Background: Suicide remains a significant global public health challenge, with hanging as the most prevalent suicide method in South Korea. This study aimed to determine diagnostic markers confirming suicidal hanging-associated deaths. Methods: In this prospective study, hemorrhages at the periosteal-clavicular origin of the sternocleidomastoid (SCM) muscles were compared among suicidal hanging, manual strangulation, and ligature strangulation cases. This study included 211 cases of suicide by hanging, and a control group of 50 individuals who underwent cardiopulmonary resuscitation but died of other causes. Additionally, nine cases of ligature strangulation and six cases of manual strangulation were analyzed. Postmortem examinations were conducted, and clavicular hemorrhages were histologically evaluated. Statistical analyses were performed using the χ2 test. Results: Hemorrhages at the periosteal-clavicular origin of the SCM were observed in 178 of the 211 hanging cases (84.4%). The highest frequency of clavicular hemorrhage was found in typical hanging cases with complete suspension. Among the 50 control cases, only three showed hemorrhages in the clavicular region, but these were extravasations in the adjoining soft tissue, not in the periosteum. In cases of manual and ligature strangulation, SCM hemorrhages were found within the muscle tissue and were not of periosteal-clavicular origin. Conclusion Hemorrhage at the periosteal-clavicular origin of the SCM is a significant finding in suicidal hanging and serves as a potential pathognomonic marker for confirming cases of suicidal hanging. The study revealed a statistically significant association between the type of hanging, completeness of body suspension, and the occurrence of these hemorrhages.Cardiopulmonary resuscitation does not cause a hemorrhage at this location.

Background: Suicide remains a significant global public health challenge, with hanging as the most prevalent suicide method in South Korea. This study aimed to determine diagnostic markers confirming suicidal hanging-associated deaths. Methods: In this prospective study, hemorrhages at the periosteal-clavicular origin of the sternocleidomastoid (SCM) muscles were compared among suicidal hanging, manual strangulation, and ligature strangulation cases. This study included 211 cases of suicide by hanging, and a control group of 50 individuals who underwent cardiopulmonary resuscitation but died of other causes. Additionally, nine cases of ligature strangulation and six cases of manual strangulation were analyzed. Postmortem examinations were conducted, and clavicular hemorrhages were histologically evaluated. Statistical analyses were performed using the χ2 test. Results: Hemorrhages at the periosteal-clavicular origin of the SCM were observed in 178 of the 211 hanging cases (84.4%). The highest frequency of clavicular hemorrhage was found in typical hanging cases with complete suspension. Among the 50 control cases, only three showed hemorrhages in the clavicular region, but these were extravasations in the adjoining soft tissue, not in the periosteum. In cases of manual and ligature strangulation, SCM hemorrhages were found within the muscle tissue and were not of periosteal-clavicular origin. Conclusion Hemorrhage at the periosteal-clavicular origin of the SCM is a significant finding in suicidal hanging and serves as a potential pathognomonic marker for confirming cases of suicidal hanging. The study revealed a statistically significant association between the type of hanging, completeness of body suspension, and the occurrence of these hemorrhages.Cardiopulmonary resuscitation does not cause a hemorrhage at this location.

Background: Suicide remains a significant global public health challenge, with hanging as the most prevalent suicide method in South Korea. This study aimed to determine diagnostic markers confirming suicidal hanging-associated deaths. Methods: In this prospective study, hemorrhages at the periosteal-clavicular origin of the sternocleidomastoid (SCM) muscles were compared among suicidal hanging, manual strangulation, and ligature strangulation cases. This study included 211 cases of suicide by hanging, and a control group of 50 individuals who underwent cardiopulmonary resuscitation but died of other causes. Additionally, nine cases of ligature strangulation and six cases of manual strangulation were analyzed. Postmortem examinations were conducted, and clavicular hemorrhages were histologically evaluated. Statistical analyses were performed using the χ2 test. Results: Hemorrhages at the periosteal-clavicular origin of the SCM were observed in 178 of the 211 hanging cases (84.4%). The highest frequency of clavicular hemorrhage was found in typical hanging cases with complete suspension. Among the 50 control cases, only three showed hemorrhages in the clavicular region, but these were extravasations in the adjoining soft tissue, not in the periosteum. In cases of manual and ligature strangulation, SCM hemorrhages were found within the muscle tissue and were not of periosteal-clavicular origin. Conclusion Hemorrhage at the periosteal-clavicular origin of the SCM is a significant finding in suicidal hanging and serves as a potential pathognomonic marker for confirming cases of suicidal hanging. The study revealed a statistically significant association between the type of hanging, completeness of body suspension, and the occurrence of these hemorrhages.Cardiopulmonary resuscitation does not cause a hemorrhage at this location.

Background: Suicide remains a significant global public health challenge, with hanging as the most prevalent suicide method in South Korea. This study aimed to determine diagnostic markers confirming suicidal hanging-associated deaths. Methods: In this prospective study, hemorrhages at the periosteal-clavicular origin of the sternocleidomastoid (SCM) muscles were compared among suicidal hanging, manual strangulation, and ligature strangulation cases. This study included 211 cases of suicide by hanging, and a control group of 50 individuals who underwent cardiopulmonary resuscitation but died of other causes. Additionally, nine cases of ligature strangulation and six cases of manual strangulation were analyzed. Postmortem examinations were conducted, and clavicular hemorrhages were histologically evaluated. Statistical analyses were performed using the χ2 test. Results: Hemorrhages at the periosteal-clavicular origin of the SCM were observed in 178 of the 211 hanging cases (84.4%). The highest frequency of clavicular hemorrhage was found in typical hanging cases with complete suspension. Among the 50 control cases, only three showed hemorrhages in the clavicular region, but these were extravasations in the adjoining soft tissue, not in the periosteum. In cases of manual and ligature strangulation, SCM hemorrhages were found within the muscle tissue and were not of periosteal-clavicular origin. Conclusion Hemorrhage at the periosteal-clavicular origin of the SCM is a significant finding in suicidal hanging and serves as a potential pathognomonic marker for confirming cases of suicidal hanging. The study revealed a statistically significant association between the type of hanging, completeness of body suspension, and the occurrence of these hemorrhages.Cardiopulmonary resuscitation does not cause a hemorrhage at this location.

This manuscript represents the official position of the Korean Society of Echocardiography on valvular heart diseases.This position paper focuses on the diagnosis and management of valvular heart diseases with referring to the guide‑ lines recently published by the American College of Cardiology/American Heart Association and the European Society of Cardiology. The committee sought to reflect national data on the topic of valvular heart diseases published to date through a systematic literature search based on validity and relevance. In the part II of this article, we intend to pre‑ sent recommendations for diagnosis and treatment of mitral valve disease and tricuspid valve disease.

Purpose: This study aimed to measure COVID-19 stress and the quantitative electroencephalography (QEEG) stress quotient and identify the coping styles of face-to-face service industry employees during the COVID-19 pandemic. Methods: This cross-sectional study administered structured questionnaires consisting of sections on general characteristics, COVID-19 stress, and coping style for stress to 21 face-to-face service industry employees between April 1 and April 18, 2021. The physical tension & stress quotient and psychological distraction & stress quotient were measured in the prefrontal lobe with QEEG. Results: Emotional easiness (r=.62, p=.002) and escape-avoidance (r=.55, p=.009) as a passive coping style were associated with COVID-19 stress, and seeking social support as an active coping style was associated with the left physical tension & stress quotient (r=.47, p=.031). Conclusion These findings provide evidence regarding the objective status of the mental health of face-to-face service industry employees using both a self-reported scale and neuroscientific indicators, including brain quotients.

Objective: The aim of this study was to investigate the prognostic value of the maximum standardized uptake value (SUVmax) measured while restaging with F-18 fluorodeoxyglucose (18F-FDG) positron emission tomography/computed tomography (PET/ CT) to predict the 3-year post-recurrence survival (PRS) in patients with recurrent gastric cancer after curative surgical resection. Materials and Methods: In total, 47 patients with recurrent gastric cancer after curative resection who underwent restaging with 18F-FDG PET/CT were included. For the semiquantitative analysis, SUVmax was measured over the visually discernable 18F-FDG-avid recurrent lesions. Cox proportional-hazards regression models were used to predict the 3-year PRS. Differences in 3-year PRS were assessed with the Kaplan–Meier analysis. Results: Thirty-nine of the 47 patients (83%) expired within 3 years after recurrence in the median follow-up period of 30.3 months. In the multivariate analysis, SUVmax (p = 0.012), weight loss (p = 0.025), and neutrophil count (p = 0.006) were significant prognostic factors for 3-year PRS. The Kaplan–Meier curves demonstrated significantly poor 3-year PRS in patients with SUVmax > 5.1 than in those with SUVmax ≤ 5.1 (3-year PRS rate, 3.5% vs. 38.9%, p < 0.001). Conclusion High SUVmax on restaging with 18F-FDG PET/CT is a poor prognostic factor for 3-year PRS. It may strengthen the role of 18F-FDG PET/CT in further stratifying the prognosis of recurrent gastric cancer.

Purpose: This study aimed to identify the mental fitness, perspective taking, attitude toward the elderly, and quantitative encephalogram among caregivers. Methods: In this mixed method research, 14 female caregivers at an elderly care facility in Y city were participated from December 1st to December 31st, 2019. Structured questionnaires were applied to measure general characteristics, mental fitness, perspective taking, and attitude toward the elderly. Brain waves were measured by quantitative encephalogram in the prefrontal lobe. High frequency and high level of care tasks were analyzed using content analysis. Results: According to analysis of brain waves, caregivers experienced high level of physical strain & stress and psychological distraction & stress.Mental fitness (p<.05) and perspective taking (p<.001) were associated with attitude toward the elderly.Moreover, physical strain & stress was associated with psychological distraction & stress (p<.05, p<.001). High frequency and high level tasks were excretion and position change & movement care related tasks, respectively. Conclusion These findings should be consider as an evidence for supporting care tasks based on concrete and objective understanding of caregivers using self-reported index as well as neurophysiological indicators including brain waves.

Purpose: This study aimed to identify the effect of integrated nursing using cognicise and neurofeedback on cognition and ⍺ waves among elderly individuals. Methods: This quasi-experimental single group pretest-posttest study included 29 Korean adults aged 65 years or older who participated at a senior welfare center in Y city from February to May 2019. Each integrated nursing session consisted of cognicise (10 minutes) and neurofeedback (20 minutes). Subjects participated twice a week for 10 weeks. Structured questionnaires to assess participants' general characteristics and the Korean version of the Mini-Mental Status Examination for Dementia Screening (K-MMSE-DS) were applied. Alpha waves were measured using BrainMaster. Results: Following the integrated nursing program, alpha waves improved in F3 (t=2.41, p=.023), C3 (t=3.00, p=.006), C4 (t=2.60, p=.015), P3 (t=2.43, p=.022), O1 (t=2.30, p=.029), T3 (t=3.05, p=.005), T4 (t=2.28, p=.030), T5 (t=2.91, p=.007), Fz (t=2.30, p=.029), Cz (t=2.73, p=.011), and Pz (t=2.23, p=.034). Most subjects experienced improvement in concentration after participating in the intervention. Conclusion This study provides evidence for the use of a neuroscientific approach including brain wave measurement to improve cognitive health among community-living elderly people.

Purpose: This study aimed to define and clarify learning transfer in nursing. Methods: This study used a hybrid model to analyze the concept of learning transfer in nursing through three phases. For the theoretical phase, learning transfer attributes were identified through a scoping literature review. In the fieldwork phase, in-depth focus group interviews were conducted to develop attributes. Purposive sampling was performed with ten participants(five nursing students, two nurses, three nursing faculty members). In the analysis phase, the attributes and final analysis of learning transfer in nursing were extracted and integrated from the previous two phases. Results: According to the analysis, learning transfer was represented in two dimensions with eight attributes. The development of competency dimension had three attributes: 1) theory acquisition, nursing skills, professional attitude, 2) integration, and 3) analysis competency. The competency change dimension had five attributes: 1) appropriateness in patient care, 2) proficiency in patient care, 3) satisfaction, 4) achievement, and 5) confidence. Conclusion The concept analysis might provide a basic understanding of learning transfer, a development framework toward a measurement of nursing learning transfer and effective educational nursing strategies.