Background: and Purpose: Given the irreversible nature of dementia, this study examined the effects of a 20-week exercise-based dementia prevention program in community-dwelling older adults, focusing on prior exercise experience and program adherence. Methods: In this exploratory, non-randomized trial, 55 older adults (65–79 years) were allocated to an intervention (n=26) or control (n=29) group, and blinding was not feasible.The intervention comprised supervised rhythmic aerobic exercise with cognitive-motor components performed three times per week. Cognition was the primary outcome, and secondary outcomes included physical fitness, blood pressure, and blood biomarkers.Subgroup analyses classified participants by prior exercise experience and intervention exposure: G1 and G2 comprised control subgroups with no intervention exposure, whereas G3 and G4 comprised intervention-exposed subgroups stratified by adherence. Results: No significant group-by-time interactions were observed for cognitive outcomes.Participants with prior exercise experience and low adherence (G2) showed significant improvement on the Korean Mini-Mental State Examination (β=1.66, p=0.024) despite declines in physical fitness, whereas higher adherence in G3–G4 was associated with stable or favorable physical performance, with G4 showing a positive trend in the 30-second sit-tostand test. Systolic blood pressure decreased significantly in G2–G4. Conclusions Although overall cognitive gains were modest and not group specific, prior exercise experience and sustained adherence were associated with favorable changes in physical fitness and vascular outcomes, suggesting that tailored multicomponent exercise programs and long-term engagement may help promote cognitive health in older adults.

Background: and Purpose: Tailored physical exercise interventions have the potential to promote cognitive health in older adults and offer significant advantages for those more vulnerable to decline. The specific relationship between physical fitness and cognition among the elderly has not been clearly established. The purpose of this investigation was to assess the relationship between physical fitness and cognitive function in older Korean adults. Methods: Eighty-four community-dwelling older adults (mean age: 70.7±5.3 years; 81.0% female) completed a standardized physical fitness battery assessing handgrip strength, sit-and-reach, 30-second sit-to-stand, 2-minute stationary march, 3-m sit-walk-and-return, figure-8-walk, and T-wall response time. Cognitive function was evaluated using the Repeatable Battery for the Assessment of Neuropsychological Status (RBANS). Descriptive statistics, partial correlation analyses, and stepwise multiple linear regression were conducted. Results: Slower T-wall response time was significantly correlated with lower RBANS total index, immediate memory, and delayed memory scores. In regression models, slower T-wall response time was independently associated with lower RBANS total index (β=−0.234, p=0.026) and delayed memory scores (β=−0.295, p=0.029). The regression model for immediate memory was not statistically significant overall; therefore, no predictive conclusion was drawn for this domain. Higher education showed a significant positive association with cognitive performance. Conclusions Coordination, as measured by T-wall response time, emerged as the only physical fitness component consistently associated with cognitive performance in older adults. Coordination-related fitness may be an important correlate of cognitive function in older adults and a promising target for future exercise interventions.

Although we have multiple senses, multimedia mainly targets vision and olfaction. To expand the senses impacted by multimedia, olfactory stimulation has been used to enhance the sense of reality. Odors are primarily matched with objects in scenes. However, it is impractical to select all odors that match all objects in a scene and offer them to viewers. As an alternative, offering a single odor in a category as representative of other odors belonging to that category has been suggested. However, it is unclear whether viewers’ responses to videos with multiple odors (e.g., rose, lavender, and lily) from a category (e.g., flowers) are comparable. Therefore, we studied whether odors belonging to a given category could be similar in behavioral congruency and in the five frequency bands (delta, theta, alpha, beta, and gamma) of electroencephalogram (EEG) data collected while viewers watched videos. We conducted questionnaires and EEG experiments to understand the effects of similar odors belonging to categories. Our results showed that similar odors in a specific odor category were more congruent with videos than those in different odor categories. In our EEG data, the delta and theta bands were mainly clustered when odors were offered to viewers in similar categories. The theta band is known to be primarily related to the neural signals of odor information. Our studies showed that choosing odors based on odor categories in multimedia can be feasible.

Although we have multiple senses, multimedia mainly targets vision and olfaction. To expand the senses impacted by multimedia, olfactory stimulation has been used to enhance the sense of reality. Odors are primarily matched with objects in scenes. However, it is impractical to select all odors that match all objects in a scene and offer them to viewers. As an alternative, offering a single odor in a category as representative of other odors belonging to that category has been suggested. However, it is unclear whether viewers’ responses to videos with multiple odors (e.g., rose, lavender, and lily) from a category (e.g., flowers) are comparable. Therefore, we studied whether odors belonging to a given category could be similar in behavioral congruency and in the five frequency bands (delta, theta, alpha, beta, and gamma) of electroencephalogram (EEG) data collected while viewers watched videos. We conducted questionnaires and EEG experiments to understand the effects of similar odors belonging to categories. Our results showed that similar odors in a specific odor category were more congruent with videos than those in different odor categories. In our EEG data, the delta and theta bands were mainly clustered when odors were offered to viewers in similar categories. The theta band is known to be primarily related to the neural signals of odor information. Our studies showed that choosing odors based on odor categories in multimedia can be feasible.

Although we have multiple senses, multimedia mainly targets vision and olfaction. To expand the senses impacted by multimedia, olfactory stimulation has been used to enhance the sense of reality. Odors are primarily matched with objects in scenes. However, it is impractical to select all odors that match all objects in a scene and offer them to viewers. As an alternative, offering a single odor in a category as representative of other odors belonging to that category has been suggested. However, it is unclear whether viewers’ responses to videos with multiple odors (e.g., rose, lavender, and lily) from a category (e.g., flowers) are comparable. Therefore, we studied whether odors belonging to a given category could be similar in behavioral congruency and in the five frequency bands (delta, theta, alpha, beta, and gamma) of electroencephalogram (EEG) data collected while viewers watched videos. We conducted questionnaires and EEG experiments to understand the effects of similar odors belonging to categories. Our results showed that similar odors in a specific odor category were more congruent with videos than those in different odor categories. In our EEG data, the delta and theta bands were mainly clustered when odors were offered to viewers in similar categories. The theta band is known to be primarily related to the neural signals of odor information. Our studies showed that choosing odors based on odor categories in multimedia can be feasible.

Background: Limited data are available on the mortality rates of patients receiving extracorporeal membrane oxygenation (ECMO) support for coronavirus disease 2019 (COVID-19). We aimed to analyze the relationship between COVID-19 and clinical outcomes for patients receiving ECMO. Methods: We retrospectively investigated patients with COVID-19 pneumonia requiring ECMO in 19 hospitals across Korea from January 1, 2020 to August 31, 2021. The primary outcome was the 90-day mortality after ECMO initiation. We performed multivariate analysis using a logistic regression model to estimate the odds ratio (OR) of 90-day mortality. Survival differences were analyzed using the Kaplan–Meier (KM) method. Results: Of 127 patients with COVID-19 pneumonia who received ECMO, 70 patients (55.1%) died within 90 days of ECMO initiation. The median age was 64 years, and 63% of patients were male. The incidence of ECMO was increased with age but was decreased after 70 years of age. However, the survival rate was decreased linearly with age. In multivariate analysis, age (OR, 1.048; 95% confidence interval [CI], 1.010–1.089; P = 0.014) and receipt of continuous renal replacement therapy (CRRT) (OR, 3.069; 95% CI, 1.312–7.180; P = 0.010) were significantly associated with an increased risk of 90-day mortality. KM curves showed significant differences in survival between groups according to age (65 years) (log-rank P = 0.021) and receipt of CRRT (log-rank P = 0.004). Conclusion Older age and receipt of CRRT were associated with higher mortality rates among patients with COVID-19 who received ECMO.

Although we have multiple senses, multimedia mainly targets vision and olfaction. To expand the senses impacted by multimedia, olfactory stimulation has been used to enhance the sense of reality. Odors are primarily matched with objects in scenes. However, it is impractical to select all odors that match all objects in a scene and offer them to viewers. As an alternative, offering a single odor in a category as representative of other odors belonging to that category has been suggested. However, it is unclear whether viewers’ responses to videos with multiple odors (e.g., rose, lavender, and lily) from a category (e.g., flowers) are comparable. Therefore, we studied whether odors belonging to a given category could be similar in behavioral congruency and in the five frequency bands (delta, theta, alpha, beta, and gamma) of electroencephalogram (EEG) data collected while viewers watched videos. We conducted questionnaires and EEG experiments to understand the effects of similar odors belonging to categories. Our results showed that similar odors in a specific odor category were more congruent with videos than those in different odor categories. In our EEG data, the delta and theta bands were mainly clustered when odors were offered to viewers in similar categories. The theta band is known to be primarily related to the neural signals of odor information. Our studies showed that choosing odors based on odor categories in multimedia can be feasible.

Background/Aims: This study assessed the efficacy and safety of adalimumab (ADA) and explored predictors of response in Korean patients with ulcerative colitis (UC). Methods: A prospective, observational, multicenter study was conducted over 56 weeks in adult patients with moderately to severely active UC who received ADA. Clinical response, remission, and mucosal healing were assessed using the Mayo score. Results: A total of 146 patients were enrolled from 17 academic hospitals. Clinical response rates were 52.1% and 37.7% and clinical remission rates were 24.0% and 22.0% at weeks 8 and 56, respectively. Mucosal healing rates were 39.0% and 30.1% at weeks 8 and 56, respectively. Prior use of anti-tumor necrosis factor-α (anti-TNF-α) did not affect clinical and endoscopic responses. The ADA drug level was significantly higher in patients with better outcomes at week 8 (P<0.05). In patients with lower endoscopic activity, higher body mass index, and higher serum albumin levels at baseline, the clinical response rate was higher at week 8. In patients with lower Mayo scores and C-reactive protein levels, clinical responses, and mucosal healing at week 8, the clinical response rate was higher at week 56. Serious adverse drug reactions were identified in 2.8% of patients. Conclusions ADA is effective and safe for induction and maintenance in Korean patients with UC, regardless of prior anti-TNF-α therapy. The ADA drug level is associated with the efficacy of induction therapy. Patients with better short-term outcomes were predictive of those with an improved long-term response.

Background/Aims: The prospective Crohn’s Disease Clinical Network and Cohort Study is a nationwide multicenter cohort study of patients with Crohn’s disease (CD) in Korea, aiming to prospectively investigate the clinical features and long-term prognosis associated with CD. Methods: Patients diagnosed with CD between January 2009 and September 2019 were prospectively enrolled. They were divided into two cohorts according to the year of diagnosis: cohort 1 (diagnosed between 2009 and 2011) versus cohort 2 (between 2012 and 2019). Results: A total of 1,175 patients were included, and the median follow-up duration was 68 months (interquartile range, 39.0 to 91.0 months). The treatment-free durations for thiopurines (p<0.001) and anti-tumor necrosis factor agents (p=0.018) of cohort 2 were shorter than those of cohort 1. Among 887 patients with B1 behavior at diagnosis, 149 patients (16.8%) progressed to either B2 or B3 behavior during follow-up. Early use of thiopurine was associated with a reduced risk of behavioral progression (adjusted hazard ratio [aHR], 0.69; 95% confidence interval [CI], 0.50 to 0.90), and family history of inflammatory bowel disease was associated with an increased risk of behavioral progression (aHR, 2.29; 95% CI, 1.16 to 4.50). One hundred forty-one patients (12.0%) underwent intestinal resection, and the intestinal resection-free survival time was significantly longer in cohort 2 than in cohort 1 (p=0.003). The early use of thiopurines (aHR, 0.35;95% CI, 0.23 to 0.51) was independently associated with a reduced risk of intestinal resection. Conclusions The prognosis of CD in Korea appears to have improved over time, as evidenced by the decreasing intestinal resection rate. Early use of thiopurines was associated with an improved prognosis represented by a reduced risk of intestinal resection.

Background/Aims: Acute upper gastrointestinal (UGI) bleeding is a significant emergency situation with a mortality rate of 2% to 10%. Therefore, initial risk stratification is important for proper management. We aimed to evaluate the role of contrast-enhanced multidetector computed tomography (MDCT) for risk stratification in patients with acute UGI bleeding in the emergency room (ER). Methods: This retrospective study included patients with UGI bleeding in the ER. Glasgow-Blatchford risk score-computed tomography (GBS-CT) was assessed using a combination of GBS and the MDCT scan scoring system. Results: Of the 297 patients with UGI bleeding, 124 (41.8%) underwent abdominal MDCT. Among them, 90.3% were classified as high-risk by GBS, and five patients died (4.0%). Rebleeding occurred in nine patients (7.3%). The high-risk GBS-CT group had significantly higher in-hospital mortality (10.5% in high-risk vs. 1.4% in moderate risk vs. 0% in low-risk, p = 0.049), transfusion amount (p < 0.001), and endoscopic hemostasis (p < 0.001) compared to the moderate- and low-risk groups. Conclusions Adding MDCT scans to the existing validated prognosis model when predicting the risk of UGI bleeding in patients in the ER plays a significant role in determining in-hospital mortality, transfusions, and the need for endoscopic hemostasis.