Background: Living-donor liver transplantation (LDLT) is a viable alternative to deceased-donor liver transplantation. Enhanced recovery after surgery protocols that include early extubation offer short-term benefits; however, the effect of immediate extubation in the operating room (OR) on long-term outcomes in patients undergoing LDLT remains unknown. We hypothesized that immediate OR extubation is associated with improved long-term outcomes in patients undergoing LDLT. Methods: This retrospective cohort study included 205 patients who underwent LDLT. The patients were classified based on the extubation location as OREX (those extubated in the OR) or NOREX (those extubated in the intensive care unit [ICU]). The primary outcome was overall survival (OS), while secondary outcomes included ICU stay, hospital stay duration, and various postoperative outcomes. Results: Among the 205 patients, 98 (47.8%) underwent extubation in the OR after LDLT. Univariate analysis revealed that OR extubation did not significantly affect OS (hazard ratio [HR]: 0.50, 95% confidence interval [CI]: 0.24–1.05; P = 0.066). Furthermore, multivariate analysis revealed no statistically significant association between OR extubation and OS (HR: 0.79, 95% CI: 0.35–1.80; P = 0.580). However, OR extubation was significantly associated with a lower incidence of 30-day composite complications and shorter ICU and hospital stays. Multivariate analysis indicated that higher preoperative platelet counts, increased serum creatinine levels, and a longer surgery duration were associated with poorer OS. Conclusions Immediate OR extubation following LDLT surgery was associated with fewer 30-day composite complications and shorter ICU and hospital stays; however, it did not significantly improve OS compared with ICU extubation.

Objectives: The dietary habits of school-aged children play a critical role in their growth and development, and are strongly influenced by the home environment. Household income is closely associated with caregivers’ food literacy, social support, and food environment. This directly affects the nutritional status of children. This study aimed to provide evidence to inform policies and educational programs for improving dietary habits in children, and to establish a foundation for tailored support strategies for low-income families. Methods: This cross-sectional study included 846 primary caregivers of school-aged children from 17 regions across Korea, recruited through an online survey. Household income, caregivers’ food literacy, social support, and food environment were assessed. Nutritional status in children was measured using the Nutrition Quotient for Children (NQ-C). Statistical analyses included descriptive statistics, chi-square tests, one-way analysis of variance (ANOVA), analysis of covariance (ANCOVA), correlation analyses, and multiple linear regression. Results: Caregivers from higher income households demonstrated significantly greater food literacy and social support (P < 0.001). Children from these households showed high balance scores and a large proportion of these children were in the “high” NQ-C grade. The NQ-C score in children was positively correlated with food literacy (r = 0.425), social support (r = 0.471), and the food environment (r = 0.235) (P < 0.001). Multiple regression analysis showed that food literacy (β = 0.256) and social support (β = 0.348) were significant predictors of nutritional status in children. Conclusion This study confirmed that the nutritional status in children is not only determined solely by household income but is also mediated by caregivers’ food literacy, social support, and food environment. These findings highlighted the limitations of providing only economic support. The findings underscore the need for multifaceted interventions such as strengthening parental nutrition education, expanding social support networks, and improving access to healthy foods.

Purpose: This study investigated the impact of depression, fear of falling, and activities of daily living (ADL) on the quality of life (QoL) among patients with spinal cord injuries (SCIs) in South Korea. Methods: This study adopted a prospective cross-sectional design. Data were collected using self-reported questionnaires from 70 SCI patients who visited the outpatient department of rehabilitation medicine. The data collection period was from October 16, 2017 to February 2, 2018. Participants’ American Spinal Injury Association Impairment Scale classifications were C and D. Results: The study found that QoL correlated with self-rated health (Spearman rho=.41, p<.001), SCI duration (Spearman rho=-.26, p=.030), depressive symptoms (Spearman rho=-.43, p<001), and fear of falling (Spearman rho=-.75, p<.001). Additionally, QoL was associated with fear of falling (β=-.68, p<.001) and SCI duration (β=-.18, p=.025) in the regression analyses. These results were significant and accounted for 59.5% of the variance in QoL. Conclusion Interventions targeting the QoL of patients with SCI can help reduce the fear of falling.

Purpose: This meta-analysis was conducted to determine the effect size of anxiety and psychological outcomes of virtual reality interventions in patients with anxiety disorders. Methods: A total of 835 studies were initially identified, of which six were found to be suitable according to the PICO (P: Patients with social phobia, I: VR technology, C: non VR technology, O: Variables related to mental health). criteria. Results: An analysis of the effect size of these studies confirmed that virtual reality interventions were not statistically significantly effective for generalized anxiety disorder (standardized mean difference [SMD]=0.16, 95% confidence interval [CI]=-0.84 to 1.15), but exhibited statistically significant effects for social anxiety (SMD=-0.56, 95% CI=-0.87 to -0.25) disorder and relational anxiety disorder (SMD -0.83, 95% CI=-1.49 to -0.16). Although these interventions were not statistically significantly effective for depression (SMD=-0.40, 95% CI=-0.84 to 0.04), they were effective in reducing negative emotions (SMD=-0.75, 95% CI=-1.20 to -0.31). Conclusion Virtual reality interventions based on the desensitization effect may be considered a viable option for reducing anxiety disorders.

Objectives: We conducted a meta-analysis of randomized controlled trials to investigate the therapeutic effects of mindfulnessbased interventions on depressive symptoms in patients with major depressive disorder. Methods: In February 2021, we searched Embase, MEDLINE, Cochrane Library, PsycINFO, CINAHL, and AMED. Under the guidance of the corresponding author, two evaluators independently reviewed and selected articles based on predetermined selection criteria. Results: Based on the selection criteria, we systematically screened and included a total of 12 randomized controlled trials comprising 720 cases for the final analysis. Utilizing a random-effects model for data analysis, we determined the Hedges’ g value to be 0.787, indicating a medium-sized effect according to Cohen’s interpretation. The 95% confidence interval for the effect size ranged from 0.414 to 1.160 (p-value < 0.0001). Conclusions This study reveals the potential effectiveness of mindfulness-based interventions in treating depressive symptoms among patients with major depressive disorder.

BACKGROUND/OBJECTIVES: The purpose of this study was to compare nutrient intake according to the presence of glaucoma among Korean individuals aged 60 yrs or older and to establish evidence for the necessity of dietary habits and nutritional management in the prevention and management of glaucoma. SUBJECTS/METHODS: The study was conducted on 4,195 older adults aged 60 or older who participated in the Korea National Health and Nutrition Examination Survey in 2017 and 2018. The subjects were classified into glaucoma (n = 186) and non-glaucoma (n = 4,009) groups based on the doctor’s diagnosis of glaucoma. Nutrient intake was estimated using a 24-h recall method, and the intake of nutrients between the 2 groups was compared. RESULTS: The comparison of food group and nutrient intake according to the subjects’ prevalence of glaucoma showed that the average intake of potatoes and starches was higher in the glaucoma group than in the non-glaucoma group (P = 0.049), whereas the average intake of meat, fish, and shellfish was higher in the non-glaucoma group than in the glaucoma group (P = 0.045, P = 0.018). Additionally, the average intake of omega-3 and vitamin C was higher in the non-glaucoma group than in the glaucoma group (P = 0.022, P = 0.045), while the average intake of niacin was higher in the glaucoma group than in the non-glaucoma group (P = 0.046). CONCLUSION The intake of meats, fish, and shellfish, omega-3, and vitamin C was higher in the non-glaucoma group than in the glaucoma group. These results suggest that a healthy diet might be necessary for the prevention and management of glaucoma.

Purpose: This study investigated the impact of depression, fear of falling, and activities of daily living (ADL) on the quality of life (QoL) among patients with spinal cord injuries (SCIs) in South Korea. Methods: This study adopted a prospective cross-sectional design. Data were collected using self-reported questionnaires from 70 SCI patients who visited the outpatient department of rehabilitation medicine. The data collection period was from October 16, 2017 to February 2, 2018. Participants’ American Spinal Injury Association Impairment Scale classifications were C and D. Results: The study found that QoL correlated with self-rated health (Spearman rho=.41, p<.001), SCI duration (Spearman rho=-.26, p=.030), depressive symptoms (Spearman rho=-.43, p<001), and fear of falling (Spearman rho=-.75, p<.001). Additionally, QoL was associated with fear of falling (β=-.68, p<.001) and SCI duration (β=-.18, p=.025) in the regression analyses. These results were significant and accounted for 59.5% of the variance in QoL. Conclusion Interventions targeting the QoL of patients with SCI can help reduce the fear of falling.

Purpose: This meta-analysis was conducted to determine the effect size of anxiety and psychological outcomes of virtual reality interventions in patients with anxiety disorders. Methods: A total of 835 studies were initially identified, of which six were found to be suitable according to the PICO (P: Patients with social phobia, I: VR technology, C: non VR technology, O: Variables related to mental health). criteria. Results: An analysis of the effect size of these studies confirmed that virtual reality interventions were not statistically significantly effective for generalized anxiety disorder (standardized mean difference [SMD]=0.16, 95% confidence interval [CI]=-0.84 to 1.15), but exhibited statistically significant effects for social anxiety (SMD=-0.56, 95% CI=-0.87 to -0.25) disorder and relational anxiety disorder (SMD -0.83, 95% CI=-1.49 to -0.16). Although these interventions were not statistically significantly effective for depression (SMD=-0.40, 95% CI=-0.84 to 0.04), they were effective in reducing negative emotions (SMD=-0.75, 95% CI=-1.20 to -0.31). Conclusion Virtual reality interventions based on the desensitization effect may be considered a viable option for reducing anxiety disorders.

Background: Preeclampsia (PE) is a hypertensive pregnancy disorder linked to placental dysfunction, often involving pathological lesions like acute atherosis, decidual vasculopathy, accelerated villous maturation, and fibrinoid deposition. However, there is no gold standard for the pathological diagnosis of PE and this limits the ability of clinicians to distinguish between PE and non-PE pregnancies. Recent advances in computational pathology have provided the opportunity to automate pathological analysis for diagnosis, classification, prediction, and prediction of disease progression. In this study, we assessed whether computational pathology could be used to identify PE placentas. Methods: A total of 168 placental whole-slide images (WSIs) of patients from Seoul National University Hospital (comprising 84 PE cases and 84 normal controls) were used for model development and internal validation. For external validation of the model, 76 placental slides (including 38 PE cases and 38 normal controls) were obtained from the Boramae Medical Center (BMC). To establish standard criteria for diagnosing PE and distinguishing it from controls using placental WSIs, patch characteristics and quantification of terminal and intermediate villi were employed. In unsupervised learning, K-means clustering was conducted as a feature obtained through an Auto Encoder to extract the ratio of each cluster for each WSI. For supervised learning, quantitative assessments of the villi were obtained using a U-Net-based segmentation algorithm. The prediction model was developed using an ensemble method and was compared with a clinical feature model developed by using placental size features. Results: Using ensemble modeling, we developed a model to identify PE placentas.The model showed good performance (area under the precision-recall curve [AUPRC], 0.771; 95% confidence interval [CI], 0.752–0.790), with 77.3% of sensitivity and 71.1% of specificity, whereas the clinical feature model showed an AUPRC 0.713 (95% CI, 0.694–0.732) with 55.6% sensitivity and 86.8% specificity. External validation of the predictive model employing the BMC-derived set of placental slides also showed good discrimination (AUPRC, 0.725; 95% CI, 0.720–0.730). Conclusion The proposed computational pathology model demonstrated a strong ability to identify preeclamptic placentas. Computational pathology has the potential to improve the identification of PE placentas.

Purpose: This study investigated the impact of depression, fear of falling, and activities of daily living (ADL) on the quality of life (QoL) among patients with spinal cord injuries (SCIs) in South Korea. Methods: This study adopted a prospective cross-sectional design. Data were collected using self-reported questionnaires from 70 SCI patients who visited the outpatient department of rehabilitation medicine. The data collection period was from October 16, 2017 to February 2, 2018. Participants’ American Spinal Injury Association Impairment Scale classifications were C and D. Results: The study found that QoL correlated with self-rated health (Spearman rho=.41, p<.001), SCI duration (Spearman rho=-.26, p=.030), depressive symptoms (Spearman rho=-.43, p<001), and fear of falling (Spearman rho=-.75, p<.001). Additionally, QoL was associated with fear of falling (β=-.68, p<.001) and SCI duration (β=-.18, p=.025) in the regression analyses. These results were significant and accounted for 59.5% of the variance in QoL. Conclusion Interventions targeting the QoL of patients with SCI can help reduce the fear of falling.