Purpose: This study was conducted to revise the Nutrition Quotient for Preschool children (NQ-P), a tool for evaluating the overall dietary quality and eating behavior among Korean preschool-aged children. Methods: At the first stage, 20 items for assessing dietary behavior were selected based on the previous NQ-P checklist, incorporating the results of the Seventh Korea National Health and Nutrition Examination Survey, national nutrition policies, dietary guidelines, and recent literature reviews. A pilot study was conducted with 100 preschool children residing in Seoul and Gyeonggi Province, using an 18-item checklist. After exploratory factor analysis and expert consultation, 15 items were finalized for use in nationwide survey checklists. The nationwide survey was conducted with a stratified sample of 800 preschool children across six metropolitan cities. Confirmatory factor analysis was used to revise the NQ-P 2021 and make it suitable for the structural equation model. Results: The NQ-P 2021 was developed using 15 checklist items organized into three factors:balance (7 items), moderation (4 items), and practice (4 items). The standardized path coefficients were used as item weights to determine the nutrition quotients. The weights of balance, moderation, and practice were 0.40, 0.15, and 0.45, respectively. In the nationwide survey, the mean NQ-P 2021 score was 59.67. The average scores for balance, moderation, and practice were 51.00, 62.45, and 66.46, respectively. Conclusion The revised NQ-P 2021 provides a validated and practical tool for assessing the dietary quality and eating behaviors of preschool children in Korea.

Purpose: The study aimed to identify the clear properties of the concept of self-management in children with chronic kidney diseases and provide a theoretical basis for understanding. Methods: The study was conducted based on the basic principle of concept analysis by Walker and Avant (2005). Results: Self-management in children with chronic kidney diseases can be divided into internal, environmental, and behavioral dimensions. The internal dimension includes a positive attitude toward life and overcoming a sense of unsafe self-control caused by chronic kidney disease. The environmental dimension includes support from peer groups and family, and the behavioral dimension includes controlling one’s own daily routine and self-directed chronic kidney disease management behavior. The definition of self-management in children with chronic kidney disease refers to “overcoming the unstable sense of self-control caused by chronic kidney disease through a positive attitude toward life, while receiving support from peers and family in their environment, and autonomously managing their chronic illness by taking control of their daily lives.” Conclusion This study provides a framework for the development of interventions for increased self-management in children with chronic kidney diseases. The study employed a concept analysis of self-management in children with chronic kidney diseases and its understanding to establish this framework, as well as data for the development of tools that identify the educational demand of the target and evaluate the effect of intervention.

Purpose: The study aimed to identify the clear properties of the concept of self-management in children with chronic kidney diseases and provide a theoretical basis for understanding. Methods: The study was conducted based on the basic principle of concept analysis by Walker and Avant (2005). Results: Self-management in children with chronic kidney diseases can be divided into internal, environmental, and behavioral dimensions. The internal dimension includes a positive attitude toward life and overcoming a sense of unsafe self-control caused by chronic kidney disease. The environmental dimension includes support from peer groups and family, and the behavioral dimension includes controlling one’s own daily routine and self-directed chronic kidney disease management behavior. The definition of self-management in children with chronic kidney disease refers to “overcoming the unstable sense of self-control caused by chronic kidney disease through a positive attitude toward life, while receiving support from peers and family in their environment, and autonomously managing their chronic illness by taking control of their daily lives.” Conclusion This study provides a framework for the development of interventions for increased self-management in children with chronic kidney diseases. The study employed a concept analysis of self-management in children with chronic kidney diseases and its understanding to establish this framework, as well as data for the development of tools that identify the educational demand of the target and evaluate the effect of intervention.

Purpose: The study aimed to identify the clear properties of the concept of self-management in children with chronic kidney diseases and provide a theoretical basis for understanding. Methods: The study was conducted based on the basic principle of concept analysis by Walker and Avant (2005). Results: Self-management in children with chronic kidney diseases can be divided into internal, environmental, and behavioral dimensions. The internal dimension includes a positive attitude toward life and overcoming a sense of unsafe self-control caused by chronic kidney disease. The environmental dimension includes support from peer groups and family, and the behavioral dimension includes controlling one’s own daily routine and self-directed chronic kidney disease management behavior. The definition of self-management in children with chronic kidney disease refers to “overcoming the unstable sense of self-control caused by chronic kidney disease through a positive attitude toward life, while receiving support from peers and family in their environment, and autonomously managing their chronic illness by taking control of their daily lives.” Conclusion This study provides a framework for the development of interventions for increased self-management in children with chronic kidney diseases. The study employed a concept analysis of self-management in children with chronic kidney diseases and its understanding to establish this framework, as well as data for the development of tools that identify the educational demand of the target and evaluate the effect of intervention.

Background: Calcineurin inhibitor (CNI) toxicity is a significant cause of graft dysfunction in kidney transplant recipients, yet distinguishing it from acute rejection (AR) and acute tubular necrosis (ATN) remains challenging. This study investigated the use of urinary mRNA biomarkers as a noninvasive tool for identifying CNI toxicity. Methods: We retrospectively enrolled 110 kidney transplant recipients and classified them into four groups based on pathological findings: stable graft function (n=35), CNI toxicity (n=25), AR (n=30), and ATN (n=20). Candidate biomarkers were selected using the GEO database. Urinary mRNA was extracted from cell pellets, reverse-transcribed, and quantified by real-time polymerase chain reaction. Results: Estimated glomerular filtration rates were comparable among the CNI toxicity, AR, and ATN groups. Four transcripts (LTF, NNMT, WFDC2, and HIF1A) were identified as candidate biomarkers. Urinary mRNA levels of LTF, NNMT, and HIF1A were significantly lower in the CNI toxicity group than the AR group. NNMT and HIF1A levels were also significantly lower than those observed in the ATN group. In contrast, WFDC2 levels did not differ significantly across groups. A three-gene signature (LTF, NNMT, and HIF1A) effectively differentiated CNI toxicity from AR and ATN (area under the curve [AUC], 0.867;95% confidence interval [CI], 0.787–0.947) and significantly enhanced the diagnostic performance of the clinical variable-based model (AUC increased from 0.776; 95% CI, 0.660–0.892, to 0.934; 95% CI, 0.881–0.986). Conclusions Urinary mRNA levels of LTF, NNMT, and HIF1A may serve as useful biomarkers for identifying CNI toxicity in kidney transplant recipients with graft dysfunction.

Endostatin is released during extracellular matrix remodeling and is involved in the development of vascular pathology and cardiovascular (CV) disease. However, the role of circulating endostatin as a biomarker of vascular calcification and CV events in patients undergoing hemodialysis (HD) remains unclear. Methods: A total of 372 patients undergoing HD were prospectively recruited. Plasma endostatin levels were measured at baseline, and their associations with circulating mineral bone disease (MBD) biomarkers and abdominal aortic vascular calcification scores were analyzed. The primary endpoint was defined as a composite of CV and cardiac events. Results: Plasma levels of patients in endostatin tertile 3 were significantly associated with low-density lipoprotein cholesterol levels and predialysis systolic blood pressure in multivariate analysis. However, endostatin levels did not correlate with circulating MBD biomarkers or vascular calcification scores. Patients in endostatin tertile 3 had a significantly higher cumulative event rate for the composite of CV events (p = 0.006). Endostatin tertile 3 was also associated with an increased cumulative rate of cardiac events (p = 0.04). In multivariate Cox regression analyses, endostatin tertile 3 was associated with a 4.37-fold risk for composite CV events and a 3.88-fold risk for cardiac events after adjusting for multiple variables. Conclusion: Higher circulating endostatin levels were independently associated with atherosclerotic risk factors but did not correlate with MBD markers or vascular calcification. Higher circulating endostatin levels were associated with a greater risk of composite CV events in patients undergoing HD, and endostatin is a biomarker that helps to determine the high risk of CV events.

Purpose: This study was conducted to update the Nutrition Quotient for Adolescents (NQ-A), which is used to assess the overall dietary quality and food behavior among Korean adolescents. Methods: The first 30 candidate items of the measurable eating behavior checklist were obtained based on a previous NQ-A checklist, the results of the seventh Korea National Health and Nutrition Examination Survey data, Korea Youth Risk Behavior Survey data, national nutrition policies and dietary guidelines, and literature reviews. A total of 100 middle and high school students residing in Seoul and Gyeonggi Province participated in a pilot study using the 25-item checklist. Factor analysis and frequency analysis were conducted to determine if the checklist items were organized properly and whether the responses to each item were distributed adequately, respectively. As a result, 22 checklist items were selected for the nationwide survey, which was applied to 1,000 adolescent subjects with stratified sampling from 6 metropolitan cities. The construct validity of the updated NQ-A 2021 was assessed using confirmatory factor analysis. Results: Twenty checklist items were determined for the final NQ-A 2021. The items were composed of three factors: balance (8 items), moderation (9 items), and practice (3 items). The standardized path coefficients were used as the weights of items to determine the nutrition quotients. NQ-A 2021 and 3-factor scores were calculated according to the weights of questionnaire items. The weight for each of the 3 factors was determined as follows: balance, 0.15; moderation, 0.30; and practice, 0.55. Conclusion The updated NQ-A 2021 is a useful instrument for easily and quickly evaluating the dietary qualities and eating behaviors of Korean adolescents

Purpose: The purpose of this study was to determine whether the dietary quality of food consumed by the elderly is influenced by the consumption of healthy functional foods using Nutrition Quotients for the Elderly (NQ-E). Methods: The study subjects were 250 adults aged ≥ 65 living in Seoul or Gyeonggi-do. Those who had consumed healthy functional food for more than 2 weeks within the previous year were classified as healthy functional food consumers, and the quality of their meals was evaluated using the NQ-E. Statistical analysis was performed using SAS 9.4, and sex and age-associated differences were adjusted before comparing differences based on healthy functional food intake. Results: The average age of the study subjects was 70.8. The scores for each area and the Nutrition Quotient (NQ) score were as follows: balance 43.3 points, moderation 56.7 points, practice 65.7 points, and NQ 52.5 points. When comparing differences according to healthy functional food intake status, healthy functional food consumers had significantly higher balance and NQ scores than non-consumers. When considering each NQ item score, healthy functional food consumers had significantly higher scores than non-consumers for fruit, fish and seafood, eggs, nuts, and whole grain rice, and a higher score for effort to maintain a healthy diet. Conclusion Dietary quality as assessed by Nutrition Quotients for the Elderly was better for healthy functional food consumers than non-consumers.

OBJECTIVES: We estimated the population prevalence of antibodies to severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), including unreported infections, through a Korea Seroprevalence Study of Monitoring of SARS-CoV-2 Antibody Retention and Transmission (K-SEROSMART) in 258 communities throughout Korea. METHODS: In August 2022, a survey was conducted among 10,000 household members aged 5 years and older, in households selected through two stage probability random sampling. During face-to-face household interviews, participants self-reported their health status, COVID-19 diagnosis and vaccination history, and general characteristics. Subsequently, participants visited a community health center or medical clinic for blood sampling. Blood samples were analyzed for the presence of antibodies to spike proteins (anti-S) and antibodies to nucleocapsid proteins (anti-N) SARS-CoV-2 proteins using an electrochemiluminescence immunoassay. To estimate the population prevalence, the PROC SURVEYMEANS statistical procedure was employed, with weighting to reflect demographic data from July 2022. RESULTS: In total, 9,945 individuals from 5,041 households were surveyed across 258 communities, representing all basic local governments in Korea. The overall population-adjusted prevalence rates of anti-S and anti-N were 97.6% and 57.1%, respectively. Since the Korea Disease Control and Prevention Agency has reported a cumulative incidence of confirmed cases of 37.8% through July 31, 2022, the proportion of unreported infections among all COVID-19 infection was suggested to be 33.9%. CONCLUSIONS The K-SEROSMART represents the first nationwide, community-based seroepidemiologic survey of COVID-19, confirming that most individuals possess antibodies to SARS-CoV-2 and that a significant number of unreported cases existed. Furthermore, this study lays the foundation for a surveillance system to continuously monitor transmission at the community level and the response to COVID-19.

Purpose: This study was undertaken to revise and update the Nutrition Quotient (NQ) for Korean adults, a tool used to evaluate dietary quality and behavior. Methods: The first 31 items of the measurable food behavior checklist were adopted based on considerations of the previous NQ checklist, recent literature reviews, national nutrition policies, and recommendations. A pilot survey was conducted on 100 adults aged 19 to 64 residing in Seoul and Gyeonggi Province from March to April 2021 using a provisional 26-item checklist. Pilot survey data were analyzed using factor analysis and frequency analysis to determine whether checklist items were well organized and responses to questions were well distributed, respectively. As a result, the number of items on the food behavior checklist was reduced to 23 for the nationwide survey, which was administered to 1,000 adults (470 men and 530 women) aged 19 to 64 from May to August 2021. The construct validity of the developed NQ (NQ-2021) was assessed using confirmatory factor analysis, linear structural relations. Results: Eighteen items in 3 categories, that is, balance (8 items), moderation (6 items), and practice (4 items), were finally included in NQ-2021 food behavior checklist. ‘Balance’ items addressed the intake frequencies of essential foods, ‘moderation’ items the frequencies of unhealthy food intakes or behaviors, and ‘practice’ items addressed eating behaviors. Items and categories were weighted using standardized path coefficients to calculate NQ-2021 scores. Conclusion The updated NQ-2021 appears to be suitable for easily and quickly assessing the diet qualities and behaviors of Korean adults.