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PURPOSE This study aimed to identify the prevalence of sarcopenia among acute stroke patients, differences in characteristics based on the presence of sarcopenia, the association between functional and sarcopenia factors, and the association between characteristics and the presence of sarcopenia. METHODS This study was conducted using a cross-sectional design. Sixty-two stroke patients volunteered to participate and were assigned to the sarcopenia group (n=32) and the non-sarcopenia group (n=30). All data collection, including assessment of general characteristics, sarcopenia factors and functional factors, was completed within one day. RESULTS A sarcopenia prevalence rate of 51% was observed. As skeletal muscle mass index (SMI) and grip strength increased, the berg balance scale (BBS) also increased. Additionally, as grip strength increased, the modified Barthel index (MBI) increased. Significant differences between groups were observed in the characteristics of age, weight, mini-mental state examination, SMI, grip strength, manual muscle testing, BBS, functional ambulation category, and MBI. Furthermore, with each increase of 1 in SMI, the probability of belonging to the sarcopenia group decreased by 0.204 times. CONCLUSIONS A high prevalence of sarcopenia was observed in acute stroke patients, with differences in characteristics between stroke patients without sarcopenia and those with sarcopenia. As sarcopenia factors increased, BBS and MBI also increased. Increasing SMI in acute stroke patients can reduce the risk of sarcopenia diagnosis; therefore, exercise interventions aimed at increasing SMI should be considered.

Purpose Cancer is the leading cause of death in Korea, leading many investigators to focus on cancer research. We present the current practice of variable selection methods for multivariate analyses in cancer studies recently published in major oncology journals in Korea. Methods We included observational studies investigating associations between exposures and outcomes using multivariate analysis from 10 major oncology journals published in 2021 in KoreaMed, a Korean electronic database. Two reviewers independently and in duplicate performed the reference screening and data extraction. For each study included in this review, we collected important aspects of the variable selection methods in multivariate models, including the study characteristics, analytic methods, and covariate selection methods. The descriptive statistics of the data are presented. Results In total, 107 studies were included. None used prespecified covariate selection methods, and half of the studies did not provide enough information to classify covariate selection methods. Among the studies reporting selection methods, almost all studies only used data-driven methods, despite having study questions related to causality. The most commonly used method for variable selection was significance in the univariate model, with the outcome as the dependent variable. Conclusion Half of the included studies did not provide sufficient information to assess the variable selection method, and most used a limited data-driven method. We believe that the reporting of covariate selection methods requires improvement, and our results can be used to educate researchers, editors, and reviewers to increase the transparency and adequacy of covariate selection for multivariable analyses in observational studies.

Background and Objectives: Respiratory and periodontal diseases are among the most common diseases affecting humans worldwide. Periodontal disease is a risk factor for aspiration pneumonia and other respiratory diseases. However, the evidence supporting the link between respiratory and periodontal disease is inconclusive and insufficient. Therefore, this study aimed to investigate the relationship between oral disease symptoms and respiratory diseases. Materials and Methods: Adults who underwent oral examinations and lung disease tests were recruited from the 2019 Korea National Health and Nutrition Examination Survey (KNHANES). A total of 14,956 individuals participated in the 2019 KNHANES. Among the 6846 participants who underwent oral examinations, 1320 children and adolescents were excluded. Additionally, of the 4119 adults aged ≥40 years who underwent dual lung function tests, those who did not respond to key independent confounding variables were excluded. The final sample consisted of 2988 adults. Results: Complex sample multivariate logistic regression analysis revealed that the risk of restrictive ventilation disorder was lower in individuals without chewing discomfort compared to individuals with chewing discomfort (odds ratio, 0.68; 95% confidence interval, 0.479–0.996), and the difference was statistically significant. Only one significant difference was observed between the two groups. Conclusions: Chewing discomfort is a major periodontal health-related factor associated with chronic obstructive pulmonary disease (COPD). Although the exact mechanism underlying the relationship between masticatory discomfort and COPD remains unclear, masticatory discomfort is an early symptom of oral diseases. The findings from this study provide additional basic data for the prevention of oral diseases and COPD in Korea.

Background and Objectives: Sarcopenia is a significant concern in stroke rehabilitation, with a high prevalence reported in acute stroke patients. This study examines the effect of sarcopenia on rehabilitation outcomes in acute stroke patients. Materials and Methods: This study was conducted with acute stroke patients admitted within 90 days of onset to the rehabilitation hospital. Participants were divided into a stroke with sarcopenia group and a stroke without sarcopenia group. Evaluations were conducted at baseline, 4 weeks, and 8 weeks, including the following assessments: manual muscle testing (MMT), Berg Balance Scale (BBS), functional ambulation category (FAC), and Modified Barthel Index (MBI). Both groups received an identical rehabilitation program for 8 weeks. Results: Significant within-group improvements were observed in both groups across all measures (p < 0.05). However, the stroke with sarcopenia group showed significantly less improvement in MMT, BBS, FAC, and MBI compared to the stroke without sarcopenia group at both 4 and 8 weeks (p < 0.05). Conclusions: These results underscore the significant impact of sarcopenia on functional recovery in stroke patients, despite both groups receiving identical rehabilitation programs. The presence of sarcopenia was a critical predictor of poorer outcomes in muscle strength, balance, ambulation, and activities of daily living. Given these findings, specific rehabilitation strategies targeting sarcopenia are needed to improve recovery in stroke patients. Future research should include larger sample sizes, longer follow-ups, and sarcopenic patient-specific rehabilitation programs.

BackgroundThe nutrition support team (NST) works to improve malnutrition in hospitalized patients, and its role is expanding as more hospitals adopt NST. This study aimed to identify the clinical characteristics of NST-referred patients admitted to a tertiary hospital. The study focused on two groups: those who achieved the target calories, approximately 75% or more of their caloric needs relative to their body weight regardless of the period after the first NST referral, and those who improved their calorie intake 1 week after NST therapy. This study also analyzed the important factors affecting the achievement of target calorie intake and improvement in calorie intake to discover the focus of future NST therapy.MethodsThis study examined 1,171 adult patients (aged ≥18 years) who were referred to the NST from all the departments within a tertiary hospital at least twice, with a minimum one-week interval between referrals, between January 1, 2019, and December 31, 2020. The study participants consisted of patients receiving

Objectives: This study aimed to investigate the nutritional status and dietary behavior of adolescents from North Korean refugee (NKR) families residing in South Korea (SK), who are known to be at a higher risk of malnutrition due to their lower socioeconomic status and facing other psychological challenges. Methods: A total of 178 adolescents (91 males and 87 females) from NKR families were included in the analysis, and their demographic details such as age, birthplace, parental nationality, and duration of their settlement in SK were collected through questionnaires. Anthropometric measurements were also taken to determine their growth and nutritional status according to the 2017 Korean National Growth Charts for children and adolescents. The study used the Nutrition Quotient for Korean Adolescents (NQ-A) questionnaire to assess the dietary behavior of the participants. Results: Approximately 11.8% and 10.1% of participants were identified with malnutrition and obesity, respectively. The total mean score for the NQ-A was 50.1. The mean scores for the individual factors of balance, diversity, moderation, environment, and practice were 49.2, 44.7, 43.8, 51.2, and 61.5, respectively. Approximately 47.2% of participants had a low NQ-A grade. However, there was no significant difference in the NQ-A scores according to their nutritional status or duration of time in SK. Conclusions: Adolescents from NKR families exhibited both malnutrition and obesity. However, their dietary behavior, as assessed using the NQ-A, did not vary with their nutritional status. The unique challenges and related dietary behavior of North Korean adolescent refugees should be taken into consideration, when developing targeted strategies for nutritional education and health management programs.

Aim To assess the growth status of North Korean refugee adolescents (NKRA) living in South Korea (SK) and compare their growth status with that of SK adolescents (SKA). Subjects and methods NKRA were interviewed from 2017 to 2020, whereas the data for SKA were from the 2016 to 2018 Korea National Health and Nutrition Examination Surveys. SKA and NKRA were matched by age and gender in a 3:1 ratio and 534 SKA and 185 NKRA were enrolled. Results After adjusting for the covariates, NKRA had greater prevalences of thinness (odds ratio [OR], 11.5; 95% confidence interval [CI], 2.9–45.6) and obesity (OR, 12.0; 95% CI, 3.1–46.1) than SKA, but were not of short stature. In comparison with SKA in low-income families, NKRA had similarly greater prevalences of thinness and obesity, but not of short stature. As the length of stay of NKRA in SK increased, the prevalence of short stature and thinness did not decrease, while the prevalence of obesity increased significantly. Conclusion Although they had lived in SK for several years, NKRA had greater prevalences of thinness and obesity than SKA and the prevalence of obesity increased significantly with the length of stay in SK.

This study aimed to assess and evaluate the prevalence and methodological quality of systematic reviews (SRs) published in major Korean medical journals (KMJs). The top 15 journals with the highest Korean Medical Citation Index, published between 2018 to 2021, were selected. We assessed the methodological quality of SRs using A Measurement Tool to Assess Systematic Reviews 2 (AMSTAR 2). In total, 126 SRs were included, with an average of 32 SRs being reported annually. The overall prevalence of SRs in KMJs was 2.8%, with an increase from 2.6% in 2018 to 3.4% in 2021. Overall, the methodological quality of SRs was low (9.5% low, 90.5% critically low). More than 80% of the studies adhered to critical domain items such as a comprehensive literature search and risk of bias assessment, but for items such as protocol registration and listing excluded studies and the justification for exclusion, the adherence rate was less than 15%. While the number of SRs in KMJs steadily increased, the overall confidence in the methodological quality was low to critically low. Therefore, in order to provide the best evidence for decision-making in clinical and public health areas, editors, reviewers, and authors need to pay more attention to improving the quality of SRs.

Background and aimsThe nutrition support team (NST) comprises doctors, nutritionists, pharmacists, and nurses who provide intensive nutritional treatment designed for each patient by evaluating their nutritional status of hospitalized patients. This study aimed to identify the clinical characteristics of patients referred to the NST among those admitted to a tertiary hospital and to understand the factors affecting their clinical course and changes in pressure sore grades.MethodsThis study included 1,171 adult patients aged 18 years or older referred to the NST at a tertiary hospital in a metropolitan city between 1 January 2019 and 31 December 2020. Patients were divided into five age groups, neuro department and non-neuro department, those treated in the intensive care unit (ICU), and those not treated in the ICU. Patients were also compared based on the presence of pressure sores at the time of NST referral and changes in pressure sore grades at the first time of NST referral and discharge (improved pressure sores, no change in pressure sores, and aggravated pressure sores). In addition, this study examined the factors affecting changes in pressure sore grades.ResultsAs age increased, the proportion of both low albumin levels and pressure sores significantly increased (p < 0.001), and the neuro department showed a significantly lower proportion of low albumin levels and pressure sores (p < 0.001). The proportion of patients with pressure sores was higher (64.9%), and this patient group showed significantly higher rates of low albumin levels (p < 0.001) and treatment in the ICU (p < 0.001). The group with aggravated pressure sore grades had a significantly higher proportion of patients in the surgery department (p = 0.009) and those treated in the ICU (p < 0.001). Admission to the surgery department was a factor that aggravated the grade of pressure sores [adjusted odds ratio (aOR) = 1.985, 95% confidence interval (CI) = 1.168–3.371]. When patients were not treated in the ICU, the grade of the pressure sores was less likely to worsen (aOR = 0.364, 95% CI = 0.217–0.609).ConclusionPressure sores and low albumin levels are closely related, and the risk of developing and aggravating pressure sores is particularly high in patients in the surgery department and those receiving ICU treatment. Therefore, it is necessary to actively implement NST referral to ensure that overall nutrition, including albumin, is well supplied, especially for patients in the surgery department and treated in the ICU, as they are at high risk of pressure sore development and aggravation. Moreover, since low albumin levels frequently occur in elderly patients, it is necessary to consider including the elderly in the indications for referral to the NST.

Background and Objectives: Grip strength is a measure of general health and is associated with oral health. This study aimed to investigate the relationship between the number of teeth and grip strength in Korean adults. Methods and Materials: We recruited adult participants who underwent oral examinations in the Korean National Health and Nutrition Examination Survey (KNHANES) between 2016–2018. When performing the KNHANES oral examination, an experienced dentist performed it according to the oral examination guidelines and recorded the results. A total of 24,269 participants from the 2016–2018 KNHANES were included in this study. Of these, only 16,489 participants underwent oral screening. A total of 3209 were non-adult children and adolescents, and 1781 did not respond to the grip strength test; those who did not respond to the main independent confounder were excluded. The relationships between grip strength, general characteristics, general health, oral health, and the number of remaining teeth were analyzed. There were 11,499 subjects in total in this study, with 4839 males and 6660 females. The age groups were 19–65 years of age, with 8387 subjects, and 65 years and older, with 3112 subjects, and the number of remaining teeth was 0–9 for 936 subjects, 10–19 for 1015 subjects, and 20–28 for 9548 subjects. Results: The probability that the higher the grip strength, the higher the residual number of gingiva was estimated by multinomial logistic regression analysis using complex sampling. The higher the grip strength, the higher the probability of having 20–28 teeth remaining (adjusted odds ratio, 1.59; 95% confidence interval, 1.19–2.13). Conclusions: Maintaining general health is related to maintaining teeth; the higher the grip strength, the higher the number of remaining teeth.

The generation of royalties on the use of foreign-made inoculum strains or starters as a result of the implementation of the ‘Nagoya Protocol’ has led to efforts and healthy competition to secure useful biological resources in each country. In this study, we recognized the necessity and importance of securing useful strains in Korea and produced starters using five strains of fungi (Aspergillus oryzae and Aspergillus niger). Specifically, the quality characteristics exhibited by different strain inoculum concentrations (1, 3, 5% (v/w)) and drying conditions (low-temperature air drying at 35 °C for 24 h and high-temperature hot air drying at 45 °C for 18 h) during the starter manufacturing process were analyzed. Parameters such as enzyme activity and free amino acid and volatile flavor compound content, which may vary based on production conditions, are expected to produce basic data for the production of Korean-type starters.

Objective This study aimed to investigate the nutritional status of children and adolescents from North Korean defector (NKD) families who are currently living in South Korea (SK) and compared with the status of those from SK families.Design A cross-sectional study comparing the prevalence of malnutrition, overweight and obesity between children and adolescents from NKD families and SK families.Setting Children and adolescents from NKD families were interviewed face-to-face directly, whereas the data about those from SK families acquired by using 2017 Korea National Health and Nutrition Examination Survey. Their nutritional status were estimated using the 2017 Korean National Growth Charts for children and adolescents.Participants The total number of children and adolescents was 2136 consisting of 527 subjects from the NKD families and 1609 subjects from the SK families.Results The overall prevalence of stunting, wasting, underweight, overweight and obesity in NKD group was 8.9%, 10.2%, 10.4%, 11.2% and 12.2% respectively, and 1.9%, 7.1%, 5.9%, 9.2% and 9.3%, respectively, in SK families. The NKD group showed significantly higher prevalence than SK group in stunting (p

Parents' socialization beliefs have implications for the psychological adjustment of their children through their parenting behaviors; however, such pathways have rarely been established among Chinese American families. The present study examined how Chinese American parents' goals for their children to take on bicultural values and behaviors (i.e., bicultural socialization beliefs) influenced their child's level of depressive symptoms in emerging adulthood through their parenting behaviors and the level of parent-child alienation. Data came from Waves 2 (adolescence) and 3 (emerging adulthood) of a longitudinal study of 444 Chinese American families. Mothers' reports of their bicultural socialization beliefs positively predicted adolescents' reports of mothers' autonomy-supporting behaviors and interdependence-focused shaming behaviors. In addition, there was a significant and negative indirect effect of mothers' bicultural socialization beliefs on emerging adult depressive symptoms through adolescents' reports of mothers' autonomy-supporting behaviors and emerging adults' reports of alienation to their parents. In contrast, there was a significant and positive indirect effect from fathers' reports of their bicultural socialization beliefs to emerging adult depressive symptoms, through emerging adults' reports of alienation only. Findings contribute to our understanding of bicultural processes in Chinese American families and establish that parents' beliefs have significant implications for the psychological adjustment of Chinese American youth.

This study adopts a cultural ecological perspective to examine how cumulative effects of external transcultural and cultural strengths are related to baseline and changes in three markers of Mexican-origin adolescents' self-growth (i.e., resilience, life meaning, and discipline). Using a three-wave longitudinal data set (5 years) of 604 adolescents, cumulative strengths (CS) was calculated, and growth curve analyses showed a similar pattern of findings for both transcultural and cultural cumulative strengths models: Adolescents with higher CS showed higher baseline resilience, life meaning, and discipline. While there were no significant associations between adolescents' CS scores and the increase in resilience, adolescents with higher CS scores showed steeper declines in life meaning and discipline (although these declines were no longer significant for cultural CS when transcultural and cultural CS were simultaneously tested in the same model). The findings emphasize a cultural ecological understanding of Mexican-origin youths' positive development from early to later adolescence. They also provide support for a CS model and have implications for positive psychology theories.

Few studies have considered bilingualism's impact on cognitive development within the sociolinguistic and cultural context of the immigrant communities where bilingualism is commonly practiced. In the United States, many Mexican-origin bilingual youth practice their bilingual skills by "brokering" (i.e. translating/interpreting between languages) for their immigrant parents who have low English proficiency. Meanwhile, these youth may also experience discrimination in their daily life. The present study focuses on Mexican-origin bilingual youth brokers (N = 334) in order to examine how discriminatory experiences (i.e. daily and ethnic discrimination) and bilingual brokering experiences captured by profiles are related to cognitive control performance (i.e. attentional control and inhibition). We found no significant direct influence of either bilingual broker profiles or discriminatory experiences on cognitive control. However, the associations between discriminatory experiences and cognitive control performance depended upon brokering experiences. Specifically, greater discrimination was associated with lower cognitive control performance among moderate brokers (with moderate bilingual experiences), but the association was attenuated among efficacious brokers (with positive bilingual experiences). Findings highlight the need to consider the sociolinguistic heterogeneity of both discriminatory experiences and language use when investigating cognitive control performance in bilinguals.

This study aims to investigate the joint strength of longitudinal plate-to-high-strength steel circular hollow-section X-type joints under plate axial load. The material properties of high-strength steel with nominal yield strengths of 460, 650, 900, and 1100 MPa were used for parametric analysis. The variables for analysis were ratios of chord diameter to thickness, plate width to chord diameter, and utilization. To determine the capacity of connections, the joint strengths using a deformation limit and a strength limit were considered and compared with American Institute of Steel Construction (AISC), Eurocode 3, and ISO 14346. The joint strength determined by the ultimate deformation limit is approximately equal to the joint strength determined by the strength limit state at the yield strength of 460 MPa. The difference between both the joint strengths, however, becomes higher with increasing yield strength. The design equations estimate the joint strength based on the ultimate deformation limit approximately until the limitation of the nominal yield strength in each design code. As the nominal yield strength increases, the joint strengths are overestimated. In using high-strength steel in circular hollow-section X-type joints, the reduction factors of 0.75 and 0.62 for AISC and ISO 14346 are suggested for the nominal yield strengths of 900 and 1100 MPa, respectively. In Eurocode 3, the reduction factor of 0.67 is also suggested for a yield strength of 1100 MPa.

Here, the authors construct 102 complete metagenome-assembled genomes (cMAGs) from Pacific Biosciences (PacBio) high-accuracy long-read (HiFi) metagenomic sequencing, showing as high nucleotide accuracy as reference genomes and revealing that regions hard to assemble by short-read sequencing comprise mostly of genomic islands and rRNAs.

Polyalkenoate cement (PAC) is a promising material for regenerative hard tissue therapy. The ionically rich glass component of PAC encourages bioactive interaction via. the release of essential ions. However, PAC bioactivity is restricted owing to (i) structurally inherent cationic network formers and (ii) surface bacterial biofilm formation. These two factors cause a deficiency in ion release, further complicated by secondary infections and premature therapeutic failure. Here, a multivalent zwitterionic network modifier (mZM) is presented for upregulation of ionic exchange and bioactivity enhancement. By introducing a non-zero charged mZM into PACs, an increase in the proportion of non-bridging oxygen occurs. The network modification promotes ion channel formation, causing a multiple-fold increase in ion release and surface deposition of hydroxy-carbonate apatite (ca. 74%). Experiments ex vivo and animal models also demonstrate the efficient remineralization ability of the mZM. Furthermore, divalent cationic interaction results in bacterial biofilm reduction (ca. 68%) while also influencing a shift in the biofilm species composition, which favors commensal growth. Therefore, PAC modification with mZM offers a promising solution for upregulation of bioactivity, even aiding in customization by targeting site-specific regenerative therapy in future applications.

Partial trisomy 1q is a rare chromosomal disorder characterized by ventriculomegaly with craniofacial, renal, cardiac, and finger and toe anomalies. Most reported cases of partial trisomy1q have involved stillborn or premature deaths due to cardiac or liver failure. This case report describes an 18-month-old patient with partial duplication of the 1q32-44 segments and consequent developmental delays who exhibited improvement in developmental status with rehabilitation. Prenatal ultrasonography and magnetic resonance imaging of the mother revealed ventriculomegaly and atrophic changes in the left cerebral hemisphere of the fetus. The infant was born with micrognathia, microphthalmia, macrocephaly, low-set ears, polydactyly, and long feet at 37+5 weeks of gestation. A chromosomal study revealed an abnormal male karyotype of 46,XY,rec(1)dup(1)(q32.1q44)inv(1)(p36.3q32.1)pat. In this rare case of a patient with partial trisomy, we observed improvement in developmental delays following treatment using appropriate rehabilitation techniques. Further research is required to help validate the findings of this case study and establish a standardized rehabilitation technique that can be subsequently applied to such cases.

Objective: The improvement of carcass traits is essential for the Hanwoo industry because of the Hanwoo grade determination system, and genome-wide association study (GWAS) analysis is an instrumental tool for identifying the genetic factors that impact these traits. While GWAS analysis utilizing family data offers advantages in minimizing genetic bias, research on family-based GWAS in Hanwoo is currently lacking. Methods: This study classified Group A using both parental and offspring genetic information, and Group B based solely on offspring genetic information, to compare GWAS analysis results of Hanwoo carcass traits. Results: A total of 16 significant single nucleotide polymorphism (SNP) markers were identified in Group A, comprising 7 for carcass weight (CWT), 3 for back fat thickness (BFT), and 6 for marbling score (MS). In Group B, 7 significant SNP markers were identified, including 3 for CWT, 1 for eye muscle area, 1 for BFT, and 2 for MS. Functional annotation analysis revealed only one common function related to carcass traits between the groups, while protein-protein interaction analysis indicated more gene interactions in Group A. The reliability of estimated values for common SNP markers identified between the groups was higher in Group A. Conclusion: GWAS analysis utilizing parental genetic information holds greater potential for application, owing to its higher reliability of estimated values and the ability to explore numerous candidate genes. [ABSTRACT FROM AUTHOR]

Breast cancer has been a significant contributor to cancer-related mortality, but advancements in early detection through regular mammography and improvements in treatment modalities have contributed to declining mortality rates in several regions. This study presents a novel approach to cancer diagnosis utilizing Full-Field Digital Mammography images through predictive analysis methods. By using predictive analytic techniques and mammography images, this study offers a novel way to cancer detection. The research involves the application of deep learning techniques to extract valuable insights from cancer images captured by mammography devices. The CBIS-DDSM (Curated Breast Imaging Subset of Digital Database for Screening Mammography) dataset including images from patients with varying types and stages of cancer, is collected and pre-processed to ensure uniformity and quality. Relevant features, including color, texture, and shape characteristics, are extracted, and a rigorous feature selection process is employed to identify discriminative markers. The Residual Network (ResNet) model is selected and trained on the dataset, with a focus on classification accuracy and robust predictive performance. Validation metrics, such as accuracy, IoU (Intersection over Union) score, dice score, and ROC (Receiver Operating Characteristic) curve are employed to evaluate the model's efficiency. After analysis, the proposed method had the best degree of mass lesion detection accuracy, at 99.24%. This research contributes to the advancement of non-invasive and efficient diagnostic tools, potentially enhancing early detection and intervention in cancer patients. The proposed method not only demonstrates promising results in terms of diagnostic accuracy but also emphasizes interpretability, seamless integration into clinical workflows, and adherence to ethical standards. [ABSTRACT FROM AUTHOR]