Quantification of tyrosine hydroxylase (TH)-positive neurons is essential for the preclinical study of Parkinson’s disease (PD). However, manual analysis of immunohistochemical (IHC) images is labor-intensive and has less reproducibility due to the lack of objectivity. Therefore, several automated methods of IHC image analysis have been proposed, although they have limitations of low accuracy and difficulties in practical use. Here, we developed a convolutional neural network-based machine learning algorithm for TH+ cell counting. The developed analytical tool showed higher accuracy than the conventional methods and could be used under diverse experimental conditions of image staining intensity, brightness, and contrast. Our automated cell detection algorithm is available for free and has an intelligible graphical user interface for cell counting to assist practical applications. Overall, we expect that the proposed TH+ cell counting tool will promote preclinical PD research by saving time and enabling objective analysis of IHC images.

Purpose: This study systematically reviewed the effects of physical activity on depression and various menopausal symptoms in middle-aged women. We aimed to identify physical activity as a useful intervention for mitigating the physiological and psychological challenges associated with menopause and promoting healthy aging. Methods: Electronic searches were conducted in the MEDLINE, EMBASE, CINAHL, and the Cochrane Library databases using predefined keywords “menopause” and “physical activities”. Of the 1,391 initial articles, 15 randomized controlled trials involving 1,692 middle-aged women were included. Results: Physical activities led to a reduction in depressive symptoms, with a standardized mean difference (SMD) of -0.60 (95% CI, -0.90 to -0.30). Moreover, all menopausal symptoms, except vasomotor symptoms, were decreased. Specifically, the SMDs for the five subscales of menopausal symptoms were as follows: total scores: -1.53 (95% CI, -2.57 to -0.49); vasomotor: -0.76 (95% CI, -1.53 to 0.00); psychological: -0.93 (95% CI, -1.62 to -0.25); physical: -1.10 (95% CI, -1.77 to -0.43); and urogenital/sexual: -0.67 (95% CI, -1.23 to -0.12). Conclusion Physical activity is beneficial for middle-aged women transitioning from peri- to post-menopause. Engagement in physical activity can contribute to the maintenance of overall health and well-being during aging by reducing depression and menopausal symptoms.

BACKGROUND/OBJECTIVES: This study was designed to provide scientific evidence on the effectiveness of worksite-based dietary intervention to reduce obesity among overweight/obese employees. MATERIALS/METHODS: Electronic search was performed using Ovid Medline, Embase, Cochrane Library, and CINAHL databases. The keywords used were “obesity,” “nutrition therapy,” and “worksite.” The internal validity of the randomized controlled trials (RCTs) was assessed using the Cochrane's Risk of Bias. Meta-analysis of selected studies was performed using Review Manager 5.3. RESULTS: A total of seven RCTs with 2,854 participants were identified. The effectiveness of dietary interventions was analyzed in terms of changes in weight, body mass index (BMI), total cholesterol, and blood pressure. The results showed that weight decreased with weighted mean difference (WMD) of −4.37 (95% confidence interval (CI): −6.54 to −2.20), but the effectiveness was statistically significant only in short-term programs < 6 months (P = 0.001). BMI also decreased with WMD of −1.26 (95% CI: −1.98 to −0.55), but the effectiveness was statistically significant only in short-term programs < 6 months (P = 0.001). Total cholesterol decreased with WMD of −5.57 (95% CI: −9.07 to −2.07) mg/dL, demonstrating significant effectiveness (P = 0.002). Both systolic (WMD: −4.90 mmHg) and diastolic (WMD: −2.88 mmHg) blood pressure decreased, demonstrating effectiveness, but with no statistical significance. CONCLUSIONS: The worksite-based dietary interventions for overweight/obese employees showed modest short-term effects. These interventions can be considered successful because weight loss was below approximately 5-10 kg of the initial body weight, which is the threshold for the management of obesity recommended by the Scottish Intercollegiate Guideline Network (SIGN).

PURPOSE: We reviewed the effects of resistance training on obesity index, lipid index, blood pressure, pulse rate, and bone mineral densitometer in middle-aged women. METHODS: Randomized, controlled trials lasting 12 weeks investigating the effects of resistance training obesity index, lipid index, blood pressure, and bone densitometer in middle-aged women and published in a peer-reviewed journal up to March 2018 were included. Random- and fixed-effects models were used for analyses, with data reported as weighted means and 95% confidence limits. RESULTS: We included 8 randomized, controlled trials, involving 18 study groups and 335 participants. Overall, resistance training induced a significant low-density lipoprotein reduction [−13.44 (95% CI=−26.71~−0.18)]. No significant effect was observed on other blood lipids, obesity index, blood pressure, pulse rate, and bone mineral density. When study groups were divided according to the period of training, resistance training groups for 24 weeks resulted in a significant decrease in systolic blood pressure [−6.19 (95% CI=−10.95~−1.43 mm Hg)]. CONCLUSION: This meta-analysis supports the potential of resistance training to reduce the level of low-density lipoprotein in middle-aged women. Based on these results, we suggest the application of comprehensive management strategies such as aerobic exercise, resistance exercise, behavior control, and dietary management to prevent obesity in middle-aged women.
Behavior Control ; Blood Pressure ; Bone Density ; Exercise ; Female ; Heart Rate ; Humans ; Lipoproteins ; Miners ; Obesity ; Resistance Training

PURPOSE: Group-based interventions help the members of the parent group work together to share their parenting stress, provide opportunities for them to support each other emotionally and informatively, and allow them to achieve what they want to accomplish. The purpose of this study is to investigate and synthesize the outcome of a parenting support program for infant and toddler parents. METHODS: Published randomized control trials were identified through Ovid-Medline, Embase and CINAHL DB. Eligible studies include articles published between 2008 and 2018 in English in the randomized controlled trial design in which parenting support programs were implemented for infant and toddler parents group. RESULTS: A total of 11 studies was selected for this review. These programs reported large level of effect size for parenting, and middle level effect size for parent's psycho-social outcomes and child development. There were many programs conducted for parents with infants between 13 and 24 months, and the frequency of programs provided for 2 hours a week was high with 9 to 12 sessions. Most programs were facilitated by trained professionals including nurses and social workers except two programs led by lay persons. CONCLUSION: This review demonstrates that group-based parenting support programs have positive effects on parenting, parent's psychosocial health and infant development. To disseminate the effective group-based parenting support programs, further research is needed to confirm the long term effect and develop nurse's role as a group facilitator.
Child ; Child Development ; Humans ; Infant ; Nurse's Role ; Parenting ; Parents ; Peer Group ; Social Work ; Social Workers

OBJECTIVES: This study was conducted to examine the effects of mobile health (mHealth), using mobile phones as an intervention for weight loss in obese adults. METHODS: An electronic search was carried out using multiple databases. A meta-analysis of selected studies was performed. The effects of mHealth were analyzed using changes in body weight and body mass index (BMI). RESULTS: We identified 20 randomized controlled trials (RCTs) involving 2,318 participants who fit our inclusion criteria. The meta-analysis showed that body weight was reduced with a weighted mean difference (WMD) of −2.35 kg (95% confidence interval [CI], −2.84 to −1.87). An examination of the impact of duration of intervention showed that weight loss was greater after 6 months of mHealth (WMD = −2.66 kg) than between three and four months (WMD = −2.25 kg); it was maintained for up to 9 months (WMD = −2.62 kg). At 12 months, weight loss was reduced to a WMD of −1.23 kg. BMI decreased with a WMD of −0.77 kg/m2 (95% CI, −1.01 to −0.52). BMI changes were not statistically significant at 3 months (WMD = −1.10 kg/m2), but they were statistically significant at 6 months (WMD = −0.67 kg/m2). CONCLUSIONS: The use of mHealth for obese adults showed a modest short-term effect on body weight and BMI. Although the weight loss associated with mHealth did not meet the recommendation of the Scottish Intercollegiate Guideline Network, which considers a reduction of approximately 5 to 10 kg of the initial body weight as a successful intervention. Well-designed RCTs are needed to reveal the effects of mHealth interventions.
Adult* ; Body Mass Index ; Body Weight ; Cell Phones ; Humans ; Mobile Applications ; Obesity ; Telemedicine* ; Weight Loss

BACKGROUND: The aim of this study was to determine which fall-risk tool is most accurate for detecting and predicting adults in the hospital setting. METHODS: A literature search was performed to identify all studies published between 1946 and 2014 from periodicals indexed in Ovid Medline, Embase, CINAHL, KoreaMed, NDSL and other databases, using the following keywords: 'fall', 'fall risk assessment', 'fall screening', 'mobility scale', and 'risk assessment tool'. The QUADAS-2 was applied to assess the internal validity of the diagnostic studies. Fourteen studies were analyzed using meta-analysis with MetaDisc 1.4. RESULTS: The result of comparing twelve tools was that the Morse Fall Scale (MFS) is the best tool for predicting falls for acute hospitalized adult patients. Six prospective validation studies using MFS with high methodological quality, involving 9,255 patients, were included. Meta-analysis finding of MFS was as follows; pooled sensitivity 0.73 (95% confidence interval [CI]: 0.68-0.78), pooled specificity 0.75 (95% CI: 0.74-0.76), area under the curve (AUC) of summary receiver operating characteristics (sROC) curve 0.79 (standard error [SE] = 0.02), and value of index Q* 0.72 (SE = 0.01) respectively. CONCLUSIONS: Falls in hospitalized adult patients can be effectively prevented using the MFS. These findings provide scientific evidence for using appropriate tool to prevent accidental falls and improve the safety of patients.
Accidental Falls ; Adult* ; Humans ; Inpatients* ; Prospective Studies ; Risk Assessment* ; ROC Curve ; Sensitivity and Specificity

Unlike conventional T cells, innate CD8 T cells develop a memory-like phenotype in the thymus and immediately respond upon antigen stimulation, similar to memory T cells. The development of innate CD8 T cells in the thymus is known to require IL-4, which upregulates Eomesodermin (Eomes). These features are similar to that of virtual memory CD8 T cells and IL-4-induced memory-like CD8 T cells generated in the peripheral tissues. However, the relationship between these cell types has not been clearly documented. In the present study, IL-4-induced memory-like CD8 T cells generated in the peripheral tissues were compared with innate CD8 T cells in terms of phenotype and function. When an IL-4/anti-IL-4 antibody complex (IL-4C) was injected into C57BL/6 mice daily for 7 days, the Eomes(hi)CXCR3+ CD8 T cell population was markedly increased in the peripheral lymphoid organs and blood. These cells were generated from naïve CD8 T cells or accumulated via the expansion of pre-existing CD44(hi)CXCR3+ CD8 T cells. Initially, the majority of these CXCR3+ CD8 T cells expressed low levels of CD44, which was followed by the conversion to the CD44(hi) phenotype. This conversion was associated with the acquisition of enhanced effector function. After discontinuation of IL-4C treatment, Eomes expression levels gradually decreased in CXCR3+ CD8 T cells. Taken together, the results of this study demonstrate that IL-4-induced memory-like CD8 T cells generated in the peripheral lymphoid tissues are phenotypically and functionally similar to the innate CD8 T cells generated in the thymus.
Animals ; Interleukin-4* ; Lymphoid Tissue* ; Memory ; Mice ; Phenotype ; T-Lymphocytes* ; Thymus Gland

Situs inversus is an extremely rare autosomal recessive disease with left-right inversion of internal organs. It carries technical difficulties in diagnostic or therapeutic procedures. There have been a few case reports on stone extraction by ERCP in situs inversus patients. ERCP techniques in situs inversus can be classified into conventional method and mirror image method. In mirror image method, the procedure is performed with the patient in the right lateral decubitus position and the endoscopist on the patient's left side. Until now, there is no consensus about which method is better. Herein, we report an unusual case of choledocholithiasis in a patient with situs inversus who underwent ERCP for stone extraction by both conventional method and mirror image method.
Aged ; Balloon Occlusion ; Cholangiopancreatography, Endoscopic Retrograde ; Gallstones/complications/*diagnosis/therapy ; Humans ; Male ; Situs Inversus/complications/*diagnosis ; Stents ; Tomography, X-Ray Computed

PURPOSE: This study investigated evidence for the use of relaxation therapies as interventions to decrease irritable bowel syndrome (IBS) symptoms and severity as well as reduce anxiety and improve quality of life in IBS patients. METHODS: A search of electronic bibliographic databases (e.g., Medline Ovid, Embase, KoreaMed, and National Discovery for Science Leaders) was conducted to identify randomized controlled trials that included relaxation exercise programs for adults (>18 years old) with IBS. Of the 486 publications identified, 8 studies met inclusion and exclusion criteria, and all studies were used in the meta-analysis. We used Cochrane's risk of bias to assess study quality. RESULTS: The results showed that IBS symptoms decreased significantly, 6.19 (95% confidence interval [2.74, 14.02]) and there was no heterogeneity. Symptom severity and anxiety decreased by 0.38 (95% confidence interval [-1.41, 0.65]) and -0.08 (95% confidence interval [-0.38, 0.23]) due to relaxation therapies, but theses scores were not statistically significant. CONCLUSION: This review revealed positive effects of relaxation therapy on IBS symptoms in adult patients with IBS. However, these results should be interpreted with caution due to the small number of studies examined and the associated methodological problems. Further studies are needed to ascertain the longterm effects of relaxation therapy and the underlying psychosocial mechanisms leading to anxiety reduction and improved quality of life.
Adult ; Anxiety ; Bias (Epidemiology) ; Databases, Bibliographic ; Humans ; Irritable Bowel Syndrome* ; Population Characteristics ; Quality of Life ; Relaxation ; Relaxation Therapy*