Dongshin University

Against the backdrop of population aging, community parks are important spaces for older adults’ daily activities, and perceived safety plays a key role in shaping their use and spatial satisfaction. This study selected six typical community parks in central Beijing, constructed an indicator system for safety perception needs, and applied an analytical KANO–IPA (Integrated Kano and Importance-Performance Analysis) approach to identify the demand attributes and optimization priorities of safety elements. The results reveal a clear hierarchy in older adults’ safety perception needs. Basic environmental and facility safety factors, such as pavement conditions and facility reliability, function as must-be needs. Elements related to spatial visibility, circulation, lighting, and wayfinding act as one-dimensional needs that steadily influence satisfaction, whereas features including natural surveillance, spatial enclosure, and activity atmosphere mainly enhance spatial experience as attractive needs. Priority analysis further indicates that circulation conditions and facility safety constitute the most critical aspects for improvement. Overall, older adults’ safety perception in community parks results from the combined effects of multiple spatial factors. Hierarchical spatial optimization can enhance user experience and improve resource allocation efficiency. The findings provide theoretical support and decision-making guidance for safety-oriented planning and age-friendly renewal of urban community parks in aging societies.

Chronic lymphocytic leukemia (CLL) is uncommon in Asia, and longitudinal genomic data from Asian cohorts are limited. We conducted serial whole-exome sequencing (WES) in a multicenter Korean cohort of newly diagnosed, elderly CLL treated with chlorambucil-obinutuzumab to evaluate mutational heterogeneity and clonal hematopoiesis of indeterminate potential (CHIP) during treatment and follow-up. Tumor-only variants were filtered, restricted to nonsynonymous or loss-of-function coding/splice-site mutations, and summarized as a binary patient-by-gene matrix for principal component analysis (PCA), trajectory analysis, and k-means clustering. CHIP was defined as ≥1 qualifying mutation in a prespecified CHIP gene set. Baseline PCA was more compact in patients with complete response at end of treatment, whereas partial response or progressive disease cases were more dispersed. PCA trajectories were compact and directionally consistent in complete responders, more dispersed in partial responders, and highly heterogeneous without a dominant direction in progressive disease. Clustering identified dispersed and compact clusters, and CHIP-associated mutations were enriched in the dispersed cluster (55.6% vs. 8.3%, Fisher's exact p = 0.0086). In paired samples collected 3-5 months after end of treatment, CHIP status changed in some patients. Serial WES may provide complementary information to treatment response, although these observations require confirmation in larger cohorts.

Atopic dermatitis (AD) has no definitive cure; therefore, alternative treatments should be developed. We have demonstrated in preliminary clinical trials that Biodegradable Microneedle Acupuncture (BMA) treatment improves symptoms and is safe for mild to moderate AD. The study focused on evaluating the effectiveness and safety of a new medical device called BMA for AD, while also assessing its cost-effectiveness. It also explored the gut microbiome of patients with AD before and after BMA treatment. This multicenter, participant-assessor-blinded, sham-controlled trial will be conducted from January 10, 2025, to January 10, 2026. In total, 184 participants with AD (n = 92 per group) will be recruited. Participants will be assigned randomly to two equal-sized groups: the BMA and sham groups. Treatment will be administered three times per weekduring the 4-week intervention phase. The primary outcome measure will be the objective SCORing Atopic Dermatitis index. Secondary outcome measures will include the Eczema Area and Severity Index, Dermatology Life Quality Index, Patient-Oriented Eczema Measure, and pruritus Visual Analog Scale scores. Other outcome measures will include gut microbiome, economic and safety evaluations. This study protocol will provide an important and thorough assessment of the effectiveness of BMA treatment in improving the symptoms of moderate or milder AD. In addition, we will evaluate the safety and costeffectiveness of BMA. We will also determine the link between AD and the microbiome. This clinical trial has been registered with the Korean Clinical Trial Registry (registration number: KCT0009870; date of registration: 25 October 2024).

Background/AimsThe clinical characteristics of Clostridioides difficile infection (CDI) in patients within the Asia-Pacific region who test positive on the nucleic acid amplification test (NAAT) and negative on the toxin enzyme immunoassay (EIA, hereafter referred to as “Toxin”) are unclear. We evaluated the clinical significance and associated factors of NAAT+/Toxin− patients whose diagnosis of CDI was confirmed by toxigenic C. difficile culture.MethodsThis retrospective cohort study enrolled adult patients admitted to Seoul St. Mary’s Hospital between January 2015 and December 2015 with a diagnosis of active CDI.ResultsIn total, 3,311 stool samples were subjected to C. difficile culture, NAAT, and toxin EIA. Among them, 298 culture-positive patients fulfilled the criteria for CDI, and 3 NAAT−/Toxin− patients were excluded. The risk factors for a negative EIA and positive NAAT and culture results were evaluated in 295 patients. Among them, 128 patients were Toxin− and 167 were Toxin+. No clinical or laboratory parameters (fever, white blood cell count of < 1,000/mm3, eosinophils, C-reactive protein, creatinine, or albumin) differed significantly between NAAT+/Toxin+ and NAAT+/Toxin− patients. In addition, the clinical outcomes did not differ between the two groups. In the multivariable analysis, previous use of antibiotics was inversely associated with negative EIA results, whereas high-dose corticosteroid use was positively associated.ConclusionsClinical outcomes related to CDI are not different between NAAT+/Toxin+ and NAAT+/Toxin− patients, emphasizing the need for individual clinical evaluation.

BackgroundIntegrative Neuromuscular Training (INT) is a multi-component training approach aimed at optimizing neuromuscular function, improving athletic performance, and reducing injury-related risks. While existing studies suggest that INT can improve injury risk factors and enhance performance, its effectiveness and underlying mechanisms remain contentious, with many existing studies lacking comprehensive quantitative synthesis and subgroup analyses.MethodsA systematic search was conducted across nine databases from their inception to August 31, 2025, for randomized controlled trials (RCTs) on the application of INT in athletes. The Cochrane Risk of Bias Assessment Tool (ROB2) was used for quality assessment. Meta-analysis was performed using Stata/MP 17.0, with risk ratios (RR) for dichotomous outcomes and standardized mean differences (SMD) for continuous outcomes. Hedges’ g and 95% confidence intervals (CI) were calculated for effect sizes, and publication bias was assessed using funnel plots and Begg’s and Egger’s tests. The GRADE method was employed to assess the quality of evidence.ResultsA total of 25 RCTs (10,124 participants) were included. The meta-analysis revealed that INT is associated with a reduced injury risk in athletes (RR = 0.73, 95% CI: 0.58–0.91, p = 0.004), as well as improvements in jump performance (SMD = 0.88, 95% CI: 0.58–1.17, p < 0.001), sprinting ability (SMD = 0.75, 95% CI: 0.44–1.06, p < 0.001), change-of-direction ability (SMD = 0.97, 95% CI: 0.38–1.57, p = 0.001), and dynamic balance (SMD = 0.91, 95% CI: 0.31–1.51, p = 0.003), However, significant heterogeneity was found in most studies, and according to ROB2, the majority of studies were categorized as “having some concerns”. Therefore, the certainty of the evidence should be interpreted in the context of the GRADE framework. Subgroup analysis suggests that INT may be particularly effective in adult athletes (≥ 18 years), female athletes, football players, and those undergoing high-frequency (≥ 3 sessions/week) and longer-duration (single session > 30 min) interventions.ConclusionCurrent evidence suggests that INT is associated with reduced injury risk and improvements in jump performance, sprinting, change-of-direction, and dynamic balance in athletes. Adult athletes, female athletes, and football players may benefit more significantly from INT, especially when the intervention frequency is ≥ 3 sessions per week and the duration exceeds 30 min per session.This study has been prospectively registered with the International Prospective Register of Systematic Reviews (PROSPERO) (registration number: CRD420251131811) and was reported in strict adherence to the PRISMA 2020 guidelines. The complete PRISMA flowchart and relevant details can be found in the supplementary materials.Supplementary InformationThe online version contains supplementary material available at 10.1186/s13102-026-01549-4.

Abstract Knee osteoarthritis (KOA) is a common degenerative joint disease impairing mobility and quality of life, especially in the elderly. Conventional treatments often fail to address its multifactorial nature. This study explores invasive laser acupuncture integrated with electroacupuncture, delivering precise and minimally invasive multimodal stimulation. A randomized, sham-controlled, assessor-blinded, pilot sized clinical trial will evaluate the safety and efficacy of laser acupuncture combined with electroacupuncture in 45 KOA patients. Participants will be assigned to one of three groups: (1) 650 nm laser with electroacupuncture, (2) 830 nm laser with electroacupuncture, or (3) sham laser with sham electroacupuncture. Treatments occur twice weekly for four weeks. Primary outcome: pain reduction (VAS). Secondary outcomes: functional improvement (KOOS), quality of life (EQ-5D-5L), and safety. Of 45 randomized patients, 43 completed the trial. At week 5, VAS at rest decreased from 62.5 ± 11.3 to 32.7 ± 15.6 in the 650-nm group, 59.7 ± 8.6 to 30.5 ± 23.0 in the 830-nm group, and 66.9 ± 10.3 to 41.9 ± 20.5 in the control group. VAS during activity decreased from 68.7 ± 8.7 to 32.8 ± 14.6, 67.8 ± 7.6 to 31.4 ± 22.0, and 69.3 ± 10.2 to 43.8 ± 20.6, respectively. KOOS improved to 84.7 ± 19.5 (650 nm) and 83.3 ± 25.5 (830 nm) but not in controls (91.1 ± 21.1). EQ-5D scores improved slightly but without significance. PGA rose to 6.7 ± 1.1 (650 nm), 7.1 ± 1.5 (830 nm), and 6.8 ± 1.0 (control). No serious adverse events occurred; mild bruising was the most common event. This pilot-sized trial proposes an innovative, patient-centered approach to KOA management, potentially reducing reliance on medications and invasive procedures. And is a cornerstone to larger clinical trials. Trial Registration: CRIS PRE20231022-003.

ObjectivesAcupuncture has been widely studied for its safety across multiple countries. Sterile acupuncture (SA), represented by the thumbtack needle, is commonly used due to its ease of application, minimal pain, and allowance of free movement. However, it is also associated with adverse events (AEs) such as foreign body sensation and allergic contact dermatitis. Biodegradable microneedle acupuncture (BMA) is a newly developed medical device that may overcome these limitations. This trial aims to confirm the superiority of BMA over SA (represented by the thumbtack needle) in terms of safety.MethodsA total of 224 participants diagnosed with dry eye disease, asthenopia, ocular pain, Bell’s palsy and its sequelae, or ptosis will be recruited from two hospitals. Participants will be randomly assigned to receive either BMA or SA in a 11 ratio. Acupuncture will be performed at eight standardized points bilateral GB14, TE23, EX-HN5, and ST1. Treatments will be administered three times per week for four weeks by Korean medicine doctors or residents with at least three years of clinical experience. The needles will be removed by the participants after four hours. The primary outcome is the incidence of treatment-related AEs. Secondary outcomes include vital signs, blood test results, incidence of allergic reactions, visual analog scale (VAS) scores for symptoms, quality of life, Ocular Surface Disease Index (OSDI) scores, and treatment satisfaction.ConclusionThis trial will provide evidence regarding the safety of BMA. The results may help clinicians select a safer alternative to conventional thumbtack needles, especially for patients with sensitive skin. In addition, findings may serve as reference data for regulatory evaluation of BMA safety and efficacy.

Myopia is a major global public health concern, with a particularly high and increasing prevalence in East Asia. Although significant progress has been made in regard to developing strategies to slow the progression of myopia, the precise biological mechanisms underlying the onset and progression of myopia remain unclear. Repeated low-level red light (RLRL) therapy, a novel non-invasive photobiomodulation (PBM) technique, has demonstrated promising efficacy for controlling axial elongation and refractive error progression. This review first outlines the clinical definition, epidemiology, and global health impact of myopia, followed by the etiology-based pathogenesis and corresponding intervention strategies. Special attention has been given to emerging mechanistic evidence supporting RLRL, particularly its role in activating mitochondrial cytochrome c oxidase (CCO), enhancing retinal metabolism, influencing choroidal changes in blood perfusion and thickness, and in scleral remodeling. Finally, the feasibility and potential mechanism of the RLRL therapy for slowing myopia progression have been discussed from the perspective of safety.

Lithium-ion batteries are extensively employed in electric vehicles (EVs) and energy storage systems (ESSs) owing to their high energy density, long cyclability, and cost-effectiveness. However, the use of flammable electrolytes makes them inherently susceptible to thermal runaway (TR), which can lead to ignition, explosion, and large-scale fires. Accordingly, early detection of defect internal conditions that precede thermal events is essential for ensuring battery safety. This study proposes a time-resolved partial discharge (TRPD)-based diagnostic method for identifying early electrical precursors of fire hazards in lithium-ion batteries. Both destructive (ex situ) and non-destructive (in situ) experiments were performed to collect defect signal data under physical deformation and accelerated degradation conditions. Through fast fourier transform (FFT) analysis of the acquired signals, specific frequency-domain characteristics associated with micro internal short circuits (MISC) were identified, particularly within the 3.9 MHz, 11.9 MHz, and 19 MHz bands. Defect signals were clearly distinguishable from background common-mode voltage (CMV) noise, confirming the diagnostic sensitivity of the proposed approach. The results demonstrate that the TRPD-based technique enables early recognition of latent insulation degradation and internal short-circuit phenomena before thermal runaway occurs. This work bridges the gap between conventional insulation monitoring and battery safety diagnostics, providing a scalable framework for integrating high-frequency signal analysis into EV and ESS battery management systems for fire prevention.