Objective: Non-pharmacological interventions (NPIs) are effective in treating gaming disorder (GD). However, studies have not comprehensively evaluated the most effective NPIs. This systematic review and meta-analysis aimed to evaluate the effects of NPIs on the prevention and reduction of GD in the general population with GD. Methods: We searched five databases (MEDLINE, Embase, Cochrane CENTRAL, PsycINFO, and CINAHL) for English-language randomized controlled trials (RCTs) published till May 12, 2024, using Preferred Reporting Items for Systematic reviews and Meta-Analyses guidelines. Two independent reviewers selected studies, extracted data, and assessed quality using the Cochrane Risk of Bias Tool (RoB2). Meta-analyses were conducted using a random-effect model, with effect sizes calculated using Hedges’s g and heterogeneity assessed using I2 statistics. Results: A total of 18 RCTs involving 1,950 participants were included. The NPIs included psychotherapy, behavioral interventions, and other strategies. The pooled analysis showed a significant reduction in GD severity (Hedges’s g=-0.82; 95% confidence interval, -1.23 to -0.52; I2=90.36%). Psychotherapy, particularly cognitive-behavioral therapy, showed the most substantial effect (10 studies, 1,036 participants; Hedges’s g=-1.34). Behavioral interventions (4 studies, 456 participants) and prevention-focused interventions (6 studies, 1,164 participants) had smaller but positive effects. Subgroup analyses revealed greater effectiveness of treatment interventions in adults than in adolescents. Sensitivity analyses confirmed the robustness of these results despite high heterogeneity (I2=90.36%). Conclusion NPIs, particularly psychotherapy, are effective in reducing GD severity. However, more high-quality RCTs are needed robust, evidence-based treatment guidelines.

Purpose: The coronavirus disease 2019 (COVID-19) pandemic brought stringent social distancing measures, resulting in changes to daily routines such as increased time at home, remote learning, altered meal schedules, and reduced physical activity. Therefore, we aimed to investigate the impact of the COVID-19 lockdown on glycemic control among pediatric patients with type 1 diabetes. Methods: This study retrospectively analyzed the medical records of 47 pediatric patients with type 1 diabetes who visited Ajou University Hospital before and after the lockdown. To analyze the effects of the lockdown on glycemic control, we examined the change in glycated hemoglobin (HbA1c) levels before and after the lockdown. Results: Among 47 patients, 23 (49%) were female and the average age before the lockdown as of March 2020 was 11.65±3.03 years. The mean HbA1c levels were 8.22%±1.69% and 7.86%±1.57% before and after the lockdown, respectively, showing better glycemic control during the lockdown (P=0.001). The decrease in HbA1c was more significant in subjects with higher pre-lockdown HbA1c levels, older patients, and individuals not using continuous glucose monitoring or continuous subcutaneous insulin infusion. However, from a long-term perspective, HbA1c levels at 3 years and 1 year before and after the lockdown were not significantly different. Conclusion This study demonstrated the beneficial effect of intensive social distancing for COVID-19 on blood glucose control in pediatric patients with type 1 diabetes mellitus. Furthermore, changes due to the lockdown had a more pronounced effect on patients with existing poor glycemic control.

Objective: Non-pharmacological interventions (NPIs) are effective in treating gaming disorder (GD). However, studies have not comprehensively evaluated the most effective NPIs. This systematic review and meta-analysis aimed to evaluate the effects of NPIs on the prevention and reduction of GD in the general population with GD. Methods: We searched five databases (MEDLINE, Embase, Cochrane CENTRAL, PsycINFO, and CINAHL) for English-language randomized controlled trials (RCTs) published till May 12, 2024, using Preferred Reporting Items for Systematic reviews and Meta-Analyses guidelines. Two independent reviewers selected studies, extracted data, and assessed quality using the Cochrane Risk of Bias Tool (RoB2). Meta-analyses were conducted using a random-effect model, with effect sizes calculated using Hedges’s g and heterogeneity assessed using I2 statistics. Results: A total of 18 RCTs involving 1,950 participants were included. The NPIs included psychotherapy, behavioral interventions, and other strategies. The pooled analysis showed a significant reduction in GD severity (Hedges’s g=-0.82; 95% confidence interval, -1.23 to -0.52; I2=90.36%). Psychotherapy, particularly cognitive-behavioral therapy, showed the most substantial effect (10 studies, 1,036 participants; Hedges’s g=-1.34). Behavioral interventions (4 studies, 456 participants) and prevention-focused interventions (6 studies, 1,164 participants) had smaller but positive effects. Subgroup analyses revealed greater effectiveness of treatment interventions in adults than in adolescents. Sensitivity analyses confirmed the robustness of these results despite high heterogeneity (I2=90.36%). Conclusion NPIs, particularly psychotherapy, are effective in reducing GD severity. However, more high-quality RCTs are needed robust, evidence-based treatment guidelines.

Objective: Non-pharmacological interventions (NPIs) are effective in treating gaming disorder (GD). However, studies have not comprehensively evaluated the most effective NPIs. This systematic review and meta-analysis aimed to evaluate the effects of NPIs on the prevention and reduction of GD in the general population with GD. Methods: We searched five databases (MEDLINE, Embase, Cochrane CENTRAL, PsycINFO, and CINAHL) for English-language randomized controlled trials (RCTs) published till May 12, 2024, using Preferred Reporting Items for Systematic reviews and Meta-Analyses guidelines. Two independent reviewers selected studies, extracted data, and assessed quality using the Cochrane Risk of Bias Tool (RoB2). Meta-analyses were conducted using a random-effect model, with effect sizes calculated using Hedges’s g and heterogeneity assessed using I2 statistics. Results: A total of 18 RCTs involving 1,950 participants were included. The NPIs included psychotherapy, behavioral interventions, and other strategies. The pooled analysis showed a significant reduction in GD severity (Hedges’s g=-0.82; 95% confidence interval, -1.23 to -0.52; I2=90.36%). Psychotherapy, particularly cognitive-behavioral therapy, showed the most substantial effect (10 studies, 1,036 participants; Hedges’s g=-1.34). Behavioral interventions (4 studies, 456 participants) and prevention-focused interventions (6 studies, 1,164 participants) had smaller but positive effects. Subgroup analyses revealed greater effectiveness of treatment interventions in adults than in adolescents. Sensitivity analyses confirmed the robustness of these results despite high heterogeneity (I2=90.36%). Conclusion NPIs, particularly psychotherapy, are effective in reducing GD severity. However, more high-quality RCTs are needed robust, evidence-based treatment guidelines.

Purpose: This study aimed to evaluate the outcomes and current status of reduced-port laparoscopic distal gastrectomy (RLDG) compared with multiport laparoscopic distal gastrectomy (MLDG) based on a 2019 nationwide survey of surgical gastric cancer treatments by the Korean Gastric Cancer Association (KGCA). Materials and Methods: The study was conducted retrospectively from March to December 2020 using data from the 2019 KGCA nationwide survey database. To compare RLDG and MLDG based on age, sex, body mass index, American Society of Anesthesiologists score, histological type, tumor invasion, and lymph node metastasis, propensity score matching was performed. Results: Of the 14,076 registered patients with gastric cancer, the five-port approach was the most favored for multiport gastrectomy, accounting for 6,396 (70.9%) cases, followed by the four-port approach, with 1,462 (16.2%) cases. The single-port approach was used in 303 (3.4%) cases, the two-port approach in 95 (1.1%) cases, and the three-port approach in 731 (8.1%) cases. RLDG was performed in 805 patients (6.4%), MLDG was conducted in 4,831 patients (34.3%), and 804 patients were 1:1 matched in each group. The average operation time was shorter in the RLDG (168.2±49.1 min vs. 179.5±61.5 min, P<0.001). No significant difference was found in blood loss (84.8±115.9 cc vs. 75.5±119.6 cc, P=0.152), overall complication rates (11.3% vs. 13.1%, P=0.254), or complications ≥ to grade IIIa (3.2% vs. 4.4%, P=0.240). Conclusions This study revealed that RLDG is a safe and effective surgical option for gastric cancer with the potential to offer shorter operation times without increasing the risk of complications.

Purpose: The coronavirus disease 2019 (COVID-19) pandemic brought stringent social distancing measures, resulting in changes to daily routines such as increased time at home, remote learning, altered meal schedules, and reduced physical activity. Therefore, we aimed to investigate the impact of the COVID-19 lockdown on glycemic control among pediatric patients with type 1 diabetes. Methods: This study retrospectively analyzed the medical records of 47 pediatric patients with type 1 diabetes who visited Ajou University Hospital before and after the lockdown. To analyze the effects of the lockdown on glycemic control, we examined the change in glycated hemoglobin (HbA1c) levels before and after the lockdown. Results: Among 47 patients, 23 (49%) were female and the average age before the lockdown as of March 2020 was 11.65±3.03 years. The mean HbA1c levels were 8.22%±1.69% and 7.86%±1.57% before and after the lockdown, respectively, showing better glycemic control during the lockdown (P=0.001). The decrease in HbA1c was more significant in subjects with higher pre-lockdown HbA1c levels, older patients, and individuals not using continuous glucose monitoring or continuous subcutaneous insulin infusion. However, from a long-term perspective, HbA1c levels at 3 years and 1 year before and after the lockdown were not significantly different. Conclusion This study demonstrated the beneficial effect of intensive social distancing for COVID-19 on blood glucose control in pediatric patients with type 1 diabetes mellitus. Furthermore, changes due to the lockdown had a more pronounced effect on patients with existing poor glycemic control.

Purpose: This study aimed to evaluate the outcomes and current status of reduced-port laparoscopic distal gastrectomy (RLDG) compared with multiport laparoscopic distal gastrectomy (MLDG) based on a 2019 nationwide survey of surgical gastric cancer treatments by the Korean Gastric Cancer Association (KGCA). Materials and Methods: The study was conducted retrospectively from March to December 2020 using data from the 2019 KGCA nationwide survey database. To compare RLDG and MLDG based on age, sex, body mass index, American Society of Anesthesiologists score, histological type, tumor invasion, and lymph node metastasis, propensity score matching was performed. Results: Of the 14,076 registered patients with gastric cancer, the five-port approach was the most favored for multiport gastrectomy, accounting for 6,396 (70.9%) cases, followed by the four-port approach, with 1,462 (16.2%) cases. The single-port approach was used in 303 (3.4%) cases, the two-port approach in 95 (1.1%) cases, and the three-port approach in 731 (8.1%) cases. RLDG was performed in 805 patients (6.4%), MLDG was conducted in 4,831 patients (34.3%), and 804 patients were 1:1 matched in each group. The average operation time was shorter in the RLDG (168.2±49.1 min vs. 179.5±61.5 min, P<0.001). No significant difference was found in blood loss (84.8±115.9 cc vs. 75.5±119.6 cc, P=0.152), overall complication rates (11.3% vs. 13.1%, P=0.254), or complications ≥ to grade IIIa (3.2% vs. 4.4%, P=0.240). Conclusions This study revealed that RLDG is a safe and effective surgical option for gastric cancer with the potential to offer shorter operation times without increasing the risk of complications.