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Virtual reality-based cognitive assessment tools for mild cognitive impairment screening: comparison with traditional paper-and-pencil-based cognitive assessment tools

2026-06-11T06:54:35Z

Title: Virtual reality-based cognitive assessment tools for mild cognitive impairment screening: comparison with traditional paper-and-pencil-based cognitive assessment tools Authors: Lee, Seungryul; Jang, Sooah; Kim, Eosu; Son, Sang Joon; Kim, Woo Jung; Lee, San; Hong, Chang Hyung; Roh, Hyun Woong; Seok, Jeong-Ho; Jung, Eunjin; 김지혜; Kim, In-young; Oh, Jooyoung; 장수아; 이산 Abstract: Background and Objectives Dementia is becoming increasingly prevalent, highlighting the need for early detection of mild cognitive impairment (MCI), a risk state for dementia. Traditional cognitive assessments often require trained examiners and lack ecological validity. This study examined the diagnostic accuracy of a virtual reality (VR)-based cognitive assessment tool, VARABOM.D, by comparing it with three standard tests: Seoul Neuropsychological Screening Battery (SNSB), Montreal Cognitive Assessment (MoCA), and Mini-Mental State Examination (MMSE).Research Design and Methods Seventy-seven participants, divided into normal (n = 44) and MCI (n = 33) groups based on their Clinical Dementia Rating scores, completed the VARABOM.D program, in addition to SNSB, MoCA, and MMSE. Correlation analyses were performed on the test results, and the specificity, sensitivity, and area under the curve (AUC) of VARABOM.D were compared to those of the other assessments. To monitor for any adverse reactions to the VR environment, the Simulator Sickness Questionnaire (SSQ) was administered both before and after the VR sessions.Results VARABOM.D scores showed significant positive associations with established cognitive assessments. Its AUC values were comparable to those of the MoCA, MMSE, and most SNSB subdomains except for attention, where VARABOM.D demonstrated greater discriminative ability. SSQ scores remained stable across pre- and post-VR sessions in both study groups, underscoring the VR platform's safety and feasibility.Discussion and Implications VARABOM.D demonstrated accuracy comparable to traditional cognitive assessments and even outperformed the attention subdomain of SNSB. Additionally, no adverse reactions were observed in the normal or MCI groups, further emphasizing the safety and stability of VARABOM.D.

Diabetes-dependent association between metabolic score for visceral fat and chronic kidney disease: findings from a longitudinal cohort study

2026-06-12T08:06:50Z

Title: Diabetes-dependent association between metabolic score for visceral fat and chronic kidney disease: findings from a longitudinal cohort study Authors: Kwon, Yu-Jin; Song, Youhyun; Lee, Ji-Won; Heo, Seok-Jae; Lee, Jung Eun Abstract: Aims: Metabolic dysfunction drives chronic kidney disease (CKD). Although the metabolic score for visceral fat (METS-VF) emerged as a novel marker of cardiometabolic health, its association with CKD remains unclear. We investigated the association between METS-VF and incident CKD and determined whether this relationship varies according to diabetes status. Methods: This longitudinal study analyzed data from 8,092 participants in the Korean Genome and Epidemiology Study. METS-VF was categorized into quartiles. Hazard ratios (HRs) for CKD development were estimated using Cox proportional hazards model and underwent multivariate adjustment. Results: During a mean follow-up of 12.8 years, 2,202 incident CKD cases were identified. Compared to Q1, Q4 was associated with an increased CKD risk in the unadjusted model (HR: 2.941; 95% CI: 2.591-3.339; P < 0.001) which persisted after multivariate adjustment (adjusted HR: 1.373; 95% CI: 1.201-1.571; P < 0.001). Subgroup analyses revealed the association between METS-VF and incident CKD was significant only in individuals with normoglycemia. Conclusions: Higher METS-VF was associated with increased risk of CKD development; however, it was confined to individuals with normal glucose tolerance. This suggests METS-VF may serve as an exploratory marker for stratified risk assessment for early CKD risk before the onset of glucose dysregulation, emphasizing the critical window for early metabolic intervention.

Natural language processing-based chatbots for chronic disease self-management: A systematic review of implementation and health outcomes

2026-05-22T07:32:33Z

Title: Natural language processing-based chatbots for chronic disease self-management: A systematic review of implementation and health outcomes Authors: Han, Ga In; Lee, Hi Jae; Son, Youn-Jung Abstract: BackgroundConversational agents (chatbots) are increasingly used as digital health interventions to support chronic disease self-management. Advances in natural language processing (NLP) have improved their capacity for interactive dialogue and personalization, yet evidence regarding their implementation and clinical impact remains limited.ObjectivesThis systematic review identifies and synthesizes studies implementing NLP-based chatbots for chronic disease self-management.MethodsWe searched seven electronic databases (PubMed, Embase, CINAHL, Web of Science, Scopus, Cochrane Library, and IEEE Xplore) and Google Scholar for studies published between January 2010 and November 2025. Studies evaluating NLP-based chatbots designed to support chronic disease self-management were deemed eligible. Study quality and risk of bias were assessed using the Mixed Methods Appraisal Tool and the Quality Assessment with Diverse Studies instrument.ResultsSix studies met the inclusion criteria; most were published in 2023 and targeted conditions such as cancer, diabetes, and hypertension. Chatbot functions primarily focused on symptom monitoring and disease-related education. Reported outcomes included improvements in disease-related knowledge, symptom burden, mental well-being, and self-care adherence. Usability and acceptability were generally favorable, with high satisfaction, perceived usefulness, and engagement. However, evidence of objective clinical benefits, including laboratory outcomes, was limited. Technical architectures varied widely, and advanced NLP capabilities-such as free-text natural language understanding-were rarely implemented.ConclusionsNLP-based chatbots show promise for supporting chronic disease self-management, particularly for psychosocial and behavioral outcomes. However, evidence of clinical efficacy remains limited. Future research should prioritize adaptive, context-aware designs and standardized outcome frameworks aligned with real-world self-management needs.

Trends and Sociodemographic Characteristics of Nontuberculous Mycobacterial Infections in South Korea: A Nationwide NHIS-Based Study (2010-2022)

2026-04-29T08:27:00Z

Title: Trends and Sociodemographic Characteristics of Nontuberculous Mycobacterial Infections in South Korea: A Nationwide NHIS-Based Study (2010-2022) Authors: Seo, Jeong Mi; Kang, Sungchan; Lim, Taeyoon; Shin, So-mi; Whang, Jake; Ko, Jinsoo; Lee, Gyeong In Abstract: Background: In South Korea, nontuberculous mycobacteria (NTM) is not a notifiable disease, while the absence of a national surveillance system hampers accurate assessment of its incidence. Therefore, this study utilized National Health Insurance Service (NHIS) claims data to investigate nationwide trends in NTM occurrence over the past decade. Methods: We used NHIS claims (2010-2022) to assemble a cohort with International Classification of Diseases, 10th Revision A31 (A31.0, A31.1, A31.8, A31.9). For incidence, cases diagnosed in 2010-2011 were excluded. Incidence was estimated under three definitions: >= 2 outpatient visits or >= 1 inpatient admission with A31 during the study period; same as A, but with <= 180 days between visits; meeting B plus >= 1 antibiotic prescription within 180 days (treatment initiation). Age-standardized prevalence and incidence were calculated using the 2010 Korean population. Results: A total of 178,287 newly diagnosed NTM cases were identified from 2012 to 2022 (mean age 51.4 years; 66.8 % female). The age-standardized prevalence increased from 15.5 to 69.8 per 100,000 in 2010 to 2022. Incidence peaked in 2017 (38.9/100,000), then declined to 26.9 in 2022. Age-specific incidence of NTM infection showed distinct sex-related patterns. Among men, incidence was consistently concentrated in older adults, particularly those >= 80 years, throughout 2012-2022. In contrast, women experienced a marked epidemiologic shift beginning in 2017, with incidence in their 20s and 30s surpassing older age groups. Medical Aid beneficiaries consistently showed higher incidence rates. By region, Daejeon and Chungnam showed the greatest increase in incidence rates in 2022, compared to 2012. Conclusion: NTM infection is increasing in Korea, with distinct epidemiologic patterns by sex, age, and socioeconomic status. The rising burden, especially among young women and the socioeconomically disadvantaged, warrants targeted public health strategies.