Background: Active surveillance (AS) has emerged as a viable management strategy for low-risk papillary thyroid microcarcinoma (PTMC), following pioneering trials at Kuma Hospital and the Cancer Institute Hospital in Japan. Numerous prospective cohort studies have since validated AS as a management option for low-risk PTMC, leading to its inclusion in thyroid cancer guidelines across various countries. From 2016 to 2020, the Multicenter Prospective Cohort Study of Active Surveillance on Papillary Thyroid Microcarcinoma (MAeSTro) enrolled 1,177 patients, providing comprehensive data on PTMC progression, sonographic predictors of progression, quality of life, surgical outcomes, and cost-effectiveness when comparing AS to immediate surgery. The second phase of MAeSTro (MAeSTro-EXP) expands AS to low-risk papillary thyroid carcinoma (PTC) tumors larger than 1 cm, driven by the hypothesis that overall risk assessment outweighs absolute tumor size in surgical decision-making. Methods: This protocol aims to address whether limiting AS to tumors smaller than 1 cm may result in unnecessary surgeries for low-risk PTCs detected during their rapid initial growth phase. By expanding the AS criteria to include tumors up to 1.5 cm, while simultaneously refining and standardizing the criteria for risk assessment and disease progression, we aim to minimize overtreatment and maintain rigorous monitoring to improve patient outcomes. Conclusion This study will contribute to optimizing AS guidelines and enhance our understanding of the natural course and appropriate management of low-risk PTCs. Additionally, MAeSTro-EXP involves a multinational collaboration between South Korea and Australia. This cross-country study aims to identify cultural and racial differences in the management of low-risk PTC, thereby enriching the global understanding of AS practices and their applicability across diverse populations.

Background: Active surveillance (AS) has emerged as a viable management strategy for low-risk papillary thyroid microcarcinoma (PTMC), following pioneering trials at Kuma Hospital and the Cancer Institute Hospital in Japan. Numerous prospective cohort studies have since validated AS as a management option for low-risk PTMC, leading to its inclusion in thyroid cancer guidelines across various countries. From 2016 to 2020, the Multicenter Prospective Cohort Study of Active Surveillance on Papillary Thyroid Microcarcinoma (MAeSTro) enrolled 1,177 patients, providing comprehensive data on PTMC progression, sonographic predictors of progression, quality of life, surgical outcomes, and cost-effectiveness when comparing AS to immediate surgery. The second phase of MAeSTro (MAeSTro-EXP) expands AS to low-risk papillary thyroid carcinoma (PTC) tumors larger than 1 cm, driven by the hypothesis that overall risk assessment outweighs absolute tumor size in surgical decision-making. Methods: This protocol aims to address whether limiting AS to tumors smaller than 1 cm may result in unnecessary surgeries for low-risk PTCs detected during their rapid initial growth phase. By expanding the AS criteria to include tumors up to 1.5 cm, while simultaneously refining and standardizing the criteria for risk assessment and disease progression, we aim to minimize overtreatment and maintain rigorous monitoring to improve patient outcomes. Conclusion This study will contribute to optimizing AS guidelines and enhance our understanding of the natural course and appropriate management of low-risk PTCs. Additionally, MAeSTro-EXP involves a multinational collaboration between South Korea and Australia. This cross-country study aims to identify cultural and racial differences in the management of low-risk PTC, thereby enriching the global understanding of AS practices and their applicability across diverse populations.

Background: Active surveillance (AS) has emerged as a viable management strategy for low-risk papillary thyroid microcarcinoma (PTMC), following pioneering trials at Kuma Hospital and the Cancer Institute Hospital in Japan. Numerous prospective cohort studies have since validated AS as a management option for low-risk PTMC, leading to its inclusion in thyroid cancer guidelines across various countries. From 2016 to 2020, the Multicenter Prospective Cohort Study of Active Surveillance on Papillary Thyroid Microcarcinoma (MAeSTro) enrolled 1,177 patients, providing comprehensive data on PTMC progression, sonographic predictors of progression, quality of life, surgical outcomes, and cost-effectiveness when comparing AS to immediate surgery. The second phase of MAeSTro (MAeSTro-EXP) expands AS to low-risk papillary thyroid carcinoma (PTC) tumors larger than 1 cm, driven by the hypothesis that overall risk assessment outweighs absolute tumor size in surgical decision-making. Methods: This protocol aims to address whether limiting AS to tumors smaller than 1 cm may result in unnecessary surgeries for low-risk PTCs detected during their rapid initial growth phase. By expanding the AS criteria to include tumors up to 1.5 cm, while simultaneously refining and standardizing the criteria for risk assessment and disease progression, we aim to minimize overtreatment and maintain rigorous monitoring to improve patient outcomes. Conclusion This study will contribute to optimizing AS guidelines and enhance our understanding of the natural course and appropriate management of low-risk PTCs. Additionally, MAeSTro-EXP involves a multinational collaboration between South Korea and Australia. This cross-country study aims to identify cultural and racial differences in the management of low-risk PTC, thereby enriching the global understanding of AS practices and their applicability across diverse populations.

Background: Active surveillance (AS) has emerged as a viable management strategy for low-risk papillary thyroid microcarcinoma (PTMC), following pioneering trials at Kuma Hospital and the Cancer Institute Hospital in Japan. Numerous prospective cohort studies have since validated AS as a management option for low-risk PTMC, leading to its inclusion in thyroid cancer guidelines across various countries. From 2016 to 2020, the Multicenter Prospective Cohort Study of Active Surveillance on Papillary Thyroid Microcarcinoma (MAeSTro) enrolled 1,177 patients, providing comprehensive data on PTMC progression, sonographic predictors of progression, quality of life, surgical outcomes, and cost-effectiveness when comparing AS to immediate surgery. The second phase of MAeSTro (MAeSTro-EXP) expands AS to low-risk papillary thyroid carcinoma (PTC) tumors larger than 1 cm, driven by the hypothesis that overall risk assessment outweighs absolute tumor size in surgical decision-making. Methods: This protocol aims to address whether limiting AS to tumors smaller than 1 cm may result in unnecessary surgeries for low-risk PTCs detected during their rapid initial growth phase. By expanding the AS criteria to include tumors up to 1.5 cm, while simultaneously refining and standardizing the criteria for risk assessment and disease progression, we aim to minimize overtreatment and maintain rigorous monitoring to improve patient outcomes. Conclusion This study will contribute to optimizing AS guidelines and enhance our understanding of the natural course and appropriate management of low-risk PTCs. Additionally, MAeSTro-EXP involves a multinational collaboration between South Korea and Australia. This cross-country study aims to identify cultural and racial differences in the management of low-risk PTC, thereby enriching the global understanding of AS practices and their applicability across diverse populations.

Background: Single room isolation with contact precautions is widely regarded as a fundamental strategy to prevent the transmission of multidrug-resistant organisms (MDROs). However, its implementation demands substantial resources, limiting its universal application to all MDROs. In this study, we assessed the effect of discontinuing single room isolation for vancomycin-resistant Enterococcus (VRE). Methods: This is a retrospective, observational study conducted at a single 750-bed tertiary center. We conducted an interrupted time series analysis to compare incidence rates and trends of new-onset VRE colonization and bacteremia during the one year before and after the strategy change on January 1, 2023. Results: Single-room occupancy decreased from 79.7% pre-intervention to 23.6% postintervention (P < 0.001). The incidence rate of new-onset VRE colonization was 0.452 and 0.535 per 1,000 patient-days in the pre- and post-intervention periods, respectively, with no statistically significant difference (P = 0.202). However, there was a slightly increasing trend (0.036 [95% confidence interval, −0.002, 0.074] increase per month, P = 0.066). The new-onset VRE bacteremia incidence rate was not differed in incidence (0.060 and 0.055, P= 0.571) or trend (P = 0.720). Conclusion Our study suggests that discontinuing single-room isolation for VRE patients may not affect the incidence of new-onset VRE bacteremia, but caution is needed due to the potential increase in colonization.

Objectives: This study aimed to explore whether there are differences in smoking status between two regions of Wonju-City and Chuncheon-City, Gangwon State, and to determine whether the experience of smoking cessation programs in the region affects quit attempts. Methods: The study design was a cross-sectional study in which adults aged 19 and older living in two cities were surveyed using a pre-developed mobile app to investigate social capital for smoking cessation, and a total of 600 citizens were participated, including 310 in Wonju-City and 290 in Chuncheon-City.The statistical analysis was conducted using chi-square test and logistic regression analysis. Results: Wonju-City had a higher prevalence of current smoking than Chuncheon-City. Among smoking cessation programs operated by local public health centers, Wonju-City had a lower odds ratio for experience with smoking cessation education than Chuncheon-City (OR=0.52, 95% CI=0.33 to 0.81). When examining the effect of smoking cessation program experience on quit attempts, in Wonju-City, citizens who had completed smoking cessation education and used a smoking cessation clinic were more likely to attempt to quit than those who had not (OR=2.31 and OR=2.29, respectively). In Chuncheon-City, citizens who were aware of smoking cessation support services were 2.26 times more likely to attempt to quit smoking than those who were not, but statistical significance was not reached due to the small sample size. Conclusion Therefore, healthcare organizations in both regions should develop more practical intervention strategies to increase smokers' quit attempts, reduce smoking rates in the community, and address regional disparities.

Background: The increasing rate of excess body weight (EBW) in the global population has led to growing health concerns, including cancer-related EBW. We aimed to estimate the population attributable fraction (PAF) of cancer incidence and deaths linked to EBW in Korean individuals from 2015 to 2030 and to compare its value with various body mass index cutoffs. Methods: Levin’s formula was used to calculate the PAF; the prevalence rates were computed using the Korean National Health and Nutrition Examination Survey data, while the relative risks of specific cancers related to EBW were estimated based on the results of Korean cohort studies. To account for the 15-year latency period when estimating the PAF in 2020, the prevalence rates from 2015 and attributable cases or deaths from 2020 were used. Results: The PAF attributed to EBW was similar for both cancer incidence and deaths using either the World Health Organization (WHO) Asian-Pacific region standard or a modified Asian standard, with the WHO standard yielding the lowest values. In the Korean population, the PAFs of EBW for cancer incidence were 2.96% in men and 3.61% in women, while those for cancer deaths were 0.67% in men and 3.06% in women in 2020. Additionally, PAFs showed a gradual increase in both sexes until 2030. Conclusion The EBW continues to have a significant impact on cancer incidence and deaths in Korea. Effective prevention strategies targeting the reduction of this modifiable risk factor can substantially decrease the cancer burden.

Background: Single room isolation with contact precautions is widely regarded as a fundamental strategy to prevent the transmission of multidrug-resistant organisms (MDROs). However, its implementation demands substantial resources, limiting its universal application to all MDROs. In this study, we assessed the effect of discontinuing single room isolation for vancomycin-resistant Enterococcus (VRE). Methods: This is a retrospective, observational study conducted at a single 750-bed tertiary center. We conducted an interrupted time series analysis to compare incidence rates and trends of new-onset VRE colonization and bacteremia during the one year before and after the strategy change on January 1, 2023. Results: Single-room occupancy decreased from 79.7% pre-intervention to 23.6% postintervention (P < 0.001). The incidence rate of new-onset VRE colonization was 0.452 and 0.535 per 1,000 patient-days in the pre- and post-intervention periods, respectively, with no statistically significant difference (P = 0.202). However, there was a slightly increasing trend (0.036 [95% confidence interval, −0.002, 0.074] increase per month, P = 0.066). The new-onset VRE bacteremia incidence rate was not differed in incidence (0.060 and 0.055, P= 0.571) or trend (P = 0.720). Conclusion Our study suggests that discontinuing single-room isolation for VRE patients may not affect the incidence of new-onset VRE bacteremia, but caution is needed due to the potential increase in colonization.

Purpose: Relative energy deficiency in sport (REDs) is a syndrome of physiological and/or psychological functioning experienced by female and male athletes that is caused by exposure to problematic low energy availability. For the prevention and intervention of REDs, awareness of REDs among sports physicians is important, but it is largely unknown. This study aimed to survey the awareness and clinical treatment experience of REDs in sports physicians. Methods: We conducted an online survey to assess awareness of the triad and REDs among sports physicians and members of The Korean Society of Sports Medicine. Results: A total of 69 members (62.2% male, including sports physicians) to this survey. Most participants (84.1%) were aware of the triad compared to fewer with awareness regarding REDs (23.2%). People who knew about the difference between REDs and triad was 33.3%, which was lower than those who did not (66.6%). Only 10.1% of the study subjects had experience treating REDs patients, and the biggest difficulty in treating patients was a lack of information and education (50.7%). It appeared that the most information about REDs was obtained from academic conferences (59.4%). Conclusion This survey found relatively low awareness of REDs among physicians treating athletes and sports professionals. Considering the various negative effects of REDs on athlete health and performance, education and promotion are needed to increase awareness among sports physicians and sports professionals.

Purpose: Relative energy deficiency in sport (REDs) is a syndrome of physiological and/or psychological functioning experienced by female and male athletes that is caused by exposure to problematic low energy availability. For the prevention and intervention of REDs, awareness of REDs among sports physicians is important, but it is largely unknown. This study aimed to survey the awareness and clinical treatment experience of REDs in sports physicians. Methods: We conducted an online survey to assess awareness of the triad and REDs among sports physicians and members of The Korean Society of Sports Medicine. Results: A total of 69 members (62.2% male, including sports physicians) to this survey. Most participants (84.1%) were aware of the triad compared to fewer with awareness regarding REDs (23.2%). People who knew about the difference between REDs and triad was 33.3%, which was lower than those who did not (66.6%). Only 10.1% of the study subjects had experience treating REDs patients, and the biggest difficulty in treating patients was a lack of information and education (50.7%). It appeared that the most information about REDs was obtained from academic conferences (59.4%). Conclusion This survey found relatively low awareness of REDs among physicians treating athletes and sports professionals. Considering the various negative effects of REDs on athlete health and performance, education and promotion are needed to increase awareness among sports physicians and sports professionals.