Purpose: This study aimed to address the shift toward competency-based education and the planned 2028 “Integrated Nursing” National Licensing Examination (NLE), this study aimed to establish structural alignment among NLE domains, the seven integrated nursing competencies (INCs), and curriculum goals, with a particular focus on implementing symptom-based clinical reasoning (SBCR). Methods: This Delphi-based methodological study included seven content experts for content validity index (CVI) assessment and 24 nursing education experts who participated in a consensus workshop. The item-level CVI and the scale-level CVI/average were calculated to confirm the linkage between INCs and NLE domains. In addition, qualitative analysis of workshop materials and meeting records was conducted to derive 10 integrated learning topics and to develop an SBCR educational model for the key symptom of headache, grounded in Miller’s Clinical Competence Pyramid (levels 2–4). Results: The analysis confirmed the validity of integrating the INCs within the overall curriculum structure. The resulting framework delineates staged learning objectives and core clinical questions designed to systematically enhance clinical reasoning, promote safe nursing practice, and support professional reflection within a unified curriculum. Conclusion This study provides a practical foundation for nursing curriculum redesign by facilitating a transition from fragmented, subject-based instruction to a holistic, patient-centered SBCR model. This approach aligns with the requirements of the integrated NLE and is expected to contribute to meaningful improvements in actual clinical competency.

Purpose: This study aimed to evaluate surgical outcomes, identify complications, and analyze recurrence in patients undergoing surgery for primary retroperitoneal tumors (RPTs), which pose significant therapeutic challenges. Methods: We retrospectively reviewed the medical records of 59 patients who underwent surgery for primary RPTs at Ajou University Hospital between January 2015 and December 2024. Patients were divided into a multivisceral resection (MVR) group (n = 25) and a non-MVR group (n = 34) to compare demographics, clinical characteristics, pathological findings, and postoperative outcomes. Results: Compared to the non-MVR group, the MVR group had a significantly higher rate of open surgery (96.0% vs.73.5%, P = 0.034), longer operative times (237.6 minutes vs. 188.8 minutes, P = 0.032), more frequent R2 resections (32.0% vs. 8.8%, P = 0.018), and longer hospital stays (13.1 days vs. 7.0 days, P = 0.007). Malignant tumors comprised 67.7% of cases, with sarcoma being the most common. Recurrence rates were highest in well-differentiated liposarcoma (50.0%) and dedifferentiated liposarcoma (22.2%). While univariate analysis showed MVR was associated with severe morbidity (Clavien-Dindo grade ≥III; odds ratio, 6.200; P = 0.029), this was not sustained as an independent predictor in multivariable analysis. Conclusion Although MVR was associated with severe complications in univariate analysis, it was not an independent predictor in multivariable analysis. This suggests the increased risk reflects overall surgical complexity. Therefore, MVR should be pursued when oncologically necessary, as it presents an acceptable morbidity profile.

Digital therapeutics are emerging as treatments for diseases and disabilities. In chronic kidney disease (CKD), gait is a potential biomarker for health status and intervention effectiveness. This study aims to analyze gait characteristics in CKD patients, providing baseline data for digital therapeutics development. Methods: At baseline and after an 8-week intervention, we performed bioimpedance analysis measurements, the Timed Up and Go, Tinetti, and grip strength tests, and gait analysis in 217 healthy individuals and 276 patients with CKD. Demographic and clinical information was collected, including underlying diseases and medications, laboratory tests, and quality of life satisfaction surveys. Gait analysis was performed using skeleton data, which involved acquiring three-dimensional skeleton data of a walker using a single Kinect sensor. The performance of an artificial intelligence-based classification model in distinguishing between healthy individuals and those with CKD was then investigated. Simultaneously, inertia measurement unit analysis was conducted using measurements taken from the wrist and waist. Results: Most subjects received a health intervention via an app, and their gait was assessed for improvements after an 8-week period. Incidents such as falls, fractures, hospitalizations, and deaths will be investigated in years 1 and 3. Conclusion: This study confirmed that the gaits of healthy individuals and CKD patients were different, and the effect of the 8-week app-based health intervention will be analyzed. The study will yield important baseline data for creating digital therapeutics for CKD patients’ diet/exercise in the future.

Purpose: We developed a comprehensive return to work (RTW) intervention covering physical, psycho-social and practical issues for patients newly diagnosed and evaluated its efficacy in terms of RTW. Materials and Methods: A multi-center randomized controlled trial was done to evaluate the efficacy of the intervention conducted at two university-based cancer centers in Korea. The intervention program comprised educational material at diagnosis, a face-to-face educational session at completion of active treatment, and three individualized telephone counseling sessions. The control group received other education at enrollment. Results: At 1-month post-intervention (T2), the intervention group was more likely to be working compared to the control group after controlling working status at diagnosis (65.4% vs. 55.9%, p=0.037). Among patients who did not work at baseline, the intervention group was 1.99-times more likely to be working at T2. The mean of knowledge score was higher in the intervention group compared to the control group (7.4 vs. 6.8, p=0.029). At the 1-year follow-up, the intervention group was 65% (95% confidence interval, 0.78 to 3.48) more likely to have higher odds for having work. Conclusion The intervention improved work-related knowledge and was effective in facilitating cancer patients’ RTW.

Background and Objectives: MYC, also known as an oncogenic reprogramming factor, is a multifunctional transcription factor that maintains induced pluripotent stem cells (iPSCs). Although MYC is frequently upregulated in various cancers and is correlated with a poor prognosis, MYC is downregulated and correlated with a good prognosis in lung adenocarcinoma. MYC and two other MYC family genes, MYCN and MYCL, have similar structures and could contribute to tumorigenic conversion both in vitro and in vivo. Methods: and Results: We systematically investigated whether MYC family genes act as prognostic factors in various human cancers. We first evaluated alterations in the expression of MYC family genes in various cancers using the Oncomine and The Cancer Genome Atlas (TCGA) database and their mutation and copy number alterations using the TCGA database with cBioPortal. Then, we investigated the association between the expression of MYC family genes and the prognosis of cancer patients using various prognosis databases. Multivariate analysis also confirmed that co-expression of MYC/MYCL/MYCN was significantly associated with the prognosis of lung, gastric, liver, and breast cancers. Conclusions Taken together, our results demonstrate that the MYC family can function not only as an oncogene but also as a tumor suppressor gene in various cancers, which could be used to develop a novel approach to cancer treatment.

Objectives: This study used the Korean National Health and Nutrition Examination Survey (KNHANES) to determine the association between fractures and low muscle mass. Methods: This cross-sectional study used the 2010–2011 KNHANES data. Low muscle mass was defined as (appendicular skeletal muscle mass [kg]/Height2 [m2 ]) < 5.45 kg/m2 , which is < 2 SD below the sex-specific mean of a young reference group. Patients with T-scores between –1.0 and –2.5 indicated osteopenia, whereas those with T-scores lower than –2.5 indicated osteoporosis. Results: Out of 1,306 women enrolled in the study, 330 were diagnosed with low muscle mass according to the abovementioned diagnostic criterion. The prevalence of fractures at various sites was significantly higher in postmenopausal women with low muscle mass than in those without low muscle mass (relative risk [RR], 1.64; odds ratio [OR], 1.62; 95% confidence interval [CI], 1.06–2.48; P = 0.027). Furthermore, the prevalence of fractures was increased by the presence of osteopenia or osteoporosis in addition to low muscle mass (RR, 1.59; OR, 1.60; 95% CI, 1.02–2.49; P = 0.039) and by osteoporosis only (RR, 2.12; OR, 2.29; 95% CI, 1.11–4.70; P = 0.025). Conclusions Fracture was more prevalent in postmenopausal women with low muscle mass than in those without low muscle mass.This finding is consistent in a subgroup analysis that included women who had osteoporosis or osteopenia. Moreover, the risk of fractures increased as low muscle mass worsened.

Neurocritical patients who can self-report pain use the 0-10 numerical rating scale (NRS, verbal or visual form). However, critically ill patients whose nervous systems cannot express pain use the behavioral pain scale (BPS) and the critical care pain observation tool (CPOT) behavioral pain assessment tools. These tools reveal pain-related changes in movement, facial expression, posture, and physiological indicators such as heart rate, blood pressure, and respiratory rate. In pain control, it is first essential to reduce unnecessary painkillers through non-drug therapy and maximize the effect of the administered analgesics. For nonneuropathic pain, narcotic analgesics such as fentanyl, hydromorphone, morphine, and remifentanil are administered intravenously. Gabapentin, pregabalin, and carbamazepine are recommended along with narcotic analgesics for neuropathic pain control. In addition, nonnarcotic analgesics for multi-modal analgesia are used to reduce the use of narcotic analgesics or the side effects of narcotic analgesics. In the intensive care unit (ICU), the sedation-agitation scale (SAS) and the Richmond agitation-sedation scale (RASS) are used to determine the depth of sedation to be maintained during shallow or deep sedation, considering the condition of the critically ill patient. When selecting sedatives for critically ill patients, preferentially consider nonbenzodiazepines such as propofol or dexmedetomidine rather than benzodiazepines such as midazolam or lorazepam. In addition, patients use painkillers or sedatives for over a week, and neurological changes or physiological dependence may occur. Therefore, clinicians should evaluate the critically ill patient’s condition, and sedatives and painkillers should be reduced or discontinued.

Purpose: To determine the clinical manifestations and maternal and perinatal outcomes in pregnant women with coronavirus disease 2019 (COVID-19). Methods: We conducted a retrospective observational study of pregnant women with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection who were admitted to National Health Insurance Service (NHIS) Ilsan Hospital between August 2020 and October 2021. The maternal and perinatal outcomes were investigated. Results: Among 184 pregnant women infected with SARS-CoV-2, 79 women delivered. Of the women who delivered, with 36 women giving birth during the quarantine period. At delivery, 45 women were positive for SARS-CoV-2 by polymerase chain reaction (PCR), whereas 34 women were negative. The most common clinical manifestations were cough (65.2%), fever (38.0%), and myalgia (33.2%). Regarding perinatal outcomes, none of the babies had an Apgar score <7 at 5 minutes, and none were intubated following the delivery. The preterm birth rate and small-for-gestational-age (SGA) rate were 15.2% and 16.5%, respectively. All babies who was delivered at NHIS Ilsan Hospital were negative for SARS-CoV-2 infection by PCR, which was evaluated using amniotic fluid, cord blood, neonatal nasopharyngeal and oropharyngeal swabs in the 1st and 2nd days following delivery, although 45 women were positive for SARS-CoV-2 infection by PCR at the time of delivery. Conclusion Most pregnant women with COVID-19 in South Korea were unlikely to manifest symptoms or present with a severe disease progression. The observed preterm birth rate and SGA rate were higher in women with COVID-19 than in those without COVID-19. However, there was no evidence of vertical transmission, and all babies were negative for SARS-CoV-2 infection during pregnancy.

Mutations in the Leucine-rich repeat kinase 2 (LRRK2 ) gene are the most prevalent cause of familial Parkinson’s disease (PD). The increase in LRRK2 kinase activity observed in the pathogenic G2019S mutation is important for PD development. Several studies have reported that increased LRRK2 kinase activity and treatment with LRRK2 kinase inhibitors decreased and increased ciliogenesis, respectively, in mouse embryonic fibroblasts (MEFs) and retinal pigment epithelium (RPE) cells. In contrast, treatment of SH-SY5Y dopaminergic neuronal cells with PD-causing chemicals increased ciliogenesis. Because these reports were somewhat contradictory, we tested the effect of LRRK2 kinase activity on ciliogenesis in neurons. In SH-SY5Y cells, LRRK2 inhibitor treatment slightly increased ciliogenesis, but serum starvation showed no increase. In rat primary neurons, LRRK2 inhibitor treatment repeatedly showed no significant change. Little difference was observed between primary cortical neurons prepared from wild-type (WT) and G2019S +/- mice. However, a significant increase in ciliogenesis was observed in G2019S +/- compared to WT human fibroblasts, and this pattern was maintained in neural stem cells (NSCs) differentiated from the induced pluripotent stem cells (iPSCs) prepared from the same WT/G2019S fibroblast pair. NSCs differentiated from G2019S and its gene-corrected WT counterpart iPSCs were also used to test ciliogenesis in an isogenic background. The results showed no significant difference between WT and G2019S regardless of kinase inhibitor treatment and B27-deprivation-mimicking serum starvation. These results suggest that LRRK2 kinase activity may be not a direct regulator of ciliogenesis and ciliogenesis varies depending upon the cell type or genetic background.