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Background: In clinical practice, the importance of interactive engagement behaviors is overlooked in children with developmental problems other than autism spectrum disorder (ASD). Parenting stress affects children’s development but lacks attention from clinicians.Purpose: This study aimed to identify the characteristics of interactive engagement behaviors and parenting stress among non-ASD children with developmental delays (DDs). We also analyzed whether engagement behaviors affect parenting stress.Methods: At Gyeongsang National University Hospital, between May 2021 and October 2021, we retrospectively enrolled 51 consecutive patients diagnosed with DDs in language or cognition (but not ASD) in the delayed group and 24 typically developing children in the control group. The Korean version of the Parenting Stress Index-4 and Child Interactive Behavior Test were used to assess the participants.Results: The median age of the delayed group was 31.0 months (interquartile range, 25.0–35.5 months); this group included 42 boys (82.4%). There were no intergroup differences in child age, child sex, parental age, parental educational background, mother’s employment status, or marital status. Higher parenting stress (PPP=0.440). Instead, DDs contributed to total parenting stress, which was mediated by children’s overall interactive engagement behaviors (β=57.30, P

Despite the introduction of a diagnostic code and acceptance of a diagnostic process for sarcopenia as a new health technology in Korea, many practitioners remain unfamiliar with the evaluation of sarcopenia. Thus, the Korean Working Group on Sarcopenia (KWGS) developed clinical practice guidelines for the diagnosis of sarcopenia in older Korean adults. A two-phase Delphi interview comprising 19 questions was conducted with 40 expert panelists, 22 of whom participated in the first round between June and August 2022. The second round of the Delphi interview included the remaining 11 questions that were not agreed upon in the first round. The screening process for sarcopenia includes various questionnaires and examinations used in different research and clinical settings. The diagnostic process for sarcopenia was simplified by combining the steps of case finding and assessment. The Short Physical Performance Battery test was given particular emphasis owing to its multifaceted nature. Regardless of muscle mass, having low muscle strength with low physical performance is considered clinically relevant and newly defined as “functional sarcopenia.” Comprehensive geriatric assessment is important for diagnosing sarcopenia. The KWGS’s clinical guideline aims to facilitate the early detection of sarcopenia by allowing various screening tools to be used in a unified process and reducing confusion about which tools to use for diagnosis. This recommendation expands the conceptual definition of sarcopenia as a complex pathophysiological state in line with the concept of frailty and aims to stimulate further research on the diagnosis and management of sarcopenia in clinical settings.

Osteoporosis and osteoporotic fractures cause socioeconomic concerns, and medical system and policies appear insufficient to prepare for these issues in Korea, where the older adult population is rapidly increasing. Many countries around the world are already responding to osteoporosis and osteoporotic fractures by adopting fracture liaison service (FLS), and such an attempt has only begun in Korea. In this article, we introduce the operation methods for institutions implementing FLS and characteristics of services, and activities of the FLS Committee for FLS implementation in the Korean Society for Bone and Mineral Research. In addition, we hope that the current position statement will contribute to the implementation of FLS in Korea and impel policy changes to enable a multidisciplinary and integrated FLS operated under the medical system.

In recent years, we have faced challenges in managing coronavirus disease 2019 (COVID-19), especially in older adults. We have witnessed a crisis in geriatric care services, mining the possibility for older adults to maintain their capacities and abilities during the pandemic. Disruption of the routine management of chronic diseases, physical inactivity, deteriorating physical function and quality of life, malnutrition, and mental disorders have been suggested as major threats to the health of older adults.1 To address these problems and plan the reactivation of normal care activities, this article summarizes the contents of a webinar held by the Annals of Geriatric Medicine and Research (AGMR) regarding the future directions of geriatric medicine and research in the post-COVID-19 era.

A digital healthcare system based on augmented reality (AR) has promising uses for postoperative rehabilitation. We compare effectiveness of AR-based and conventional rehabilitation in patients after rotator cuff repair (RCR). This study randomly allocates 115 participants who underwent RCR to digital healthcare rehabilitation group (DR group) and conventional rehabilitation group (CR group). The DR group performs AR-based home exercises using UINCARE Home+, whereas the CR group performs brochure-based home exercises. The primary outcome is a change in the Simple Shoulder Test (SST) score between baseline and 12 weeks postoperatively. The secondary outcomes are the Disabilities of the Arm, Shoulder and Hand (DASH) score; Shoulder Pain And Disability Index (SPADI) score; EuroQoL 5-Dimension 5-Level (EQ5D5L) questionnaire score; pain; range of motion (ROM); muscle strength; and handgrip strength. The outcomes are measured at baseline, and at 6, 12, and 24 weeks postoperatively. The change in SST score between baseline and 12 weeks postoperatively is significantly greater in the DR group than in the CR group (p = 0.025). The SPADI, DASH, and EQ5D5L scores demonstrate group×time interactions (p = 0.001, = 0.04, and = 0.016, respectively). However, no significant differences over time are observed between the groups in terms of pain, ROM, muscle strength, and handgrip strength. The outcomes show significant improvement in both groups (all p

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Antiangiogenic therapies, despite initial encouragement, have demonstrated a limited benefit in ovarian cancer. Laboratory studies suggest antiangiogenic therapy–induced hypoxia can induce tumor “stemness” as resistance to antiangiogenic therapy develops and limits the therapeutic benefit. Resistance to antiangiogenic therapy and an induction of tumor stemness may be mediated by proangiogenic tumor-associated macrophages (TAM). As such, TAMs have been proposed as a therapeutic target. We demonstrate here that ovarian TAMs express high levels of the folate receptor-2 (FOLR2) and can be selectively targeted using G5-dendrimer nanoparticles using methotrexate as both a ligand and a toxin. G5-methotrexate (G5-MTX) nanoparticles deplete TAMs in both solid tumor and ascites models of ovarian cancer. As a therapeutic agent, these nanoparticles are more effective than cisplatin. Importantly, these nanoparticles could (i) overcome resistance to antiangiogenic therapy, (ii) prevent antiangiogenic therapy–induced increases in cancer stem–like cells in both murine and human tumor cell models, (iii) prevent antiangiogenic therapy–induced increases in VEGF-C, and (iv) prevent antiangiogenic therapy–induced BRCA1 gene expression. Combined, this work strongly supports the development of TAM-targeted nanoparticle therapy. Mol Cancer Ther; 17(1); 96–106. ©2017 AACR.

Muscle aging ultimately leads to the deterioration of human physiological functioning, including declining muscle strength, loss of muscle mass, and decreased quality of life in advanced age. Eccentric exercise is a key intervention that has the potential to ameliorate this problem. Recent studies have focused on evidence-based exercise interventions to prevent declines in muscle strength and physical function in older adults. This paper reviewed relevant literature on the use of eccentric exercise to improve muscle and mobility function in older adults. We explained not only the changes in mobility that occur with aging but also the rationale for and positive effects of eccentric intervention in older adults. We also explored several proposed mechanisms for the intramuscular changes caused by eccentric muscle contraction and considered the safety and side effects accompanying eccentric training. We concluded by suggesting that eccentric exercise is an exercise modality that can potentially improve muscle strength and enhance mobility in older adults.

Rotavirus infection has been reported to be associated with neonatal seizures with a diffuse and symmetrical diffusion restriction of periventricular white matter, namely, neonatal rotavirus-associated leukoencephalopathy. The extensive white matter injury seen in this cohort raises concerns about the long-term neurodevelopmental outcomes. In the present study, we prospectively assessed the neurodevelopmental outcomes of 13 patients with neonatal rotavirus-associated leukoencephalopathy at a median age of 26 months (range, 23–68 months). Neurodevelopmental outcomes were evaluated using a neurological examination, developmental evaluations, and magnetic resonance imaging (MRI) of the brain. Overall, 6 of the 13 patients (46%) had abnormal neurodevelopmental outcomes: 1 patient had mental retardation, visual–motor integration (VMI) dysfunction, cerebral palsy, and epilepsy; 1 patient had cerebral palsy and VMI dysfunction; remaining 4 patients had VMI dysfunction. Follow-up MRI in 12 of 13 patients showed an increased signal intensity on periventricular white matter in all patients. These findings suggested that neonatal rotavirus-associated leukoencephalopathy could not be assumed to be benign in long-term neurodevelopment, particularly in VMI function. Early intervention and long-term follow-up are necessary for these patients. Our findings raise caution for rotavirus infection in this vulnerable population for infants.

Background/Aims: Drugs with anticholinergic properties (DAPs) are associated with adverse health outcomes in older patients. The objective of this study was to evaluate the factors that determine the prescribing of more DAPs in long-term care hospitals (LTCHs) in Korea. In addition, the current patterns of DAP prescription were explored using a novel platform, which can collect data from LTCHs.Methods: This was a Health-RESPECT (integrated caRE Systems for elderly PatiEnts using iCT) sub-study, which is a pragmatic, cluster-randomized, controlled trial. The Health-RESPECT platform was used to collect prescribed medication data of 466 patients (aged ≥ 65 years) from seven LTCHs. DAPs were identified using the Korean Anticholinergic Burden Scale (KABS). Physical frailty, cognitive function, functional status, and quality of life were evaluated.Results: Among 466 LTCH patients, 88.8% (n = 414) were prescribed DAPs, and the prevalence of high KABS (≥ 3) was 70.4% (n = 328). The drugs that contributed most to the total KABS were quetiapine (20.7%), chlorpheniramine (19.5%), tramadol (9.8%), cimetidine (5.8%), and furosemide (3.6%). Polypharmacy, higher body mass index, less dependence, better communication and cognitive functions, and poorer quality of life were associated with high KABS.Conclusions: Although the patients with a high burden of DAPs were less dependent and had better cognitive and communication functions, they had poorer quality of life. DAP use in LTCH patients should be monitored carefully, and the risk/ benefit relationship for their use should be considered.

Purpose Acute promyelocytic leukemia (APL) is a rare disease in children and there are some different characteristics between children and adult. We aimed to evaluate incidence, clinical characteristics and treatment outcomes of pediatric APL in Korea.Materials and Methods Seventy-nine pediatric APL patients diagnosed from January 2009 to December 2016 in 16 tertiary medical centers in Korea were reviewed retrospectively.Results Of 801 acute myeloid leukemia children, 79 (9.9%) were diagnosed with APL. The median age at diagnosis was 10.6 years (range, 1.3 to 18.0). Male and female ratio was 1:0.93. Thirty patients (38.0%) had white blood cell (WBC) count greater than 10×109/L at diagnosis. All patients received induction therapy consisting of all-trans retinoic acid and chemotherapy. Five patients (6.6%) died during induction chemotherapy and 66 patients (86.8%) achieved complete remission (CR) after induction chemotherapy. The causes of death were three intracranial hemorrhage, one cerebral infarction, and one sepsis. Five patients (7.1%) suffered a relapse during or after maintenance chemotherapy. The estimated 4-year event-free survival and overall survival (OS) rates were 82.1%±4.4%, 89.7%±5.1%, respectively. The 4-year OS was significantly higher in patients with initial WBC < 10×109/L than in those with initial WBC ≥ 10×109/L (p=0.020).Conclusion This study showed that the CR rates and survival outcomes in Korean pediatric APL patients were relatively good. The initial WBC count was the most important prognostic factor and most causes of death were related to serious bleeding in the early stage of treatment.

Animal models have been utilized to understand the pathogenesis of Zellweger spectrum disorders (ZSDs); however, the link between clinical manifestations and molecular pathways has not yet been clearly established. We generated peroxin 5 homozygous mutant zebrafish (pex5−/−) to gain insight into the molecular pathogenesis of peroxisome dysfunction. pex5−/− display hallmarks of ZSD in humans and die within one month after birth. Fasting rapidly depletes lipids and glycogen in pex5−/− livers and expedites their mortality. Mechanistically, deregulated mitochondria and mechanistic target of rapamycin (mTOR) signaling act together to induce metabolic alterations that deplete hepatic nutrients and accumulate damaged mitochondria. Accordingly, chemical interventions blocking either the mitochondrial function or mTOR complex 1 (mTORC1) or a combination of both improve the metabolic imbalance shown in the fasted pex5−/− livers and extend the survival of animals. In addition, the suppression of oxidative stress by N-acetyl L-cysteine (NAC) treatment rescued the apoptotic cell death and early mortality observed in pex5−/−. Furthermore, an autophagy activator effectively ameliorated the early mortality of fasted pex5−/−. These results suggest that fasting may be detrimental to patients with peroxisome dysfunction, and that modulating the mitochondria, mTORC1, autophagy activities, or oxidative stress may provide a therapeutic option to alleviate the symptoms of peroxisomal diseases associated with metabolic dysfunction.

Background/aim Annals of Geriatric Medicine and Research held its inaugural international editorial board virtual meeting on September 16, 2021, to brainstorm ideas for sustainable growth. This special article summarizes the key concepts obtained from the webinar proceedings, with further development of ideas from ensuing discussions occurring after the meeting. Methods From the initial discussion points provided by eight editorial board members, including six presenters, email discussions further enriched these ideas to construct the current special article. The key points discussed were: 1) impactful research and impact factors, 2) international and Asian perspectives, and 3) challenges to sustainable growth. Results The editors noted the existing gap between the impact factor and research impact as a challenge for the growth paths of regional journals. However, they agreed that persevering with impactful research would ultimately translate into parallel and gradual gains in impact, which is, therefore, consistent with the organic growth of the journal. Acknowledging challenges in navigating between unique Asian perspectives and international outlooks, the editors encouraged academic journals to serve as bridges linking international evidence with the richness of local perspectives. For sustainable growth, the editors suggested that journals may be forged into the academic ecosystems of the region, diversify value streams, and establish themselves as reputable brands in disciplines. Conclusion By combining these discussions, we proposed the 'IMPACT' strategy for journals on the growth path in the region, which stands for 1) IMmersive user experience encompassing authors, reviewers, and readers; 2) Pasteur's quadrant use-inspired research; 3) Asia-Pacific context; 4) Collaborative; and 5) Translation to practice and policy.

Background: To improve the rehabilitation team’s awareness of patient mobility and participation by enhancing communication between therapists and nurses and conducting patient education.Methods: This study used a non-equivalent control group with a non-synchronized design. To facilitate communication between therapists and nurses, we used a manual for mobility management to improve the sharing of information on the functional status of patients. We also implemented patient education to improve their awareness of mobility and participation. Finally, we conducted newly devised surveys related to patient functional status and awareness that were applied by therapists and nurses.Results: The nurses reported significantly lower functional levels of patients compared to those assessed by therapists. After the intervention, the kappa values representing the concordance between therapists and nurses improved to almost perfect agreement for transfer ability (κ=0.836), mobility (κ=0.664), and toileting (κ=1.000). We also observed a statistically significant increase in questionnaire scores with respect to nurses’ awareness (p

Among the many potential organizational contexts, this study focuses on organizational culture, as it is critical for transformational leadership (TFL) behaviors to percolate into individual employees. Particularly, the study relies on the Competing Values Framework developed by Quinn and his colleagues. Relying on a Korean survey of central and local government employees, the study explores whether TFL influences employees’ perceptions of helping behavior and performance. Moreover, the study examines the moderating role of employees’ perceptions of organizational culture on the TFL-helping and TFL-performance linkages. The results demonstrate that clan culture enhances the TFL-helping and TFL-performance linkages, whereas hierarchical culture attenuates TFL’s relationship with helping behavior and performance.

A digital healthcare system based on augmented reality (AR) has promising uses for postoperative rehabilitation. We compared effectiveness of AR-based and conventional rehabilitation in patients after rotator cuff repair (RCR). This study randomly allocated 115 participants who underwent RCR to digital healthcare rehabilitation group (DR group) and conventional rehabilitation group (CR group). The DR group performed AR-based home exercises using UINCARE Home+, whereas the CR group performed brochure-based home exercises. The primary outcome was a change in the Simple Shoulder Test (SST) score between baseline and 12 weeks postoperatively. The secondary outcomes were the Disabilities of the Arm, Shoulder and Hand (DASH) score; Shoulder Pain And Disability Index (SPADI) score; EuroQoL 5-Dimension 5-Level (EQ5D5L) questionnaire score; pain; range of motion (ROM); muscle strength; and handgrip strength. The outcomes were measured at baseline, and at 6, 12, and 24 weeks postoperatively. The change in SST score between baseline and 12 weeks postoperatively was significantly greater in the DR group than in the CR group (p = 0.025). The SPADI, DASH, and EQ5D5L scores demonstrated group \(\times\) time interactions (p = 0.001, = 0.04, and = 0.016, respectively). However, no significant differences over time were observed between the groups in terms of pain, ROM, muscle strength, and handgrip strength. The outcomes showed significant improvement in both groups (all p Trial registration: ClinicalTrials.gov (identifier: NCT04511377). Registered on August 10, 2020. http://clinicaltrials.gov/ct2/show/NCT04511377

This study aimed to investigate the macrophage migration inhibitory factor (MIF) and associated clinical factors in neonates. Clinical information and blood samples were obtained from 77 neonates. Clinical details were reviewed from medical records, and MIF was measured by enzyme-linked immunosorbent assay using blood samples acquired within a week after birth. Statistical analyses were performed between plasma MIF concentration and clinical factors. Among the 77 newborn infants, 25 were born at34 weeks of gestation (preterm), 25 at 34 to 37 weeks (late preterm), and 27 at term gestation. The mean MIF was 9849.5 ± 7187.8 pg/mL in preterm, 5718.7 ± 4596.4 in late preterm, and 5361.1 ± 3895.7 in term infants (P = .016). Among 25 preterm infants born at34 weeks of gestation, MIF was significantly higher in infants with necrotizing enterocolitis (NEC, 19,478.6 ± 8162.4 pg/mL, n = 5) than that in infants without NEC (feeding intolerance 7173.7 ± 4203.0 pg/mL, n = 12 and others 7844.9 ± 5311.2 pg/mL, n = 8, P = .020). Elevated plasma MIF levels in the transitional period were significantly associated with preterm birth before 34 weeks of gestation and the development of NEC.

The effects of some drugs, aging, cancers, and other diseases can cause muscle wasting. Currently, there are no effective drugs for treating muscle wasting. In this study, the effects of ginsenoside Rd (GRd) on muscle wasting were studied.Tumour necrosis factor-alpha (TNF-α)/interferon-gamma (IFN-γ)-induced myotube atrophy in mouse C2C12 and human skeletal myoblasts (HSkM) was evaluated based on cell thickness. Atrophy-related signalling, reactive oxygen species (ROS) level, mitochondrial membrane potential, and mitochondrial number were assessed. GRd (10 mg/kg body weight) was orally administered to aged mice (23-24 months old) and tumour-bearing (Lewis lung carcinoma [LLC1] or CT26) mice for 5 weeks and 16 days, respectively. Body weight, grip strength, inverted hanging time, and muscle weight were assessed. Histological analysis was also performed to assess the effects of GRd. The evolutionary chemical binding similarity (ECBS) approach, molecular docking, Biacore assay, and signal transducer and activator of transcription (STAT) 3 reporter assay were used to identify targets of GRd.GRd significantly induced hypertrophy in the C2C12 and HSkM myotubes (average diameter 50.8 ± 2.6% and 49.9% ± 3.7% higher at 100 nM, vs. control, P ≤ 0.001). GRd treatment ameliorated aging- and cancer-induced (LLC1 or CT26) muscle atrophy in mice, which was evidenced by significant increases in grip strength, hanging time, muscle mass, and muscle tissue cross-sectional area (1.3-fold to 4.6-fold, vs. vehicle, P ≤ 0.05; P ≤ 0.01; P ≤ 0.001). STAT3 was found to be a possible target of GRd by the ECBS approach and molecular docking assay. Validation of direct interaction between GRd and STAT3 was confirmed through Biacore analysis. GRd also inhibited STAT3 phosphorylation and STAT3 reporter activity, which led to the inhibition of STAT3 nuclear translocation and the suppression of downstream targets of STAT3, such as atrogin-1, muscle-specific RING finger protein (MuRF-1), and myostatin (MSTN) (29.0 ± 11.2% to 84.3 ± 30.5%, vs. vehicle, P ≤ 0.05; P ≤ 0.01; P ≤ 0.001). Additionally, GRd scavenged ROS (91.7 ± 1.4% reduction at 1 nM, vs. vehicle, P ≤ 0.001), inhibited TNF-α-induced dysregulation of ROS level, and improved mitochondrial integrity (P ≤ 0.05; P ≤ 0.01; P ≤ 0.001).GRd ameliorates aging- and cancer-induced muscle wasting. Our findings suggest that GRd may be a novel therapeutic agent or adjuvant for reversing muscle wasting.

The arts in the United States, for a long time received strong support from both sides of the political aisle. However, in recent years, the arts have been transformed into a partisan issue that pits conservatives against liberals. The article points to the importance of political trust as a means of helping conservatives overcome their ideological inclinations and support the arts. Scholars argue that political trust influences more strongly individuals who perceive a given policy to be one that imposes ideological risks for them compared with those without such risks. Focusing on the moderating role of political trust, the article examines whether political trust can help alleviate the conservatives’ hostility to the arts. Relying on the 2016 General Social Survey, the article finds that conservatives have no direct relationship with arts spending, but they will be more likely to support arts spending when this is contingent upon political trust.

Although the relationships between public service motivation and work-related outcomes are contingent on an employee’s psychological state, little empirical evidence exists on whether psychological empowerment conditions the relationship between public service motivation and perceived organizational performance in public organizations. This study addresses this gap by examining data from the 2010 US Merit Principles Survey on psychological empowerment’s moderating role between public service motivation and the perceived achievement of organizational goals, as well as the perceived quality of work-unit products and services in the US federal government. First, the findings indicate that public service motivation and psychological empowerment improve both of these perceived organizational performance measures. Second, the findings indicate that the link between public service motivation and perceived organizational performance is slightly enhanced when public employees feel more psychologically empowered. Points for practitioners This article offers practical lessons for practitioners who are concerned about improving organizational performance. Emphasizing the importance of psychological empowerment in strengthening the link between public service motivation and perceived organizational performance, the article suggests a critical need to cultivate psychological empowerment in the public sector, which has been under heavy pressure to do more with less in a rapidly changing environment.

Depuis plusieurs dernieres decennies, la recherche sur le demantelement connait une transformation, passant d’un domaine obscur a un domaine en croissance rapide. Depuis le debut des recherches dans les annees 70, les pressions internationales, toujours plus nombreuses, en faveur de l’austerite gouvernementale necessitent une comprehension systemique du demantelement des organisations. Dans le present article, nous examinons l’evolution de la recherche sur le demantelement dans les organisations, qui est passee d’etudes de cas a des etudes statistiques. Nous formulons ensuite plusieurs suggestions sur les moyens de faire avancer la recherche sur le demantelement dans les organisations.Remarques a l’intention des praticiensLe present article propose des enseignements pratiques aux praticiens qui souhaitent comprendre la question du demantelement des organisations. En presentant l’evolution des recherches sur le demantelement des organisations depuis leur creation jusqu’a aujourd’hui, nous donnons un apercu succinct de la question du demantelement des organisations. Notre article interessera des lors ceux qui doivent operer dans le monde d’aujourd’hui, ou les pressions en faveur de l’austerite budgetaire sont de plus en plus fortes.

AIM We aimed to determine whether both hands should be tested for handgrip strength and whether it is necessary to perform repeated measurements in each hand. METHODS The data were obtained from the Korea National Health and Nutrition Examination Survey conducted from 2014 to 2018. The participants performed three trials of handgrip strength measurement for each hand alternately, with 60-s rest between the trials. From this pool of data, we included 23 901 participants aged ≥19 years who had completed surveys on the handgrip strength test, and obtained their medical history. RESULTS The dominant hand had a significantly stronger handgrip strength than the non-dominant hand (32.75 ± 0.10 vs. 30.95 ± 0.09 kg, P