1.Formative versus reflective measurement models in nursing research: a secondary data analysis of a cross-sectional study in Korea
Eun Seo PARK ; Young Il CHO ; Hyo Jin KIM ; YeoJin IM ; Dong Hee KIM
Journal of Korean Academy of Nursing 2025;55(1):107-118
Purpose:
This study aimed to empirically verify the impact of measurement model selection on research outcomes and their interpretation through an analysis of children’s emotional and social problems measured by the Pediatric Symptom Checklist (PSC) using both reflective and formative measurement models. These models were represented by covariance-based structural equation modeling (CB-SEM) and partial least squares SEM (PLS-SEM), respectively.
Methods:
This secondary data analysis evaluated children’s emotional and social problems as both reflective and formative constructs. Reflective models were analyzed using CB-SEM, while formative models were assessed using PLS-SEM. Comparisons between these two approaches were based on model fit and parameter estimates.
Results:
In the CB-SEM analysis, which assumed a reflective measurement model, a model was not identified due to inadequate fit indices and a Heywood case, indicating improper model specification. In contrast, the PLS-SEM analysis, assuming a formative measurement model, demonstrated adequate reliability and validity with significant path coefficients, supporting the appropriateness of the formative model for the PSC.
Conclusion
The findings indicate that the PSC is more appropriately analyzed as a formative measurement model using PLS-SEM, rather than as a reflective model using CB-SEM. This study highlights the necessity of selecting an appropriate measurement model based on the theoretical and empirical characteristics of constructs in nursing research. Future research should ensure that the nature of measurement variables is accurately reflected in the choice of statistical models to improve the validity of research outcomes.
2.2025 Seoul Consensus on Clinical Practice Guidelines for Irritable Bowel Syndrome
Yonghoon CHOI ; Young Hoon YOUN ; Seung Joo KANG ; Jeong Eun SHIN ; Young Sin CHO ; Yoon Suk JUNG ; Seung Yong SHIN ; Cheal Wung HUH ; Yoo Jin LEE ; Hoon Sup KOO ; Kwangwoo NAM ; Hong Sub LEE ; Dong Hyun KIM ; Ye Hyun PARK ; Min Cheol KIM ; Hyo Yeop SONG ; Sung-Hoon YOON ; Sang Yeol LEE ; Miyoung CHOI ; Moo-In PARK ; In-Kyung SUNG ;
Journal of Neurogastroenterology and Motility 2025;31(2):133-169
Irritable bowel syndrome (IBS) is a chronic, disabling, and functional bowel disorder that significantly affects social functioning and reduces quality of life and increases social costs. The Korean Society of Neurogastroenterology and Motility published clinical practice guidelines on the management of IBS based on a systematic review of the literature in 2017, and planned to revise these guidelines in light of new evidence on the pathophysiology, diagnosis, and management of IBS. The current revised version of the guidelines is consistent with the previous version and targets adults diagnosed with or suspected of having IBS. These guidelines were developed using a combination of de novo and adaptation methods, with analyses of existing guidelines and discussions within the committee, leading to the identification of key clinical questions. Finally, the guidelines consisted of 22 recommendations, including 3 concerning the definition and risk factors of IBS, 4 regarding diagnostic modalities and strategies, 2 regarding general management, and 13 regarding medical treatment. For each statement, the advantages, disadvantages, and precautions were thoroughly detailed. The modified Delphi method was used to achieve expert consensus to adopt the core recommendations of the guidelines. These guidelines serve as a reference for clinicians (including primary care physicians, general healthcare providers, medical students, residents, and other healthcare professionals) and patients, helping them to make informed decisions regarding IBS management.
3.Post‑transplant cyclophosphamide plus anti‑thymocyte globulin decreased serum IL‑6 levels when compared with post‑transplant cyclophosphamide alone after haploidentical hematopoietic stem cell transplantation
Jeong Suk KOH ; Myung‑Won LEE ; Thi Thuy Duong PHAM ; Bu Yeon HEO ; Suyoung CHOI ; Sang‑Woo LEE ; Wonhyoung SEO ; Sora KANG ; Seul Bi LEE ; Chul Hee KIM ; Hyewon RYU ; Hyuk Soo EUN ; Hyo‑Jin LEE ; Hwan‑Jung YUN ; Deog‑Yeon JO ; Ik‑Chan SONG
Blood Research 2025;60():5-
Background:
Post-transplantation cyclophosphamide (PTCy) and anti-thymocyte globulin (ATG) are common pro‑ phylactic strategies for graft-versus-host disease (GVHD) after haploidentical hematopoietic stem cell transplantation (haplo-HSCT). Interleukin (IL)-6 is a surrogate marker for cytokine release syndrome (CRS) and acute GVHD.Method The clinical outcomes and complications of haplo-HSCT with PTCy plus ATG versus PTCy monotherapy were compared according to serum IL-6 levels at Chungnam National University Hospital (Daejeon, South Korea) from Jan‑ uary 2019 to February 2023.
Results:
Forty patients who underwent haplo-HSCT were analyzed. A significant difference in IL-6 levels was observed between the PTCy plus ATG and PTCy alone groups (7.47 ± 10.55 vs. 117.65 ± 127.67; p = 0.003). More patients in the PTCy plus ATG group had a CRS grade of 0 than in the PTCy alone group (p < 0.001). Serum IL-6 levels were associated with grades II–IV acute GVHD (r = 0.547, p < 0.001). The cumulative incidence (CI) of grades II–IV acute GVHD was significantly higher in the PTCy alone group (67.9% vs. 4.8%; p < 0.001). No significant difference in the CI for chronic GVHD was detected between the PTCy plus ATG and PTCy alone groups (72.1% vs. 82.0%; p = 0.730). The CI of 1-year non-relapse mortality was significantly higher in the PTCy alone group than in the PTCy plus ATG group (42.2% vs. 15.9%; p = 0.022). The 1-year overall survival (OS) was significantly better in the PTCy plus ATG group (75.9% vs. 35.3%; p = 0.011). The 1-year GVHD-free, relapse-free survival rate was 29.4% in the PTCy alone group and 54.0% in the PTCy plus ATG group (p = 0.038).
Conclusion
Serum IL-6 levels were higher in the PTCy alone group than in the PTCy plus ATG group. The addition of ATG before stem cell infusion affected IL-6 levels and reduced the incidences of CRS and grade II–IV acute GVHD in haplo-HSCT patients. This study suggests that PTCy plus ATG as GVHD prophylaxis in haplo-HSCT is beneficial in terms of clinical outcomes and complications of HSCT.
4.Formative versus reflective measurement models in nursing research: a secondary data analysis of a cross-sectional study in Korea
Eun Seo PARK ; Young Il CHO ; Hyo Jin KIM ; YeoJin IM ; Dong Hee KIM
Journal of Korean Academy of Nursing 2025;55(1):107-118
Purpose:
This study aimed to empirically verify the impact of measurement model selection on research outcomes and their interpretation through an analysis of children’s emotional and social problems measured by the Pediatric Symptom Checklist (PSC) using both reflective and formative measurement models. These models were represented by covariance-based structural equation modeling (CB-SEM) and partial least squares SEM (PLS-SEM), respectively.
Methods:
This secondary data analysis evaluated children’s emotional and social problems as both reflective and formative constructs. Reflective models were analyzed using CB-SEM, while formative models were assessed using PLS-SEM. Comparisons between these two approaches were based on model fit and parameter estimates.
Results:
In the CB-SEM analysis, which assumed a reflective measurement model, a model was not identified due to inadequate fit indices and a Heywood case, indicating improper model specification. In contrast, the PLS-SEM analysis, assuming a formative measurement model, demonstrated adequate reliability and validity with significant path coefficients, supporting the appropriateness of the formative model for the PSC.
Conclusion
The findings indicate that the PSC is more appropriately analyzed as a formative measurement model using PLS-SEM, rather than as a reflective model using CB-SEM. This study highlights the necessity of selecting an appropriate measurement model based on the theoretical and empirical characteristics of constructs in nursing research. Future research should ensure that the nature of measurement variables is accurately reflected in the choice of statistical models to improve the validity of research outcomes.
5.2025 Seoul Consensus on Clinical Practice Guidelines for Irritable Bowel Syndrome
Yonghoon CHOI ; Young Hoon YOUN ; Seung Joo KANG ; Jeong Eun SHIN ; Young Sin CHO ; Yoon Suk JUNG ; Seung Yong SHIN ; Cheal Wung HUH ; Yoo Jin LEE ; Hoon Sup KOO ; Kwangwoo NAM ; Hong Sub LEE ; Dong Hyun KIM ; Ye Hyun PARK ; Min Cheol KIM ; Hyo Yeop SONG ; Sung-Hoon YOON ; Sang Yeol LEE ; Miyoung CHOI ; Moo-In PARK ; In-Kyung SUNG ;
Journal of Neurogastroenterology and Motility 2025;31(2):133-169
Irritable bowel syndrome (IBS) is a chronic, disabling, and functional bowel disorder that significantly affects social functioning and reduces quality of life and increases social costs. The Korean Society of Neurogastroenterology and Motility published clinical practice guidelines on the management of IBS based on a systematic review of the literature in 2017, and planned to revise these guidelines in light of new evidence on the pathophysiology, diagnosis, and management of IBS. The current revised version of the guidelines is consistent with the previous version and targets adults diagnosed with or suspected of having IBS. These guidelines were developed using a combination of de novo and adaptation methods, with analyses of existing guidelines and discussions within the committee, leading to the identification of key clinical questions. Finally, the guidelines consisted of 22 recommendations, including 3 concerning the definition and risk factors of IBS, 4 regarding diagnostic modalities and strategies, 2 regarding general management, and 13 regarding medical treatment. For each statement, the advantages, disadvantages, and precautions were thoroughly detailed. The modified Delphi method was used to achieve expert consensus to adopt the core recommendations of the guidelines. These guidelines serve as a reference for clinicians (including primary care physicians, general healthcare providers, medical students, residents, and other healthcare professionals) and patients, helping them to make informed decisions regarding IBS management.
6.Interpretation, Reporting, Imaging-Based Workups, and Surveillance of Incidentally Detected Gallbladder Polyps and Gallbladder Wall Thickening: 2025 Recommendations From the Korean Society of Abdominal Radiology
Won CHANG ; Sunyoung LEE ; Yeun-Yoon KIM ; Jin Young PARK ; Sun Kyung JEON ; Jeong Eun LEE ; Jeongin YOO ; Seungchul HAN ; So Hyun PARK ; Jae Hyun KIM ; Hyo Jung PARK ; Jeong Hee YOON
Korean Journal of Radiology 2025;26(2):102-134
Incidentally detected gallbladder polyps (GBPs) and gallbladder wall thickening (GBWT) are frequently encountered in clinical practice. However, characterizing GBPs and GBWT in asymptomatic patients can be challenging and may result in overtreatment, including unnecessary follow-ups or surgeries. The Korean Society of Abdominal Radiology (KSAR) Clinical Practice Guideline Committee has developed expert recommendations that focus on standardized imaging interpretation and follow-up strategies for both GBPs and GBWT, with support from the Korean Society of Radiology and KSAR. These guidelines, which address 24 key questions, aim to standardize the approach for the interpretation of imaging findings, reporting, imaging-based workups, and surveillance of incidentally detected GBPs and GBWT. This recommendation promotes evidence-based practice, facilitates communication between radiologists and referring physicians, and reduces unnecessary interventions.
7.Resveratrol attenuates aging-induced mitochondrial dysfunction and mitochondria-mediated apoptosis in the rat heart
Youngju CHOI ; Mi-Hyun NO ; Jun-Won HEO ; Eun-Jeong CHO ; Dong-Ho PARK ; Ju-Hee KANG ; Chang-Ju KIM ; Dae Yun SEO ; Jin HAN ; Hyo-Bum KWAK
Nutrition Research and Practice 2025;19(2):186-199
RESULTS:
Resveratrol significantly reduced cardiac hypertrophy and remodeling in aging hearts. In addition, resveratrol significantly ameliorated aging-induced mitochondrial dysfunction (e.g., decreased oxygen respiration and increased hydrogen peroxide emission) and mitochondria-dependent apoptotic signaling (the Bax/Bcl-2 ratio, mitochondrial permeability transition pore opening sensitivity, and cleaved caspase-3 protein levels).Resveratrol also significantly attenuated aging-induced apoptosis (determined via cleaved caspase-3 staining and TUNEL-positive myonuclei) in cardiac muscles.
CONCLUSION
This study demonstrates that resveratrol treatment has a beneficial effect on aging-induced cardiac remodeling by ameliorating mitochondrial dysfunction and inhibiting mitochondria-mediated apoptosis in the heart.
8.Comparison of Anticancer Effects of Histone Deacetylase Inhibitors CG-745 and Suberoylanilide Hydroxamic Acid in Non-small Cell Lung Cancer
Hyo Jin KIM ; Ui Ri AN ; Han Jee YOON ; Hyun LIM ; Ki Eun HWANG ; Young Suk KIM ; Hak Ryul KIM
Tuberculosis and Respiratory Diseases 2025;88(2):342-352
Background:
Histone deacetylase (HDAC) inhibition offers potential anticancer effects across diverse cancers due to HDAC's significant role in cancer development and progression. Consequently, we demonstrated the therapeutic efficacy of the novel HDAC inhibitor, CG-745, in comparison with existing inhibitors such as suberoylanilide hydroxamic acid (SAHA) in non-small cell lung cancer (NSCLC) cells.
Methods:
CG-745's effect on apoptosis and reactive oxygen species (ROS)-dependent mitochondrial dysfunction was investigated using annexin V assay, MitoSoX, and Western blot in human A549 and H460 cells. Additionally, HDAC expression was analyzed through real-time polymerase chain reaction. We also evaluated the inhibitory effect of CG-745 on epithelial-mesenchymal transition (EMT) induced by transforming growth factor β1 (TGF-β1) via Western blot, scratch analysis, and matrigel invasion analysis.
Results:
Compared to SAHA, CG-745 inhibited cell viability and mRNA expression of HDACs such as HDAC1, HDAC2, HDAC3, and HDAC8. It also induced apoptosis, ROS, and mitochondrial dysfunction in a concentration-dependent manner. CG-745 reversed EMT triggered by TGF-β1 in A549 and H460 cells, and curtailed the migration and invasion enhanced by TGF-β1. CG-745 has demonstrably inhibited EMT and induced apoptosis in NSCLC cells.
Conclusion
CG-745 may represent a novel therapeutic strategy for NSCLC treatment.
9.Regenerative Capacity of Alveolar Type 2 Cells Is Proportionally Reduced Following Disease Progression in Idiopathic Pulmonary Fibrosis-Derived Organoid Cultures
Hyeon Kyu CHOI ; Gaeul BANG ; Ju Hye SHIN ; Mi Hwa SHIN ; Ala WOO ; Song Yee KIM ; Sang Hoon LEE ; Eun Young KIM ; Hyo Sup SHIM ; Young Joo SUH ; Ha Eun KIM ; Jin Gu LEE ; Jinwook CHOI ; Ju Hyeon LEE ; Chul Hoon KIM ; Moo Suk PARK
Tuberculosis and Respiratory Diseases 2025;88(1):130-137
Background:
Idiopathic pulmonary fibrosis (IPF) is a chronic, progressive lung disease that culminates in respiratory failure and death due to irreversible scarring of the distal lung. While initially considered a chronic inflammatory disorder, the aberrant function of the alveolar epithelium is now acknowledged as playing a central role in the pathophysiology of IPF. This study aimed to investigate the regenerative capacity of alveolar type 2 (AT2) cells using IPF-derived alveolar organoids and to examine the effects of disease progression on this capacity.
Methods:
Lung tissues from three pneumothorax patients and six IPF patients (early and advanced stages) were obtained through video-assisted thoracoscopic surgery and lung transplantation. HTII-280+ cells were isolated from CD31-CD45-epithelial cell adhesion molecule (EpCAM)+ cells in the distal lungs of IPF and pneumothorax patients using fluorescence-activated cell sorting (FACS) and resuspended in 48-well plates to establish IPF-derived alveolar organoids. Immunostaining was used to verify the presence of AT2 cells.
Results:
FACS sorting yielded approximately 1% of AT2 cells in early IPF tissue, and the number decreased as the disease progressed, in contrast to 2.7% in pneumothorax. Additionally, the cultured organoids in the IPF groups were smaller and less numerous compared to those from pneumothorax patients. The colony forming efficiency decreased as the disease advanced. Immunostaining results showed that the IPF organoids expressed less surfactant protein C (SFTPC) compared to the pneumothorax group and contained keratin 5+ (KRT5+) cells.
Conclusion
This study confirmed that the regenerative capacity of AT2 cells in IPF decreases as the disease progresses, with IPF-derived AT2 cells inherently exhibiting functional abnormalities and altered differentiation plasticity.
10.2025 Seoul Consensus on Clinical Practice Guidelines for Irritable Bowel Syndrome
Yonghoon CHOI ; Young Hoon YOUN ; Seung Joo KANG ; Jeong Eun SHIN ; Young Sin CHO ; Yoon Suk JUNG ; Seung Yong SHIN ; Cheal Wung HUH ; Yoo Jin LEE ; Hoon Sup KOO ; Kwangwoo NAM ; Hong Sub LEE ; Dong Hyun KIM ; Ye Hyun PARK ; Min Cheol KIM ; Hyo Yeop SONG ; Sung-Hoon YOON ; Sang Yeol LEE ; Miyoung CHOI ; Moo-In PARK ; In-Kyung SUNG ;
Journal of Neurogastroenterology and Motility 2025;31(2):133-169
Irritable bowel syndrome (IBS) is a chronic, disabling, and functional bowel disorder that significantly affects social functioning and reduces quality of life and increases social costs. The Korean Society of Neurogastroenterology and Motility published clinical practice guidelines on the management of IBS based on a systematic review of the literature in 2017, and planned to revise these guidelines in light of new evidence on the pathophysiology, diagnosis, and management of IBS. The current revised version of the guidelines is consistent with the previous version and targets adults diagnosed with or suspected of having IBS. These guidelines were developed using a combination of de novo and adaptation methods, with analyses of existing guidelines and discussions within the committee, leading to the identification of key clinical questions. Finally, the guidelines consisted of 22 recommendations, including 3 concerning the definition and risk factors of IBS, 4 regarding diagnostic modalities and strategies, 2 regarding general management, and 13 regarding medical treatment. For each statement, the advantages, disadvantages, and precautions were thoroughly detailed. The modified Delphi method was used to achieve expert consensus to adopt the core recommendations of the guidelines. These guidelines serve as a reference for clinicians (including primary care physicians, general healthcare providers, medical students, residents, and other healthcare professionals) and patients, helping them to make informed decisions regarding IBS management.

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