Comment on Krikorian et al. Early Intervention in Cognitive Aging with Strawberry Supplementation. Nutrients 2023, 15, 4431.

I read with interest the paper by Krikorian et al [...].

Holistic rubric vs. analytic rubric for measuring clinical performance levels in medical students.

BACKGROUND: Task-specific checklists, holistic rubrics, and analytic rubrics are often used for performance assessments. We examined what factors evaluators consider important in holistic scoring of clinical performance assessment, and compared the usefulness of applying holistic and analytic rubrics respectively, and analytic rubrics in addition to task-specific checklists based on traditional standards. METHODS: We compared the usefulness of a holistic rubric versus an analytic rubric in effectively measuring the clinical skill performances of 126 third-year medical students who participated in a clinical performance assessment conducted by Pusan National University School of Medicine. We conducted a questionnaire survey of 37 evaluators who used all three evaluation methods-holistic rubric, analytic rubric, and task-specific checklist-for each student. The relationship between the scores on the three evaluation methods was analyzed using Pearson's correlation. Inter-rater agreement was analyzed by Kappa index. The effect of holistic and analytic rubric scores on the task-specific checklist score was analyzed using multiple regression analysis. RESULTS: Evaluators perceived accuracy and proficiency to be major factors in objective structured clinical examinations evaluation, and history taking and physical examination to be major factors in clinical performance examinations evaluation. Holistic rubric scores were highly related to the scores of the task-specific checklist and analytic rubric. Relatively low agreement was found in clinical performance examinations compared to objective structured clinical examinations. Meanwhile, the holistic and analytic rubric scores explained 59.1% of the task-specific checklist score in objective structured clinical examinations and 51.6% in clinical performance examinations. CONCLUSION: The results show the usefulness of holistic and analytic rubrics in clinical performance assessment, which can be used in conjunction with task-specific checklists for more efficient evaluation.

Effects of 4-Week Intervention with Ulmus macrocarpa Hance Extract on Immune Function Biomarkers in Healthy Adults: A Randomized Controlled Trial.

Ulmus macrocarpa extract has been shown to have immune-related effects in animals, but no studies have yet been performed in humans. This randomized, double-blind, placebo-controlled trial was conducted to determine the effect of short-term administration of Ulmus macrocarpa Hance extract (UME) on immune function biomarkers and its safety in human subjects. Fifty-eight subjects were randomly assigned to a UME group or a placebo group. Subjects in the UME group were given 500 mg per day of UME orally for 4 weeks. Mean fluorescence intensity (MFI) of tumor necrotic factor-α increased only in the UME group at 1 week (P = 0.027). The MFI of interleukin-2 decreased less significantly in the UME group than in the placebo group at 1 week (P = 0.028). However, unfortunately, at 4 weeks, no intergroup differences were detected in MFIs of cytokine. In conclusion, administration of UME for 1 week increased serum TNF-α and sustains IL-2 in human, which suggests that UME increases Th1-related immune function in the short term in healthy people. However, additional studies are needed to confirm the results of this first-stage study and further trials are required to decide on optimal dosage and duration of administration. This trial is registered with ClinicalTrials.gov Identifier: NCT02414412.

Effects of Electrical Muscle Stimulation on Waist Circumstance in Adults with Adbominal Obesity: A Randomized, Double-blind, Sham-Controlled Trial.

INTRODUCTION: We investigated the effects of electrical muscle stimulationon waist circumference as compared with an identical device providing transcutaneous electrical nerve stimulation as control in adults with abdominal obesity. METHODS: This was a randomized, double-blind, sham-controlled trial. Sixty patients with abdominal obesity received electrical muscle stimulation or transcutaneous electrical nerve stimulation randomly five times a week for 12 weeks. RESULTS: The electrical muscle stimulationgroup achieved a mean 5.2±2.8 cm decrease in waist circumference while the transcutaneous electrical nerve stimulation group showed only a 2.9±3.3 cm decrease (P=0.005). About 20 (70.0%) of the electrical muscle stimulation group lost more than 4 cm of waist circumference but that only 8 (33.3%) of the transcutaneous electrical nerve stimulation group did so (P=0.008). Furthermore, fasting free fasting acid levels were significantly higher in the electrical muscle stimulation than in the transcutaneous electrical nerve stimulationgroup at week 12 (P=0.006). In the electrical muscle stimulation group, slight decreases in visceral abdominal fat and total abdominal fat areas by computer tomography were observed at 12 weeks, but these decreases were not significant. In addition, patients' self-rated satisfaction scores with this program were significantly higher in the electrical muscle stimulation group. CONCLUSIONS: The 12-week electrical muscle stimulation program modestly reduced waist circumference in abdominally obese adults without side effects.

Effect of Loquat Leaf Extract on Muscle Strength, Muscle Mass, and Muscle Function in Healthy Adults: A Randomized, Double-Blinded, and Placebo-Controlled Trial.

Ursolic acid (UA) is the major active component of the loquat leaf extract (LLE) and several previous studies have indicated that UA may have the ability to prevent skeletal muscle atrophy. Therefore, we conducted a randomized, double-blind, and placebo-controlled study to investigate the effects of the LLE on muscle strength, muscle mass, muscle function, and metabolic markers in healthy adults; the safety of the compound was also evaluated. We examined the peak torque/body weight at 60°/s knee extension, handgrip strength, skeletal muscle mass, physical performance, and metabolic parameters at baseline, as well as after 4 and 12 weeks of intervention. Either 500 mg of LLE (50.94 mg of UA) or a placebo was administered to fifty-four healthy adults each day for 12 weeks; no differences in muscle strength, muscle mass, and physical performance were observed between the two groups. However, the right-handgrip strength of female subjects in the LLE group was found to be significantly better than that of subjects in the control group (P = 0.047). Further studies are required to determine the optimal dose and duration of LLE supplementation to confirm the first-stage study results for clinical application. ClinicalTrials.gov Identifier is NCT02401113.

Vitamin-Mineral Supplement Use Patterns in Elderly Koreans: Data from the 2007-2008 Korean National Health and Nutrition Examination Survey.

BACKGROUND: Vitamin-mineral supplements are the most popular dietary supplements in Korea. However, few studies have assessed the relationship between vitamin-mineral supplementation and associated factors among the Korean elderly. The purpose of this study was to assess the use of vitamin-mineral supplements among elderly in Korea as well as its association with sociodemographic factors, health-related behaviors, medical conditions, and nutrient intake. METHODS: This study was based on data from the Korean National Health and Nutrition Examination Survey, conducted by the Korean Ministry of Health and Welfare from 2008 to 2009. Data from 3,294 elderly men and women (65 years of age and older) were analyzed. Multivariable-weighted logistic regression model analysis was used to evaluate the association between vitamin-mineral supplement use and sociodemographic factors, health-related habits, and medical conditions. RESULTS: Vitamin-mineral supplementation was reported by 16.3% of the participants. The most common reason for using dietary supplements was recommendations from friends and acquaintances. Highly educated person, female participants had a greater likelihood of taking vitamin-mineral supplements. In addition, analysis of nutrient intake from food sources alone revealed a lower proportion of vitamin-mineral supplement users with nutrient intakes below the estimated average requirements for vitamin A, vitamin C, thiamine, riboflavin, niacin, calcium, iron, and phosphorus, compared to nonusers. However, vitamin-mineral supplementation was not associated with health-related behaviors or medical conditions. CONCLUSION: Highly educated person, elderly Korean women had a greater likelihood of using vitamin-mineral supplements. In addition, nutrient intakes from food sources alone were significantly higher among vitamin-mineral supplement users. Finally, vitamin-mineral supplementation may be an indicator of healthier diet in elderly Koreans.

Effect of pumpkin seed oil on hair growth in men with androgenetic alopecia: a randomized, double-blind, placebo-controlled trial.

Pumpkin seed oil (PSO) has been shown to block the action of 5-alpha reductase and to have antiandrogenic effects on rats. This randomized, placebo-controlled, double-blind study was designed to investigate the efficacy and tolerability of PSO for treatment of hair growth in male patients with mild to moderate androgenetic alopecia (AGA). 76 male patients with AGA received 400 mg of PSO per day or a placebo for 24 weeks. Change over time in scalp hair growth was evaluated by four outcomes: assessment of standardized clinical photographs by a blinded investigator; patient self-assessment scores; scalp hair thickness; and scalp hair counts. Reports of adverse events were collected throughout the study. After 24 weeks of treatment, self-rated improvement score and self-rated satisfaction scores in the PSO-treated group were higher than in the placebo group (P = 0.013, 0.003). The PSO-treated group had more hair after treatment than at baseline, compared to the placebo group (P < 0.001). Mean hair count increases of 40% were observed in PSO-treated men at 24 weeks, whereas increases of 10% were observed in placebo-treated men (P < 0.001). Adverse effects were not different in the two groups.

Effect of Korean red ginseng on insulin sensitivity in non-diabetic healthy overweight and obese adults.

BACKGROUND: Korean red ginseng is one of the most popular herbs worldwide due to the belief that it contains ingredients that possess a variety of health enhancing effects including anti-diabetic effects. The objective of this study was to determine whether Korean red ginseng supplement has an effect on insulin sensitivity in healthy overweight or obese adults without overt diabetes and hypertension. METHODS: In a double-blinded, placebo controlled, randomized trial, a total of 68 participants (BMI >=23 kg/m2) received either 6 g of Korean red ginseng rootlets (n=34) or a placebo each day over a 12 week period. RESULTS: Similar insulin levels and insulin sensitivity index were observed at baseline in the Korean red ginseng and control groups. Korean red ginseng had no significant effect on improving the insulin sensitivity over time. Korean red ginseng does not improve the insulin sensitivity of overweight and obese subjects who do not have diabetes or hypertension.

Omega-3 index and smoking in patients with acute ST-elevation myocardial infarction taking statins: a case-control study in Korea.

BACKGROUND: n-3 fatty acids and lifestyle also are closely related to risk of CVD. Most Koreans have higher fish consumption than people of Western populations. However, little is known about the recommended value of omega-3 index in Korean patients with acute ST-elevation myocardial infarction (STEMI) taking statins. Here, we tested the hypothesis that lower omega-3 fatty acids and/or smoking are associated with acute STEMI, even though patients with dyslipidemia who were taking statins and who attained their LDL-C goals. METHODS: We conducted a case-control study in which omega-3 fatty acids and lifestyle factors were determined in 24 consecutive Korean patients taking statins with angiographically confirmed acute STEMI and 68 healthy controls without acute STEMI. The omega-3 index was calculated by the sum of eicosapentaenoic acid and docosahexaenoic acid in erythrocyte membranes. Multivariable adjusted regression analysis was used to assess independent associations between acute STEMI, omega-3 index, and lifestyle factors after adjusting for age, sex, and body mass index (BMI). RESULTS: The mean age of total subjects was 59.9 years, and 57.6% of the subjects were male. The omega-3 index was significantly lower in cases (8.83%) than controls (11.13%; P < 0.001); however, total trans-fatty acids were not different between the two groups. The omega-3 index was inversely associated with odds for being a case (OR 0.16 (95% CI 0.03-1.14); P = 0.047), while smoking was positively associated with odds for being a case (OR 6.67 (95% CI 1.77-25.23); P = 0.005) after adjusting for all confounding variables. CONCLUSION: This study shows that relative to controls, acute STEMI cases are more likely to be smokers and to have a lower omega-3 index, even though the cases were taking statins. An omega-3 index of at least 11% and abstinence from smoking are associated with cardioprotection for Koreans.