Validity of the Tablet-Based Digital Cognitive Test (SCST) in Identifying Different Degrees of Cognitive Impairment.

BACKGROUND: As society ages, the incidence of Alzheimer's disease and other dementias has surged, highlighting the importance of early dementia diagnosis. The Seoul Cognitive Status Test (SCST), a digital neuropsychological test, is designed for the early detection of cognitive impairment and has been standardized to establish reliability and validity. This study aims to verify whether the SCST effectively discriminates between groups based on three cognitive statuses (subjective cognitive decline [SCD], mild cognitive impairment [MCI], Dementia) in a large sample. We also seek to determine whether the SCST discriminates between individuals with three different cognitive statuses as defined by the Cognitive Dementia Rating (CDR). METHODS: We enrolled 254 participants from a dementia clinic who underwent a comprehensive neuropsychological battery (Seoul Neuropsychological Screening Battery-II) during the dementia evaluation by experienced neurologists (55 with SCD, 126 with MCI, 73 with dementia). In addition, the degree of cognitive decline in participants was classified by CDR level (186 with CDR 0.5, 52 with CDR 1, 15 with CDR 2). One-way analysis of variance was used to compare SCST scores according to each of the three cognitive status groups and CDR levels. RESULTS: The SCST total score, cognitive domain scores (attention, language, visuospatial function, memory, executive function), and most of the subtest scores decreased significantly in the order of SCD, MCI and dementia. Likewise, the differences in SCST scores between CDR levels were significant, particularly in distinguishing between CDR 0.5 and CDR 1. CONCLUSION: This study reaffirmed that the SCST can significantly discriminate between groups of individuals with SCD, MCI, and dementia based on a large sample. Furthermore, differences in SCT scores were found across the levels of CDR, confirming the clinical utility of the SCST. These findings suggest that the SCST is an efficient and useful neuropsychological test for the sensitive detection of early cognitive impairment.

Brain-computer interface on wrist training with or without neurofeedback in subacute stroke: a study protocol for a double-blinded, randomized control pilot trial.

Background: After a stroke, damage to the part of the brain that controls movement results in the loss of motor function. Brain-computer interface (BCI)-based stroke rehabilitation involves patients imagining movement without physically moving while the system measures the perceptual-motor rhythm in the motor cortex. Visual feedback through virtual reality and functional electrical stimulation is provided simultaneously. The superiority of real BCI over sham BCI in the subacute phase of stroke remains unclear. Therefore, we aim to compare the effects of real and sham BCI on motor function and brain activity among patients with subacute stroke with weak wrist extensor strength. Methods: This is a double-blinded randomized controlled trial. Patients with stroke will be categorized into real BCI and sham BCI groups. The BCI task involves wrist extension for 60 min/day, 5 times/week for 4 weeks. Twenty sessions will be conducted. The evaluation will be conducted four times, as follows: before the intervention, 2 weeks after the start of the intervention, immediately after the intervention, and 4 weeks after the intervention. The assessments include a clinical evaluation, electroencephalography, and electromyography using motor-evoked potentials. Discussion: Patients will be categorized into two groups, as follows: those who will be receiving neurofeedback and those who will not receive this feedback during the BCI rehabilitation training. We will examine the importance of motor imaging feedback, and the effect of patients' continuous participation in the training rather than their being passive.Clinical Trial Registration: KCT0008589.

Discriminative Power of Seoul Cognitive Status Test in Differentiating Subjective Cognitive Decline, Amnestic Mild Cognitive Impairment, and Dementia Based on CERAD-K Standards.

Background and Purpose: We developed a new digital cognitive assessment called Seoul Cognitive Status Test (SCST), formerly called Inbrain Cognitive Screening Test. The purpose of this study was to validate the clinical utility of the SCST by comparing its scores of those with subjective cognitive decline (SCD), amnestic mild cognitive impairment (aMCI), and dementia diagnosed by the Korean version of the Consortium to Establish a Registry for Alzheimer's Disease Assessment Packet (CERAD-K). Methods: All participants (n=296) who completed the CERAD-K, SCST, and Instrumental Activities of Daily Living tests were included in this study. Total score, cognitive domain scores, and subtest scores of the SCST were compared among the 3 groups (SCD, aMCI, and dementia). Additionally, correlations between SCST and CERAD-K subtests were examined. Results: Cognitive domain scores and total score of the SCST showed significant differences among the three groups, with scores being the highest in the order of SCD, aMCI, and dementia (p<0.001). Most subtests of the SCST also showed higher scores in the order of SCD, aMCI, and dementia (p<0.001). However, SCD and aMCI groups showed no significant differences in scores of the Phonemic Word Fluency Test (p=0.083) or Korean Trail Making Test-Elderly version Part A (p=0.434). Additionally, there was no significant difference in the score of Place Recognition (p=0.274) of the Word-Place Association Test between aMCI and dementia groups. Conclusions: In conclusion, differences in total score, cognitive domain scores, and subtest scores of the SCST among the 3 groups of participants diagnosed using CERAD-K confirm the clinical utility of the SCST for cognitive assessment.

Effectiveness of mixed reality-based rehabilitation on hands and fingers by individual finger-movement tracking in patients with stroke.

BACKGROUND: Mixed reality (MR) is helpful in hand training for patients with stroke, allowing them to fully submerge in a virtual space while interacting with real objects. The recognition of individual finger movements is required for MR rehabilitation. This study aimed to assess the effectiveness of updated MR-board 2, adding finger training for patients with stroke. METHODS: Twenty-one participants with hemiplegic stroke (10 with left hemiplegia and 11 with right hemiplegia; nine female patients; 56.7 ± 14.2 years of age; and onset of stroke 32.7 ± 34.8 months) participated in this study. MR-board 2 comprised a board plate, a depth camera, plastic-shaped objects, a monitor, a palm-worn camera, and seven gamified training programs. All participants performed 20 self-training sessions involving 30-min training using MR-board 2. The outcome measurements for upper extremity function were the Fugl-Meyer assessment (FMA) upper extremity score, repeated number of finger flexion and extension (Repeat-FE), the thumb opposition test (TOT), Box and Block Test score (BBT), Wolf Motor Function Test score (WMFT), and Stroke Impact Scale (SIS). One-way repeated measures analysis of variance and the post hoc test were applied for the measurements. MR-board 2 recorded the fingers' active range of motion (AROM) and Dunnett's test was used for pairwise comparisons. RESULTS: Except for the FMA-proximal score (p = 0.617) and TOT (p = 0.005), other FMA scores, BBT score, Repeat-FE, WMFT score, and SIS stroke recovery improved significantly (p < 0.001) during MR-board 2 training and were maintained until follow-up. All AROM values of the finger joints changed significantly during training (p < 0.001). CONCLUSIONS: MR-board 2 self-training, which includes natural interactions between humans and computers using a tangible user interface and real-time tracking of the fingers, improved upper limb function across impairment, activity, and participation. MR-board 2 could be used as a self-training tool for patients with stroke, improving their quality of life. TRIAL REGISTRATION NUMBER: This study was registered with the Clinical Research Information Service (CRIS: KCT0004167).

Differences in severity of chemotherapy-induced nausea and vomiting between neoadjuvant and adjuvant chemotherapy in patients with breast cancer: analysis of data from two prospective observational studies.

PURPOSE: We assessed the differences in chemotherapy-induced nausea and vomiting (CINV) severity in patients with breast cancer, receiving neoadjuvant chemotherapy (NAC) and adjuvant chemotherapy (AC). METHODS: CINV severity in patients on anthracycline-based NAC (n = 203) and AC (n = 79) was assessed at baseline (C0) and after the first and fourth chemotherapy using a 10-point Likert scale. Group-by-time interaction term was used to evaluate the effect of the group on changes in CIN (cCIN) and CIV (cCIV) from C0 to the follow-up periods (C1, C4). If insignificant, group effects were analyzed without the interaction term. Subgroup analysis was performed based on age 50. In statistical analyses, sociodemographic and clinical variables that differed between groups were adjusted for. RESULTS: The effect of group by follow-up period was not significant in cCIN and cCIV. The AC group showed a significantly higher change in the severity of cCIN compared to the NAC group (estimated mean = 1.133, 95% CI = 0.104-2.161, p = 0.031), but there was no difference in cCIV. In those ≤ 50 years, significant differences in cCIN severity (estimated mean = 1.294, 95% CI = 0.103-2.484, p = 0.033) were observed, but not in cCIV. In those > 50 years, neither cCIN nor cCIV differed significantly between groups. CONCLUSIONS: NAC in breast cancer patients showed less severe CIN than adjuvant chemotherapy AC, but not in those over 50. Clinicians should recognize that the severity of CIN may vary across different chemotherapy settings and adjust their management accordingly. TRIAL REGISTRATION: The clinical trial registration ( www. CLINICALTRIALS: gov ) numbers were NCT01887925 (the registration date is from June 20, 2013, to November 27, 2015) and NCT02011815 (the registration date is from December 10, 2013, to September 22, 2019).

Attitude Toward Virtual Rehabilitation and Active Video Games Among Therapists in Korea: A Nationwide Survey.

In this study, we conducted a survey targeting 191 physical therapists (PTs) and 159 occupational therapists (OTs) in South Korea to explore attitudes toward virtual rehabilitation. Utilizing the Korean version of the ADOPT VR by Glegg et al., OT exhibited significantly more experience with virtual reality (VR) and active video games (AVG) than PT. Therapists with VR/AVG experience scored significantly higher in most categories, and the scores in each category were significantly correlated with the Behavioral Intention category, reflecting the willingness to use VR/AVG. The biggest barriers identified were insufficient funds and setup assistance for the equipment. Differences in responses between the groups with and without VR/AVG experience were most prominent in terms of lack of interest and funding. Therapists' attitudes, perceptions, and intentions toward VR/AVG are crucial factors in the establishment and implementation of VR/AVG; thus, the results of this study provide valuable evidence for future policies related to VR/AVG in rehabilitation medicine.

Effects of high-gravity acceleration forces and anti-gravity maneuver on the cardiac function of fighter pilots.

The fighter pilots exposed to high gravitational (G) acceleration must perform anti-G maneuvers similar to the Valsalva maneuver. However, the effects of high-G acceleration and anti-G maneuvers on cardiac function have rarely been studied. This study aimed to investigate the effects of high-G forces on cardiac function of fighter pilots. Fighter pilots who underwent regular health check-ups and echocardiography were included (n = 29; 100% men, 41 ± 10 years old; mean flight time, 1821 ± 1186 h). Trainees who had not experienced any flights were included in the control group (n = 16; 100% men, 36 ± 17 years old). Echocardiographic data included left ventricular chamber size, systolic and diastolic functions, right ventricular systolic pressure (RVSP), inferior vena cava (IVC) collapsibility, and tricuspid annular plane systolic excursion (TAPSE). No significant differences in left ventricular ejection fraction, RVSP, or IVC collapsibility were observed between two groups. In the multivariate linear regression analysis with total flight time as an independent continuous variable for fighter pilots, TAPSE was positively correlated with total flight time. The experience of fighter pilots who were exposed to high-G acceleration forces and anti-G maneuvers did not cause cardiac structural changes, but the exposure might be associated with right heart function changes.

Reliability and Validity of the Korean Version of the Somatic Symptom Disorder-B Criteria Scale in a Clinical Population.

OBJECTIVE: This study aimed to develop and validate the Korean version of the Somatic Symptom Disorder-B Criteria Scale (SSD-12) in outpatients at a psychiatric clinic and assess its diagnostic accuracy. METHODS: A total of 207 patients completed SSD-12. For the diagnostic accuracy of SSD-12, the somatic symptom disorder (SSD) section of the structured clinical interview for DSM-5 disorders-research version (SCID-5-RV) was used. The SSD-12 construct and concurrent validity were assessed by examining the correlations with Generalized Anxiety Disorder-7 (GAD-7), Patient Health Questionnaire-9 (PHQ-9), PHQ-15, 5-level EQ-5D version (EQ-5D-5L), and World Health Organization Quality of Life Brief Version (WHOQOL-BREF). RESULTS: The SSD-12 had excellent internal consistency (Cronbach α=0.90). Confirmatory factor analysis revealed good fit indices for a general factor model (comparative fit index [CFI]=0.92, Tucker-Lewis index [TLI]=0.88, root mean square error of approximation [RMSEA]=0.10; 95% confidence interval [CI], 0.08-0.11) and a three-factor model (CFI=0.94, TLI=0.91, RMSEA=0.08; 95% CI, 0.07-0.10). The total SSD-12 score was significantly correlated with anxiety (GAD-7: r=0.53, p<0.001), depression (PHQ-9: r=0.52, p<0.001), physical symptom burden (PHQ-15: r=0.36, p<0.001), and quality of life (EQ-5D-5L: r=-0.40, p<0.001; WHOQOL-BREF: r=-0.51, p<0.001). SSD-12 demonstrated good accuracy (area under the curve=0.75, standard error=0.04; 95% CI, 0.68-0.82) with an optimal cut-off of 29. CONCLUSION: The Korean SSD-12 demonstrates reliability and validity for diagnosing SSD in clinical setting.

The Usefulness of 18F-FDG PET to Differentiate Subtypes of Dementia: The Systematic Review and Meta-Analysis.

Background and Purpose: Dementia subtypes, including Alzheimer's dementia (AD), dementia with Lewy bodies (DLB), and frontotemporal dementia (FTD), pose diagnostic challenges. This review examines the effectiveness of 18F-Fluorodeoxyglucose Positron Emission Tomography (18F-FDG PET) in differentiating these subtypes for precise treatment and management. Methods: A systematic review following Preferred Reporting Items for Systematic reviews and Meta-Analyses guidelines was conducted using databases like PubMed and Embase to identify studies on the diagnostic utility of 18F-FDG PET in dementia. The search included studies up to November 16, 2022, focusing on peer-reviewed journals and applying the gold-standard clinical diagnosis for dementia subtypes. Results: From 12,815 articles, 14 were selected for final analysis. For AD versus FTD, the sensitivity was 0.96 (95% confidence interval [CI], 0.88-0.98) and specificity was 0.84 (95% CI, 0.70-0.92). In the case of AD versus DLB, 18F-FDG PET showed a sensitivity of 0.93 (95% CI 0.88-0.98) and specificity of 0.92 (95% CI, 0.70-0.92). Lastly, when differentiating AD from non-AD dementias, the sensitivity was 0.86 (95% CI, 0.80-0.91) and the specificity was 0.88 (95% CI, 0.80-0.91). The studies mostly used case-control designs with visual and quantitative assessments. Conclusions: 18F-FDG PET exhibits high sensitivity and specificity in differentiating dementia subtypes, particularly AD, FTD, and DLB. This method, while not a standalone diagnostic tool, significantly enhances diagnostic accuracy in uncertain cases, complementing clinical assessments and structural imaging.

Resistive versus active assisted robotic training for the upper limb after a stroke: A randomized controlled study.

BACKGROUND: Selection of a suitable training modality according to the status of upper limb function can maximize the effects of robotic rehabilitation; therefore, it is necessary to identify the optimal training modality. OBJECTIVES: This study aimed to compare robotic rehabilitation approaches incorporating either resistance training (RET) or active-assisted training (AAT) using the same rehabilitation robot in people with stroke and moderate impairment. METHODS: In this randomized controlled trial, we randomly allocated 34 people with stroke who had moderate impairment to either the experimental group (RET, n = 18) or the control group (AAT, n = 16). Both groups performed robot-assisted therapy for 30 min, 5 days per week, for 4 weeks. The same rehabilitation robot provided resistance to the RET group and assistance to the AAT group. Body function and structure, activity, and participation outcomes were evaluated before, during, and after the intervention. RESULTS: RET led to greater improvements than AAT in terms of smoothness (p = 0.006). The Fugl-Meyer Assessment (FMA)-upper extremity (p < 0.001), FMA-proximal (p < 0.001), Action Research Arm Test-gross movement (p = 0.011), and kinematic variables of joint independence (p = 0.017) and displacement (p = 0.011) also improved at the end of intervention more in the RET group. CONCLUSIONS: Robotic RET was more effective than AAT in improving upper limb function, structure, and activity among participants with stroke who had moderate impairment.

Feasibility of Isokinetic Training to Modify Coupling of Upper Limb Muscle Synergy Activation in Stroke-affected Upper Limb.

Abnormal intermuscular coordination in stroke-affected upper limbs contributes to motor deficits after stroke. In particular, abnormalities in the activation of upper limb muscle synergies after stroke were demonstrated for endpoint force control during isokinetic exercises. This study aimed to investigate the feasibility of isokinetic training to alter these abnormal synergy activations and improve motor control. Muscle synergies and Wolf Motor Function Test Functional Ability Scale (WMFT-FAS) score were compared before and after three weeks of electromyography-based training. The proposed training changed the synergy activation and improved the WMFT-FAS score in a chronic stroke survivor while preserving the muscle weights of the synergies.Clinical Relevance- This study presents the feasibility of neuromuscular training to modify the activation of upper limb muscle synergies against stroke-specific patterns of intermuscular coordination and improve WMFT-FAS score.

Functional MRI Assessment of Brain Activity During Hand Rehabilitation with an MR-Compatible Soft Glove in Chronic Stroke Patients: A Preliminary Study.

Brain plasticity plays a significant role in functional recovery after stroke, but the specific benefits of hand rehabilitation robot therapy remain unclear. Evaluating the specific effects of hand rehabilitation robot therapy is crucial in understanding how it impacts brain activity and its relationship to rehabilitation outcomes. This study aimed to investigate the brain activity pattern during hand rehabilitation exercise using functional magnetic resonance imaging (fMRI), and to compare it before and after 3-week hand rehabilitation robot training. To evaluate it, an fMRI experimental environment was constructed to facilitate the same hand posture used in rehabilitation robot therapy. Two stroke survivors participated and the conjunction analysis results from fMRI scans showed that patient 1 exhibited a significant improvement in activation profile after hand rehabilitation robot training, indicative of improved motor function in the bilateral motor cortex. However, activation profile of patient 2 exhibited a slight decrease, potentially due to habituation to the rehabilitation task. Clinical results supported these findings, with patient 1 experiencing a greater increase in FMA score than patient 2. These results suggest that hand rehabilitation robot therapy can induce different brain activity patterns in stroke survivors, which may be linked to patient-specific training outcomes. Further studies with larger sample sizes are necessary to confirm these findings.

Relevance of Upper Limb Muscle Synergies to Dynamic Force Generation: Perspectives on Rehabilitation of Impaired Intermuscular Coordination in Stroke.

This study investigated the impact of stroke on the control of upper limb endpoint force during isokinetic exercise, a dynamic force-generating task, and its association with stroke-affected muscle synergies. Three-dimensional upper limb endpoint force and electromyography of shoulder and elbow muscles were collected from sixteen chronic stroke survivors and eight neurologically intact adults. Participants were instructed to control the endpoint force direction during three-dimensional isokinetic upper limb movements. The endpoint force control performance was quantitatively evaluated in terms of the coupling between forces in orthogonal directions and the complexity of the endpoint force. Upper limb muscle synergies were compared between participants with varying levels of endpoint force coupling. The stroke survivors generating greater force abnormality than the others exhibited interdependent activation profiles of shoulder- and elbow-related muscle synergies to a greater extent. Based on the relevance of synergy activation to endpoint force control, this study proposes isokinetic training to correct the abnormal synergy activation patterns post-stroke. Several ideas for implementing effective training for stroke-affected synergy activation are discussed.

Ankle stiffness asymmetry is associated with balance function in individuals with chronic stroke.

Ankle joint is one of important contributors on balance in stroke survivors. This study aimed to investigate the relationships of ankle stiffness symmetry ratios along the talocrural and subtalar axes with clinical balance measures and weight distribution during quiet standing in ambulatory chronic post-stroke survivors. The clinical trials involved 15 ambulatory elderly with chronic post-stroke hemiparesis and 15 healthy controls. Ankle stiffness was evaluated during non-weight-bearing isokinetic passive biaxial ankle movements, and ankle stiffness symmetry ratios between paretic and non-paretic ankle stiffness (SR: Inversion/Eversion SRIE & Dorsi-/Plantarflexion SRDP) were measured. A certified physiotherapist evaluated the Berg Balance Scale (BBS) and weight-distribution ratio (WDR) on bilateral force plates during quiet standing. Correlation coefficients, the factor analysis, and Pearson linear multiple regression were assessed with measured parameters. Correlation coefficients showed significances in-betweens; BBS and SRDP (r = -0.543, p = 0.022), WDR and SRIE (r = -0.667, p = 0.004), SRIE and SRDP (r = -0.604, p = 0.011). The exploratory factor analysis suggested four extracted factors; (1) Balance & Gait, (2) Stroke, (3) Symmetry and (4) Dimension. The first and second factors include general and pathological characteristics in stoke participants respectively. The third factor is associated with symmetrical characteristics explaining up to 99.9% of the variance. Multiple regression analysis showed ankle stiffness ratios predict BBS up to 60% of variance. The biaxial ankle stiffness ratio is a useful clinical variable that assesses balance function, in ambulatory chronic stroke survivors.

Sustained beneficial effect of ß-blockers on clinical outcomes after discontinuation in patients with ST elevation myocardial infarction.

Our previous study demonstrated that beneficial effect of ß-blockers on clinical outcomes in patients with ST elevation myocardial infarction (STEMI). In clinical practice, ß-blocker treatment is occasionally discontinued due to their side effect. The purpose of this study is to assess the impact of discontinuation of ß-blockers on long-term clinical outcomes in patients with STEMI. We analyzed the data and clinical outcomes of 901 patients (716 males, 58 ± 13-year-old) STEMI patients who underwent successful primary percutaneous coronary intervention. At discharge of index STEMI, 598 patients were treated with ß-blockers (491 males, 56 ± 12-year-old). After more than 1-month ß-blocker treatment, ß-blockers were stopped in 188 patients for any reason. We classified patients into continuation of ß-blockers (410 patients, 56 ± 12-year-old) and discontinuation of ß-blockers groups (188 patients, 57 ± 11-year-old) according to discontinuation of ß-blockers. Occurrence of major adverse cardiovascular events (MACEs; death, recurrent MI and target vessel revascularization) during up to 10 years of follow-up was evaluated. Mean follow-up month was 56 ± 28 month. In 132 patients (22%), MACEs were occurred. The MACE-free survival rates in the 2 groups were not statistically different (log-rank P = .461). Adjusted hazard ratio (HR) of discontinuation of ß-blockers for MACEs was 1.006 (95% confidence interval (CI) 0.701-1.445, P = .973; all cause of death, HR = 0.942, 95% CI = 0.547-1.622, P = .828; recurrent MI, HR = 0.476, 95% CI = 0.179-1.262, P = .136; target vessel revascularization, HR = 1.417, 95% CI = 0.865-2.321, P = .166). The MACE-free survival and survival rates of the non ß-blockers treatment group was significantly worse than the discontinuation of ß-blockers group (log-rank P = .003 and < 0.001, respectively). This study demonstrated that discontinuation of ß-blockers was not associated with adverse cardiovascular outcomes after STEMI. The beneficial effect of ß-blockers on clinical outcomes may persist in patients with initial ß-blockers treatment at index STEMI.

Randomized, multicenter, parallel, open, phase 4 study to compare the efficacy and safety of rosuvastatin/amlodipine polypill versus atorvastatin/amlodipine polypill in hypertension patient with dyslipidemia.

The authors performed this study to investigate the efficacy and safety of a rosuvastatin (RSV)/amlodipine (AML) polypill compared with those of atorvastatin (ATV)/AML polypill. We included 259 patients from 21 institutions in Korea. Patients were randomly assigned to 1 of 3 treatment groups: RSV 10 mg/AML 5 mg, RSV 20 mg/AML 5 mg, or ATV 20 mg /AML 5 mg. The primary endpoint was the efficacy of the RSV 10.20 mg/AML 5 mg via percentage changes in LDL-C after 8 weeks of treatment, compared with the ATV 20 mg /AML 5 mg. There was a significant difference in the mean percentage change of LDL-C at 8 weeks between the RSV 10 mg/AML 5 mg and the ATV 20 mg/AML 5 mg (full analysis set [FAS]: -7.08%, 95% CI: -11.79 to -2.38, p = .0034, per-protocol analysis set [PPS]: -6.97%, 95% CI: -11.76 to -2.19, p = .0046). Also, there was a significant difference in the mean percentage change of LDL-C at 8 weeks between the RSV 20 mg/AML 5 mg and the ATV 20 mg/AML 5 mg (FAS: -10.13%, 95% CI: -15.41 to -4.84, p = .0002, PPS: -10.96%, 95% CI: -15.98 to -5.93, p < .0001). There was no significant difference in the adverse events rates between RSV 10 mg/AML 5 mg, RSV 20 mg/AML 5 mg, and ATV 20 mg/AML 5 mg. In conclusion, while maintaining safety, RSV 10 mg/AML 5 mg and the RSV 20 mg/AML 5 mg more effectively reduced LDL-C compared with the ATV 20 mg /AML 5 mg (Clinical trial: NCT03951207).

Clinical Practice Guideline for Stroke Rehabilitation in Korea-Part 1: Rehabilitation for Motor Function (2022).

This clinical practice guideline (CPG) is the fourth edition of the Korean guideline for stroke rehabilitation, which was last updated in 2016. The development approach has been changed from a consensus-based approach to an evidence-based approach using the Grading of Recommendations Assessment Development and Evaluation (GRADE) method. This change ensures that the guidelines are based on the latest and strongest evidence available. The aim is to provide the most accurate and effective guidance to stroke rehabilitation teams, and to improve the outcomes for stroke patients in Korea. Fifty-five specialists in stroke rehabilitation and one CPG development methodology expert participated in this development. The scope of the previous clinical guidelines was very extensive, making it difficult to revise at once. Therefore, it was decided that the scope of this revised CPG would be limited to Part 1: Rehabilitation for Motor Function. The key questions were selected by considering the preferences of the target population and referring to foreign guidelines for stroke rehabilitation, and the recommendations were completed through systematic literature review and the GRADE method. The draft recommendations, which were agreed upon through an official consensus process, were refined after evaluation by a public hearing and external expert evaluation.

Virtual reality-based music attention training for acquired brain injury: A protocol for randomized cross-over trial.

Attention training is the primary step in the rehabilitation for patients with acquired brain injury (ABI). While active music performance has been reported to aid neural and functional recovery, its efficacy for patients with ABI remains uncertain due to methodological concerns. The purpose of the study is to develop a virtual reality-based music attention training (VR-MAT), which utilizes a visually guided, bilateral drumming in an immersive environment to train attention and executive functions. We also aims to examine the feasibility and effectiveness of the VR-MAT with a small sample size of participants (3-60 months after ABI, N = 20 approximately). Participants will be randomly assigned to either a waitlist control or music group, in which VR-MAT will take place five times weekly over 4 weeks (randomized crossover design). The evaluation of VR-MAT performance will include accuracy and response time in music responses. Neurocognitive outcome measures will be administered to quantify pre-post changes in attention, working memory, and executive functions. Additionally, functional near-infrared spectroscopy will be employed to explore the relationships between musical behavior, neurocognitive function, and neurophysiological responses.

Highly Sensitive and Selective Gas Sensors Based on Metal Iodates: Material Characterization and Sensor Performance Evaluation.

This study proposes the possibility of employing metal iodates as novel gas-sensing materials synthesized using a facile chemical precipitation method. An extensive survey of a library of metal iodates reveals that cobalt, nickel, and copper iodates are useful for gas sensor applications. Material analysis conducted using scanning electron microscopy, X-ray diffraction, X-ray photoelectron spectroscopy, thermal gravity differential temperature analysis, and Raman spectroscopy enables us to understand the thermal behavior and optimize post-annealing conditions. The evaluation of the gas-sensing performance of the specified metal iodates indicates that all of them display p-type sensing behavior and exhibit a high gas response toward different gases: a gas response of 18.6 by cobalt iodate to 1.8 ppm of acetone, a gas response of 4.3 by nickel iodate to 1 ppm of NO2, and a gas response of 6.6 by copper iodate to 1.8 ppm of H2S. Further investigation of the temperature-programmed reduction of H2 and polarization-electric field hysteresis analyses elucidates that the high gas response originates from the inherent characteristics of metal iodates, such as the high oxygen-reduction ability of iodine, highlighting the potential of the iodates as novel gas-sensing materials.