Objectives: This study investigated changes in toothbrushing in adolescents in response to public health policy changes during coronavirus disease 2019 (COVID-19) focusing on behavioral trends before, during, and after policy enforcement according to socio-demographic subgroups. Methods: Data from the Korean Youth Risk Behavior Survey (2018–2024) were divided into 3 periods: before (2018–2019), during (2020–2022), and after (2023–2024) the implementation of COVID-19 school restrictions. A total of 354 943 middle and high school students were included. The primary outcome variable was self-reported toothbrushing after lunch at school. Multivariable logistic regression was conducted, adjusting for confounders such as sex, academic performance, school level, school type, handwashing, and oral health status (toothache and gum bleeding). Results: The compliance rate for toothbrushing declined significantly during the restriction period across all groups. It varied by sex, school type, school level, health-related behaviors (drinking, smoking, handwashing), and oral health status. Female students, middle schoolers, students in single-sex schools, non-smokers, and those practicing hand hygiene showed higher compliance. After restrictions were lifted, toothbrushing rates improved but remained lower than pre-pandemic levels. Recovery of the toothbrushing rate was observed in most groups, particularly among female students, high schoolers, and those with positive health-related behaviors. However, academic performance and oral health status were not significantly associated with recovery rate in adjusted analyses. Conclusions This study highlights that adolescents’ health behaviors are highly sensitive to environmental and policy changes. Variations in compliance and recovery rates underscore the need for adolescent-centered policies that account for both compliance and recovery, especially during crises such as pandemics.

Background: Diabetes mellitus (DM) is prevalent among adults, many of whom require surgical interventions. Although metformin may improve postoperative outcomes by reducing inflammation, its effects on postoperative mortality and complications remain unclear. This study aimed to determine whether preoperative metformin use is associated with improved postoperative outcomes after noncardiac surgery. Methods: This retrospective study included adult patients with type 2 DM who underwent noncardiac surgery between 2011 and 2019. Patients were assigned to one of two groups based on the use of preoperative metformin at admission. To evaluate dose-related effects, patients in the metformin group were further divided into low- and high-dose groups based on daily dose (< or ≥ 1,000 mg). The primary outcome was one-year mortality after surgery, and the secondary outcomes were 30-day mortality, five-year mortality, and postoperative complications in major organs within 7 d. Results: Among 22 944 patients, 12 536 (54.6%) were exposed to preoperative metformin. After inverse probability of treatment weighting, preoperative metformin use was associated with a reduced one-year mortality (hazard ratio: 0.76, 95% CI [0.68–0.85]). For secondary outcomes, metformin use decreased postoperative complications in respiratory (odds ratio [OR]: 0.76, 95% CI [0.61−0.93]) and renal systems (OR: 0.66, 95% CI [0.58−0.74]). In a dose-related analysis, both doses were associated with a lower risk of postoperative mortality, with reductions in respiratory complications primarily due to high-dose metformin (OR: 0.69, 95% CI [0.54−0.89]). Conclusion Preoperative use of metformin is associated with reduced postoperative mortality and complications in diabetic patients undergoing noncardiac surgery.

Background: There are few safe effective ways to relieve osteoarthritis (OA) pain; as a result, off-label psychotropic drug prescriptions have increased worldwide. This study examined the change in psychotropic drug prescriptions for patients with OA from 2011 to 2020 using the Korean National Health Insurance Service dataset. Methods: The study population consisted of patients with hip or knee OA aged ≥ 65 years.Psychotropic drugs included opioids, benzodiazepines, non-benzodiazepine hypnotics (Z-drugs), anti-epileptics, tricyclic antidepressants, selective serotonin reuptake inhibitors (SSRIs), serotonin and norepinephrine reuptake inhibitors (SNRIs), typical antipsychotics, atypical antipsychotics, and anxiolytics. The prevalence and long-term (> 3 months) prescription rates of psychotropic drugs in OA patients were calculated. Results: The study included 1,821,158 patients with OA (mean age 71.7 years; 65.32% female).Of the cohort, 49% had comorbidities for which psychotropics were indicated. The prevalence of psychotropic prescriptions decreased from 58.2% to 52.0% in 2018 and then leveled off.The long-term prescription rate remained constant until 2018 and then increased slightly.The most commonly prescribed psychotropics were opioids and long- and short-acting benzodiazepines. The prescription rates of opioids and long-acting benzodiazepines decreased from 2011 to 2020. For those with psychiatric co-morbidities, the prescription rates of anti-epileptics and SNRIs increased, while the prescription rates of anti-epileptics, SSRIs, other antidepressants, and atypical psychotropics increased for those without such co-morbidities. The most commonly prescribed psychotropics were diazepam and alprazolam, excluding tramadol and tramadol–acetaminophen combination. For those with psychiatric co-morbidities, the prescription rates of gabapentin and fentanyl increased, while for those without such co-morbidities, the prescription rates of lorazepam, fentanyl, escitalopram and quetiapine increased. Conclusion A significant number of older Korean patients with OA were prescribed psychotropic drugs in the absence of comorbidities requiring such drugs, including drugs that have little effect on OA and unfavorable safety profiles in older adults.

Background: There are few safe effective ways to relieve osteoarthritis (OA) pain; as a result, off-label psychotropic drug prescriptions have increased worldwide. This study examined the change in psychotropic drug prescriptions for patients with OA from 2011 to 2020 using the Korean National Health Insurance Service dataset. Methods: The study population consisted of patients with hip or knee OA aged ≥ 65 years.Psychotropic drugs included opioids, benzodiazepines, non-benzodiazepine hypnotics (Z-drugs), anti-epileptics, tricyclic antidepressants, selective serotonin reuptake inhibitors (SSRIs), serotonin and norepinephrine reuptake inhibitors (SNRIs), typical antipsychotics, atypical antipsychotics, and anxiolytics. The prevalence and long-term (> 3 months) prescription rates of psychotropic drugs in OA patients were calculated. Results: The study included 1,821,158 patients with OA (mean age 71.7 years; 65.32% female).Of the cohort, 49% had comorbidities for which psychotropics were indicated. The prevalence of psychotropic prescriptions decreased from 58.2% to 52.0% in 2018 and then leveled off.The long-term prescription rate remained constant until 2018 and then increased slightly.The most commonly prescribed psychotropics were opioids and long- and short-acting benzodiazepines. The prescription rates of opioids and long-acting benzodiazepines decreased from 2011 to 2020. For those with psychiatric co-morbidities, the prescription rates of anti-epileptics and SNRIs increased, while the prescription rates of anti-epileptics, SSRIs, other antidepressants, and atypical psychotropics increased for those without such co-morbidities. The most commonly prescribed psychotropics were diazepam and alprazolam, excluding tramadol and tramadol–acetaminophen combination. For those with psychiatric co-morbidities, the prescription rates of gabapentin and fentanyl increased, while for those without such co-morbidities, the prescription rates of lorazepam, fentanyl, escitalopram and quetiapine increased. Conclusion A significant number of older Korean patients with OA were prescribed psychotropic drugs in the absence of comorbidities requiring such drugs, including drugs that have little effect on OA and unfavorable safety profiles in older adults.

Background: There are few safe effective ways to relieve osteoarthritis (OA) pain; as a result, off-label psychotropic drug prescriptions have increased worldwide. This study examined the change in psychotropic drug prescriptions for patients with OA from 2011 to 2020 using the Korean National Health Insurance Service dataset. Methods: The study population consisted of patients with hip or knee OA aged ≥ 65 years.Psychotropic drugs included opioids, benzodiazepines, non-benzodiazepine hypnotics (Z-drugs), anti-epileptics, tricyclic antidepressants, selective serotonin reuptake inhibitors (SSRIs), serotonin and norepinephrine reuptake inhibitors (SNRIs), typical antipsychotics, atypical antipsychotics, and anxiolytics. The prevalence and long-term (> 3 months) prescription rates of psychotropic drugs in OA patients were calculated. Results: The study included 1,821,158 patients with OA (mean age 71.7 years; 65.32% female).Of the cohort, 49% had comorbidities for which psychotropics were indicated. The prevalence of psychotropic prescriptions decreased from 58.2% to 52.0% in 2018 and then leveled off.The long-term prescription rate remained constant until 2018 and then increased slightly.The most commonly prescribed psychotropics were opioids and long- and short-acting benzodiazepines. The prescription rates of opioids and long-acting benzodiazepines decreased from 2011 to 2020. For those with psychiatric co-morbidities, the prescription rates of anti-epileptics and SNRIs increased, while the prescription rates of anti-epileptics, SSRIs, other antidepressants, and atypical psychotropics increased for those without such co-morbidities. The most commonly prescribed psychotropics were diazepam and alprazolam, excluding tramadol and tramadol–acetaminophen combination. For those with psychiatric co-morbidities, the prescription rates of gabapentin and fentanyl increased, while for those without such co-morbidities, the prescription rates of lorazepam, fentanyl, escitalopram and quetiapine increased. Conclusion A significant number of older Korean patients with OA were prescribed psychotropic drugs in the absence of comorbidities requiring such drugs, including drugs that have little effect on OA and unfavorable safety profiles in older adults.

Background: There are few safe effective ways to relieve osteoarthritis (OA) pain; as a result, off-label psychotropic drug prescriptions have increased worldwide. This study examined the change in psychotropic drug prescriptions for patients with OA from 2011 to 2020 using the Korean National Health Insurance Service dataset. Methods: The study population consisted of patients with hip or knee OA aged ≥ 65 years.Psychotropic drugs included opioids, benzodiazepines, non-benzodiazepine hypnotics (Z-drugs), anti-epileptics, tricyclic antidepressants, selective serotonin reuptake inhibitors (SSRIs), serotonin and norepinephrine reuptake inhibitors (SNRIs), typical antipsychotics, atypical antipsychotics, and anxiolytics. The prevalence and long-term (> 3 months) prescription rates of psychotropic drugs in OA patients were calculated. Results: The study included 1,821,158 patients with OA (mean age 71.7 years; 65.32% female).Of the cohort, 49% had comorbidities for which psychotropics were indicated. The prevalence of psychotropic prescriptions decreased from 58.2% to 52.0% in 2018 and then leveled off.The long-term prescription rate remained constant until 2018 and then increased slightly.The most commonly prescribed psychotropics were opioids and long- and short-acting benzodiazepines. The prescription rates of opioids and long-acting benzodiazepines decreased from 2011 to 2020. For those with psychiatric co-morbidities, the prescription rates of anti-epileptics and SNRIs increased, while the prescription rates of anti-epileptics, SSRIs, other antidepressants, and atypical psychotropics increased for those without such co-morbidities. The most commonly prescribed psychotropics were diazepam and alprazolam, excluding tramadol and tramadol–acetaminophen combination. For those with psychiatric co-morbidities, the prescription rates of gabapentin and fentanyl increased, while for those without such co-morbidities, the prescription rates of lorazepam, fentanyl, escitalopram and quetiapine increased. Conclusion A significant number of older Korean patients with OA were prescribed psychotropic drugs in the absence of comorbidities requiring such drugs, including drugs that have little effect on OA and unfavorable safety profiles in older adults.

Background: Recent landmark trials have shown that several pharmacologic therapies improve outcomes in patients with heart failure with mildly reduced ejection fraction (HFmrEF) and heart failure with preserved ejection fraction (HFpEF), leading to updates in heart failure (HF) management guidelines. However, real-world adherence to guideline-directed medical therapy (GDMT) in these populations remains uncertain. This study evaluated GDMT prescription patterns in patients with HFmrEF or HFpEF based on the 2022 Korean Heart Failure Society guidelines. Methods: This single-center observational study included patients newly diagnosed with HF between January and December 2023, identified using International Classification of Diseases codes. Patients without recent echocardiographic or N-terminal pro–brain natriuretic peptide data, those with reduced ejection fraction, or those with end-stage renal disease were excluded. Electronic medical records were reviewed to assess GDMT prescription rates. Results: Among 615 patients (mean age, 68.9 years; 52.4% female), 568 had HFpEF and 47 had HFmrEF. Common comorbidities included hypertension (75.5%), diabetes mellitus (50.9%), ischemic heart disease (43.7%), and chronic kidney disease (22.6%). Overall prescription rates were 73.3% for renin–angiotensin system inhibitors, 83.7% for beta-blockers, 41.1% for mineralocorticoid receptor antagonists (MRAs), and 42.9% for sodium–glucose cotransporter 2 inhibitors (SGLT2is). SGLT2i use was significantly higher in patients with diabetes than in those without (71.6% vs. 13.2%; p<0.001). Angiotensin receptor–neprilysin inhibitors and MRAs were more frequently prescribed in HFmrEF than HFpEF. Beta-blocker use was lower in patients aged ≥75 years. Conclusions A substantial gap persists between guideline recommendations and real-world GDMT use in patients with HFmrEF and HFpEF, particularly for SGLT2is. Multicenter studies are warranted to further characterize and address this treatment gap.

Background: Stress management is an important component of management of mental health. Stress processing can be understood as the appraisal of and coping with stress. This study aimed to compare positive and negative perceptions of stress according to patterns of coping strategies. Methods: The study recruited 116 college students who completed the Perceived Stress Scale and Coping Inventory for Stressful Situations using a tablet PC or smartphone application. K-means cluster analysis was used to categorize the subjects into three clusters. Results: Positive perceptions were highest in Cluster 2 (i.e., task and avoidance dominant) at 3.18±0.66 followed by 2.30±0.65 in Cluster 1 (passive coping) and lowest in Cluster 3 (emotion dominant) at 1.75±0.63. Negative perceptions were highest in Cluster 3 at 2.45±0.66 followed by Cluster 1 at 1.66±0.65 and Cluster 2 at 1.07±0.68. Conclusion Differences in coping patterns can reduce the negative effects of stress. Thus, assessing the perception and management of stress can be useful and help people change their coping styles to more adaptive ones. Toward this end, a mobile application can be an appropriate tool.

Background: Stress management is an important component of management of mental health. Stress processing can be understood as the appraisal of and coping with stress. This study aimed to compare positive and negative perceptions of stress according to patterns of coping strategies. Methods: The study recruited 116 college students who completed the Perceived Stress Scale and Coping Inventory for Stressful Situations using a tablet PC or smartphone application. K-means cluster analysis was used to categorize the subjects into three clusters. Results: Positive perceptions were highest in Cluster 2 (i.e., task and avoidance dominant) at 3.18±0.66 followed by 2.30±0.65 in Cluster 1 (passive coping) and lowest in Cluster 3 (emotion dominant) at 1.75±0.63. Negative perceptions were highest in Cluster 3 at 2.45±0.66 followed by Cluster 1 at 1.66±0.65 and Cluster 2 at 1.07±0.68. Conclusion Differences in coping patterns can reduce the negative effects of stress. Thus, assessing the perception and management of stress can be useful and help people change their coping styles to more adaptive ones. Toward this end, a mobile application can be an appropriate tool.

Background: Stress management is an important component of management of mental health. Stress processing can be understood as the appraisal of and coping with stress. This study aimed to compare positive and negative perceptions of stress according to patterns of coping strategies. Methods: The study recruited 116 college students who completed the Perceived Stress Scale and Coping Inventory for Stressful Situations using a tablet PC or smartphone application. K-means cluster analysis was used to categorize the subjects into three clusters. Results: Positive perceptions were highest in Cluster 2 (i.e., task and avoidance dominant) at 3.18±0.66 followed by 2.30±0.65 in Cluster 1 (passive coping) and lowest in Cluster 3 (emotion dominant) at 1.75±0.63. Negative perceptions were highest in Cluster 3 at 2.45±0.66 followed by Cluster 1 at 1.66±0.65 and Cluster 2 at 1.07±0.68. Conclusion Differences in coping patterns can reduce the negative effects of stress. Thus, assessing the perception and management of stress can be useful and help people change their coping styles to more adaptive ones. Toward this end, a mobile application can be an appropriate tool.