(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.

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 and objectives: To perform a updated systematic review and meta-analysis comparing effectiveness of percutaneous nephrolithotomy (PCNL), retrograde intrarenal surgery (RIRS), and extracorporeal shock wave lithotripsy (ESWL) for treatment of renal stones (RS). Materials and Methods: A total of 37 studies were included in this systematic review and meta-analysis about effectiveness to treat RS. Endpoints were stone-free rates (SFR), incidence of auxiliary procedure, retreatment, and complications. We also conducted a sub-analysis of ≥2 cm stones. Results: First, PCNL had the highest SFR than others regardless of stone sizes and RIRS showed a higher SFR than ESWL in <2 cm stones. Second, auxiliary procedures were higher in ESWL than others, and it did not differ between PCNL and RIRS. Finally, in <2 cm stones, the retreatment rate of ESWL was higher than others. RIRS required significantly more retreatment procedures than PCNL in ≥2 cm stones. Complication was higher in PCNL than others, but there was no statistically significant difference in complications between RIRS and PCNL in ≥2 cm stones. For ≥2 cm stones, PCNL had the highest SFR, and auxiliary procedures and retreatment rates were significantly lower than others. Conclusions: We suggest that PCNL is a safe and effective treatment, especially for large RS.

Background: 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. Objective: 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. Methods: 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. Results: 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 (F2,114=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. Conclusions: 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. Trial Registration: Clinical Research Information Service KCT0007287; https://cris.nih.go.kr/cris/search/detailSearch.do?seq=23344

Background: Early cognitive training is important to prevent cognitive decline in patients with mild cognitive impairment (MCI) or dementia. Therefore, developing an application that can provide evidence-based cognitive training is necessary for patients with MCI or dementia. Method: This study aimed to develop and evaluate Smart Brain, an evidence-based application that provides comprehensive cognitive training tailored to this population. The application was developed using an ADDIE (analysis, design, development, implementation, and evaluation) model. A systematic review of databases, including Ovid-MEDLINE, Ovid-EMBASE, Cochrane Library, and CINAHL, was conducted up to April 15, 2021, to identify key content areas. Additionally, a survey of 100 participants highlighted the need for features such as cognitive games, health notes, social networking services, and goal achievement. Result: The application was developed with distinct user and administrator interfaces to support engagement and monitoring. Usability testing involved 7 experts and 11 elderly individuals with MCI or dementia from a daycare center. Based on usability feedback, features such as the time limits for cognitive games were refined. The final application integrates cognitive games, physical exercises, emotional support, and health management tools to address user needs comprehensively. Conclusion: Smart Brain holds significant potential to improve the quality of life and cognitive health of elderly individuals with MCI or dementia. Its usability and functionality make it a promising tool for community-based interventions.

BACKGROUND 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. OBJECTIVE 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. METHODS 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. RESULTS 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 (F2,114=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. CONCLUSIONS 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. CLINICALTRIAL Clinical Research Information Service KCT0007287; https://cris.nih.go.kr/cris/search/detailSearch.do?seq=23344