Purpose: We aimed to investigate how genetic predisposition to drinking and gastric cancer (GC) modifies the association between alcohol consumption and GC risk in the Korean population. Materials and Methods: Polygenic risk scores for GC (PRS-GC) and alcohol consumption (PRS-Alcohol) were formulated using genome-wide association results from BioBank Japan. Validation was performed using Korean cohorts (SNUBH-GENIE cohort), incorporating 8,846 controls and 531 patients with GC. Subsequently, these PRSs were applied to an independent Korean cohort of 67,771 participants, including 313 patients with GC during the follow-up for 14 years (KoGES cohort). Results: In KoGES cohort, the influence of alcohol consumption on GC risk was significantly altered by the PRS-GC and exhibited a synergistic interaction effect. PRS-Alcohol itself shows a negative correlation with GC risk. However, when actual alcohol consumption significantly exceeded genetically predicted levels, the risk of alcohol-related GC was notably increased (adjusted hazard ratio, 1.32; 95% confidence interval, 1.01 to 1.72). Heavy drinkers in the high–PRS-GC/low–PRS-Alcohol group had a 2.16 times higher risk of GC than non-to-light drinkers, which was prominent in males. Conclusion Korean drinkers with higher PRS-GC who consume alcohol more than genetically predicted levels are susceptible to GC. PRS-GC and PRS-Alcohol may be beneficial for assessing the impact of alcohol consumption on GC risk in Koreans.

Purpose: It is essential to regulate nursing to protect the population's health. As regulation constantly changes in response to societal trends, periodic reviews of nursing regulations become imperative. Therefore, we developed a legal framework by extracting essential elements for nursing regulation and explored its potential application. Methods: This study consisted of two parts. First, the legal framework for nursing regulation was developed through reviewing literature that mentions the content that can be included in nursing regulations, and through a content validity assessment by five experts. Second, this legal framework was applied to the nursing laws of China, Hong Kong, Japan, and Taiwan to confirm the suitability of the framework. Results: In the first part of the study, the legal framework for nursing regulation consists of seven categories (purpose, definitions, standards for practice, license acquisition and registration to practice, regulatory body, protection of the legal authority of nurses, offenses/penalties, and disciplinary procedures) and 17 items was developed. As a result of applying this framework to nursing laws in four countries, the average utilization rate for all 17 items was 68.4%. The matching scores between the framework and the law were over 60% for all four laws. Conclusion Regulations, especially in the form of legislation, must be carefully considered because laws involve enforcement and potential penalties. This study is significant for identifying essential nursing regulation elements and offering a practical reference tool, expected to be widely utilized in future nursing policy and regulatory research.

Purpose: It is essential to regulate nursing to protect the population's health. As regulation constantly changes in response to societal trends, periodic reviews of nursing regulations become imperative. Therefore, we developed a legal framework by extracting essential elements for nursing regulation and explored its potential application. Methods: This study consisted of two parts. First, the legal framework for nursing regulation was developed through reviewing literature that mentions the content that can be included in nursing regulations, and through a content validity assessment by five experts. Second, this legal framework was applied to the nursing laws of China, Hong Kong, Japan, and Taiwan to confirm the suitability of the framework. Results: In the first part of the study, the legal framework for nursing regulation consists of seven categories (purpose, definitions, standards for practice, license acquisition and registration to practice, regulatory body, protection of the legal authority of nurses, offenses/penalties, and disciplinary procedures) and 17 items was developed. As a result of applying this framework to nursing laws in four countries, the average utilization rate for all 17 items was 68.4%. The matching scores between the framework and the law were over 60% for all four laws. Conclusion Regulations, especially in the form of legislation, must be carefully considered because laws involve enforcement and potential penalties. This study is significant for identifying essential nursing regulation elements and offering a practical reference tool, expected to be widely utilized in future nursing policy and regulatory research.

Purpose: It is essential to regulate nursing to protect the population's health. As regulation constantly changes in response to societal trends, periodic reviews of nursing regulations become imperative. Therefore, we developed a legal framework by extracting essential elements for nursing regulation and explored its potential application. Methods: This study consisted of two parts. First, the legal framework for nursing regulation was developed through reviewing literature that mentions the content that can be included in nursing regulations, and through a content validity assessment by five experts. Second, this legal framework was applied to the nursing laws of China, Hong Kong, Japan, and Taiwan to confirm the suitability of the framework. Results: In the first part of the study, the legal framework for nursing regulation consists of seven categories (purpose, definitions, standards for practice, license acquisition and registration to practice, regulatory body, protection of the legal authority of nurses, offenses/penalties, and disciplinary procedures) and 17 items was developed. As a result of applying this framework to nursing laws in four countries, the average utilization rate for all 17 items was 68.4%. The matching scores between the framework and the law were over 60% for all four laws. Conclusion Regulations, especially in the form of legislation, must be carefully considered because laws involve enforcement and potential penalties. This study is significant for identifying essential nursing regulation elements and offering a practical reference tool, expected to be widely utilized in future nursing policy and regulatory research.

Background: and Purpose The Karolinska Sleepiness Scale (KSS) is widely used for assessing current level of sleepiness, but it has not been validated in South Korea. This study aimed to validate the KSS using the Stanford Sleepiness Scale (SSS), polysomnography (PSG), and electroencephalography (EEG). Methods: The sample consisted of 27 adult participants in this study aged 40.5±7.7 years (mean±standard deviation) and included 22 males. They completed questionnaires and underwent EEG recording and overnight PSG. The KSS was completed from 18:00 to 24:00 every 2 hours and following PSG (at 07:00). KSS scores changed over time and in particular increased with the time since waking, with the score peaking at 24:00. Results: Convergent validity of the KSS was verified by performing a Spearman correlation analysis between the KSS and SSS (r=0.742, p<0.01). Concurrent validity of the KSS was verified by performing a Spearman correlation analysis between the KSS administered before sleep and the sleep onset latency measured using PSG (r=-0.456, p<0.05). Alpha waves were measured 5 minutes before administering the KSS, and the KSS scores were compared with these alpha waves. There were no significant correlations observed between the KSS scores and alpha waves measured in the left occipital area (O1), left frontal area (F3), or left central area (C3). In addition, Spearman correlation analyses of the difference between KSS scores and alpha waves measured at O1, F3, and C3 produced no significant results. Conclusions This study verified the convergent validity and concurrent validity of the KSS, and confirmed the capabilities of this scale in assessing sleepiness changes over time.

BACKGROUND/AIMS: Colorectal cancer incidence among patients aged ≤50 years is increasing. This study aimed to develop and validate an advanced colorectal neoplasm (ACRN) screening model for young adults aged <50 years in Korea. METHODS: This retrospective cross-sectional study included 59,575 consecutive asymptomatic Koreans who underwent screening colonoscopy between 2003 and 2012 at a single comprehensive health care center. Young Adult Colorectal Screening (YCS) score was developed as an optimized risk stratification model for ACRN using multivariate analysis and was internally validated. The predictive power and diagnostic performance of YCS score was compared with those of Asia-Pacific Colorectal Screening (APCS) and Korean Colorectal Screening (KCS) scores. RESULTS: 41,702 and 17,873 subjects were randomly allocated into the derivation and validation cohorts, respectively, by examination year. ACRN prevalence was 0.9% in both cohorts. YCS score comprised sex, age, alcohol, smoking, obesity, glucose metabolism abnormality, and family history of CRC, with score ranges of 0 to 10. In the validation cohort, ACRN prevalence was 0.6% in the low-risk tier (score, 0–4), 1.5% in the moderate-risk tier (score, 5–7), and 3.4% in the high-risk tier (score, 8–10). ACRN risk increased 2.5-fold (95% confidence interval [CI], 1.8–3.4) in the moderate-risk tier and 5.8-fold (95% CI, 3.4–9.8) in the high-risk tier compared with the low-risk tier. YCS score identified better balanced accuracy (53.9%) than APCS (51.5%) and KCS (50.7%) scores and had relatively good discriminative power (area under the curve=0.660). CONCLUSIONS: YCS score based on clinical and laboratory risk factors was clinically effective and beneficial for predicting ACRN risk and targeting screening colonoscopy in adults aged <50 years.
Adult ; Cohort Studies ; Colonoscopy ; Colorectal Neoplasms ; Comprehensive Health Care ; Cross-Sectional Studies ; Early Detection of Cancer ; Glucose ; Humans ; Incidence ; Korea ; Mass Screening ; Metabolism ; Multivariate Analysis ; Obesity ; Prevalence ; Retrospective Studies ; Risk Assessment ; Risk Factors ; Smoke ; Smoking ; Young Adult

Purpose: The role of registered nurses is expanding in scope as the healthcare paradigm shifts from acute, hospital-based care to community and population-based care. Given this paradigm shift, this study explores the legal aspects of the role of a registered nurse. Methods: We used document analysis for extracting laws and legal orders related to nursing from the entirety of Korean law. Using textualism approach, we examined the contents utilizing a framework that was developed based on the role classification of community nurses by Clark in this study. Results: A total of 119 items related to nursing were derived from 64 laws. Of these, 71.4 % can be performed by people in multiple types of occupations including nurses. As a result of analyzing required qualifications, 45.4% of 119 items required additional qualifications besides registered nurse license. Analysis of workplace and activity type demonstrated that 26.1% of the 119 items were related to medical institutions, with nurses performing mostly “Client-oriented role.” More than half (68.9%) were non-medical institutions, with nurses performing mostly “Delivery-oriented role.” Some, however, did not stipulate the nurse’s roles clearly. Conclusion Therefore, to match the enhanced scope and responsibilities of registered nurses and to appropriately recognize, guide, and hold these nurses accountable, laws and policy must reflect these changes. In doing so, these updated laws and policies will ultimately serve as a basis for improving the quality and safety of nursing services.

PURPOSE: The role of registered nurses is expanding in scope as the healthcare paradigm shifts from acute, hospital-based care to community and population-based care. Given this paradigm shift, this study explores the legal aspects of the role of a registered nurse.METHODS: We used document analysis for extracting laws and legal orders related to nursing from the entirety of Korean law. Using textualism approach, we examined the contents utilizing a framework that was developed based on the role classification of community nurses by Clark in this study.RESULTS: A total of 119 items related to nursing were derived from 64 laws. Of these, 71.4 % can be performed by people in multiple types of occupations including nurses. As a result of analyzing required qualifications, 45.4% of 119 items required additional qualifications besides registered nurse license. Analysis of workplace and activity type demonstrated that 26.1% of the 119 items were related to medical institutions, with nurses performing mostly “Client-oriented role.” More than half (68.9%) were non-medical institutions, with nurses performing mostly “Delivery-oriented role.” Some, however, did not stipulate the nurse's roles clearly.CONCLUSION: Therefore, to match the enhanced scope and responsibilities of registered nurses and to appropriately recognize, guide, and hold these nurses accountable, laws and policy must reflect these changes. In doing so, these updated laws and policies will ultimately serve as a basis for improving the quality and safety of nursing services.
Classification ; Delivery of Health Care ; Humans ; Jurisprudence ; Legislation, Nursing ; Licensure ; Nurse's Role ; Nurses ; Nursing ; Nursing Services ; Occupations ; Republic of Korea

Gene-gene interaction (GGI) analysis is known to play an important role in explaining missing heritability. Many previous studies have already proposed software to analyze GGI, but most methods focus on a binary phenotype in a case-control design. In this study, we developed “Hierarchical structural CoMponent analysis of Gene-Gene Interactions” (HisCoM-GGI) software for GGI analysis with a continuous phenotype. The HisCoM-GGI method considers hierarchical structural relationships between genes and single nucleotide polymorphisms (SNPs), enabling both gene-level and SNP-level interaction analysis in a single model. Furthermore, this software accepts various types of genomic data and supports data management and multithreading to improve the efficiency of genome-wide association study data analysis. We expect that HisCoM-GGI software will provide advanced accessibility to researchers in genetic interaction studies and a more effective way to understand biological mechanisms of complex diseases.
Case-Control Studies ; Genome-Wide Association Study ; Methods ; Phenotype ; Polymorphism, Single Nucleotide ; Statistics as Topic

With the success of the genome-wide association studies (GWASs), many candidate loci for complex human diseases have been reported in the GWAS catalog. Recently, many disease prediction models based on penalized regression or statistical learning methods were proposed using candidate causal variants from significant single-nucleotide polymorphisms of GWASs. However, there have been only a few systematic studies comparing existing methods. In this study, we first constructed risk prediction models, such as stepwise linear regression (SLR), least absolute shrinkage and selection operator (LASSO), and Elastic-Net (EN), using a GWAS chip and GWAS catalog. We then compared the prediction accuracy by calculating the mean square error (MSE) value on data from the Korea Association Resource (KARE) with body mass index. Our results show that SLR provides a smaller MSE value than the other methods, while the numbers of selected variables in each model were similar.
Body Mass Index* ; Decision Support Techniques ; Genome-Wide Association Study ; Humans ; Korea ; Learning ; Linear Models