Objectives: Maternal depression negatively affects depression and anxiety symptoms in the offspring. This study examined the association between maternal depression and their adolescent offspring depression and anxiety, as well as the mediating role of emotional trauma in determining the association. Methods: Participants were 237 mothers (46.08±5.00 years) and their adolescent offspring (16.54±1.51 years). The participants completed the Beck Depression Inventory-II, Early Trauma Inventory Self Report-Short Form, Center for Epidemiological Studies Depression Scale for Children, and the Screen for Children’s Anxiety Related Disorders. The mediating effect of emotional trauma on offspring was explored using mediation analysis. Results: Maternal depressive symptoms were significantly correlated with adolescent offspring traumatic experiences, as well as with their depressive and anxiety symptoms. Mediation analysis results showed that emotional trauma of offspring significantly mediated the effect of maternal depression on their depressive and anxiety symptoms. Conclusion Findings indicate that maternal depression was significantly associated with depressive and anxiety symptoms in adolescent offspring, mediated by their emotional trauma. Future research is needed to investigate pathways and intervention strategies to prevent the intergenerational transmission of emotional problems.

Objectives: Many three-dimensionally-evaluated difficulty indices for impacted third molars have been suggested; however, their radiological and clinical validation according to the inferior alveolar nerve (IAN) remains unknown. This study aimed to evaluate the association of the difficulty index with IAN proximity and injury risk. Materials and Methods: We retrospectively enrolled patients with cone-beam computed tomography (CBCT) for a fully impacted mandibular third molar from January to December 2020. We evaluated the third molar according to the difficulty index based on panoramic x-ray and the nerve index based on CBCT and analyzed postoperative nerve complications. The relationships among nerve proximity, difficulty indices, and nerve complications were evaluated. Data were analyzed using the Pearson’s chi-square test and the Cochran–Armitage test for trends. Results: We included 367 subjects (177 males, 28.9±9.8 years) with follow-up of at least 1 month. Twenty-two subjects had nerve complications.Radiologic evaluation showed that third molars with a high nerve index had an increased difficulty index (P=0.001). Nerve complication risk showed a statistically significant correlation with both nerve and difficulty indices. Conclusion In conclusion, the difficulty index of an impacted third molar was valid in terms of its spatial relationship with the IAN and in predicting nerve complications.

Objectives: Clinical situations that make it challenging to differentiate odontogenic cysts from non-odontogenic cysts and benign tumors of the jaw include cases with cystic conditions accompanied by secondary infection, impacted teeth, cortical thinning and expansion, or external root resorption.This study aimed to identify risk factors for complications in patients undergoing cyst enucleation of the jaw, propose a clinical model, and determine the necessary indications for preoperative root canal of adjacent teeth. Materials and Methods: A review of surgical, pathological, and radiological reports, as well as medical records, was conducted. Pathological diagnosis, lesion size, history of preoperative endodontic treatment of the adjacent tooth, operator details, surgical procedures, age, gender, and complications (with severity) were analyzed. Results: This study involved 77 patients (55 men, 22 women) and found 10 complications. Procedure type (cyst enucleation only, apicoectomy and bone graft, or bone graft only) and lesion size were significant risk factors. Preoperative root canal therapy and men gender also tended to positively correlate with complications, while age was not a factor. Conclusion Within the limitations of our study, additional procedures contributed to lower risk of complications with the exception of bone graft.A large cyst size was also associated with a higher risk of complications. It is important to consider the possibility of a second procedure and take thorough precautions to prevent infection when performing bone grafts. Patients should be informed of these risks in advance, scheduled for regular follow-up, and provided additional treatment when necessary.

This study developed and validated a standardized scale to assess the adaptation of novice nutrition teachers to the teaching profession. A comprehensive literature review and a Delphi survey were conducted to identify the key adaptation factors, followed by a survey of 200 novice nutrition teachers across South Korea.Exploratory factor analysis (EFA) and confirmatory factor analysis (CFA) were conducted to verify the reliability and validity of the scale. The final scale consisted of five factors: personal, interpersonal, organizational, community, and policy factors, having 56 items. Reliability analysis indicated high internal consistency (Cronbach’s α≥0.7 for all factors), and EFA confirmed that all items met the factor loading threshold (≥ 0.3). The CFA results revealed good model fit indices (CFI, TLI≥0.9, RMSEA≤0.1), confirming the structural validity of the scale. The socioecological scale developed in this study is an objective and practical tool for evaluating the adaptation levels of novice nutrition teachers and can be used as foundational data for developing support programs and policy development. Unlike previous studies that focused on individual teacher characteristics, this study applied a socioecological approach, incorporating organizational, social, and policy-related factors in addition to personal adaptation. Future research should extend the empirical application of this scale to diverse educational settings that verify its effectiveness, and develop comprehensive support strategies.

Purpose: In Korea, the absence of a modified physical activity (PA) questionnaire specifically tailored for Koreans hinders the accurate assessment of PA among individuals with spinal cord injury (SCI). This study aimed to evaluate PA levels in individuals with SCI using a modified PA questionnaire and to provide insights into their PA patterns in Korea. Methods: A self-reported questionnaire was developed by revising and adapting the Korean version of the International Physical Activity Questionnaire (K-IPAQ) during an advisory meeting. Between April and June 2023, 176 individuals with SCI from metropolitan areas in Korea were recruited to assess their weekly PA. PA was quantified in Metabolic Equivalent Task-min/week (MET-min/week) by multiplying the reported PA duration. Results: The average PA level among individuals with SCI in Korea was 2,907.2±194.8 MET-min/week. By intensity, high-intensity activities accounted for 2,760.0±280.5 MET-min/week, moderate-intensity activities for 1,148.8±89.0 MET-min/week, and low-intensity activities for 1,869.4±110.3 MET-min/week. Approximately half of the participants met the World Health Organization (WHO) recommendations for PA. Conclusion Although Korean individuals with SCI demonstrated higher average PA levels compared to findings from other countries and the WHO recommendations, only about half of the participants met the WHO’s guidelines. These results underscore the need to strengthen efforts to promote PA participation among individuals with SCI.

Cerebellar ataxia, neuropathy, and vestibular areflexia syndrome (CANVAS) is a neurodegenerative disorder caused by a biallelic expansion of pentanucleotide repeats in the RFC1 gene. Previous studies have reported up to 22% of patients with late-onset ataxia harbor this pathogenic repeat expansion. Despite its relatively high prevalence, CANVAS is often underdiagnosed because the disease is not well recognized and genetic testing is not performed in clinical practice. Here, we present a patient with characteristic clinical features, confirmed by genetic testing.

The initial molecular cytogenetic characteristics of blasts plays a significant role in determining the treatment course of B-cell acute lymphoblastic leukemia (B-ALL).B-ALL with intrachromosomal amplification of chromosome 21 (iAMP21) has been well known to have unfavorable prognosis. Also, there are previously recognized germline mutations that increase the risk of ALL, such as trisomy 21, Down syndrome. This case report is about a 16-year-old girl who presented with lymphadenitis, purpura, and fever followed by initial lab of elevated white blood cell with blasts.She had some notable facial features, but no typical Down syndrome related one.Bone marrow biopsy and fluorescence in situ hybridization finalized the diagnosis as B-ALL with iAMP21, high-risk group. The minimal residual disease-negative complete remission was achieved after the induction chemotherapy with Korean multicenter high-risk protocol. However, abnormal karyotype was sustained in bone marrow. Microarrays with her buccal swab raised the possibility that the abnormal karyotype was not from the leukemic blasts but rather from the germline. Although she underwent scheduled chemotherapy uneventfully as slow early responder type, thrombocytopenia and abnormal karyotype persisted, leading to the diagnosis of acute myeloid leukemia. Additional chemotherapy and peripheral blood stem cell transplantation was performed which resulted in engraftment. This case highlights the discovery of a constitutional genetic aberration, which played like a silent yet critical background factor for B-ALL with iAMP21. As the number of reported cases are limited, the role of germline chromosome 21 mutation as the indicator for prognosis of B-ALL should be studied further.

Objective: Recently, various mental health promotion programs using virtual reality (VR) technology have been tried in the psychiatric field. Considering the importance of mental health in pregnant women, VR-assisted mental health promotion programs for pregnant women are needed to be developed. This study aimed to prospectively investigate the efficacy of a VR-assisted mental health promotion program for pregnant women. Methods: Fifty-five pregnant women were participated in this study. Mental health states such as depression, anxiety, perceived stress, and quality of life were assessed by Patient Health Questionnaire-9 (PHQ-9), Generalized Anxiety Disorder-7 (GAD-7), Perceived Stress Scale, and World Health Organization Quality of Life Scale Abbreviated Version (WHOQOL-BREF) before and after using VR program treatment. Based on the mental health types of pregnant women classified by cluster analysis, the effects of the VR program were analyzed by paired t test and Wilcoxon signed rank test. Results: The VR program significantly reduced PHQ-9 (p = 0.033) and GAD-7 (p = 0.046) scores, and significantly increased WHOQOL-BREF (p = 0.026) score of the participants. Additionally, when classifying the mental health types of pregnant women, the VR program was significantly effective to improve depression, anxiety, and quality of life in the most severe group based on the cluster analysis. Conclusion The results of this study suggest that VR program may be effective to improve the mental health of pregnant women. Particularly, VR programs for the high-risk group of depression might be the most effective. Therefore, VR-assisted mental health promotion programs could be useful for managing the mental health in pregnant women.

Background: This study aimed to assess the severity of postoperative delirium (PD) in elderly patients who underwent reverse total shoulder arthroplasty (rTSA) for irreparable massive rotator cuff tears (mRCTs) under general anesthesia (GA) compared to those under interscalene block (IB). Methods: Forty elderly patients aged 65 years or older diagnosed with an irreparable mRCT who underwent rTSA were included in the prospective case-controlled study. Of these, 20 patients were operated under GA and the other 20 under IB. The average age was 77.1 years (range, 65–95 years). The severity of delirious symptoms was evaluated by the Delirium Rating Scale–revised–98 (DRS) score from the patients or guardians before the surgery and at 0, 3, and 7 days and 1, 3, and 6 months after the surgery and compared between the 2 groups. Results: Immediately after surgery, the visual analog scale score difference between the groups was statistically significant, with the GA group at 6.25 (standard deviation, ± 0.85) and the IB group at 3.80 (± 0.62) (p < 0.001). On the day of operation, the mean DRS score in the GA and IB groups were 9.10 (± 5.63) and 6.60 (± 5.33), respectively (p = 0.157). On day 3 of surgery, the mean DRS score in the GA group peaked to 9.95 (± 8.73), while in the IB group, it declined to 6.40 (±5.81) (p = 0.138). After 3 days, DRS scores showed a decreasing trend in both groups. When comparing the mean change (∆) from the preoperative baseline scores to the postoperative values, the ∆DRS score was significantly higher with 4.15 (± 4.53) points in the GA group as compared to 1.30 (± 1.92) in the IB group (p = 0.014). Conclusions IB can be an attractive and efficient anesthetic choice in preventing PD for elderly patients undergoing rTSA for irreparable mRCTs. The IB group showed lower DRS scores and a peak on day 0 compared to the higher DRS scores and peak on day 3 in the GA group. Additionally, IB showed less pain than GA.

Background: Proximal humerus nails, frequently used for managing proximal humerus fractures, significantly enhance rotational stability and reinforce fractured fragments. Few research exists regarding the optimal number and positioning of distal screws.This study aimed to assess the stability of diverse screw configurations and scrutinize screw distribution and bone stress via finite element analysis. Methods: The humerus intramedullary nail (Humerus Interlocking Nail System; TDM) underwent assessment using finite element analysis applied to a humerus model. Three groups were established based on varying distal screw numbers and locations: all 3 distal locking holes were used in group 1; 2 screws (dynamic hole and proximal static hole) in group 2, and 2 screws (dynamic hole and distal static hole) in group 3. Finite element analysis computed stress distribution within the implant and bone for each group.A 1-mm fracture gap was simulated at the surgical neck, and stress distributions were analyzed in both normal and osteoporotic bone models. Results: Using two screws did not compromise rotational stability. Stress distribution analysis revealed stability across all groups without reaching failure strength. Group 3 exhibited a minor rise in component 11 (direct stress [force per unit area] acting on the positive and negative 1 faces in the 1-axis. direction) and component 22 (direct stress [force per unit area] acting on the positive and negative 2 faces in the 2-axis direction) stress, remaining below failure strength thresholds. Group 1 exhibited the lowest von Mises stress in the nail and screws, while groups 2 and 3 did not reach failure strength levels. Findings remained consistent in the osteoporotic model. Conclusions All 3 groups demonstrated rotational stability concerning stress distribution, indicating that using 2 screws for distal fixation does not adversely affect stability. This suggests the potential for saving surgical time and reducing radiation exposure without compromising stability.