Purpose: This study evaluates the prognostic significance of tumor size at disease progression (PD) and depth of response (DOR) in cancer patients. Materials and Methods: We performed post hoc analysis using data from six prospective clinical trials conducted by the Korean Cancer Study Group. Patients with tumor size at PD was categorized into ‘Mild PD’ and ‘Significant PD’ based on the cutoff values of relative change from baseline using maximally selected rank statistics. The overall survival (OS) and progression-free survival (PFS) were compared between PD and DOR categories. Results: Among the 194 evaluable patients, 130 experienced PD. A 35.48% decrease from baseline in tumor size at PD was chosen for the cutoff between mild and significant PD for OS (mild PD: tumor size from the baseline ≤ −35.48%; significant PD > −35.48%). The mild PD had superior OS compared to the significant PD (25.8 vs. 12.8 months; Hazard ratio [HR] 0.47, 95% CI 0.266-0.843, p=0.009). When using an exploratory cutoff based on whether the tumor size was below vs. exceeded from the baseline (mild PD: tumor size from the baseline ≤ 0%; significant PD > 0%), OS remained significantly longer in the mild PD (17.1 vs. 11.8 months; HR 0.60, 95% CI 0.392-0.932, p=0.021). The greatest DOR was associated with the longest OS and PFS (p<0.001 for both). Conclusion Tumor size at PD and DOR were significant prognostic factors for progressive disease. Maintaining a sufficiently reduced tumor size even during PD was associated with better survival outcomes.

Purpose: This study evaluates the prognostic significance of tumor size at disease progression (PD) and depth of response (DOR) in cancer patients. Materials and Methods: We performed post hoc analysis using data from six prospective clinical trials conducted by the Korean Cancer Study Group. Patients with tumor size at PD was categorized into ‘Mild PD’ and ‘Significant PD’ based on the cutoff values of relative change from baseline using maximally selected rank statistics. The overall survival (OS) and progression-free survival (PFS) were compared between PD and DOR categories. Results: Among the 194 evaluable patients, 130 experienced PD. A 35.48% decrease from baseline in tumor size at PD was chosen for the cutoff between mild and significant PD for OS (mild PD: tumor size from the baseline ≤ −35.48%; significant PD > −35.48%). The mild PD had superior OS compared to the significant PD (25.8 vs. 12.8 months; Hazard ratio [HR] 0.47, 95% CI 0.266-0.843, p=0.009). When using an exploratory cutoff based on whether the tumor size was below vs. exceeded from the baseline (mild PD: tumor size from the baseline ≤ 0%; significant PD > 0%), OS remained significantly longer in the mild PD (17.1 vs. 11.8 months; HR 0.60, 95% CI 0.392-0.932, p=0.021). The greatest DOR was associated with the longest OS and PFS (p<0.001 for both). Conclusion Tumor size at PD and DOR were significant prognostic factors for progressive disease. Maintaining a sufficiently reduced tumor size even during PD was associated with better survival outcomes.

Purpose: This study evaluates the prognostic significance of tumor size at disease progression (PD) and depth of response (DOR) in cancer patients. Materials and Methods: We performed post hoc analysis using data from six prospective clinical trials conducted by the Korean Cancer Study Group. Patients with tumor size at PD was categorized into ‘Mild PD’ and ‘Significant PD’ based on the cutoff values of relative change from baseline using maximally selected rank statistics. The overall survival (OS) and progression-free survival (PFS) were compared between PD and DOR categories. Results: Among the 194 evaluable patients, 130 experienced PD. A 35.48% decrease from baseline in tumor size at PD was chosen for the cutoff between mild and significant PD for OS (mild PD: tumor size from the baseline ≤ −35.48%; significant PD > −35.48%). The mild PD had superior OS compared to the significant PD (25.8 vs. 12.8 months; Hazard ratio [HR] 0.47, 95% CI 0.266-0.843, p=0.009). When using an exploratory cutoff based on whether the tumor size was below vs. exceeded from the baseline (mild PD: tumor size from the baseline ≤ 0%; significant PD > 0%), OS remained significantly longer in the mild PD (17.1 vs. 11.8 months; HR 0.60, 95% CI 0.392-0.932, p=0.021). The greatest DOR was associated with the longest OS and PFS (p<0.001 for both). Conclusion Tumor size at PD and DOR were significant prognostic factors for progressive disease. Maintaining a sufficiently reduced tumor size even during PD was associated with better survival outcomes.

Purpose: This study aimed to explore customer perspectives of nursing services in tertiary hospitals. Methods: The data comprised mobile Voice Of Customer (VOC) data related to “nursing” or “nurses” generated from June 25, 2019, to December 31, 2022, in a tertiary hospital. A total of 44,727 VOC data points were collected, of which 4,040 were selected for the final analysis. Text network analysis and topic modeling were conducted using NetMiner 4.5.1. Results: Topic modeling identified five topics for positive aspects and four topics for areas requiring improvement.The positive aspects were: 1) sincere nursing care; 2) rapid response from professional medical staff; 3) teamwork for delivering customer-centric services; 4) provision and coordination of system-based healthcare services; and 5) customer-focused responsiveness. The areas requiring improvement were: 1) demand for skilled nursing care tailored to customer expectations; 2) demand for enhanced communication and reduced mechanical responses; 3) demand for appropriate handling of diverse situations; and 4) demand for overall improvements to the healthcare system, including reservation systems. Conclusion These results may be used to enhance customer and patient experiences in tertiary hospitals and are necessary for utilization from a hospital management perspective.

Background: While there are many studies on adolescents’ suicide attempts in the western countries, studies on adolescent suicide in South Korea are relatively scarce. We compared demographical and clinical variables between the first and multiple suicide attempters and examined potential risk factors predicting multiple suicide attempts. Methods: Two hundred forty-eight suicide attempters aged from 11 to 19 years old who visited emergency department of Uijeongbu St. Mary’s Hospital, South Korea were recruited and divided into two groups: first attempter (n = 139, 56%) and multiple attempter (n = 109, 44%). A psychiatric interview with the Brief Emergency Room Suicide Risk Assessment were administered to all participants, and univariate analyses to compare characteristics of the two group and a multivariable logistic regression analysis to predict multiple suicidal attempts were performed. Results: Our results showed multiple suicide attempters were mostly female (78%), more severe in psychopathology (e.g., higher rate of psychiatric family history, diagnosis of axis I history, history of major depressive disorder, higher feeling of hopelessness/helplessness) and suicidality (e.g., repetitive/severe/continuous suicide ideation, lower regret for suicide attempt). Moreover, multiple suicide attempters were lower in psychiatric resources, such as lower personal achievement, lower ability to control emotion, and less insight. Multivariate logistic regression analysis showed that suicide ideation severity (odds ratio [OR], 2.30;P = 0.004), past history of axis I diagnosis (especially major depressive disorder; OR, 2.55; P = 0.002), and the use of “cutting” (OR, 2.85; P = 0.001) predicted multiple suicide attempts. Conclusion The present study suggests that multiple suicide attempters tend to have more severe clinical profiles than the first suicide attempters. Intervention for depression and selfmutilation behavior of suicide attempters may be important in preventing multiple suicide attempts of adolescents.

Purpose: This study aimed to explore customer perspectives of nursing services in tertiary hospitals. Methods: The data comprised mobile Voice Of Customer (VOC) data related to “nursing” or “nurses” generated from June 25, 2019, to December 31, 2022, in a tertiary hospital. A total of 44,727 VOC data points were collected, of which 4,040 were selected for the final analysis. Text network analysis and topic modeling were conducted using NetMiner 4.5.1. Results: Topic modeling identified five topics for positive aspects and four topics for areas requiring improvement.The positive aspects were: 1) sincere nursing care; 2) rapid response from professional medical staff; 3) teamwork for delivering customer-centric services; 4) provision and coordination of system-based healthcare services; and 5) customer-focused responsiveness. The areas requiring improvement were: 1) demand for skilled nursing care tailored to customer expectations; 2) demand for enhanced communication and reduced mechanical responses; 3) demand for appropriate handling of diverse situations; and 4) demand for overall improvements to the healthcare system, including reservation systems. Conclusion These results may be used to enhance customer and patient experiences in tertiary hospitals and are necessary for utilization from a hospital management perspective.

Background: While there are many studies on adolescents’ suicide attempts in the western countries, studies on adolescent suicide in South Korea are relatively scarce. We compared demographical and clinical variables between the first and multiple suicide attempters and examined potential risk factors predicting multiple suicide attempts. Methods: Two hundred forty-eight suicide attempters aged from 11 to 19 years old who visited emergency department of Uijeongbu St. Mary’s Hospital, South Korea were recruited and divided into two groups: first attempter (n = 139, 56%) and multiple attempter (n = 109, 44%). A psychiatric interview with the Brief Emergency Room Suicide Risk Assessment were administered to all participants, and univariate analyses to compare characteristics of the two group and a multivariable logistic regression analysis to predict multiple suicidal attempts were performed. Results: Our results showed multiple suicide attempters were mostly female (78%), more severe in psychopathology (e.g., higher rate of psychiatric family history, diagnosis of axis I history, history of major depressive disorder, higher feeling of hopelessness/helplessness) and suicidality (e.g., repetitive/severe/continuous suicide ideation, lower regret for suicide attempt). Moreover, multiple suicide attempters were lower in psychiatric resources, such as lower personal achievement, lower ability to control emotion, and less insight. Multivariate logistic regression analysis showed that suicide ideation severity (odds ratio [OR], 2.30;P = 0.004), past history of axis I diagnosis (especially major depressive disorder; OR, 2.55; P = 0.002), and the use of “cutting” (OR, 2.85; P = 0.001) predicted multiple suicide attempts. Conclusion The present study suggests that multiple suicide attempters tend to have more severe clinical profiles than the first suicide attempters. Intervention for depression and selfmutilation behavior of suicide attempters may be important in preventing multiple suicide attempts of adolescents.

Objective: To investigate whether reader training improves the performance and agreement of radiologists in interpreting unenhanced breast magnetic resonance imaging (MRI) scans using diffusion-weighted imaging (DWI). Materials and Methods: A study of 96 breasts (35 cancers, 24 benign, and 37 negative) in 48 asymptomatic women was performed between June 2019 and October 2020. High-resolution DWI with b-values of 0, 800, and 1200 sec/mm 2 was performed using a 3.0-T system. Sixteen breast radiologists independently reviewed the DWI, apparent diffusion coefficient maps, and T1-weighted MRI scans and recorded the Breast Imaging Reporting and Data System (BI-RADS) category for each breast. After a 2-h training session and a 5-month washout period, they re-evaluated the BI-RADS categories. A BI-RADS category of 4 (lesions with at least two suspicious criteria) or 5 (more than two suspicious criteria) was considered positive.The per-breast diagnostic performance of each reader was compared between the first and second reviews. Inter-reader agreement was evaluated using a multi-rater κ analysis and intraclass correlation coefficient (ICC). Results: Before training, the mean sensitivity, specificity, and accuracy of the 16 readers were 70.7% (95% confidence interval [CI]: 59.4–79.9), 90.8% (95% CI: 85.6–94.2), and 83.5% (95% CI: 78.6–87.4), respectively. After training, significant improvements in specificity (95.2%; 95% CI: 90.8–97.5; P = 0.001) and accuracy (85.9%; 95% CI: 80.9–89.8; P = 0.01) were observed, but no difference in sensitivity (69.8%; 95% CI: 58.1–79.4; P = 0.58) was observed. Regarding inter-reader agreement, the κ values were 0.57 (95% CI: 0.52–0.63) before training and 0.68 (95% CI: 0.62–0.74) after training, with a difference of 0.11 (95% CI: 0.02–0.18; P = 0.01). The ICC was 0.73 (95% CI: 0.69–0.74) before training and 0.79 (95% CI: 0.76–0.80) after training (P = 0.002). Conclusion Brief reader training improved the performance and agreement of interpretations by breast radiologists using unenhanced MRI with DWI.

Purpose: This study aimed to explore customer perspectives of nursing services in tertiary hospitals. Methods: The data comprised mobile Voice Of Customer (VOC) data related to “nursing” or “nurses” generated from June 25, 2019, to December 31, 2022, in a tertiary hospital. A total of 44,727 VOC data points were collected, of which 4,040 were selected for the final analysis. Text network analysis and topic modeling were conducted using NetMiner 4.5.1. Results: Topic modeling identified five topics for positive aspects and four topics for areas requiring improvement.The positive aspects were: 1) sincere nursing care; 2) rapid response from professional medical staff; 3) teamwork for delivering customer-centric services; 4) provision and coordination of system-based healthcare services; and 5) customer-focused responsiveness. The areas requiring improvement were: 1) demand for skilled nursing care tailored to customer expectations; 2) demand for enhanced communication and reduced mechanical responses; 3) demand for appropriate handling of diverse situations; and 4) demand for overall improvements to the healthcare system, including reservation systems. Conclusion These results may be used to enhance customer and patient experiences in tertiary hospitals and are necessary for utilization from a hospital management perspective.

Background: While there are many studies on adolescents’ suicide attempts in the western countries, studies on adolescent suicide in South Korea are relatively scarce. We compared demographical and clinical variables between the first and multiple suicide attempters and examined potential risk factors predicting multiple suicide attempts. Methods: Two hundred forty-eight suicide attempters aged from 11 to 19 years old who visited emergency department of Uijeongbu St. Mary’s Hospital, South Korea were recruited and divided into two groups: first attempter (n = 139, 56%) and multiple attempter (n = 109, 44%). A psychiatric interview with the Brief Emergency Room Suicide Risk Assessment were administered to all participants, and univariate analyses to compare characteristics of the two group and a multivariable logistic regression analysis to predict multiple suicidal attempts were performed. Results: Our results showed multiple suicide attempters were mostly female (78%), more severe in psychopathology (e.g., higher rate of psychiatric family history, diagnosis of axis I history, history of major depressive disorder, higher feeling of hopelessness/helplessness) and suicidality (e.g., repetitive/severe/continuous suicide ideation, lower regret for suicide attempt). Moreover, multiple suicide attempters were lower in psychiatric resources, such as lower personal achievement, lower ability to control emotion, and less insight. Multivariate logistic regression analysis showed that suicide ideation severity (odds ratio [OR], 2.30;P = 0.004), past history of axis I diagnosis (especially major depressive disorder; OR, 2.55; P = 0.002), and the use of “cutting” (OR, 2.85; P = 0.001) predicted multiple suicide attempts. Conclusion The present study suggests that multiple suicide attempters tend to have more severe clinical profiles than the first suicide attempters. Intervention for depression and selfmutilation behavior of suicide attempters may be important in preventing multiple suicide attempts of adolescents.