Background: and Purpose Whole-exome sequencing (WES) is a valuable tool for identifying causative mutations in adult moyamoya disease (MMD), thereby advancing our understanding of the genetic mechanisms underlying this condition. Here, we conducted the first WESbased association study aimed at identifying genetic modifiers implicated in MMD. Methods: This WES study involved 160 patients with MMD and 189 controls from a multicenter hospital-based biobank, and evaluated combined annotation-dependent depletion (CADD) scores. Mutant-allele frequencies were compared in 369,121 individuals derived from the UK Biobank (UKB) WES. Mutant-allele risk scores (MARSs) were created based on WESidentified mutations. Gene-based association analyses and pooled analyses in East-Asian populations were further performed. Results: Fourteen mutations reached the genome-wide significance criterion (p<5×10-8 ), among which the p.R4810K mutation in the ring finger protein 213 gene (RNF213) showed the strongest significance (odds ratio=117.4, p=8.54×10-24 ). Notably, two mutations—p.G576S (alpha-glucosidase [GAA]) and p.D54N (charged multivesicular body protein 6 [CHMP6])— exhibited high CADD scores of 32 and 25, respectively, whereas the RNF213 p.R4810K mutation demonstrated a moderate deleteriousness score of 10.63. Fourteen mutations exhibited significant differences in allele frequencies between patients and UKB controlled data (p<1×10-8 ).The MARS9 model (incorporating nine missense mutations) showed better predictability for MMD (90.89%). The analysis of gene-based associations revealed four candidate genes: GAA, RNF213, CHMP6, and CARD14 (p=5×10-19 to 4×10-7 ). The subsequent pooled analyses validated four mutations in East Asian populations: p.V1195M, p.D1331G, p.S2334N, and p.R4810K (p<3×10-8 ). Conclusions This pioneering study has corroborated the significance of p.R4810K and identified several causative mutations predisposing patients to MMD, which helps to improve the understanding of its polygenetic nature.

Purpose: This study aims to develop a fundamental nursing practice education program using the room of errors simulation for second-year nursing students and to validate its effects on their perceptions, knowledge, and activities related to patient safety management. Methods: A non-equivalent control group pretest-posttest design was used. Participants were 68 nursing students (experimental group: 35, control group: 33) from two universities. The experimental group completed two 2-hour simulation sessions using the room of errors simulation. The study was conducted from December 9 to December 30, 2024. Results: After participating in the error simulation, the experimental group showed statistically significant improvements in knowledge (t=4.70, p<.001) and activities (t=3.60, p=.001) related to patient safety management compared with the control group. However, no significant difference was observed in perceptions of patient safety management between the groups (t= -0.70, p=.489). Conclusion The room of errors simulation program effectively enhanced nursing students’ knowledge and activities related to patient safety management. These findings indicate that integrating “room of errors” simulation training strategies into second-year fundamental nursing practice is essential.

Purpose: This study aimed to examine the relationships between artificial intelligence (AI) knowledge, attitudes, perceptions, and utilization ability, and their influence on communication competence in nursing students. Methods: A descriptive cross-sectional study was conducted with 160 nursing students from three universities in Chungcheongbuk-do, Korea, between September 12 and 19, 2025. Data were collected using self-administered questionnaires to assess AI knowledge, attitudes, perception and utilization ability, and communication competence. Data were analyzed using descriptive statistics, independent t-tests, one-way ANOVA, Pearson’s correlation coefficients, and stepwise multiple regression using IBM SPSS version 26.0. Results: The mean scores for communication competence were 180.63±16.56. The scores for AI knowledge, positive attitudes, negative attitudes, and perception/utilization ability were 10.53±3.59, 45.06±4.44, 22.25±3.80, and 88.33±12.50, respectively. Significant predictors of communication competence included positive attitudes toward AI (B=0.95, p=.003), perceived ease of use (B=1.15, p=.009), and AI usage time of five hours or more per week (B=8.23, p=.015). These factors explained 22.0% of the variance in communication competence. Conclusion Educational interventions that foster positive attitudes toward AI, enhance perceived ease of use through user-friendly tools, and provide sufficient hands-on experience with AI programs may effectively improve nursing students’ communication competence.

Purpose: : This retrospective study clarified the peripheral limb ischemiaincidence and examined the differences in demographic, clinical, and nursing care-related characteristics according to the presence of peripheral limb ischemia in intensive care unit (ICU) patients undergoing extracorporeal membrane oxygenation (ECMO) therapy. Methods: : Participants were 170 patients who received ECMO therapy at a university hospital over a 10-year period (January 2013 to December 2022). Data, including general, clinical, and nursing care characteristics, were collected from electronic medical records. Data analysis was conducted using descriptive statistics, independent t-tests, χ2-tests, and Fisher’s exact tests. Results: : Participants’ mean age was 57.49 years, 125 (73.5%) were male, and the average duration of ECMO therapy was 7.22 days. Among them, 75 (44.1%) patients developed peripheral limb ischemia. Significant differences were found between the groups with and without peripheral limb ischemia in mean arterial pressure (t=6.19, p ‹.001), vasopressor use (χ2=8.54, p =.003), anticoagulant use (χ2=15.01, p ‹.001), use of clotting factors (χ2=5.84, p=.016), presence of abdominal distension (χ2=8.97, p=.003), insertion site bleeding (χ2=8.14, p =.004), and laboratory values including white blood cell count (t=2.65, p =.009), hemoglobin (t=2.71, p =.008), platelet count (t=2.88, p =.004), creatine kinase (t=-4.47, p ‹.001), prothrombin time (t=-4.22, p ‹.001), international normalized ratio (t=-4.29, p ‹.001), and frequency of lower limb monitoring (t=5.57, p ‹.001). Conclusion : This study explored the clinical and nursing care-related characteristics associated with peripheral limb ischemia in ICU patients undergoing ECMO therapy. The findings provide evidence to support future research focusing on the early detection and proactive nursing interventions to prevent peripheral limb ischemia in this high-risk population.

Purpose: Psychiatric conditions are common in children and adolescents with diabetes and can hinder disease management. In this study, we examined whether mental health status at diagnosis predicts glycemic control at 1 year. Methods: We included 57 patients aged 6–18 years diagnosed with type 1 or type 2 diabetes between 2019 and 2023 at Seoul National University Bundang Hospital. Mental health was assessed within 3 months of diagnosis using the Eating Disorder Inventory-2, Children’s Depression Inventory, and Child Behavior Checklist (CBCL) for ages 6–18. Poor glycemic control was defined as glycated hemoglobin >6.5% at 1 year. Associations between screening results and glycemic control were analyzed using Fisher exact test and multivariate logistic regression. Results: Of the 57 patients, 32 (56.1%) had type 1 diabetes, and the mean age at diagnosis was 12.9±3.1 years; 31 (54.4%) were male. Poor glycemic control at 1 year was observed in 16 patients (28.1%). Although individual subscale positivity was not significantly associated with glycemic control, borderline somatic complaints on the CBCL were significantly associated with poor control (p=0.022). In multivariate analysis, having 2 or more positive CBCL subscales showed a trend toward association with poor glycemic control (adjusted odds ratio=21.47, p=0.054). Conclusion Early psychological screening, especially for somatic symptoms or multiple psychological problems, may help identify those at risk for poor glycemic control in pediatric diabetes. These findings underscore the importance of early detection and intervention in optimizing diabetes management.

Objectives: This study aimed to investigate the association between obesity and falls among community-dwelling older adults in Korea and to assess whether body mass index (BMI) or waist circumference (WC) more accurately predicts fall risk. Methods: This study included 4378 community-dwelling older adults aged ≥65 years from the seventh Korea National Health and Nutrition Examination Survey (2016–2018). Complex-sample logistic regression analyses were conducted to examine the associations between general and central obesity and falls, stratified by sex and age group. Predictive accuracy was evaluated using Harrell’s C-index, and differences between WC and BMI were assessed using the ΔC-index and the DeLong test. Results: BMI-defined general obesity was not significantly associated with falls. In contrast, WC-defined central obesity was significantly associated with falls among older adults overall (adjusted odds ratio, 1.82; 95% confidence interval, 1.20 to 2.76). In sex-stratified analyses, central obesity remained significantly associated with falls in both males and females. Age-stratified analyses showed a significant association between central obesity and falls among adults aged 65–74 years, but not among those aged ≥75 years. WC demonstrated a modest but statistically significant improvement in predictive ability compared with BMI (ΔC-index=0.047, p=0.044), although subgroup differences were not statistically significant. Conclusions Central obesity, but not general obesity defined by BMI, was significantly associated with falls among community-dwelling older Korean adults. WC showed slightly better predictive performance than BMI. These findings suggest that WC may be a more appropriate indicator than BMI for identifying older adults at increased risk of falls.

A phytochemical study of the root extract of Hemerocallis fulva var. kwanso Regel resulted in the isolation and structural characterization of four lignans (1‒4), three flavanones (5, 6, and 8), one chalcone (9), and two monoterpenes (7 and 10). Enzyme inhibition assays revealed that two flavanone glucosides (5 and 6) showed significant inhibitory effect against protein tyrosine phosphatase 1B (PTP1B), with IC50 values of 31.38 µM and 51.46 µM, respectively. Further enzyme kinetic studies demonstrated that these two compounds acted as noncompetitive PTP1B inhibitors, with Ki values of 30.88 µM and 50.38 µM, respectively.

Dystaenia takeshimana (Nakai) Kitagawa belongs to the family Apiaceae (Umbelliferae) and is a perennial herb naturally endemic to Ulleung Island, Republic of Korea. Following its successful introduction and cultivation in mainland Korea, a phytochemical investigation of this plant was carried out. As a result, thirteen compounds were isolated and structurally characterized, including one flavonoid glycoside (1), two polyacetylenes (2 and3), one caffeoylquinic acid derivative (4), one aliphatic hydroxy acid (5), four phenolic acids and their derivatives(6, 8–10), one aromatic alcohol derivative (7), two carbohydrates (11 and 12), and one phytosterol (13). The structures of these compounds were elucidated based on spectroscopic analyses and comparison with previously reported literature data. To the best of our knowledge, this study represents the first report on the isolation of falcarinol (2), trans-4-hydroxy-2-nonenoic acid (5), and sucrose (11) from D. takeshimana and the evaluation of their protein tyrosine phosphatase 1B (PTP1B) inhibitory activity. Compounds 2, 3, and 5 exhibited potent PTP1B inhibitory effects with IC50 values of 10.74, 8.31, and 25.24 µM, respectively. Enzyme kinetic studies indicated noncompetitive inhibition by 2 and mixed-type inhibition by 5 against PTP1B. Furthermore, molecular docking analysis was performed to investigate the binding interactions between the active compounds and the enzyme active site.

Phytochemical investigation of the water extract and alkaloid fraction of Areca catechu L. led to theisolation of one new methoxyflavonoid rutinoside (1), together with eleven known compounds (2−12), five of which (8−12) belong to the pyridine alkaloid class. The structure of the new compound was elucidated through extensive spectroscopic analyses, including 1D and 2D NMR experiments and high-resolution mass spectrometry.Notably, rhamnazin-3-O-rutinoside (2) is reported here for the first time from this species. The isolated compounds were evaluated for their inhibitory activity against protein tyrosine phosphatase 1B (PTP1B) using a p-nitrophenyl phosphate assay. Flavonoids (3 and 4) and stilbene (5) exhibited notable inhibitory activity, with IC50 values of 13.30 ± 0.71, 13.44 ± 0.84, and 8.68 ± 0.12 μM, respectively. In contrast, methoxyflavonoid rutinosides (1 and 2) and pyridine alkaloids (8−12) did not show significant inhibitory activity against PTP1B.These findings provide additional chemical insights into A. catechu and its constituents in relation to PTP1B inhibition.