Increased adolescent game usage and health-related risk behaviors during the COVID-19 pandemic.

This study examines adolescent game usage and corresponding health-related risk behaviors during a period of limited social interaction and activity due to the COVID-19 pandemic. Participants included 225 middle- and 225 high-school students in Seoul who completed a survey online from October 1 to 30, 2021. The study measured participants' game usage level and the health-related risk behavior index. Findings showed that participants who engaged in excessive gaming showed higher levels of health-related risk behaviors. A multivariate analysis of variance was conducted to compare the health-related risk behaviors of students in the general, potential, and high-risk groups on excessive gaming. Results indicated that female students in the high-risk group showed higher stress levels and fatigue (f = 5.549, p < .01, Cohen's d = 0.016) than the males of the same group. However, male students showed higher physical inactivity levels (f = 3.195, p > .05, Cohen's d = 0.009) than females. The post hoc test indicated clear sex distinctions among the general, potential, and high-risk groups on excessive gaming (p < .001). Among the high-risk game usage group, female students displayed a higher level of risk behaviors than males. Adolescent gaming addiction should be considered an emotional and behavioral disorder for which parental guidance and support are needed, and counseling experts and professionals must come together to provide a cure and reform program.

Scalable terahertz generation by large-area optical rectification at 80 TW laser power.

We demonstrate high-energy terahertz generation from a large-aperture (75-mm diameter) lithium niobate wafer by using a femtosecond laser with energy up to 2 J. This scheme utilizes optical rectification in a bulk lithium niobate crystal, where most terahertz energy is emitted from a thin layer of the rear surface. Despite its simple setup, this scheme can yield 0.19 mJ of terahertz energy with laser-to-terahertz conversion efficiencies of ∼10-4, about 3 times better than ZnTe when pumped at 800 nm. The experimental setup is upscalable for multimillijoule terahertz generation with petawatt laser pumping.

p-Coumaric acid modulates glucose and lipid metabolism via AMP-activated protein kinase in L6 skeletal muscle cells.

p-Coumaric acid (3-[4-hydroxyphenyl]-2-propenoic acid) is a ubiquitous plant metabolite with antioxidant, anti-inflammatory, and anticancer properties. In this study, we examined whether p-coumaric acid modulates glucose and lipid metabolism via AMP-activated protein kinase (AMPK) in L6 skeletal muscle cells. p-Coumaric acid increased the phosphorylation of AMPK in a dose-dependent manner in differentiated L6 skeletal muscle cells. It also increased the phosphorylation of acetyl-CoA carboxylase (ACC) and the expression of CPT-1 mRNA and PPARα, suggesting that it promotes the ß-oxidation of fatty acids. Also, it suppressed oleic acid-induced triglyceride accumulation, and enhanced 2-NBDG uptake in differentiated L6 muscle cells. Pretreatment with compound C inhibited AMPK activation, reduced ACC phosphorylation and 2-NBDG uptake, and increased triglyceride accumulation. However, p-coumaric acid counterbalanced the inhibitory effects of compound C. Taken together, these results suggest that p-coumaric acid modulates glucose and lipid metabolism via AMPK activation in L6 skeletal muscle cells and that it has potentially beneficial effects in improving or treating metabolic disorders.

Sasa quelpaertensis and p-coumaric acid attenuate oleic acid-induced lipid accumulation in HepG2 cells.

In this study, we examined the effects of Jeju dwarf bamboo (Sasa quelpaertensis Nakai) extract (JBE) and p-coumaric acid (CA) on oleic acid (OA)-induced lipid accumulation in HepG2 cells. JBE and CA increased the phosphorylation of AMP-activated protein kinase (AMPK), and acetyl-CoA carboxylase (ACC) and the expression of carnitine palmitoyl transferase 1a (CPT1a) in OA-treated HepG2 cells. Additionally, these compounds decreased sterol regulatory element-binding protein-1c (SREBP-1c), fatty acid synthase (FAS), and OA-induced lipid accumulation, suggesting that JBE and CA modulate lipid metabolism in HepG2 cells via the AMPK activation pathway.

Variation in leisure sport conflicts and coping strategies depending on participation type and proximity during the COVID-19 pandemic.

Introduction: New conflict types have arisen in leisure sports activities due to social regulations designed to address COVID-19. We analyze the differences in conflict-inducing factors and coping strategies across various types of leisure sports and levels of spatial proximity. Methods: Korean adults aged between 20 and 60 years, who had participated in leisure sports activities since the COVID-19 outbreak in January 2020, were surveyed, and 508 responses were collected for analysis. The differences in leisure sports conflicts and coping strategies across the types of leisure sports participation and spatial proximity were tested. Results: The results show that conflict due to prejudice was higher in typical indoor sports activities, such as Pilates, yoga, and gym workouts, whereas conflict due to competition or not observing etiquette was higher in indoor golf. Second, conflict due to prior expectations and prejudice was high in outdoor sports activities, such as jogging and hiking. Finally, all participants showed avoidance behavior, but it was observed more frequently in outdoor sports than indoor sports. Discussion: The study reveals how much leisure conflict is induced by various types of leisure sports participation, particularly during outdoor activities, which usually feature a relatively low density of participants. It underscores the necessity of developing structural approaches to resolving leisure conflicts in dangerous spaces or requiring intensive management and creating new leisure sports activities.

Impact of leisure satisfaction on perceived risk of infectious disease during the COVID-19 pandemic: evidence from new worker classes.

Introduction: This study examines how job market changes affect individuals' leisure choices and satisfaction, focusing on worker classes that have undergone daily life changes (e.g., economic and social activities) due to the coronavirus disease-2019 (COVID-19) pandemic. Methods: A population-based cross-sectional study design was employed. South Korean workers aged 20-59 years answered an online survey administered from September 14 to October 4, 2021. Ultimately, 764 responses were used in the analysis. The measures used in this study consisted of factors affecting infectious disease risk perception and leisure satisfaction among the six new worker classes that emerged during the pandemic, according to socio-demographic status. Results: The results showed that among male participants, social, emotional, physical, environmental, and educational factors of leisure satisfaction were more strongly affected, with higher social, physical, and interpersonal relationships being factors in the perception of infectious disease risk. Among female participants, the interpersonal relationship factor of perceived risk was significantly affected by the social, emotional, and educational factors of leisure satisfaction. Interpersonal relationships, affected leisure satisfaction among members of Classes 1-3, who experienced no change in pay. However, for the members of Class6 who experienced a decrease in pay, the economic factor negatively affected leisure satisfaction and played a pivotal role in our findings. Conclusion: This study verified the risk factors that inhibit leisure satisfaction among new worker classes that emerged during the COVID-19 pandemic. Furthermore, the psychological health of people suffering pandemic-related financial constraints was affected, as they experienced a lower quality of life owing to reduced leisure activities and satisfaction.

Immature Citrus sunki peel extract exhibits antiobesity effects by ß-oxidation and lipolysis in high-fat diet-induced obese mice.

The peel of Citrus sunki HORT. ex TANAKA has been widely used in traditional Asian medicine for the treatment of many diseases, including indigestion and bronchial asthma. In this study, we investigated the antiobesity activity of immature C. sunki peel extract (designated CSE) using high-fat diet (HFD)-induced obese C57BL/6 mice and mature 3T3-L1 adipocytes. In the animal study, body weight gain, adipose tissue weight, serum total cholesterol, and triglyceride in the CSE-administered group decreased significantly compared to the HFD group. Also, CSE supplementation reduced serum levels of glutamic pyruvic transaminase, glutamic oxaloacetic transaminase, and lactate dehydrogenase. Moreover, it significantly decreased the accumulation of fatty droplets in liver tissue, suggesting a protective effect against HFD-induced hepatic steatosis. Dietary supplementation with CSE reversed the HFD-induced decrease in the phosphorylation levels of AMP-activated protein kinase (AMPK) and acetyl-CoA carboxylase (ACC), which are related to fatty acid ß-oxidation, in the epididymal adipose tissue. Also, CSE increased AMPK and ACC phosphorylation in mature 3T3-L1 adipocytes. CSE also enhanced lipolysis by phosphorylation of cAMP-dependent protein kinase (PKA) and hormone-sensitive lipase (HSL) in mature 3T3-L1 adipocytes. These results suggest that CSE had an antiobesity effect via elevated ß-oxidation and lipolysis in adipose tissue.

Anti-obesity properties of a Sasa quelpaertensis extract in high-fat diet-induced obese mice.

This study explores the anti-obesity properties of a Sasa quelpaertensis leaf extract (SQE) in high-fat diet (HFD)-induced obese C57BL/6 mice and mature 3T3-L1 adipocytes. SQE administration with HFD for 70 d significantly decreased the body weight gain, adipose tissue weight, and serum total cholesterol and triglyceride levels in comparison with the HFD group. SQE administration also reduced the serum levels of glutamic oxaloacetic transaminase, glutamic pyruvic transaminase and lactate dehydrogenase, and the accumulation of lipid droplets in the liver, suggesting a protective effect against HFD-induced hepatic steatosis. SQE administration restored the HFD-induced decreases with phosphorylation of AMP-activated protein kinase (AMPK) and acetyl-CoA carboxylase (ACC) in epididymal adipose tissue. SQE also induced AMPK phosphorylation in mature 3T3-L1 adipocytes. These results suggest that SQE exerted an anti-obesity effect on HFD-induced obese mice by activating AMPK in adipose tissue and reducing lipid droplet accumulation in the liver.

An Analysis of the Relationship between the Modified Theory of Planned Behavior and Leisure Rumination of Korean Employees.

An increasing trend among employees has been to engage in leisure activities, which has been proven to be an effective method of overcoming work stress. As a result, employees are doing "Other Things" (i.e., non-work activities) as a way to relieve stress. Based on the existing studies on rumination, this study considered doing "Other Things" as a new concept of "leisure rumination" and identified its influence as a means to help employees recover from work stress. Accordingly, this study provided basic data on the meaning of leisure activities and leisure rumination in office workers who suffer from failure to recover from work stress using partial least squares structural equation modeling. This study was conducted on employees residing in the Seoul metropolitan area and the Gyeongsang-do district in November 2019 through a structured questionnaire. The results of this study verified the significance of leisure rumination and the possibility of it being utilized as a practical research tool for leisure activities. Our findings may be considered when planning interventions for work addiction and burnout through leisure rumination.

Perceived Crowding and Risk Perception According to Leisure Activity Type during COVID-19 Using Spatial Proximity.

This study aimed to investigate the difference in people's perceived crowding and risk perception during leisure activities using the criteria of spatial proximity during the COVID-19 pandemic. COVID-19 is a viral respiratory tract disease that poses an increasing risk of infection through person-to-person transmission in a confined space or close proximity to an infected person. It is thus crucial to maintain a sufficiently safe distance from others during leisure activities. In this study, measures concerning leisure activity spaces and the current status of leisure activities were investigated. Data were gathered from a total of 1078 participants via an online survey conducted from 26 to 29 October 2020. Frequency analysis was performed to investigate the sample characteristics and exploratory factor analysis was performed to analyze the validity of the measurement tools. Results revealed that people's perceived crowding of leisure activity spaces directly influenced their participation in leisure activities. Regarding age, those in their 20s were more aware of congestion and their risk perception was higher than those in their 40s and 50s. It was found that people perceived cultural and artistic activities to be dangerous as they often take place as part of tourism and leisure activities and amidst crowds. However, their high-risk perception indirectly influenced their participation patterns, making it difficult to enjoy leisure activities. To lower the risk perception of leisure activity spaces, it was necessary to secure more safe distancing than current regulations require. Future research must conduct a longitudinal investigation by objectively stratifying the degree of perceived crowding.

The Quality of Life, Psychological Health, and Occupational Calling of Korean Workers: Differences by the New Classes of Occupation Emerging Amid the COVID-19 Pandemic.

This study aimed to create new classifications for occupations that have emerged from the COVID-19 pandemic in Korea, based on Reich's classifications for the United States. We examined Korean workers' occupational calling, psychological health, and quality of life. An online questionnaire was administered and data from 1029 Korean workers were analyzed. The questionnaire comprised the Korean version of the Multidimensional Calling Measure to assess occupational calling, the Psychosocial Well-being Index-short form for psychological health, and the Control, Autonomy, Self-realization, and Pleasure (CASP-19) scale for quality of life. We created a Korean-adapted version of the classes of occupation based on those created by the COVID-19 situation in the USA. Our results showed that Korean workers had a high perceived calling to work, and different classes showed different levels of quality of life and psychological health. We need a health concentration management system for essential groups or personal safety protection equipment should be provided. Education on infection control should be offered and effective medical system processes should be in place. We need to develop technology to respond to medical needs online, remotely, or telephonically. The government should implement policies to ensure job security and to improve wages and welfare.

Study on the Relationship between Leisure Activity Participation and Wearing a Mask among Koreans during COVID-19 Crisis: Using TPB Model.

This study utilizes the Theory of Planned Behavior (TPB) variables-including "attitude," "subjective norms," and "perceived behavioral control"-to understand the relationship between mask-wearing behavior and physical/non-physical leisure activity participation in Koreans as well as the tendencies behind mask-wearing intentions within leisure activities. The measurement tools used attitude, subjective norms, control, and mask use intention factors based on the TPB. Overall, 545 individuals participated, and the non-overlapping regions, sex, and age were considered through the stratified sampling method. The survey was conducted online owing to COVID-19, and collected data were derived through descriptive and multiple linear regression analyses. First, a difference in mask-wearing intention based on physical and non-physical leisure activities was identified; second, attitudes and perceived behaviors were considered in light of the dangers posed by COVID-19. It was found that control influences the tendency of intention to wear a mask depending on whether the group was engaged in physical or non-physical activity. Therefore, it can be stated that mask-wearing must be mandatory during physical and non-physical activities owing to respiratory diseases such as COVID-19. It is also important to simultaneously promote a positive attitude toward mask-wearing to enable people to believe that they can stay in full control of their own health.

Hypoxia due to positive pressure ventilation in Edwards' syndrome: A case report.

Edwards' syndrome also known as trisomy 18 is a congenital disorder associated with cardiovascular issues including ventricular septal defect (VSD), atrial septal defect (ASD) and patent duct arteriosus (PDA). An emergency colostomy was performed on a neonate born with an imperforate anus. Pre-operative transthoracic echocardiography showed presence of VSD, a patent foramen ovale (PFO) or ASD. Even though the baby had a good general condition and optimal peripheral oxygen saturation (SpO2), during positive pressure ventilation, she suffered severe hypoxia (50% SpO2). The cause of the hypoxia was thought to be the right-left shunt and so during a second attempt at anaesthesia a vasopressor (noradrenaline 0.03 µg/kg/min) was infused to increase systemic vascular resistance. Thereafter, SpO2 increased to 80-90% and the surgery was completed. The baby recovered without any neurological complications. Genetic testing post-partum showed she had Edwards' syndrome.

Ultrasound-Guided Hyaluronic Acid Injection for the Management of Morton's Neuroma.

BACKGROUND: Morton's neuroma is one of the common causes of forefoot pain. In the present study, hyaluronic acid injection was performed on patients to determine the efficacy and adverse effects of hyaluronic acid in management of Morton's neuroma. METHODS: Eighty-three patients with Morton's neuroma in their third intermetatarsal space with definite Mulder's click were included in the study. Those with severe forefoot deformities such as forefoot cavus or hallux valgus on plain X-rays were excluded. Ultrasound-guided hyaluronic acid injections were performed on all patients weekly for 3 weeks. Pain during walking using visual analogue scale (VAS) and AOFAS Forefoot Scale were prospectively evaluated preinjection, and at 2, 4, 6, 12 months postinjection. RESULTS: Significant improvement in VAS and AOFAS Forefoot Scale were seen overall at 2 months after hyaluronic acid injections ( P < .05). Then, there were almost no changes after 4 months, continuing until 12 months. The mean VAS was decreased from 73.1 initially to 23.0 at 12 months and AOFAS Forefoot Scale was increased from 32.2 to 86.5. There were no complications which occurred. CONCLUSION: In the present study, ultrasound-guided hyaluronic injection was clinically effective for pain relief and functional improvement for at least 12 months in patients with Morton's neuroma. However, numbness associated with Morton's neuroma should be addressed more cautiously since it may persist without much improvement. LEVEL OF EVIDENCE: Level IV, retrospective case series.

Effects of repeated tianeptine treatment on CRF mRNA expression in non-stressed and chronic mild stress-exposed rats.

Accumulating evidence suggests that dysregulation of corticotropin-releasing factor (CRF) may play a role in depression and that this dysregulation may be corrected by antidepressant drug treatment. Here, we examined whether chronic mild stress (CMS) alters CRF mRNA levels in stress-related brain areas including the bed nucleus of the stria terminalis (BNST) and the central nucleus of amygdala (CeA), and whether repeated tianeptine treatment can attenuate CMS-induced changes in CRF mRNA levels. Male rats were exposed to CMS for 19 days, and control animals were subjected to brief handling. Both groups were injected daily with tianeptine or saline. CMS significantly increased CRF mRNA levels in the dorsal BNST (dBNST), but not in other areas. Repeated tianeptine treatment prevented the CMS-induced increase in CRF mRNA levels in the dBNST, and reduced CRF mRNA levels in dBNST in non-stressed controls. Moreover, repeated tianeptine treatment significantly decreased CRF mRNA levels in the ventral BNST and CeA of non-stressed controls as well as CMS-exposed rats. These results show that CMS induces a rather selective increase of CRF mRNA in the dBNST. In addition, these results suggest that repeated tianeptine treatment diminishes the basal activity of CRF neurons and reduces their sensitivity to stress.

Rapid chiral separation of racemic cetirizine in human plasma using subcritical fluid chromatography-tandem mass spectrometry.

A method for fast chiral separation of cetirizine and quantitation of levocetirizine in human plasma using subcritical fluid chromatography with tandem mass spectrometry was developed and validated. The chromatographic separation was performed using a Chiralpak IE column (2.1 mm×150 mm, 5 µm) with an isocratic elution of CO2/organic modifier (55/45, v/v) at a flow rate of 0.85 mL/min. The organic modifier was composed of water/methanol (5/95, v/v). The makeup flow was optimized at water/methanol (10/90, v/v) and 0.2 mL/min. The most influential parameters on the separation of cetirizine affecting resolution, retention time and sensitivity were selected by fractional factorial design. The 3 selected factors were optimized by response surface methodology. Tandem mass spectrometry was used at electrospray ionization, positive ion mode, and multiple-reaction monitoring mode. Isotope-labeled cetirizine-d4 was used as the internal standard. The sample preparation of human plasma was conducted by solid phase extraction of hydrophilic-lipophilic balance (HLB) type. The developed method was validated for selectivity, linearity, precision, accuracy, recovery, limit of quantitation (LOQ), and limit of detection (LOD). The real human plasma samples were analyzed and the pharmacokinetic results were compared with results of previous research. The developed method was found to be reliable based on the similarity between the results of the current and previous methods. The chiral separation for cetirizine and economic feasibility were compared with those of previous studies using normal phase-HPLC or reversed phase-HPLC. The established analytical method could be successfully applied to pharmacokinetic study with reduction in the analysis time and costs.

Emergency department visit volume variability.

OBJECTIVE: One of the most important and basic variables in emergency department (ED) operations is patient visit volumes. This variable is usually predicted on the basis of the average ED patient visit volume over a certain period. However, ED patient visit variability is poorly understood. Therefore, we evaluated ED patient visit variability in order to determine if the average can be used to operate EDs. METHODS: Nationwide ED patient visit data were from the standard emergency patient data of the National Emergency Department Information System. The data are transferred automatically by 141 EDs nationwide. The hourly ED visit volumes over 365 days were determined, and the variability was analyzed to evaluate the representativeness of the average. RESULTS: A total of 4,672,275 patient visits were collected in 2013. The numbers of daily ED patient visits were widely dispersed and positively skewed rather than symmetric and narrow with a normal distribution. CONCLUSION: The daily variability of ED visit is too large and it did not show normal distribution. The average visit volume does not adequately represent ED operation.

Sasa quelpaertensis Nakai extract and its constituent p-coumaric acid inhibit adipogenesis in 3T3-L1 cells through activation of the AMPK pathway.

In this study, we investigated the effects of Sasa quelpaertensis Nakai extract (SQE) and its main constituent, p-coumaric acid, on adipogenesis in 3T3-L1 cells. SQE markedly inhibited adipogenesis by downregulating the expression of CCAAT/enhancer-binding protein α (C/EBPα), peroxisome proliferator-activated receptor γ (PPARγ), sterol regulatory element-binding protein-1c (SREBP-1c), and aP2. It also decreased the expression of fatty acid synthase (FAS) and adiponectin mRNAs in differentiating adipocytes. SQE increased AMP-activated protein kinase (AMPK) and acetyl-CoA carboxylase (ACC) phosphorylation during the early phase of MDI-induced differentiation, suggesting that SQE exerted its anti-adipogenic effect via AMPK activation at an early stage of the differentiation process. p-Coumaric acid suppressed adipogenesis by attenuating the expression of C/EBPα, PPARγ, and SREBP-1c during the late phase of MDI-induced differentiation. In addition, p-coumaric acid increased the phosphorylation of AMPK and ACC, and the expression of carnitine palmitoyl transferase-1 (CPT-1) mRNA, in fully differentiated adipocytes, indicating that it promotes fatty acid ß-oxidation via AMPK signaling. Taken together, our data suggest that SQE and p-coumaric acid might have the anti-obesitic effects via AMPK pathway in 3T3-L1 cells.

Petalonia binghamiae extract and its constituent fucoxanthin ameliorate high-fat diet-induced obesity by activating AMP-activated protein kinase.

In this study, we investigated the antiobesity properties of Petalonia binghamiae extract (PBE) in mice in which obesity was induced with a high-fat diet (HFD). PBE administration (150 mg/kg/day) for 70 days decreased body weight gain, adipose tissue weight, and the serum triglyceride level in mice fed a HFD. PBE reduced serum levels of glutamic pyruvic transaminase and glutamic oxaloacetic transaminase as well as the accumulation of lipid droplets in the liver. PBE restored the HFD-induced decrease in phosphorylation of AMP-activated protein kinase (AMPK) and acetyl-CoA carboxylase (ACC) in epididymal adipose tissue. PBE increased the phosphorylation of AMPK and ACC and decreased the expression of SREBP1c in mature 3T3-L1 adipocytes. In addition, we further explored the active compound responsible for AMPK activation by PBE in 3T3-L1 adipocytes. Fucoxanthin isolated from PBE increased the phosphorylation of AMPK and ACC with increasing LKB1 phosphorylation in mature 3T3-L1 adipocytes. Taken together, these data suggest that PBE (or fucoxanthin) exert improving effects on HFD-induced obesity by promoting ß-oxidation and reducing lipogenesis.

Enantioselective determination of cetirizine in human plasma by normal-phase liquid chromatography-atmospheric pressure chemical ionization-tandem mass spectrometry.

A highly sensitive and enantioselective method has been developed and validated for the determination of levocetirizine [(R)-cetirizine] in human plasma by normal-phase liquid chromatography coupled to tandem mass spectrometry with an atmospheric pressure chemical ionization (APCI) interface in the positive ion mode. Enantioselective separation was achieved on a CHIRALPAK AD-H column using an isocratic mobile phase consisting of a mixture of n-hexane, ethyl alcohol, diethylamine, and acetic acid (60:40:0.1:0.1, v/v/v/v). Levocetirizine-D(8) was used as an internal standard (IS). Levocetirizine and the IS were detected by multiple-reaction monitoring (MRM). Mass transitions of analyte and IS were m/z 389.2→201.1 and 397.2→201.1, respectively. Under optimized analytical conditions, a baseline separation of two enantiomers and IS was obtained in less than 11 min. Samples were prepared by a simple two-step extraction by protein precipitation using acetonitrile followed by liquid-liquid extraction with a n-hexane-dichloromethane mixture (50:50, v/v). The standard curve for levocetirizine was linear (r(2)>0.995) in the concentration range 0.5-300 ng/mL. Recovery was between 97.0 and 102.2% at low, medium, and high concentration. The limit of quantification (LOQ) was 0.5 ng/mL. Other method validation parameters, such as precision, accuracy, and stability, were very satisfactory. Finally, the proposed method was successfully applied to the study of enantioselective oral pharmacokinetics of levocetirizine in healthy Korean volunteers.