A decrease in the incidence of encephalitis in South Korea during the COVID-19 pandemic: A nationwide study between 2010 and 2021.

Limited data are available on the impact of the coronavirus disease (COVID-19) pandemic on encephalitis. Therefore, we evaluated trends in encephalitis in South Korea between 2010 and 2021 using data from the National Health Insurance Service. During the pandemic (February 2020 to 2021), the monthly incidence of encephalitis declined by 0.027 per 100 000 population (95% confidence interval [CI]: -0.055 to 0.001, p = 0.062) compared to that before the pandemic. In subgroup analysis, the estimated coefficient for level change during the pandemic in the 0-4 and 5-9 years age groups were -2.050 (95% CI: -2.972 to -1.128, p < 0.001) and -0.813 (95% CI: -1.399 to -0.227, p = 0.008), respectively. The annual incidence of encephalitis during the pandemic period significantly decreased in the 0-4 and 5-9 years age groups (incidence rate ratio: 0.34 [p = 0.007] and 0.28 [p = 0.024], respectively). The intensive care unit admission rate (39.1% vs. 58.9%, p < 0.001) and cases of death (8.9% vs. 11.1%, p < 0.001) decreased significantly during the pandemic compared to the prepandemic. During the pandemic, the incidence of encephalitis decreased markedly in South Korea, particularly in children aged ≤9 years. In addition, there were changes in the clinical outcome of encephalitis during the COVID-19 pandemic.

Probiotic Lactobacillus fermentum KU200060 isolated from watery kimchi and its application in probiotic yogurt for oral health.

Lactobacillus fermentum KU200060 was isolated from watery kimchi and its probiotic characteristics were evaluated, including tolerance to artificial gastric acid and bile salt, production of enzymes, ability to adhere to HT-29 cells, and antibiotic susceptibility. The antibacterial and antibiofilm effects of L. fermentum KU200060 against Streptococcus mutans KCTC 5316 were compared to those of Lactobacillus rhamnosus GG and Lactobacillus brevis KU15006. L. fermentum KU200060 demonstrated higher antibacterial activity and inhibition of biofilm formation by S. mutans than L. rhamnosus GG via inhibiting formation of water-insoluble glucan and related gene expression. In addition, L. fermentum KU200060 was applied as a probiotic in yogurt, and its physicochemical property and sensory value demonstrated its potential as a yogurt starter. The physicochemical characteristics and consumer acceptability of the probiotic yogurt containing L. fermentum KU200060 were not significantly different compared to those of the control yogurt. Therefore, L. fermentum KU200060 could be used for oral health in the probiotic industry.

Comparing the performance of artificial intelligence and conventional diagnosis criteria for detecting left ventricular hypertrophy using electrocardiography.

AIMS: Although left ventricular hypertrophy (LVH) has a high incidence and clinical importance, the conventional diagnosis criteria for detecting LVH using electrocardiography (ECG) has not been satisfied. We aimed to develop an artificial intelligence (AI) algorithm for detecting LVH. METHODS AND RESULTS: This retrospective cohort study involved the review of 21 286 patients who were admitted to two hospitals between October 2016 and July 2018 and underwent 12-lead ECG and echocardiography within 4 weeks. The patients in one hospital were divided into a derivation and internal validation dataset, while the patients in the other hospital were included in only an external validation dataset. An AI algorithm based on an ensemble neural network (ENN) combining convolutional and deep neural network was developed using the derivation dataset. And we visualized the ECG area that the AI algorithm used to make the decision. The area under the receiver operating characteristic curve of the AI algorithm based on ENN was 0.880 (95% confidence interval 0.877-0.883) and 0.868 (0.865-0.871) during the internal and external validations. These results significantly outperformed the cardiologist's clinical assessment with Romhilt-Estes point system and Cornell voltage criteria, Sokolov-Lyon criteria, and interpretation of ECG machine. At the same specificity, the AI algorithm based on ENN achieved 159.9%, 177.7%, and 143.8% higher sensitivities than those of the cardiologist's assessment, Sokolov-Lyon criteria, and interpretation of ECG machine. CONCLUSION: An AI algorithm based on ENN was highly able to detect LVH and outperformed cardiologists, conventional methods, and other machine learning techniques.

Probiotic Properties and Neuroprotective Effects of Lactobacillus buchneri KU200793 Isolated from Korean Fermented Foods.

The purpose of this study was to evaluate the probiotic characteristics and neuroprotective effects of bacteria isolated from Korean fermented foods. Three bacterial strains (Lactobacillus fermentum KU200060, Lactobacillus delbrueckii KU200171, and Lactobacillus buchneri KU200793) showed potential probiotic properties, such as high tolerance against artificial gastric juice and bile salts, sensitivity to antibiotics, nonproduction of carcinogenic enzymes, and high adhesion to intestinal cells. Heat-killed L. fermentum KU200060 and L. buchneri KU200793 showed higher antioxidant activity than heat-killed L. delbrueckii KU200171. The conditioned medium (CM) was used to evaluate the reaction between HT-29 cells and each heat-killed strain. All CMs protected SH-SY5Y cells from 1-methyl-4-phenylpyridinium (MPP+)-induced toxicity. The expression of brain-derived neurotropic factor (BDNF) mRNA in HT-29 cells treated with CM containing heat-killed L. buchneri KU200793 was the highest. The CM significantly reduced the Bax/Bcl-2 ratio and increased BDNF mRNA expression in SH-SY5Y cells treated with MPP+. These results indicate that L. buchneri KU200793 can be used as a prophylactic functional food, having probiotic potential and neuroprotective effects.

Smart device usage in early childhood is differentially associated with fine motor and language development.

AIM: We evaluated the relationships between the use of smart devices, such as smartphones and tablet computers, and the development levels and language scores in young children. METHODS: A cross-sectional analysis with 117 children aged three to five years was conducted. The participants were recruited from kindergartens in South Korea between November 2015 and April 2016. Parental questionnaires to assess smart device usage status by children, developmental screening test and receptive-expressive language scale were administered; metrics included smart device usage frequency and usage time, appropriate smart device usage level, developmental levels and language scores. RESULTS: Smart device usage frequency was significantly positively correlated with fine motor skill development [Spearman's correlation coefficient (rs ) = 0.426] in three-year-old children. Appropriate smart device usage level was also positively correlated with social development (rs  = 0.466). However, smart device usage time was significantly negatively correlated with expressive language months (rs  = -0.481). There were no such correlations in children aged four to five years. For the subcategories of appropriate usage level, the suitability of social relationship was significantly positively correlated with social development in three-year-old children (rs  = 0.474). CONCLUSION: In three-year-old children, smart device usage was positively correlated with fine motor development and negatively correlated with language development.

Effectiveness and safety of electroacupuncture for poststroke patients with shoulder pain: study protocol for a double-center, randomized, patient- and assessor-blinded, sham-controlled, parallel, clinical trial.

BACKGROUND: Practitioners of complementary and alternative medicine have suggested that acupuncture could alleviate poststroke shoulder pain, based on the clinical evidence. This study protocol is aimed at showing the effectiveness and safety of electroacupuncture therapy for stroke survivors with shoulder pain. METHODS: After assessing their eligibility, 60 stroke survivors with shoulder pain will be enrolled from two traditional Korean medicine hospitals and randomly divided into either the verum or the sham electroacupuncture (EA) group with a 1:1 ratio. The participants will receive 9 sessions of EA procedures for 3 weeks. The verum EA consists of needling on 6 unilateral acupoints (LI4, LI15, TE14, SI9, SI11, and GB21) with electronic stimulation. A non-penetrating Park sham device and fake electronic stimulation will be used in the sham group on the same acupoints. Patients and outcome assessors will be blinded throughout the entire study. A visual analog scale will be used primarily for the evaluation, and pain rating scale, Fugl-Meyer assessment for upper extremity, modified Ashworth scale, manual muscle test, passive range of motion test, Korean version of a modified Barthel index, and Korean version of the Beck depression inventory will be also be measured. A blinding index will be assessed. For safety, adverse events will be recorded. Data will be statistically analyzed by two-sample t-test or Wilcoxon rank sum test for efficacy and a chi-squared test or Fisher's exact test for safety, at 5% of significance level. DISCUSSION: We expect this double-center, randomized, sham-controlled, patient- and assessor-blinded parallel trial to explore the effectiveness and safety of EA therapy, compared with sham EA, for poststroke shoulder pain. TRIAL REGISTRATION: https://clinicaltrials.gov/ct2/show/NCT03086863.

Acupuncture for insomnia after stroke: a systematic review and meta-analysis.

BACKGROUND: Insomnia is the common complaint among patients with stroke. Acupuncture has increasingly been used for insomnia relief after stroke. The aim of the present study was to summarize and evaluate evidence on the effectiveness of acupuncture in relieving insomnia after stroke. METHODS: Seven databases were searched from inception through October 2014 without language restrictions. Randomized controlled trials (RCTs) were included if acupuncture was compared to placebo or other conventional therapy for treatment of insomnia after stroke. Assessments were performed using the Pittsburgh sleep quality index (PSQI), the insomnia severity index (ISI), the Athens insomnia scale (AIS), and the efficacy standards of Chinese medicine. RESULTS: A total of 165 studies were identified; 13 RCTs met our inclusion criteria. Meta-analysis showed that acupuncture appeared to be more effective than drugs for treatment of insomnia after stroke, as assessed by the PSQI (weighted mean difference, 4.31; 95 % confidence interval [CI], 1.67-6.95; P = 0.001) and by the efficacy standards of Chinese medicine (risk ratio, 1.25; 95 % CI, 1.12-1.40; P < 0.001). Intradermal acupuncture had significant effects compared with sham acupuncture, as assessed by the ISI (weighted mean difference, 4.44; 95 % CI, 2.75-6.13; P < 0.001) and the AIS (weighted mean difference, 3.64; 95 % CI, 2.28-5.00; P < 0.001). CONCLUSIONS: Our results suggest that acupuncture could be effective for treating insomnia after stroke. However, further studies are needed to confirm the role of acupuncture in the treatment of this disorder.

Trends in the Development of Acupuncture-Related Technologies Based on Patents in South Korea.

Background: Several studies have assessed the safety and efficacy of acupuncture, but none have reviewed patent trends related to acupuncture as an intervention. This study analyzed trends in patents for the development of acupuncture-related technologies in Korea. Methods: The Korea Intellectual Property Rights Information Service (KIPRIS) was searched for information on acupuncture-related patents registered until August 11, 2021, without any limit on the search period. Only acupuncture and electro-acupuncture were included in this review. The current status, contents, and technological characteristics of the relevant patents were analyzed systematically to identify the overall status of acupuncture-related patents. Results: Overall, 126 patents were identified from the KIPRIS database, of which 93 were unrelated to the research topic and were excluded. Finally, 33 patents were assessed. Interest in the development of acupuncture technology has increased steadily over the past decade. Patent applications reached their peak in 2018 with six instances, while patent registration peaked in 2019 with seven instances. The interval between the application and registration of an individual patent was 14.3 months (449 days). Twenty-two acupuncture-related patents were for acupuncture (66.6%) and 11 for electro-acupuncture (33.3%). The technical specifications for the patents included acupuncture devices (30.3%), acupuncture manufacturing methods and equipment (36.4%), and electro-acupuncture devices (33.3%). Conclusion: Acupuncture-related technology currently focuses on technological advancements for the safe and effective delivery of stimulation. The findings demonstrate trends toward new diverse and complex technological advancements for acupuncture devices, manufacturing methods and equipment, and electro-acupuncture devices.

A systematic review of sham acupuncture validation studies.

BACKGROUND: Acupuncture is widely used worldwide; however, studies on its effectiveness have been impeded by limitations regarding the design of appropriate control groups. In clinical research, noninvasive sham acupuncture techniques can only be applied through validation studies. Therefore, this systematic review aimed to evaluate the scope of existing literature on this topic to identify trends. METHODS: We queried Pubmed, EMBASE, and the Cochrane Central Register of Controlled Trials databases from inception to July 2022 for relevant articles. Author names were used to identify additional relevant articles. Two independent reviewers assessed the identified articles based on the inclusion and exclusion criteria. The following data were extracted: study design, information regarding acupuncturists and participants, general and treatment-related characteristics of the intervention and control groups, participants' experience of acupuncture, and research findings. RESULTS: The database query yielded 673 articles, of which 29 articles were included in the final review. Among these, 18 involved the use of one of three devices: Streitberger (n = 5), Park (n = 7), and Takakura (n = 6) devices. The remaining 11 studies used other devices, including self-developed needles. All the included studies were randomized controlled trials. The methodological details of the included studies were heterogeneous with respect to outcomes assessed, blinding, and results. CONCLUSIONS: Sham acupuncture validation studies have been conducted using healthy volunteers, with a focus on blind review and technological developments in sham acupuncture devices. However, theren may be language bias in our findings since we could not query Chinese and Japanese databases due to language barriers. There is a need for more efforts toward establishing control groups suitable for various acupuncture therapy interventions. Moreover, there is a need for more rigorous sham acupuncture validation studies, which could lead to higher-quality clinical studies.

Incidence and disease burden of autoimmune inflammatory rheumatic diseases after non-pharmaceutical interventions in the COVID-19 era: A nationwide observational study in Korea.

BACKGROUND: Infections are considered risk factors for autoimmune inflammatory rheumatic diseases (AIRDs), the incidence of which is considered to have been impacted by the COVID-19 pandemic. The impact of non-pharmaceutical interventions (NPIs) on the incidence of AIRDs and their associated health care services and medical expenses in Korea was investigated. METHODS: We included all AIRD cases reported between January 2016 and February 2021 based on the National Health Insurance Service data. We evaluated changes in incidence trends for each AIRD before and after NPI implementation (Feb 2020 to Feb 2021) using segmented regression analysis. Changes in health care utilization and medical costs for each AIRD before and after NPI implementation were also investigated. RESULTS: After NPI implementation, monthly incidence rates declined significantly by 0.205 per 1 000 000 (95% confidence interval [CI], -0.308 to -0.101, p < .001) in patients with systemic lupus erythematosus (SLE). No significant changes in the incidence of all AIRDs other than SLE were observed before and after implementation. Further, annual outpatient department visits per patient were lower during implementation for all diseases, except juvenile idiopathic arthritis (JIA). The prescription days per outpatient visit increased significantly during implementation for all diseases, except JIA and ankylosing spondylitis. During implementation, the total annual medical costs per patient tended to decrease for all diseases, except JIA and mixed connective tissue disease. CONCLUSION: Implementation of NPIs to contain the pandemic led to a reduction in the incidence of SLE and changed patterns of medical care utilization and treatment cost for most AIRDs.

Improving Upper Limb Spasticity in Patients with Stroke by Electroacupuncture Therapy: a Pre- and Post-Treatment Study.

Background: : Post-stroke upper limb spasticity (PS-ULS) causes a decline in the quality of life of patients by reducing their ability to perform normal daily activities. Objectives: : We performed pre- and post-treatment analyses of the changes in stroke patients with ULS following constant electroacupuncture therapy (EAT). Methods: : Thirty patients with PS-ULS underwent 12 sessions of EAT over 4 weeks. After performing acupuncture therapy at four acupoints on the affected arm (LI11, LI10, LI4, and TE5), electrostimulation (60 Hz) was performed for 20 min. The modified Ashworth scale (MAS) and the Fugl-Meyer assessment of the upper extremity (FMA-UE) were measured as the outcome variables. Results: : Following EAT, there was a significant decrease in the elbow MAS score (p < 0.001), a significant decrease in the wrist MAS score (p < 0.01), and a significant increase in the FMA-UE score (p < 0.001). Adverse events related to EAT were not reported. Conclusion: : EAT decreased upper limb spasticity and improved functional recovery at the elbow and wrist. Large-scale and rigorous clinical trials are needed to verify the efficacy of EAT.

The impact of non-pharmaceutical interventions on premature births during the COVID-19 pandemic: a nationwide observational study in Korea.

Background: Non-pharmaceutical interventions (NPIs), such as social distancing and hand washing, have been associated with a decline in the preterm birth rate worldwide. We aimed to evaluate whether the preterm birth rate in Korea during the coronavirus disease 2019 lockdown has changed compared to that in previous years. Method: A birth registry from the Korea Statistical Information Service, which is a nationwide official database, was used to include all births claimed to have occurred between 2011 and 2020. Newborns with gestational age (GA) less than 22 weeks and birth weight less than 220 g were excluded. The pre-NPI period was designated as January 2011 to January 2020, and the NPI period was defined as February 2020 to December 2020. We assessed the effect of NPI on the incidence of prematurity per 100 births using an interrupted time-series quasi-experimental design and implementing an autoregressive integrated moving average (ARIMA) model. Results: From 2011 to 2020, a total of 3,931,974 live births were registered, among which 11,416 were excluded. Consequently, the final study population included 3,920,558 live births (both singleton and multiple births) among which 275,009 (7.0%) were preterm. The preterm birth rate was significantly higher during the NPI period (8.68%) compared to that in the pre-NPI period (6.92%) (P < 0.001). The ARIMA model showed that in all singleton and multiple births, except those in July (observed 9.24, expected 8.54, [95% prediction interval {PI} 8.13-8.96], percent difference 7.81%), September (observed 7.89, expected 8.35, [95% PI 7.93-8.76], percent difference -5.66%), and December (observed 9.90, expected 9.40, [95% PI 8.98-9.82], percent difference 5.2%), most observed values were within the 95% PI of the expected values and showed an increasing trend. Conclusion: In this nationwide observational study, the trend in premature birth rate did not significantly change due to NPI implementation in Korea, as it had been increasing since 2011. The trend of Korea's birth rate appears to be unaffected by the implementation of NPIs; however, further studies with a longer follow-up period are needed.

Microbial energy metabolism fuels an intestinal macrophage niche in solitary isolated lymphoid tissues through purinergic signaling.

Maintaining macrophage (MΦ) heterogeneity is critical to ensure intestinal tissue homeostasis and host defense. The gut microbiota and host factors are thought to synergistically guide intestinal MΦ development, although the exact nature, regulation, and location of such collaboration remain unclear. Here, we report that microbial biochemical energy metabolism promotes colony-stimulating factor 2 (CSF2) production by group 3 innate lymphoid cells (ILC3s) within solitary isolated lymphoid tissues (SILTs) in a cell-extrinsic, NLRP3/P2X7R-dependent fashion in the steady state. Tissue-infiltrating monocytes accumulating around SILTs followed a spatially constrained, distinct developmental trajectory into SILT-associated MΦs (SAMs). CSF2 regulated the mitochondrial membrane potential and reactive oxygen species production of SAMs and contributed to the antimicrobial defense against enteric bacterial infections. Collectively, these findings identify SILTs and CSF2-producing ILC3s as a microanatomic niche for intestinal MΦ development and functional programming fueled by the integration of commensal microbial energy metabolism.

Comparison of Clinical Characteristics and Risk Factors for Recurrence of Kikuchi-Fujimoto Disease Between Children and Adult.

Purpose: Kikuchi-Fujimoto disease (KFD) is a rare, benign, and self-limited disease, characterized by cervical lymphadenopathy and fever. Herein, we analyzed the differences in its clinical manifestations and risk factors for recurrence between children and adults. Patients and Methods: We retrospectively reviewed the medical records of patients diagnosed with KFD at a tertiary referral hospital between 2005 and 2019. Patients were divided into two groups based on their age: children (<19 years) and adults (≥19 years). Results: During the 14-year study period, 127 patients were diagnosed with KFD. Among these, 34 (26.8%) were children and 93 (73.2%) were adults. The fever duration was longer and the frequency of myalgia was higher in adults than in children; however, no other significant symptomatic differences were noted between the two groups. Lymph node evaluation was mainly performed using ultrasound in children (61.8%) and computed tomography in adults (78.5%). Moreover, the frequency of antibiotic use was higher in children than in adults (76.5% vs 54.8%, P = 0.027). In adults, multivariable logistic regression analysis revealed anti-nuclear antibody (ANA) positivity (titer ≥1:80) as a risk factor for recurrence (odds ratio: 7.813; 95% confidence interval = 1.818-33.333; P = 0.006). Conclusion: The clinical features of KFD in children and adults were similar; however, the preferred imaging study and frequency of antibiotic use differed significantly between the two groups. Furthermore, in adults, ANA positivity was associated with KFD recurrence. Thus, patients with KFD who present with ANA positivity at diagnosis will benefit from a regular follow-up for monitoring KFD recurrence.

Safety of Live Immunization in DiGeorge Syndrome: A Retrospective Single-Center Study in Korea, 2005-2021.

Live immunization is contraindicated in patients with DiGeorge syndrome (DGS). We retrospectively investigated the occurrence of adverse events after live immunization in patients with DGS in Korea. The data of patients matching the International Classification of Disease-10 code of DGS (D82.1) at Severance Hospital Seoul, Korea, were extracted; patients without genetically diagnosed DGS were excluded. Based on T cell immunity status, the included patients were categorized into group A (CD3 < 500 or CD8 < 200 cells/mm3); group B (CD3 ≥ 500 and CD8 ≥ 200 cells/mm3); or group C (unknown). Among 94 patients, 38 (~40%, group A: 8 [21%]; group B: 30 [79%]) underwent immunological testing and 73 (~80%) received at least one live immunization (measles−mumps−rubella vaccination was most common [66/94, ~70%]). Fifty adverse events (fever [n = 29], upper respiratory infection [n = 9], diarrhea [n = 4], rash [n = 3], thrombocytopenia [n = 3], injection site pus [n = 1], and febrile convulsion [n = 1]) were observed; 13 (26%) occurred in group A, with no significant difference in incidence between groups A and B. Serious adverse events, including intensive care unit hospitalization or death, or diseases due to vaccine strains were not observed. In this study, live immunization was well tolerated by patients with partial DGS.

Risk of Dental Discoloration and Enamel Dysplasia in Children Exposed to Tetracycline and Its Derivatives.

PURPOSE: To examine the risk of dental abnormalities after exposure to tetracycline and its derivatives (TCs) in Korean children. MATERIALS AND METHODS: Children aged 0-17 years with a claim for prescriptions of TCs between 2002 and 2015 were identified from the Sample Research Database 2.0 of the National Health Insurance Service. Children not exposed to TCs were selected as the control group by matching sex and age (1:4). Cumulative incidence rate and relative risk of dental abnormalities after TCs exposure were investigated. RESULTS: The 10-year cumulative incidence rate in the 0-12 years group was 3.1% [95% confidence interval (CI), 2.3-3.9]. The 10-year cumulative incidence rates were 7.0%, 1.9%, and 1.6% in the 0-7, 8-12, and 13-17 years age groups (95% CI: 4.7-9.3, 1.2-2.6, and 1.3-1.9, respectively). There was no significant difference in the risk of dental abnormalities according to TC exposure among the age groups of 0-7 years [adjusted hazard ratio (aHR)=1.0], 8-12 years (aHR=1.1), and 13-17 years (aHR=1.2). CONCLUSION: Short-term exposure to TCs does not appear to increase the risk of dental abnormalities in children aged 0-7 and 0-12 years. Restrictions on the use of TCs in children aged 8-12 years, in some countries, may warrant consideration.

Physicochemical Analysis of Yogurt Produced by Leuconostoc mesenteroides H40 and Its Effects on Oxidative Stress in Neuronal Cells.

Leuconostoc mesenteroides H40 (H40) was isolated from kimchi, and its probiotic properties and neuroprotective effect was evaluated in oxidatively stressed SH-SY5Y cells. H40 was stable in artificial gastric conditions and can be attached in HT-29 cells. In addition, H40 did not produce ß-glucuronidase and showed resistant to several antibiotics. The conditioned medium (CM) was made using HT-29 cells refined with heat-killed probiotics (Probiotics-CM) and heated yogurts (Y-CM) to investigate the neuroprotective effect. Treatment with H40-CM not only increased cell viability but also significantly improved brain derived neurotropic factor (BDNF) expression and reduced the Bax/Bcl-2 ratio in oxidatively stress-induced SH-SY5Y cells. Besides, probiotic Y-CM significantly increased BDNF mRNA expression and decreased Bax/Bcl-2 ratio. The physicochemical properties of probiotic yogurt with H40 was not significantly different from the control yogurt. The viable cell counts of lactic acid bacteria in control and probiotic yogurt with H40 was 8.66 Log CFU/mL and 8.96 Log CFU/mL, respectively. Therefore, these results indicate that H40 can be used as prophylactic functional dairy food having neuroprotective effects.

Usefulness of virtual reality-based training to diagnose strabismus.

To study the usefulness of virtual reality (VR)-based training for diagnosing strabismus. Fourteen residents in ophthalmology performed at least 30 VR training sessions to diagnose esotropia and exotropia. Examinations of real patients with esotropia or exotropia before and after the VR training were video-recorded and presented to a strabismus expert to assess accuracy and performance scores for measuring the deviation angle and diagnosing strabismus with anonymization. A feedback survey regarding the usefulness and ease of use of the VR application was conducted for participants. The mean age of the 14 ophthalmology residents (10 men and 4 women), was 29.7 years. Before VR training, participants showed a mean accuracy score of 14.50 ± 5.45 and a performance score of 9.64 ± 4.67 for measuring the deviation angle and diagnosing strabismus in real patients with strabismus. After VR training, they showed a significantly improved accuracy score of 22.14 ± 4.37 (p = 0.012) and a performance score of 15.50 ± 1.99 (p = 0.011). According to the survey, most participants agreed on the usefulness of VR applications. This study suggests that VR-based training improved ophthalmology residents' clinical diagnostic skills for strabismus in a short period.

Potential neuroprotective effects of heat-killed Lactococcus lactis KC24 using SH-SY5Y cells against oxidative stress induced by hydrogen peroxide.

The present study was an investigation of the neuroprotective effects of probiotic bacteria in SH-SY5Y neuroblastoma cells experiencing oxidative stress. The bacterial strains were: commercial Lactobacillus rhamnosus GG; two isolated bacterial strains (Lactobacillus delbrueckii KU200170 and Lactobacillus plantarum KU200661); and probiotic Lactococcus lactis KC24. To evaluate the neuroprotective effects of the bacteria, a conditioned medium (CM) was prepared using HT-29 cells cultured with the heat-killed probiotic strains. Of the bacterial strains tested, the oxidatively stressed SH-SY5Y cells were most viable when cultured with L. lactis KC24-CM. L. lactis KC24-CM promoted the expression of brain-derived neurotropic factor (BDNF) in the HT-29 cells. It also significantly increased BDNF expression and reduced the apoptosis-related Bax/Bcl-2 ratio in the oxidatively stressed SH-SY5Y cells. Therefore, L. lactis KC24 is a potential psychobiotic for use in the functional food industry.

Mental health and quality of life of patients with osteoarthritis pain: The sixth Korea National Health and Nutrition Examination Survey (2013-2015).

OBJECTIVES: This study aims to investigate the association between mental health and quality of life of osteoarthritis (OA) patients according to the site of pain. DESIGN: Retrospective cross-sectional study. PARTICIPANTS: Data of 22,948 participants of the sixth Korea National Health and Nutrition Examination Survey conducted from 2013-2015 were used. OUTCOME MEASURES: Participants were asked if they had OA pain in the hip joint, knee joint, and lower back (yes/no) and whether they experienced anxiety or depression. The EQ-5D questionnaire was used to determine the quality of life of patients with hip, knee, and lower back OA. Multiple logistic regression analysis was performed after adjusting. RESULTS: A total of 5,401 patients reported pain in the hip joint, knee joint, or lower back. The analysis showed significant relations between pain sites, mental health, and quality of life. First, more female patients with OA experienced stress and depression than males. Second, for males with OA, stress was reported in the order of: lower back > hip > knee, while pain and depression was reported in the order of: lower back > knee > hip (p < 0.05). For females with OA, stress was reported in the order of: knee > lower back > hip, while depression was reported in the order of: knee > lower back > hip. Third, considering quality of life, for males, hip joint pain had the greatest impact on quality of life and for females, knee joint pain had the largest impact (p < 0.001). CONCLUSIONS: For patients with OA, the effect on the mental health and quality of life differed according to sex and sites of pain. Therefore, this study confirms that pain sites, sex, mental health, and quality of life are independent risk factors when determining OA pain.