This study examined sleep-related characteristics among university students and the associations between sleep quality, dietary habits, and diet quality.Three hundred and ninety-three university students (206 men and 187 women) enrolled at universities in the Chungcheong region of Korea participated in this study between November and December 2023. Data on the general characteristics, dietary habits, sleep status, and the Nutrition Quotient (NQ) for adults were collected using a structured questionnaire. The sleep quality was assessed using the Pittsburgh Sleep Quality Index– Korean version (PSQI-K). The participants were classified into a good sleeper group (PSQI-K≤5) and a poor sleeper group (PSQI-K≥6). The dietary habits and NQ scores were compared according to the sleep quality. Compared with good sleepers, poor sleepers had a significantly higher prevalence of eating alone at least once per day (P<0.01) and higher scores for unhealthy dietary behaviors, including overeating, eating quickly, a preference for salty food, skipping meals, and irregular meal timing (P<0.05). Although the total NQ scores and balance and practice domain scores did not differ according to sleep quality, the moderation domain scores were significantly lower among poor sleepers, particularly in men (P<0.05). In conclusion, poor sleep quality among university students was associated with unhealthy dietary habits and lower diet quality related to dietary restraint. These findings highlight the importance of improving sleep quality as a part of health education and dietary intervention programs for university students.

Objectives: Previous studies have shown that combined interventions involving cognitive training and physical activity are effective in enhancing brain function. This study examined the effects of a dual-task intervention—simultaneously combining cognitive and physical tasks—on the cognitive and physical function of community-dwelling older adults aged 65 years and older. Methods: From July to December 2023, cognitively normal adults aged 65 years or older were recruited through the Jeollabuk-do Regional Dementia Center. Participants completed an eightsession group-based program (60 minutes per session) that combined cognitive training and physical activity. The cognitive functions were evaluated using a neuropsychological test battery, and the physical functions were assessed using the Short Physical Performance Battery (SPPB), before and after the intervention. Results: Of 79 participants, 73 completed the intervention. After the program, significant improvements in orientation, memory, visuoconstruction, naming, total cognitive scores, and performance were observed on the Trail Making Test-Part A and Trail Making Test-Part B (p<0.05 to p<0.001).Physical performance also significantly improved the balance, gait speed, chair-stand ability, and total SPPB scores (p<0.001). Multiple regression analysis showed that lower educational attainment and cohabitation with children were associated with greater cognitive improvements, while antihypertensive medication use was negatively associated, and diabetes medication use was positively associated with cognitive outcomes. Conclusion Simultaneous dual-task–based combined intervention may be an effective strategy for enhancing the cognitive and physical functions in cognitively preserved older adults. Nevertheless, further studies will be needed to explore its long-term effects and underlying neurobiological mechanisms.

Objective: We aimed to identify the individual and interactive effects of childhood abuse and suicidal ideation on antidepressant treatment response in 12 months. Methods: In this prospective research, 1,262 depressive patients were asked about their childhood abuse history, suicidal ideation, and other clinical characteristics and socio-demographic features at baseline, and 1,015 of them were followed during 1 year of stepwise pharmacotherapy. The individual and interactive relationships of the childhood abuse history and suicidal ideation on 12-month antidepressant non-remission were explored by logistic regression with relevant covariates. Results: Having a childhood abuse history and higher suicidal ideation significantly predicted a non-remission state in 12 months respectively. The interaction term of childhood abuse and suicidal ideation was also significantly related to a non-remission state at 12 months. To be specific, in the low suicidal ideation group, depressive patients with a childhood abuse history were more likely to be in a non-remission state after 12 months of medication. In the high suicidal ideation group, however, childhood abuse history was not significantly associated with the non-remission state at 12 months. Conclusion The childhood abuse history and the level of suicidal ideation are informative factors predicting the long-term results of antidepressant treatment, especially when they are combined. Clinicians may consider antidepressants with a higher affinity for patients with childhood abuse history even if they don’t have suicidal ideation. The cognitive intervention for suicidal ideation might be helpful in addition to pharmacological treatment.

Schwannomas are slow-growing benign tumors originating from the Schwann cells of the peripheral nerve sheaths. Herein, we report the first documented case of a schwannoma presenting as a painful nipple mass in a 32-year-old woman. This mass initially developed six years ago following a period of breastfeeding. Breast magnetic resonance imaging (MRI) scans revealed an iso-intense mass, with an approximate size of 2.2 cm, on a T1-weighted image with internal cystic changes. The mass exhibited heterogeneously delayed enhancement and restricted diffusion.Surgical excision was performed, and the diagnosis of cutaneous plexiform nipple schwannoma was confirmed histopathologically. A literature review revealed that the MRI findings of the nipple mass in our case were consistent with the common features of a schwannoma.

Objective: This study investigated associations of life stressors and serum ghrelin levels with suicidal ideation (SI), and evaluated the potential mediating effect of ghrelin on associations between life stressors and SI in patients with acute coronary syndrome (ACS). Methods: In total, 969 ACS patients recruited from a tertiary university hospital in Korea within 2 weeks of disease onset were evaluated in terms of life stressors (using the List of Threatening Events Questionnaire), serum ghrelin levels, and SI (using the “suicidal thoughts” item of the Montgomery–Asberg Depression Rating Scale). Covariates included sociodemographics, depression, vascular risk factors, and disease severity. After 1 year, 711 patients were re-evaluated in terms of SI; logistic regression was performed with adjustment for covariates. Results: Life stressors were significantly associated with SI at baseline and follow-up. Serum ghrelin showed no such associations, but high levels thereof mediated associations of life stressors with SI; significant interaction terms were also observed after adjustment for covariates. Conclusion By evaluating life stressors and serum ghrelin levels, clinical prediction of SI in the acute and chronic phases of ACS could be improved.

FLASH radiotherapy (FLASH RT) is a technique to deliver ultra-high dose rate in a fraction of a second. Evidence from experimental animal models suggest that FLASH RT spares various normal tissues including the lung, gastrointestinal track, and brain from radiation-induced toxicity (a phenomenon known as FLASH effect), which is otherwise commonly observed with conventional dose rate RT. However, it is not simply the ultra-high dose rate alone that brings the FLASH effect. Multiple parameters such as instantaneous dose rate, pulse size, pulse repetition frequency, and the total duration of exposure all need to be carefully optimized simultaneously. Furthermore it is critical to validate FLASH effects in an in vivo experimental model system. The exact molecular mechanism responsible for this FLASH effect is not yet understood although a number of hypotheses have been proposed including oxygen depletion and less reactive oxygen species (ROS) production by FLASH RT, and enhanced ability of normal tissues to handle ROS and labile iron pool compared to tumors. In this review, we briefly overview the process of ionization event and history of radiotherapy and fractionation of ionizing radiation. We also highlight some of the latest FLASH RT reviews and results with a special interest to neurocognitive protection in rodent model with whole brain irradiation. Lastly we discuss some of the issues remain to be answered with FLASH RT including undefined molecular mechanism, lack of standardized parameters, low penetration depth for electron beam, and tumor hypoxia still being a major hurdle for local control. Nevertheless, researchers are close to having all answers to the issues that we have raised, hence we believe that advancement of FLASH RT will be made more quickly than one can anticipate.

Purpose: : This study aimed to understand and describe the nurses’ experiences caring for severe COVID-19 patients at isolation room with negative pressure in South Korea. Methods: : Data were collected through individual in-depth interviews from February 16 to March 31, 2021 with 11 nurses who had been caring for severe COVID-19 patients at isolation room. Verbatim transcripts were analyzed according to Colaizzi’s phenomenological analysis. Results: : As a result, 5 theme clusters were extracted about nurses’ experiences. The 5 theme clusters, “Adapting to unexpected adversity”, “Accepting unresonable and heavy work”, “Dulness and disconnection from the outside world”, “Changing in perception of new infectious diseases”, and “Pathetic isolated patients” emerged. Conclusion : The results of this study provided a deeper understanding of nurses struggling to care for COVID-19 severe patients. This study is expected to be useful in providing basic evidence for improving intensive care practices and for preparing policies in other infection disease situations.

Purpose: This study was performed to verify reliability and validity of the Korean Pediatric Patient Classification System (KPPCS) and estimate nursing time conversion index. Methods: The study was conducted in 9 children’s hospital which included various areas and size of bed settings. To verify intraclass correlation reliability and construct validity, staff nurses and nurse managers of 21 wards classified 575 patients according to KPPCS comparing differences by age, days of stay, type of stay and medical department. Direct and indirect nursing time of 575 patients were measured by 284 nursing staffs by stopwatch observation and self reports for 24 hours. Results: KPPCS has 12 categories, 55 nursing activities and 80 criterions. High agreement among nurses (r=.91, p<.001) suggested substantial reliability. Construct validity was verified by comparing differences in age, days of stay, type of stay and medical department (p<.05). The correlation of nursing time and classification score was also statistically significant (r=.59, p<.001). The nursing time conversion index was 10.78 minutes per 1 classification score. The entire patient group were classified to four groups using KPPCS. Conclusion The findings suggest that KPPCS would be a useful tool for estimating nursing demands related to the complexity of pediatric patients.

Purpose: Acute promyelocytic leukemia (APL) is a rare disease in children and there are some different characteristics between children and adult. We aimed to evaluate incidence, clinical characteristics and treatment outcomes of pediatric APL in Korea. Materials and Methods: Seventy-nine pediatric APL patients diagnosed from January 2009 to December 2016 in 16 tertiary medical centers in Korea were reviewed retrospectively. Results: Of 801 acute myeloid leukemia children, 79 (9.9%) were diagnosed with APL. The median age at diagnosis was 10.6 years (range, 1.3 to 18.0). Male and female ratio was 1:0.93. Thirty patients (38.0%) had white blood cell (WBC) count greater than 10×109/L at diagnosis. All patients received induction therapy consisting of all-trans retinoic acid and chemotherapy. Five patients (6.6%) died during induction chemotherapy and 66 patients (86.8%) achieved complete remission (CR) after induction chemotherapy. The causes of death were three intracranial hemorrhage, one cerebral infarction, and one sepsis. Five patients (7.1%) suffered a relapse during or after maintenance chemotherapy. The estimated 4-year event-free survival and overall survival (OS) rates were 82.1%±4.4%, 89.7%±5.1%, respectively. The 4-year OS was significantly higher in patients with initial WBC < 10×109/L than in those with initial WBC ≥ 10×109/L (p=0.020). Conclusion This study showed that the CR rates and survival outcomes in Korean pediatric APL patients were relatively good. The initial WBC count was the most important prognostic factor and most causes of death were related to serious bleeding in the early stage of treatment.