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Polycystic ovary syndrome (PCOS) is a common disease that has an effect on approximately 10% of women of childbearing age. Although there is evidence regarding the role of lifestyle factors in the development of PCOS, the exact etiology remains unclear. Additionally, metformin is used in the treatment of PCOS but its role remains unclear. We compared the effects of lifestyle modification (LSM) + metformin and metformin alone on PCOS. We performed a systematic review by searching electronic databases for publications until December 2019. The primary endpoints were clinical outcomes, such as menstrual cycles and pregnancy rates, and the secondary endpoints were anthropometric, metabolic, and androgenic parameters. The meta-analysis revealed that there was no significant difference in the improvements in the menstrual cycles between LSM and metformin alone (weighted mean difference [MD] = 1.62) and between LSM + metformin and LSM (MD = 1.20). The pregnancy rates and body mass indices were not significantly different between LSM and metformin alone (MD = 1.44 and −0.11, respectively). LSM reduced insulin resistance (MD = −0.52) and increased serum levels of sex hormone-binding globulins (MD = 8.27) compared with metformin. Therefore, we suggest recommending lifestyle modifications actively to women with PCOS if they do not have indications for metformin.

Background Knee osteoarthritis (OA) is a leading cause of disability, with current treatment options often falling short of providing satisfactory outcomes. Autologous-cultured adipose-derived mesenchymal stem cells (ADMSCs) and stromal vascular fractions (SVFs) have emerged as potential regenerative therapies. Methods A comprehensive search was conducted among multiple databases for studies up to June 2023. The risk of bias was assessed in randomized and non-randomized studies, adhering to PRISMA guidelines. The study has been registered with PROSPERO (CRD 42023433160). Results Our analysis encompassed 31 studies involving 1,406 patients, of which, 19 studies with 958 patients were included in a meta-analysis, examining both SVF and autologous-cultured ADMSC methods. Significant pain reduction was observed with autologous-cultured ADMSCs starting at 3 months (MD = −2.43, 95% CI, −3.99, −0.86), whereas significant pain mitigation in response to SVF therapy was found to start at 12 months (MD = −2.13, 95% CI, −3.06, −1.21). Both autologous-cultured ADMSCs and SVF provided significant improvement in knee function starting at 12 months (MD = −9.19, 95% CI, −12.48, −5.90 vs. MD = −9.09, 95% CI, −12.67, −5.51, respectively). We found no evidence of severe adverse events linked directly to ADMSC therapy. Conclusion Autologous-cultured ADMSCs offer a promising alternative for more rapid pain relief in knee OA, with both ADMSCs and SVF demonstrating substantial long-term benefits in joint function and cartilage regeneration, in the absence of any severe ADMSC-related adverse events.

(1) Background: Polycystic ovary syndrome (PCOS) is the most common cause of anovulatory infertility and endocrine disorders among women of reproductive age. Previous studies have employed lifestyle interventions to manage anovulatory infertility and endocrine disorders. However, the effect of lifestyle interventions on the metabolic index remains ambiguous; (2) Methods: Data were obtained through a systematic search of the Ovid-Medline, Ovid-EMBASE, and Cochrane Library databases. Two reviewers independently reviewed the literature in two stages. A consensus was achieved through discussions regarding the final selection of the literature; (3) Results: This study observed that the group that underwent lifestyle modifications displayed significant improvement in reproductive function compared to the control group. Combination therapy with diet and exercise resulted in improved fasting insulin levels, compared to monotherapy with diet or exercise. Moreover, moderate weight loss (a minimum of 5%) resulted in an improved metabolic index. The subgroup analysis revealed that the group that underwent lifestyle modifications had a significantly higher number of patients with improved menstrual cycles, compared to the control groups; (4) Conclusions: Lifestyle modification using combination therapy is a promising therapeutic approach that can be employed in the management of PCOS patients with obesity. This scenario warrants further studies with larger sample sizes to develop ideal treatment protocols.

Insomnia is a common sleep disorder, especially among older adults, with a significant impact on the quality of life (QoL) and is associated with various comorbidities. Traditional pharmacotherapy for insomnia is often unsuitable for older adults because of potential drug interactions and side effects, making nonpharmacological interventions such as cognitive behavioral therapy for insomnia (CBT-I) more appropriate. However, delivering CBT-I in a traditional face-to-face setting poses challenges including accessibility and adherence, particularly for older adults. This study aimed to evaluate the effectiveness of an information and communication technology (ICT)-based CBT-I program, \"Smart Sleep,\" specifically designed to improve insomnia among community-dwelling older persons. A single-blind randomized controlled trial was conducted with 59 older participants from Incheon, South Korea. Participants were divided into an intervention group, which used the Smart Sleep mobile app, and a control group. The intervention group received 8 weeks of non-face-to-face CBT-I through the app, which included sleep diaries, relaxation exercises, and real-time consultations. Outcomes were measured at baseline, week 4, and week 8, with a focus on insomnia severity, sleep quality, sleep efficiency, dysfunctional beliefs about sleep, depression, and QoL. The intervention group showed significant improvements in insomnia severity, sleep quality, sleep efficiency, and dysfunctional beliefs about sleep compared to the control group. However, there was no significant difference in the QoL between the 2 groups (F =0.998, P=.37). Participation rates in the Smart Sleep program were high, with a 94% completion rate for sleep diary tasks and 100% participation in real-time consultations. In addition, subgroup analysis based on sleep medication use showed significant improvements in insomnia severity for both medicated and nonmedicated participants. The ICT-based CBT-I program \"Smart Sleep\" effectively improved sleep-related outcomes among older participants, demonstrating the potential of non-face-to-face interventions in managing insomnia in this population. The program is user-friendly, and ICT-based coaching contributed to high engagement. To ensure broader access for older adults, distribution through community welfare or public health centers is recommended. Clinical Research Information Service KCT0007287; https://cris.nih.go.kr/cris/search/detailSearch.do?seq=23344.

Background and Objectives: Falls are a leading cause of morbidity and mortality among older adults in hospitals and long-term care facilities (LTCFs). Digital healthcare approaches are increasingly being applied to fall detection and prevention; however, their effectiveness remains uncertain. This review evaluated the effectiveness, usability, and clinical applicability of detection- and prediction-based systems in institutional settings. Materials and Methods: We systematically searched major international and Korean databases—PubMed, Embase, Ovid-MEDLINE, CINAHL, the Cochrane Library, IEEE, KMbase, KISS, KoreaMed, and RISS—for studies published up to December 2024. The eligible studies included randomized controlled trials, quasi-experimental, and observational studies involving older adults in hospitals or LTCFs. Two reviewers independently screened the studies, extracted data, and assessed their quality using standardized tools. Results: Thirty-three studies comprising 20 fall detection systems and 13 fall prediction models were included. Detection systems using inertial, pressure, radar, or multimodal sensors have improved monitoring and achieved high usability (>80% acceptance); however, they did not consistently reduce fall incidence or the occurrence of injurious falls. For instance, one trial reported a nonsignificant reduction in injurious falls (aRR 0.56, 95% CI 0.17–1.79), whereas another trial observed a nonsignificant increase (aIRR 1.60, 95% CI 0.83–3.08). Frequent false alarms contribute to alarm fatigue. The prediction models showed moderate-to-strong discrimination. Gradient boosting and neural networks performed best for continuous gait features, while regression and boosting approaches were effective for categorical EHR data. Most models lacked external validation and were not linked to clinical care pathways. Conclusions: Digital approaches show potential for fall prevention in hospitals and LTCFs; however, current evidence remains inconsistent and limited. Detection systems improve surveillance but offer limited preventive effects, whereas prediction models demonstrate technical promise without establishing clinical benefits. Future research should refine the technology, validate models externally, and integrate them into patient-centered workflows.

Polycystic ovary syndrome (PCOS) is a common endocrine disorder in women, characterized by hormonal imbalances and metabolic disturbances. Lifestyle modifications, including weight loss, are crucial for the management of PCOS symptoms. Mobile applications have emerged as promising tools to support lifestyle modifications. This study aimed to evaluate the effectiveness of a 12-week integrated lifestyle modification program, which used a mobile application, among overweight women with PCOS. A randomized controlled trial was conducted with 28 participants, who were assigned to either treatment group, which received a 12-week lifestyle modification program facilitated by a mobile application, or the control group, who were instructed to maintain their usual lifestyle and received an evidence-based leaflet containing information on PCOS. The primary outcome measure was a change in weight over 12 weeks. Insulin resistance, levels of sex hormones, hirsutism, acne, and depressive symptoms were measured as secondary outcomes. The results showed significant weight loss in the treatment group compared to the control group (3.19 vs. 0.79 kg; p < 0.05). Similarly, significant improvements were observed across time in postprandial insulin levels (22.25 vs. 9.29 μIU/mL), hirsutism (2.98 vs. −0.16 points), and depression (7.73 vs. 1.7 points) (p < 0.05) between the two groups. This study highlights the potential benefits of using a mobile application to support lifestyle modifications, including weight loss and improvement in depressive symptoms, in overweight women with PCOS. Further research is needed to explore the long-term effects and incorporation of advanced technologies to enhance PCOS management outcomes. Mobile applications for lifestyle modifications offer a promising avenue for addressing the unique challenges faced by women with PCOS and provide accessible and personalized support for their health needs.

Aims To examine the association of nursing hours given to patients with stroke with clinical characteristics to predict the nursing care needs. Design Twenty‐four‐hour observational study Methods Nursing hours per patient day (NHPPD) of 171 stroke patients were measured by 146 nursing personnel who worked on the day of the observation. Cognitive function, balance ability and dependency level were assessed using the Korean version of the Mini‐Mental State Examination (K‐MMSE), the Korean version of the Berg Balance Scale (K‐BBS) and the Korean version of the Modified Barthel Index (K‐MBI), respectively. Results The NHPPD were moderately correlated with K‐MMSE (r = −.450), K‐BBS (r = −.529) and K‐MBI (r = −.549). The worse the cognitive function, balance ability and dependency level, the more were the nursing hours given to the patients. Therefore, these factors can be considered to be factors that predict nursing care needs for patients with stroke.

CD24 is associated with unfavourable prognoses in various cancers, but the prevalence of CD24 expression and its influence on clinical outcome in subtypes of breast cancers remain unclear. CD24 expression was analyzed by immunohistochemistry in 747 breast cancer tissues, and DNA methylation and histone modification status in the promoter region of CD24 were assessed using bisulfite sequencing and chromatin immunoprecipitation assay. 213 (28.5%) samples exhibited high CD24 expression in the membrane and/or cytoplasm of breast cancer cells, and CD24 overexpression was significantly correlated with the presence of lymph node metastasis and more advanced pathological stage. Patients with CD24-high tumours had significantly shorter patient survival than those with CD24-low tumours. Importantly, multivariate analysis that included tumour size, lymph node metastasis and chemotherapy demonstrated that high CD24 expression is independently associated with poorer survival in luminal A and triple-negative breast cancer (TNBC) subtypes. Furthermore, CD24 gene expression was associated with histone acetylation independent of DNA methylation, suggesting its epigenetic regulation in breast cancer. Our results suggest that CD24 overexpression is an independent unfavourable prognostic factor in breast cancer, especially for luminal A and TNBC subtypes, and CD24 may be a promising therapeutic target for specific subtypes of breast cancer.

Watson for Oncology (WfO) is a clinical decision support system driven by artificial intelligence. In Korea, WfO is used by multidisciplinary teams (MDTs) caring for cancer patients. This study aimed to investigate the effect of WfO use on hospital satisfaction and perception among patients cared for by MDTs. This was a descriptive study that used a written survey to gather information from cancer patients at a hospital in Korea. The rate of positive change in patient perception after treatment was 86.8% in the MDT-WfO group and 71.2% in the MDT group. In terms of easily understandable explanations, the MDT-WfO (9.53 points) group reported higher satisfaction than the MDT group (9.24 points). Younger patients in the MDT-WfO group showed high levels of satisfaction and reliability of treatment. When WfO was used, the probability of positive change in patient perception of the hospital was 2.53 times higher than when WfO was not used. With a one-point increase in overall satisfaction, the probability of positive change in patient perception of the hospital increased 1.97 times. Therefore, if WfO is used appropriately in the medical field, it may enhance patient satisfaction and change patient perception positively.

This study aimed to systematically review and analyze factors contributing to caregiver burden among family caregivers of older adults with chronic illnesses in local communities. Specific objectives included exploring the characteristics of older adults with chronic illness and caregiver burden through an extensive literature review and identifying factors influencing caregiver burden in this population. Using Korean (RISS, KISS, and KoreaMed) and international (EMBASE, MEDLINE, CINAHL, and the Cochrane Library) databases, this study employed systematic search methods to identify relevant literature. The inclusion and exclusion criteria were systematically applied in accordance with the PRISMA guidelines, focusing on studies that addressed caregiver burden among family caregivers of older adults with chronic illnesses in local communities. Following the database search, 15,962 articles were identified. After eliminating duplicates and applying the selection criteria, 18 studies were included in this review. These studies, representing various countries, contribute to a diverse dataset covering caregiver and care-recipient characteristics, including age, sex, chronic conditions, and various caregiver burden assessment tools. This systematic review provides a comprehensive understanding of the factors that influence caregiver burden among family caregivers of older adults with chronic illness in local communities. These findings emphasize the need for integrated nursing interventions and community efforts to address the welfare concerns of this population and support their caregivers.