Both insufficient and excessive sleep durations have been recognized as important risk factors for mortality. Nevertheless, the impact of sleep duration on cause-specific mortality and potential effect modifiers has not been investigated extensively. Therefore, this study aimed to assess the association between sleep duration and mortality categorized by cause of death and potential effect modifiers using data from the National Health and Nutrition Examination Survey (NHANES). Methods: We established a prospective cohort based on NHANES participants aged 50 years or older, linked to the National Death Index (NDI) in the United States between 2009 and 2018. The NDI included all-cause, cardiovascular, and respiratory deaths. Sleep duration was assessed during the NHANES examination period. A survey-weighted Cox proportional hazards model was used to evaluate the association between sleep and mortality. Results: A total of 13,947 participants with available NHANES data were included in this study. A U-shaped association between sleep duration and mortality was observed for all-cause and cardiovascular mortality, meanwhile, respiratory mortality was linked to moderately short sleep (>5 and <7 hours). For total mortality, the association with severe short sleep (5 hours or less; p<0.01) was generally stronger than the association with long sleep (>8 hours; p=0.029), with the effect of severe short sleep being significantly prominent in males (p<0.01), non-Hispanic White (0.001), high-income (0.056), and those with a body mass index ≥23.0 kg/m2 (0.001) than those in their counterparts. Conclusions: This study suggests that sleep duration is associated with the mortality risk. Our results provide evidence for a more targeted allocation of public health resources to improve sleep and health.

Both insufficient and excessive sleep durations have been recognized as important risk factors for mortality. Nevertheless, the impact of sleep duration on cause-specific mortality and potential effect modifiers has not been investigated extensively. Therefore, this study aimed to assess the association between sleep duration and mortality categorized by cause of death and potential effect modifiers using data from the National Health and Nutrition Examination Survey (NHANES). Methods: We established a prospective cohort based on NHANES participants aged 50 years or older, linked to the National Death Index (NDI) in the United States between 2009 and 2018. The NDI included all-cause, cardiovascular, and respiratory deaths. Sleep duration was assessed during the NHANES examination period. A survey-weighted Cox proportional hazards model was used to evaluate the association between sleep and mortality. Results: A total of 13,947 participants with available NHANES data were included in this study. A U-shaped association between sleep duration and mortality was observed for all-cause and cardiovascular mortality, meanwhile, respiratory mortality was linked to moderately short sleep (>5 and <7 hours). For total mortality, the association with severe short sleep (5 hours or less; p<0.01) was generally stronger than the association with long sleep (>8 hours; p=0.029), with the effect of severe short sleep being significantly prominent in males (p<0.01), non-Hispanic White (0.001), high-income (0.056), and those with a body mass index ≥23.0 kg/m2 (0.001) than those in their counterparts. Conclusions: This study suggests that sleep duration is associated with the mortality risk. Our results provide evidence for a more targeted allocation of public health resources to improve sleep and health.

Both insufficient and excessive sleep durations have been recognized as important risk factors for mortality. Nevertheless, the impact of sleep duration on cause-specific mortality and potential effect modifiers has not been investigated extensively. Therefore, this study aimed to assess the association between sleep duration and mortality categorized by cause of death and potential effect modifiers using data from the National Health and Nutrition Examination Survey (NHANES). Methods: We established a prospective cohort based on NHANES participants aged 50 years or older, linked to the National Death Index (NDI) in the United States between 2009 and 2018. The NDI included all-cause, cardiovascular, and respiratory deaths. Sleep duration was assessed during the NHANES examination period. A survey-weighted Cox proportional hazards model was used to evaluate the association between sleep and mortality. Results: A total of 13,947 participants with available NHANES data were included in this study. A U-shaped association between sleep duration and mortality was observed for all-cause and cardiovascular mortality, meanwhile, respiratory mortality was linked to moderately short sleep (>5 and <7 hours). For total mortality, the association with severe short sleep (5 hours or less; p<0.01) was generally stronger than the association with long sleep (>8 hours; p=0.029), with the effect of severe short sleep being significantly prominent in males (p<0.01), non-Hispanic White (0.001), high-income (0.056), and those with a body mass index ≥23.0 kg/m2 (0.001) than those in their counterparts. Conclusions: This study suggests that sleep duration is associated with the mortality risk. Our results provide evidence for a more targeted allocation of public health resources to improve sleep and health.

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.

Background: CycloZ, a combination of cyclo-His-Pro and zinc, has anti-diabetic activity. However, its exact mode of action remains to be elucidated. Methods: KK-Ay mice, a type 2 diabetes mellitus (T2DM) model, were administered CycloZ either as a preventive intervention, or as a therapy. Glycemic control was evaluated using the oral glucose tolerance test (OGTT), and glycosylated hemoglobin (HbA1c) levels. Liver and visceral adipose tissues (VATs) were used for histological evaluation, gene expression analysis, and protein expression analysis. Results: CycloZ administration improved glycemic control in KK-Ay mice in both prophylactic and therapeutic studies. Lysine acetylation of peroxisome proliferator-activated receptor gamma coactivator 1-alpha, liver kinase B1, and nuclear factor-κB p65 was decreased in the liver and VATs in CycloZ-treated mice. In addition, CycloZ treatment improved mitochondrial function, lipid oxidation, and inflammation in the liver and VATs of mice. CycloZ treatment also increased the level of β-nicotinamide adenine dinucleotide (NAD+), which affected the activity of deacetylases, such as sirtuin 1 (Sirt1). Conclusion Our findings suggest that the beneficial effects of CycloZ on diabetes and obesity occur through increased NAD+ synthesis, which modulates Sirt1 deacetylase activity in the liver and VATs. Given that the mode of action of an NAD+ booster or Sirt1 deacetylase activator is different from that of traditional T2DM drugs, CycloZ would be considered a novel therapeutic option for the treatment of T2DM.

Background: Commonly used epidural or systemic analgesics for pain control after hip surgery carry risk for potential adverse effects. In contrast, the quadratus lumborum block (QLB) utilizes a simple and easy fascial plane technique and provides a wide area of sensory blockade. Thus, the QLB may be beneficial as analgesia after total hip arthroplasty. CaseHere, we report the case of an 83-year-old man who received a continuous transmuscular QLB as part of a multimodal analgesia after hardware removal and total hip arthroplasty. The patient received a continuous infusion of 0.2% ropivacaine at 8 ml/h through an indwelling catheter in addition to patient-controlled analgesia with intravenous fentanyl and oral celecoxib. The patient’s pain scores did not exceed 4, and no additional analgesics were required until postoperative day 5. Conclusions Transmuscular QLB may be a suitable option for multimodal analgesia after total hip arthroplasty.

Purpose: This study aimed to assess the effect of the emotional coaching program for hospital nurses. Methods: The study used anon-equivalent control group pretest-posttest design, and participants included 60 nurses (30 in the experimental group and 30 in thecontrol group) who worked at a general hospital. The experimental group attended four sessions, one per week, with each session lastingtwo and a half hours. Collected data were analyzed using descriptive statistics, Fisher’s exact test, x2 test, t-test, paired t-test, and repeatedmeasures ANOVA using SPSS WIN 23.0 program. Results: Significant differences were shown between the experimental and the controlgroups regarding emotional labor (F=68.40, p<.001), resilience (F=48.77, p<.001), and self-efficacy (F=15.31, p<.001). Conclusion Theemotional coaching program for nurses is useful for enhancing nurses’ emotional labor management, resilience, and self-efficacy. In addition,this program may serve as a basis for providing emotional coaching to nurses in the future.

Purpose: The purpose of this study was to develop and examine the effects of a simulation learning module based on schizophrenic patients care on the knowledge of schizophrenic patients care, learning self-efficacy, and nursing skill performance of nursing students. Methods: Junior nursing students with no mental health nursing experience from two different colleges in G city participated. A total of 64 participants were classified into the experimental group (31) and the control group (33). This study was conducted based on the Jeffries simulation model, and the simulation learning module based on schizophrenic patient care was developed based on the Instructional System Design simulation learning module based on schizophrenic patients care comprising the module I lecture, the module II case-based team learning, and the module III standardized patient-based simulation learning. Results: There were significant increases in the knowledge of schizophrenic patients care (t=2.85, p=.006), learning self-efficacy (t=3.42, p=.001) and nursing skill performance (t=16.69, p<.001) in the experimental group compared to the control group Conclusion The simulation learning module based on schizophrenic patients care can be useful in the educational and clinical environment as effective strategies in contributing to nursing education and clinical changes.

PURPOSE: The purpose of this study was to examine the effects of an infant cardiopulmonary resuscitation (CPR) training program that applied the 5-step method on the knowledge, attitudes, and performance ability of nursing students in terms of enhancement and sustainability. METHODS: Sixty-one nursing students (28 in the experimental group and 33 in the control group) from D city participated in this study. Data were collected from April 25 to December 15, 2016. The experimental group and control group received infant CPR education using the 5-step method and the traditional method, respectively. The outcome variables were measured 3 times (pretest and posttest at 1 week and 6 months after training). RESULTS: There were significant differences in attitude (t=2.68, p=.009) and performance ability (t=4.56, p < .001) between the groups at 1 week after training, as well as in sustained performance ability at 6 months after training (F=6.76, p=.012). CONCLUSION: The 5-step method of infant CPR training was effective for improving performance ability in a sustained manner and promoting a positive attitude. Therefore, it is recommended that nursing students, as infant CPR novices, receive training using this effective method.
Cardiopulmonary Resuscitation* ; Education ; Humans ; Infant* ; Methods* ; Nursing* ; Students, Nursing

BACKGROUND: Although case reports have suggested that the erector spinae plane block (ESPB) may help analgesia for patients after breast surgery, no study to date has assessed its effectiveness. This retrospective observational study analyzed the analgesic effects of the ESPB after total mastectomy. METHODS: Forty-eight patients were divided into an ESPB group (n = 20) and a control group (n = 28). Twenty patients in the control group were selected by their propensity score matching the twenty patients in the ESPB group. Patients in the ESPB group were injected with 30 mL 0.375% ropivacaine, followed by catheter insertion for further injections of local anesthetics every 12 hours. Primarily, total fentanyl consumption was compared between the two groups during the first 24 hours postoperatively. Secondary outcomes included pain intensity levels (visual analogue scale) and incidence of postoperative nausea and vomiting (PONV). RESULTS: Median cumulative fentanyl consumption during the first 24 hours was significantly lower in the ESPB (33.0 μg; interquartile range [IQR], 27.0–69.5 μg) than in the control group (92.8 μg; IQR, 40.0–155.0 μg) (P = 0.004). Pain level in the early postoperative stage (<3 hr) and incidence of PONV (0% vs. 55%) were also significantly lower in the ESPB group compared to the control (P = 0.001). CONCLUSIONS: Intermittent ESPB after total mastectomy reduces fentanyl consumption and early postoperative pain. ESPB is a good option for multimodal analgesia after breast surgery.
Acute Pain ; Analgesia ; Anesthesia, Conduction ; Anesthetics, Local ; Breast ; Catheters ; Fentanyl ; Humans ; Incidence ; Mastectomy ; Mastectomy, Simple ; Nerve Block ; Observational Study ; Pain, Postoperative ; Postoperative Nausea and Vomiting ; Propensity Score ; Retrospective Studies ; Ultrasonography