Background/Aims: This study aimed to evaluate the performance of the Model for End-Stage Liver Disease (MELD) 3.0 for predicting mortality and liver-related complications compared with the Child-Pugh classification, albumin-bilirubin (ALBI) grade, the MELD, and the MELD sodium (MELDNa) score. Methods: We evaluated a multicenter retrospective cohort of incorporated patients with cirrhosis between 2013 and 2019. We conducted comparisons of the area under the receiver operating characteristic curve (AUROC) of the MELD3.0 and other models for predicting 3-month mortality. Additionally, we assessed the risk of cirrhosis-related complications according to the MELD3.0 score. Results: A total of 3,314 patients were included. The mean age was 55.9±11.3 years, and 70.2% of the patients were male. Within the initial 3 months, 220 patients (6.6%) died, and the MELD3.0had the best predictive performance among the tested models, with an AUROC of 0.851, outperforming the Child-Pugh classification, ALBI grade, MELD, and MELDNa. A high MELD3.0score was associated with an increased risk of mortality. Compared with that of the group with a MELD3.0 score <10 points, the adjusted hazard ratio of the group with a score of 10–20 pointswas 2.176, and that for the group with a score of ≥20 points was 4.892. Each 1-point increase inthe MELD3.0 score increased the risk of cirrhosis-related complications by 1.033-fold. The risk of hepatorenal syndrome showed the highest increase, with an adjusted hazard ratio of 1.149, followed by hepatic encephalopathy and ascites. Conclusions The MELD3.0 demonstrated robust prognostic performance in predicting mortality in patients with cirrhosis. Moreover, the MELD3.0 score was linked to cirrhosis-related complications, particularly those involving kidney function, such as hepatorenal syndrome and ascites.

Infiltration and activation of peripheral immune cells are critical in the progression of multiple sclerosis and its experimental animal model, experimental autoimmune encephalomyelitis (EAE). This study investigates the role of high mobility group box 1 (HMGB1) in oligodendrocyte precursor cells (OPCs) in modulating pathogenic T cells infiltrating the central nervous system through the blood-brain barrier (BBB) by using OPC-specific HMGB1 knockout (KO) mice. We found that HMGB1 released from OPCs promotes BBB disruption, subsequently allowing increased immune cell infiltration. The migration of CD4+ T cells isolated from EAE-induced mice was enhanced when co-cultured with OPCs compared to oligodendrocytes (OLs). OPC-specific HMGB1 KO mice exhibited lower BBB permeability and reduced immune cell infiltration into the CNS, leading to less damage to the myelin sheath and mitigated EAE progression. CD4+ T cell migration was also reduced when co-cultured with HMGB1 knock-out OPCs. Our findings reveal that HMGB1 secretion from OPCs is crucial for regulating immune cell infiltration and provides insights into the immunomodulatory function of OPCs in autoimmune diseases.
Animals ; Encephalomyelitis, Autoimmune, Experimental/metabolism* ; HMGB1 Protein/deficiency* ; Mice, Knockout ; Oligodendrocyte Precursor Cells/immunology* ; Mice, Inbred C57BL ; CD4-Positive T-Lymphocytes/immunology* ; Cell Movement ; Blood-Brain Barrier/immunology* ; Mice ; Myelin Sheath/pathology* ; Disease Models, Animal ; Coculture Techniques ; Oligodendroglia/metabolism* ; Female ; Cells, Cultured

Background/Aims: This study aimed to evaluate the performance of the Model for End-Stage Liver Disease (MELD) 3.0 for predicting mortality and liver-related complications compared with the Child-Pugh classification, albumin-bilirubin (ALBI) grade, the MELD, and the MELD sodium (MELDNa) score. Methods: We evaluated a multicenter retrospective cohort of incorporated patients with cirrhosis between 2013 and 2019. We conducted comparisons of the area under the receiver operating characteristic curve (AUROC) of the MELD3.0 and other models for predicting 3-month mortality. Additionally, we assessed the risk of cirrhosis-related complications according to the MELD3.0 score. Results: A total of 3,314 patients were included. The mean age was 55.9±11.3 years, and 70.2% of the patients were male. Within the initial 3 months, 220 patients (6.6%) died, and the MELD3.0had the best predictive performance among the tested models, with an AUROC of 0.851, outperforming the Child-Pugh classification, ALBI grade, MELD, and MELDNa. A high MELD3.0score was associated with an increased risk of mortality. Compared with that of the group with a MELD3.0 score <10 points, the adjusted hazard ratio of the group with a score of 10–20 pointswas 2.176, and that for the group with a score of ≥20 points was 4.892. Each 1-point increase inthe MELD3.0 score increased the risk of cirrhosis-related complications by 1.033-fold. The risk of hepatorenal syndrome showed the highest increase, with an adjusted hazard ratio of 1.149, followed by hepatic encephalopathy and ascites. Conclusions The MELD3.0 demonstrated robust prognostic performance in predicting mortality in patients with cirrhosis. Moreover, the MELD3.0 score was linked to cirrhosis-related complications, particularly those involving kidney function, such as hepatorenal syndrome and ascites.

Purpose: Nursing students are future healthcare workers responsible for maintaining public health. Owing to the increase in early resignation among new nurses, nursing education outcomes must be evaluated by investigating students' practice readiness. Methods: Using convenience sampling, we recruited fourth-year students from two nursing colleges to participate in a cross-sectional online survey in November 2023. The Casey-Fink Readiness for Practice Survey was used to assess practice readiness and the data were analyzed using descriptive statistics, independent t-tests, and ANOVA. Results: Among the 157 participants (female, 77.7%; mean age, 23.12±1.93 yrs), the overall practice readiness score was 63.53±8.30 (range: 20~80) and the mean subscale score was 23.14±3.73 for clinical problem-solving (range: 7~28), 6.69±1.25 for learning techniques (range: 2~8), 16.87±2.46 for professional identity (range: 5~20), and 16.82±3.46 for trials and tribulations (range: 6~24). Practice readiness did not differ significantly by gender or age and was greater among subgroups with high grades and satisfaction with the major, classroom practice, simulation practice, clinical practice, and lectures. Conclusion Universities must improve the quality of classes and practical education to enhance fourth-year nursing students’ practice readiness.Nursing education programs incorporating problem-based learning must be developed and evaluated to strengthen students’ clinical inference and critical-thinking skills.

Background/Aims: This study aimed to evaluate the performance of the Model for End-Stage Liver Disease (MELD) 3.0 for predicting mortality and liver-related complications compared with the Child-Pugh classification, albumin-bilirubin (ALBI) grade, the MELD, and the MELD sodium (MELDNa) score. Methods: We evaluated a multicenter retrospective cohort of incorporated patients with cirrhosis between 2013 and 2019. We conducted comparisons of the area under the receiver operating characteristic curve (AUROC) of the MELD3.0 and other models for predicting 3-month mortality. Additionally, we assessed the risk of cirrhosis-related complications according to the MELD3.0 score. Results: A total of 3,314 patients were included. The mean age was 55.9±11.3 years, and 70.2% of the patients were male. Within the initial 3 months, 220 patients (6.6%) died, and the MELD3.0had the best predictive performance among the tested models, with an AUROC of 0.851, outperforming the Child-Pugh classification, ALBI grade, MELD, and MELDNa. A high MELD3.0score was associated with an increased risk of mortality. Compared with that of the group with a MELD3.0 score <10 points, the adjusted hazard ratio of the group with a score of 10–20 pointswas 2.176, and that for the group with a score of ≥20 points was 4.892. Each 1-point increase inthe MELD3.0 score increased the risk of cirrhosis-related complications by 1.033-fold. The risk of hepatorenal syndrome showed the highest increase, with an adjusted hazard ratio of 1.149, followed by hepatic encephalopathy and ascites. Conclusions The MELD3.0 demonstrated robust prognostic performance in predicting mortality in patients with cirrhosis. Moreover, the MELD3.0 score was linked to cirrhosis-related complications, particularly those involving kidney function, such as hepatorenal syndrome and ascites.

Background/Aims: This study aimed to evaluate the performance of the Model for End-Stage Liver Disease (MELD) 3.0 for predicting mortality and liver-related complications compared with the Child-Pugh classification, albumin-bilirubin (ALBI) grade, the MELD, and the MELD sodium (MELDNa) score. Methods: We evaluated a multicenter retrospective cohort of incorporated patients with cirrhosis between 2013 and 2019. We conducted comparisons of the area under the receiver operating characteristic curve (AUROC) of the MELD3.0 and other models for predicting 3-month mortality. Additionally, we assessed the risk of cirrhosis-related complications according to the MELD3.0 score. Results: A total of 3,314 patients were included. The mean age was 55.9±11.3 years, and 70.2% of the patients were male. Within the initial 3 months, 220 patients (6.6%) died, and the MELD3.0had the best predictive performance among the tested models, with an AUROC of 0.851, outperforming the Child-Pugh classification, ALBI grade, MELD, and MELDNa. A high MELD3.0score was associated with an increased risk of mortality. Compared with that of the group with a MELD3.0 score <10 points, the adjusted hazard ratio of the group with a score of 10–20 pointswas 2.176, and that for the group with a score of ≥20 points was 4.892. Each 1-point increase inthe MELD3.0 score increased the risk of cirrhosis-related complications by 1.033-fold. The risk of hepatorenal syndrome showed the highest increase, with an adjusted hazard ratio of 1.149, followed by hepatic encephalopathy and ascites. Conclusions The MELD3.0 demonstrated robust prognostic performance in predicting mortality in patients with cirrhosis. Moreover, the MELD3.0 score was linked to cirrhosis-related complications, particularly those involving kidney function, such as hepatorenal syndrome and ascites.

Purpose: Nursing students are future healthcare workers responsible for maintaining public health. Owing to the increase in early resignation among new nurses, nursing education outcomes must be evaluated by investigating students' practice readiness. Methods: Using convenience sampling, we recruited fourth-year students from two nursing colleges to participate in a cross-sectional online survey in November 2023. The Casey-Fink Readiness for Practice Survey was used to assess practice readiness and the data were analyzed using descriptive statistics, independent t-tests, and ANOVA. Results: Among the 157 participants (female, 77.7%; mean age, 23.12±1.93 yrs), the overall practice readiness score was 63.53±8.30 (range: 20~80) and the mean subscale score was 23.14±3.73 for clinical problem-solving (range: 7~28), 6.69±1.25 for learning techniques (range: 2~8), 16.87±2.46 for professional identity (range: 5~20), and 16.82±3.46 for trials and tribulations (range: 6~24). Practice readiness did not differ significantly by gender or age and was greater among subgroups with high grades and satisfaction with the major, classroom practice, simulation practice, clinical practice, and lectures. Conclusion Universities must improve the quality of classes and practical education to enhance fourth-year nursing students’ practice readiness.Nursing education programs incorporating problem-based learning must be developed and evaluated to strengthen students’ clinical inference and critical-thinking skills.

Purpose: Nursing students are future healthcare workers responsible for maintaining public health. Owing to the increase in early resignation among new nurses, nursing education outcomes must be evaluated by investigating students' practice readiness. Methods: Using convenience sampling, we recruited fourth-year students from two nursing colleges to participate in a cross-sectional online survey in November 2023. The Casey-Fink Readiness for Practice Survey was used to assess practice readiness and the data were analyzed using descriptive statistics, independent t-tests, and ANOVA. Results: Among the 157 participants (female, 77.7%; mean age, 23.12±1.93 yrs), the overall practice readiness score was 63.53±8.30 (range: 20~80) and the mean subscale score was 23.14±3.73 for clinical problem-solving (range: 7~28), 6.69±1.25 for learning techniques (range: 2~8), 16.87±2.46 for professional identity (range: 5~20), and 16.82±3.46 for trials and tribulations (range: 6~24). Practice readiness did not differ significantly by gender or age and was greater among subgroups with high grades and satisfaction with the major, classroom practice, simulation practice, clinical practice, and lectures. Conclusion Universities must improve the quality of classes and practical education to enhance fourth-year nursing students’ practice readiness.Nursing education programs incorporating problem-based learning must be developed and evaluated to strengthen students’ clinical inference and critical-thinking skills.

Purpose: Nursing students are future healthcare workers responsible for maintaining public health. Owing to the increase in early resignation among new nurses, nursing education outcomes must be evaluated by investigating students' practice readiness. Methods: Using convenience sampling, we recruited fourth-year students from two nursing colleges to participate in a cross-sectional online survey in November 2023. The Casey-Fink Readiness for Practice Survey was used to assess practice readiness and the data were analyzed using descriptive statistics, independent t-tests, and ANOVA. Results: Among the 157 participants (female, 77.7%; mean age, 23.12±1.93 yrs), the overall practice readiness score was 63.53±8.30 (range: 20~80) and the mean subscale score was 23.14±3.73 for clinical problem-solving (range: 7~28), 6.69±1.25 for learning techniques (range: 2~8), 16.87±2.46 for professional identity (range: 5~20), and 16.82±3.46 for trials and tribulations (range: 6~24). Practice readiness did not differ significantly by gender or age and was greater among subgroups with high grades and satisfaction with the major, classroom practice, simulation practice, clinical practice, and lectures. Conclusion Universities must improve the quality of classes and practical education to enhance fourth-year nursing students’ practice readiness.Nursing education programs incorporating problem-based learning must be developed and evaluated to strengthen students’ clinical inference and critical-thinking skills.

Objective: Obstructive sleep apnea (OSA) is a breathing disorder characterized by recurrent airway obstruction during sleep. Previous western studies have investigated the link between medical disorders and the pathophysiology of OSA. The prevalence and comorbidity rates of OSA; however, vary across different countries and racial groups. This study aimed to delve into medical comorbidities in patients with OSA using a large nationwide healthcare database in Korea. Methods: This nationwide study used the Korean National Health Insurance claims database (2010–2019). The effect of OSA on the incidence of medical disorders was estimated using the Cox proportional hazard ratio (HR) model. The results were reported as crude and adjusted HRs with 95% confidence intervals (CI). Subgroup analysis was conducted by sex and age. Results: In total, 103,785 patients with OSA and 207,570 patients without OSA were included. OSA group had significantly higher HRs for ischemic heart disease and stroke even after adjusting for hypertension, dyslipidemia, and diabetes. The OSA group also showed an increased risk of metabolic syndrome-related diseases, chronic kidney disease, and gastroesophageal reflux disease. Female patients with OSA exhibited notably higher rates of comorbid liver cirrhosis, chronic obstructive pulmonary disease, and asthma. The cardiovascular burden of patients increased in accordance with the patients’ age. Conclusion Korean patients with OSA have a significantly increased risk of cardio-cerebrovascular diseases, which aligns with the previous studies conducted in the western countries. This result holds particular significance as it represents the first nationwide, population-based study conducted in Asia.