Purpose: This study aimed to identify the mediating effect of social phobia between social interaction anxiety and endemic blue among university students who experienced the coronavirus disease 2019 (COVID-19) pandemic. Methods: This study employed a descriptive correlational design. The participants were 196 university students from 10 universities located in four major regions across the Republic of Korea. Data were collected from July 12 to 31, 2022, through an online self-reported questionnaire and were then analyzed using an independent t-test, one-way ANOVA with Scheffé test, Pearson’s correlation coefficient, and multiple regression. The mediating effect was analyzed using PROCESS macro model 4 with a bootstrapping method using IBM SPSS 27.0. Results: There were significant positive correlations among social interaction anxiety, social phobia, and endemic blue. Social interaction anxiety had significant effects on social phobia (β=0.77, p<.001) and social interaction anxiety (β=0.33, p<.001) and social phobia had a significant effect on endemic blue (β=0.29, p=.001). Concerning the influence of social interaction anxiety on endemic blue, a significant indirect mediating effect of social phobia was confirmed, and the size of the indirect effect was 0.14 (0.04~0.24). Conclusion In order to manage the social and psychological health of university students who experienced the COVID-19 pandemic period, it is necessary to develop strategies to overcome endemic blue that reduce social interaction anxiety and take into account the mediating effect of social phobia.

The aim of this study was to develop evidence-based recommendations for determining the surgical extent in patients with locally invasive differentiated thyroid cancer (DTC). Locally invasive DTC with gross extrathyroidal extension invading surrounding anatomical structures may lead to several functional deficits and poor oncological outcomes. At present, the optimal extent of surgery in locally invasive DTC remains a matter of debate, and there are no adequate guidelines. On October 8, 2021, four experts searched the PubMed, Embase, and Cochrane Library databases; the identified papers were reviewed by 39 experts in thyroid and head and neck surgery. The Grading of Recommendations Assessment, Development and Evaluation (GRADE) approach was used to assess the quality of evidence, and to develop and report recommendations. The strength of a recommendation reflects the confidence of a guideline panel that the desirable effects of an intervention outweigh any undesirable effects, across all patients for whom the recommendation is applicable. After completing the draft guidelines, Delphi questionnaires were completed by members of the Korean Society of Head and Neck Surgery. Twenty-seven evidence-based recommendations were made for several factors, including the preoperative workup; surgical extent of thyroidectomy; surgery for cancer invading the strap muscles, recurrent laryngeal nerve, laryngeal framework, trachea, or esophagus; and surgery for patients with central and lateral cervical lymph node involvement. Evidence-based guidelines were devised to help clinicians make safer and more efficient clinical decisions for the optimal surgical treatment of patients with locally invasive DTC.

This systematic review and meta-analysis aimed to understand the characteristics of medication adherence interventions for older adults with chronic illnesses, and to investigate the average effect size by combining the individual effects of these interventions. Data from studies meeting the inclusion criteria were systematically collected in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analysis guidelines. The results showed that the average effect size (Hedges’ g) of the finally selected medication adherence interventions for older adults with chronic illnesses calculated using a random-effects model was 0.500 (95% confidence interval [CI], 0.342−0.659). Of the medication adherence interventions, an implementation intention intervention (using face-to-face meetings and telephone monitoring with personalized behavioral strategies) and a health belief model–based educational program were found to be highly effective. Face-to-face counseling was a significantly effective method of implementing medication adherence interventions for older adults with chronic illnesses (Hedges’ g= 0.531, 95% CI, 0.186−0.877), while medication adherence interventions through education and telehealth counseling were not effective. This study verified the effectiveness of personalized behavioral change strategies and cognitive behavioral therapy based on the health belief model, as well as face-to-face meetings, as medication adherence interventions for older adults with chronic illnesses.

Stroke causes systemic immunosuppression. T lymphocytes are involved in infarct size in the early stages of stroke. However, the phenotypes of T lymphocytes and their functions in peripheral immune organs and the brain have not been well analyzed in the acute and chronic phases of stroke. Here, we investigated pathological phenotypic alterations in the systemic immune response, especially changes in T lymphocytes, from one day to six months after ischemic stroke in mice. Impairment in thymocyte numbers, development, proliferation, and apoptosis were observed for up to two weeks. The number of mature T cells in the spleen and blood decreased and showed reduced interferon-γ production. Increased numbers of CD4-CD8-CD3+ double-negative T cells were observed in the mouse brain during the early stages of stroke, whereas interleukin (IL)-10+Foxp3+ regulatory T lymphocytes increased from two weeks during the chronic phase. These phenotypes correlated with body weight and neurological severity scores. The recovery of T lymphocyte numbers and increases in IL-10+Foxp3+ regulatory T lymphocytes may be important for long-term neurological outcomes. Dynamic changes in T lymphocytes between the acute and chronic phases may play different roles in pathogenesis and recovery. This study provides fundamental information regarding the T lymphocyte alterations from the brain to the peripheral immune organs following stroke.

Stroke causes systemic immunosuppression. T lymphocytes are involved in infarct size in the early stages of stroke. However, the phenotypes of T lymphocytes and their functions in peripheral immune organs and the brain have not been well analyzed in the acute and chronic phases of stroke. Here, we investigated pathological phenotypic alterations in the systemic immune response, especially changes in T lymphocytes, from one day to six months after ischemic stroke in mice. Impairment in thymocyte numbers, development, proliferation, and apoptosis were observed for up to two weeks. The number of mature T cells in the spleen and blood decreased and showed reduced interferon-γ production. Increased numbers of CD4-CD8-CD3+ double-negative T cells were observed in the mouse brain during the early stages of stroke, whereas interleukin (IL)-10+Foxp3+ regulatory T lymphocytes increased from two weeks during the chronic phase. These phenotypes correlated with body weight and neurological severity scores. The recovery of T lymphocyte numbers and increases in IL-10+Foxp3+ regulatory T lymphocytes may be important for long-term neurological outcomes. Dynamic changes in T lymphocytes between the acute and chronic phases may play different roles in pathogenesis and recovery. This study provides fundamental information regarding the T lymphocyte alterations from the brain to the peripheral immune organs following stroke.

Purpose: Microbiota manipulation through selected probiotics may be a promising tool to prevent cancer development as well as onset, to improve clinical efficacy for cancer treatments. The purpose of this study was to evaluate change in microbiota composition after-probiotics supplementation and assessed the efficacy of probiotics in improving quality of life (QOL) in postoperative cancer patients. Methods: Stool samples were collected from 30 cancer patients from February to October 2020 before (group I) and after (group II) 8 weeks of probiotics supplementation. We performed 16S ribosomal RNA gene sequencing to evaluate differences in gut microbiota between groups by comparing gut microbiota diversity, overall composition, and taxonomic signature abundance. The health-related QOL was evaluated through the EORTC Quality of life Questionnaire Core 30 questionnaire. Results: Statistically significant differences were noted in group II; increase of Shannon and Simpson index (P = 0.004 and P = 0.001), decrease of Bacteroidetes and Fusobacteria at the phylum level (P = 0.032 and P = 0.014, retrospectively), increased of beneficial bacteria such as Weissella (0.096% vs. 0.361%, P < 0.004), Lactococcus (0.023% vs. 0.16%, P < 0.001), and Catenibacterium (0.0% vs. 0.005%, P < 0.042) at the genus level. There was a significant improvement in sleep disturbance (P = 0.039) in group II. Conclusion Gut microbiota in cancer patients can be manipulated by specific probiotic strains, result in an altered microbiota. Microbiota modulation by probiotics can be considered as part of a supplement that helps to increase gut microbiota diversity and improve QOL in cancer patients after surgery.

OBJECTIVE: The present study assessed the prevalence of overactive bladder (OAB) symptoms in gynecologic outpatients and the effects of OAB on a patient's quality of life.METHODS: The survey was completed by adult female patients who visited the gynecology clinic for examination or treatment of gynecologic conditions. The subjects who met the exclusion criteria were excluded. The survey included a questionnaire assessing general characteristics, the purpose of the visit, diagnosis, and the presence or absence of OAB. The subjects were asked whether they were under medical treatment for OAB symptoms, and the degree of discomfort in daily activities was evaluated.RESULTS: In total, 1,990 female subjects visiting the gynecology clinics of 4 different institutions were recruited. On OAB Symptom Score, 188 subjects responded with scores of ≥2 for question #3 (≥1 time(s) weekly). The severity of OAB symptoms was as follows: 345 subjects had mild OAB, 127 subjects had moderate OAB, and 12 subjects had severe OAB. The prevalence of OAB symptoms was 10.30%.CONCLUSION: The present study confirmed that OAB symptoms are common, with a prevalence of 10.30%. Patients with OAB symptoms frequently neglect to seek medical intervention. Our findings will help inform patients to recognize their condition and seek medical assistance, especially in gynecologic outpatient clinics.

Purpose: Many studies have shown that the enhanced recovery after surgery (ERAS) protocols improve postoperative surgical outcomes. The purpose of this study was to observe the effects on postoperative inflammatory markers and to explore the effects of a high degree of compliance and the use of epidural anesthesia on inflammation and surgical outcomes. Methods: Four hundred patients underwent colorectal cancer surgery at 2 hospitals during 2 different periods, namely, from January 2006 to December 2009 and from January 2017 to July 2017. Data related to the patient’s clinicopathological features, inflammatory markers, percentage of compliance with elements of the ERAS protocol, and use of epidural anesthesia were collected from a prospectively maintained database. Results: The complication rate and the length of hospital stay (LOS) were less in the ERAS group than in the conventional group (P = 0.005 and P ≤ 0.001, respectively). The postoperative white blood cell count and the duration required for leukocytes to normalize were reduced in patients following the ERAS protocol (P ≤ 0.001). Other inflammatory markers, such as lymphocyte count (P = 0.008), neutrophil/lymphocyte ratio (P = 0.032), and C-reactive protein level (P ≤ 0.001), were lower in the ERAS protocol group. High compliance ( ≥ 70%) was strongly associated with the complication rate and the LOS (P = 0.008 and P ≤ 0.001, respectively). Conclusion ERAS protocols decrease early postoperative inflammation and improves short-term postoperative recovery outcomes such as complication rate and the LOS. High compliance ( ≥ 70%) with the ERAS protocol elements accelerates the positive effects of ERAS on surgical outcomes; however, the effect on inflammation was very small.

PURPOSE: To evaluate the effects of daily vacuuming of mattresses on the concentration of house dust mite (HDM) allergens and on allergic rhinitis (AR) symptoms in children sensitized to HDM. METHODS: Forty children between the ages of 6 and 12 years with mild persistent AR and sensitized only to HDM were enrolled and randomly allocated to 2 groups. Caregivers of children in the experimental group cleaned the children's rooms and vacuumed their mattresses daily for 2 weeks. Caregivers of children in the control group cleaned the children's rooms without vacuuming mattresses. Symptoms of AR were checked weekly and dust samples were collected from the mattresses before and after the study. RESULTS: Demographics at the beginning of the study were not significantly different between the 2 groups. In the experimental group, symptoms of AR and dust weight were significantly decreased after 2 weeks (total symptoms of AR, P <0.001; sneezing, P < 0.001; rhinorrhea, P <0.001; nasal obstruction, P < 0.001; itching, P <0.001; and dust weight, P = 0.006). The concentrations of HDM allergens were not changed significantly (Der p1, P = 0.333; Der f1, P = 0.841). In the control group, there were no significant changes in symptoms of AR, dust weight, or the concentration of HDM allergens. CONCLUSIONS: Our findings showed that daily vacuuming of mattresses reduced dust weight and symptoms of AR. However, the concentration of HDM allergens did not significantly decrease.
Allergens ; Beds ; Caregivers ; Child ; Demography ; Dermatophagoides pteronyssinus ; Dust ; Humans ; Nasal Obstruction ; Pruritus ; Pyroglyphidae ; Rhinitis, Allergic ; Sneezing ; Vacuum

PURPOSE: This study is a systematic review and meta-analysis designed to investigate effects of alcohol management programs for Korean university students. METHODS: Research results published until October 14, 2016 were systematically collected in accordance with the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analysis). A total of 12 papers were selected for the meta-analysis. To estimate the effect size, meta-analysis of the studies was performed with the Comprehensive Meta-Analysis 3.0. RESULTS: The mean effect size of 12 studies in total (Hedges' g=-0.36; 95% Confidence Interval [CI]: -0.76~0.05) was not significant statistically. In a study of college students classified as problematic drinking (total of 9), the drinking program showed a median effect size of Hedges' g=-0.57(95% CI: -0.96~-0.18). Results of the drinking-related outcome variables showed a significant effect size (Hedges' g=-0.61; 95% CI: -1.10~-0.13), but psychosocial related outcome variables were not significant (Hedges' g=-0.50; 95% CI: -1.24~0.23). CONCLUSION: It can be seen that the alcohol management program for college students has a significant effect on controlling the problem drinking of college students. In addition, application of a differentiated drinking program with problem drinkers selected as a risk group will be effective in controlling drinking and drinking related factors.
Alcohol Drinking ; Drinking ; Humans ; Korea