and collagene gene (SHC) and p90 ribosomal protein S6 kinases (p90RSK) were key up-regulated proteins in the rTMS group. However, the C-terminal src kinase-homologous kinase (CHK) was down-regulated whereas p90RSK was up-regulated in the combined group based on the RNA sequencing analysis. Conclusions: Each stimulation method showed different patterns with neurotrophin signaling pathway including NFκB, SHC, p90RSK, and CHK. These can be used in further mechanistic studies about gene expression related to neurorecovery. [ABSTRACT FROM AUTHOR]

Being well prepared for a competitive business environment is crucial for future dentists. The aims of this study were to assess dental students' satisfaction with their practice management education, their current and future interest in business-related education and attending a DDS/DMD-MBA program, and the relationship between their demographic and other characteristics and their business education-related responses. The study, conducted in 2016 and 2017, surveyed students in all four years at the authors' home school and at other schools that did not have a DDS/DMD-MBA program. At the home school, 273 students responded (response rate 63%); and 341 students from 11 of the 51 U.S. dental schools without a DDS/DMD-MBA program responded (respondents were from 21% of schools invited; the response rate of those students could not be calculated). The responding students disagreed that their school adequately prepared them for the business aspects of dentistry (mean=2.42 on a scale from 1=disagree strongly to 5=agree strongly). Large majorities agreed/strongly agreed that dentistry is a career that requires a certain amount of business acumen (95%) and that they were very interested in learning about business (85%). A total of 68% agreed/strongly agreed that their school should offer a dual DDS/DMD-MBA degree and 63% that they would consider enrolling in such a program. The more advanced the respondents were, the less satisfied they were with their practice management education (r=-0.20; p<0.001). Female respondents were less interested in business-related education (r=-0.20; p<0.001) and less likely to consider a DDS/DMD-MBA program than the males. Respondents planning to own a dental practice were more interested in additional current business education (r=0.22; p<0.001) and in future business education (r=0.15; p<0.001) than those without that plan. These results showed that a significant percentage of these dental students were interested in a DDS/DMD-MBA program. The male students and students who planned to own a practice were more interested in business education than the female students and students who did not plan to own their own practice. [ABSTRACT FROM AUTHOR]

Background: This study aimed to evaluate the quality of reports about randomized controlled trials (RCTs) of scalp acupuncture (SA) for the treatment of vascular dementia (VD).Method: A systematic search of reports published through to December 2015 was performed in eight databases. The quality of RCTs that used SA as an intervention for VD was evaluated based on the 2010 Consolidated Standards for Reporting of Trials (CONSORT) and 2010 Standards for Reporting Interventions in Controlled Trials of Acupuncture (STRICTA) guidelines. Thirteen items from the CONSORT guideline were scored to give an overall quality score (OQS, range 0-13), and a combined key methodological index score (MIS) (range 0-5) of five key methodological items was measured. The OQS of 17 items from the STRICTA guideline (range 0-17) was also measured.Results: In total, 26 reports were evaluated. The median OQS based on the CONSORT guideline was 8 (minimum 5, maximum 11), and "trial design," "sample size," "ancillary analyses," and "harms" had a positive rate of less than 10%. The median MIS was 2 (minimum 0, maximum 5), with "allocation concealment and implementation," "blinding," and "intent-to-treat analysis" having a positive rate of less than 15%. The median OQS based on the STRICTA guideline was 12 (minimum 8, maximum 14), with "extent to which treatment was varied (1c)," "number of needle insertions per subject per session (2a)," and "setting and context of treatment (4b)" having a positive rate of less than 10%.Conclusions: The overall quality of reports on RCTs of SA treatment for VD was moderate to low. The quality of methodological items was markedly lower than that of other items. The CONSORT and STRICTA guidelines should be used more frequently to standardize the quality of RCT reports of SA treatment for VD. [ABSTRACT FROM AUTHOR]

Aims and objectives The aim of the study was to assess the prognostic factors of short-term sexual recovery in patients with acute myocardial infarction after phase II cardiac rehabilitation for six weeks. Background It is often observed that patients who have suffered acute myocardial infarction and have sufficient aerobic capacity for sexual activity do not recover sexual activity. Until now, few studies have investigated factors associated with recovery of sexual activity. Design Observational study. Methods Among 627 male patients with acute myocardial infarction who were referred for cardiac rehabilitation from October 2010-September 2014, 72 were finally analysed. Subjects who met all the following criteria were included: (1) completed a questionnaire about sexual activity before and after phase II cardiac rehabilitation; (2) showed usual sexual activity before onset of acute myocardial infarction and (3) revealed decreased sexual activity at baseline of cardiac rehabilitation compared to preacute myocardial infarction status despite ≥5 maximal metabolic equivalents. Information on sociodemographic characteristics and cardiopulmonary function obtained before cardiac rehabilitation was used for the analysis. Results (1) Twenty-five of the 72 subjects (34·7%) had improved sexual activity after six weeks of cardiac rehabilitation, but 47 (65·3%) continued the status of no-recovery sexual activity after cardiac rehabilitation. (2) Age, body mass index and use of statins were significantly different between subjects who recovered and those who did not. (3) No differences in other clinical characteristics and cardiopulmonary functions were detected between the two groups. (4) Age and body mass index were significant factors associated with recovery of sexual activity. Conclusions Age and body mass index were significant factors associated with recovery of sexual activity in acute myocardial infarction patients. Aerobic capacity at baseline of cardiac rehabilitation was not an independent factor to predict the recovery of sexual activity. Relevance to clinical practice These results should be considered when educating patients under phase II cardiac rehabilitation on their return to normal sexual activity. [ABSTRACT FROM AUTHOR]

Highlights: [•] High-yield hydrotreated biodiesel synthesized from scCO2-purified waste cooking oil. [•] ScCO2-purification effectively removed organic and metallic impurities in waste cooking oil. [•] The effect of scCO2-purification was prominent on supported metal catalysts. [•] The origin of catalyst deactivation by organic and metallic impurity is discussed. [Copyright &y& Elsevier]

Abstract: In this study, psychological distances of various hedonic phrases used in Korean hedonic scales were measured. Two hundred and twenty consumers measured the psychological distances of 42 hedonic phrases used in Korean hedonic scales utilizing a magnitude estimation method. In addition, usage frequency of each hedonic phrase was surveyed. The hedonic phrases were categorized into positive, negative, and neutral phrases, and the psychological magnitudes of 42 hedonic phrases were estimated. Results show that attention must be given in selecting hedonic phrases when conducting cross-cultural studies. For instance, a couple of translated phrases were rarely used in daily life and a Korean label of “▪” corresponding to “like moderately” was perceived closer to neutral than “like” without any adverb. English hedonic phrases translated to the target country language without any validation can be misleading. [Copyright &y& Elsevier]

The aim of this study was to evaluate the effect of chronic formaldehyde (FA) exposure on the hippocampus in the chronic cerebral hypoperfusion rat model. Seventy-two male Sprague-Dawley rats were randomly divided into four groups: (A) sham-operated bilateral common carotid artery occlusion (BCCAO) with room air inhalation, (B) BCCAO with room air inhalation, (C) sham-operated BCCAO with FA inhalation at a concentration of 10 mL vapor m−3, 1 h per day for 90 days, and (D) BCCAO with FA inhalation. Decreased mobility, injected conjunctivae, and overreaction were observed in groups C and D rats after 30 days of FA exposure. The level of malondialdehyde (MDA) increased significantly in group D at 90 days after FA exposure. The expression of Bax protein increased, while Bcl-2 and NR2B proteins decreased significantly in group D compared to group B or C. Neuronal nuclear antigen (NeuN) positive cells decreased significantly in group D. Neuronal loss, oxidative stress, and the expression of proteins were more prominent at 90 days after FA exposure, especially in group D. Oxidative stress-induced neuronal damages in the hippocampus may be a possible mechanism of neurotoxicity as a result of chronic FA exposure. Chronic exposure of FA caused more neuronal damage in the chronic cerebral hypoperfusion rat model. [ABSTRACT FROM PUBLISHER]

This study was performed to evaluate the effect of C-reactive protein (CRP) measured within 24 hr after stroke onset on functional outcome in ischemic stroke patients. The medical records of 28 first-ever hemiplegic ischemic stroke patients with the lesions on the middle cerebral arterial territory were reviewed. Subjects were classified into experimental group (serum CRP ≥ 0.5 mg/dL) and control group (serum CRP < 0.5 mg/dL) based on the level of serum CRP measured within 24 hr after stroke onset. Serum CRP measured within 24 hr after stroke onset was significantly correlated with functional scales in ischemic stroke patients. [ABSTRACT FROM AUTHOR]

Regional Cardiocerebrovascular Centers (RCCs)—a Korean government initiative—seek to reduce medical gaps across regions, and their cardiac rehabilitation (CR) programs are expected to model post-acute care for the Korean CR program. Accordingly, this study aimed to evaluate the current status of CR programs in the RCCs. We distributed surveys on the CR condition, activity, and barriers to 12 RCCs in different provinces. The results revealed significant gaps in the annual number of acute myocardial infarction admissions, and CR candidates, capacity, and density across the 12 RCCs. The CR capacity (50–500) and density (0.42–7.36) indicated particularly large gaps. Twelve RCCs had the necessary facilities, equipment and personnel for CR assessments and management, with high CR referral (97%) and patient education (78%) rates. However, the inpatient CR exercise training (56%) participation rate was inadequate, with much lower enrollment (47%) and adherence (17%) rates to the outpatient CR program and large differences across centers. Therefore, this study's results will provide the evidence required to establish special national health strategies to overcome the CR barriers of patient, doctor/hospital, and policy factors for activating Korean CR programs. [ABSTRACT FROM AUTHOR]

Transcranial alternating current stimulation (tACS) is a neuromodulation procedure that is currently studied for the purpose of improving cognitive function in various diseases. A few studies have shown positive effects of tACS in Alzheimer's disease (AD). However, the mechanism underlying tACS has not been established. The purpose of this study was to investigate the mechanism of tACS in five familial AD mutation (5xFAD) mouse models. We prepared twenty 4-month-old mice and divided them into four groups: wild-type mice without stimulation (WT-NT group), wild-type mice with tACS (WT-T group), 5xFAD mice without stimulation (AD-NT group), and 5xFAD mice with tACS (AD-T group). The protocol implemented was as follows: gamma frequency 200 μA over the bilateral frontal lobe for 20 min over 2 weeks. The following tests were conducted: excitatory postsynaptic potential (EPSP) recording, Western blot analysis (cyclic AMP response element-binding (CREB) proteins, phosphorylated CREB proteins, brain-derived neurotrophic factor, and parvalbumin) to examine the synaptic plasticity. The EPSP was remarkably increased in the AD-T group compared with in the AD-NT group. In the Western blot analysis, the differences among the groups were not significant. Hence, tACS can affect the long-lasting enhancement of synaptic transmission in mice models of AD. [ABSTRACT FROM AUTHOR]

Spinocerebellar ataxia (SCA) is a hereditary neurodegenerative disorder that presents as ataxia. Due to the decline in balance, patients with SCA often experience restricted mobility and a decreased quality of life. Thus, many studies have emphasized the importance of physiotherapies, including gait training, in SCA patients. However, few studies have examined the effectiveness of robotic gait training in SCA. Here, we report the therapeutic outcomes of exoskeleton-assisted gait training in a patient with SCA. A 23-year-old woman with SCA participated in a gait training program using a powered lower-limb robotic exoskeleton, ANGELLEGS. The 8-week training program consisted of standing training, weight-shifting exercises, and gait training. Several measures of general function, balance, gait, and cardiopulmonary function were applied before, after, and 4 weeks after the program. After the program, overall improvements were found on scales measuring balance and gait function, and these improvements remained at 4 weeks after the program. Cardiopulmonary function was also improved 4 weeks after the program. Robotic exoskeleton gait training can be a beneficial option for training balance, gait, and cardiopulmonary function in SCA. [ABSTRACT FROM AUTHOR]

Background: This study aimed to present the development process and characteristics of the Korean Registry of Acute Myocardial Infarction for Regional Cardiocerebrovascular Centers (KRAMI-RCC). Methods: We developed KRAMI-RCC, a web-based registry for patients with AMI. Patients from 14 RCCs were registered for more than three years from July 2016. It includes an automatic error-checking system, and user training and on-site monitoring are performed to manage data quality. Results: A total of 11,700 AMI patients were registered in KRAMI-RCC over three years (73.9% men). The proportions of patients with ST-elevation and non-ST-elevation myocardial infarction at discharge were 43.4% and 56.6%, respectively. Of the total three-year patients, 5.6% died in the hospital, and 4.4% died 12 months after discharge. The case fatality within 12 months was 9.7%. Pre-hospital care data showed delayed arrival time after onset of symptoms (median 153 min) and low transportation rate by public ambulance (25.2%). Post-hospital care data showed lower participation rate in the second rehabilitation program (16.8%). Conclusions: The recently developed KRAMI-RCC registry has been more focused on pre-hospital and post-hospital data, which will be helpful in understanding the current state of AMI disease management and in making policy decisions to reduce case fatality in Korea. [ABSTRACT FROM AUTHOR]

This outcome assessor-blinded, randomized controlled clinical trial investigated the effects of electroacupuncture combined with computer-based cognitive rehabilitation (EA-CCR) on mild cognitive impairment (MCI). A per-protocol analysis was employed to compare the efficacy of EA-CCR to that of computer-based cognitive rehabilitation (CCR). Thirty-two patients with MCI completed the trial (EA-CCR group, 16; CCR group, 16). Patients received EA-CCR or CCR treatment once daily three days per week for eight weeks. Outcome (primary, ADAS-K-cog; secondary, MoCA-K, CES-D, K-ADL, K-IADL, and EQ-5D-5L) measurements were performed at baseline (week 0), at the end of the intervention (week 8), and at 12 weeks after completion of the intervention (week 20). Both groups showed significant changes in ADAS-K-cog score (EA-CCR, p < 0.001; CCR, p < 0.001) and MoCA-K (EA-CCR, p < 0.001; CCR, p < 0.001). Only the EA-CCR group had a significant change in CES-D (p = 0.024). No significant differences in outcomes and in the results of a subanalysis based on age were noted between the groups. These results indicate that EA-CCR and CCR have beneficial effects on improving cognitive function in patients with MCI. However, electroacupuncture in EA-CCR showed no positive add-on effects on improving cognitive function, depression, activities of daily living, and quality of life in patients with MCI. [ABSTRACT FROM AUTHOR]