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SoUth Korean study to PrEvent cognitive impaiRment and protect BRAIN health through Multidomain interventions via facE-to-facE and video communication plaTforms in mild cognitive impairment (SUPERBRAIN-MEET): Protocol for a Multicenter Randomized Controlled Trial

  • Soo Hyun Cho;Hae Jin Kang;Yoo Kyoung Park;So Young Moon;Chang Hyung Hong;Hae Ri Na;Hong-Sun Song;Muncheong Choi;Sooin Jeong;Kyung Won Park;Hyun Sook Kim;Buong-O Chun;Jiwoo Jung;Jee Hyang Jeong;Seong Hye Choi
    • Dementia and Neurocognitive Disorders
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    • v.23 no.1
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    • pp.30-43
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    • 2024
  • Background and Purpose: The SoUth Korea study to PrEvent cognitive impaiRment and protect BRAIN health through lifestyle intervention (SUPERBRAIN) proved the feasibility of multidomain intervention for elderly people. One-quarter of the Korean population over 65 years of age has mild cognitive impairment (MCI). Digital health interventions may be cost-effective and have fewer spatial constraints. We aim to examine the efficacy of a multidomain intervention through both face-to-face interactions and video communication platforms using a tablet personal computer (PC) application in MCI. Methods: Three hundred participants aged 60-85 years, with MCI and at least one modifiable dementia risk factor, will be recruited from 17 centers and randomly assigned in a 1:1 ratio to the multidomain intervention and the waiting-list control groups. Participants will receive the 24-week intervention through the tablet PC SUPERBRAIN application, which encompasses the following five elements: managing metabolic and vascular risk factors, cognitive training, physical exercise, nutritional guidance, and boosting motivation. Participants will attend the interventions at a facility every 1-2 weeks. They will also engage in one or two self-administered cognitive training sessions utilizing the tablet PC application at home each week. They will participate in twice or thrice weekly online exercise sessions at home via the ZOOM platform. The primary outcome will be the change in the total scale index score of the Repeatable Battery for the Assessment of Neuropsychological Status from baseline to study end. Conclusions: This study will inform the effectiveness of a comprehensive multidomain intervention utilizing digital technologies in MCI.

Transplantation of human umbilical cord mesenchymal stem cells optimized with IFN-γ is a potential procedure for modification of motor impairment in multiple sclerosis cases: a preclinical systematic review and meta-analysis study

  • Mohamad Mahdi Esmaeili Araghi;Amir Abdolmaleki;Hadi Esmaeili Gouvarchin Ghaleh;Bahman Jalali Kondori;Akbar Ghorbani Alvanegh;Mehrdad Moosazadeh Moghaddam;Seyed Javad Hosseini Nejad Anbaran
    • Anatomy and Cell Biology
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    • v.57 no.3
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    • pp.333-345
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    • 2024
  • Stem cells transplantation (SCT) is known as a newfound strategy for multiple sclerosis (MS) treatment. Human umbilical cord mesenchymal stem cells (hUCMSCs) contain various regenerative features. Experimental autoimmune encephalomyelitis (EAE) is a laboratory model of MS. This meta-analysis study was conducted to assess the overall therapeutic effects of hUCMSCs on reduction of clinical score (CS) and restoration of active movement in EAE-induced animals. For comprehensive searching (in various English and Persian databases until May 1, 2024), the main keywords of "Experimental Autoimmune Encephalomyelitis", "Multiple Sclerosis", "Human", "Umbilical Cord", "Mesenchymal", and "Stem Cell" were hired. Collected data were transferred to the citation manager software (EndNote x8) and duplicate papers were merged. Primary and secondary screenings were applied (according to the inclusion and exclusion criteria) and eligible studies were prepared for data collection. CS of two phases of peak and recovery of EAE were extracted as the difference in means and various analyses including heterogeneity, publication bias, funnel plot, and sensitivity index were reported. Meta-analysis was applied by CMA software (v.2), P<0.05 was considered a significant level, and the confidence interval (CI) was determined 95% (95% CI). Six eligible high-quality (approved by ARRIVE checklist) papers were gathered. The difference in means of peak and recovery phases were -0.775 (-1.325 to -0.225; P=0.006; I2=90.417%) and -1.230 (-1.759 to -0.700; P<0.001; I2=93.402%), respectively. The overall therapeutic effects of SCT of hUCMSCs on the EAE cases was -1.011 (95% CI=-1.392 to -0.629; P=0.001). hUCMSCs transplantation through the intravenous route to the animal MS model (EAE) seems a considerably effective procedure for the alleviation of motor defects in both phases of peak and recovery.

Mild Impairments in Cognitive Function in the Elderly with Restless Legs Syndrome (노인 하지불안증후군에서의 인지기능 저하)

  • Kim, Eun Soo;Yoon, In-Young;Kweon, Kukju;Park, Hye Youn;Lee, Chung Suk;Han, Eun Kyoung;Kim, Ki Woong
    • Sleep Medicine and Psychophysiology
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    • v.20 no.1
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    • pp.15-21
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    • 2013
  • Objectives: Cognitive impairment in restless legs syndrome (RLS) patients can be affected by sleep deprivation, anxiety and depression, which are common in RLS. The objective of this study is to investigate relationship between cognitive impairment and RLS in the non-medicated Korean elderly with controlling for psychiatric conditions. Method: The study sample for this study comprised 25 non-medicated Korean elderly RLS patients and 50 age-, sex-, and education- matched controls. All subjects were evaluated with comprehensive cognitive function assessment tools- including the Korean version of Consortium to Establish a Registry for Alzheimer's Disease Assessment Packet (CERAD-K), severe cognitive impairment rating scale (SCIRS), frontal assessment battery (FAB), and clock drawing test (CLOX). Sleep quality and depression were also assessed with Pittsburgh sleep quality index (PSQI) and geriatric depression scale (GDS). Results: PSQI and GDS score showed no difference between RLS and control group. There was no significant difference between two groups in nearly all the cognitive function except in constructional recognition test, in which subjects with RLS showed lower performance than control group (t=-2.384, p=0.02). Subjects with depression ($GDS{\geq}10$) showed significant cognitive impairment compared to control in verbal fluency, Korean version of Mini Mental Status Examination in the CERAD-K (MMSE-KC), word list memory, trail making test, and frontal assessment battery (FAB). In contrast, no difference was observed between subjects who have low sleep quality (PSQI>5) and control group. Conclusions: At the exclusion of the impact of insomnia and depression, cognitive function was found to be relatively preserved in RLS patients compared to control. Impairment of visual recognition in RLS patients can be explained in terms of dopaminergic dysfunction in RLS.

Analysis of the Issues received by Quality Improvement Department and their Management in a Medical Center (일 의료원의 통합 고충처리센터 접수 내용과 이에 대한 해결방안 분석)

  • Tark, Kwan-Chul;Park, Hyun-Ju;Chun, Ja-Hae;Kang, Eun-Sook;Moon, Ju-Young;Choi, Mi-Young;Kim, Hyun-Ju;Kang, Jin-Kyung
    • Quality Improvement in Health Care
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    • v.7 no.1
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    • pp.118-131
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    • 2000
  • Background : A continuous healthcare quality improvement is needed to provide high quality healthcare service as well as to maintain trust in terms of satisfying the needs of the patients. Recently it also became an essential issue. in hospital management, recognized for it's competitive potentiality among healthcare organization groups. This study was conducted to analyze patient complaints and issues received by the Quality Improvement Department. Its purpose is to improve healthcare qualities within the hospital, as well as establish policies and appropriate strategies in hospital management. Method : From July 1st to September 30th of the year 1999, we analyzed all complaints and issues made by various patients and their families, which were received through 24 hour phone consultation, numerous suggestion boxes, letters and E-mails, The issues were classified into 16 different categories based on a Patient Satisfaction Assessment Tool. All data were segregated according to the departmental frequencies and their contents. To come up with for environmental and patient satisfaction improvement, all complaints or issues were communicated with hospital administrators, medical and nursing staff and employees. Comprehensive customer satisfaction activities including improving phone etiquette were discussed in Customer Satisfaction Team, CQI Team and each Department. All opportunities for improvement were implemented. Feedback actions were discussed. Results : A total of 317 cases were collected. Issues regarding parking and other accommodation facilities were most common complaints that were 14.5% of total. Issues regarding admission rooms (10.7%), admission procedures (10.7%), waiting room environment (8.8%), nurses and nurse assistants (7.6%), physicians (6.6%) and others (23%) followed. Thirteen of 45 departments received more than 8 complaints. The Nursing Department had the most complaint, receiving 9.8% of total complaints. Complaints regarding the Nursing Department were predominantly related to the environment of patient rooms. The Department of Psychiatry for phone etiquette (4.7%), Department of Otolaryngology for the nursing staff's attitude and phone etiquette (4.4%), and the Admission Department followed. As a part of efforts to improve patient satisfaction, a new parking structure was built and reallocation of the parking space was done. Renovation of other accommodation facilities were carried out by hospital administration, Monthly phone call and answering attitude survey was done by QI Department. Based on this survey we made a phone etiquette manual and distributed throughout the hospital. Compare to the last year, Patient Satisfaction Index measured by Korea Productivity Center using National Customer Satisfaction Index was improved 7 points. According to our organization's own study, we confirmed the phone etiquette was improved 11% than last year. Conclusions : Issues related to parking and other accommodation facilities ranked first followed by complaints made regarding the patient care area, the admission and cashier process, and nurses' and doctors' attitude. The Nursing and Psychiatry Departments need improvement regarding phone etiquette. Results were shared and played a vital role in policymaking and strategic planning of the hospital. It is imperative that we keep our database updated by listening to and solving the needs of each patient. The CQI activities can be achieved only by full commitment of the hospital top management supported by related personal.

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Policies for Improving Thermal Environment Using Vulnerability Assessment - A Case Study of Daegu, Korea - (열취약성 평가를 통한 열환경 개선 정책 제시 - 대구광역시를 사례로 -)

  • KIM, Kwon;EUM, Jeong-Hee
    • Journal of the Korean Association of Geographic Information Studies
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    • v.21 no.2
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    • pp.1-23
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    • 2018
  • This study aims to propose a way for evaluating thermal environment vulnerability associated with policy to improve thermal environment. For this purpose, a variety of indices concerning thermal vulnerability assessment and adaptation policies for climate change applied to 17 Korean cities were reviewed and examined. Finally, 15 indices associated with policies for improving thermal environment were selected. The selected indices for thermal vulnerability assessment were applied to Daegu Metropolitan City of South Korea as a case study. As results, 15 vulnerability maps based on the standardized indices were established, and a comprehensive map with four grades of thermal vulnerability were established for Daegu Metropolitan City. As results, the area with the highest rated area in the first-grade(most vulnerable to heat) was Dong-gu, followed by Dalseo-gu and Buk-gu, and the highest area ratio of the first-grade regions was Ansim-1-dong in Dong-gu. Based on the standardized indices, the causes of the thermal environment vulnerability of Ansim-1-dong were accounted for the number of basic livelihood security recipients, the number of cardiovascular disease deaths, heat index, and Earth's surface temperature. To improve the thermal environment vulnerability of Ansim-1-dong, active policy implementation is required in expansion and maintenance of heat wave shelters, establishment of database for the population with diseases susceptible to high temperature environments, expansion of shade areas and so on. This study shows the applicability of the vulnerability assessment method linked with the policies and is expected to contribute to the strategic and effective establishment of thermal environment policies in urban master district plans.

Factors Influencing on the Cognitive Function in Type 2 Diabetics (2형 당뇨병 환자의 인지 기능에 영향 미치는 인자)

  • Goh, Dong Hwan;Cheon, Jin Sook;Choi, Young Sik;Kim, Ho Chan;Oh, Byoung Hoon
    • Korean Journal of Psychosomatic Medicine
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    • v.26 no.1
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    • pp.59-67
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    • 2018
  • Objectives : The aims of this study were to know the frequency and the nature of cognitive dysfunction in type 2 diabetics, and to reveal influencing variables on it. Methods : From eighty type 2 diabetics (42 males and 38 females), demographic and clinical data were obtained by structured interviews. Cognitive functions were measured using the MMSE-K (Korean Version of the Mini-Mental State Examination) and the Korean Version of the Montreal Cognitive Assessment (MoCA-K) tests. Severity of depression was evaluated by the Korean Version of the Hamilton Depression Rating Scale (K-HDRS). Results : 1) Among eighty type 2 diabetics, 13.75% were below 24 on the MMSE-K, while 38.8% were below 22 on the MoCA-K. 2) The total scores and subtest scores of the MoCA-K including visuospatial/ executive, attention, language, delayed recall and orientation were significantly lower in type 2 diabetics with cognitive dysfunction (N=31) than those without cognitive dysfunction (N=49) (p<0.001, respectively). 3) There were significant difference between type 2 diabetics with and those without cognitive dysfunction in age, education, economic status, body mass index, duration of diabetes, total scores of the K-HDRS, the MMSE-K and the MoCA-K (p<0.05, respectively). 4) The total scores of the MoCA-K had significant correlation with age, education, body mass index, family history of diabetes, duration of diabetes, total scores of the K-HDRS (p<0.05, respectively). 5) The risks of cognitive dysfunction in type 2 diabetics were significantly influenced by sex, education, fasting plasma glucose and depression. Conclusions : The cognitive dysfunction in type 2 diabetics seemed to be related to multiple factors. Therefore, more comprehensive biopsychosocial approaches needed for diagnosis and management of type 2 diabetes.

The Effect of Dental Health Knowledge and Oral Hygiene Management Skills on Periodontal Health Status Assessment in Their Twenties (20대 구강보건지식과 구강위생관리능력이 치주건강상태평가에 미치는 영향)

  • Bok, Hye Jeong;Lee, Eun-Ju;Choi, Jung-Mi
    • Journal of dental hygiene science
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    • v.13 no.1
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    • pp.36-44
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    • 2013
  • The purpose of this study was to provide basic data for healthy and effective dental management by providing the knowledge and information on periodontal health promotion as well as high dental health interests, by doing a comparative analysis of the effect of dental health knowledge and oral hygiene management skills of people in their 20s on periodontal health status assessment, to find periodontal disease early and prevent it targeting 130 adults in their 20s who visited dental hygienic lab for comprehensive dental hygiene care and treatment from September 25 to October 30. The data collected used SPSS 18.0. To present the technical characteristics of the data, frequency was used and chi-squared test through cross-analysis was conducted to investigate dental health knowledge and the relevance between the variables of oral hygiene management skills of general characteristics. To examine periodontal health status assessment, t-test and One-way ANOVA and Turkey post-hoc tests were carried out at the 5% significance level. Regression analysis was performed to investigate the impact of dental health knowledge and oral hygiene management skills on dental health status assessment. As a result of this study, as dental health knowledge on tooth brushing of people in their 20s increased, plaque index reduced, as dental health knowledge on periodontal disease increased, plaque index reduced. Dental health status assessment according to a total number of times tooth brushing, tooth brushing methods, whether to use dental hygiene devices, smoking status, drinking frequency per week, whether to have oral health education was statistically significant. To improve the level of dental health knowledge and oral hygiene management skills, oral health education should be strengthened as well as the publicity through the media to have the information on oral health and learn it.

Analysis of Dose Reduction Rate with Dose Modulation Technic Depending on BMI (PET/CT검사에서 Dose Modulation Technic 적용시 BMI에 따른 선량 감소율 분석)

  • Kim, Jung Wook;Park, Se Yun;Jo, Young Jun;Park, Jong Yeop
    • The Korean Journal of Nuclear Medicine Technology
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    • v.16 no.2
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    • pp.25-28
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    • 2012
  • Purpose : It is important to reduce radiation dose associated with computed tomography (CT) scanning to as low as reasonably achievable (ALARA). With Dose Modulation Technic, user select a desired image quality and the system adapts tube current to obtain the desired image quality with greater radiation dose efficiency. In this paper, we presents a comprehensive description of fundamentals, clinical applications and radiation dose benefits of Dose Modulation Technic depending on Body Mass Index(BMI). Materials and Methods : In this study, 149 patients were examined(The mean age : $58{\pm}12.4$ years old). Biograph True Point 40 (Siemens, USA) and Gemini TF 64 (Philips. Cleveland) were used for equipment. When we used Care Dose 4D (Siemens, USA) and D-dom (Philips, Cleveland), we measured dose reduction and Computed Tomography Dose Index (CTDI) depending on BMI. Then we analyze data using SPSS Ver.18. Results : When we used Care Dose 4D, p-value is considered statistically significant by groups with the result that we compared Care Dose 4D with D-dom. On the other hand, p-value isn't considered statistically significant by groups using D-dom. Conclusion : Dose modulation based on the projection angle didn't affect degree of obesity. And When using Care Dose 4D, dose reduction rate in the normal patients were higher than the obese. In this study, there are errors on somato type. So I think more research have to be done. Then application of Dose Modulation technic can help in maintaining acceptable image quality while reducing radiation dose by 20-60% in most instances.

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Initial nutritional status of stomach cancer patients (위암환자의 입원시 영양상태)

  • An, Su-Mi;Yun, Gi-Yeong;Kim, Eun-Sil;Gang, Won-Geun;Ryu, Dong-Won;Kim, Tae-Hyeon;Choe, Gyeong-Hyeon;Jeong, Eun-Ae;Im, Seon-Gye;Kim, Hong-Seon;Lee, Geum-Suk;Kim, Jong-Suk;Lee, Seon-Ok
    • Journal of the Korean Dietetic Association
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    • v.8 no.3
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    • pp.217-226
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    • 2002
  • The purpose of this study is to investigate initial nutritional status of stomach cancer patients. The study subjects were 88 patients with stomach cancer admitted at Kosin University Gospel Hospital in Busan. We assessed the initial nutritional status by anthropometric, biochemical and dietary intake data along with subjective global assessment(SGA). The results are as follows. 1. The mean age, weight, height, triceps skinfold thickness, mid arm circumference, and mid arm muscle circumference of the subjects were 55.9$\pm$11.0years, 60.0$\pm$9.8kg, 162.4$\pm$8.5cm, 10.9$\pm$5.7mm, 26.8$\pm$3.8cm, and 23.4$\pm$3.5cm respectively. The mean body mass index was within the normal range, with 22.7$\pm$2.8kg/m2, while 15.4% of the patients was underweight. The result shows that body fat mass and body protein mass of the patients with stomach cancer were decreased. 2. The mean biochemical data of the subjects were 4.0$\pm$0.5g/dl for albumin, 174.7$\pm$41.9mg/dl for cholesterol, 107.6$\pm$57.2mg/dl for triglyceride, 92.1μg/dl for Zn,  297.0$\pm$103.1mg/dl for transferrin, 1980.0$\pm$0.8$mm^3$ for total lymphocyte count. 3. Daily energy intake was 1997.8$\pm$579.3kcal. And the ratio of carbohydrate, protein, and lipid to energy intake was 72:14:14. 4. The patients were divided into three groups according to SGA performed by an observer. Group A(well nourished) was 55.7% with 49 patients, Group B(moderately malnourished) was 22.7 % with 20 patients, and Group C(severely malnourished) was 21.6 % with 19 patients. The three groups showed a significant difference in body weight(p<0.01), 1 month weight loss %(p<0.001), 6 months weight loss %(p<0.001), body mass index(p<0.01), and mid arm circumference(p<0.05), albumin(p<0.01), energy intake(p<0.05) as well as carbohydrate intake(p<0.05). From these results, it may be concluded that SGA can be used as a nutrition screening tool, and comprehensive nutrition assessment is desirable for those malnourished.

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Lithological Characteristics and Deterioration Diagnosis of Dosolammaaebulsang (Rock-carved Buddha Statue of Dosolam) in the Seonunsa Temple, Gochang, Korea (고창 선운사 도솔암마애불의 암석학적 특성과 손상도 진단)

  • Park, Sung-Mi;Ryu, Keong-Seok;Choi, Hee-Soo;Lee, Chan-Hee
    • Journal of Conservation Science
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    • v.27 no.1
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    • pp.101-114
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    • 2011
  • The rock-carved Buddha statue at Dosolam (Korea Treasure No. 1200) of the Seonunsa temple in Gochang is unique style sculptured on natural rock cliff of 13.0m height. The Buddha statue is composed of volcanic complex with tuff, dacitic tuff breccia, tuff bereccia and lithic tuff. Especially, the Buddha statue is characterized by hydrothermal alteration and fragmentation on the upper and lower part. As a result of damage diagnosis, exfoliation and detachment of physical weathering are high of 11.3% and 9.3%, respectively. Infrared thermography analysis, exfoliation and micro-cracks occurred in the measuring parts that have not been confirmed by naked eyes. Chemical index of alteration and weathering potential index of host rock for the Buddha statue are 55.16 to 64.01 and 6.14 to 9.92 which are represented within highly weathering degree. In surface, dark black, reddish brown and white discoloration are observed prominently in the lower. Brown discoloration 6.9% is highest. According to the P-XRF measurements, high concentration of Fe in common, in part of dark black discoloration was Mn, white and brown discoloration in part of S and Ca content were higher. Biological weathering that yellowish brown and dark gray crustoes lichenes appeared by 20.8% and 13.3%, respectively. Therefore, comprehensive deterioration rate of Buddha statue show physical damage by 21.2%, discoloration for inorganic contaminants by 10.8% and biological damage by 39.4%. Ultrasonic velocity measurement carried out of Buddha statue on the surface by 555 points. Measured value of ultrasonic velocity was about 2,273m/s(1,067 to 3,215m/s, and weathering coefficient is 0.5(0.4 to 0.8) that progress on MW(moderately weathered) to HW(highly weathered) grade of rocks.