Objective To explore the association between cognitive function and non-traditional blood lipid parameters in patients with cerebral small vessel disease （CSVD）. Methods A prospective study was conducted among 376 CSVD patients who were treated in Dongfang Hospital，Beijing University of Chinese Medicine，from July 2017 to August 2022. Blood samples were collected from all subjects in the morning after 12 hours of fasting to measure blood lipid parameters，and then non-traditional blood lipid parameters were calculated. According to the Montreal Cognitive Assessment Scale，the patients were divided into cognitive impairment CSVD group and non-cognitive impairment CSVD group. A multivariate logistic regression analysis was used to investigate the association between non-traditional blood lipid parameters and cognitive function in CSVD patients，and the receiver operating characteristic （ROC） curve was used to assess their predictive value. Results A total of 376 CSVD patients were enrolled，among whom there were 250 patients with cognitive impairment and 126 patients without cognitive impairment. The multivariate logistic regression analysis showed that TC/HDL-C （OR=1.454，95%CI 1.147-1.843，P=0.002） and LDL-C/HDL-C ratio （OR=1.457，95% CI 1.109-1.915，P=0.023） were independently associated with cognitive impairment in CSVD patients. The ROC curve analysis showed that TC/HDL-C ratio had an area under the ROC curve （AUC） of 0.606 （95%CI 0.547-0.665） in predicting cognitive impairment in CSVD patients，with a sensitivity of 0.560 and a specificity of 0.659； LDL-C/HDL-C ratio had an AUC 0.617 （95%CI 0.558-0.676） in predicting cognitive impairment，with a sensitivity of 0.552 and a specificity of 0.762； TC/HDL-C ratio combined with LDL-C/HDL-C ratio had an AUC of 0.776 （95%CI 0.726-0.825） in predicting cognitive impairment，with a sensitivity of 0.772 and a specificity of 0.667. Conclusion Increases in TC/HDL-C ratio and LDL-C/HDL-C ratio are risk factors for cognitive impairment in CSVD patients and thus have a certain predictive value for cognitive impairment in CSVD patients，and the combination of these two ratios has a higher predictive value.

Purpose: To identify factors influencing health-related quality of life for young single-person households, this study investigated physical and mental health status, health behavior, depression, resilience, and health-related quality of life. Methods: An online survey was administered to members of young single-person households from March 22 to 30, 2022. The data were analyzed using the chi-square test, independent t-test, one-way analysis of variance, Pearson correlation coefficients, multiple regression, and a simple mediation model applying the PROCESS macro model 4 with 95% bias-corrected bootstrapped confidence intervals. Results: The participants were 229 members of young single-person households. Health-related quality of life showed significant relationships with residence (t = 2.80, p = .006), monthly income (F = 3.70, p = .026), mental health status (F = 20.33, p < .001), and high-intensity exercise (F = 7.35, p = .001) among general and health-related characteristics. Health-related quality of life had significant correlations with depression (r = -.72, p < .001) and resilience (r = .58, p < .001). Multiple regression analysis showed that depression (β = -.57, p < .001) and resilience (β = .21, p < .001) influenced health-related quality of life. Moreover, resilience had a mediating effect between depression and health-related quality of life (indirect effect = -0.002, 95% bias-corrected bootstrapped confidence interval = -0.003 to -0.001). Conclusion Members of young single-person households tended to be more vulnerable to emergency situations, such as during the coronavirus disease 2019 pandemic, when lockdowns and quarantines were frequent. To improve health-related quality of life in young single-person households, people with high levels of depression or low levels of resilience need special attention and support to promote mental health.

Purpose: This study aimed to review the intervention programs designed for married immigrant women living in Korea. Methods: A total of 39 articles published from 2010 to 2020 were selected and analyzed using domestic and international web-based academic databases according to a systematic literature review procedure. The selected studies were evaluated for quality according to RoB (Risk of Bias) and RoBANS (Risk of Bias for Non-randomized studies). Additionally, intervention programs and outcome variables were based on the Nursing Intervention Classification (NIC) and Nursing Outcome Classification (NOC) system. Results: According to the NIC categories, 69.2% of the interventions were in the behavioral domain, and 23.1% were in the family domain. The outcome variables primarily measured in NOC categories were psychological well-being (45.8%), health knowledge (11.0%), and health belief (10.2%). The quality of the selected studies was low overall in random sequence generation, allocation concealment, blinding of participants and personnel, and blinding of outcome data in randomized controlled trials (RCT) studies and confounding variables, blinding of outcome data, and incomplete outcome bias in non-RCT studies. Conclusion Based on the results of this study, future studies will have to consider the characteristics of the subjects, life cycle, daily life, or language limitations. In addition, it is necessary to develop high-quality programs through continuous research on currently and frequently used interventions and outcome variables and on other various mediations and to verify the outcome variables.

Purpose: The purpose of this study was to survey the Coronavirus Disease 2019 (COVID-19) related knowledge, risk perception, preventive behaviors, depression, and anxiety levels among nursing students, and to identify factors that influence preventive behaviors. Methods: An online survey was conducted among nursing students from October 7, 2020 to October 12, 2020. The data were analyzed using independent t-test, one-way ANOVA, Pearson’s correlation coefficients, and multiple regression. Results: A total of 222 nursing students participated in this study. The correct answer rate for COVID-19 knowledge was 90.0%, risk perception was 5.51 ± 1.26, and the rate for preventive behaviors was 92.5%. The depression score was 6.28 ± 4.63; 59.9% of nursing students had depression, and the anxiety score was 5.56 ± 3.98; 59.9% of nursing students had anxiety. COVID-19 preventive behaviors had a positive correlation with COVID-19 knowledge (r = .30, p < .001), COVID-19 risk perception (r = .18, p = .009), and anxiety (r = .21, p = .001).Factors influencing COVID-19 preventive behaviors by multiple regression were identified as COVID-19 knowledge, anxiety, physical health status before and after COVID-19, grade, practical experience after COVID-19, and COVID-19 risk perception (F = 12.46, p < .001, R 2 = 25.8%). Conclusion The results of this research on factors influencing COVID-19 prevention behaviors can be used in the future to develop appropriate health policies for individual and community infectious disease prevention behaviors.

Purpose: The purpose of this study was to survey the Coronavirus Disease 2019 (COVID-19) related knowledge, risk perception, preventive behaviors, depression, and anxiety levels among nursing students, and to identify factors that influence preventive behaviors. Methods: An online survey was conducted among nursing students from October 7, 2020 to October 12, 2020. The data were analyzed using independent t-test, one-way ANOVA, Pearson’s correlation coefficients, and multiple regression. Results: A total of 222 nursing students participated in this study. The correct answer rate for COVID-19 knowledge was 90.0%, risk perception was 5.51 ± 1.26, and the rate for preventive behaviors was 92.5%. The depression score was 6.28 ± 4.63; 59.9% of nursing students had depression, and the anxiety score was 5.56 ± 3.98; 59.9% of nursing students had anxiety. COVID-19 preventive behaviors had a positive correlation with COVID-19 knowledge (r = .30, p < .001), COVID-19 risk perception (r = .18, p = .009), and anxiety (r = .21, p = .001).Factors influencing COVID-19 preventive behaviors by multiple regression were identified as COVID-19 knowledge, anxiety, physical health status before and after COVID-19, grade, practical experience after COVID-19, and COVID-19 risk perception (F = 12.46, p < .001, R 2 = 25.8%). Conclusion The results of this research on factors influencing COVID-19 prevention behaviors can be used in the future to develop appropriate health policies for individual and community infectious disease prevention behaviors.

Purpose: This study aimed to review the intervention programs designed for married immigrant women living in Korea. Methods: A total of 39 articles published from 2010 to 2020 were selected and analyzed using domestic and international web-based academic databases according to a systematic literature review procedure. The selected studies were evaluated for quality according to RoB (Risk of Bias) and RoBANS (Risk of Bias for Non-randomized studies). Additionally, intervention programs and outcome variables were based on the Nursing Intervention Classification (NIC) and Nursing Outcome Classification (NOC) system. Results: According to the NIC categories, 69.2% of the interventions were in the behavioral domain, and 23.1% were in the family domain. The outcome variables primarily measured in NOC categories were psychological well-being (45.8%), health knowledge (11.0%), and health belief (10.2%). The quality of the selected studies was low overall in random sequence generation, allocation concealment, blinding of participants and personnel, and blinding of outcome data in randomized controlled trials (RCT) studies and confounding variables, blinding of outcome data, and incomplete outcome bias in non-RCT studies. Conclusion Based on the results of this study, future studies will have to consider the characteristics of the subjects, life cycle, daily life, or language limitations. In addition, it is necessary to develop high-quality programs through continuous research on currently and frequently used interventions and outcome variables and on other various mediations and to verify the outcome variables.

Objective: To provide guidelines for the prevention of post-stroke dementia, we investigated whether stroke patients were aware of post-stroke dementia and their level of dementia-related knowledge. Methods: Five dementia-related questions were designed. A field survey was conducted in a question-and-answer method using the designed questions. The surveys assessed 3000 stroke patients (2 weeks-6 months after stroke attacks) from 14 hospitals/clinical centers in 7 provinces and cities across China. Results: Among 3000 stroke patients, 80.5％had heard of dementia, 39.1％knew that stroke can lead to dementia, 55.7％ believed dementia can be prevented, 50.8％ thought dementia can be cured, and only 8.8％had ever seen a doctor because of memory deterioration. Then, patients were classified into three groups, including a no cognitive impairment (NCI) group, a mild cognitive impairment (MCI) group, and a mild dementia (MD) group. Among the MCI and MD groups, only 8.7％ (75/861) and 9.9％ (64/649) of patients, respectively, had ever seen a doctor because of memory deterioration. According to our results, patients with a higher level of cognitive impairment had a lower awareness of dementia (P<.001). Conclusion: The awareness of dementia in stroke patients in China is low, and the consultation rate is even lower. Moreover, patients with a higher level of cognitive impairment have a lower awareness of dementia. To improve public awareness and improve prevention, more emphasis should be put on ed-ucation regarding post-stroke dementia. Routine cognitive function screening should be conducted on stroke patients as an effective way to assess dementia.

PURPOSE: Identification of biomarkers to predict recurrence risk is essential to improve adjuvant treatment strategies in stage II/III gastric cancer patients. This study evaluated biomarkers for predicting survival after surgical resection. MATERIALS AND METHODS: This post-hoc analysis evaluated patients from the CLASSIC trial who underwent D2 gastrectomywith orwithout adjuvant chemotherapy (capecitabine plus oxaliplatin) at the Yonsei Cancer Center. Tumor expressions of thymidylate synthase (TS), excision repair cross-complementation group 1 (ERCC1), and programmed death-ligand 1 (PD-L1) were evaluated by immunohistochemical (IHC) staining to determine their predictive values. RESULTS: Among 139 patients, IHC analysis revealed high tumor expression of TS (n=22, 15.8%), ERCC1 (n=23, 16.5%), and PD-L1 (n=42, 30.2%) in the subset of patients. Among all patients, high TS expression tended to predict poor disease-free survival (DFS; hazard ratio [HR], 1.80; p=0.053), whereas PD-L1 positivity was associated with favorable DFS (HR, 0.33; p=0.001) and overall survival (OS; HR, 0.38; p=0.009) in multivariate Cox analysis. In the subgroup analysis, poor DFS was independently predicted by high TS expression (HR, 2.51; p=0.022) in the adjuvant chemotherapy subgroup (n=66). High PD-L1 expression was associated with favorable DFS (HR, 0.25; p=0.011) and OS (HR, 0.22; p=0.015) only in the surgery-alone subgroup (n=73). The prognostic impact of high ERCC1 expression was not significant in the multivariate Cox analysis. CONCLUSION: This study shows that high TS expression is a predictive factor for worse outcomes on capecitabine plus oxaliplatin adjuvant chemotherapy, whereas PD-L1 expression is a favorable prognostic factor in locally advanced gastric cancer patients.
Biomarkers ; Capecitabine ; Chemotherapy, Adjuvant ; Disease-Free Survival ; DNA Repair ; Humans ; Immunohistochemistry ; Prognosis ; Prospective Studies ; Recurrence ; Stomach Neoplasms ; Thymidylate Synthase

Adenoid cystic carcinoma (ACC) is one of the high grade malignant tumors in salivary glands, prognosticallycharacterized by multiple recurrences and late distant metastasis. Recently, Myb-NFIB fusion or rearrangements of Myb have been detected as a hallmark of ACC. However, no biological marker estimating the outcome of ACC has been proven yet. Purpose of this study was to investigate whether the protein expression of ATM gene is related to patients’ survival in ACC. This study consists of 48 surgical samples for detecting expression of ATM and its downstream p53. Kaplan-Meier plots were used to evaluate the relationship between the protein expression ratios of ATM, p53 and its ATM-mediated phosphorylation and the overall survival rate of patients with ACC. low expression of ATM in cancer cells correlated with poor survival rate (p = 0.037). However, low expression of ATM in stromal fibroblasts was not significantly associated with patient outcome. Moreover, this study evaluated ATM expression stratified by p53 and its ATM-mediated phosphorylation status. ATM loss was associated with a significantly decreased overall survival in patients simultaneously showing overexprssion of p53 (p = 0.01) and low expression of p53 phospho S15 (p = 0.05). These data supported that loss of ATM and its functional status in p53 pathway is an important factor associated with poor outcome of patients in ACC of salivary glands.

PURPOSE: Adenoid cystic carcinoma (ACC) is a high-grade malignant tumor of the salivary glands, clinically characterized by multiple recurrences and late distant metastasis. Biological markers for assessing the prognosis of ACC have remained elusive. The purpose of this study was to investigate whether the protein expressions of ataxia telangiectasia mutated (ATM), p53, and ATM-mediated phosphorylated p53 are related to patient survival in ACC. MATERIALS AND METHODS: In this study, 48 surgical samples were used to assess the expressions of ATM and its downstream target p53. Fisher's exact test and Kaplan-Meier analysis were conducted to evaluate the role of ATM, p53, and phospho-p53 (S15) protein expressions in predicting patient survival and distant metastasis. RESULTS: Myb expression was positive in 85.4% of ACCs, but did not reflect patient survival rate. In contrast, low expression of ATM in cancer cells was significantly correlated with poor survival rate (p=0.037). Moreover, under positive p53 expression, low expression of ATM was highly predictive of poor survival in ACC (p=0.017). CONCLUSION: These data indicate that combined assessment of ATM and p53 expression can serve as a useful prognostic marker for assessing survival rate in patients with ACC of the salivary glands.
Adenoids* ; Ataxia Telangiectasia ; Biomarkers ; Carcinoma, Adenoid Cystic* ; Humans ; Kaplan-Meier Estimate ; Neoplasm Metastasis ; Prognosis ; Recurrence ; Salivary Glands* ; Survival Rate