Objective: Disaster survivors often experience negative impacts on their mental health, but some may also exhibit posttraumatic growth, overcoming adversity, and finding positive outcomes. This study aimed to identify psychological factors influencing posttraumatic growth (PTG) among students who survived the Sewol ferry disaster. Methods: The study used a longitudinal design. Data were collected at 6-month intervals between high school graduation and 6 years after the ferry disaster. Data were obtained from 48 adolescents who completed self-report measures of rumination, meaning in life, coping, PTG, family adaptability and cohesion. Generalized estimating equation models were fitted to 11 waves of follow-up data. Results: Intrusive rumination (coefficient [coef]=0.165; p<0.001; 95% confidence interval [CI] 0.081–0.250) and deliberate rumination (coef=0.554; p<0.001; 95% CI 0.376–0.732) were significantly associated with PTG. Concerning meaning in life, the presence of meaning (coef=0.312; p<0.001; 95% CI 0.189–0.435) and the search for meaning (coef=0.216; p=0.001; 95% CI 0.093–0.340) were also significantly associated with PTG. Finally, the problem-focused (coef=0.682; p=0.011; 95% CI 0.153–1.210) and emotion-focused (coef=0.736; p=0.009; 95% CI 0.186–1.285) coping strategies both showed significant associations with PTG. Conclusion The results of this study indicate that rumination, meaning in life, and adaptive coping (including cognitive and emotional coping) were protective factors for mental health problems among adolescents who survived the Sewol ferry disaster. These psychological factors may promote PTG over time.

Objective: This study aimed to elicit expert consensus on the necessary components of a seclusion room module required to accommodate and manage psychiatric emergency patients requiring both medical and surgical interventions in infectious disease situations. Methods: A two-round Delphi survey was conducted among 38 medical professionals, architects, and spatial design experts. The survey assessed the effectiveness, feasibility, and urgency of spatial scales, spatial organization, and movement system domains related to the necessary elements of a seclusion room. Results: In the spatial scale domain, items such as “sufficient width to comply with disability standards (wheelchair accessible)” and “larger space should be provided for patients with a large range of motion or requiring special medical procedures” emerged as priorities. In the movement system domain, priorities included “anticipating situations where stable patients need to be pushed on a stretcher cart from both sides, necessitating a wider passage.” In the spatial organization domain, priorities included “installing interior elements (wall images, media panels, etc.) that aid patient stability, although a separate area for patients’ activities reflecting psychiatric characteristics is not necessary.” Conclusion Expert consensus was achieved regarding the spatial scales, spatial organization, and movement system domains related to the necessary elements of a seclusion room for psychiatric emergency patients.

Purpose: The cytotoxic T-lymphocyte-associated protein 4 (CTLA4) is involved in the progression of various cancers, but its biological roles in breast cancer (BRCA) remain unclear. Therefore, we performed a systematic multiomic analysis to expound on the prognostic value and underlying mechanism of CTLA4 in BRCA. Methods: We assessed the effect of CTLA4 expression on BRCA using a variety of bioinformatics platforms, including Oncomine, GEPIA, UALCAN, PrognoScan database, Kaplan-Meier plotter, and R2: Kaplan-Meier scanner. Results: CTLA4 was highly expressed in BRCA tumor tissue compared to normal tissue (P < 0.01). The CTLA4 messenger RNA levels in BRCA based on BRCA subtypes of Luminal, human epidermal growth factor receptor 2, and triple-negative BRCA were considerably higher than in normal tissues (P < 0.001). However, the overexpression of CTLA4 was associated with a better prognosis in BRCA (P < 0.001) and was correlated with clinicopathological characteristics including age, T stage, estrogen receptors, progesterone receptors, and prediction analysis of microarray 50 (P < 0.01). The infiltration of multiple immune cells was associated with increased CTLA4 expression in BRCA (P < 0.001). CTLA4 was highly enriched in antigen binding, immunoglobulin complexes, lymphocyte-mediated immunity, and cytokine-cytokine receptor interaction. Conclusion This study provides suggestive evidence of the prognostic role of CTLA4 in BRCA, which may be a therapeutic target for BRCA. Furthermore, CTLA4 may influence BRCA prognosis through antigen binding, immunoglobulin complexes, lymphocyte-mediated immunity, and cytokine-cytokine receptor interaction. These findings help us understand how CTLA4 plays a role in BRCA and set the stage for more research.

Objective: Disaster survivors often experience negative impacts on their mental health, but some may also exhibit posttraumatic growth, overcoming adversity, and finding positive outcomes. This study aimed to identify psychological factors influencing posttraumatic growth (PTG) among students who survived the Sewol ferry disaster. Methods: The study used a longitudinal design. Data were collected at 6-month intervals between high school graduation and 6 years after the ferry disaster. Data were obtained from 48 adolescents who completed self-report measures of rumination, meaning in life, coping, PTG, family adaptability and cohesion. Generalized estimating equation models were fitted to 11 waves of follow-up data. Results: Intrusive rumination (coefficient [coef]=0.165; p<0.001; 95% confidence interval [CI] 0.081–0.250) and deliberate rumination (coef=0.554; p<0.001; 95% CI 0.376–0.732) were significantly associated with PTG. Concerning meaning in life, the presence of meaning (coef=0.312; p<0.001; 95% CI 0.189–0.435) and the search for meaning (coef=0.216; p=0.001; 95% CI 0.093–0.340) were also significantly associated with PTG. Finally, the problem-focused (coef=0.682; p=0.011; 95% CI 0.153–1.210) and emotion-focused (coef=0.736; p=0.009; 95% CI 0.186–1.285) coping strategies both showed significant associations with PTG. Conclusion The results of this study indicate that rumination, meaning in life, and adaptive coping (including cognitive and emotional coping) were protective factors for mental health problems among adolescents who survived the Sewol ferry disaster. These psychological factors may promote PTG over time.

Objective: This study aimed to elicit expert consensus on the necessary components of a seclusion room module required to accommodate and manage psychiatric emergency patients requiring both medical and surgical interventions in infectious disease situations. Methods: A two-round Delphi survey was conducted among 38 medical professionals, architects, and spatial design experts. The survey assessed the effectiveness, feasibility, and urgency of spatial scales, spatial organization, and movement system domains related to the necessary elements of a seclusion room. Results: In the spatial scale domain, items such as “sufficient width to comply with disability standards (wheelchair accessible)” and “larger space should be provided for patients with a large range of motion or requiring special medical procedures” emerged as priorities. In the movement system domain, priorities included “anticipating situations where stable patients need to be pushed on a stretcher cart from both sides, necessitating a wider passage.” In the spatial organization domain, priorities included “installing interior elements (wall images, media panels, etc.) that aid patient stability, although a separate area for patients’ activities reflecting psychiatric characteristics is not necessary.” Conclusion Expert consensus was achieved regarding the spatial scales, spatial organization, and movement system domains related to the necessary elements of a seclusion room for psychiatric emergency patients.

Objective: Disaster survivors often experience negative impacts on their mental health, but some may also exhibit posttraumatic growth, overcoming adversity, and finding positive outcomes. This study aimed to identify psychological factors influencing posttraumatic growth (PTG) among students who survived the Sewol ferry disaster. Methods: The study used a longitudinal design. Data were collected at 6-month intervals between high school graduation and 6 years after the ferry disaster. Data were obtained from 48 adolescents who completed self-report measures of rumination, meaning in life, coping, PTG, family adaptability and cohesion. Generalized estimating equation models were fitted to 11 waves of follow-up data. Results: Intrusive rumination (coefficient [coef]=0.165; p<0.001; 95% confidence interval [CI] 0.081–0.250) and deliberate rumination (coef=0.554; p<0.001; 95% CI 0.376–0.732) were significantly associated with PTG. Concerning meaning in life, the presence of meaning (coef=0.312; p<0.001; 95% CI 0.189–0.435) and the search for meaning (coef=0.216; p=0.001; 95% CI 0.093–0.340) were also significantly associated with PTG. Finally, the problem-focused (coef=0.682; p=0.011; 95% CI 0.153–1.210) and emotion-focused (coef=0.736; p=0.009; 95% CI 0.186–1.285) coping strategies both showed significant associations with PTG. Conclusion The results of this study indicate that rumination, meaning in life, and adaptive coping (including cognitive and emotional coping) were protective factors for mental health problems among adolescents who survived the Sewol ferry disaster. These psychological factors may promote PTG over time.

Objective: This study aimed to elicit expert consensus on the necessary components of a seclusion room module required to accommodate and manage psychiatric emergency patients requiring both medical and surgical interventions in infectious disease situations. Methods: A two-round Delphi survey was conducted among 38 medical professionals, architects, and spatial design experts. The survey assessed the effectiveness, feasibility, and urgency of spatial scales, spatial organization, and movement system domains related to the necessary elements of a seclusion room. Results: In the spatial scale domain, items such as “sufficient width to comply with disability standards (wheelchair accessible)” and “larger space should be provided for patients with a large range of motion or requiring special medical procedures” emerged as priorities. In the movement system domain, priorities included “anticipating situations where stable patients need to be pushed on a stretcher cart from both sides, necessitating a wider passage.” In the spatial organization domain, priorities included “installing interior elements (wall images, media panels, etc.) that aid patient stability, although a separate area for patients’ activities reflecting psychiatric characteristics is not necessary.” Conclusion Expert consensus was achieved regarding the spatial scales, spatial organization, and movement system domains related to the necessary elements of a seclusion room for psychiatric emergency patients.

Objective: Disaster survivors often experience negative impacts on their mental health, but some may also exhibit posttraumatic growth, overcoming adversity, and finding positive outcomes. This study aimed to identify psychological factors influencing posttraumatic growth (PTG) among students who survived the Sewol ferry disaster. Methods: The study used a longitudinal design. Data were collected at 6-month intervals between high school graduation and 6 years after the ferry disaster. Data were obtained from 48 adolescents who completed self-report measures of rumination, meaning in life, coping, PTG, family adaptability and cohesion. Generalized estimating equation models were fitted to 11 waves of follow-up data. Results: Intrusive rumination (coefficient [coef]=0.165; p<0.001; 95% confidence interval [CI] 0.081–0.250) and deliberate rumination (coef=0.554; p<0.001; 95% CI 0.376–0.732) were significantly associated with PTG. Concerning meaning in life, the presence of meaning (coef=0.312; p<0.001; 95% CI 0.189–0.435) and the search for meaning (coef=0.216; p=0.001; 95% CI 0.093–0.340) were also significantly associated with PTG. Finally, the problem-focused (coef=0.682; p=0.011; 95% CI 0.153–1.210) and emotion-focused (coef=0.736; p=0.009; 95% CI 0.186–1.285) coping strategies both showed significant associations with PTG. Conclusion The results of this study indicate that rumination, meaning in life, and adaptive coping (including cognitive and emotional coping) were protective factors for mental health problems among adolescents who survived the Sewol ferry disaster. These psychological factors may promote PTG over time.

Objective: This study aimed to elicit expert consensus on the necessary components of a seclusion room module required to accommodate and manage psychiatric emergency patients requiring both medical and surgical interventions in infectious disease situations. Methods: A two-round Delphi survey was conducted among 38 medical professionals, architects, and spatial design experts. The survey assessed the effectiveness, feasibility, and urgency of spatial scales, spatial organization, and movement system domains related to the necessary elements of a seclusion room. Results: In the spatial scale domain, items such as “sufficient width to comply with disability standards (wheelchair accessible)” and “larger space should be provided for patients with a large range of motion or requiring special medical procedures” emerged as priorities. In the movement system domain, priorities included “anticipating situations where stable patients need to be pushed on a stretcher cart from both sides, necessitating a wider passage.” In the spatial organization domain, priorities included “installing interior elements (wall images, media panels, etc.) that aid patient stability, although a separate area for patients’ activities reflecting psychiatric characteristics is not necessary.” Conclusion Expert consensus was achieved regarding the spatial scales, spatial organization, and movement system domains related to the necessary elements of a seclusion room for psychiatric emergency patients.

Objective: Disaster survivors often experience negative impacts on their mental health, but some may also exhibit posttraumatic growth, overcoming adversity, and finding positive outcomes. This study aimed to identify psychological factors influencing posttraumatic growth (PTG) among students who survived the Sewol ferry disaster. Methods: The study used a longitudinal design. Data were collected at 6-month intervals between high school graduation and 6 years after the ferry disaster. Data were obtained from 48 adolescents who completed self-report measures of rumination, meaning in life, coping, PTG, family adaptability and cohesion. Generalized estimating equation models were fitted to 11 waves of follow-up data. Results: Intrusive rumination (coefficient [coef]=0.165; p<0.001; 95% confidence interval [CI] 0.081–0.250) and deliberate rumination (coef=0.554; p<0.001; 95% CI 0.376–0.732) were significantly associated with PTG. Concerning meaning in life, the presence of meaning (coef=0.312; p<0.001; 95% CI 0.189–0.435) and the search for meaning (coef=0.216; p=0.001; 95% CI 0.093–0.340) were also significantly associated with PTG. Finally, the problem-focused (coef=0.682; p=0.011; 95% CI 0.153–1.210) and emotion-focused (coef=0.736; p=0.009; 95% CI 0.186–1.285) coping strategies both showed significant associations with PTG. Conclusion The results of this study indicate that rumination, meaning in life, and adaptive coping (including cognitive and emotional coping) were protective factors for mental health problems among adolescents who survived the Sewol ferry disaster. These psychological factors may promote PTG over time.