REM sleep behavior disorder portends poor prognosis in Parkinson's disease: A systematic review.

REM sleep behavior disorder (RBD) is a parasomnia wherein a loss of REM sleep atonia manifests as dream-enactment, often violent. Aside from its significance as a predictor of PD, RBD in PD may imply more than merely screaming at night and experiencing sleep fragmentation. To probe its significance as a prognostic factor in PD, we performed a systematic literature review. Analysis of prospective studies reveals baseline RBD confers a higher risk of developing dementia and hallucinations. In cross-sectional studies, RBD is associated with the non-tremor predominant motor phenotype and autonomic dysfunction. Clinical, imaging, and autopsy studies support the presence of dense and diffuse pathology extending beyond the brainstem in PD with RBD. As RBD in PD is associated with a greater disease burden and an increased risk of mortality, we propose the RBD subtype in PD to highlight that RBD may mark a distinct subtype with relatively poor prognosis.

Evolutionary History of Chemosensory-Related Gene Families across the Arthropoda.

Chemosensory-related gene (CRG) families have been studied extensively in insects, but their evolutionary history across the Arthropoda had remained relatively unexplored. Here, we address current hypotheses and prior conclusions on CRG family evolution using a more comprehensive data set. In particular, odorant receptors were hypothesized to have proliferated during terrestrial colonization by insects (hexapods), but their association with other pancrustacean clades and with independent terrestrial colonizations in other arthropod subphyla have been unclear. We also examine hypotheses on which arthropod CRG family is most ancient. Thus, we reconstructed phylogenies of CRGs, including those from new arthropod genomes and transcriptomes, and mapped CRG gains and losses across arthropod lineages. Our analysis was strengthened by including crustaceans, especially copepods, which reside outside the hexapod/branchiopod clade within the subphylum Pancrustacea. We generated the first high-resolution genome sequence of the copepod Eurytemora affinis and annotated its CRGs. We found odorant receptors and odorant binding proteins present only in hexapods (insects) and absent from all other arthropod lineages, indicating that they are not universal adaptations to land. Gustatory receptors likely represent the oldest chemosensory receptors among CRGs, dating back to the Placozoa. We also clarified and confirmed the evolutionary history of antennal ionotropic receptors across the Arthropoda. All antennal ionotropic receptors in E. affinis were expressed more highly in males than in females, suggestive of an association with male mate-recognition behavior. This study is the most comprehensive comparative analysis to date of CRG family evolution across the largest and most speciose metazoan phylum Arthropoda.

Predictors of the placebo response in clinical trials on Parkinson's disease: A meta-analysis.

INTRODUCTION: Previous studies have assessed the placebo response in clinical trials on PD using the individual data of participants from the placebo-assigned group. The aim of this study was to examine the group predictors of the placebo response in randomized placebo-controlled trials on PD using a meta-analysis with meta-regression models. METHODS: The placebo response was defined as the mean change in the UPDRS part III score from baseline to the primary efficacy end point in the placebo group. The impacts of the predictors were assessed with meta-regression analyses, and significant predictors were used in a multivariable analysis. Subgroup analyses were conducted in studies that enrolled PD patients with or without motor fluctuations. RESULTS: Forty-eight studies (consisting of 5618 participants on placebo) were included. Motor fluctuation and baseline UPDRS part III score were significant predictors in the univariable analyses. The high baseline UPDRS part III score (ß = -0.21, 95% CI -0.34, -0.08; p = 0.005) significantly increased the magnitude of the positive placebo response in the multivariable analysis. In the subgroup analyses, the positive placebo response was significant only in studies that enrolled patients with motor fluctuations; high baseline UPDRS part III score and low baseline daily levodopa dose increased the positive placebo response independently in the subgroup with motor fluctuations. CONCLUSION: Researchers should consider the positive placebo response when they design clinical trials in advanced PD patients with motor fluctuations and severe motor symptoms. Baseline daily levodopa dose may be the independent predictor in studies that enrolled fluctuating patients.

Factors Influencing Suicidal Ideation Among Korean Adults by Age: Results of the 2010-2011 Korean Health and Nutrition Examination Survey.

Suicidal ideation increases the risk of suicide. This study investigated the age-specific contributions of sociodemographic factors, health status, and health behaviors to suicidal ideation using nationally representative data. The factors associated with suicidal ideation differ by age. Perceived bad health, stress, and depression had a significant influence on suicidal ideation in all age groups, but their specific effects differed in different age groups. The influence of perceived bad health increased with age, and the effect of stress was strongest among those aged 45-64 years. Moreover, the effect of being depressed decreased by age and was strongest among those 20-44 years of age. Disease and marital status did not have a significant effect on suicidal ideation among those 45-64 years old, and education had no effect among those 65 years or older.

Impact of lower urinary tract symptoms and depression on health-related quality of life in older adults.

PURPOSE: We aimed primarily to investigate the level of health-related quality of life (HRQoL), lower urinary tract symptoms (LUTS), and depression in older adults and secondly to identify the impact of LUTS and depression on HRQoL. METHODS: A community-based cross-sectional study was conducted from April to November 2010. Participants were recruited from five community senior centers serving community dwelling older adults in Jeju city. Data analysis was based on 171 respondents. A structured questionnaire was used to guide interviews; the data were collected including demographic characteristics, body mass index, adherence to regular exercise, comorbidities (hypertension, diabetes mellitus, and osteoarthritis), depression, urinary incontinence, LUTS (measured via the International Prostate Symptom Score [IPSS]), and HRQoL as assessed by use of the EQ-5D Index. Stepwise multiple regression analysis was used to test predictors of HRQoL. RESULTS: Eighteen percent (18.6%) of the respondents reported depressive symptoms. The mean LUTS score was 8.9 (IPSS range, 0 to 35). The severity of LUTS, was reported to be mild (score, 0 to 7) by 53% of the respondents, moderate (score, 8 to 19) by 34.5%, and severe (score, 20 to 35) by 12.5%. HRQoL was significantly predicted by depression (Partial R(2)=0.193, P<0.01) and LUTS (Partial R(2)=0.048, P=0.0047), and 24% of the variance in HRQoL was explained. CONCLUSIONS: LUTS and depression were the principal predictors of HRQoL in older adults.

A placebo-controlled trial of Korean red ginseng extract for preventing influenza-like illness in healthy adults.

BACKGROUND: Standardized Korean red ginseng extract has become the best-selling influenza-like illness (ILI) remedy in Korea, yet much controversy regarding the efficacy of the Korean red ginseng (KRG) in reducing ILI incidence remains. The aim of the study is to assess the efficacy of the KRG extract on the ILI incidence in healthy adults. METHODS/DESIGN: We will conduct a randomized, double-blind, placebo-controlled study at the onset of the influenza seasons. A total of 100 subjects 30-70 years of age will be recruited from the general populations. The subjects will be instructed to take 9 capsules per day of either the KRG extract or a placebo for a period of 3 months. The primary outcome measure is to assess the frequency of ILI onset in participated subjects. Secondary variable measures will be included severity and duration of ILI symptoms. The ILI symptoms will be scored by subjects using a 4-point scale. DISCUSSION: This study is a randomized placebo controlled trial to evaluate the efficacy of the KRG extract compared to placebo and will be provided valuable new information about the clinical and physiological effects of the KRG extract on reduction of ILI incidence including flu and upper respiratory tract infections. The study has been pragmatically designed to ensure that the study findings can be implemented into clinical practice if KRG extract can be shown to be an effective reduction strategy in ILI incidence. TRIAL REGISTRATION: NCT01478009.

Influence of the Chungkookjang on histamine-induced wheal and flare skin response: a randomized, double-blind, placebo controlled trial.

BACKGROUND: Allergic disease is a consequence of exposure to normally innocuous substances that elicit the activation of mast cells. Mast-cell-mediated allergic response is involved in many diseases such as anaphylaxis, urticaria, allergic rhinitis, asthma and allergic dermatitis. The development of food products for the prevention of allergic disease is an important subject in human health. The chungkookjang (CKJ) has been reported to exhibit antiallergic inflammatory activity. Therefore, the aim of the study is to examine the effects of the CKJ to reduce histamine-induced wheal and flare skin responses. METHODS/DESIGN: A randomized, double-blind, placebo-controlled study in 60 healthy subjects will be carried out. Sixty volunteers (aged 20-80) who gave a written consent before entering the study will be randomized in two groups of thirty subjects each. The skin prick test with histamine solution of 10 mg/ml will be performed on the ventral forearm, 10 cm from the elbow. The subjects will be instructed to take 35 g per day of either the CKJ pills or a placebo pills for a period of 3 months. Diameters of wheal and flare will be assessing 15 minutes after performing the above-mentioned skin prick test. The primary outcome is change in wheal and flare responses. Secondary outcomes will be include change in serum histamine, immunoglobulin E, cytokines (interferon-gamma, interleukin-4, -10, and tumor necrosis factor-alpha), and eosinophil cationic protein. DISCUSSION: This study will show the potential anti-inflammatory properties of the CKJ in their skin activity when histamine is the challenging agent as occurs in the clinical situation. And the present protocol will confirm the efficacy and safety of the CKJ for allergy symptoms, suggesting more basic knowledge to conduct further randomized controlled trials (RCT). If this study will be successfully performed, the CKJ will be an alternative dietary supplemental remedy for allergy patients. TRIAL REGISTRATION: NCT01402141.

The relationship between social participation and self-rated health by sex and age: a cross-sectional survey.

BACKGROUND: Social participation contributes to better health and has been regarded as an important component of quality of life. Despite its importance, social participation significantly decreases as age advances. Social participation may vary by sex and age and, consequently, may have different influences on health by age and sex. Few studies have examined how sex and age affect individual health status in this regard. OBJECTIVES: This paper focuses on whether the association between self-rated health and social participation differs between men and women, and among age groups. DESIGN: The study was based on cross-sectional analysis of data from the 2003 Social Statistics Survey. SETTINGS: This survey was conducted in South Korea. PARTICIPANTS: The survey respondents were 59,202 Koreans aged 25 and over. The sample population comprised each household member of 33,000 sample households who were selected by multistage probability sampling of household registries based on geographic area, sex and age group. METHODS: Face-to-face interviews were nationally conducted. Multiple logistic regression analysis was performed to examine factors that associated social participation with self-rated health, and the adjusted odds ratios (ORs) were presented, together with their 95% confidence intervals (CIs). The model included various individual socioeconomic characteristics, health behaviors, and morbidity variables, such as marital status, education level, housing tenure, employment status, smoking status, alcohol intake, number of restricted activity days, and bed days. RESULTS: For both sexes, self-rated good health was strongly associated with social participation levels in all age groups. The influence of social participation increased as age advanced. Particularly among elderly women, those who had participated in more than two activities had more than twice the odds of self-rated good health of those who did not participate in any activities. CONCLUSIONS: Social participation significantly decreases as people age, however, the influence of social participation on health status increases with age. This study has shown that social participation, which is an individual psychological resource, is important for health in all age groups, notwithstanding that the effect of social participation differs by age and sex. Social participation should be a basic consideration in the field of community nursing intervention, especially for the elderly and women's health promotion. Promoting social participation by individuals may lead to better health, and may therefore be an effective strategy for enhancing health.

A study of lower urinary tract symptoms for the Korean women aged 30 and over.

The purposes of this study were (1) to identify the prevalence of urinary incontinence (UI) and lower urinary tract symptoms (LUTS) for Korean women, (2) to evaluate the LUTS scores of the subjects in relation with each UI patterns and general characteristics, and (3) to identify affecting factors developing LUTS by using self-administered questionnaire. Community-based cross-sectional study was conducted for 3,371 women aged 30 to 89 years old who were allocated at six provinces in South Korea. UI and LUTS were assessed by validated symptom scales including the International Prostate Symptom Score. Of all the respondents, 63.4% had experienced UI more than once a month during the prior 12 months. Among the respondents, 36.6% had no UI, 47.5% had stress UI, 0.4% had urge UI, and 15.5% had mixed UI. The mean LUTS score of the total respondents was 7.8 +/- 4.1. The LUTS was significantly predicted by age (p < .0001) and mixed UI (p < .0001), and 79.4% of variance in LUTS was explained. The highest LUTS scores were shown in the subjects with mixed UI, and we found that LUTS scores increased with age.

[A meta-analysis of the effects of smoking prevention programs in Korea].

PURPOSE: The purpose of this paper was to describe the characteristics of smoking prevention programs in Korea, to estimate overall effect size of Korean smoking prevention programs, and to investigate effect size variations by program modality and instruction method. METHOD: Meta-analysis was performed on 21 programs in 20 studies. RESULT: The estimation of overall effect size for knowledge and attitude was not possible because effect sizes were not homogeneous in this meta-analysis. However, effect sizes of studies that were socially influential programs or active/interactive methods were larger than information-oriented programs or passive/non-interactive methods in the pictures. The effects for behavioral outcomes were generally not as positive and not statistically significant. Q statistics showed that variations among effect sizes within program modality and instruction method classifications were heterogeneous. CONCLUSION: The results from this meta-analysis support the continued use of socially influential programs and active/interactive methods for smoking prevention programs. Because behavioral effect might be the fundamental objective of smoking prevention programs, the present results indicate that smoking prevention programs should consider adopting more effective programs.