Background: Prevention and management of metabolic syndrome (MetS) during childhood are crucial. Recently, obesity among children and adolescents has increased with an increase in mothers’ working hours. The present study was conducted to determine the relationship between mothers’ working hours and MetS in their children. Methods: Data from the 2016–2020 National Health and Nutrition Examination Survey were used, and 2,598 children and adolescents aged 10–18 years were included. Logistic regression analysis was conducted to confirm the association between MetS and mothers’ working hours for each risk factor. Linear regression analysis was conducted to confirm the association between mothers’ working hours and the number of risk factors for MetS. Results: Abdominal obesity in children was higher when the mothers’ working hours were 53 hours or more (odds ratio [OR], 2.267; 95% confidence interval [CI], 1.21–4.25). In the trend analysis, the OR of children’s abdominal obesity increased significantly as mothers’ working hours increased (P-value <0.05). Additionally, sex-stratified analysis revealed a significant trend between maternal work hours and the presence of MetS in female children (P=0.016). The adjusted OR of the presence of MetS in female children with mothers working 53 hours or more weekly was 6.065 (95% CI, 1.954–18.822). Conclusion Mothers’ working hours were highly correlated with the risk of abdominal obesity in their children. The OR of the presence of MetS significantly increased in female children with mothers having longer working hours compared with those with stay-at-home mothers.

Background: Prevention and management of metabolic syndrome (MetS) during childhood are crucial. Recently, obesity among children and adolescents has increased with an increase in mothers’ working hours. The present study was conducted to determine the relationship between mothers’ working hours and MetS in their children. Methods: Data from the 2016–2020 National Health and Nutrition Examination Survey were used, and 2,598 children and adolescents aged 10–18 years were included. Logistic regression analysis was conducted to confirm the association between MetS and mothers’ working hours for each risk factor. Linear regression analysis was conducted to confirm the association between mothers’ working hours and the number of risk factors for MetS. Results: Abdominal obesity in children was higher when the mothers’ working hours were 53 hours or more (odds ratio [OR], 2.267; 95% confidence interval [CI], 1.21–4.25). In the trend analysis, the OR of children’s abdominal obesity increased significantly as mothers’ working hours increased (P-value <0.05). Additionally, sex-stratified analysis revealed a significant trend between maternal work hours and the presence of MetS in female children (P=0.016). The adjusted OR of the presence of MetS in female children with mothers working 53 hours or more weekly was 6.065 (95% CI, 1.954–18.822). Conclusion Mothers’ working hours were highly correlated with the risk of abdominal obesity in their children. The OR of the presence of MetS significantly increased in female children with mothers having longer working hours compared with those with stay-at-home mothers.

Background: Prevention and management of metabolic syndrome (MetS) during childhood are crucial. Recently, obesity among children and adolescents has increased with an increase in mothers’ working hours. The present study was conducted to determine the relationship between mothers’ working hours and MetS in their children. Methods: Data from the 2016–2020 National Health and Nutrition Examination Survey were used, and 2,598 children and adolescents aged 10–18 years were included. Logistic regression analysis was conducted to confirm the association between MetS and mothers’ working hours for each risk factor. Linear regression analysis was conducted to confirm the association between mothers’ working hours and the number of risk factors for MetS. Results: Abdominal obesity in children was higher when the mothers’ working hours were 53 hours or more (odds ratio [OR], 2.267; 95% confidence interval [CI], 1.21–4.25). In the trend analysis, the OR of children’s abdominal obesity increased significantly as mothers’ working hours increased (P-value <0.05). Additionally, sex-stratified analysis revealed a significant trend between maternal work hours and the presence of MetS in female children (P=0.016). The adjusted OR of the presence of MetS in female children with mothers working 53 hours or more weekly was 6.065 (95% CI, 1.954–18.822). Conclusion Mothers’ working hours were highly correlated with the risk of abdominal obesity in their children. The OR of the presence of MetS significantly increased in female children with mothers having longer working hours compared with those with stay-at-home mothers.

Background: Prevention and management of metabolic syndrome (MetS) during childhood are crucial. Recently, obesity among children and adolescents has increased with an increase in mothers’ working hours. The present study was conducted to determine the relationship between mothers’ working hours and MetS in their children. Methods: Data from the 2016–2020 National Health and Nutrition Examination Survey were used, and 2,598 children and adolescents aged 10–18 years were included. Logistic regression analysis was conducted to confirm the association between MetS and mothers’ working hours for each risk factor. Linear regression analysis was conducted to confirm the association between mothers’ working hours and the number of risk factors for MetS. Results: Abdominal obesity in children was higher when the mothers’ working hours were 53 hours or more (odds ratio [OR], 2.267; 95% confidence interval [CI], 1.21–4.25). In the trend analysis, the OR of children’s abdominal obesity increased significantly as mothers’ working hours increased (P-value <0.05). Additionally, sex-stratified analysis revealed a significant trend between maternal work hours and the presence of MetS in female children (P=0.016). The adjusted OR of the presence of MetS in female children with mothers working 53 hours or more weekly was 6.065 (95% CI, 1.954–18.822). Conclusion Mothers’ working hours were highly correlated with the risk of abdominal obesity in their children. The OR of the presence of MetS significantly increased in female children with mothers having longer working hours compared with those with stay-at-home mothers.

Purpose: Several studies have evaluated the impact of sarcopenic obesity (SO) on postoperative complications, including postoperative pancreatic fistula (POPF), in patients undergoing pancreatoduodenectomy (PD). Previous studies have shown that SO increases POPF, but it remains unclear whether SO increases postoperative complications. In this study, we aimed to determine the relationship between SO and immediate postoperative complications. Methods: From January 2005 to December 2019, the medical records of patients who underwent PD for periampullary cancer were retrospectively reviewed. Skeletal muscle index (SMI) and visceral fat area (VFA) were calculated from preoperative computed tomography images. Patients with high VFA were classified as obese, while those with low SMI were classified as sarcopenic. Patients were divided into 4 groups: normal group, sarcopenia only group, obesity only group, and SO group. Postoperative outcomes were compared between groups, and factors affecting postoperative complications were analyzed by multivariate analysis. Results: Normal group (n = 176), sarcopenia only group (n = 130), obesity only group (n = 207), and SO group (n = 117) were analyzed retrospectively. SO group had significantly more frequent major complications compared to the normal group (P = 0.006), as well as a significantly more frequent clinically relevant POPF compared to the other groups (P = 0.002). In multivariate analysis, SO was an independent risk factor for major complications (P = 0.008) and clinically relevant POPF (P = 0.003). Conclusion SO is a factor associated with poor immediate postoperative outcomes after PD for periampullary cancer.

OBJECTIVES: Studies evaluating weight changes during the coronavirus disease 2019 (COVID-19) pandemic have yielded inconsistent results, and most of those studies were based on self-reported anthropometric measures. We investigated changes in body mass index (BMI), professionally measured waist circumference (WC), and metabolic syndrome components from before to during the pandemic in a sample of the adult population in Korea. METHODS: This retrospective study included 1,118 male and female (age≥18 years) who underwent health checkups at a university medical center between January 1, 2016 and March 31, 2022. Changes in BMI, lifestyles, and metabolic syndrome components during the pandemic were analyzed using the paired t-test, McNemar test, generalized estimating equations, and repeated-measures analysis of variance. RESULTS: Changes in body weight, BMI, and body fat percentage during the pandemic were not clinically significant. However, statistically significant results were found for decreased physical activity (p<0.001) and WC (p<0.001), and exacerbation of all metabolic syndrome components (except serum triglyceride levels). Moreover, the metabolic syndrome prevalence increased significantly from 20.2% to 31.2% during the pandemic (p<0.001). The prevalence of abdominal obesity and high fasting blood glucose levels also significantly increased from 2019 to 2021. CONCLUSIONS Metabolic syndrome, its components, and fat distribution worsened significantly after the implementation of social distancing and lockdowns, despite no clinically significant changes in body weight and BMI. Further studies on the post- pandemic period should investigate the long-term impact of social lockdowns on BMI and the prevalence of metabolic syndrome.

Background: Physical activity is known to prevent several diseases and positively affect mental health. Previous studies have shown that smartphone addiction negatively affects the physical activity of children and adolescents. This study aimed to investigate the relationship between problematic smartphone use and physical activity among adolescents and the related factors using path analysis. Methods: Using data from the 16th Youth Risk Behavior Web-based Survey from 2020, scores on the Smartphone Addiction Scale—Short Version for Adolescents, physical activity, sex, socioeconomic status (SES), academic performance, depression, smoking, drinking, and sitting time were assessed. Complex sampling and path analyses were performed. Results: Of the total 54,948 students, 25.5% were smartphone risk users, including potential and high-risk users. The direct path coefficients of each factor indicated that female sex (-0.14 for male), low SES (-0.062), high academic performance (0.056), low sitting time for studying purposes (-0.033), high sitting time for non-studying purposes (0.071), and depressive mood (0.130) were related to problematic smartphone use (all P<0.001). Each factor affected problematic smartphone use, and subsequently had a negative effect on the amount of physical activity, with a direct path coefficient of -0.115 (P<0.001). Conclusion In this study, we confirmed that problematic smartphone use among adolescents was negatively associated with performing an adequate amount of physical activity and that various factors, such as sex, SES, academic performance, and sitting time, directly and indirectly affected this relationship.

Background: Although numerous studies have indicated that lower levels of physical activity correlate with a higher risk of depression, an association between the type of physical activity and depression has not been identified in Korea. This study aimed to examine whether the type and intensity of physical activity are associated with depression in Korean adults. Methods: This cross-sectional study used data from the Korea National Health and Nutrition Examination Survey (KNHANES). A total of 11,679 individuals were analyzed using multiple logistic regression analyses to identify any association between the type of physical activity and depressive disorders in the sample subjects. Results: Measured weekly in units of energy expenditure, known as metabolic equivalents (METs), the amount of work-related physical activity was higher in individuals with depression according to the Patient Health Questionnaire- 9 than the participants without depression (386.7 vs. 206.7 MET-min/wk, P=0.01). Those diagnosed with depression tended to engage in less recreational activity per week (143.7 vs. 316.3 MET-min/wk, P<0.001) than those without depression. After controlling for covariates, the risk of depression among all participants was 1.012 times higher with a 100-unit increase in total work-related activity measured in METs (95% confidence interval [CI], 1.006–1.017; P<0.001) and 0.962 times lower with a 100-unit increase in total leisure activity measured in METs (95% CI, 0.937–0.987; P=0.003). Conclusion Different types of physical activity were shown to be differently associated with depressive disorders in Korean adults. This study might guide in reducing work-related physical activity and increasing leisure activity to prevent the occurrence of depression.

Background: There has been no comparison of the determinants of admission route between acute ischemic stroke (AIS) and acute myocardial infarction (AMI). We examined whether factors associated with direct versus transferred-in admission to regional cardiocerebrovascular centers (RCVCs) differed between AIS and AMI. Methods: Using a nationwide RCVC registry, we identified consecutive patients presenting with AMI and AIS between July 2016 and December 2018. We explored factors associated with direct admission to RCVCs in patients with AIS and AMI and examined whether those associations differed between AIS and AMI, including interaction terms between each factor and disease type in multivariable models. To explore the influence of emergency medical service (EMS) paramedics on hospital selection, stratified analyses according to use of EMS were also performed. Results: Among the 17,897 and 8,927 AIS and AMI patients, 66.6% and 48.2% were directly admitted to RCVCs, respectively. Multivariable analysis showed that previous coronary heart disease, prehospital awareness, higher education level, and EMS use increased the odds of direct admission to RCVCs, but the odds ratio (OR) was different between AIS and AMI (for the first 3 factors, AMI > AIS; for EMS use, AMI < AIS). EMS use was the single most important factor for both AIS and AMI (OR, 4.72 vs. 3.90). Hypertension and hyperlipidemia increased, while living alone decreased the odds of direct admission only in AMI;additionally, age (65–74 years), previous stroke, and presentation during non-working hours increased the odds only in AIS. EMS use weakened the associations between direct admission and most factors in both AIS and AMI. Conclusions Various patient factors were differentially associated with direct admission to RCVCs between AIS and AMI. Public education for symptom awareness and use of EMS is essential in optimizing the transportation and hospitalization of patients with AMI and AIS.

Percutaneous transthoracic needle biopsy (PTNB) is one of the essential diagnostic procedures for pulmonary lesions. Its role is increasing in the era of CT screening for lung cancer and precision medicine. The Korean Society of Thoracic Radiology developed the first evidence-based clinical guideline for PTNB in Korea by adapting pre-existing guidelines. The guideline provides 39 recommendations for the following four main domains of 12 key questions: the indications for PTNB, pre-procedural evaluation, procedural technique of PTNB and its accuracy, and management of post-biopsy complications. We hope that these recommendations can improve the diagnostic accuracy and safety of PTNB in clinical practice and promote standardization of the procedure nationwide.