Purpose: This study explored the experiences of physicians and nurses providing end-oflife care in Korean acute care hospitals. It aimed to identify the challenges faced in caring for dying patients and to suggest strategies for improving hospital-based end-of-life care. Methods: A qualitative exploratory design was employed using focus group interviews.Eleven healthcare professionals (five physicians and six nurses) working in tertiary or general hospitals participated in the study between July and August 2018. The interviews were conducted using a semi-structured guide covering seven thematic areas. All sessions were audio-recorded, transcribed verbatim, and analyzed thematically following Braun and Clarke’s framework. Results: Six major themes emerged: (1) communication with patients and families, (2) physical care for dying patients, (3) psychological and spiritual support, (4) hospital environment and system constraints, (5) moral distress and emotional burden on healthcare providers, and (6) suggestions for improvement. The participants described difficulties in open communication, limited resources for comfort care, emotional strain from invasive treatment at the end of life, and the absence of standardized institutional protocols.They emphasized the need for structured communication training, multidisciplinary collaboration, and integration of palliative care principles into acute care practice. Conclusion Physicians and nurses play a pivotal yet emotionally demanding role in providing end-oflife care in acute hospitals. Institutional reforms, including education, protocol development, and supportive environments, are essential to ensuring dignified, patient-centered care and sustain healthcare providers in their professional roles.

Purpose: Patients with stage I colorectal cancer (CRC) rarely experience recurrence after curative resection. Therefore, the risk factors for stage I CRC recurrence are yet to be established. We aimed to identify risk factors for stage I CRC recurrence. Methods: MEDLINE, Embase, and Cochrane Library were searched for articles published between 1990 and 2022. The pooled proportions and hazard ratios (HRs) were calculated. Fixed- or random-effect models were considered based on heterogeneity, using Cochran’s Q-statistic and the I2 -test. Results: Nine studies involving 19,440 patients were included. Nine analyzed risk factors were identified. T2 stage (pooled HR, 2.070; 95% confidence interval [CI], 1.758–2.438; P < 0.001; I2 =0.0%), lymphovascular invasion (HR, 1.685; 95% CI, 1.420–1.999; P < 0.001; I2 = 0.0%), venous invasion (HR, 1.794; 95% CI, 1.515–2.125; P < 0.001; I2 = 0.0%), CEA level (HR, 1.472; 95% CI, 1.093–1.983; P = 0.011; I2 = 1.8%) and rectal cancer (HR, 2.981; 95% CI, 2.378–3.735; P < 0.001; I2 = 0.0%) were risk factors for the recurrence. However, the risk of recurrence in right-sided colon cancer was lower than in leftsided colon cancer. (HR, 0.712; 95% CI, 0.537–0.944; P = 0.018; I2 = 0.0%). No statistically significant differences were observed in the number of harvested lymph nodes, age, and sex. Conclusion T2 stage, lymphovascular invasion, venous invasion, CEA level, rectal cancer, and left-sided colon cancer were risk factors for recurrence in stage I CRC. Intensive monitoring and surveillance are warranted for patients with high-risk features of recurrence.

Purpose: Patients with stage I colorectal cancer (CRC) rarely experience recurrence after curative resection. Therefore, the risk factors for stage I CRC recurrence are yet to be established. We aimed to identify risk factors for stage I CRC recurrence. Methods: MEDLINE, Embase, and Cochrane Library were searched for articles published between 1990 and 2022. The pooled proportions and hazard ratios (HRs) were calculated. Fixed- or random-effect models were considered based on heterogeneity, using Cochran’s Q-statistic and the I2 -test. Results: Nine studies involving 19,440 patients were included. Nine analyzed risk factors were identified. T2 stage (pooled HR, 2.070; 95% confidence interval [CI], 1.758–2.438; P < 0.001; I2 =0.0%), lymphovascular invasion (HR, 1.685; 95% CI, 1.420–1.999; P < 0.001; I2 = 0.0%), venous invasion (HR, 1.794; 95% CI, 1.515–2.125; P < 0.001; I2 = 0.0%), CEA level (HR, 1.472; 95% CI, 1.093–1.983; P = 0.011; I2 = 1.8%) and rectal cancer (HR, 2.981; 95% CI, 2.378–3.735; P < 0.001; I2 = 0.0%) were risk factors for the recurrence. However, the risk of recurrence in right-sided colon cancer was lower than in leftsided colon cancer. (HR, 0.712; 95% CI, 0.537–0.944; P = 0.018; I2 = 0.0%). No statistically significant differences were observed in the number of harvested lymph nodes, age, and sex. Conclusion T2 stage, lymphovascular invasion, venous invasion, CEA level, rectal cancer, and left-sided colon cancer were risk factors for recurrence in stage I CRC. Intensive monitoring and surveillance are warranted for patients with high-risk features of recurrence.

Purpose: Patients with stage I colorectal cancer (CRC) rarely experience recurrence after curative resection. Therefore, the risk factors for stage I CRC recurrence are yet to be established. We aimed to identify risk factors for stage I CRC recurrence. Methods: MEDLINE, Embase, and Cochrane Library were searched for articles published between 1990 and 2022. The pooled proportions and hazard ratios (HRs) were calculated. Fixed- or random-effect models were considered based on heterogeneity, using Cochran’s Q-statistic and the I2 -test. Results: Nine studies involving 19,440 patients were included. Nine analyzed risk factors were identified. T2 stage (pooled HR, 2.070; 95% confidence interval [CI], 1.758–2.438; P < 0.001; I2 =0.0%), lymphovascular invasion (HR, 1.685; 95% CI, 1.420–1.999; P < 0.001; I2 = 0.0%), venous invasion (HR, 1.794; 95% CI, 1.515–2.125; P < 0.001; I2 = 0.0%), CEA level (HR, 1.472; 95% CI, 1.093–1.983; P = 0.011; I2 = 1.8%) and rectal cancer (HR, 2.981; 95% CI, 2.378–3.735; P < 0.001; I2 = 0.0%) were risk factors for the recurrence. However, the risk of recurrence in right-sided colon cancer was lower than in leftsided colon cancer. (HR, 0.712; 95% CI, 0.537–0.944; P = 0.018; I2 = 0.0%). No statistically significant differences were observed in the number of harvested lymph nodes, age, and sex. Conclusion T2 stage, lymphovascular invasion, venous invasion, CEA level, rectal cancer, and left-sided colon cancer were risk factors for recurrence in stage I CRC. Intensive monitoring and surveillance are warranted for patients with high-risk features of recurrence.

Purpose: This report describes the development of a simulation scenario for medical student that incorporates cultural diversity within the context of family presence during resuscitation (FPDR). Methods: Using a hybrid simulation approach, we designed a scenario focusing on communication with a family that immigrated from Korea to the United States during cardiopulmonary resuscitation (CPR). The scenario objectives were for learners to perform CPR with family presence, communicate with the family, and understand and negotiate cultural needs. Following a pilot scenario with two inexperienced volunteer medical students as learners, the program was evaluated through anonymous surveys and informal focus group feedback. Results: Students noted that this simulation differed from previous experiences as compared with emphasizing family communication rather than patient diagnosis or treatment. Students valued experiencing the practical application of cultural competence concepts. The suggestions for scenario improvement included balancing two student participation roles, adjusting the timeline, and utilizing a standardized family member. Conclusion This pilot study suggests that an FPDR simulation program can be effectively repeated with multiple medical students and applied to CPR simulations involving diverse cultural backgrounds.

Purpose: This report describes the development of a simulation scenario for medical student that incorporates cultural diversity within the context of family presence during resuscitation (FPDR). Methods: Using a hybrid simulation approach, we designed a scenario focusing on communication with a family that immigrated from Korea to the United States during cardiopulmonary resuscitation (CPR). The scenario objectives were for learners to perform CPR with family presence, communicate with the family, and understand and negotiate cultural needs. Following a pilot scenario with two inexperienced volunteer medical students as learners, the program was evaluated through anonymous surveys and informal focus group feedback. Results: Students noted that this simulation differed from previous experiences as compared with emphasizing family communication rather than patient diagnosis or treatment. Students valued experiencing the practical application of cultural competence concepts. The suggestions for scenario improvement included balancing two student participation roles, adjusting the timeline, and utilizing a standardized family member. Conclusion This pilot study suggests that an FPDR simulation program can be effectively repeated with multiple medical students and applied to CPR simulations involving diverse cultural backgrounds.

Purpose: This report describes the development of a simulation scenario for medical student that incorporates cultural diversity within the context of family presence during resuscitation (FPDR). Methods: Using a hybrid simulation approach, we designed a scenario focusing on communication with a family that immigrated from Korea to the United States during cardiopulmonary resuscitation (CPR). The scenario objectives were for learners to perform CPR with family presence, communicate with the family, and understand and negotiate cultural needs. Following a pilot scenario with two inexperienced volunteer medical students as learners, the program was evaluated through anonymous surveys and informal focus group feedback. Results: Students noted that this simulation differed from previous experiences as compared with emphasizing family communication rather than patient diagnosis or treatment. Students valued experiencing the practical application of cultural competence concepts. The suggestions for scenario improvement included balancing two student participation roles, adjusting the timeline, and utilizing a standardized family member. Conclusion This pilot study suggests that an FPDR simulation program can be effectively repeated with multiple medical students and applied to CPR simulations involving diverse cultural backgrounds.

Purpose: This report describes the development of a simulation scenario for medical student that incorporates cultural diversity within the context of family presence during resuscitation (FPDR). Methods: Using a hybrid simulation approach, we designed a scenario focusing on communication with a family that immigrated from Korea to the United States during cardiopulmonary resuscitation (CPR). The scenario objectives were for learners to perform CPR with family presence, communicate with the family, and understand and negotiate cultural needs. Following a pilot scenario with two inexperienced volunteer medical students as learners, the program was evaluated through anonymous surveys and informal focus group feedback. Results: Students noted that this simulation differed from previous experiences as compared with emphasizing family communication rather than patient diagnosis or treatment. Students valued experiencing the practical application of cultural competence concepts. The suggestions for scenario improvement included balancing two student participation roles, adjusting the timeline, and utilizing a standardized family member. Conclusion This pilot study suggests that an FPDR simulation program can be effectively repeated with multiple medical students and applied to CPR simulations involving diverse cultural backgrounds.

The aim of this study was to investigate the relaxant effect of ethanol extract, fractions from Epimedium koreanum (E. koreanum) on penile corpus cavernosum smooth muscle (PCCSM) in a rabbit. The contractility on PCCSM was also evaluated with icariin, active major compound, from E. koreanum quantified using HPLC analysis. The pre-contracted PCCSM with 10 μM phenylephrine (Phe) was accumulatively treated with extract and fractions (n-hexane, ethyl acetate and n-butanol) from E. koreanum at concentrations of 1, 2, 3 and 4 mg/mL. Icariin was performed with final concentrations of 0.1, 1, 10 and 100 μM. The interaction of icariin with phosphodiesterase-5 (PDE-5) inhibitor, udenafil, was also examined on PCCSM contractility. Extract and three fractions had the relaxant effect on PCCSM in a dose-dependent manner and the maximum relaxation was obtained in ethyl acetate fraction. Icariin dose-dependently relaxed the PCCSM and efficiently enhanced the udenafil-induced relaxation at least two-fold. These results indicate the possibility that icariin fromE. koreanum may be a candidate for a new or alternative medicine in erectile dysfunction patients who do not completely respond to PDE-5 inhibitors.

Purpose: It is important to reduce stress and improve quality of life for shift nurses, who experience high levels of occupational stress. Identifying evidence-based interventions to enhance their well-being is crucial for both individual and healthcare system outcomes. This study aimed to evaluate the effects of music therapy and aromatherapy on stress, quality of life, and happiness among shift nurses. Methods: In this randomized controlled trial, participants were randomly assigned using computer-generated random numbers. A total of 78 shift nurses who met the inclusion criteria were enrolled. The experimental treatment involved providing music therapy for one week to the music group and aromatherapy for one week to the aroma group, whereas the control group followed their usual daily routines for one week. Results: No significant differences were observed among the three groups concerning general characteristics and baseline dependent variables, thereby confirming the homogeneity of the groups. Nevertheless, post-intervention analyses demonstrated significant improvements in perceived stress (F = 5.55, p = .006), stress index (F = 3.38, p = .039), quality of life (F = 11.79, p < .001), and happiness (F = 9.29, p < .001) in the experimental groups. Conclusion Both music therapy and aromatherapy were found to be effective in mitigating stress and improving quality of life and happiness among shift nurses. Therefore, these interventions can be regarded as valuable strategies for improving overall well-being within this population.