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.

Janus kinase (JAK) inhibitors are an important treatment option for ulcerative colitis, providing rapid onset of action, oral administration, and efficacy even after biologic failure. The 3 approved agents—tofacitinib, filgotinib, and upadacitinib—differ in JAK isoform selectivity, leading to clinically meaningful differences in efficacy and safety. Evidence from network meta-analyses, clinical trials, and real-world studies consistently shows that upadacitinib provides the highest efficacy for induction and maintenance of remission, whereas filgotinib demonstrates the most favorable safety profile. The strong efficacy of upadacitinib and tofacitinib is particularly relevant in patients with severe disease, including acute severe ulcerative colitis, and upadacitinib maintains high efficacy regardless of prior advanced therapy exposure. JAK inhibitors also benefit extraintestinal manifestations. Although risks such as herpes zoster, serious infection, thromboembolism, and major cardiovascular events differ among agents, long-term data suggest generally acceptable safety when used appropriately. Intraclass JAK-to-JAK cycling is feasible, with about half of patients achieving steroid-free clinical remission in retrospective cohorts. Based on mechanistic, clinical, and real-world evidence, filgotinib may be a first-line option for patients with lower disease activity or when safety is a priority, whereas upadacitinib or tofacitinib may be preferred in higher disease activity. Strategically selecting agents may improve durability and outcomes.

Purpose: This study identified outpatient nurses’ duties and tasks at a tertiary hospital using the Developing a Curriculum (DACUM) method, and assessed their perceived performance, importance, and difficulty. Methods: A DACUM Workshop was conducted in November 2024. A convenience sample of 207 outpatient nurses with over one year of experience was recruited, and 190 responses were analyzed. Performance, importance, and difficulty of 11 duties and 77 tasks derived from the DACUM process were rated on a 5-point Likert scale. An Importance-Difficulty Analysis (IDA) was conducted to determine priorities and visualize the distribution of duties and tasks. Results: The mean scores for performance, importance, and difficulty across duties were 3.27±0.67, 4.21±0.63, and 3.23±0.58, respectively. ‘A. Outpatient care preparation’ showed the highest performance (4.26±1.08) and importance (4.52±0.79), while ‘D. Outpatient education and counseling’ had the highest difficulty (3.79±0.79). At the task level, ‘B10. Prescription confirmation and interdepartmental communication’ showed the highest performance (4.68±0.81), with ‘B7. Patient identity verification and room admission guidance’ were rated as having the highest importance (4.76±0.75), and ‘D6.Counseling for patient complaints and grievances’ was the highest difficulty (4.31±0.98). The mean difference between importance and difficulty was statistically significant (t=17.65, p<.001). IDA classified duties and tasks into four areas: strategic focus, competency development, incremental improvement, and sustaining. Conclusion The DACUM approach provided empirical evidence to establish educational priorities and support the expansion of outpatient nurses’ professional roles. Tailored training focused on communication and counseling, along with role-specific strategies, is essential to enhance outpatient nurses’ competencies.

Background: We aimed to determine whether propofol-based total intravenous anesthesia (TIVA) is associated with mortality and morbidity following cranial neurosurgery compared with inhalation anesthesia. Methods: This nationwide, retrospective, population-based cohort study included patients who underwent cranial neurosurgery under general anesthesia between January 1, 2016, and December 31, 2021. The two study endpoints were 90-day mortality and postoperative complications. Results: In total, 144,506 adult patients were included: 65,442 patients (45.3%) who received TIVA (TIVA group) and 79,064 (54.7%) who received inhalation anesthesia (inhalation anesthesia group). After propensity score (PS) matching, 97,156 patients (48,578 in each group) were included. The 90-day mortality rates after cranial neurosurgery were 14.0% (6,660/48,578) in the TIVA group and 14.2% (6,779/48,578) in the inhalation anesthesia group. Moreover, the postoperative complication rates following cranial neurosurgery were 47.1% (22,411/48,578) and 50.3% (23,912/48,578) in the TIVA and inhalation anesthesia groups, respectively. Based on the logistic regression analysis, TIVA was not associated with 90-day mortality compared with inhalation anesthesia (odds ratio [OR]: 0.97, 95% CI [0.94, 1.01], P = 0.188) in the PS-matched cohort. Logistic regression analysis revealed that the TIVA group had a 12% (OR: 0.88, 95% CI [0.86, 0.90], P < 0.001) lower postoperative complication rate than the inhalation anesthesia group. Conclusions There was no significant association between the type of anesthesia and postoperative 90-day mortality in patients who underwent cranial neurosurgery in South Korea. However, propofol-based TIVA was associated with a lower incidence of postoperative complications than inhalation anesthesia.

Background: We aimed to determine whether propofol-based total intravenous anesthesia (TIVA) is associated with mortality and morbidity following cranial neurosurgery compared with inhalation anesthesia. Methods: This nationwide, retrospective, population-based cohort study included patients who underwent cranial neurosurgery under general anesthesia between January 1, 2016, and December 31, 2021. The two study endpoints were 90-day mortality and postoperative complications. Results: In total, 144,506 adult patients were included: 65,442 patients (45.3%) who received TIVA (TIVA group) and 79,064 (54.7%) who received inhalation anesthesia (inhalation anesthesia group). After propensity score (PS) matching, 97,156 patients (48,578 in each group) were included. The 90-day mortality rates after cranial neurosurgery were 14.0% (6,660/48,578) in the TIVA group and 14.2% (6,779/48,578) in the inhalation anesthesia group. Moreover, the postoperative complication rates following cranial neurosurgery were 47.1% (22,411/48,578) and 50.3% (23,912/48,578) in the TIVA and inhalation anesthesia groups, respectively. Based on the logistic regression analysis, TIVA was not associated with 90-day mortality compared with inhalation anesthesia (odds ratio [OR]: 0.97, 95% CI [0.94, 1.01], P = 0.188) in the PS-matched cohort. Logistic regression analysis revealed that the TIVA group had a 12% (OR: 0.88, 95% CI [0.86, 0.90], P < 0.001) lower postoperative complication rate than the inhalation anesthesia group. Conclusions There was no significant association between the type of anesthesia and postoperative 90-day mortality in patients who underwent cranial neurosurgery in South Korea. However, propofol-based TIVA was associated with a lower incidence of postoperative complications than inhalation anesthesia.

Background: We aimed to determine whether propofol-based total intravenous anesthesia (TIVA) is associated with mortality and morbidity following cranial neurosurgery compared with inhalation anesthesia. Methods: This nationwide, retrospective, population-based cohort study included patients who underwent cranial neurosurgery under general anesthesia between January 1, 2016, and December 31, 2021. The two study endpoints were 90-day mortality and postoperative complications. Results: In total, 144,506 adult patients were included: 65,442 patients (45.3%) who received TIVA (TIVA group) and 79,064 (54.7%) who received inhalation anesthesia (inhalation anesthesia group). After propensity score (PS) matching, 97,156 patients (48,578 in each group) were included. The 90-day mortality rates after cranial neurosurgery were 14.0% (6,660/48,578) in the TIVA group and 14.2% (6,779/48,578) in the inhalation anesthesia group. Moreover, the postoperative complication rates following cranial neurosurgery were 47.1% (22,411/48,578) and 50.3% (23,912/48,578) in the TIVA and inhalation anesthesia groups, respectively. Based on the logistic regression analysis, TIVA was not associated with 90-day mortality compared with inhalation anesthesia (odds ratio [OR]: 0.97, 95% CI [0.94, 1.01], P = 0.188) in the PS-matched cohort. Logistic regression analysis revealed that the TIVA group had a 12% (OR: 0.88, 95% CI [0.86, 0.90], P < 0.001) lower postoperative complication rate than the inhalation anesthesia group. Conclusions There was no significant association between the type of anesthesia and postoperative 90-day mortality in patients who underwent cranial neurosurgery in South Korea. However, propofol-based TIVA was associated with a lower incidence of postoperative complications than inhalation anesthesia.

Background: The treatment success rate for tuberculosis (TB) has stagnated at 80–81% in South Korea, indicating unsatisfactory outcomes. Enhancing treatment success rate necessitates the development of individualized treatment approaches for each patient. This study aimed to identify the risk factors associated with unfavorable treatment outcomes to facilitate tailored TB care. Methods: We retrospectively analyzed the data of patients with active TB between January 2019 and December 2020 at a single tertiary referral center. We classified unfavorable treatment outcomes according to the 2021 World Health Organization guidelines as follows:“lost to follow-up” (LTFU), “not evaluated” (NE), “death,” and “treatment failure” (TF).Moreover, we analyzed risk factors for each unfavorable outcome using Cox proportional hazard regression analysis. Results: A total of 659 patients (median age 62 years; male 54.3%) were included in the study.The total unfavorable outcomes were 28.1%: 4.6% LTFU, 9.6% NE, 9.1% deaths, and 4.9% TF. Multivariate analysis showed that a culture-confirmed diagnosis of TB was associated with a lower risk of LTFU (adjusted hazard ratio [aHR], 0.25; 95% confidence interval [CI], 0.10–0.63), whereas the occurrence of adverse drug reactions (ADRs) significantly increased the risk of LTFU (aHR, 6.63; 95% CI, 2.63–16.69). Patients living far from the hospital (aHR, 4.47; 95% CI, 2.50–7.97) and those with chronic kidney disease (aHR, 3.21; 95% CI, 1.33–7.75) were at higher risk of being transferred out to other health institutions (NE). Higher mortality was associated with older age (aHR, 1.06; 95% CI, 1.04–1.09) and comorbidities. The ADRs that occurred during TB treatment were a risk factor for TF (aHR, 6.88; 95% CI, 2.24–21.13). Conclusion Unfavorable outcomes of patients with TB were substantial at a tertiary referral center, and the risk factors for each unfavorable outcome varied. To improve treatment outcomes, close monitoring and the provision of tailored care for patients with TB are necessary.

Background: Coronary artery disease patients undergoing percutaneous coronary intervention (PCI) often exhibit reduced left ventricular ejection fraction (LVEF). However, the impact of LV dysfunction status in conjunction with platelet reactivity on clinical outcomes has not been previously investigated. Methods: From the multicenter PTRG-DES (Platelet function and genoType-Related long-term prognosis in DES-treated patients) consortium, the patients were classified as preserved-EF (PEF: LVEF ≥ 50%) and reduced-EF (REF: LVEF< 5 0%) group by echocardiography. Platelet reactivity was measured using VerifyNow P2Y 12 assay and high platelet reactivity (HPR) was defined as PRU ≥ 252. The major adverse cardiac and cerebrovascular events (MACCEs) were a composite of death, myocardial infarction, stent thrombosis and stroke at 5 years after PCI. Major bleeding was defined as Bleeding Academic Research Consortium bleeding types 3–5. Results: A total of 13,160 patients from PTRG-DES, 9,319 (79.6%) patients with the results of both PRU and LVEF were analyzed. The incidence of MACCE and major bleeding was higher in REF group as compared with PEF group (MACCEs: hazard ratio [HR] 2.17, P < 0.001, 95% confidence interval [CI] 1.85–2.55; major bleeding: HR 1.78, P < 0.001, 95% CI 1.39–2.78).The highest rate of MACCEs was found in patients with REF and HPR, and the difference between the groups was statistically significant (HR 3.14 in REF(+)/HPR(+) vs. PEF(+)/HPR(-) group,P <0.01, 95% CI 2.51–3.91). The frequency of major bleeding was not associated with the HPR in either group. Conclusion LV dysfunction was associated with an increased incidence of MACCEs and major bleeding in patients who underwent PCI. The HPR status further exhibited significant increase of MACCEs in patients with LV dysfunction in a large, real-world registry.Trial Registration: ClinicalTrials.gov Identifier: NCT04734028

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.