Background: Hand hygiene is considered the simplest and most cost-effective method of infection prevention. Regular observation and feedback on hand hygiene compliance are key strategies for its enhancement. This study evaluated the effectiveness of hand hygiene surveillance, including direct observation and feedback, by comprehensively analyzing the reported hand hygiene compliance within the Korean National Healthcare-Associated Infections Surveillance System from 2019 to 2022. Methods: Participating medical institutions included general hospitals and hospitals with infection control departments that consented to participate. Hand hygiene surveillance was conducted using direct observation. Collected data, including healthcare workers, clinical areas, hand hygiene moments, and hand hygiene compliance, were recorded to calculate hand hygiene compliance rates. Additionally, the volume of alcohol-based hand sanitizers used per patient per day was investigated as an indirect indicator of hand hygiene compliance. The study was conducted from July 2019 to December 2022. Results: Hand hygiene compliance increased from 87.2% in Q3 2019 to 89.9% in 2022. Nurses and medical technologists showed the highest compliance rates, whereas doctors showed the lowest compliance rates. Intensive care units excelled in compliance, whereas emergency de partments lagged. Compliance was highest after patient contact and lowest when the patient’s surroundings were touched. Larger hospitals consumed more alcohol-based hand sanitizers than smaller hospitals did. Conclusion This study confirmed an improvement in hand hygiene compliance through sustained surveillance, indicating its contribution not only to preventing infection transfer within healthcare facilities but also to fostering a culture of hand hygiene in the country.

A new fixed-dose combination (FDC) formulation of raloxifene 60 mg and cholecalciferol 800 IU was developed to improve the medication compliance and overall efficacy of raloxifene treatment in postmenopausal osteoporosis patients. The aim of this study was to compare the pharmacokinetics between two tablets of FDC formulation of raloxifene/cholecalciferol and the two products administered concomitantly at respective doses. This randomized, open-label, single-dose, two-treatment, two-way crossover study included 46 volunteers. During each treatment period, subjects received the test formulation (FDC formulation containing raloxifene and cholecalciferol) or the reference formulation (co-administration of raloxifene and cholecalciferol), with a 14-d washout period. Serial blood samples were collected periodically over 96 hours after drug intake. In total, 46 subjects completed the study. The geometric mean ratios and its 90% confidence intervals of the FDC to the single agents for the area under the concentration-time curve from zero to the last quantifiable time point and the maximum plasma concentration met the regulatory criteria for bioequivalence: 1.1364 (1.0584–1.2201) and 1.1010 (0.9945–1.2188) for raloxifene and 1.0266 (0.9591–1.0989) and 1.0354 (0.9816–1.0921) for baseline-corrected cholecalciferol, respectively. Both formulations were well tolerated. No significant differences was observed in the incidence of adverse events between the two treatments. It was concluded that two tablets of the newly developed FDC formulation of raloxifene and cholecalciferol and the corresponding two agents administered concomitantly at respective doses were bioequivalent.

BACKGROUND/OBJECTIVES: To evaluate the nutritional status and prevalence of malnutrition in hospitalized children at admission and during hospitalization in South Korea. SUBJECTS/METHODS: This first cross-sectional nationwide “Pediatric Nutrition Day (pNday)” survey was conducted among 872 hospitalized children (504 boys, 368 girls; 686 medical, 186 surgical) from 23 hospitals in South Korea. Malnutrition risk was screened using the Pediatric Yorkhill Malnutrition Score (PYMS) and the Screening Tool Risk on Nutritional status and Growth. Nutritional status was assessed by z-scores of weight-for-age for underweight, weight-for-height for wasting, and height-for-age for stunting as well as laboratory tests. RESULTS: At admission, of the 872 hospitalized children, 17.2% were underweight, and the prevalence of wasting and stunting was 20.2% and 17.3%, respectively. During hospitalization till pNday, 10.8% and 19.6% experienced weight loss and decreased oral intake, respectively.During the aforementioned period, fasting was more prevalent in surgical patients (7.5%) than in medical patients (1.6%) (P < 0.001). According to the PYMS, 34.3% and 30% of the children at admission and on pNday, respectively, had a high-risk of malnutrition, requiring consultation with the nutritional support team (NST). However, only 4% were actually referred to the NST during hospitalization. CONCLUSIONS Malnutrition was prevalent at admission and during hospitalization in pediatric patients, with many children experiencing weight loss and poor oral intake. To improve the nutritional status of hospitalized children, it is important to screen and identify all children at risk of malnutrition and refer malnourished patients to the multidisciplinary NST for proper nutritional interventions.

BACKGROUND/OBJECTIVES: To evaluate the nutritional status and prevalence of malnutrition in hospitalized children at admission and during hospitalization in South Korea. SUBJECTS/METHODS: This first cross-sectional nationwide “Pediatric Nutrition Day (pNday)” survey was conducted among 872 hospitalized children (504 boys, 368 girls; 686 medical, 186 surgical) from 23 hospitals in South Korea. Malnutrition risk was screened using the Pediatric Yorkhill Malnutrition Score (PYMS) and the Screening Tool Risk on Nutritional status and Growth. Nutritional status was assessed by z-scores of weight-for-age for underweight, weight-for-height for wasting, and height-for-age for stunting as well as laboratory tests. RESULTS: At admission, of the 872 hospitalized children, 17.2% were underweight, and the prevalence of wasting and stunting was 20.2% and 17.3%, respectively. During hospitalization till pNday, 10.8% and 19.6% experienced weight loss and decreased oral intake, respectively.During the aforementioned period, fasting was more prevalent in surgical patients (7.5%) than in medical patients (1.6%) (P < 0.001). According to the PYMS, 34.3% and 30% of the children at admission and on pNday, respectively, had a high-risk of malnutrition, requiring consultation with the nutritional support team (NST). However, only 4% were actually referred to the NST during hospitalization. CONCLUSIONS Malnutrition was prevalent at admission and during hospitalization in pediatric patients, with many children experiencing weight loss and poor oral intake. To improve the nutritional status of hospitalized children, it is important to screen and identify all children at risk of malnutrition and refer malnourished patients to the multidisciplinary NST for proper nutritional interventions.

Objective: Recent evidence shows that the quantitative value of amyloid-beta (Aβ) deposition below the threshold of Aβ positivi-ty carries biological and clinical significance regarding future cognitive decline. We evaluated whether the quantitative value of sub-threshold Aβ deposition had a significant correlation with neuropsychological test scores in cognitively normal older adults without the APOE ε4 allele. Methods: Sixty cognitively normal APOE ε4 allele non-carriers with negative Aβ retention aged 60 to 85 years were included in this study. We assessed neuropsychological performance with the Korean version of the Consortium to Establish a Registry for Al-zheimer’s Disease (CERAD-K) and obtained standardized [ 18 F] flutemetamol uptake values in the pons as a reference (SUVR PONS), evaluated with PET. Multiple regression analyses were conducted to assess the effect of global and regional Aβ load on cognitive performance, adjusting for age, sex, years of education, and volumes of white matter hyperintensities. Results: We found that Aβ deposition in the precuneus, posterior cingulate cortex, and parietal lobe had a significant association with the total CERAD-K scores. There was also a significant correlation between the SUVR PONS in the precuneus and the CERAD-K total score after Bonferroni correction. Conclusion Subthreshold Aβ retention in the core brain regions of the default mode network could affect cognitive functions in the cognitively normal APOE ε4 non-carriers, considered to be the lowest risk group for Alzheimer’s disease (AD).

Purpose: Coronavirus Disease 2019 (COVID-19), an emerging infectious disease introduced in South Korea in 2020. Medically inclined college students are more susceptible to be infected by the virus. The purpose of this study was to investigate factors influencing preventive behavior against COVID-19 among medically inclined college students. Methods: This is a cross-sectional study using a questionnaire survey. Data were collected from 400 medically inclined college students from four colleges of medice. Independent t-test, one-way ANOVA, Pearson correlation coefficients and multiple regression analysis were conducted to analysis the data. Results: The study subjects had high knowledge and optimism related to COVID-19. Preventive behavior against COVID-19 was affected mostly by attitude (β=.32, p<.001). Such behavior was also high in relation to knowledge (β=.17, p<.001), and nursing students (β=.15, p=.002). Conclusion Infection prevention education for medically inclined college students mainly focuses on knowledge transfer. Infection preventive education programs aimed at improving COVID-19 optimistic attitudes and knowledge are helpful for these students to maintain appropriate preventive practices. The confirmation of the importance of optimistic attitudes and risk perception toward infectious diseases through this study can provide insight into infection prevention education programs to improve practice to wards new epidemic prevention behaviors.

BACKGROUND AND OBJECTIVES: Dysregulation of histone deacetylase expression and enzymatic activity is associated with a number of diseases. It has been reported that protein levels of histone deacetylase (HDAC)1 and HDAC5 increase during human pulmonary hypertension, and that the enzymatic activity of HDAC6 is induced in a chronic hypertensive animal model. This study investigated the protein expression profiles of class I and II a/b HDACs in three systemic hypertension models. SUBJECTS AND METHODS: We used three different hypertensive animal models: (i) Wistar-Kyoto rats (n=8) and spontaneously hypertensive rats (SHR; n=8), (ii) mice infused with saline or angiotensin II to induce hypertension, via osmotic mini-pump for 2 weeks, and (iii) mice that were allowed to drink L-N(G)-nitro-L-arginine methyl ester (L-NAME) to induce hypertension. RESULTS: SHR showed high systolic, diastolic, and mean blood pressures. Similar increases in systolic blood pressure were observed in angiotensin II or L-NAME-induced hypertensive mice. In SHR, class IIa HDAC (HDAC4, 5, and 7) and class IIb HDAC (HDAC6 and 10) protein expression were significantly increased. In addition, a HDAC3 protein expression was induced in SHR. However, in L-NAME mice, class IIa HDAC protein levels (HDAC4, 5, 7, and 9) were significantly reduced. HDAC8 protein levels were significantly reduced both in angiotensin II mice and in SHR. CONCLUSION: These results indicate that dysregulation of class I and class II HDAC protein is closely associated with chronic hypertension.
Angiotensin II ; Animals* ; Blood Pressure ; Histone Deacetylases* ; Histones* ; Humans ; Hypertension ; Hypertension, Pulmonary ; Mice ; Models, Animal* ; NG-Nitroarginine Methyl Ester ; Rats ; Rats, Inbred SHR

OBJECTIVE: This study investigated the association between social relations, activities of daily living, cognitive functions and depressive symptoms among the Korean elderly. METHODS: Study subjects were 10,260 elderly participated in 2014 Korean National Survey on Older Adults. General characteristics, social relations, activities of daily living, cognitive functions and depressive symptoms were collected by face-to-face interview. Descriptive analyses, chi-square tests and multiple logistic regression analysis were performed using SAS 9.4 statistical program. RESULTS: Total 33.0% of elderly had depressive symptoms. The odds ratios (OR) for depressive symptoms were significantly higher in elderly without housemate [OR=1.30, 95% confidence interval (CI)=1.11-1.53], without contact of living children (OR=1.76, 95% CI=1.03-2.99), lower social activity (OR=2.00, 95% CI=1.71-2.35) and without contact of friends (OR=1.47, 95% CI=1.30-1.67). And impaired activity of daily living (ADL) (ADL : OR=1.61, 95% CI=1.18-2.20, instrumental activities of daily living : OR=1.68, 95% CI=1.36-2.06) and cognitive impairment (OR=1.21, 95% CI=1.07-1.38) were also associated the risk of depressive symptoms. CONCLUSION: Social support for elderly who lack social relationships and services to improve the daily life of elderly with impaired activities are helpful to decrease depressive symptoms. And it is necessary to investigate and manage the depressive symptoms of elderly with impaired cognitive function.
Activities of Daily Living* ; Adult* ; Aged* ; Child ; Cognition Disorders ; Cognition* ; Depression* ; Friends ; Health Surveys ; Humans ; Interpersonal Relations ; Logistic Models ; Odds Ratio ; Sociological Factors

OBJECTIVES: The purpose of this study was to compare the physical activity level (PAL), the physical activity pattern and the energy expenditure in male and female elementary school soccer players using the accelerometer and the physical activity diary. METHODS: Twenty-five (male 11, female 14) elementary school soccer players (9–12 years) participated in this study. During their daily activities, they wore an accelerometer for seven days (five weekdays and two weekend days) and completed the physical activity diary for three days (two weekdays and one weekend day). PAL was calculated by using the physical activity diary and three equations (Pate Preschool, Freedson Children, and Freedson) were used to calculate the intensity of physical activity and energy expenditure from the counts of accelerometer. RESULTS: The average of physical activity by day of the week, CPM (Counts Per Minute) and METs (Metabolic Equivalents) were significantly higher in males (723.3 ± 149.2 CPM, 2.07 ± 0.18 METs) compared to females (505.6 ± 119.9 CPM, 1.79 ± 0.20 METs), but there was no significant difference in PAEE (Physical Activity Energy Expenditure) between the two groups (males: 15.5 ± 9.1 kcal/day, females: 11.5 ± 6.0 kcal/day). During weekdays, physical activity intensity was significantly higher in males compared to females at lunch time and training time than at other times. In both genders, the PAL was higher during weekdays (males 1.98, females 1.89) compared to weekend (males 1.62, females 1.61) (p<0.05). CONCLUSIONS: Our study observations suggest the necessity to develop an accelerometer equation for accurately evaluating the physical activity of elementary school athletes.
Athletes ; Child ; Energy Metabolism* ; Female* ; Humans ; Lunch ; Male* ; Motor Activity* ; Soccer*

PURPOSE: This study was conducted to evaluate the impact of supraclavicular lymph node radiotherapy (SCNRT) on N1 breast cancer patients receiving post-lumpectomy whole-breast irradiation (WBI) and anthracycline plus taxane-based (AT) chemotherapy. MATERIALS AND METHODS: We performed a case-control analysis to compare the outcomes of WBI and WBI plus SCNRT (WBI+SCNRT). Among 1,147 patients with N1 breast cancer who received post-lumpectomy radiotherapy and AT-based chemotherapy in 12 hospitals, 542 were selected after propensity score matching. Patterns of failure, disease-free survival (DFS), distant metastasis-free survival (DMFS), and treatment-related toxicity were compared between groups. RESULTS: A total of 41 patients (7.6%) were found to have recurrence. Supraclavicular lymph node (SCN) failure was detected in three patients, two in WBI and one in WBI+SCNRT. All SCN failures were found simultaneously with distant metastasis. There was no significant difference in patterns of failure or survival between groups. The 5-year DFS and DMFS for patients with WBI and WBI+SCNRT were 94.4% versus 92.6% (p=0.50) and 95.1% versus 94.5% (p=0.99), respectively. The rates of lymphedema and radiation pneumonitis were significantly higher in the WBI+SCNRT than in the WBI. CONCLUSION: We did not find a benefit of SCNRT for N1 breast cancer patients receiving AT-based chemotherapy.
Breast Neoplasms* ; Breast* ; Case-Control Studies* ; Disease-Free Survival ; Drug Therapy* ; Humans ; Lymph Nodes ; Lymphatic Irradiation ; Lymphedema ; Mastectomy, Segmental* ; Neoplasm Metastasis ; Propensity Score ; Radiation Pneumonitis ; Radiotherapy ; Radiotherapy, Adjuvant ; Recurrence