Objectives: Both shift work and restless legs syndrome (RLS) are common and can disrupt sleep and mood. However, the effects of shift work on RLS remain unclear. The current study aims to explore the prevalence, severity, and related sleep and mood symptoms of RLS in shift workers (SWs) compared to non-shift workers (Non-SWs). Methods: This study recruited 4,562 SWs (age 36.98±9.84, 2,150 males and 2,422 females) and 2,093 NSWs (age 37.79±9.73, 999 males and 1,094 females). All participants completed online self-report questionnaires regarding RLS, sleep, and depression. The presence of RLS was screened using a single standard question for rapid screening of RLS. The severity of RLS was assessed using the International Restless Legs Syndrome Rating Scale (iRLS). Additionally, the Epworth Sleepiness Scale (ESS), Insomnia Severity Index (ISI), and short-term Center for Epidemiologic Studies Depression Scale (CES-D) were used to assess daytime sleepiness, insomnia, and depressive symptoms, respectively. Results: Of participants, 1,255 (27.45%) of SWs and 548 (26.18%) of Non-SWs were screened as having RLS, with no significant differences in the prevalence of RLS between the groups. However, among those with RLS, SWs with RLS showed higher iRLS scores compared to Non-SWs with RLS after controlling for age and sex (SWs: 9.55±7.26, NSWs: 6.75±6.05, F=64.15, p<0.01). In addition, SWs with RLS exhibited higher ISI scores (F=46.09, p<0.01), higher ESS scores (F=4.80, p=0.03), and higher CES-D scores (F=33.50, p<0.01) than Non-SWs with RLS. Conclusion Although there was no significant difference in RLS prevalence between SWs and Non-SWs, SWs with RLS exhibited more severe RLS symptoms and RLS-related symptoms, such as insomnia, sleepiness, and depression, compared to NSWs with RLS. The current study suggests that shift work may exacerbate RLS severity and RLS-related sleep and mood symptoms, although it may not be associated with the onset of RLS.

Objectives: Both shift work and restless legs syndrome (RLS) are common and can disrupt sleep and mood. However, the effects of shift work on RLS remain unclear. The current study aims to explore the prevalence, severity, and related sleep and mood symptoms of RLS in shift workers (SWs) compared to non-shift workers (Non-SWs). Methods: This study recruited 4,562 SWs (age 36.98±9.84, 2,150 males and 2,422 females) and 2,093 NSWs (age 37.79±9.73, 999 males and 1,094 females). All participants completed online self-report questionnaires regarding RLS, sleep, and depression. The presence of RLS was screened using a single standard question for rapid screening of RLS. The severity of RLS was assessed using the International Restless Legs Syndrome Rating Scale (iRLS). Additionally, the Epworth Sleepiness Scale (ESS), Insomnia Severity Index (ISI), and short-term Center for Epidemiologic Studies Depression Scale (CES-D) were used to assess daytime sleepiness, insomnia, and depressive symptoms, respectively. Results: Of participants, 1,255 (27.45%) of SWs and 548 (26.18%) of Non-SWs were screened as having RLS, with no significant differences in the prevalence of RLS between the groups. However, among those with RLS, SWs with RLS showed higher iRLS scores compared to Non-SWs with RLS after controlling for age and sex (SWs: 9.55±7.26, NSWs: 6.75±6.05, F=64.15, p<0.01). In addition, SWs with RLS exhibited higher ISI scores (F=46.09, p<0.01), higher ESS scores (F=4.80, p=0.03), and higher CES-D scores (F=33.50, p<0.01) than Non-SWs with RLS. Conclusion Although there was no significant difference in RLS prevalence between SWs and Non-SWs, SWs with RLS exhibited more severe RLS symptoms and RLS-related symptoms, such as insomnia, sleepiness, and depression, compared to NSWs with RLS. The current study suggests that shift work may exacerbate RLS severity and RLS-related sleep and mood symptoms, although it may not be associated with the onset of RLS.

Objectives: Both shift work and restless legs syndrome (RLS) are common and can disrupt sleep and mood. However, the effects of shift work on RLS remain unclear. The current study aims to explore the prevalence, severity, and related sleep and mood symptoms of RLS in shift workers (SWs) compared to non-shift workers (Non-SWs). Methods: This study recruited 4,562 SWs (age 36.98±9.84, 2,150 males and 2,422 females) and 2,093 NSWs (age 37.79±9.73, 999 males and 1,094 females). All participants completed online self-report questionnaires regarding RLS, sleep, and depression. The presence of RLS was screened using a single standard question for rapid screening of RLS. The severity of RLS was assessed using the International Restless Legs Syndrome Rating Scale (iRLS). Additionally, the Epworth Sleepiness Scale (ESS), Insomnia Severity Index (ISI), and short-term Center for Epidemiologic Studies Depression Scale (CES-D) were used to assess daytime sleepiness, insomnia, and depressive symptoms, respectively. Results: Of participants, 1,255 (27.45%) of SWs and 548 (26.18%) of Non-SWs were screened as having RLS, with no significant differences in the prevalence of RLS between the groups. However, among those with RLS, SWs with RLS showed higher iRLS scores compared to Non-SWs with RLS after controlling for age and sex (SWs: 9.55±7.26, NSWs: 6.75±6.05, F=64.15, p<0.01). In addition, SWs with RLS exhibited higher ISI scores (F=46.09, p<0.01), higher ESS scores (F=4.80, p=0.03), and higher CES-D scores (F=33.50, p<0.01) than Non-SWs with RLS. Conclusion Although there was no significant difference in RLS prevalence between SWs and Non-SWs, SWs with RLS exhibited more severe RLS symptoms and RLS-related symptoms, such as insomnia, sleepiness, and depression, compared to NSWs with RLS. The current study suggests that shift work may exacerbate RLS severity and RLS-related sleep and mood symptoms, although it may not be associated with the onset of RLS.

Objectives: Both shift work and restless legs syndrome (RLS) are common and can disrupt sleep and mood. However, the effects of shift work on RLS remain unclear. The current study aims to explore the prevalence, severity, and related sleep and mood symptoms of RLS in shift workers (SWs) compared to non-shift workers (Non-SWs). Methods: This study recruited 4,562 SWs (age 36.98±9.84, 2,150 males and 2,422 females) and 2,093 NSWs (age 37.79±9.73, 999 males and 1,094 females). All participants completed online self-report questionnaires regarding RLS, sleep, and depression. The presence of RLS was screened using a single standard question for rapid screening of RLS. The severity of RLS was assessed using the International Restless Legs Syndrome Rating Scale (iRLS). Additionally, the Epworth Sleepiness Scale (ESS), Insomnia Severity Index (ISI), and short-term Center for Epidemiologic Studies Depression Scale (CES-D) were used to assess daytime sleepiness, insomnia, and depressive symptoms, respectively. Results: Of participants, 1,255 (27.45%) of SWs and 548 (26.18%) of Non-SWs were screened as having RLS, with no significant differences in the prevalence of RLS between the groups. However, among those with RLS, SWs with RLS showed higher iRLS scores compared to Non-SWs with RLS after controlling for age and sex (SWs: 9.55±7.26, NSWs: 6.75±6.05, F=64.15, p<0.01). In addition, SWs with RLS exhibited higher ISI scores (F=46.09, p<0.01), higher ESS scores (F=4.80, p=0.03), and higher CES-D scores (F=33.50, p<0.01) than Non-SWs with RLS. Conclusion Although there was no significant difference in RLS prevalence between SWs and Non-SWs, SWs with RLS exhibited more severe RLS symptoms and RLS-related symptoms, such as insomnia, sleepiness, and depression, compared to NSWs with RLS. The current study suggests that shift work may exacerbate RLS severity and RLS-related sleep and mood symptoms, although it may not be associated with the onset of RLS.

Objectives: Both shift work and restless legs syndrome (RLS) are common and can disrupt sleep and mood. However, the effects of shift work on RLS remain unclear. The current study aims to explore the prevalence, severity, and related sleep and mood symptoms of RLS in shift workers (SWs) compared to non-shift workers (Non-SWs). Methods: This study recruited 4,562 SWs (age 36.98±9.84, 2,150 males and 2,422 females) and 2,093 NSWs (age 37.79±9.73, 999 males and 1,094 females). All participants completed online self-report questionnaires regarding RLS, sleep, and depression. The presence of RLS was screened using a single standard question for rapid screening of RLS. The severity of RLS was assessed using the International Restless Legs Syndrome Rating Scale (iRLS). Additionally, the Epworth Sleepiness Scale (ESS), Insomnia Severity Index (ISI), and short-term Center for Epidemiologic Studies Depression Scale (CES-D) were used to assess daytime sleepiness, insomnia, and depressive symptoms, respectively. Results: Of participants, 1,255 (27.45%) of SWs and 548 (26.18%) of Non-SWs were screened as having RLS, with no significant differences in the prevalence of RLS between the groups. However, among those with RLS, SWs with RLS showed higher iRLS scores compared to Non-SWs with RLS after controlling for age and sex (SWs: 9.55±7.26, NSWs: 6.75±6.05, F=64.15, p<0.01). In addition, SWs with RLS exhibited higher ISI scores (F=46.09, p<0.01), higher ESS scores (F=4.80, p=0.03), and higher CES-D scores (F=33.50, p<0.01) than Non-SWs with RLS. Conclusion Although there was no significant difference in RLS prevalence between SWs and Non-SWs, SWs with RLS exhibited more severe RLS symptoms and RLS-related symptoms, such as insomnia, sleepiness, and depression, compared to NSWs with RLS. The current study suggests that shift work may exacerbate RLS severity and RLS-related sleep and mood symptoms, although it may not be associated with the onset of RLS.

Background/Aims: Increased prevalence of nonalcoholic fatty liver disease (NAFLD) and inflammatory bowel disease (IBD) has been reported. However, the effects of NAFLD on the outcome of IBD remains unclear. We investigated whether the presence of NAFLD could influence the outcomes of patients with IBD. Methods: We recruited 3,356 eligible patients with IBD into our study between November 2005and November 2020. Hepatic steatosis and fibrosis were diagnosed using hepatic steatosisindex of ≥30 and fibrosis-4 of ≥1.45, respectively. The primary outcome was clinical relapse, defined based on the following: IBD-related admission, surgery, or first use of corticosteroids, immunomodulators, or biologic agents for IBD. Results: The prevalence of NAFLD in patients with IBD was 16.7%. Patients with hepatic ste-atosis and advanced fibrosis were older, had a higher body mass index, and were more likely to have diabetes (all p<0.05). Conclusions Hepatic steatosis was independently associated with increased risks of clinical relapse in patients with ulcerative colitis and Crohn’s disease, whereas fibrotic burden in the liver was not. Future studies should investigate whether assessment and therapeutic intervention for NAFLD will improve the clinical outcomes of patients with IBD.

Purpose: This study aimed to identify challenges and potential improvements in Korea's medical education accreditation process according to the Accreditation Standards of the Korean Institute of Medical Education and Evaluation 2019 (ASK2019). Meta-evaluation was conducted to survey the experiences and perceptions of stakeholders, including self-assessment committee members, site visit committee members, administrative staff, and medical school professors. Methods: A cross-sectional study was conducted using surveys sent to 40 medical schools. The 332 participants included self-assessment committee members, site visit team members, administrative staff, and medical school professors. The t-test, one-way analysis of variance and the chi-square test were used to analyze and compare opinions on medical education accreditation between the categories of participants. Results: Site visit committee members placed greater importance on the necessity of accreditation than faculty members. A shared positive view on accreditation’s role in improving educational quality was seen among self-evaluation committee members and professors. Administrative staff highly regarded the Korean Institute of Medical Education and Evaluation’s reliability and objectivity, unlike the self-evaluation committee members. Site visit committee members positively perceived the clarity of accreditation standards, differing from self-assessment committee members. Administrative staff were most optimistic about implementing standards. However, the accreditation process encountered challenges, especially in duplicating content and preparing self-evaluation reports. Finally, perceptions regarding the accuracy of final site visit reports varied significantly between the self-evaluation committee members and the site visit committee members. Conclusion This study revealed diverse views on medical education accreditation, highlighting the need for improved communication, expectation alignment, and stakeholder collaboration to refine the accreditation process and quality.

Objectives: This study explored the experiences of medical students enrolled in an elective course titled "Healthcare Innovation and Women's Ventures II" at Ewha Womans University College of Medicine. The research questions were as follows: First, what motivated medical students to participate in the experiential entrepreneurship course? Second, what experiences did the students have during the course? Third, what changes did the students undergo as a result of the course? Methods: Focus group interviews were conducted with six medical students who participated in the experiential entrepreneurship course from February 13 to 23, 2024. Results: The analysis identified three domains, seven categories, and 17 subcategories. In terms of motivations for enrolling in the experiential entrepreneurship course, two categories were identified: "existing interest" and "new exploration." With respect to the experiences gained from the course, three categories emerged: "cognitive experiences," "emotional experiences," and "behavioral experiences." Finally, two categories were identified concerning the changes participants experienced through the course: "changes related to entrepreneurship" and "changes related to career paths." Conclusion Students were motivated to enroll in this course by both their existing interests and their desire to explore new areas. Following the course, they underwent cognitive, emotional, and behavioral changes. Their perceptions of entrepreneurship and career paths were significantly altered.This study is important because it explores the impact of entrepreneurship education in medical schools from the students' perspective.

Objectives: Suicide is the major public mental health concerns all over the world. The comparison of suicide attempters and suicide completers could be the fundamental evidence for the suicide prevention. The aim of this study is to explore the differences between suicide attempters and suicide completers in terms of the stressors, suicide methods, and psychiatric diagnosis. Methods: Two types of secondary data were collected for the analyses. Data of the suicide attempters (n = 680) were gathered by intensive reviewing the medical records of Samsung Medical Center, Seoul, Republic of Korea. Data of suicide completers (n = 11,722) were collected by the psychological autopsy data which were gathered by Korean Foundation for Suicide Prevention. Suicidal methods, psychiatric disorders and stressors before suicidal attempt were compared between suicide attempter and completers. Results: Suicide completers were older and male predominant compared to suicidal attempt. Hanging or gas intoxication were more commonly used in the suicide completion, while wrist cutting or drug intoxication were more common in suicide attempters. All types of stressors were found to be high in suicide completers than suicide attempters. However, the proportion of economic and physical stress were greater in suicide completers, while the proportion of family stress were greater in suicide attempters. According to the recorded diagnoses, the rates of depressive disorders, sleep-wake disorders, substance-related disorders were higher in suicide completers, while the rates of anxiety disorders and trauma- and stressor-related disorders, bipolar and related disorders and somatic symptom disorders were higher in suicide attempters. However, after controlling the gender and age, there were no significant differences in diagnosis between suicide attempters and suicide completers. Conclusion These findings implicate that suicide attempters and completers differed in suicide methods and type of stress. The results suggests that economic stressors, physical illness might raise the risk of suicide completion.

Purpose: To evaluate the role of postmastectomy radiation therapy (PMRT) in patients with node-negative breast cancer of 5cm or larger tumors undergoing mastectomy Materials and Methods: Medical records of 274 patients from 18 institutions treated with mastectomy between January 2000 and December 2016 were retrospectively reviewed. Among these, 202 patients underwent PMRT, while 72 did not. Two hundred and forty-one patients (88.0%) received systemic chemotherapy, and 172 (62.8%) received hormonal therapy. Patients receiving PMRT were younger, more likely to have progesterone receptor-positive tumors, and received adjuvant chemotherapy more frequently compared with those without PMRT (p <0.001, 0.018, and <0.001, respectively). Other characteristics were not significantly different between the two groups. Results: With a median follow-up of 95 months (range, 1-249), there were 9 locoregional recurrences, and 20 distant metastases. The 8-year locoregional recurrence-free survival rates were 98.0% with PMRT and 91.3% without PMRT (p=0.133), and the 8-year disease-free survival (DFS) rates were 91.8% with PMRT and 73.9% without PMRT (p=0.008). On multivariate analysis incorporating age, histologic grade, lymphovascular invasion, hormonal therapy, chemotherapy, and PMRT, the absence of lymphovascular invasion and the receipt of PMRT were associated with improved DFS (p=0.025 and 0.009, respectively). Conclusion Locoregional recurrence rate was very low in node-negative breast cancer of 5cm or larger tumors treated with mastectomy regardless of the receipt of PMRT. However, PMRT was significantly associated with improved DFS. Further investigation is needed to confirm these findings.