Objective: Primary frozen shoulder causes significant pain and progressively restricts shoulder movements. Diagnosis is made clinically based on patient history and physical examination. Management is mainly non-invasive owing to its self-limiting clinical course. However, clinical practice guidelines for frozen shoulder have not yet been developed in Korea. The developed guidelines aim to provide evidence-based recommendations for the diagnosis and treatment of frozen shoulder. Methods: A guideline development committee reviewed the literature from four databases (PubMed, Embase, Cochrane Library, and KMbase). Using the Population, Intervention, Comparator, and Outcome (PICO) framework, the committee formulated two backgrounds and 16 key questions to address common clinical concerns. Recommendations were made using the Grading of Recommendations, Assessment, Development, and Evaluation framework. Results: Diabetes, thyroid disease, and dyslipidemia significantly increase the risk of developing a frozen shoulder. Although frozen shoulder is often self-limiting, some patients may experience long-term functional disabilities. Ultrasound and magnetic resonance imaging should be used as adjunctive tools alongside clinical diagnosis, and rather than as independent diagnostic methods. Noninvasive approaches, such as medications, physical modalities, exercises, electrical stimulation, and manual therapy, may reduce pain and improve shoulder function. Other noninvasive interventions have limited evidence, and their application should be based on clinical judgment. Intra-articular steroid injections are recommended for treatment, and physiotherapy or hydrodilation with steroid injections can also be beneficial. Conclusion These guidelines provide evidence-based recommendations for diagnosing and treating primary frozen shoulder.

Purpose: Providing continuous self-care support to the growing diabetes population is challenging. Strategies are needed to enhance engagement in self-care, utilizing innovative technologies for personalized feedback. This study aimed to assess the feasibility of the Automated Personalized Self-Care program among type 2 diabetes patients and evaluate its preliminary effectiveness. Methods: A parallel randomized pilot trial with qualitative interviews occurred from May 3, 2022, to September 27, 2022. Participants aged 40e69 years with type 2 diabetes and HbA1c ! 7.0% were recruited. The three-month program involved automated personalized goal setting, education, monitoring, and feedback. Feasibility was measured by participants' engagement and intervention usability. Preliminary effectiveness was examined through self-care self-efficacy, self-care behaviors, and health outcomes. Qualitative interviews were conducted with the intervention group. Results: A total of 404 patients were screened. Out of the 61 eligible patients, 32 were enrolled, resulting in a recruitment rate of 52.5%. Retention rates at three months were 84.2% and 84.6% in the intervention and control groups, respectively. Among the intervention group, 81.3% satisfied adherence criteria.Mobile application's usability scored 66.25, and participants' satisfaction was 8.06. Intention-to-treat analysis showed improvements in self-measured blood glucose testing, grain intake, and HbA1c in the intervention group. Qualitative content analysis identified nine themes. Conclusion Feasibility of the program was verified. A larger randomized controlled trial is needed to determine its effectiveness in self-care self-efficacy, self-care behaviors, and health outcomes among type 2 diabetes patients. This study offers insights for optimizing future trials assessing clinical effectiveness.

In May 2023, the Committee of Clinical Practice Guidelines of the Korean Diabetes Association published the revised clinical practice guidelines for Korean adults with diabetes and prediabetes. We incorporated the latest clinical research findings through a comprehensive systematic literature review and applied them in a manner suitable for the Korean population. These guidelines are designed for all healthcare providers nationwide, including physicians, diabetes experts, and certified diabetes educators who manage patients with diabetes or individuals at risk of developing diabetes. Based on recent changes in international guidelines and the results of a Korean epidemiological study, the recommended age for diabetes screening has been lowered. In collaboration with the relevant Korean medical societies, recently revised guidelines for managing hypertension and dyslipidemia in patients with diabetes have been incorporated into this guideline. An abridgment containing practical information on patient education and systematic management in the clinic was published separately.

Purpose: This study aimed to identify the factors influencing job satisfaction among nurses working in integrated nursing care wards. Methods: The study participants were 196 nurses working in integrated nursing care wards at four general hospitals and one tertiary hospital. Data were collected using structured questionnaires from April 11 to 25, 2022, through an online survey. Data were analyzed using descriptive statistics, t-test, one-way ANOVA, Pearson correlation, and stepwise multiple regression with SPSS/WIN 26.0. Results: The factors influencing job satisfaction of participants were team structure (β=.32, p<.001), role conflict regarding nursing practice (β=-.24, p<.001), mutual support (β=.23, p<.001), master's degree or higher(β=.16, p=.004), and spousal presence (β=.15, p=.005). Conclusion The findings of this study suggest that the tasks and roles of team members should be clarified, and a supportive team culture of mutual cooperation should be fostered to improve the job satisfaction of nurses working in the integrated nursing ward. In addition, it is necessary to reduce role conflict by providing support focused on allocating tasks that can strengthen the role of professional nurses.

Purpose: Aging process comes with cognitive impairment due to decreased neuronal cell number, activity, and neuronal circuit. Alteration of inhibitory neurons contributes to cognitive impairment in normal aging and is responsible for disrupting the excitation/ inhibition balance by reducing the synthesis of gamma-aminobutyric acid (GABA). Morus nigra (Mulberry) is a natural physiologically active substance that has been proven to have anti-oxidant, anti-diabetic, and anti-inflammatory effects through many studies. This study aimed to evaluate the effects of the mulberry extract (ME) on cognitive function through anti-oxidant enzyme and GABAergic neuronal activity in aged rat brain. Methods: Sprague Dawley rats were randomly assigned as the young group (8 weeks, n = 8), aging group (67 weeks, n = 8), and aging + mulberry extract group (67 weeks, n = 8). The aging + mulberry extract group was orally administered 500 mg/kg/d mulberry extract for 6 weeks. Results: The aging + mulberry extract group improved spatial and short-term memory. The antioxidant potential of ME increased the expression of superoxide dismutase-1 (SOD-1) and decreased inducible nitric oxide synthase (iNOS). Also, the aging + mulberry extract group significantly increased the expression of GABAergic interneuron in hippocampus cornu ammonis1 (CA1) compared to the aging group. Conclusion The number of GABAergic inhibitory interneurons was deceased and memory functions in the aging process, but those symptoms were improved and restored by mulberry extract administration.

Background: Low-density lipoprotein (LDL) cholesterol is a strong predictor of cardiovascular disease, resulting in the promotion of low-fat diets that emphasize the need to lower LDL cholesterol levels. We investigated the relationship between dietary carbohydrate intake and cardiovascular risk factors according to LDL cholesterol levels in Korean adults who typically consumed high-carbohydrate, low-fat diets. Methods: A total of 25,925 Korean adults were selected from the 2007-2015 Korea National Health and Nutrition Examination Surveys. Dietary carbohydrate intake was grouped into quintiles and cardiovascular risk factors included obesity, metabolic syndrome, type 2 diabetes, and dyslipidemia. Multiple logistic regression models were used to examine association between carbohydrate intake and cardiovascular risk factors by sex and LDL cholesterol levels. Results: Subjects with LDL cholesterol ≥130 mg/dL had significantly less energy and fat intake than those with LDL cholesterol <130 mg/dL both in men and women. In men, a higher carbohydrate intake was related to increased prevalence of atherogenic dyslipidemia and low high-density lipoprotein (HDL) cholesterol regardless of LDL cholesterol levels. Meanwhile, dietary carbohydrate intake was positively associated with low HDL cholesterol but inversely associated with hypercholesterolemia only in women with LDL cholesterol <130 mg/dL. Conclusions High carbohydrate intake in Korean adults is associated with low HDL cholesterol or atherogenic dyslipidemia regardless of LDL cholesterol levels. Carbohydrate intake should be carefully recommended according to the lipid profiles of individuals for the prevention and management of cardiovascular disease.

Background: Low-density lipoprotein (LDL) cholesterol is a strong predictor of cardiovascular disease, resulting in the promotion of low-fat diets that emphasize the need to lower LDL cholesterol levels. We investigated the relationship between dietary carbohydrate intake and cardiovascular risk factors according to LDL cholesterol levels in Korean adults who typically consumed high-carbohydrate, low-fat diets. Methods: A total of 25,925 Korean adults were selected from the 2007-2015 Korea National Health and Nutrition Examination Surveys. Dietary carbohydrate intake was grouped into quintiles and cardiovascular risk factors included obesity, metabolic syndrome, type 2 diabetes, and dyslipidemia. Multiple logistic regression models were used to examine association between carbohydrate intake and cardiovascular risk factors by sex and LDL cholesterol levels. Results: Subjects with LDL cholesterol ≥130 mg/dL had significantly less energy and fat intake than those with LDL cholesterol <130 mg/dL both in men and women. In men, a higher carbohydrate intake was related to increased prevalence of atherogenic dyslipidemia and low high-density lipoprotein (HDL) cholesterol regardless of LDL cholesterol levels. Meanwhile, dietary carbohydrate intake was positively associated with low HDL cholesterol but inversely associated with hypercholesterolemia only in women with LDL cholesterol <130 mg/dL. Conclusions High carbohydrate intake in Korean adults is associated with low HDL cholesterol or atherogenic dyslipidemia regardless of LDL cholesterol levels. Carbohydrate intake should be carefully recommended according to the lipid profiles of individuals for the prevention and management of cardiovascular disease.

Purpose: Some of the adolescent drinks more sugar-sweetened beverages. However, there is little evidence on the effect of eating behavior on emotional state and neurochemical changes under stress, especially on the levels of typical inhibitory neurotransmitters and gamma-aminobutyric acid. This article demonstrates that sucrose or saccharin drink reduces stress-related behavior responses and GABAergic deficits in adolescent rats. Methods: We randomly assigned 7-weeks-old Sprague-Dawley male rats to three groups:control group (Control), restraint stress only group (Stress), and restraint stress with unrestricted access to saccharin solution (Saccharin) and sucrose solution (Sucrose) as a positive control. We evaluated both anxious and depressive moods using an open field test and forced swim test, respectively. Using western blot analyses, the expression of a GABA-synthesizing enzyme, glutamate decarboxylase-67 (GAD67) and GABAergic markers, including calbindin and parvalbumin was assessed in the prefrontal cortex and the amygdala. Results: We found that both the drinks alleviated anxiety and depressive moods, induced significant attenuation in GAD67 level, and reduced calbindin level under stress in the prefrontal cortex and the amygdala. Conclusion The results provide an understanding of the effect of sucrose or saccharin drink on stress-related responses. We propose the consumption of sweet drinks as a plausible strategy to alleviate stress-related alterations in adolescents.

PURPOSE: Caffeine is the most widely consumed psychostimulant of the methylxanthine class. Among adolescents, high-dose of caffeine consumption has increased rapidly over the last few decades due to the introduction of energy drinks. However, little is known about the time-dependent effect of high doses of caffeine consumption in adolescents. The present study aims to examine the short- and long-term influence of high-dose caffeine on behavior of adolescence. METHODS: The animals were divided into three groups: a “vehicle” group, which was injected with 1 ml of phosphate-buffered saline for 14 days; a “Day 1” group, which was injected with caffeine (30 mg/kg), 2 h before the behavioral tests; and a “Day 14” group, which was infused with caffeine for 14 days. An open-field test, a Y-maze test, and a passive avoidance test were conducted to assess the rats'activity levels, anxiety, and cognitive function. RESULTS: High-dose caffeine had similar effects in short-and long-term treatment groups. It increased the level of locomotor activity and anxiety-like behavior, as evidenced by the increase in the number of movements and incidences of rearing and grooming in the caffeine-treated groups. No significant differences were observed between the groups in the Y-maze test. However, in the passive avoidance test, the escape latency in the caffeine-treated group was decreased significantly, indicating impaired memory acquisition. CONCLUSION: These results indicate that high-dose caffeine in adolescents may increase locomotor activity and anxiety-like behavior and impair learning and memory, irrespective of the duration of administration. The findings will be valuable for both evidence-based education and clinical practice.
Adolescent ; Animals ; Anxiety ; Behavior Rating Scale ; Caffeine ; Cognition ; Education ; Energy Drinks ; Grooming ; Humans ; Incidence ; Learning ; Locomotion ; Memory ; Models, Animal ; Motor Activity ; United Nations

No abstract available.
Dyslipidemias ; Korea