Objective: This study aimed to compare aneuploidy rates and clinical outcomes between trophectoderm biopsy at fresh blastocyst (biopsy-fresh) followed by vitrification and biopsy at vitrified-warmed blastocyst (biopsy-vitri) followed by next day transfer (without re-vitrification). Methods: This retrospective study included 844 patients undergoing 844 cycles conducted from August 2019 to December 2023. Preimplantation genetic testing for aneuploidy (PGT-A) was performed via trophectoderm biopsy using array comparative genomic hybridization or next-generation sequencing for comprehensive 24-chromosome screening. Patients were divided into two groups based on the blastocyst status at the time of biopsy: the biopsy-fresh group (531 patients) and the biopsy-vitri group (313 patients). Results: The clinical pregnancy rate was significantly higher in the biopsy-fresh group compared to the biopsy-vitri group (58.7% vs. 45.6%; odds ratio [OR], 1.695; 95% confidence interval [CI], 1.215 to 2.364; p=0.002). Furthermore, the biopsy-fresh group showed higher implantation rates (45.6% vs. 32.1%; OR, 1.767; 95% CI, 1.274 to 2.451; p=0.002), ongoing pregnancy or live birth rates per cycle (48.0% vs. 35.8%; OR, 1.652; 95% CI, 1.177 to 2.319; p=0.004), and rates of good-quality blastocysts (57.1% vs. 32.1%, p<0.001) compared with the biopsy-vitri group. Miscarriage rates did not differ significantly between the groups (18.2% vs. 21.4%; OR, 0.818; 95% CI, 0.457 to 1.465; p=0.501). Conclusion Biopsy at fresh blastocyst demonstrated superior clinical outcomes compared with biopsy at vitrified-warmed blastocyst, likely due to better embryo quality. Both biopsy at fresh blastocyst and vitrified-warmed blastocyst remain viable options for PGT-A, with biopsy at vitrified-warmed blastocyst serving as a practical alternative. Embryo quality and euploid status continue to be critical considerations for embryo transfer selection.

Purpose: The goniometer, the gold standard for range of motion (ROM) assessment, has significant limitations including physical contact requirements and high interrater variability. While markerless motion capture using deep learning (e.g., Sports2D) offers a noncontact alternative, its clinical reliability remains unestablished. This study evaluated Sports2D's reliability for ROM measurement using smartphone cameras compared to conventional goniometry. Methods: Fifty healthy adults (25 males, 25 females; mean age, 22.42±2.58 years) participated. Ten joint ROM types (17 total measurements including left/right) were measured using both traditional goniometry (by an experienced clinician) and Sports2D (smartphone camera at 3 m distance). Reliability and agreement were analyzed using concordance correlation coefficient (CCC), Pearson correlation, and Bland-Altman plots. Results: Sports2D demonstrated very high reliability for elbow flexion (CCC, 0.906−0.955), neck extension (CCC, 0.928), and right hip flexion (CCC, 0.920). Good reliability (CCC, ≥ 0.8) was observed for neck flexion, left knee flexion, and trunk flexion. However, all ankle measurements showed clinically unacceptable reliability (CCC, ＜ 0.3), including dorsiflexion (CCC, 0.072−0.099) and plantarflexion (CCC, 0.174–0.211). Bland-Altman plots confirmed proportional bias for ankle measurements, particularly at smaller angles. Conclusion Sports2D is a reliable noncontact tool for measuring ROM in specific joints including elbow, neck, knee, hip, and trunk. However, it is unreliable for ankle joint assessment due to significant measurement discrepancies. These findings highlight the need for selective clinical application of markerless motion capture based on joint-specific validation.

Purpose: Sepsis-related deaths occur during both the early proinflammatory and the late immunosuppressive phases of the condition. The balance of pro- and anti-inflammatory responses is influenced by damaged cells that die via either proinflammatory necroptosis or anti-inflammatory apoptosis. Both forms of cell death may be mediated by reactive oxygen species (ROS) generated during the proinflammatory response. Recent evidence suggests that exercise training boosts antioxidative capacity and could offer protection against sepsis. Given these findings, we aimed to examine the impact of exercise training on neural cell death in the context of sepsis. Methods: We assessed the effectiveness of exercise in reducing ROS production and the inflammatory response using a cecal ligation and puncture (CLP)-induced sepsis model. Forty C57BL/6N male mice were randomly divided into 2 groups: control (CLP-Con; n=20) and experimental (CLP-Ex; n=20). Before the induction of sepsis by CLP, the CLP-Ex mice underwent interval training on a treadmill 3 days per week for 8 weeks. Each day involved 10 cycles of 2 minutes at 8 m/min and 2 minutes at 15 m/min. After the CLP procedure, we monitored the survival of 10 mice from each group over a 30-hour period. Results: The findings indicated that exercise training increased the survival rate among mice with CLP-induced sepsis by enhancing antioxidative capacity and delaying the transition from a hyperdynamic to an immunosuppressive state. Conclusions Exercise training may delay the progression from the hyperdynamic state to the hypodynamic phase of sepsis by increasing antioxidant capacity and reducing apoptotic cell death.

Background: Turner syndrome (TS) is a common chromosomal abnormality, which is caused by loss of all or part of one X chromosome. Hormone replacement therapy in TS is important in terms of puberty, growth and prevention of osteoporosis however, such a study has never been conducted in Korea. Therefore, the purpose of our study was to determine relationship between the starting age, duration of estrogen replacement therapy (ERT) in TS and develop a hormone replacement protocol suitable for the situation in Korea. Methods: This is retrospective study analyzed the medical records in TS patients treated at the Severance hospital, Yonsei University College of Medicine, Seoul, Korea from 1997 to 2019. Total of 188 subjects who had received a bone density test at least once were included in the study. Korean National Health and Nutrition Examination Survey (KNHANES) was used for achieving bone mineral density (BMD) of normal control group. Student’s t-test, MannWhitney U test, ANOVA and correlation analysis were performed using SPSS 18.0. Results: Each BMD measurement was significantly lower in women with TS than in healthy Korean women. Early start and longer duration of ERT is associated with higher lumbar spine BMD but not femur neck BMD. Femur neck BMD, but not lumbar spine BMD was significantly higher in women with mosaicism than 45XO group. Conclusion Early onset and appropriate duration of hormone replacement therapy is important for increasing bone mineral density in patients with Turner syndrome. Also, ERT affects differently to TS patients according to mosaicism.

Nutrition education is essential for the health of people with disabilities. This paper presents nutrition education topics and operational directions for people with disabilities living in social welfare facilities for people with disabilities. This study was conducted through one-on-one, in-depth interviews with 11 operators and workers at social welfare facilities where people with disabilities reside. They were asked about the current status of nutrition education at the social welfare facility for people with disabilities where the interviewee works, major diseases of residents, topics of nutrition education needed, and preferred education methods to determine the type of nutrition education for people with disabilities needed in the field. As a topic of nutrition education, dietary education for obesity prevention and management was most requested, and education on basic nutritional ingredients was also desired. It was mentioned that the educational level would be appropriate for children aged 6∼9, and using materials that would attract interest was recommended. Activity-based face-to-face education was preferred for the operation of the program, and it was mentioned that education would be possible in a short period. In addition, it was mentioned that nutrition education is necessary for people with disabilities and workers at social welfare facilities for people with disabilities. Confirming the topic and operation direction of the nutrition education program required by social welfare facilities for people with disabilities will make it possible to contribute to providing nutrition education tailored to social welfare facilities for people with disabilities in Korea.

Objectives: This study investigated the need for nutrition education aimed at improving the health of residents and users of social welfare facilities for persons with disability and aimed to provide basic information for developing a nutrition education program that meets the needs of the field. Methods: Altogether, 249 employees working in social welfare facilities for people with disabilities were included in the study. Data on the health status of residents/users, meal management, nutritional education, nutritional education needs, and awareness of nutritional education were obtained through online surveys. A descriptive analysis was conducted to analyze the demographic characteristics, needs, and perceptions of the respondents, and independent t-tests and χ2 tests were performed to analyze and compare the differences between residential and daycare facilities. Results: The majority of residents/users of social welfare facilities for persons with disabilities have developmental disabilities. When educating residents with residents/users of social welfare facilities, ‘personal hygiene’ was the most necessary topic, followed by ‘obesity management’ education. Regarding the methods of providing education, face-toface lectures demonstrated a high demand. They responded that when nutrition education experts provide nutrition education to people with disabilities, they must understand ‘the physical characteristics of persons with disabilities’ and have the ability to determine appropriate nutrition for such people. The most appropriate nutrition program training would be twice a year, lasting 30 min to 1 h per training session. Conclusions It will present a direction for operating a nutrition education program for persons with disabilities that meets their needs of social welfare facilities and ultimately contribute to the establishment and activation of nutrition education tailored to welfare facilities for such individuals in Korea.

Purpose: The study was to investigate exercise capacity (peak oxygen uptake [peak VO2 ]) and pulmonary capacitance (GXcap), which is an estimate of pulmonary vascular capacitance, in patients with nonalcoholic steatohepatitis (NASH). Methods: This study utilized a database of patients with NASH (n=26 [17 male and 9 female], aged 58.9±4.3 years) and healthy individuals (n=23 [12 male and 11 female, aged 58.6±7.9 years) who underwent a maximal exercise test on a recumbent cycle ergometer (Corival; Lode) in our laboratory. During cardiopulmonary exercise tests, breathing patterns and respiratory gas exchange including breathing efficiency (VE/VCO2 ) and end-tidal CO2 (PETCO2 ) were measured. In addition, peak VO2 was obtained via averaging the last 30 seconds at peak level and GXcap was obtained by calculation as follows: GXcap=oxygen pulse (O2 pulse)×PETCO2. Results: The NASH group demonstrated reduced peak VO2 relative to the healthy group (17.5±8.4 mL/kg/min vs. 34±10.2 mL/kg/min, respectively; p＜ 0.05). In addition, there was a higher VE/VCO2 relationship in the NASH group relative to the healthy group (34.9±5.5 vs. 32.2±4.0, respectively; p＜ 0.05) and lower PETCO2 in the NASH group compared to the healthy group (32.8±4.0 mm Hg vs. 35.3±3.8 mm Hg, respectively; p＜ 0.05). Furthermore, the NASH group showed lower GXcap than the healthy group (456±150 vs. 551±202, respectively; p＜ 0.05). Conclusion Patients with NASH had reduced exercise capacity and pulmonary vascular capacitance relative to age-matched healthy adults and this may contribute to pulmonary pathophysiology in NASH.

Background: The effectiveness of exercise for improving osteoporosis and fall prevention in patients diagnosed with osteoporosis or osteopenia has not been fully summarized. The Korean Society for Bone and Mineral Research and the Korean Society of Exercise Physiology has developed exercise guidelines for patients with osteoporosis or osteopenia and provide evidence-based recommendations. Methods: A systematic review identified randomized controlled trials (RCT) assessing the effect of resistance, impact, balance, aerobic training, and physical activity in osteoporosis and osteopenia on bone quality, physical performance, quality of life, and fall prevention. PubMed, Embase, KoreaMed, and RISS were searched from January 2000 to August 2022. Ten key questions were established to review the evidence and formulate recommendations. Results: The 50 RCTs reported that even with osteoporosis and osteopenia, resistance and impact training consistently maximized bone strength, improved body strength and balance, and eventually reduced fall incidences. Resistance exercise combining 3 to 10 types of free weight and mechanical exercise of major muscle groups performed with an intensity of 50% to 85% 1-repetition maximum, 5 to 12 repetitions/set, 2 to 3 days/week, for 3 to 12 months is recommended. Impact exercises such as jumping chin-ups with drop landings and jump rope performed 50 jumps/session for at least 6 months with 3 or more days/week are recommended. Conclusions A multi-component exercise mainly comprised of resistance and impact exercise seems to be an effective strategy to attenuate the risk factors of osteoporosis and osteopenia. The integration of exercise guidelines and individualized exercise plans has significant potential to reduce the morbidity and mortality of osteoporosis.

This study investigated the cumulative effects of depressive symptoms on cognitive function over time in community-dwelling older adults. Methods: Data were investigated from 2,533 community-dwelling older adults who participated in the Korean Longitudinal Study of Aging (KLoSA) from the 5th (2014) to the 8th wave (2020). The association between cumulative depressive symptoms and cognitive function was identified through multiple regression analysis. Results: When the multiple regression analysis was conducted from each wave, the current depressive symptoms scores and cognitive function scores were negatively associated, regardless of the waves (B5th = - 0.26, B6th = - 0.26, B7th = - 0.26, and B8th = - 0.27; all p < .001). Further, when all the previous depressive symptoms scores were added as explanatory variables in the 8th wave, the current one (B8th = - 0.09, p < .001) and the previous ones (B5th = - 0.11, B6th = - 0.09, and B7th = - 0.13; all p < .001) were also negatively associated with the cognitive function score. The delta R2 , which indicates the difference between the model’s R2 with and without the depressive symptoms scores, was greater in the model with all the previous and current depressive symptoms scores (6.4%) than in the model with only the current depressive symptoms score (3.6%). Conclusion: Depressive symptoms in older adults have a long-term impact. This results in an accumulated adverse effect on the cognitive function. Therefore, to prevent cognitive decline in older adults, we suggest detecting their depressive symptoms early and providing continuous intervention to reduce exposure to long-term depressive symptoms.