The maxillary anterior region is critical for esthetics and function, requiring precise analysis and restoration when damaged by trauma. This case report presents the restorative process using a digital workflow for a patient with anterior trauma. A 22-year-old female exhibited fractures and extrusive luxation of maxillary central incisors, diagnosed with pulp necrosis. After endodontic treatment, intraoral and facial scans were performed, and provisional and definitive restorations were digitally designed. Various shade-matching techniques were employed to achieve natural esthetics. The definitive prosthesis improved harmony between the incisal edge and lower lip, as well as tooth axis, length, and zenith position, fulfilling the patient’s esthetic demands. This case suggests that combining digital technology and gingivectomy with a minimally invasive approach enables esthetic and functional restoration of the maxillary anterior region.

Purpose: This study aimed to evaluate the performance of a clinical ladder system in a tertiary hospital by examining how nurses' clinical competence and perceptions of the system affect organizational commitment. Methods: The study involved 394 nurses working at a tertiary hospital. Data were collected from May 3 to July 10, 2023, using a self-reported questionnaire. Statistical analyses, including descriptive statistics, independent t-tests, one-way ANOVA, Kruskal-Wallis test, Scheffé post-hoc test, Pearson correlation, and hierarchical regression analysis, were performed using SPSS 27.0. Results: Nurses who applied for promotion to the CN III level and current CN III nurses reported higher clinical competence, perceptions of the clinical ladder system, and organizational commitment than those who did not and those at lower levels (p<.001). A positive correlation existed among all independent variables.Controlling for general characteristics, the effects of clinical competence and perceptions of the clinical ladder system explained 49% of organizational commitment variance (Adjusted R 2 =.49, F=33.43, p<.001). Conclusion Greater clinical competence and positive perceptions of the clinical ladder system are likely to enhance organizational commitment, emphasizing its effectiveness in fostering better organizational outcomes.

Purpose: This study aimed to evaluate the performance of a clinical ladder system in a tertiary hospital by examining how nurses' clinical competence and perceptions of the system affect organizational commitment. Methods: The study involved 394 nurses working at a tertiary hospital. Data were collected from May 3 to July 10, 2023, using a self-reported questionnaire. Statistical analyses, including descriptive statistics, independent t-tests, one-way ANOVA, Kruskal-Wallis test, Scheffé post-hoc test, Pearson correlation, and hierarchical regression analysis, were performed using SPSS 27.0. Results: Nurses who applied for promotion to the CN III level and current CN III nurses reported higher clinical competence, perceptions of the clinical ladder system, and organizational commitment than those who did not and those at lower levels (p<.001). A positive correlation existed among all independent variables.Controlling for general characteristics, the effects of clinical competence and perceptions of the clinical ladder system explained 49% of organizational commitment variance (Adjusted R 2 =.49, F=33.43, p<.001). Conclusion Greater clinical competence and positive perceptions of the clinical ladder system are likely to enhance organizational commitment, emphasizing its effectiveness in fostering better organizational outcomes.

Purpose: This study aimed to evaluate the performance of a clinical ladder system in a tertiary hospital by examining how nurses' clinical competence and perceptions of the system affect organizational commitment. Methods: The study involved 394 nurses working at a tertiary hospital. Data were collected from May 3 to July 10, 2023, using a self-reported questionnaire. Statistical analyses, including descriptive statistics, independent t-tests, one-way ANOVA, Kruskal-Wallis test, Scheffé post-hoc test, Pearson correlation, and hierarchical regression analysis, were performed using SPSS 27.0. Results: Nurses who applied for promotion to the CN III level and current CN III nurses reported higher clinical competence, perceptions of the clinical ladder system, and organizational commitment than those who did not and those at lower levels (p<.001). A positive correlation existed among all independent variables.Controlling for general characteristics, the effects of clinical competence and perceptions of the clinical ladder system explained 49% of organizational commitment variance (Adjusted R 2 =.49, F=33.43, p<.001). Conclusion Greater clinical competence and positive perceptions of the clinical ladder system are likely to enhance organizational commitment, emphasizing its effectiveness in fostering better organizational outcomes.

Purpose: This study aimed to evaluate the performance of a clinical ladder system in a tertiary hospital by examining how nurses' clinical competence and perceptions of the system affect organizational commitment. Methods: The study involved 394 nurses working at a tertiary hospital. Data were collected from May 3 to July 10, 2023, using a self-reported questionnaire. Statistical analyses, including descriptive statistics, independent t-tests, one-way ANOVA, Kruskal-Wallis test, Scheffé post-hoc test, Pearson correlation, and hierarchical regression analysis, were performed using SPSS 27.0. Results: Nurses who applied for promotion to the CN III level and current CN III nurses reported higher clinical competence, perceptions of the clinical ladder system, and organizational commitment than those who did not and those at lower levels (p<.001). A positive correlation existed among all independent variables.Controlling for general characteristics, the effects of clinical competence and perceptions of the clinical ladder system explained 49% of organizational commitment variance (Adjusted R 2 =.49, F=33.43, p<.001). Conclusion Greater clinical competence and positive perceptions of the clinical ladder system are likely to enhance organizational commitment, emphasizing its effectiveness in fostering better organizational outcomes.

Purpose: This study aimed to compare clinical, nutritional, and endoscopic outcomes among Roux-en-Y (RY), uncut Roux-en-Y (uRY), and Billroth II with Braun anastomosis (BB) reconstruction methods in gastric cancer patients after distal gastrectomy. Methods: This retrospective study analyzed gastric cancer patients who underwent laparoscopic distal gastrectomy between January 2018 and December 2022, categorized into RY, uRY, and BB. Demographic, pathological, clinical, nutritional, and endoscopic data were collected over 24 months. Endoscopic outcomes were assessed using the RGB scoring system, evaluating residual food, gastritis, and bile reflux. Delayed gastric emptying was defined by clinical and imaging criteria. Multivariable linear regression was performed to identify relevant factors associated with 24 months RGB scores and mixed linear model was applied to assess the time interaction. Results: A total of 221 patients were included (70 RY, 75 uRY, 76 BB). Baseline characteristics, perioperative and nutritional outcomes were comparable among groups. The uRY group showed less weight loss at 3 months (5.9%, P<0.05) but did not differ in other studied periods. The RY group had the lowest RGB scores at all time points, while BB showed the highest and progressively worsening scores. Regression model showed that BB and uRY was related to increase 24 month RGB score. BB showed increased RGB score while RY was stable in time and uRY showed intermediate change in the mixed linear model (P<0.05). Conclusion The nutritional clinical outcomes were comparable between the reconstructions. RY reconstruction demonstrated favorable endoscopic outcomes, while BB was associated with higher RGB scores in time.

Purpose: This pilot study aimed to evaluate the effects of the Floating Nurse system designed to improve nurses’ shift work conditions on individual and organizational outcomes. Methods: A non-equivalent posttest-only control group design was used. Individual-level data on job satisfaction, work-life balance, and turnover intention were collected through anonymous self-administered questionnaires from January 16 to 27, 2023, six months after system implementation. Organizational-level turnover rates were obtained from administrative records for the period before and after implementation (January-June and July-December 2022). The study included 352 nurses from 38 general wards at a tertiary hospital in Seoul-250 from 27 wards where the system was implemented (participation group) and 102 from 11 wards without the system (non-participation group).Multilevel modeling was applied, accounting for individual-level (Level 1) and ward-level (Level 2) factors. Results: Job satisfaction was significantly higher in the participation group than in the non-participation group (B=2.28, p=.008). Work-life balance was higher but not statistically significant (B=4.10, p=.120), and turnover intention showed no significant difference (B=-0.48, p=.204). Turnover rates decreased in both groups, with a larger reduction in the participation group (from 2.5% to 1.8%) than in the non-participation group (from 4.5% to 3.5%). Conclusion The Floating Nurse System improved job satisfaction and contributed to lower turnover rates, suggesting potential benefits for workforce stability. Although improvements in work-life balance and turnover intention were not statistically significant, enhanced job satisfaction may indirectly mitigate turnover intention. Further multi-site and longitudinal studies are warranted to confirm long-term effects.