The Effect of COVID-19 Outbreak and Incidence on the Health-Related Behaviors and Depression of Gyeongnam Residents in Republic of Korea.

Background and Objectives: This study aimed to investigate whether the occurrence of COVID-19 brought about changes in the health behaviors and depression levels of residents in Gyeongnam in Republic of Korea, and whether the prevalence of COVID-19 was related to differences in health behaviors and depression levels among different regions. Materials and Methods: The researchers utilized raw data from the 2019-2020 Community Health Survey in Gyeongnam and conducted analyses using SPSS 25.0. The study included a total of 35,880 participants from 18 cities and counties in the Gyeongnam region (17,942 participants in 2019 and 17,938 participants in 2020). Results: The results of the comparative analysis between pre- and post-COVID-19 occurrence showed that, after the occurrence of COVID-19, the smoking cessation rate and monthly alcohol consumption rate among current smokers decreased, while the high-risk drinking rate increased. The rate of physical activity (walking) increased, but the prevalence of depression experiences and depressive symptoms also increased. Furthermore, the comparative analysis between areas with a higher number of COVID-19 cases and those with a lower number of cases revealed that areas with a higher number of cases had higher monthly alcohol consumption rates, as well as a higher prevalence of depression experiences and depressive symptoms. Conclusions: Considering that the occurrence and severity of COVID-19 had significant impacts on the health behaviors and depression levels of residents in Gyeongnam, this highlights the need for active intervention and management by the national and local governments in response to the occurrence and management of infectious diseases, including COVID-19, to address the health status and health behaviors of the local population.

Translation and validation of the Korean version of the Sarcopenia Quality of Life (SarQoL-K®) questionnaire and applicability with the SARC-F screening tool.

PURPOSE: The purpose of this paper was to translate and validate into the Korea language and setting the Sarcopenia Quality of Life (SarQoL®) questionnaire. METHODS: The participants consisted of 450 individuals in Namgaram-2 cohort who were followed up in 2019-2020. The study participants were divided into four groups: (1) SARC-F < 4, (2) SARC-F ≥ 4 and robust grip strength, (3) SARC-F ≥ 4, low grip strength, robust muscle mass, (4) SARC-F ≥ 4, low grip strength, and low muscle mass. To assess construct validity, population with sarcopenia-associated symptoms (SARC-F ≥ 4) apart from the Korean SarQoL (SarQoL-K®) completed the Korean versions of two generic questionnaires, the Short Form-36 and the EuroQoL 5-dimension. To validate the Korean SarQoL®, we assessed its validity (discriminative power, construct validity), reliability (internal consistency, test-retest reliability), and floor/ceiling effects. RESULTS: The SarQoL-K® questionnaire was translated without major difficulties. The mean SarQoL-K scores were 72.9 (95%, CI; 71.2-74.6) in SARC-F < 4, 54.6 (95%, CI; 50.7-58.3) in SARC-F ≥ 4 and robust grip strength, 47.0 (95%, CI; 43.8-50.1) in SARC-F ≥ 4, low grip strength, robust muscle mass, 46.6 (95%, CI; 43.0-50.1) in SARC-F ≥ 4, low grip strength, and low muscle mass. The results indicated good discriminative power across each four groups (p < 0.001), high internal consistency (Cronbach's alpha of 0.866), and excellent test-retest reliability (ICC = 0.977, 95% CI 0.975-0.979). No floor- or ceiling-effects were observed. CONCLUSIONS: This is the first study to confirm the reliability and validity of the Korean version of the SarQoL®. We demonstrated that the population with sarcopenia-associated symptoms (determined using the SARC-F questionnaire) has a lower quality of life.

Disability, Frailty and Depression in the community-dwelling older adults with Osteosarcopenia.

BACKGROUND: The purpose of this study was to investigate the prevalence of osteosarcopenia in the over 60-year-old community and to evaluate whether osteosarcopenia is associated with disability, frailty and depression. METHODS: This study was performed using the baseline data of Namgaram-2, among the 1010 surveyed subjects, 885 study subjects who were 60 years or older and had all necessary tests performed were selected. The Kaigo-Yobo checklist (frailty), World Health Organization Disability Assessment Schedule (WHODAS) and Geriatric Depression Scale-Short Form-Korean (GDSSF-K) were used. The Asian Working Group for Sarcopenia (AWGS 2019) were applied in this study. Osteopenia was measured using data from dual energy X-ray absorptiometry (DEXA) and osteopenia was diagnosed when the T-score was less than - 1.0. The study subjects were divided into four groups: the normal group, in which both sarcopenia and osteopenia were undiagnosed, osteopenia only, sarcopenia only and the osteosarcopenia group, which was diagnosed with both sarcopenia and osteopenia. RESULTS: Of the 885 subjects over 60 years old evaluated, the normal group comprised 34.0%, the only osteopenia group 33.7%, the only sarcopenia group 13.1%, and the osteosarcopenia group 19.2%. WHODAS (17.5, 95% CI: 14.8-20.1), Kaigo-Yobo (3.0, 95% CI: 2.6-3.4), and GDSSF mean score (4.6, 95% CI: 3.9-5.4) were statistically significantly higher in the osteosarcopenia group compared the other groups. Partial eta squared (ηp2) of WHODAS (0.199) and Kaigo-Yobo (0.148) values ​​according to Osteosarcopenia were large, and GDSSF (0.096) was medium CONCLUSIONS: Osteosarcopenia is a relatively common disease group in the older adults community that may cause deterioration of health outcomes. Therefore, when evaluating osteopenia or sarcopenia in the older adults, management of those in both disease groups should occur together.

The relationship between extracellular water-to-body water ratio and sarcopenia according to the newly revised Asian Working Group for Sarcopenia: 2019 Consensus Update.

OBJECTIVE: The purpose of this study was to evaluate the association between sarcopenia and extracellular water-to-total body water ratio (ECW/TBW), one of the results of bioimpedance that can be easily measured in communities, following the recent revision of the Asian Working Group for Sarcopenia. METHODS: This study data were extracted from the baseline data of Namgaram-2. Among the surveyed subjects, 885 persons aged 60 years or older were selected as study subjects. All surveys were conducted on a one-on-one interview basis; blood tests, physical function evaluations (hand grip strength, short physical performance battery; SPPB), and dual-energy X-ray absorptiometry (DEXA) and bioimpedance were also conducted. The Asian Working Group's revised definition of sarcopenia was applied. ECW/TBW was one of the results of bioimpedance this study. RESULTS: A high ECW/TBW was 1.63 times higher in the low grip strength group than in the robust group (P = 0.017) and was 2.13 times higher in the low SPPB group compared to the robust group (P < 0.001). ECW/TBW higher than 0.391 was 2.17 times more likely to occur in sarcopenic patients compared to the robust group (P < 0.001). In addition, ECW/TBW lower than 0.391 was 3.65 times more likely to occur in severely sarcopenic patients compared to the robust group (P = 0.002). CONCLUSION: The ECW/TBW may be one of the valid research tools to evaluate the strength and physical performance of the elderly. In addition, it is expected to be one of the effective indicators for tracking physical function under newly revised sarcopenia criteria.

Role of Solvation on Diffusion of Ions in Diblock Copolymers: Understanding the Molecular Weight Effect through Modeling.

Salt-doped diblock copolymers with microphase-separated domains of both an ion conductive and a mechanically strong polymer have been extensively studied due to their potential in transport applications. Several unusual or counterintuitive trends regarding their transport properties have been observed experimentally, such as increasing ion conduction as a function of molecular weight. A crucial feature of these systems is the strong solvation of ions in the conducting microphase due to its higher dielectric constant. Here, we perform molecular dynamics simulations using a coarse-grained model that includes a 1/r4 potential form to generically represent ion solvation, allowing us to reproduce experimentally observed trends and explore their molecular underpinnings. We find that increasing ion concentration can increase or decrease ion diffusion, depending on solvation strength. We also show that the trend of increasing diffusion with molecular weight becomes more dramatic as ions are solvated in one polymer block more strongly or as the ion-ion interactions get stronger. In contrast to expectations, the interfacial width or the overlap of ions with the nonconductive polymer block does not adequately explain this phenomenon; instead, local ion agglomeration best explains reduced diffusion. Interfacial sharpening, controlled by the Flory χ parameter and molecular weight, tends to allow ions to spread more uniformly, and this increases their diffusion.

Ion Correlation Effects in Salt-Doped Block Copolymers.

We apply classical density functional theory to study how salt changes the microphase morphology of diblock copolymers. Polymers are freely jointed and one monomer type favorably interacts with ions, to account for the selective solvation that arises from different dielectric constants of the microphases. By including correlations from liquid state theory of an unbound reference fluid, the theory can treat chain behavior, microphase separation, ion correlations, and preferential solvation, at the same coarse-grained level. We show good agreement with molecular dynamics simulations.

Intradomain Textures in Block Copolymers: Multizone Alignment and Biaxiality.

Block copolymer (BCP) melt assembly has been studied for decades, focusing largely on self-organized spatial patterns of periodically ordered segment density. Here, we demonstrate that underlying the well-known composition profiles (i.e., ordered lamella, cylinders, spheres, and networks) are generic and heterogeneous patterns of segment orientation that couple strongly to morphology, even in the absence of specific factors that promote intra or interchain segment alignment. We employ both self-consistent field theory and coarse-grained simulation methods to measure polar and nematic order parameters of segments in a freely jointed chain model of diblock melts. We show that BCP morphologies have a multizone texture, with segments predominantly aligned normal and parallel to interdomain interfaces in the respective brush and interfacial regions of the microdomain. Further, morphologies with anisotropically curved interfaces (i.e., cylinders and networks) exhibit biaxial order that is aligned to the principal curvature axes of the interface.

Effect of sequence dispersity on morphology of tapered diblock copolymers from molecular dynamics simulations.

Tapered diblock copolymers are similar to typical AB diblock copolymers but have an added transition region between the two blocks which changes gradually in composition from pure A to pure B. This tapered region can be varied from 0% (true diblock) to 100% (gradient copolymer) of the polymer length, and this allows some control over the microphase separated domain spacing and other material properties. We perform molecular dynamics simulations of linearly tapered block copolymers with tapers of various lengths, initialized from fluids density functional theory predictions. To investigate the effect of sequence dispersity, we compare systems composed of identical polymers, whose taper has a fixed sequence that most closely approximates a linear gradient, with sequentially disperse polymers, whose sequences are created statistically to yield the appropriate ensemble average linear gradient. Especially at high segregation strength, we find clear differences in polymer conformations and microstructures between these systems. Importantly, the statistical polymers are able to find more favorable conformations given their sequence, for instance, a statistical polymer with a larger fraction of A than the median will tend towards the A lamellae. The conformations of the statistically different polymers can thus be less stretched, and these systems have higher overall density. Consequently, the lamellae formed by statistical polymers have smaller domain spacing with sharper interfaces.

Fluids density functional theory and initializing molecular dynamics simulations of block copolymers.

Classical, fluids density functional theory (fDFT), which can predict the equilibrium density profiles of polymeric systems, and coarse-grained molecular dynamics (MD) simulations, which are often used to show both structure and dynamics of soft materials, can be implemented using very similar bead-based polymer models. We aim to use fDFT and MD in tandem to examine the same system from these two points of view and take advantage of the different features of each methodology. Additionally, the density profiles resulting from fDFT calculations can be used to initialize the MD simulations in a close to equilibrated structure, speeding up the simulations. Here, we show how this method can be applied to study microphase separated states of both typical diblock and tapered diblock copolymers in which there is a region with a gradient in composition placed between the pure blocks. Both methods, applied at constant pressure, predict a decrease in total density as segregation strength or the length of the tapered region is increased. The predictions for the density profiles from fDFT and MD are similar across materials with a wide range of interfacial widths.

Association between Disability and Edema Index Values in Rural Older Adult Osteosarcopenia Patients.

PURPOSE: This study analyzed the relationship between degree of disability and edema index [extracellular water/total body water (ECW/TBW) ratio] values in a rural population of older adult patients with osteopenia, sarcopenia, or osteosarcopenia (OS). MATERIALS AND METHODS: This study used data from the Namgaram-2 cohort. The degree of disability was measured using the World Health Organization Disability Assessment Schedule (WHODAS) 12, and ECW/TBW ratio was calculated using bioelectrical impedance analysis. Based on ECW/TBW ratio, the participants were stratified into normal (<0.391) and abnormal (≥0.391) groups, and the mean WHODAS 12 scores were compared between the two groups. Multiple regression analysis corrected for demographic factors, smoking history, hypertension, diabetes, and serological test results was also conducted. RESULTS: Significant differences in mean WHODAS 12 scores were observed in the healthy group (5.8±7.4 vs. 9.2±9.7, p=0.008), the osteopenia only group (7.4±8.7 vs. 12.9±12.0, p<0.001), and the OS group (16.0±13.2 vs. 23.1±17.1, p=0.004). However, no significant difference in mean WHODAS 12 score was observed in the sarcopenia only group (14.9±13.4 vs. 20.7±14.8, p= 0.051). There were significant differences in ECW/TBW ratio values between the abnormal and normal groups in the osteopenia only group (B=4.646 and p=0.001), the sarcopenia only group (B=5.097 and p=0.016), and the OS group (B=5.653 and p=0.043). CONCLUSION: This study found that the degree of disability is related to the edema index in older patients with osteopenia, sarcopenia, or OS. Since the edema index indicates the nutritional status of an individual, proper nutrition and fluid intake are important to reduce disability.

Factors Affecting the Timing of a Central Line Associated Bloodstream Infection Onset in Children with Cancer.

PURPOSE: The purpose of this study is to identify controllable treatment-environment-related factors affecting the timing of a central line-associated bloodstream infection (CLABSI) onset in children with cancer with central venous catheters (CVC). DESIGN: This study is a secondary data analysis with the data extracted from electronic medical records in a tertiary hospital in South Korea. This study was conducted by reviewing electronic medical records of 470 pediatric cancer patients younger than the age of 18 years from 2010 to 2016. METHOD: The timing of a CLABSI onset was identified through the onset of CLABSI and the duration of catheterization. Cox proportional hazards regression analysis was used to estimate the impact of variables on the timing of CLABSI onset. The duration of catheterization was estimated using the Kaplan-Meier method. FINDING: Multivariable analysis by Cox proportional model analysis showed that there are six independent variables affecting the timing of a CLABSI onset: length of stay in hospital, catheter insertion location, use of antibiotics on day of catheter insertion, catheter function, number of blood transfusions per 100 days, and number of blood tests per 100 days. CONCLUSIONS: The findings of this study provide a foundation for the development of EBP-based CVC guidelines to effectively reduce CLABSIs and maintain a long-term CVC without a CLABSI.

Association of the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) with Muscle Strength in Community-Dwelling Elderly with Knee Osteoarthritis.

PURPOSE: The purpose of this study was to evaluate the correlation between muscle strength and knee symptoms (pain, stiffness, and functional limitation) regardless of the presence of radiologic knee osteoarthritis (RKOA) in community-dwelling elderly. PATIENTS AND METHODS: This cross-sectional study used data from the Namgaram-2 cohort. The Namgaram-2 cohort consisted of participants living in three rural communities. Such participants were included for studies on activity limitation due to age-related musculoskeletal disorders including knee osteoarthritis, osteoporosis, and sarcopenia. The Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC), a health assessment tool for patients with arthritis in lower extremities, was used to assess health-related quality of life (HRQOL). Muscle strengths were measured by knee strength (by using the isokinetic dynamometer) and hand grip strength. RESULTS: The WOMAC pain of Kallgren-Lawrence (K/L) grade < 2 was correlated with age, grip strength, nutrition status, and knee extension 180 peak torque. The WOMAC pain of K/L grade ≥ 2 was correlated with age, nutrition status, and knee extension 60 peak torque. The WOMAC stiffness of K/L grade < 2 was correlated with having a spouse, nutrition status, and knee extension 60 peak torque. The WOMAC stiffness of K/L grade ≥ 2 was correlated with knee extension 60 peak torque. The WOMAC function of K/L grade < 2 was correlated with age, grip strength, osteoporosis, nutrition status, and knee extension 180 peak torque. The WOMAC function of K/L grade ≥ 2 was correlated with age, nutrition status, and knee extension 60 peak torque. CONCLUSION: Muscle strength as measured by grip strength and knee extension was statistically significantly correlated with the WOMAC scores in patients with knee symptoms regardless of whether radiologic signs of knee osteoarthritis were observed.

The Association between Frailty and Disability among the Elderly in Rural Areas of Korea.

BACKGROUND: The rapid increase in the elderly population in Korea is associated with an expanded burden of health problems. The purpose of this study was to investigate the association between frailty and physical disability among Koreans using the frailty index, which was developed to assess health conditions in elderly people. METHODS: We included 503 elderly people from the Namgaram-II cohort. We used the Korean version of the Kaigo-Yobo checklist as our frailty assessment tool. For the disability assessment tool, we used the Korean version of the 12-item World Health Organization Disability Assessment Schedule (WHODAS-12). We fit multiple linear regression models for men and women for each section. Our models also included variables for musculoskeletal diseases that are known to be associated with frailty, such as sarcopenia, osteoporosis, and radiologic knee osteoarthritis. RESULTS: After correcting for social demographic characteristics, blood profiles, high blood pressure, and diabetes, the Kaigo-Yobo results showed a significant difference in frailty between men (1.53 ± 0.74) and women (2.60 ± 0.77), and WHODAS-12 also showed a significant difference between men (6.59 ± 5.08) and women (15.99 ± 5.70). After correcting for social demographic characteristics, blood profiles, high blood pressure, and diabetes, Kaigo-Yobo and WHODAS-12 were significantly associated with each other among both men (ß = 2.667) and women (ß = 3.200) (p < 0.001). CONCLUSIONS: The study results show an association between frailty and disability among elderly people in rural areas. Therefore, prevention should occur at the pre-frailty stage of a person's life to prevent further disability. Also, disability welfare programs should be provided to elderly people who present with frailty.

Diffusion of Selective Penetrants in Interfacially Modified Block Copolymers from Molecular Dynamics Simulations.

To show the influence of the interface on structure and dynamics of microphase separated polymer systems, we study interfacially modified AB block copolymers with small molecule penetrants. The polymers have a random midblock or tapered midblock whose composition varies from pure A to pure B (or from pure B to pure A for an inverse taper) between two pure blocks of A and B. We perform simple coarse-grained molecular dynamics simulations of symmetric polymers that form lamellae. With normal tapering, both polymer and penetrant diffusion parallel to the lamellae increases as taper length increases. Inverse tapered polymers exist in different conformational states (e.g., stretched vs folded back and forth across the interface) with different dynamic behavior, leading to nonmonotonic trends in their diffusion. However, the local mixing of monomers (rather than polymer conformation) appears to be the most important factor in determining penetrant diffusion.