This study presents the development and validation of a risk assessment program of highly pathogenic avian influenza (HPAI). This program was developed by the Korean government (Animal and Plant Quarantine Agency) and a private corporation (Korea Telecom, KT), using a national database (Korean animal health integrated system, KAHIS).

Purpose: The study aimed to design and develop an automated personalized self-care (APSC) program for patients with type 2 diabetes mellitus. The secondary aim was to present a clinical protocol as a mixed-method research to test the program effects. Methods: The APSC program was developed in the order of analysis, design, implementation, and evaluation according to the software development life cycle, and was guided by the self-regulatory theory. The content validity, heuristics, and usability of the program were verified by experts and patients with type 2 diabetes mellitus. Results: The APSC program was developed based on goal setting, education, monitoring, and feedback components corresponding to the phases of forethought, performance/volitional control, and self-reflection of self-regulatory theory. Using the mobile application, the participants are able to learn from educational materials, monitor their health behaviors, receive weekly-automated personalized goals and feedback messages, and use an automated conversation system to solve the problems related to self-care. The ongoing two-year study utilizes a mixed method design, with 180 patients having type 2 diabetes mellitus randomized to receive either the intervention or usual care. The participants will be reviewed for self-care self-efficacy, health behaviors, and health outcomes at 6, 12, 18, and 24 months. Participants in the intervention group will be interviewed about their experiences. Conclusion The APSC program can serve as an effective tool for facilitating diabetes health behaviors by improving patients’ self-care self-efficacy and self-regulation for self-care. However, the clinical effectiveness of this program requires further investigation.

Purpose: Preventing diabetic complications involves regular outpatient follow-up and maintaining low variability in hemoglobin A1c (HbA1c) levels. This study investigated the factors associated with diabetic complications, with a specific focus on the impact of regular outpatient follow-up and HbA1c variability, among patients with type 2 diabetes. Methods: The study design was secondary data analysis of electronic medical records from a university hospital in Korea. It included patients aged 40–79 with type 2 diabetes who were prescribed diabetes medication within three months of their first HbA1c test by an endocrinologist and were followed up for at least five years. Follow-up regularity, adjusted standard deviation of HbA1c levels, and diabetic complication indices were collected. Data were analyzed using the Chi-square test, independent t-test, repeated measures analysis of variance, and multiple regression analysis. Results: The study included 1566 patients. Lower follow-up regularity was observed in patients of older age, with comorbidities, diabetic complications, insulin treatment, a history of hospitalization, lower baseline estimated glomerular filtration rate (eGFR) and total cholesterol (TC), and higher HbA1c variability. Higher HbA1c variability was observed in younger patients without comorbidity but with insulin treatment, a history of hospitalization, higher baseline blood glucose (BG), HbA1c, TC, and triglyceride levels. HbA1c variability had the strongest influence on BG and HbA1c levels at the five-year follow-up. Baseline eGFR and TC were the most influential factors for their respective levels at the five-year follow-up. Follow-up regularity significantly affected BG, HbA1c, eGFR, and TC at five-year follow-up. Conclusions It has been shown that several variables besides regular follow-up and HbA1c variability have an influence. However, these are the two that can be corrected through nursing intervention and are important, so intervention on these is important.

γδ T cells are a rare and unique prototype of T cells that share properties with natural killer cells in secondary lymphoid organs. Although many studies have revealed the function and importance of adult-derived γδ T cells in cancer biology and regenerative medicine, the low numbers of these cells hamper their application as therapeutic cell sources in the clinic. To solve this problem, pluripotent stem cell-derived γδ T cells are considered alternative cell sources; however, few studies have reported the generation of human pluripotent stem cell-derived γδ T cells. In the present study, we investigated whether lymphoid lineage γδ T cells were successfully generated from human pluripotent stem cells via hemogenic endothelium under defined culture conditions. Our results revealed that pluripotent stem cells successfully generated γδ T cells with an overall increase in transcriptional activity of lymphoid lineage genes and cytolytic factors, indicating the importance of the optimization of culture conditions in generating lymphoid lineage γδ T cells. We uncovered an initial step in differentiating γδ T cells that could be applied to basic and translational investigations in the field of cancer biology. Based on our result, we will develop an appropriate method to purify γδ T cells with functionality and it helpful for the study of basic mechanism of γδ T cells in pathophysiologic condition as well as clinic application.

Purpose: This study aimed to determine the consistency of 1-day and 3-day average dietary intake using the 24-hour diet recall method and to investigate the relationship of diet intake with physiological indicators potentially associated with diabetic complications in patients with diabetes. Methods: This study conducted a secondary data analysis using pretest data of a nursing intervention study entitled “Development of deep learning based AI coaching program for diabetic patients with high risk and examination of its effects (PNUH, IRB No. 05-2021-030).” Data were analyzed through descriptive analysis, one-way repeated-measures analysis of variance, and Pearson correlation coefficients using SPSS 26.0. Results: The average total daily calorie intake over 3 days was 1,494.48±436.47 kcal/day: 1,510.90±547.76 kcal/day on the first day, 1,414.22±527.58 kcal/day on the second day, 1,558.34±645.83 kcal/day on the third day, showing significant differences (F=3.59, p=.031). The correlation coefficient between the 1-day and 3-day average dietary intake was 0.41–0.77 for each nutrient and 0.62–0.80 for each food group. Vegetable intake showed negative correlations with body mass index (BMI; r=-.19, p=.023) and triglycerides (r=-.18, p=.036), whereas dairy intake was positively associated with low-density lipoprotein-cholesterol (LDL; r=-0.18, p=.034) and triglycerides (r=.40, p<.001). Conclusion This study demonstrated that 1-day dietary intake was highly correlated with 3-day average dietary intake using the 24-hour diet recall method. Food groups showed significant associations with physiological indicators of potential diabetic complications such as BMI, triglycerides, and LDL levels. Further studies are needed to improve the knowledge base on the relationships between physiological indicators and food groups.

The enhanced primary care demonstration (EPD) was launched in November 2014 to provide high-quality care for people with chronic illnesses. In the EPD, comprehensive assessment and care planning (CAP) is a critical component, along with behavior modification and case management services. In this study, we measured CAP duration and calculated the fee for CAP sessions performed with patients with hypertension and/or diabetes mellitus. In 5 primary care clinics participating in the EPD, the duration of CAP sessions and usual consultations was measured. The duration of CAP sessions was measured on 2 separate occasions because CAP involves 2 separate consultations, including an initial consultation for comprehensive patient assessment and laboratory testing and a follow-up consultation for creating a care plan based on the assessment and test results. The CAP fee was calculated as the ratio of CAP time to the usual consultation time. The median (interquartile range) and the mean ± standard deviation of CAP duration were 15.4 (7.1) minutes and 15.6 ± 4.2 minutes, respectively. The first and second CAP sessions lasted for 5.3 and 4.6 times longer than usual consultations, respectively. The calculated CAP fees were 76,299 won (median) and 65,766 won (mean). The length of CAP sessions for patients with hypertension and/or diabetes mellitus was approximately 5 times longer than that of usual consultations. If consultation lengths were measured in a representative patient sample, it would be possible to improve the external validity of the measurements.
Behavior Therapy ; Case Management ; Chronic Disease ; Diabetes Mellitus ; Diagnosis ; Fees and Charges* ; Fees, Medical ; Follow-Up Studies ; Humans ; Hypertension* ; Patient Care Planning ; Primary Health Care* ; Referral and Consultation

The enhanced primary care demonstration (EPD) was launched in November 2014 to provide high-quality care for people with chronic illnesses. In the EPD, comprehensive assessment and care planning (CAP) is a critical component, along with behavior modification and case management services. In this study, we measured CAP duration and calculated the fee for CAP sessions performed with patients with hypertension and/or diabetes mellitus. In 5 primary care clinics participating in the EPD, the duration of CAP sessions and usual consultations was measured. The duration of CAP sessions was measured on 2 separate occasions because CAP involves 2 separate consultations, including an initial consultation for comprehensive patient assessment and laboratory testing and a follow-up consultation for creating a care plan based on the assessment and test results. The CAP fee was calculated as the ratio of CAP time to the usual consultation time. The median (interquartile range) and the mean ± standard deviation of CAP duration were 15.4 (7.1) minutes and 15.6 ± 4.2 minutes, respectively. The first and second CAP sessions lasted for 5.3 and 4.6 times longer than usual consultations, respectively. The calculated CAP fees were 76,299 won (median) and 65,766 won (mean). The length of CAP sessions for patients with hypertension and/or diabetes mellitus was approximately 5 times longer than that of usual consultations. If consultation lengths were measured in a representative patient sample, it would be possible to improve the external validity of the measurements.
Behavior Therapy ; Case Management ; Chronic Disease ; Diabetes Mellitus ; Diagnosis ; Fees and Charges* ; Fees, Medical ; Follow-Up Studies ; Humans ; Hypertension* ; Patient Care Planning ; Primary Health Care* ; Referral and Consultation

This study aimed to explore the participation experiences of patients with type 2 diabetes in an Automated Personalized Self-Care program, assess the changes in self-care behavior and glycemic control, and evaluate the stages of change and readiness to change using the transtheoretical model (TTM). Methods: We examined 16 patients with type 2 diabetes who participated in a diabetes self-care program using a mobile application. Purposive sampling continued until data saturation. Using a mixed method study, we analyzed the participants’ characteristics, self-care behavior, stage of change, and readiness to change quantitatively and analyzed the qualitative data using Elo and Kyngas’s content analysis method. Results: The compliance group (CG) showed improved self-care behavior and glycemic control. In the CG, the proportion of participants in the action stage was higher in the exercise and diet domains and lower in the blood glucose testing and medication domains than in the non-compliance group (NCG). Readiness to change, motivation for health behaviors, and social motivation were higher in the CG, whereas personal motivation was higher in the NCG. In this qualitative study, three categories and 11 subcategories were identified. The findings suggest the CG regarded their experience in the program more frequently as positive, whereas the NCG perceived greater barriers to using the mobile application in the program. Conclusion: Based on the differences identified between the CG and NCG, TTM-based strategies are needed to facilitate the progression of NCG to the action stage.

This study aimed to explore the participation experiences of patients with type 2 diabetes in an Automated Personalized Self-Care program, assess the changes in self-care behavior and glycemic control, and evaluate the stages of change and readiness to change using the transtheoretical model (TTM). Methods: We examined 16 patients with type 2 diabetes who participated in a diabetes self-care program using a mobile application. Purposive sampling continued until data saturation. Using a mixed method study, we analyzed the participants’ characteristics, self-care behavior, stage of change, and readiness to change quantitatively and analyzed the qualitative data using Elo and Kyngas’s content analysis method. Results: The compliance group (CG) showed improved self-care behavior and glycemic control. In the CG, the proportion of participants in the action stage was higher in the exercise and diet domains and lower in the blood glucose testing and medication domains than in the non-compliance group (NCG). Readiness to change, motivation for health behaviors, and social motivation were higher in the CG, whereas personal motivation was higher in the NCG. In this qualitative study, three categories and 11 subcategories were identified. The findings suggest the CG regarded their experience in the program more frequently as positive, whereas the NCG perceived greater barriers to using the mobile application in the program. Conclusion: Based on the differences identified between the CG and NCG, TTM-based strategies are needed to facilitate the progression of NCG to the action stage.

This study aimed to explore the participation experiences of patients with type 2 diabetes in an Automated Personalized Self-Care program, assess the changes in self-care behavior and glycemic control, and evaluate the stages of change and readiness to change using the transtheoretical model (TTM). Methods: We examined 16 patients with type 2 diabetes who participated in a diabetes self-care program using a mobile application. Purposive sampling continued until data saturation. Using a mixed method study, we analyzed the participants’ characteristics, self-care behavior, stage of change, and readiness to change quantitatively and analyzed the qualitative data using Elo and Kyngas’s content analysis method. Results: The compliance group (CG) showed improved self-care behavior and glycemic control. In the CG, the proportion of participants in the action stage was higher in the exercise and diet domains and lower in the blood glucose testing and medication domains than in the non-compliance group (NCG). Readiness to change, motivation for health behaviors, and social motivation were higher in the CG, whereas personal motivation was higher in the NCG. In this qualitative study, three categories and 11 subcategories were identified. The findings suggest the CG regarded their experience in the program more frequently as positive, whereas the NCG perceived greater barriers to using the mobile application in the program. Conclusion: Based on the differences identified between the CG and NCG, TTM-based strategies are needed to facilitate the progression of NCG to the action stage.