Insomnia has been identified as a risk factor for suicide. Apart from its indirect influence on suicide risk through comorbid psychiatric illnesses, there is also strong empirical evidence that insomnia is an independent risk factor for suicide. Insomnia may affect suicide through different mechanisms, such as mood dysregulation, hopelessness, impulsivity, and sleep deprivation. Cognitive-behavioral therapy for insomnia (CBTI) is an evidence-based, non-pharmacological treatment that is effective in treating both primary and comorbid insomnia disorder. Treatment effects of CBTI can be extended to alleviate suicidality by improving sleep disturbance. Through a literature review, we summarize available data which suggests that CBTI may decrease suicidality risk, and provide clinical implications about utilizing CBTI for high risk suicidal patients.
Humans ; Impulsive Behavior ; Risk Factors ; Sleep Deprivation ; Sleep Initiation and Maintenance Disorders ; Suicide

Purpose: This study aimed to explore ecological factors and strategies for childhood obesity prevention targeting vulnerable children using a community-based participatory research (CBPR) methodology. Methods: The CBPR was conducted by following basic process steps. Participants were 12 community stakeholders such as community child center directors (n=4), vulnerable children’s mothers (n=3), community health center officials (n=2), and lay health advisors (n=4); they were purposively sampled from K municipal county in Seoul, South Korea. The qualitative content analysis was performed to explore main themes of the ecological factors and strategies by using data obtained from 5 times of focus group interview. Results: Twelve ecological factors associated with childhood obesity prevention were identified: Intrapersonal factors including emotional overeating; interpersonal factors including permissive parenting style of children’s eating behaviors; organizational factors including social workers’ less educational opportunities; and community/policy factors including less government financial support. Four ecological strategies for childhood obesity prevention were addressed: Developing obesity prevention programs targeting vulnerable children’ lifestyles; promoting parents’ active participation in education; building healthy meal service environments through empowering social workers; and building supportive community environment and securing community resources for child obesity prevention. Conclusion Our findings may be informative in terms of providing a comprehensive understanding of multi-level ecological barriers against vulnerable children’ obesity prevention and, moreover, guiding multi-level strategies for preventing childhood obesity targeting children enrolled in community child centers.

PURPOSE: The objective of this study was to investigate the effects of a high fructose and fat diet on bone growth and maturation in growing female rats. METHODS: Three-week-old female SD rats were randomly assigned to four experimental groups; the control group (CON: fed control diet based on AIN-93G, n = 8); the high-fructose diet group (HFrc: fed control diet with 30% fructose, n = 8); the high-fat diet group (Hfat: fed control diet with 45 kcal% fat, n = 8); and the high-fat diet plus high fructose group (HFrc + HFat: fed diets 45 kcal% fat with 30% fructose, n = 8). Each group was assigned their respective diets for the remaining eight weeks. Bone-related parameters (bone mineral density (BMD) and structural parameters, osteocalcin (OC), deoxypyridinoline (DPD)) and morphologic changes of kidney were analyzed at the end of the experiment. RESULTS: Final body weights and weight gain were higher in the HFat and HFrc + HFat groups and showed higher tendency in the HFrc group compared with those of the CON group (p < 0.05); however, no significant difference in caloric intake was observed among the four experimental groups. The serum OC levels of the HFrc and HFrc + HFat groups were lower than those of the CON and HFat groups (p < 0.05). Urinary levels of DPD did not differ among the experimental groups. BV/TV and Tb.N of trabecular bone were higher in the HFrc + HFat group and showed a higher tendency in the HFrc group than those of the CON and HFat groups (p < 0.05). Tb.Pf of trabecular bone were lower in the HFrc + HFat group than those in the CON and HFat groups (p < 0.05). However, no difference in trabecular BMD was observed among the experimental groups. Cortical bone volume was higher in the HFat and HFrc + HFat groups than in the CON and HFrc groups (p < 0.05). No morphology change in kidney was observed among the experimental groups. CONCLUSION: Our study suggests that 8 weeks of high-fructose and high fat intake could improve the bone quality (Structural parameters) of trabecular and cortical bone of tibia in growing female rats.
Animals ; Body Weight ; Bone Development ; Diet ; Diet, High-Fat* ; Energy Intake ; Female* ; Fructose* ; Humans ; Kidney ; Osteocalcin ; Rats* ; Tibia ; Weight Gain

Nightmares are vivid, unpleasant dreams that result in awakening during sleep. According to previous studies, the prevalence of nightmare disorder is 2–5% of the general population and is associated with other medical conditions and mental illnesses. Imagery rehearsal therapy (IRT) is an evidence-based treatment for nightmare disorder. The current study is a case study with a 35-year-old female who was diagnosed with nightmare disorder and posttraumatic stress disorder, and participated in IRT for five sessions. Prior to treatment, the patient reported difficulties initiating and maintaining sleep, and reported suffering from nightmares more than 2–3 times per week. After treatment, the patient reported no longer experienced nightmares, accompanied by improvements in both sleep and clinical indicators.
Adult ; Dreams ; Female ; Humans ; Prevalence ; Sleep Initiation and Maintenance Disorders ; Stress Disorders, Post-Traumatic

Scalp defect management is complicated secondary to reduced laxity in the scalp and forehead area. For reconstruction of larger defects with exposed bone and loss of the periosteal layer, free flap reconstruction is one option for single-stage surgery, although the procedure is lengthy and includes the possibility of flap loss. We successfully performed a single-stage reconstruction of a large scalp defect using a combination of artificial dermis, split-thickness skin graft, and full-thickness skin graft following wide excision of a cutaneous angiosarcoma, and present our method as one option for the treatment of large oncologic surgical defects in patients who are poor candidates for free flap surgery.
Dermis* ; Forehead ; Free Tissue Flaps ; Hemangiosarcoma ; Humans ; Methods ; Scalp* ; Skin ; Skull* ; Transplants

Trichothiodystrophy is a rare autosomal recessive disorder and it is caused by reduced levels of high-sulfur amino acids and most particularly cystine in hair shafts. The patients with trichothiodystrophy show a broad range of clinical phenotypes from only hair involvement to multisystem abnormalities. A 7-year-old girl visited the clinic with a complaint of short, sparse and slow-growing hair, which had been presented since birth. The patient's hair showed characteristic dark and light banding, which gave a "tiger tail" appearance under light microscopy, and polarization and cuticular degeneration were seen under the scanning microscopy. Evaluation of the mineral density in the patient's hair shaft showed a low level of sulfur. We herein report on a case of trichothiodystrophy with sulfur-deficiency in the hair shafts.
Amino Acids ; Child ; Cystine ; Hair ; Humans ; Light ; Microscopy ; Parturition ; Phenotype ; Sulfur ; Trichothiodystrophy Syndromes

BACKGROUND: Children today are exposed to various media devices, and their usage of these is increasing. Prior studies have outlined forms of harm this can potentially cause. However, there has been little empirical research on the use of media devices among preschool children in Asia. The aim of this study was to examine and analyze longitudinal trends in media device use among Korean preschool children, focusing on the frequency of engagement, time spent with, and ownership of media devices, delineated by sex. METHODS: Four hundred parents of children aged 2–5 years were invited to enroll. The baseline assessment, Wave 1, was conducted between December 2015 and June 2016, and follow-up assessments, Wave 2 and Wave 3, were conducted annually for the following 2 years. Time of media use, frequency of media use, and ownership of media devices (TV, tablet PCs, and smartphones) were investigated. RESULTS: Ownership of tablet PCs increased significantly between Wave 1 and Wave 3 for boys and girls (corrected P < 0.001). Frequency of media use increased significantly between Wave 1 and Wave 3 only in boys' use of tablet PCs (mean difference 0.8 day/wk). Time of media use increased significantly between Wave 1 and Wave 3 for both sexes in all devices, measured by mean difference on weekdays and weekends (TV by 0.6 and 0.7 hr/day, tablet PCs by 0.6 and 0.8 hr/day, and smartphones by 0.4 and 0.4 hr/day). Children spent more time using media devices during weekends than on weekdays. CONCLUSION: This study observed an increase in the tendency of media device use among preschool children in Korea. The patterns of use indicate that paying attention to the types of devices children use is needed, as well as vigilance on weekends.
Asia ; Child ; Child, Preschool ; Empirical Research ; Female ; Follow-Up Studies ; Humans ; Korea ; Ownership ; Parents ; Smartphone

The coronavirus disease (COVID-19) outbreak has reached global pandemic status as announced by the World HealthOrganization, which currently recommends reverse transcription polymerase chain reaction (RT-PCR) as the standard diagnostictool. However, although the RT-PCR test results may be found negative, there are cases that are found positive for COVID-19pneumonia on computed tomography (CT) scan. CT is also useful in assessing the severity of COVID-19 pneumonia. Whenclinicians desire a CT scan of a patient with COVID-19 to monitor treatment response, a safe method for patient transport isnecessary. To address the engagement of medical resources necessary to transport a patient with COVID-19, our institutionhas implemented the use of mobile CT. Therefore, we report two cases of COVID-19 pneumonia evaluated by using mobilecone-beam CT. Although mobile cone-beam CT had some limitations regarding its image quality such as scatter noise, motionand streak artifacts, and limited field of view compared with conventional multi-detector CT, both cases had acceptable imagequality to establish the diagnosis of COVID-19 pneumonia. We report the usefulness of mobile cone-beam CT in patients withCOVID-19 pneumonia.

Objective: As smartphone use is becoming more common, the age of initial exposure to devices is becoming younger. Young children’s screen use is influenced by various factors; it is more directly dependent on family environment than school-aged children. Our study aimed to examine the effect of mother’s smartphone addition on their child’s smartphone use. Methods: Participants were from the Kids Cohort for Understanding of internet addiction Risk factors in early childhood (K-CURE) study. Adult smartphone addiction self-diagnosis scale was used to evaluate smartphone addiction degree of mother. Child’s smartphone use was assessed by parental questionnaire. Using logistic regression analysis, we examine the association between mother’s smartphone addiction and child’s smartphone use. Results: After adjusting for other factors, mother’s smartphone addiction is related with early smartphone exposure of children. Highrisk group’s children was exposed to smartphone earlier than low risk group (adjusted OR, 0.418; p=0.021). Contrary to expectation, there is no correlation between mother’s smartphone addiction and child’s smartphone use time. Conclusion Our study explain that mother’s smartphone addiction can affect early smartphone exposure on children. Based on our findings, further study might explore the effect of early smartphone exposure on children.

Purpose: Health behaviors for metabolic syndrome (MetS) prevention should be emphasized from early adulthood. There is little information on psychosocial factors associated with health behaviors for MetS prevention. The aim of this study was to determine whether there would be a mediating effect of perceived stress on the association between social support and health behaviors for MetS prevention among university students. Methods: This cross-sectional and correlation study was conducted with 502 university students in South Korea. Social support, perceived stress, and lifestyle evaluation for metabolic syndrome scales were used. Online questionnaire survey was conducted between November and December 2019. The mediating effect of social support on health behaviors for MetS prevention was analyzed using PROCESS macro program with bootstrapping method to test our hypotheses. Results: Social support directly influenced perceived stress (β=-.35, p<.001) and health behaviors for MetS prevention (β=.14, p=.002). Health behaviors for MetS prevention was indirectly influenced by perceived stress (β=-.25, p<.001). The size of indirect effect of social support on health behaviors for MetS prevention was 0.06. Conclusions The association of social support and health behaviors for MetS prevention was partially mediated by perceived stress among university students. Therefore, a university-based nursing intervention should comprise social support strategies with stress management to promote health behaviors for MetS prevention.