Gyeongju University

Background/Objectives: Task-oriented training (TOT) is a functional, goal-directed rehabilitation approach that promotes motor recovery after stroke through repetitive, task-specific practice; however, its overall effects on gait and balance in stroke survivors remain unclear. This systematic review- and meta-analysis-based study aims to evaluate the effects of TOT on gait and balance in patients with stroke. Methods: Comprehensive searches of PubMed, Embase, Web of Science, the Cochrane Library, and Scopus were performed. Eligible studies involving TOT interventions in patients with stroke were included, and methodological quality was assessed using the PEDro scale. A random-effects meta-analysis was then performed to estimate pooled effect sizes. Results: In total, 17 randomized controlled trials involving 888 participants were included. Compared with control interventions, TOT significantly improved gait speed (standardized mean difference [SMD] = 0.48, 95% confidence interval [CI]: 0.27–0.69, p < 0.0001), gait endurance (SMD = 0.49, 95% CI: 0.27–0.71, p < 0.0001), Berg Balance Scale (BBS) (SMD = 0.45, 95% CI: 0.08–0.82, p = 0.02), and timed up and go test performance (SMD = −0.28, 95% CI: −0.47 to −0.09, p = 0.003). Subgroup analysis of the BBS revealed differences based on stroke phase. Conclusions: Task-oriented training effectively improves gait and balance in stroke survivors and should be considered a key component of post-stroke rehabilitation. Future studies should explore its long-term effects and determine optimal training parameters according to stroke phase and patient characteristics.

Jujuboside B (JJB) is a saponin extracted from the Ziziphus jujuba var. spinose and has been reported to have anticancer effects. However, the detailed mechanism of its anti-cancer effect in non-small cell lung cancer (NSCLC) remains unclear. New combination therapies may be able to overcome TRAIL resistance. In this study, we found that JJB regulates the activity of PPARγ and investigated whether the combination of JJB and TRAIL had synergistic anti-cancer effects against NSCLC cells. Experimental procedure: We assessed cell death induced by the combination of TRAIL and JJB in NSCLC cells using ATPlite Luminescence, LDH, and caspase activity assays. We also examined endoplasmic reticulum (ER) stress-mediated cell death using the intracellular calcium assay and western blot analysis. The combination of JJB and TRAIL significantly reduced cell viability and increased apoptotic cell death by binding CHOP to the DR4/5 promoter in NSCLC cells. JJB induced ferroptosis by increasing the expression of Nox4 and ATF3 and the levels of malondialdehyde (MDA) and reactive oxygen species (ROS), as well as by reducing the expression of SLC7A11 and Gpx4 and the level of glutathione (GSH) through the activation of ER stress. Consistent with this, N-acetylcysteine (NAC) suppressed ER stress-mediated ferroptosis by reducing the expression of Nox4, ATF3, and cleaved caspase-3 and by increasing the expression of SLC7A11 and Gpx4 in JJB-treated NSCLC cells. In radioresistant NSCLC models, combined treatment with JJB and radiation induced ferroptosis and overcame radioresistance by regulating the epithelial-mesenchymal transition (EMT) phenomenon. Therefore, JJB could be a potential therapeutic strategy in NSCLC.

The root of Platycodon grandiflorum has long been used as a vegetable and traditional medicine. Although the antibacterial activity of the plant's lipophilic (hexanes and dichloromethane) fractions has been reported, the specific antibacterial compounds have not been identified. In this study, chemical analysis of the lipophilic fractions of P. grandiflorum extracts led to the discovery of five new polyacetylenes (1-5) and nine known compounds (6-14). Their structures were elucidated and confirmed based on 1D and 2D NMR data together with mass spectra. In particular, the relative and absolute configurations of 1 were elucidated by coupling constants, NOESY and J-based configurational analysis in combination with Mosher's method. Compounds 1 and 2 demonstrated strong antifungal activity against Candida albicans. Additionally, compound 1 significantly inhibited quorum sensing in Chromobacterium violaceum, a commonly used biosensor strain. Compounds 2 and 14 also exhibited mild inhibitory activity. Compounds 8 and 12-14 exhibited potent antibacterial activity against Escherichia coli, Kocuria rhizophila, and Staphylococcus aureus, as well as antifungal activity against Candida albicans. These compounds may be responsible of the antimicrobial activity of P. grandiflorum.

Background: The study aim was to explore and integrate the experiences of individuals with substance addiction in South Korea using a ecological model to identify risk factors and relapse triggers across multiple dimensions.Methods: This integrative review was conducted using Whittemore and Knafl’s five-step integrative review method. A comprehensive literature search was conducted using five Korean electronic databases from June 13 to July 25, 2023. Keywords included “narcotic,” “drug,” “addict,” and “recovery.”Results: A total of 22 studies met the inclusion criteria. Risk and relapse factors in narcotics addiction were categorized into intrapersonal (emotional, cognitive, behavioral, physical, physiological), interpersonal (family, relationships, occupation), community (social, structural), and public policy (legal, institutional) aspects. These factors interacted to form a complex structure that heightened addiction risk and overlapped as both risk and relapse factors.Conclusions: Narcotics addiction remains a serious public health issue that is exacerbated by various intrapersonal, interpersonal, community, and public policy-related factors. The study findings underscore the multifaceted nature of addiction and relapse and provide a broad perspective on the complexities of prevention and recovery strategies.

Abstract BackgroundThe global increase in the aging population has led to a corresponding rise in dementia cases. This study explores the potential link between occupational toxin exposure and the incidence of dementia, aiming to identify high‐risk populations.MethodWe analyzed data from 2,485 male participants aged 60 and over in the Korean Longitudinal Study on Cognitive Ageing and Dementia (KLOSCAD). Participants were categorized into no or very low, low and high toxin exposure risk groups based on their lifetime occupation according to the International Standard Classification of Occupations classification. Exposure to the specific hazard type, including carcinogens, skin sensitizers, airway sensitizers, mutagenic substances, reprotoxic agents and biological hazards were identified in relation to their lifetime occupation. We conducted multinomial logistic regression analysis, adjusting for occupation‐related factors, APOE genotype, age, education, health status and lifestyle behaviors, to investigate the relationship between the levels of toxin exposure risk, specific toxin types, and the incidence of mild cognitive impairment (MCI), Alzheimer’s disease (AD) dementia and other dementia.ResultCompared to the no or very low toxin exposure risk group, participants in the low toxin risk exposure group (odds ratio (OR) 2.24, 95% CI 1.08 – 43.64) and high toxin risk exposure group (OR 2.97, 95% CI 1.31 – 6.74) showed a significantly increased risk of AD dementia. Exposure to carcinogens, skin sensitisers, reprotoxic agents and biological hazards showed a significant association with the risk of incident AD dementia. Among toxin types, skin sensitizers presented the highest OR of 5.48 (95% CI 1.29‐23.31) in multivariable model. No significant associations were found with MCI and other dementia.ConclusionHigher risk of lifetime occupational toxin exposure may be associated with an increased risk of AD dementia, showing consistent results across various toxin types, underscoring the need for heightened attention to toxin exposure in AD dementia prevention.

This study investigated the impact of the coronavirus disease 2019 (COVID-19) pandemic and associated control strategies on the incidence of appendicitis in Seoul, using data from 2018 to 2020 from Korea's National Health Insurance. We analyzed records of total, complicated, and uncomplicated appendicitis cases, as well as the ratio of complicated to uncomplicated appendicitis, using natural spline and piecewise regression models to identify trends and breakpoints. Bayesian structural time-series (BSTS) models were used to evaluate the causal impact of social distancing on appendicitis incidences. The spline regression analysis indicated decreasing trends in both total and uncomplicated appendicitis cases. Conversely, the incidence of complicated appendicitis and the ratio of complicated to uncomplicated cases increased. Breakpoints for a decline in uncomplicated appendicitis and a rise in the ratio occurred at 31 weeks in 2020 (95% confidence interval [CI], 23.2 to 38.8) and at 33.9 weeks (95% CI, 28.3 to 39.6), respectively. The BSTS model demonstrated a 7.8% reduction in total appendicitis cases (95% credible interval [CrI], -12.1 to -3.3). It also showed a 17.4% decrease in uncomplicated cases (95% CrI, -22.2 to -12.3) and increases of 12.8% (95% CrI, 4.9 to 22.0) in complicated cases and 39.0% (95% CrI, 27.0 to 53.3) in the ratio of complicated to uncomplicated appendicitis. The COVID-19 pandemic resulted in a decrease in both total and uncomplicated appendicitis cases, while the number of complicated cases increased. Reduced medical visits likely accounted for these changes. Strategies are needed to manage changes in disease pathophysiology resulting from altered healthcare utilization during health crises.

Research on job training and job satisfaction has been conducted from various perspectives. Job training is thought to be associated with job satisfaction, which is known as an important factor for depression among workers. We hypothesized that job training duration could influence depression through potential mediators (job satisfaction, motivation to work, and work engagement). This study encompassed participants from the sixth Korean Working Conditions Survey (KWCS), conducted between 2020 and 2021. To show the relationships between demographic or occupational characteristics and risk of depression, a χ2 test was conducted. The association between job training duration, potential mediators, and risk of depression was analyzed by constructing multiple logistic regression models. The mediating effects of potential mediators on job training duration and risk of depression was evaluated with flexible mediation analysis with weighting-based methods. The final study population consisted of 25,294 participants. Longer job training duration significantly decreased risk of depression after adjusting for confounders. In the group that received the longest job training duration (≥ 10 days), compared with the group without job training, the odds ratio (OR) for high risk of depression was 0.46 (95% confidence interval [CI], 0.39-0.54). Each three potential mediators showed statistically significant indirect effects and direct effect. Although indirect effects were not strong compared to direct effect, motivation to work had the strongest mediating effect in this study, with an OR of 0.94 (95% CI, 0.92-0.95). Job training duration was found to have a statistically significant negative association on the risk of depression, and three mediators partially mediating this effect. Although the mechanism was unknown, our findings suggest that job training has a positive influence on workers' mental health. Furthermore, by suggesting the possibility of other pathways existing between job training and depression, we provide directions for future research.

The aim of this study was to determine the differences in the risk factors for dangerous driving between older adults with normal cognition and those with cognitive impairment. The driving risk questionnaire (DRQ) that was applied to a community-dwelling older adult cohort and 2years of accident/violation records from the National Police Agency were analyzed. We conducted regression analyses with the presence or absence of risky driving based on records (accidents+violations) 2years before and after evaluation as a dependent variable and dichotomized scores of each risky driving factor as independent variables. According to four identified factors-crash history, safety concern, reduced mileage, and aggressive driving-significant associations were found between risky driving over the past 2years and crash history and for aggressive driving in the normal cognition group. In the cognitive impairment group, only crash history was significantly associated, although safety concerns showed a trend toward significance. In this study, it was suggested that the factors of DRQ have a significant association with actual risky driving. Our results are expected to contribute to establishing the evidence for evaluating and predicting risky driving and advising whether to continue driving in clinics.

Background:We examined the relationships of compassion satisfaction and fatigue among shift nurses on nursing engagement activities related to patient safety with the aim of improving shift nurses’ physical and psychological aspects in order to use the findings as a basis to enhance nurses’ engagement in activities related to patient safety.Methods:The data collection period for this cross-sectional study was from Nov 21, 2019, to Jan 3, 2020. A convenience sample of 280 shift nurses who were working for more than six months at three tertiary hospitals in Korea was used. Collected data comprised general and job-related characteristics of subjects, compassion satisfaction, compassion fatigue, and patient safety nursing activities. SPSS was used for statistical analysis, and multiple regression analysis was used to examine the relationship between shift nurses’ compassion satisfaction, compassion fatigue, and patient safety nursing activitiesResults:Compassion satisfaction had the greatest impact on engagement in nursing activities related to patient safety (β= .32, P<.001), followed by compassion fatigue. Higher compassion satisfaction and lower compassion fatigue indicates a higher engagement in patient safety-related nursing activities (β= −.15, P<.008).Conclusion:In order to maximize compassion satisfaction and reduce compassion fatigue among shift nurses, it is important for health policymakers to improve their welfare system and create a supportive environment where negative emotions can be expressed freely and accepted positively.