Background: s/Aims: In recent years, many minimally invasive techniques have been introduced to reduce the number of ports in laparoscopic cholecystectomy (LC), offering benefits such as reduced postoperative pain and improved cosmetic outcomes. ArtiSential®is a new multi-degree-of-freedom articulating laparoscopic instrument that incorporates the ergonomic features of robotic surgery, potentially overcoming the spatial limitations of laparoscopic surgery. ArtiSential® LC can be performed using only two ports. This study aims to compare the surgical outcomes of ArtiSential® LC with those of single-fulcrum LC. Methods: This retrospective study compared ArtiSential® LC and single-fulcrum LC among LCs performed for gallbladder (GB) stones at the same center, analyzing the basic characteristics of patients; intraoperative outcomes, such as operative time, estimated blood loss, and intraoperative GB rupture; and postoperative outcomes, such as length of hospital stay, incidence of postoperative complications, and postoperative pain. Results: A total of 88 and 63 patients underwent ArtiSential® LC and single-fulcrum LC for GB stones, respectively. Analysis showed that ArtiSential® LC resulted in significantly fewer cases of surgeries longer than 60 minutes (30 vs. 35 min, p = 0.009) and intraoperative GB ruptures (2 vs. 10, p = 0.007). In terms of postoperative outcomes, ArtiSential® LC showed better results in the respective visual analog scale (VAS) scores immediately after surgery (2.59 vs. 3.73, p < 0.001), and before discharge (1.44 vs. 2.02, p = 0.01). Conclusions ArtiSential® LC showed better results in terms of surgical outcomes, especially postoperative pain. Thus, ArtiSential®LC is considered the better option for patients, compared to single-fulcrum LC.

Background: s/Aims: In recent years, many minimally invasive techniques have been introduced to reduce the number of ports in laparoscopic cholecystectomy (LC), offering benefits such as reduced postoperative pain and improved cosmetic outcomes. ArtiSential®is a new multi-degree-of-freedom articulating laparoscopic instrument that incorporates the ergonomic features of robotic surgery, potentially overcoming the spatial limitations of laparoscopic surgery. ArtiSential® LC can be performed using only two ports. This study aims to compare the surgical outcomes of ArtiSential® LC with those of single-fulcrum LC. Methods: This retrospective study compared ArtiSential® LC and single-fulcrum LC among LCs performed for gallbladder (GB) stones at the same center, analyzing the basic characteristics of patients; intraoperative outcomes, such as operative time, estimated blood loss, and intraoperative GB rupture; and postoperative outcomes, such as length of hospital stay, incidence of postoperative complications, and postoperative pain. Results: A total of 88 and 63 patients underwent ArtiSential® LC and single-fulcrum LC for GB stones, respectively. Analysis showed that ArtiSential® LC resulted in significantly fewer cases of surgeries longer than 60 minutes (30 vs. 35 min, p = 0.009) and intraoperative GB ruptures (2 vs. 10, p = 0.007). In terms of postoperative outcomes, ArtiSential® LC showed better results in the respective visual analog scale (VAS) scores immediately after surgery (2.59 vs. 3.73, p < 0.001), and before discharge (1.44 vs. 2.02, p = 0.01). Conclusions ArtiSential® LC showed better results in terms of surgical outcomes, especially postoperative pain. Thus, ArtiSential®LC is considered the better option for patients, compared to single-fulcrum LC.

Background: s/Aims: In recent years, many minimally invasive techniques have been introduced to reduce the number of ports in laparoscopic cholecystectomy (LC), offering benefits such as reduced postoperative pain and improved cosmetic outcomes. ArtiSential®is a new multi-degree-of-freedom articulating laparoscopic instrument that incorporates the ergonomic features of robotic surgery, potentially overcoming the spatial limitations of laparoscopic surgery. ArtiSential® LC can be performed using only two ports. This study aims to compare the surgical outcomes of ArtiSential® LC with those of single-fulcrum LC. Methods: This retrospective study compared ArtiSential® LC and single-fulcrum LC among LCs performed for gallbladder (GB) stones at the same center, analyzing the basic characteristics of patients; intraoperative outcomes, such as operative time, estimated blood loss, and intraoperative GB rupture; and postoperative outcomes, such as length of hospital stay, incidence of postoperative complications, and postoperative pain. Results: A total of 88 and 63 patients underwent ArtiSential® LC and single-fulcrum LC for GB stones, respectively. Analysis showed that ArtiSential® LC resulted in significantly fewer cases of surgeries longer than 60 minutes (30 vs. 35 min, p = 0.009) and intraoperative GB ruptures (2 vs. 10, p = 0.007). In terms of postoperative outcomes, ArtiSential® LC showed better results in the respective visual analog scale (VAS) scores immediately after surgery (2.59 vs. 3.73, p < 0.001), and before discharge (1.44 vs. 2.02, p = 0.01). Conclusions ArtiSential® LC showed better results in terms of surgical outcomes, especially postoperative pain. Thus, ArtiSential®LC is considered the better option for patients, compared to single-fulcrum LC.

Background/Aims: Metabolic dysfunction-associated steatotic liver disease (MASLD) is characterized by fat accumulation in the liver. MASLD encompasses both steatosis and MASH. Since MASH can lead to cirrhosis and liver cancer, steatosis and MASH must be distinguished during patient treatment. Here, we investigate the genomes, epigenomes, and transcriptomes of MASLD patients to identify signature gene set for more accurate tracking of MASLD progression. Methods: Biopsy-tissue and blood samples from patients with 134 MASLD, comprising 60 steatosis and 74 MASH patients were performed omics analysis. SVM learning algorithm were used to calculate most predictive features. Linear regression was applied to find signature gene set that distinguish the stage of MASLD and to validate their application into independent cohort of MASLD. Results: After performing WGS, WES, WGBS, and total RNA-seq on 134 biopsy samples from confirmed MASLD patients, we provided 1,955 MASLD-associated features, out of 3,176 somatic variant callings, 58 DMRs, and 1,393 DEGs that track MASLD progression. Then, we used a SVM learning algorithm to analyze the data and select the most predictive features. Using linear regression, we identified a signature gene set capable of differentiating the various stages of MASLD and verified it in different independent cohorts of MASLD and a liver cancer cohort. Conclusions We identified a signature gene set (i.e., CAPG, HYAL3, WIPI1, TREM2, SPP1, and RNASE6) with strong potential as a panel of diagnostic genes of MASLD-associated disease.

Defining the molecular dynamics associated with T cell differentiation enhances our understanding of T cell biology and opens up new possibilities for clinical implications. In this study, we investigated the dynamics of CD5 expression in CD8+ T cell differentiation and explored its potential clinical uses. Using PBMCs from 29 healthy donors, we observed a stepwise decrease in CD5 expression as CD8+ T cells progressed through the differentiation stages. Interestingly, we found that CD5 expression was initially upregulated in response to T cell receptor stimulation, but diminished as the cells underwent proliferation, potentially explaining the differentiation-associated CD5 downregulation. Based on the proliferationdependent downregulation of CD5, we hypothesized that relative CD5 expression could serve as a marker to distinguish the heterogeneous CD8+ T cell population based on their proliferation history. In support of this, we demonstrated that effector memory CD8+ T cells with higher CD5 expression exhibited phenotypic and functional characteristics resembling less differentiated cells compared to those with lower CD5 expression. Furthermore, in the retrospective analysis of PBMCs from 30 non-small cell lung cancer patients, we found that patients with higher CD5 expression in effector memory T cells displayed CD8+ T cells with a phenotype closer to the less differentiated cells, leading to favorable clinical outcomes in response to immune checkpoint inhibitor (ICI) therapy. These findings highlight the dynamics of CD5 expression as an indicator of CD8+ T cell differentiation status, and have implications for the development of predictive biomarker for ICI therapy.

Purpose: The purpose of the study was to analyze the status of dietary behavior and nutrition intakes according to the gender and the level of physical activity of adolescents. Methods: Data from 659 adolescents aged 13 to 18 years who participated in the Korea National Health and Nutrition Examination Survey (2017–2018) were analyzed. Collected data were analyzed using complex sampling data analysis with SPSS v. 27.0. Results: The adolescents were categorized into three groups based on their physical activity as follows: The first group with high physical activity (8.9%), a second group with normal physical activity (29.7%), and a third group without physical activity (61.4%). Boys showed significantly higher physical activity than the girls. Adolescents with high physical activity had a significantly lower body mass index than adolescents without physical activity, but their meal regularity, subjective health status, and recognition of body image were significantly higher. In terms of biochemical factors, adolescents with high physical activity had lower triglycerides and cholesterol than adolescents without physical activity, while hemoglobin and hematocrit were significantly higher. In addition, the intakes of energy, carbohydrates, proteins, fat, vitamin B 1 , niacin, calcium, phosphorus, sodium, potassium, iron increased significantly as adolescents’ physical activity increased. Conclusion The physical activity of adolescents had a positive effect on dietary behavior, lifestyle, and nutritional factors. Therefore, it is necessary to increase participation in physical classes in schools and develop various programs considering the level of physical activity among adolescents.

Purpose: This study examines the weight control behavior depending on university students’ motives of using social media. Methods: The participants were 447 university students in the Jeonbuk area. Collected data were analyzed using factor analysis, cluster analysis, analysis of variance, and χ 2 tests with SPSS v. 26.0. Considering the motives of using social media, we investigated the usage of social media, dietary behavior related to social media, and weight control behavior. Results: Using the K-clustering method, the motives to use social media were categorized into three clusters: cluster 1 was the interest-centered group, cluster 2 was the multipurpose information-seeking group, and cluster 3 was the relationship-centered group. Among the various social media sites, YouTube (86.8%), Instagram (76.1%), and Facebook (61.1%) were the most visited by the subjects. The dietary behavior related to social media in cluster 2 was significantly higher than clusters 1 and 3 (p < 0.001). Clusters 1 and 2 showed a significantly higher dissatisfaction with one’s weight (p < 0.05) and consequent interest in weight control than cluster 3 (p < 0.001). Cluster 2 used weight control-related information from social media significantly more than other clusters (p < 0.05). Weight control experiences in cluster 1 and 2 were significantly higher than in cluster 3 (p < 0.001). Conclusion Differences in dietary behavior related to social media and weight control behavior were observed between cluster types of motivation to use social media. Based on the usage motives of university students and their behaviors, we propose that educational programs should be conducted for weight control using social media.

Purpose: This study sought to predict the reasons for skipping breakfast by adolescents aged 13–18 years using the 7th Korea National Health and Nutrition Examination Survey (KNHANES). Methods: The participants included 1,024 adolescents. The data were analyzed using a complex-sample t-test, the Rao Scott χ2-test, and the classification and regression tree (CART) algorithm for decision tree analysis with SPSS v. 27.0. The participants were divided into two groups, one regularly eating breakfast and the other skipping it. Results: A total of 579 and 445 study participants were found to be breakfast consumers and breakfast skippers respectively. Breakfast consumers were significantly younger than those who skipped breakfast. In addition, breakfast consumers had a significantly higher frequency of eating dinner, had been taught about nutrition, and had a lower frequency of eating out. The breakfast skippers did so to lose weight. Children who skipped breakfast consumed less energy, carbohydrates, proteins, fats, fiber, cholesterol, vitamin C, vitamin A, calcium, vitamin B1, vitamin B2, phosphorus, sodium, iron, potassium, and niacin than those who consumed breakfast. The best predictor of skipping breakfast was identifying adolescents who sought to control their weight by not eating meals. Other participants who had low and middle-low household incomes, ate dinner 3–4 times a week, were more than 14.5 years old, and ate out once a day showed a higher frequency of skipping breakfast. Conclusion Based on these results, nutrition education targeted at losing weight correctly and emphasizing the importance of breakfast, especially for adolescents, is required. Moreover, nutrition educators should consider designing and implementing specific action plans to encourage adolescents to improve their breakfast-eating practices by also eating dinner regularly and reducing eating out.

Purpose: The purpose of the study was to analyze the priorities for educational content regarding precautions to be taken to prevent safety accidents for employees in school foodservice using the Borich priority formula and the Locus for Focus model. Methods: A survey was conducted in February 2019 on 194 employees in elementary school and 122 employees in middle- and high school foodservice in the Jeonbuk area. Demographic characteristics, status of safety accidents, safety education, and their importance and performance levels were assessed using a self-administered questionnaire. The priorities for the educational content on precautions to prevent safety accidents were based on a 3-step analysis method, including the paired sample t-test, Borich priority formula, and the Locus for Focus Model. Results: The average perceived importance of the precautions to be taken against safety accidents of employees in elementary-, middle-, and high schools was higher compared to the average performance of the employees (p < 0.001). The top priority for elementary school employees was caution against falls during the cleaning of the gas hood and the trench in the kitchen. In addition, ‘awareness of chemical signs’ was added as one of the top priorities of middle- and high school employees. The second highest priority items were ‘do stretching’, ‘safely adjusting workbench height’, ‘keeping the right attitude’, ‘using assistive devices when moving heavy things’, and ‘checking the material safety data sheet’, which were the same for all elementary, middle- and high school employees. Conclusion Thus, to improve the educational preparedness of employees in the area of safety precautions, eight safety/accident prevention items should be included in the safety education program.

Objective: To evaluate the ultrasonography (US) features for diagnosing metastasis in cervical lymph nodes (LNs) in patients with thyroid cancer and compare the US classification of risk of LN metastasis between European and Korean guidelines. Materials and Methods: From January 2014 to December 2018, US-guided fine-needle aspiration was performed on 836 LNs from 714 patients for the preoperative nodal staging of thyroid cancer. The US features of LNs were retrospectively reviewed for the following features: size, presence of hilum, margin, orientation, cystic change, punctate echogenic foci (PEF), large echogenic foci, eccentric cortical thickening, abnormal vascularity, and cortical hyperechogenicity. A multiple logistic regression analysis was performed to identify the independent US features for the diagnosis of metastatic LNs. The diagnostic performance of independent US features was subsequently evaluated. LNs were categorized according to the Korean Thyroid Imaging Reporting and Data System (K-TIRADS) and European Thyroid Association (ETA) guidelines, and the correlation between the two sets of classifications was assessed. Results: Absence of the hilum, presence of cystic changes, PEF, abnormal vascularity, and cortical hyperechogenicity were independent US features of metastatic LNs. Cystic changes, PEF, abnormal vascularity, and cortical hyperechogenicity showed high specificity (86.8%–99.6%). The absence of the hilum had the highest sensitivity yet low specificity (66.4%). When LNs were classified according to the ETA guidelines and K-TIRADS, they yielded similar categorizations of malignancy risks and were strongly correlated (Spearman coefficient, 0.9766 [95% confidence interval, 0.973–0.979]). According to the ETA guidelines, 9.8% (82/836) of LNs were classified as “not specified.” Conclusion Absence of hilum, cystic changes, PEF, abnormal vascularity, and cortical hyperechogenicity were independent US features suggestive of metastatic LNs in thyroid cancer. Both K-TIRADS and the ETA guidelines provided similar risk stratification for metastatic LNs with a high correlation; however, the ETA guidelines failed to classify 9.8% of LNs into a specific risk stratum. These results may provide a basis for revising LN classification in future guidelines.