Integrative analysis of RNA-sequencing and microarray for the identification of adverse effects of UVB exposure on human skin.

Background: Ultraviolet B (UVB) from sunlight represents a major environmental factor that causes toxic effects resulting in structural and functional cutaneous abnormalities in most living organisms. Although numerous studies have indicated the biological mechanisms linking UVB exposure and cutaneous manifestations, they have typically originated from a single study performed under limited conditions. Methods: We accessed all publicly accessible expression data of various skin cell types exposed to UVB, including skin biopsies, keratinocytes, and fibroblasts. We performed biological network analysis to identify the molecular mechanisms and identify genetic biomarkers. Results: We interpreted the inflammatory response and carcinogenesis as major UVB-induced signaling alternations and identified three candidate biomarkers (IL1B, CCL2, and LIF). Moreover, we confirmed that these three biomarkers contribute to the survival probability of patients with cutaneous melanoma, the most aggressive and lethal form of skin cancer. Conclusion: Our findings will aid the understanding of UVB-induced cutaneous toxicity and the accompanying molecular mechanisms. In addition, the three candidate biomarkers that change molecular signals due to UVB exposure of skin might be related to the survival rate of patients with cutaneous melanoma.

[Impact of Anthropometric Indices of Obesity on the Risk of Incident Hypertension in Adults with Prehypertension: A Secondary Analysis of a Cohort Study].

PURPOSE: This study aimed to investigate the impact of anthropometric indices of obesity (body mass index [BMI], waist circumference, waist hip ratio, and body fat percentage) on the incidence of hypertension in adults with prehypertension. METHODS: A longitudinal study design using secondary data form the Korean Genome and Epidemiology Study was employed. The study included 1,838 adults with prehypertension tracked every two years from 2001 to 2018. Statistical analyses, including frequency assessments, number of cases per 1,000 person-years, log-rank tests, Kaplan-Meier curves, and Cox's proportional hazards regression, were conducted using SPSS version 25. RESULTS: Over the observation period (15,783.6 person-years), 1,136 individuals developed hypertension. The incidence of hypertension was significantly higher in the obesity groups defined by BMI (hazard ratio [HR] = 1.33), waist circumference (HR = 1.34), waist hip ratio (HR = 1.29), and body fat percentage (HR = 1.31) compared to the non-obese group. These findings indicate an increased risk of hypertension associated with obesity as measured by these indices. CONCLUSION: The study underscores the importance of avoiding obesity to prevent hypertension in individuals with prehypertension. Specifically, BMI, waist circumference, waist hip circumference, and body fat percentage were identified as significant risk factors for hypertension. The results suggest the need for individualized weight control interventions, emphasizing the role of health professionals in addressing the heightened hypertension risk in this population.

Association of KIR Genes with Middle East Respiratory Syndrome Coronavirus Infection in South Koreans.

BACKGROUND: Middle East respiratory syndrome (MERS) is a lower respiratory tract disease caused by a beta coronavirus (CoV) called MERS-CoV, characterized by a high mortality rate. We aimed to evaluate the association between genetic variation in killer cell immunoglobulin-like receptors (KIRs) and the risk of MERS in South Koreans. METHODS: KIR genes were genotyped by multiplex polymerase chain reaction with sequence-specific primers (PCR-SSP). A case-control study was performed to identify the odds ratios (OR) of KIR genes for MERS and the association of KIR genes and their ligands, human leukocyte antigens (HLA) genes. RESULTS: KIR2DS4D and KIR3DP1F showed higher frequencies in the group of all patients infected with MERS-CoV than in the control group (p = 0.023, OR = 2.4; p = 0.039, OR = 2.7). KIR2DL1, KIR2DP1, and KIR3DP1D were significantly associated with moderate/mild (Mo/Mi) cases. KIR2DL2, KIR2DS1, and KIR3DP1F were affected in severe cases. When we investigated the association between KIR genes and their ligands in MERS patient and control groups, KIR3DL1+/Bw4(80I)+, KIR3DL1+/Bw6+, KIR3DL1+/Bw6-, KIR2DS1+/C2+, and KIR3DS+/Bw4(80I)+ were associated with MERS. KIR3DL1+/Bw6- was found in Mo/Mi cases. KIR2DS1+/C2+ and KIR2DS2+/C1+ were found in severe cases. CONCLUSION: Further investigations are needed to prove the various immune responses of MERS-CoV-infected cells according to variations in the KIR gene and ligand gene. A treatment strategy based on current research on the KIR gene and MERS-CoV will suggest potential treatment targets.

Development of cost-effective and fast KIR genotyping by multiplex PCR-SSP.

Killer-cell immunoglobulin-like receptors (KIR) control natural killer (NK) cell functions by recognizing HLA molecules and modulating the activity of NK cells. The KIR gene cluster contains polymorphic and highly homologous genes. Diversity of the KIR region is achieved through differences in gene content, allelic polymorphism, and gene copy number, which result in unrelated individuals having different KIR genotypes and individualized immune responses that are relevant to multiple aspects of human health and disease. Therefore, KIR genotyping is increasingly used in epidemiological studies. Here, we developed multiplex polymerase chain reaction with sequence-specific primers (PCR-SSP) to compensate for the shortcomings of the conventional PCR-SSP method, which is most commonly used for KIR analysis. Multiplex PCR-SSP method involves six multiplex reactions that detect 16 KIR genes and distinguish variant types of some KIR genes by adding two reactions. The assay was evaluated in a blind survey using a panel of 40 reference DNA standards from the UCLA KIR Exchange Program. The results are 100% concordant with the genotype determined using Luminex-based reverse sequence-specific oligonucleotide typing systems. Additionally, we investigated the currently known 16 KIR genes and their common variants in 120 unrelated Korean individuals. The results were consistent with the KIR genotype previously reported by Hwang et al. This multiplex PCR-SSP is an efficient method for analyzing KIR genotypes in both small- and large-scale studies with minimal labor, reagents, and DNA. Furthermore, by providing a better definition of KIR polymorphisms it can contribute to developments in immunogenetics.

Prioritization of Injury Prevention and Management Programs and Research and Development (R&D) Projects: Survey Using the Delphi Technique and Analytic Hierarchy Process.

We prioritized injury prevention and management programs, and research and development (R&D) projects using the Delphi method and analytic hierarchy process (AHP) for national plan. We summarized 21 programs and 31 R&D projects based on opinions collected in the opinion survey and brainstorming. Expert panel evaluated program and project relevance in the two Delphi rounds to make consensus. Total scores were calculated by adding criterion weights calculated through the AHP multiplied by the average of scores for each program and project. The top three programs were "Integrated Management System for Injury Data," "Comprehensive Injury Surveillance System," and "Transport System Improvement Program for Major Trauma." The top three R&D projects were researches on "Identification of Vulnerable Workers Injuries to Strengthen Protections," "Data Integration on Injury and Disability," and "Using Public Health Big Data to Identify Injury Status and Risk Factors." Experts highly rated the programs to improve injury surveillance system.

Cancer risk based on alcohol consumption levels: a comprehensive systematic review and meta-analysis.

OBJECTIVES: Alcohol consumption is a well-established risk factor for cancer. Despite extensive research into the relationship between alcohol consumption and cancer risk, the effect of light alcohol consumption on cancer risk remains a topic of debate. To contribute to this discourse, we conducted a comprehensive systematic review and meta-analysis. METHODS: Our systematic review aimed to investigate the associations between different levels of alcohol consumption and the risk of several cancer types. We focused on analyzing prospective associations using data from 139 cohort studies. Among them, 106 studies were included in the meta-analysis after a quantitative synthesis. RESULTS: Our analysis did not find a significant association between light alcohol consumption and all-cause cancer risk (relative risk, 1.02; 95% confidence interval, 0.99 to 1.04), but we observed a dose-response relationship. Light alcohol consumption was significantly associated with higher risks of esophageal, colorectal, and breast cancers. Light to moderate drinking was associated with elevated risks of esophageal, colorectal, laryngeal, and breast cancers. Heavy drinking was also found to contribute to the risk of stomach, liver, pancreas, and prostate cancers, thereby increasing the risk of almost all types of cancer. Additionally, females generally had lower cancer risks compared to males. CONCLUSIONS: Our findings highlight that cancer risks extend beyond heavy alcohol consumption to include light alcohol consumption as well. These findings suggest that there is no safe level of alcohol consumption associated with cancer risk. Our results underscore the importance of public health interventions addressing alcohol consumption to mitigate cancer risks.

Understanding the Role of M13 Bacteriophage Thin Films on a Metallic Nanostructure through a Standard and Dynamic Model.

The dynamic and surface manipulation of the M13 bacteriophage via the meeting application demands the creation of a pathway to design efficient applications with high selectivity and responsivity rates. Here, we report the role of the M13 bacteriophage thin film layer that is deposited on an optical nanostructure involving gold nanoparticles/SiO2/Si, as well as its influence on optical and geometrical properties. The thickness of the M13 bacteriophage layer was controlled by varying either the concentration or humidity exposure levels, and optical studies were conducted. We designed a standard and dynamic model based upon three-dimensional finite-difference time-domain (3D FDTD) simulations that distinguished the respective necessity of each model under variable conditions. As seen in the experiments, the origin of respective peak wavelength positions was addressed in detail with the help of simulations. The importance of the dynamic model was noted when humidity-based experiments were conducted. Upon introducing varied humidity levels, the dynamic model predicted changes in plasmonic properties as a function of changes in NP positioning, gap size, and effective index (this approach agreed with the experiments and simulated results). We believe that this work will provide fundamental insight into understanding and interpreting the geometrical and optical properties of the nanostructures that involve the M13 bacteriophage. By combining such significant plasmonic properties with the numerous benefits of M13 bacteriophage (like low-cost fabrication, multi-wavelength optical characteristics devised from a single structure, reproducibility, reversible characteristics, and surface modification to suit application requirements), it is possible to develop highly efficient integrated plasmonic biomaterial-based sensor nanostructures.

Effect of music on colonoscopy performance: A propensity score-matched analysis.

BACKGROUND: Music has been used to reduce stress and improve task performance during medical therapy. AIM: To assess the effects of music on colonoscopy performance outcomes. METHODS: We retrospectively reviewed patients who underwent colonoscopy performed by four endoscopists with popular music. Colonoscopy performance outcomes, such as insertion time, adenoma detection rate (ADR), and polyp detection rate (PDR), were compared between the music and non-music groups. To reduce selection bias, propensity score matching was used. RESULTS: After one-to-one propensity score matching, 169 colonoscopies were selected from each group. No significant differences in insertion time (4.97 vs 5.17 min, P = 0.795) and ADR (39.1% vs 46.2%, P = 0.226) were found between the two groups. Subgroup analysis showed that the insertion time (3.6 vs 3.8 min, P = 0.852) and ADR (51.1% vs 44.7%, P = 0.488) did not significantly differ between the two groups in experts. However, in trainees, PDR (46.9% vs 66.7%, P = 0.016) and ADR (25.9% vs 47.6%, P = 0.006) were significantly lower in the music than in the non-music group. CONCLUSION: The current study found that listening to music during colonoscopy did not affect procedure performance. Moreover, it suggested that music may distract trainees from appropriately detecting adenomas and polyps.

The association between urinary cotinine level and metabolic syndrome profiles among adolescents: findings from the Ewha Birth and growth study.

BACKGROUND: Secondhand smoke (SHS) exposure among adolescents who are still developing can negatively affect their physical and psychological health, including metabolic syndrome (MetS), which is a risk factor for cardiovascular disease. However, the relationship between exposure to SHS and MetS in adolescence has not been evaluated. METHODS: A total of 240 subjects aged 13-15 years who were followed up in the Ewha Birth and Growth Study were included in this study. Using the urinary cotinine level, the participants' exposure to SHS was divided into tertiles, and the continuous MetS score (cMetS) and its components were compared among the three groups using a generalized linear model and trend analysis. Univariate and multivariate linear regression analyses were performed. We adjusted for several confounding variables including sex, father's education level, father's current alcohol consumption status, moderate physical activity, and overweight status. RESULTS: The association between cMetS and the urinary cotinine level was not significant. However, the higher the urinary cotinine level, the lower the high-density lipoprotein cholesterol (HDL-C) level. In particular, the significance of the HDL-C level was maintained after adjusting for covariates. CONCLUSIONS: This study supports an association between SHS exposure and the components of MetS in adolescents aged 13-15 years, and it suggests the need to address SHS exposure in adolescents to reduce the cardiovascular risk in later life.

Synergistic effect of serum uric acid and body mass index trajectories during middle to late childhood on elevation of liver enzymes in early adolescence: Findings from the Ewha Birth and Growth Study.

BACKGROUND/OBJECTIVES: We aimed to determine whether serum uric acid (SUA) and body mass index (BMI) trajectories in childhood have longitudinal association with liver enzymes in adolescence. METHODS: We conducted a study using data from the Ewha Birth and Growth Cohort. Individual trajectories of SUA (n = 203) and BMI (n = 206) from 5, 7, and 9 years were defined by group-based trajectory modeling. Also, liver function enzymes were collected at 11 to 12 year of age (Aspartate Aminotransferase [AST], Alanine transaminase [ALT], and Gamma-glutamyl transferase [γ-GTP]) (n = 206). Using a generalized linear model, the effects of SUA trajectory and BMI trajectory on liver function enzymes were assessed. We also assessed the interaction effect of SUA and BMI trajectories on liver enzymes. RESULTS: For trajectory patterns, both SUA and BMI were classified into two distinct groups (High or Low). Both trajectory of SUA and BMI in childhood were positively associated with levels of liver enzymes at 11-12 years of age. The results showed that the combined effect of SUA and BMI trajectories on liver enzymes had a higher means in high-risk group (high SUA-high BMI trajectories group) than in low-risk group (low SUA-low BMI trajectories group) for ALT and γ-GTP, respectively. It remained significant association when adjusted for covariates. In addition, the interaction of BMI and SUA trajectories showed a significant synergistic effect. CONCLUSION: Elevated childhood SUA and BMI trajectories are associated with increased liver enzymes in beginning of adolescent. This finding suggesting that early interventions in SUA and BMI may need for optimization of liver enzymes as potential marker for development of related disease in later life.

The effect of biological agent on body composition in patients with Crohn's disease.

BACKGROUND: Crohn's disease (CD) is associated with altered body composition, affecting clinical outcomes. We evaluated the impact of biologics on body composition in CD patients. METHODS: This multicenter longitudinal study across four Korean university hospitals conducted from January 2009 to August 2021 retrospectively reviewed data of CD patients with abdominal computed tomography (CT) before and after the biologic treatment. Skeletal muscle area (SMA), visceral fat area (VFA), and subcutaneous fat area (SFA) of the third lumbar vertebra (L3) on CT were measured. Myopenia was defined as L3 skeletal muscle index (SMI) of < 49 and < 31 cm2/m2 for men and women, respectively. RESULTS: Among 112 participants, 79 (70.5%) had myopenia. In the myopenia group, all body composition parameters were significantly increased after the biologic treatment: SMI (37.68 vs. 39.40 cm2/m2; P < 0.001), VFA (26.12 vs. 54.61 cm2; P < 0.001), SFA (44.29 vs. 82.42 cm2; P < 0.001), while no significant differences were observed in the non-myopenia group. In multivariate analysis, penetrating CD (hazard ratio, 5.40; P = 0.020) was the independent prognostic factor for surgery. Operation-free survival rate tended to decrease in the myopenia group (Log-rank test, P = 0.090). CONCLUSIONS: Biological agents can increase all body composition parameters in CD patients with myopenia. These patients are more likely to experience surgery.

Distributions of 11-loci HLA alleles typed by amplicon-based next-generation sequencing in South Koreans.

The range of HLA typing for successful hematopoietic stem cell transplantation (HSCT) is gradually expanding with the next-generation sequencing (NGS)-based improvement in its quality. However, it is influenced by the allocation of finances and laboratory conditions. HLA-A, -B, -C, -DRB1/3/4/5, -DQA1, -DQB1, -DPA1, and -DPB1 alleles were genotyped at the 3-field level by amplicon-based NGS using MiSeqDx system and compared to our previous study employing long-range PCR and NGS using TruSight HLA v2 kit, in healthy donors from South Korea. Exon 2, exons 2/3, exons 2/3/4 or 5 of 11-loci were amplified by multiplex PCR. The sequence reads of over 53 depth counts were consistently obtained in each sample exon, depending on the target exon determined to match the reference sequence contained in the IPD-IMGT/HLA Database. HLA alleles were investigated by combinations of the determined exons. A total of 18 alleles with a frequency over 10% were found at the 11 HLA loci. Three ambiguities of HLA-A, -C, and -DRB1 were resolved. We observed a total of 26 HLA-A ~ C ~ B and 6 HLA-DRB1 ~ DQA1 ~ DQB1 ~ DPA1 ~ DPB1 haplotypes having significant linkage disequilibrium between alleles at all neighboring HLA loci. This result was compatible with the previous one, using TruSight HLA v2 kit. Advantages are simple and short progress time because one plate is used for each PCR step in one PCR machine and 11-loci HLA typing is possible even if only eight samples. These data suggested that expanded 11-loci HLA typing data by amplicon-based NGS might help perform HSCT.

BMI trajectory and inflammatory effects on metabolic syndrome in adolescents.

BACKGROUND: Various life course factors can affect susceptibility to diseases during adolescence and adulthood, and those relationships are complex. However, few studies have assessed the potential mediating factors. Therefore, we assessed the mediating effects of factors related to growth and inflammation between perinatal factors and metabolic syndrome risk during adolescence. METHODS: The study was conducted on adolescents who participated in the follow-up in the Ewha Birth and Growth Cohort. We considered the ponderal index (PI) as a perinatal factor and the continuous metabolic syndrome score (cMetS) as the outcome and confirmed the mediating effects of body mass index (BMI) trajectory pattern in childhood and inflammation levels by using the PROCESS macro for SAS. RESULTS: Although the direct effect of BMI trajectory on the relationship between PI and cMetS was not significant (0.545), the indirect effect was significant (1.044). In addition, the indirect effect was statistically significant in the pathways mediating the BMI trajectory pattern and inflammation (ß = 1.456). CONCLUSIONS: The direct and indirect effects on the relationship between PI and cMetS suggest that childhood factors related to growth may be involved in disease susceptibility. Therefore, appropriate interventions for the management of obesity during the growth phase are necessary. IMPACT: Unlike other existing studies, this study assessed multiple mediating effects by considering the BMI trajectory pattern and inflammatory indexes as mediating factors between the ponderal index and the continuous metabolic syndrome score during adolescence. We found significant indirect effects of the BMI trajectory between PI and cMetS, and also significant indirect effects in the pathways mediating the BMI trajectory and hs-CRP. The significant indirect mediating effects support that childhood factors related to growth may be involved in disease susceptibility.

Loss to follow-up after direct-to-implant breast reconstruction.

Loss to follow-up is inevitable in retrospective cohort studies, and patients are lost to follow-up after direct-to-implant reconstruction despite annual follow-up recommendation. We analyzed more than 500 patients to analyze the rate of loss to follow-up to plastic surgery and to investigate the factors affecting it. A retrospective review of patients who underwent direct-to-implant reconstruction between July 2008 and August 2016 was performed. Loss to follow-up to plastic surgery was defined as a difference of ≥24 months between the total and plastic surgery follow-up. The rate of loss to follow-up and associated factors including patients' demographics, surgery-related variables, oncological data, and early and late complications were analyzed. Of 631 patients who underwent direct-to-implant reconstruction, 551 patients continued visiting the hospital for breast cancer-related treatment. Of the 527 patients who were eligible for the study, 157 patients (29.8%) were lost to plastic surgery follow-up. Surgery-related variables, early complications, cancer stage, and adjuvant therapies were not significantly different. Younger age was significantly associated with loss to follow-up in univariate analysis. However, logistic regression revealed that a long total follow-up period, distant metastasis, and absence of late elective complications were significant factors contributing to follow-up loss. Late elective complications such as malposition, capsular contracture, and mastectomy flap thinning were more common in the follow-up group (48%) than in the loss to follow-up group (22%). Follow-up loss after direct-to-implant reconstruction was not associated with specific demographic or surgery-related variables, and postoperative courses significantly affected the loss to follow-up.

Outcomes of smooth round implant-based immediate breast reconstruction: Long-term follow-up results.

The issue of breast implant-associated anaplastic large cell lymphoma in 2019 has resulted in the discontinuation of textured breast implants and resumption in the use of smooth round implants. However, in the field of breast reconstruction, long-term follow-up data for direct-to-implant reconstruction using smooth round implants is insufficient. This retrospective study aimed to evaluate the long-term outcomes of breast reconstruction using smooth round implants. This study included 185 patients (208 breasts) who underwent smooth round implant-based immediate breast reconstruction between 2007 and 2018. Their demographic information and surgical and oncological data were collected. Early (within 90 days) and late (after 90 days) complications, reoperations, implant maintenance, and the survival rate were analyzed to evaluate the long-term outcomes and identify the related factors. The mean follow-up period was 112.08 months. The most common early complications were skin necrosis (9.13%) and infection (3.85%). The factors influencing the development of early complications were the mastectomy specimen weight (237.14 ± 114.84 cc and 298.04 ± 141.53 cc for no complication and any complication, respectively; p = 0.0123) and implant volume (222.79 ± 77.76 cc and 264.48 ± 89.03 cc for no complication and any complication, respectively; p = 0.0082). The most common late complication was capsular contracture (13.46%). Approximately 91.35% of the implants were maintained during the follow-up period. The factors affecting the development of early complications and implant maintenance were the mastectomy specimen weight and implant volume. This study provides information on long-term follow-up results useful in cases where only smooth round implants are available, which can then serve as a basis for future related studies.

Effect of a hybrid team-based advanced cardiopulmonary life support simulation program for clinical nurses.

BACKGROUND: During in-hospital cardiac arrest events, clinical nurses are often the first responders; therefore, nurses require sufficient advanced cardiac life support (ACLS) competency. This study aimed to verify the effects of a hybrid team-based ACLS simulation (HTAS) program (developed in this study) on nurses' ACLS performance, specifically ACLS knowledge, cardiopulmonary resuscitation (CPR) self-efficacy, and CPR-related stress. METHODS: The developed HTAS comprised four lecture videos, one team-based skills training video, and a team-based ACLS simulation. A quasi-experimental pretest-posttest design with a comparison group (CG) was used to evaluate the effectiveness of the HTAS. Of the 226 general ward nurses with more than 6 months of clinical experience, 117 were allocated to the intervention group (IG), which attended the HTAS, and 109 to the CG, which attended only basic ACLS training. RESULTS: The IG's ACLS performance significantly improved (t = 50.8, p < 0.001) after the training. Relative to the respective pretest conditions, posttest ACLS knowledge (t = 6.92, p < 0.001) and CPR self-efficacy (t = 6.97, p < 0.001) of the IG also significantly increased. However, when the mean difference values were compared, there was no significant difference between the two groups with respect to ACLS knowledge (t = 1.52, p = 0.130), CPR self-efficacy (t = -0.42, p = 0.673), and CPR stress (t = -0.88, p = 0.378). CONCLUSION: The HTAS for ward nurses was effective at enhancing the nurses' ACLS performance. It is necessary to develop effective training methods for team-based ACLS and verify the sustained effects of such training.

Multimorbidity adjusted years lost to disability rates calculated through Monte-Carlo simulation in Korea.

OBJECTIVES: OBJECTIVES: To efficiently utilize limited health and medical resources, it is necessary to accurately measure the level of health, which requires estimating the multimorbidity-corrected burden of disease. METHODS: METHODS: This study used 2015 and 2016 data from the National Health Insurance Service, and employed the list of diseases defined in a Korean study of the burden of disease, the criteria for prevalence, and the "cause-sequelae-health state" disease system. When calculating the years lost to disability (YLD), multimorbidity was corrected using Monte-Carlo simulation. RESULTS: RESULTS: Correcting for multimorbidity changed YLD at all ages in Korea by -1.2% (95% confidence interval [CI], -24.1 to 3.6) in males and -12.4% (95% CI, -23.0 to 0.3) in females in 2015, and by -10.8% (95% CI, -24.1 to 4.6) in males and -11.1% (95% CI, -22.8 to 1.7) in females in 2016. The YLD rate for non-communicable diseases in males decreased more than that of other disease groups in both years, by -11.8% (95% CI, -19.5 to 3.6) and -11.5% (95% CI, -19.3 to -3.0), respectively. The overall YLD rate changed by -1.3% in the 5-year to 9-year age group, and the magnitude of this change remained similar until the 10-19-year age group, gradually decreased after 20 years of age, and steeply increased to more than 10% in those aged 60 and older. RESULTS: CONCLUSIONS: Calculations of YLD should adjust for multimorbidity, as the disease burden can otherwise be overestimated for the elderly, who tend to exhibit a high prevalence of multimorbidity.

Exploring the Health and Social Needs of Community Residents Using an Online Community Care Platform: Linkage to the International Classification of Functioning, Disability, and Health.

OBJECTIVES: This study aimed to analyze the outcomes of the Comprehensive Health and Social Need Assessment (CHSNA) system, which identifies community residents' health and social needs, and to link these needs with the International Classification of Functioning, Disability, and Health (ICF). METHODS: Adult community residents in a metropolitan city in Korea were recruited. They were asked to assess their health and social needs via the CHSNA system, which was integrated into an online community-care platform. Three assessment steps (basic health assessment, needs for activities of daily living, and in-depth health assessment) associated with five ICF components were used to evaluate physical health impairment, difficulties in activities and participation, and environmental problems. The final list of health and social needs was systematically linked to the domains and categories of the ICF. Only data from participants who completed all three assessment steps were included. RESULTS: Wide ranges of impairments and difficulties regarding the daily living activities, physical health, and environmental status of the community were recorded from 190 people who completed assessments of their health and social needs by the CHSNA system. These participants reported various health and social needs for their community life; common needs corresponded to the ICF components of body functions and activities/participation. CONCLUSIONS: The ICF may be suitable for determining the health-related problems and needs of the general population. Possible improvements to the present system include providing support for completing all assessment steps and developing an ICF core set for an enhanced understanding of health and social needs.

Relationship between multidimensional stressors and quality of life in people with stroke.

This study explored the impact of intrapersonal (stroke severity, physical dysfunction, and fear of stroke recurrence), interpersonal (loneliness), and extrapersonal (economic status) stressors on the quality of life of people with stroke. A correlational cross-sectional research design was employed. This study was based on Betty Neuman's systems theory. One hundred thirty-nine people with stroke were recruited from 10 hospitals in South Korea. Data were collected from January to February 2020 using a structured questionnaire. Data were analyzed using descriptive statistics, independent t-test, one-way analysis of variance, Scheffé test, Pearson's correlation coefficients, Spearman's correlation coefficients, and hierarchical multiple regression analysis. Stroke severity had the strongest association with quality of life among people with stroke, followed by loneliness and fear of stroke recurrence. These variables accounted for approximately 77% of the variance in the quality of life. Stroke severity, loneliness, and fear of stroke recurrence should be systematically monitored to enhance the quality of life in people with stroke. Additionally, a detailed intervention that considers all these stressors must be developed, and its effectiveness must be verified through further research.

The HLA-B*07:457 allele identified in a volunteer donor for hematopoietic stem cell transplant.

HLA-B*07:457 differs from HLA-B*07:02:01:01 in codon 117 in exon 3.