Purpose: This study aimed to evaluate the rest-activity circadian rhythm (RAR) using data obtained from wearable actigraph devices in hospitalized older adults with mild cognitive impairment (MCI), and to investigate its relationship with salivary alpha amylase (sAA). Methods: This secondary data analysis used data from the Hospitalized Older Adults’ Cognition and Physical Activity Study. Actigraph data for 3-4 days were analyzed for RAR. RAR indices such as interdaily stability (IS), intradaily variability (IV), activity level during the most active 10-hour period and during the most least active 5-hour period, and relative amplitude (RA) were calculated. Data on sAA collected in the morning and general characteristics, including body mass index (BMI), were analyzed. Results: Data from 92 hospitalized older adults with MCI were analyzed. The IS, IV, RA were 0.23, 0.73, 0.88, respectively. The average level of sAA was 77.02 U/mL, and a higher level of sAA was significantly associated with better IS and RA in the regression analysis, while age, BMI, and cognitive level were not. BMI showed positive correlations with IS and RA. Conclusion RAR in the hospitalized older adults with MCI was attenuated, showing especially low IS, which implies they failed to maintain regular and repetitive 24-hour RAR. Increased sAA and BMI were associated with robust RAR. Nurses need to pay attention to maintain robust RAR in hospitalized older adults with MCI, and strategies should be developed to improve their RAR.

PURPOSE: Chest physiotherapy (CPT) is commonly used for mechanically ventilated patients, but little is known about its physiological effects, particularly in patients with acute lung injury (ALI). The aim of the study was to determine the benefits and risks of delivering multimodal respiratory physiotherapy to mechanically ventilated patients with ALI receiving paralytic agents. METHODS: A repeated measure-experimental design using a counterbalancing method was employed. Fifteen patients received CPT (vibration, percussion, or palm-cup percussion) in addition to the routine CPT in a randomized order. Another 15 patients, contraindicated for the percussion technique, received routine CPT including manual hyperinflation and position change, and were observed as a comparative group. The effects of CPT were evaluated by measuring the volume of aspirated secretions and the dynamic lung compliance (Cd) over time. For the adverse effects, peripheral oxygen saturation (SpO2) was recorded. Cd and SpO2 were recorded at the baseline period, immediately after the physiotherapy treatment, and at 10, 20, 30 and 60 minutes posttreatment. RESULTS: The volume of collected secretions did not differ significantly when compared between the groups (p = .838). Cd increased significantly over time in the manual percussion (p = .042) and palm-cup percussion (p = .046) group, where Cd in the latter remained elevated twice longer than in the former. None of the CPT techniques exerted major detrimental effects on SpO2. CONCLUSIONS: We found that the palm-cup percussion technique was the most effective in increasing Cd without any accompanying detrimental effects on SpO2. However, additional CPT did not affect the volume of aspirated secretions.
Acute Lung Injury ; Critical Care ; Humans ; Lung ; Lung Compliance ; Oxygen ; Percussion ; Pilot Projects ; Respiratory Mechanics ; Risk Assessment ; Sputum ; Thorax ; Vibration

PURPOSE: This study was designed to test structural equation modeling of the quality of life of stroke survivors in order to provide guidelines for development of interventions and strategies to improve their quality of life. METHODS: The participants in the study were patients who visited the neurology outpatient department of a tertiary hospital in Seoul between June 25 and October 15, 2009. Data collection was carried out through one-on-one interviews. Demographic factors, functional independence, social support, nutritional status, post-stroke biobehavioral changes and quality of life were investigated. RESULTS: The final analysis included 215 patients. Fitness of the hypothetical model was appropriate (chi-square=111.5, p=.000, GFI=.926, AGFI=.880, RMSA=.068, NFI=.911, CFI=.953). Functional dependency, social support and post-stroke biobehavioral changes were found to be significant explaining variance in quality of life. Post-stroke biobehavioral changes had the strongest direct influence on quality of life. Nutritional status had an indirect effect on the quality of life. CONCLUSION: To improve the quality of life of stroke survivors, comprehensive interventions are necessary to manage post-stroke biobehavioral changes, and strengthening social support networks that can contribute to enhancing the quality of life of stroke survivors.
Aged ; Demography ; Depression ; Fatigue ; Female ; Humans ; Interviews as Topic ; Male ; Middle Aged ; *Models, Psychological ; Nutritional Status ; Pain ; *Quality of Life ; Sleep Deprivation ; Social Support ; Stroke/*psychology ; *Survivors

Cardiac papillary fibroelastomas are associated with a high risk of systemic embolization in spite of benign nature. We report a case of 85-year-old patient with left supraclinoid internal carotid artery occlusion who treated with aspiration thrombectomy. Despite of the absence of residual mass on echocardiography, we could analyze pathologic specimens using retrieved embolus and confirmed cardiac papillary fibroelastoma as a rare cause of stroke.

Various vaccines have been developed to fight severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), the virus responsible for the coronavirus disease 2019 pandemic.However, new variants of SARS-CoV-2 undermine the effort to fight SARS-CoV-2. Here, we produced S proteins harboring the receptor-binding domain (RBD) of the Omicron variant in plants. Plant-produced S proteins together with adjuvant CIA09A triggered strong immune responses in mice. Antibodies in serum inhibited interaction of recombinant human angiotensinconverting enzyme 2 with RBD of the Omicron variant, but not RBD of other variants. These results suggest that antibodies induced by RBD of the Omicron variant are highly specific for the Omicron RBD, but not for that of other variants.

The Korean Triage and Acuity Scale (KTAS) Committee under the Korean Society of Emergency Medicine developed a Korean pre-hospital emergency patient classification tool (Pre-hospital Korean Triage and Acuity Scale [Pre-KTAS]) under contract from the Ministry of Health and Welfare, Korea. The classification tool was developed separately for adults and children. The patient’ s emergency level is classified into five distinct levels and is the same as the KTAS classification system, which is a hospital-level emergency patient classification tool.

Several reports have described aberrant methylation in various types of human cancers. However, the interpretation of methylation frequency in various human cancers has some limitations because of the different materials and methods used for methylation analysis. To gain an insight into the role of DNA hypermethylation in human cancers and allow direct comparison of tissue specific methylation, we generated methylation profiles in 328 human cancers, including 24 breast, 48 colon, 61 stomach, 48 liver, 37 larynx, 24 lung, 40 prostate, and 46 uterine cervical cancer samples by analyzing CpG island hypermethylation of 13 genes using methylation-specific PCR. The mean numbers of methylated genes were 6.5, 4.4, 3.6, 3.4, 3.1, 3.1, 3.1, and 2.1 in gastric, liver, prostate, larynx, colon, lung, uterine cervix, and in breast cancer samples, respectively. The number of genes that were methylated at a frequency of more than 40% in each tumor type ranged from nine (stomach) to one (breast). Generally genes frequently methylated in a specific cancer type differed from those methylated in other cancer types. The findings indicate that aberrant CpG island hypermethylation is a frequent finding in human cancers of various tissue types, and each tissue type has its own distinct methylation pattern.
Quantitative Trait Loci/*genetics ; Polymerase Chain Reaction ; Neoplasms/*genetics ; Humans ; Genetic Predisposition to Disease/genetics ; Gene Frequency/genetics ; DNA, Neoplasm/*genetics ; *DNA Methylation ; CpG Islands/*genetics ; Chromosome Mapping/*methods

Objective: To investigate the effect of gestational weight gain (GWG) on maternal and neonatal outcomes based on the Institute of Medicine (IOM) guidelines for twin pregnancies. Methods: This study included women with twin pregnancies who delivered at Seoul National University Bundang Hospital. Based on the weight gain per gestational week according to the 2009 IOM guidelines, the subjects were divided into the following 3 groups: inadequate, adequate, and excessive GWG. We compared the maternal and neonatal outcomes of each group. Results: A total of 1,738 twin pregnancies were included in our study. Of these cases, 881, 694, and 163 (50.7%, 39.9%, and 9.4%, respectively) twin pregnancies were categorized into the inadequate, adequate, and excessive GWG groups, respectively. In the inadequate GWG group, the risks of preterm birth <34 weeks (aOR, 2.33, 95% confidence interval [CI], 1.63–3.34) and delivering neonates who were small for gestational age (aOR, 1.92, 95% CI, 1.42–2.60) were increased, and the risk of preeclampsia (aOR, 0.49, 95% CI, 0.32–0.76) was decreased. The excessive GWG group had an increased risk of the neonates being large for gestational age (aOR, 1.79, 95% CI, 1.15–2.81). Conclusion The 2009 IOM recommendations for GWG can be applied to Korean women with twin pregnancies to help achieve optimal maternal and neonatal outcomes. However, more than half of the women were categorized as having inadequate weight gain according to the guidelines. Further studies should be performed to obtain Korean national references for GWG in twin pregnancies.

Purpose: This study examined the recognition of rehabilitative robots for treatment in physical therapists. Methods: This study surveyed 100 physical therapists in Seoul and Gyeonggi-do using Google Form, an online survey tool. The questionnaire consisted of 21 questions, including eight questions on the general characteristics, 13 questions on the recognition of rehabilitative robots. Results: The general characteristics of the physical therapists showed differences and influences on recognition of rehabilitative robots, and there were statistically significant differences. There were significant differences in the recognition of rehabilitation robots according to general characteristics in gender, age, education degree, type of hospital, average weekly working time, and treatment field. Multiple regression analysis found that gender and the type of hospital influenced the recognition of rehabilitation robots. Conclusion Physical therapists showed differences in recognition of rehabilitative robots according to their general characteristics, and gender and the type of hospital influence the recognition of rehabilitation robots. Sufficient systematic education programs should be provided, and physical therapists require policy adjustments to increase their accessibility to rehabilitation robots through continuing education.

Objective: To investigate the effect of gestational weight gain (GWG) on maternal and neonatal outcomes based on the Institute of Medicine (IOM) guidelines for twin pregnancies. Methods: This study included women with twin pregnancies who delivered at Seoul National University Bundang Hospital. Based on the weight gain per gestational week according to the 2009 IOM guidelines, the subjects were divided into the following 3 groups: inadequate, adequate, and excessive GWG. We compared the maternal and neonatal outcomes of each group. Results: A total of 1,738 twin pregnancies were included in our study. Of these cases, 881, 694, and 163 (50.7%, 39.9%, and 9.4%, respectively) twin pregnancies were categorized into the inadequate, adequate, and excessive GWG groups, respectively. In the inadequate GWG group, the risks of preterm birth <34 weeks (aOR, 2.33, 95% confidence interval [CI], 1.63–3.34) and delivering neonates who were small for gestational age (aOR, 1.92, 95% CI, 1.42–2.60) were increased, and the risk of preeclampsia (aOR, 0.49, 95% CI, 0.32–0.76) was decreased. The excessive GWG group had an increased risk of the neonates being large for gestational age (aOR, 1.79, 95% CI, 1.15–2.81). Conclusion The 2009 IOM recommendations for GWG can be applied to Korean women with twin pregnancies to help achieve optimal maternal and neonatal outcomes. However, more than half of the women were categorized as having inadequate weight gain according to the guidelines. Further studies should be performed to obtain Korean national references for GWG in twin pregnancies.