Impact of Coronavirus Disease 2019 on the Diagnosis and Treatment of Pancreatic Cancer: An Observational Cohort Study.

Early pancreatic cancer diagnosis is crucial for timely intervention and better outcomes. The coronavirus disease 2019 (COVID-19) pandemic has disrupted routine health care globally. The COVID-19 pandemic has disrupted routine health care globally. This study aimed to evaluate the impact of COVID-19 on the diagnosis and treatment of pancreatic cancer. This retrospective study compared pancreatic cancer patients from 2 tertiary hospitals in pre and COVID-19 periods. Pre-COVID-19 period spanned from January 1, 2018, to January 19, 2020, while the COVID-19 period extended from January 20, 2020, to December 31, 2021. Results: A total of 542 patients were included. In the pre-COVID-19 period, 280 new cases of pancreatic cancer were enrolled, compared to 262 during COVID-19. The annual incidence rates were 136.63 and 134.50 patients, respectively. The median age was significantly lower during COVID-19 (71.5 years) compared to pre-COVID-19 (77 years) (P < .001). In subgroup analyses for stage 3 and 4, the proportion of stage 4 pancreatic cancer increased during COVID-19 (χ2 = 5.53, P = .019), and the COVID-19 group had younger diagnoses, better performance status, more surgery, higher use of FOLFIRINOX chemotherapy, fewer hospital referrals, and better median overall survival compared to the pre-COVID-19 group. This study revealed changes in the characteristics and treatment of patients diagnosed with pancreatic cancer during the COVID-19 pandemic. Although further large-scale research is necessary, the findings of this study can function as foundational data for formulating policies for the management of patients with pancreatic cancer during future pandemics of other infectious diseases.

Rapid increase in the body mass index of very preterm infants is a risk factor for iron deficiency during infancy.

Iron deficiency (ID) in very preterm infants born at 28-32 weeks of gestational age (GA) can lower mental and motor test scores. This study aimed to determine whether the rapid growth of very preterm infants might be associated with ID. Among 134 very preterm born between January 2014 and December 2020 at Jeonbuk National University Hospital and discharged home, 93 were included in this study. Rapid BMI increase (RBI) was defined as a z-score difference of > 1 standard deviation between birth and 8 months. ID occurred in 23 of 93 (24.7%) infants at 8 months of corrected age (CA). ID was more common in the RBI group (50%) than in the non-RBI group (18.7%). In the multivariate logistic regression corrected for GA, infants small for gestational age (SGA) (odds ratio [OR] 6.06, 95% confidence interval [CI] 1.34-30.21) and RBI by z-score (OR 4.26, 95% CI 1.28-14.65) were identified as independent risk factors for ID at 8 months of CA. Conclusively, both SGA and RBI in the early life of very preterm were risk factors for ID at 8 months of CA.

The double-barrier technique using platelet-rich fibrin for closure of oroantral fistulas.

An oroantral fistula (OAF) or oroantral communication (OAC) is an opening between the oral cavity and the maxillary sinus. If left untreated, these openings may cause chronic maxillary sinusitis. Although small defects (diameter <5 mm) may close spontaneously, larger communications require surgical intervention. Various studies have been conducted on OAC closure using a platelet-rich fibrin (PRF) membrane; most of these prior studies have involved simple direct application of PRF clots. This study introduces a new "double-barrier technique" using PRF for closure of an OAF involving sinus mucosal lifting and closure. The PRF material is inserted into the prepared maxillary sinus space, and the buccal advancement flap covers the oral side. This technique was successfully used to treat two patients with chronic OAF in the posterior maxillary region after implant removal or tooth extraction. The use of a PRF membrane in a double-barrier technique may have advantages in soft-tissue healing and could enable easy closure of chronic OAF with minimal trauma.

The experiences of counselors caring for children and adolescents with problematic smartphone use.

This study examines field experts' experiences to ascertain the actual circumstances and strategies to increase the efficacy of intervention programs for children and adolescents with problematic smartphone use. Three focus group interviews were conducted via video conferencing. The data were grouped into three major themes: (1) the screening and inflow phase, which included the inaccuracy of the screening tests, barriers in the inflow process, and the importance of school cooperation; (2) the intervention phase, which included the necessity of developing a program tailored to the target audience, the importance of parental participation, and concerns about the vulnerable; and (3) the maintenance phase, which included the lack of a long-term strategy, the need to re-establish the purpose of the counseling/intervention programs, and the need for systematic maintenance of the system. To improve the reliability of the screening test for children and adolescents with problematic smartphone use, it is necessary to improve the measurement tools and environment. To increase parental involvement, education should be provided on perceiving the severity of problematic smartphone use, and program running hours should be varied. The findings offer information necessary for improving counseling and interventions for children and adolescents with problematic smartphone use.

Research trends related to problematic smartphone use among school-age children including parental factors: a text network analysis.

PURPOSE: This study aimed to identify the main keywords and research topics used in research on problematic smartphone use (PSU) among children (6-12 years old), including parental factors. METHODS: The publication period for the literature was set from January 2007 to January 2022, as smartphones were first released in 2007. In total, 395 articles were identified, 230 of which were included in the final analysis. Text network analysis was performed using NetMiner 4.5. RESULTS: Research on this topic has steadily increased since 2007, with 40 papers published in 2021. Eight main research topics were derived: group 1, parental attitudes; group 2, children's PSU behavior and parental support; group 3, family environment and behavioral addiction; group 4, social relationships; group 5, seeking solutions; group 6, parent-child relationships; group 7, children's mental health and school adaptation; and group 8, PSU in adolescents. CONCLUSION: Parental factors related to PSU have been studied in various aspects. However, more active research on school-age children's PSU needs to be conducted due to the paucity of research in this population compared to studies conducted among adolescents. The results of this study provide useful data for selecting research topics in the field of PSU.

Factors influencing health-related quality of life in older adult women with sarcopenia: analysis of the Korean National Health and Nutrition Examination Survey 2019.

PURPOSE: This study aimed to identify factors influencing the health-related quality of life (HRQoL) of older adult women with sarcopenia. METHODS: The study was secondary data analysis using data from the 2019 Korea National Health and Nutrition Examination Survey. The final sample consisted of 142 women aged 60 years and older with sarcopenia and were selected from 8,110 women. The participants was analyzed using complex descriptive statistics, independent t-test, and regression. RESULTS: In terms of HRQoL, three general characteristics were found to be influential, with an explanatory power of 56.0%: difficulty climbing stairs, difficulty working, and perceived health status. Having no or mild difficulty when climbing stairs (B=.20, p=.001; B=.21, p<.001) and no or mild difficulty when working (B=.25, p=. 002; B=.208, p=.013) had a significant effect on HRQoL compared to severe difficulty. Having good or ordinary perceived health status had a significant effect on the HRQoL (B=.11, p<.001; B=.09, p<.001). CONCLUSION: Based on study findings that the HRQoL of older adult women with sarcopenia were influenced by difficulty climbing stairs and working, as well as good perceived health status, healthcare providers should assist elderly women to maintain physical activities in their daily lives.

[National Petition Analysis Related to Nursing: Text Network Analysis and Topic Modeling].

PURPOSE: This study aimed to identify the main keyword, network structure, and main topics of the national petition related to "nursing" in South Korea. METHODS: Data were gathered from petitions related to the national petition in Korea Blue House related to the topic "nursing" or "nurse" from August 17, 2017, to May 9, 2022. A total of 5,154 petitions were searched, and 995 were selected for the final analysis. Text network analysis and topic modeling were analyzed using the Netminer 4.5.0 program. RESULTS: Regarding network characteristics, a density of 0.03, an average degree of 144.483, and an average distance of 1.943 were found. Compared to results of degree centrality and betweenness centrality, keywords such as "work environment," "nursing university," "license," and "education" appeared typically in the eigenvector centrality analysis. Topic modeling derived four topics: (1) "Improving the working environment and dealing with nursing professionals," (2) "requesting investigation and punishment related to medical accidents," (3) "requiring clear role regulation and legislation of medical and nonmedical professions," and (4) "demanding improvement of healthcare-related systems and services." CONCLUSION: This is the first study to analyze Korea's national petitions in the field of nursing. This study's results confirmed both the internal needs and external demands for nurses in South Korea. Policies and laws that reflect these results should be developed.

Factors associated with place of death for terminal cancer patients who wished to die at home.

A patient's desired place of death is an important indicator of the quality of dying. The purpose of this study was to investigate the actual places of death of terminal cancer patients who wished to die at home and the factors affecting their actual place of death. A retrospective survey was used to analyze the medical records of 143 terminal cancer patients who wanted to die at home among a population of 168 patients who used a home hospice care service more than once between March 2016 and December 2019. Patients who wanted to die at home represented 85.1% of the total study population (143 patients). Of these, 31.5% and 68.5% were home and hospital deaths, respectively. Factors associated with the actual place of death of patients who desired to die at home were marital status (odds ratio [OR] = 2.57, confidence interval [CI]: 1.08-6.13), the patient's status at the time of their enrollment in a home hospice care service (OR = 3.30, CI: 1.56-7.02), and the primary caregiver's relationship with the patient (OR = 2.52, CI: 1.12-5.66). Most terminal cancer patients studied did not die in their preferred place. Support from policies and hospice professionals is needed to decrease caregiver burden and help patients die wherever they want. Consequently, quality of end-of-life care can be improved.

[Images of Nurses Appeared in Media Reports Before and After Outbreak of COVID-19: Text Network Analysis and Topic Modeling].

PURPOSE: The aims of study were to identify the main keywords, the network structure, and the main topics of press articles related to nurses that have appeared in media reports. METHODS: Data were media articles related to the topic "nurse" reported in 16 central media within a one-year period spanning July 1, 2019 to June 30, 2020. Data were collected from the Big Kinds database. A total of 7,800 articles were searched, and 1,038 were used for the final analysis. Text network analysis and topic modeling were performed using NetMiner 4.4. RESULTS: The number of media reports related to nurses increased by 3.86 times after the novel coronavirus (COVID-19) outbreak compared to prior. Pre- and post-COVID-19 network characteristics were density 0.002, 0.001; average degree 4.63, 4.92; and average distance 4.25, 4.01, respectively. Four topics were derived before and after the COVID-19 outbreak, respectively. Pre-COVID-19 example topics are "a nurse who committed suicide because she could not withstand the Taewoom at work" and "a nurse as a perpetrator of a newborn abuse case," while post-COVID-19 examples are "a nurse as a victim of COVID-19," "a nurse working with the support of the people," and "a nurse as a top contributor and a warrior to protect from COVID-19." CONCLUSION: Topic modeling shows that topics become more positive after the COVID-19 outbreak. Individual nurses and nursing organizations should continuously monitor and conduct further research on nurses' image.

Effects of depression and social interaction on smartphone addiction among female adolescents.

PURPOSE: This study aimed to investigate the effect of social interaction and depression on smartphone addiction among Korean female adolescents. METHODS: This study is a secondary analysis of the data from the Korean Children and Youth Panel Survey, a national survey conducted by the National Youth Policy Institute In Korea in 2018. The data of 1185 female adolescents was analyzed. Binary logistic regression was performed between smartphone addiction and depression, parenting behavior, peer interaction and teacher interaction. FINDINGS: Proportion of risk users was 24.9%. Depression, coercive parenting attitude, negative peer relationship, and trust/sensitivity/accessibility in teacher relationship predicted smartphone addiction. CONCLUSIONS: This study emphasizes the necessity of smartphone addiction prevention programs to lower depression levels and approach adolescents' parents, friends, and teachers.

Effect of Maternal Factors on Problematic Smartphone Use among Elementary School Children.

Mothers play a key role in ensuring their children's healthy life. This study aimed to identify the maternal factors affecting problematic smartphone use in children. We adopted a cross-sectional descriptive design using structured questionnaires. Participants were fourth to sixth grade elementary school students in Korea (n = 184). The following maternal factors were evaluated: maternal mediation, children's perception of mothers' smartphone use, mother-child communication, and parenting style. Data regarding maternal factors' effect on problematic smartphone use were analyzed by computing descriptive statistics and logistic regression analysis using SPSS Win 27.0. The results show that the maternal factors that influenced problematic smartphone use in children were maternal control over smartphone usage (odds ratio (OR) = 5.10, 95% confidence interval (CI): 1.33-19.60), smartphone usage time for social network service (OR = 1.52, 95% CI: 1.10-2.01), and problematic mother-child communication (OR = 1.07, 95% CI: 1.00-1.14). Therefore, to promote appropriate smartphone use among school children, it is necessary to develop an intervention comprising maternal supervision of their children's smartphones, guidance provision for social network service usage, and strategies for the reinforcement of positive mother-child communication.

Effects of a Physical Exercise Program on Physiological, Psychological, and Physical Function of Older Adults in Rural Areas.

With the increase in the older population, there is a concern for health in older adults. This study aimed to develop a physical exercise program that combined walking and gymnastics for older adults residing in rural areas and to evaluate its effect on their physiological and psychological health and physical function. A quasi-experimental design was adopted. Participants were aged 65 years or older, with 94 and 130 participants in the experimental and control group, respectively. The program was implemented for seven months, from April-October 2016. Walking and gymnastics were performed once a week each, for about 60 and 50 min, respectively. Data were analyzed using the Chi-squared test, Fisher's exact test, independent t-test, or Mann-Whitney U test. Results revealed that the experimental group participants displayed improved waist circumference (t = 1.70, p = 0.045), body mass index (U = 4691.00, p = 0.002), depressive symptoms (t = -2.94, p = 0.002), upper limb strength (t = 2.27, p = 0.012), and lower limb strength (t = 3.86, p < 0.001). Therefore, it can be presumed that the physical exercise program was effective and beneficial for older adults living in rural areas. This program is expected to contribute to maintaining and improving their health if implemented regularly in the future.

Analyzing Gender Differences in Factors Affecting Depression among Multicultural Adolescents in South Korea: A Cross-Sectional Study.

Suicide is the topmost cause of death among adolescents in South Korea and is deeply related to depression. This study aimed to identify gender differences in the factors affecting depression among multicultural adolescents. This study is a secondary analysis using data from a national survey, the Multicultural Adolescents Panel Study (MAPS) conducted in 2017. The participants were 1160 multicultural adolescents ranging from 15 to 18 years, living in Korea, and whose fathers were Koreans and mothers were foreigners. The results showed that depression scores were higher for females (18.35) than males (16.38, t = 6.42, p < 0.001). In total, seven factors affected depression among male multicultural adolescents' and the model explained 50.5% of the total variance (F = 77.99, p < 0.001), while four factors affected female multicultural adolescents' depression, and the model explained 51.4% of the total variance (F = 100.02, p < 0.001). Significant gender differences were found in factors that influence depression among multicultural adolescents. Therefore, depression prevention programs for multicultural adolescents need to vary according to gender. Additionally, these programs should target families and teachers of multicultural adolescents as well.

Perioperative high inspired oxygen fraction induces atelectasis in patients undergoing abdominal surgery: A randomized controlled trial.

STUDY OBJECTIVE: We evaluated the feasibility of use and effects on postoperative atelectasis and complications of lower inspired oxygen fraction (FIO2) compared to conventional oxygen therapy. DESIGN: Single center, randomized clinical trial. SETTING: University hospital, operating room and postoperative recovery area. PATIENTS: One hundred ninety patients aged ≥50 with an American Society of Anesthesiologists physical status of I-III who underwent abdominal surgery with general anesthesia. INTERVENTIONS: Participants were randomly assigned to either the low FIO2 group (intraoperative: FIO2 0.35, during induction and recovery: FIO2 0.7) or the conventional FIO2 group (intraoperative: FIO2 0.6, during induction and recovery: FIO2 1.0). MEASUREMENTS: The primary outcome was postoperative atelectasis measured with lung ultrasonography at postoperative 30 min in the post-anesthesia care unit (consolidation score: each region 0-3, 12 region, total score range of 0 to 36, a lower score indicating better aeration). MAIN RESULTS: Seven patients in the low FIO2 group were omitted from the study due to changing FIO2 during intervention (7/95 (8.4%) vs. 2/95 (2.1%), p = 0.088; low FIO2 group vs. conventional FIO2 group). Overall, atelectasis was detected in 29.7% (51/172) of patients 30 min after surgery by lung ultrasound and 40.1% (69/172) of patients after 2 days after surgery by chest X-ray. The scores of lung ultrasonography and the incidence of significant atelectasis (consolidation score ≥ 2 at any region) were lower in the low FIO2 group than in the conventional FIO2 group (median [IQR]: 3 [1,6] vs. 7 [3,9], p < 0.001 and 17/85 (20%) vs. 34/87 (39%), RR: 0.512 [95% CI: 0.311-0.843], p = 0.006, respectively). The incidence of surgical site infection and length of hospitalization were not significantly different between the two groups. CONCLUSIONS: Based on our findings, decreased inspired oxygen fraction during anesthesia and recovery did not cause hypoxic events, but instead reduced immediate postoperative atelectasis. The use of intraoperative conventional higher inspired oxygen did not afford any clinical advantages for postoperative recovery in abdominal surgery.

Changes of antibiotic prescribing pattern and its resistance to E. Coli in South Korea: a 12-year retrospective observational study.

In the present study, we investigated the pattern of changes in antibiotic prescription and antimicrobial resistance (AMR) in Escherichia coli in South Korea between 2007 and 2018. We collected data related to antibiotic prescription and AMR in E. coli from the national surveillance system. We used the Mann-Kendall test and Spearman's correlation to identify the trends of antibiotic prescription and AMR in E. coli and to examine the relationship between them, respectively. Although we noted a significant decreasing trend of ampicillin and gentamicin prescriptions in all medical institutions, we identified a higher level of AMR in long-term care facilities than in other medical institutions. We did not identify a significant positive correlation between ampicillin and gentamicin prescriptions and their resistance in E. coli. However, we found a significant positive correlation between cefotaxime prescription and its resistance in E. coli in hospitals, long-term care facilities, and clinics. Our results strongly suggest that long-term care facilities in South Korea have the potential to sustain AMR epidemics and that more efforts are needed to curb AMR in E. coli. Further epidemiological studies using enhanced AMR surveillance are warranted.

Effect of Cancer Awareness on Treatment Decision for Pancreatic Cancer Patients.

Background/Aims: With recent changes in the treatment of pancreatic cancer, patients' active decision-making has become more important. Nevertheless, it is difficult to give patients proper insights into the disease. The purpose of this study was to determine associated factors between pancreatic cancer awareness and treatment decisions as well as how cancer awareness affects the timing of treatment decisions and the desired treatment method. Methods: This is a retrospective study that reviewed and analyzed the electronic medical records of 110 patients who were diagnosed with pancreatic cancer from January 2013 to April 2016. A "patient with pancreatic cancer awareness" means that the patient was informed of their disease state before making the first treatment decision. Results: Of all, only 63.6% of patients (n=70) were shown to have pancreatic cancer awareness before making their first treatment decision. Compared to patients without pancreatic cancer awareness, patients with pancreatic cancer awareness were younger (65.00 vs. 76.98, t=6.70, p<0.001), were more likely to have presented their spouse as legal guardians (42.9% vs. 10.0%, χ2=31.70, p<0.001), and spent a shorter time for treatment decision-making (1.6 vs. 10.5 days, t=4.26, p<0.001). The patients without pancreatic cancer awareness were more likely to opt for best supportive care compared to the patients with pancreatic cancer awareness (79.5% vs. 28.6%, χ2=31.70, p<0.001). Conclusions: This study provides insights into cancer awareness. Since cancer awareness appears to influence treatment decision, it is necessary to develop guidelines to improve cancer awareness of patients.

[The Effects of Breast Milk Olfactory Stimulation on Physiological Responses, Oral Feeding Progression and Body Weight in Preterm Infants].

PURPOSE: This study was conducted to evaluate the effect of breast milk olfactory stimulation on physiological responses, oral feeding progression, and body weight in preterm infants. METHODS: A repeated measures design with nonequivalent control group was used. The participants were healthy, preterm infants born at a gestational age of 28~32 weeks; 12 in the experimental group and 16 in the control group. Data were collected prospectively in the experimental group, and retrospectively in the control group, by the same methods. Breast milk olfactory stimulation was provided 12 times over 15 days. The data were analyzed using the chi-square test, Mann-Whitney U test, Wilcoxon signed rank test and linear mixed models using SPSS 19. RESULTS: The gastric residual volume (GRV) of the experimental group was significantly less than that of the control group. The heart rate, oxygen saturation, respiration rate, transition time to oral feeding, and body weight were not significantly different between the two groups. CONCLUSION: These findings indicate that breast milk olfactory stimulation reduces GRV and improves digestive function in preterm infants without inducing distress.

[Comparison of Factors related to Smartphone Dependency among Middle School, High School, and College Students based on the Seventh Korean Children and Youth Panel Survey]. / 중학생, ê³ ë“±í•™ìƒ 및 대학생의 스마트폰 의존도 영향요인 비교: ì œ7ì°¨ 한국 ì•„ë™ì²­ì†Œë „ 패널조사 자료를 바탕으로.

PURPOSE: This study investigated differences in the relationships of factors including emotional problems, self-perception, parental behavior, and peer attachment with smartphone dependency (SD) among middle school, high school, and college students in South Korea. METHODS: This study used data from a nationwide sample of 1,882 middle school, 1,821 high school, and 1,346 college students who owned smartphones. Descriptive statistics and multiple regression analysis were conducted to investigate the predictors of SD based on school level. RESULTS: SD scores significantly differed across school levels. Female gender, more aggressive behavior, less ego-identity, and less monitoring parental behavior were linked to higher SD at all school levels. Less self-esteem and intrusive parental behavior were linked to SD in middle school students. In high school students, additional factors related to higher levels of SD were resilience, intrusive / inconsistent parental behavior, peer trust and alienation, and depression. Additionally, resilience, over-expectant parental behavior, and peer trust were linked to higher SD in college students. CONCLUSION: This study provides insights into SD and predictors of SD among middle school, high school, and college students. Based on these findings, SD prevention programs should be developed according to the developmental stages of adolescents and young adults.

Gender Differences in Smartphone Addiction Behaviors Associated With Parent-Child Bonding, Parent-Child Communication, and Parental Mediation Among Korean Elementary School Students.

OBJECTIVE: This study investigated the gender differences in smartphone addiction (SA) behaviors associated with parent-child bonding, parent-child communication, and parental mediation among Korean elementary school students aged 11-13 years. METHOD: A sample of 224 smartphone users (112 boys and 112 girls) was surveyed in a cross-sectional study. Descriptive statistics and multiple regression analysis were conducted to investigate the predictors of SA behaviors based on gender differences using SPSS Win 23.0 software. RESULTS: Of the participants, 14.3% (15.18% boys and 13.39% girls) were in the SA behaviors risk group, and the prevalence of SA behaviors was not significantly different between gender groups. In multiple stepwise regression analysis, less active safety mediation; longer duration of smartphone use; more use of smartphones for games, videos, or music; and less restrictive mediation were linked to higher SA behaviors in boys, and these indicators accounted for 22.1% of the variance in SA behaviors. Longer duration of smartphone use, less active use mediation, worse parent-child communication, and more use of smartphones for text, chatting, or social network sites were linked to higher SA behaviors in girls, and these indicators accounted for 38.2% of the variance in SA behaviors. CONCLUSION: The study provides insights into SA behaviors and predictors of SA behaviors among children based on gender differences. Development of SA behavior prevention programs is needed, not only for children but also to teach parents to use active safety mediation and restrictive mediation for boys and better communication and active use mediation for girls.

Does Parental Control Work With Smartphone Addiction?: A Cross-Sectional Study of Children in South Korea.

The purposes of this study were to (a) examine the relationship between personal characteristics (age, gender), psychological factors (depression), and physical factors (sleep time) on smartphone addiction in children and (b) determine whether parental control is associated with a lower incidence of smartphone addiction. Data were collected from children aged 10-12 years (N = 208) by a self-report questionnaire in two elementary schools and were analyzed using t test, one-way analysis of variance, correlation, and multiple linear regression. Most of the participants (73.3%) owned a smartphone, and the percentage of risky smartphone users was 12%. The multiple linear regression model explained 25.4% (adjusted R = .239) of the variance in the smartphone addiction score (SAS). Three variables were significantly associated with the SAS (age, depression, and parental control), and three variables were excluded (gender, geographic region, and parental control software). Teens, aged 10-12 years, with higher depression scores had higher SASs. The more parental control perceived by the student, the higher the SAS. There was no significant relationship between parental control software and smartphone addiction. This is one of the first studies to examine smartphone addiction in teens. Control-oriented managing by parents of children's smartphone use is not very effective and may exacerbate smartphone addiction. Future research should identify additional strategies, beyond parental control software, that have the potential to prevent, reduce, and eliminate smartphone addiction.