Hallym University

Mild cognitive impairment (MCI) represents a high-risk stage for dementia, yet limited non-pharmacological interventions are accessible. Although nature-based interventions have potential cognitive benefits, empirical validation for MCI populations remains limited. This study aims to address this gap. Fifty older adults with MCI were recruited from a psychiatric outpatient clinic and local dementia centers. The intervention group included 25 participants who received a four-session nature-based intervention over 4 weeks, while controls, matched for age and sex, received no intervention. Pre- and post-tests assessed cognitive, emotional, physiological, and physical functions. Mini-Mental State Examination (MMSE) scores demonstrated a significant time×group interaction [F(1,45)=10.226, p=0.003]. The nature-based intervention group showed that MMSE scores increased significantly (t=-2.270, p=0.034). In contrast, the control group exhibited a significant decline (t=2.262, p=0.034). No significant time and group interactions were found for emotional, physiological, or physical outcomes. This short-term, nature-based intervention yielded cognitive benefits in older adults with MCI, which supported its feasibility as an accessible, non-pharmacological intervention. Further longitudinal randomized controlled trials should confirm sustained effects across multiple domains.

Multiciliated cells generate numerous centrioles to support motile cilia essential for fluid flow. This process was thought to rely on the deuterosome, a DEUP1-dependent structure. Here, we show that DEUP1 plays a critical role in the basal foot (BF)-an asymmetric appendage of the basal body required for coordinated ciliary beating. Using high-resolution imaging, we localize DEUP1 to the middle tier of the BF, adjacent to CNTRL. In DEUP1 knockout mice, BF architecture is disrupted, leading to loss of rotational planar polarity, reduced cerebrospinal fluid flow, and ciliary degeneration with age. These defects are recapitulated in Xenopus epidermis, demonstrating evolutionary conservation. Notably, DEUP1 loss alone does not affect basal body or cilia number during early or mature adult stages, with overt degeneration emerging only in aged animals. Together, these findings establish DEUP1 as a key structural regulator of BF integrity that is required for the long-term maintenance of coordinated ciliary motility.

Early identification and appropriate management of dysphagia are critical for improving outcomes of acute ischemic stroke. To develop a simple and reliable scoring system to predict the severity of dysphagia in patients with acute ischemic stroke by integrating ultrasound (US) parameters with clinical variables. Prospective, cross-sectional observational study. Inpatient neurology department of a university-affiliated hospital. A total of 212 patients with acute ischemic stroke were prospectively enrolled in this study. The mild dysphagia group and severe dysphagia group comprised 146 patients and 66 patients, respectively. Group assignment was based on the need for dietary modifications confirmed via retrospective review of dietary status, videofluoroscopic swallowing study results, and the occurrence of aspiration pneumonia during hospitalization. Dynamic M-mode US of the suprahyoid muscle (SHM) was performed during swallowing. The following six SHM parameters were obtained: SHM thickness (baseline thickness of the SHM); SHM displacement (peak-to-peak amplitude of SHM movement); SHM difference (SHM displacement - SHM thickness); SHM ratio (SHM displacement/SHM thickness); peak-to-peak time; and total duration. The study population was randomly split into training (70%) and test (30%) sets. Least absolute shrinkage and selection operator and logistic regression analyses were performed to identify significant predictors of severe dysphagia. These predictors were used to develop and validate a simple scoring system. Brainstem lesion, bilateral lesion, National Institutes of Health Stroke Scale (NIHSS) score, SHM difference, and total duration were identified as key predictors of severe dysphagia. A simple scoring system based on these variables showed excellent discriminative performance. Areas under the receiver-operating characteristic curves (AUCs) of the training set and the test set were 0.963 and 0.935, respectively. A cutoff of ≥3 points yielded sensitivity of 97.9% and specificity of 86.4% for the training set as well as sensitivity of 78.9% and specificity of 95.3% for the test set. This simple scoring system combining US and clinical parameters enabled early identification of patients at increased risk for severe dysphagia. The dysphagia severity prediction score can facilitate timely management of patients with acute ischemic stroke, thus potentially reducing complications and enhancing dysphagia rehabilitation.

Prion diseases, also known as transmissible spongiform encephalopathies, are characterized by the accumulation of misfolded prion proteins (PrPSc), which resists clearance due to impaired removal mechanisms and immune tolerance. Although strategies aimed at enhancing intracellular clearance pathways, including autophagy, have shown promise, effective in vivo interventions remain limited. Innate immune stimulation with CpG oligodeoxynucleotides (CpG ODN), a Toll-like receptor 9 agonist that mimics bacterial DNA containing unmethylated CpG motifs, has been reported to extend survival in prion-infected mice; however, the underlying mechanisms involved remain incompletely defined. In this study, we examined the effects of CpG ODN in both in vitro and in vivo models of prion disease using the 22L scrapie strain. Mice treated with CpG ODN prior to infection exhibited prolonged mean survival compared with vehicle-treated controls and showed reduced PrPSc accumulation in spleen and brain tissues at 60 and 170 days post-infection, respectively. These changes were correlated with increased AMPK (Tyr172) phosphorylation and alterations in autophagy-associated signaling markers in the brain tissue. In 22L scrapie-infected neuronal cells, CpG ODN treatment significantly reduced PrPSc levels, and this effect was attenuated by pharmacological inhibition of autophagy-associated and lysosomal degradative processes. Collectively, these findings indicate that CpG ODN reduces PrPSc accumulation and prolongs survival in prion-infected mice, supporting the involvement of autophagy-associated degradative processes without establishing enhanced autophagic flux.

Introduction: Crowd crush is a type of disaster that continues to occur around the world, and some of these disasters have a devastating impact on society. Despite the high number of human casualties, there is no single solution, which is why a multidisciplinary approach is required rather than a single solution. Therefore, it is necessary to apply a scientific academic approach to understand crowd crush, but there is confusion on the terms and definitions underlying it. In this study, we aimed to derive appropriate conceptual definitions and terminology for crowd crush through a survey of experts. Methods: Experts were selected by discipline to conduct the expert survey. The experts were selected from the fields of safety and security management, engineering, medicine and health, sociology, and psychology, and a total of 25 experts were selected for in-depth interviews. The experts were selected based on their research, teaching, and consulting activities related to crowd crush, and only those with relevant interests and knowledge were included through preliminary interviews. Results: In some cases, experts expressed the same concept in different terms, and this was more pronounced when the experts came from different disciplines. This is likely due to applying the terminology used in their academic fields to crowd crush, which can be confusing if different terms are used. While most of the concepts and definitions were consistent, some terms needed to be reorganized to fit the context of crowd crush. Conclusion: There is some confusion about the concepts and terminology of crowd crush, even among experts. So a committee is needed to further clarify the concepts and terminology in order to develop standards of prevention, preparedness, and response in the crowd crush situation. This work was supported by the National Research Foundation of Korea(NRF) grant funded by the Korean government (MSIT) (No. NRF-2023R1A2C1002938).

Purpose: This study compared key health indicators of poor, older urban adults attending a free clinic with those of the general older population, using data from the 2023 Korea National Health and Nutrition Examination Survey (KNHANES). Methods: This cross-sectional comparative study included 60 adults aged ≥60 years who attended the Raphael Nanum Homeless Clinic in Seoul. Participants completed a questionnaire, underwent anthropometric assessment, and provided fasting blood samples for measurement of total cholesterol, low density lipoprotein (LDL)-cholesterol, and triglycerides (TG). Obesity, current smoking, monthly alcohol use, poor self-rated health, and strength exercise (≥ 2 days/week) were defined according to 2023 KNHANES criteria and compared with age-matched 2023 KNHANES estimates for adults aged ≥ 60 years using independent t-tests and two-proportion z-tests. Results: Participants were predominantly men (80.0%) with a mean age of 79.9 years; 70.0% reported no regular income, and 46.7% rated their health as poor. Compared with their 2023 KNHANES counterparts, the clinic group had a higher prevalence of obesity (50.0% vs. 35.0%), particularly among men, and a more atherogenic lipid profile characterized by higher LDL-cholesterol despite similar total cholesterol levels and lower TG. The prevalence of current smoking (3.3% vs. 10.6%) and monthly alcohol use (31.7% vs. 53.0%) was significantly lower, whereas participation in strength exercise was low in both groups, with no significant differences observed. Conclusion: Poor, older urban adults exhibited multidimensional health disparities, including obesity, adverse lipid profiles, and markedly poorer self-rated health, despite lower levels of smoking and alcohol consumption. Community-based interventions targeting nutrition, physical activity, and chronic disease management are needed to reduce health inequalities in this vulnerable population.

Abstract Background Estimating infection risk from SARS-CoV-2 Omicron and post-Omicron subvariants is challenging due to the high number of unconfirmed infections. We compared breakthrough infection risks among individuals with hybrid, vaccine-only, and infection-only immunity in South Korea, incorporating laboratory-confirmed and serology-inferred infections. Methods Using nationwide surveillance data (August–December 2022), immunity was classified by vaccination history and spike (S) and nucleocapsid (N) antibody profiles. Outcomes were assessed using two definitions: conservative (laboratory-confirmed cases) and inclusive (serology-inferred infections identified by changes in N-antibody titers). Infection dates for unconfirmed events were imputed via predictive mean matching, enabling Kaplan–Meier analyses. Time-varying Cox models estimated log hazard ratios (log-HRs). Results Including serology markedly increased four-month cumulative infection risk estimates: hybrid immunity rose from 2% to 20%, infection-only from 4% to 24%, and vaccine-only from 30% to 40%. With these additional infections, the relative advantage of hybrid immunity narrowed. Under the conservative definition, log-HRs declined for vaccine-only vs hybrid (4.10 to 2.34) and infection-only vs hybrid (1.56 to 0.31). Under the inclusive definition, the vaccine-only log-HR fell from 3.44 to 0.13, and the infection-only log-HR shifted from 3.31 to −0.56, indicating greater protection for infection-only immunity by month four. Conclusions Because confirmed cases largely capture symptomatic disease, vaccination appears to provide added protection against severe outcomes, though this benefit wanes within months. The rapid decline of hybrid immunity and the large burden of unconfirmed infections highlight the need for routine serological surveillance to detect silent transmission and timely booster campaigns to mitigate severe disease during Omicron-driven waves.

Early identification of speech, language, and literacy difficulties in preschool-aged children is crucial for timely intervention and prevention of long-term academic challenges. This study aimed to evaluate the Speech Language and Early Literacy Screening Checklist (SLELSC), a tool designed to assess key developmental milestones in 5- to 6-year-old children before they enter elementary school. The checklist was developed based on critical aspects of language acquisition, narrative discourse, phonological development, and emergent literacy skills, which collectively support the transition to formal education. A total of 155 children participated in this study, including 45 typically developing children and 110 children identified as at risk for speech, language, or literacy difficulties. The SLELSC demonstrated strong content validity (average CVI = 0.91) and clinical validity, with a significant difference in scores between the at-risk and typically developing groups. ROC curve analysis identified an optimal cut-off score of 19.5, yielding a sensitivity of 84.4% and specificity of 76.4%. The checklist also showed high diagnostic accuracy, with a positive predictive value of 92.31% and a comparatively lower negative predictive value of 59.38%, indicating that while the tool is effective in identifying children at risk, further refinement may be needed to improve its ability to rule out difficulties. The findings of this study provide strong evidence for the SLELSC as a valid and reliable tool for use in clinical and educational settings. By facilitating early assessment, this checklist contributes to the timely provision of support services, helping to mitigate the long-term effects of language and literacy delays. What is already known on this subject Early identification of speech, language, and literacy difficulties is essential for academic and social development. Approximately 10%-20% of preschoolers experience such challenges, which can lead to long-term educational and psychosocial difficulties. While various developmental screening tools exist, they often lack a specific focus on key linguistic domains for children nearing school entry. In South Korea, there is no standardised screening tool for 5- to 6-year-olds. The Speech Language and Early Literacy Screening Checklist was developed to address this gap, demonstrating initial reliability and validity, but further validation is needed to confirm its diagnostic accuracy.What this study adds to existing knowledge This study confirms the Speech Language and Early Literacy Screening Checklist as a valid and reliable tool for identifying preschool-aged children at risk for language and literacy difficulties. The checklist demonstrated strong clinical accuracy, with high sensitivity and specificity, making it effective for early detection. Additionally, it highlights the need for domain-specific cut-off scores to enhance diagnostic precision. By facilitating timely intervention before school entry, this screening tool provides a practical solution for educators and clinicians, helping to mitigate long-term academic and social challenges associated with early speech and language delays.What are the potential or actual clinical implication of this work? The Speech Language and Early Literacy Screening Checklist provides a clinically valid and reliable tool for early identification of at-risk children before school entry. Its high sensitivity ensures that most children with speech, language, or literacy difficulties receive timely intervention. The checklist can be effectively utilised in preschool settings by educators and clinicians to support early screening and referral. Additionally, refining cut-off scores for specific domains may further improve diagnostic accuracy. Future research should explore its application across diverse populations and its long-term impact on academic and social outcomes, strengthening early intervention strategies in clinical and educational settings.