Objective Despite the global decrease in influenza infections during the coronavirus disease 2019(COVID-19)pandemic,seasonal influenza remains a significant health issue.South Korea,known for its robust pandemic respo...Objective Despite the global decrease in influenza infections during the coronavirus disease 2019(COVID-19)pandemic,seasonal influenza remains a significant health issue.South Korea,known for its robust pandemic response and high influenza vaccination rates,offers a unique context for examining changes in vaccination trends during the pandemic.Using nationally representative data,we aimed to understand the impact of the pandemic on influenza vaccination behavior over a 12-year period and to identify vulnerable groups.Methods We analyzed influenza vaccination rates in South Korea between 2011-2022,focusing on pandemic-related impacts.The data of 2,426,139 adults(≥19 years)from the Korea Community Health Survey were used to assess demographic and sociological factors influencing vaccination behaviors.Results We observed an increase in influenza vaccination rates during the pre-COVID-19 period from 2011-2013(weighted prevalence:46.68%[95%confidence interval(CI):46.55-46.82])to 2017-2019(weighted prevalence:52.50%[95%CI:52.38-52.63]).However,a significant decline was observed in 2022,the late-COVID-19 pandemic period(weighted prevalence:55.78%[95%CI:55.56-56.01]),compared with the mid-pandemic period in 2021(weighted prevalence:59.12%[95%CI:58.91-59.32]),particularly among populations traditionally prioritized for influenza vaccination,including older adults(≥65 years)and patients with chronic diseases and low educational and income levels.Conclusion The influenza vaccination rate in South Korea was significantly affected by the COVID-19 pandemic,showing a notable decrease among vulnerable demographic groups.This suggests the need for targeted public health strategies to address vaccine hesitancy and improve vaccination rates,particularly among high-risk populations.展开更多
Purpose:The aim of the present study was to assess both the credibility and strength of evidence arising from systematic reviews with meta-analyses of observational studies on handgrip strength and health outcomes.Met...Purpose:The aim of the present study was to assess both the credibility and strength of evidence arising from systematic reviews with meta-analyses of observational studies on handgrip strength and health outcomes.Methods:An umbrella review of systematic reviews with meta-analyses of observational studies was conducted.We assessed meta-analyses of observational studies based on random-effect summary effect sizes and their p values,95%prediction intervals,heterogeneity,small-study effects,and excess significance.We graded the evidence from convincing(Class I)to weak(Class IV).Results:From 504 articles returned in a search of the literature,8 systematic reviews were included in our review,with a total of 11 outcomes.Overall,nine of the 11 of the outcomes reported nominally significant summary results(p<0.05),with 4 associations surviving the application of the more stringent p value(p<106).No outcome presented convincing evidence.Three associations showed Class II evidence(i.e.,highly suggestive):(1)higher handgrip values at baseline were associated with a minor reduction in mortality risk in the general population(n=34 studies;sample size=1,855,817;relative risk=0.72,95%confidence interval(95%CI):0.670.78),(2)cardiovascular death risk in mixed populations(n=15 studies;relative risk=0.84,95%CI:0.780.91),and(3)incidence of disability(n=7 studies;relative risk=0.76,95%CI:0.660.87).Conclusion:The present results show that handgrip strength is a useful indicator for general health status and specifically for early all-cause and cardiovascular mortality,as well as disability.To further inform intervention strategies,future research is now required to fully understand mechanisms linking handgrip strength scores to these health outcomes.展开更多
Background Cardiac arrhythmias are common conditions in older people.Unfortunately,there is limited literature on associations between cardiac arrhythmias and physical performance or disability.We therefore aimed to p...Background Cardiac arrhythmias are common conditions in older people.Unfortunately,there is limited literature on associations between cardiac arrhythmias and physical performance or disability.We therefore aimed to prospectively investigate associations between cardiac arrhythmias and changes in disability and physical performance during 8 years of follow-up,using data from the Italian Longitudinal Study on Aging(ILSA).Methods Cardiac arrhythmias diagnosis was posed through a screening phase,confirmed by a physician.The onset of disability in activities of daily living(ADL)and the changes in several physical performance tests during follow-up were considered as outcomes.Fully-adjusted and propensity-score Cox Proportional Hazard models and mixed models were used for exploring associations between cardiac arrhythmia and the outcomes of interest.Results The prevalence of cardiac arrhythmia at baseline was 23.3%.People reporting cardiac arrhythmia at the baseline were significantly older,more frequently male,smokers and reported a higher presence of all medical conditions investigated(hypertension,heart failure,angina,myocardial infarction,diabetes,stroke),but no difference in dementia,Parkinsonism,cognitive or mood disorder.Cardiac arrhythmia at baseline was significantly associated with the incidence of disability in ADL(HR=1.23;95%:CI:1.01–1.50;P=0.0478 in propensity score analyses;HR=1.28;95%CI:1.01–1.61;P=0.0401 in fully adjusted models).Cardiac arrhythmia at baseline was also associated with a significant worsening in balance test(P=0.0436).Conclusions The presence of cardiac arrhythmia at baseline was associated with a significant higher risk of disability and of worsening in some physical performance tests,particularly those relating to balance.Screening and frequently assessing physical performance in older people affected by cardiac arrhythmia can be important to prevent a loss of physical performance,with further,potential,complications of medical management.展开更多
Objective:This study aimed to examine(1)the independent effects of hypoxia on cognitive function and(2)the effects of exercise on cognition while under hypoxia.Methods:Design:Systematic review with meta-analysis.Data ...Objective:This study aimed to examine(1)the independent effects of hypoxia on cognitive function and(2)the effects of exercise on cognition while under hypoxia.Methods:Design:Systematic review with meta-analysis.Data sources:PubMed,Scopus,Web of Science,PsychInfo,and SPORTDiscus were searched.Eligibility criteria for selecting studies:randomized controlled trials and nonrandomized controlled studies that investigated the effects of chronic or acute exercise on cognition under hypoxia were considered(Aim 2),as were studies investigating the effects of hypoxia on cognition(Aim 1).Results:In total,18 studies met our inclusionary criteria for the systematic review,and 12 studies were meta-analyzed.Exposure to hypoxia impaired attentional ability(standardized mean difference(SMD)=-0.4),executive function(SMD=-0.18),and memory function(SMD=-0.26),but not information processing(SMD=0.27).Aggregated results indicated that performing exercise under a hypoxia setting had a significant effect on cognitive improvement(SMD=0.3,95%confidence interval:0.14-0.45,I^2=54%,p<0.001).Various characteristics(e.g.,age,cognitive task type,exercise type,exercise intensity,training type,and hypoxia level)moderated the effects of hypoxia and exercise on cognitive function.Conclusion:Exercise during exposure to hypoxia improves cognitive function.This association appears to be moderated by individual and exercise/hypoxia-related characteristics.展开更多
Background:Hospitalized patients recovering from coronavirus disease 2019(COVID-19)may experience disability and suffer from significant physical and mental impairment requiring physical rehabilitation following their...Background:Hospitalized patients recovering from coronavirus disease 2019(COVID-19)may experience disability and suffer from significant physical and mental impairment requiring physical rehabilitation following their discharge.However,to date,no attempt has been made to collate and synthesize literature in this area.Objective:This systematic review examines the outcomes of different physical rehabilitation interventions tested in COVID-19 patients who were discharged from hospital.Search strategy:A systematic search of MEDLINE/PubMed,CINAHL,Scopus and medRxiv was conducted to identify articles published up to March 2022.Inclusion criteria:This systematic review included studies of outpatient rehabilitation programs for people recovering from COVID-19 who received physical activity,exercise,or breathing training to enhance or restore functional capacity,pulmonary function,quality of life,and mental health or function.Data extraction and analysis:Selection of included articles,data extraction,and methodological quality assessments were conducted by two review authors respectively,and consensus was reached through discussion and consultation with a third reviewer.Finally,we review the outcomes of studies based on four categories including:(1)functional capacity,(2)pulmonary function,(3)quality of life,and(4)mental health status.Results:A total of 7534 titles and abstracts were screened;10 cohort studies,4 randomized controlled trials and 13 other prospective studies involving 1583 patients were included in our review.Early physical rehabilitation interventions applied in COVID-19 patients who were discharged from the hospital improved multiple parameters related to functional capacity,pulmonary function,quality of life and mental health status.Conclusion:Physical rehabilitation interventions may be safe,feasible and effective in COVID-19 patients discharged from the hospital,and can improve a variety of clinically relevant outcomes.Further studies are warranted to determine the underlying mechanisms.展开更多
The coronavirus disease 2019(COVID-19)pandemic has raised concerns about the mental health and social well-being of youth,including its potential to increase or exacerbate substance use behaviors[1].Among adolescents,...The coronavirus disease 2019(COVID-19)pandemic has raised concerns about the mental health and social well-being of youth,including its potential to increase or exacerbate substance use behaviors[1].Among adolescents,the COVID-19pandemic has resulted in limited face-to-face school contact and thus missed milestones in preventing alcohol and substance use.展开更多
This paper presents a TCAD-based methodology to enable Design-Technology Co-Optimization(DTCO)of advanced semiconductor memories.After reviewing the DTCO approach to semiconductor devices scaling,we introduce a multi-...This paper presents a TCAD-based methodology to enable Design-Technology Co-Optimization(DTCO)of advanced semiconductor memories.After reviewing the DTCO approach to semiconductor devices scaling,we introduce a multi-stage simulation flow to study the deviceto-circuit performance of advanced memory technologies in presence of statistical and process variability.We present a DRAM example to highlight the DTCO enablement for both memory and periphery.Our analysis demonstrates how the evaluation of different possible technology improvements and design combinations can be carried out to maximize the benefits of continuous technology scaling for a given set of manufacturing equipment.展开更多
Background:The choice of unicompartmental knee arthroplasty(UKA)vs.total knee arthroplasty(TKA)in the surgical treatment of knee osteoarthritis(KOA)remains controversial.This study aimed to perform a systematic review...Background:The choice of unicompartmental knee arthroplasty(UKA)vs.total knee arthroplasty(TKA)in the surgical treatment of knee osteoarthritis(KOA)remains controversial.This study aimed to perform a systematic review and meta-analysis of randomized controlled trials(RCTs)to compare the clinical results of UKA and TKA for treating unicompartmental KOA.Methods:PubMed,Embase,and the Cochrane Library were systematically searched for articles published up to January 2,2023.The literature was rigorously screened to include only RCTs comparing UKA and TKA for unicompartmental KOA.A systematic review and meta-analysis were performed to calculate the mean difference(MD),relative risk(RR),and 95%confidence interval(CI)according to the Cochrane standards.Results:Thirteen publications involving 683 UKAs and 683 TKAs were analyzed.Except for one study with a follow-up period of 15 years,all outcome measures reported were within 5 years of follow-up.Meta-analysis showed better knee recovery(MD:1.23;95%CI:1.01–1.45;P<0.001),greater knee function(MD:1.78;95%CI:0.34–3.22;P=0.020),less pain(MD:0.75;95%CI:0.43–1.06;P<0.001),and better health status(MD:3.75;95%CI:0.81–6.69;P=0.010)after UKA than TKA.However,considering the minimal clinically important difference values for these variables,the findings were not clinically relevant.Moreover,UKA patients had fewer complications(RR:0.59;95%CI:0.45–0.78;P<0.001)and shorter hospital stays(MD:–0.89;95%CI:–1.57 to–0.22;P=0.009)than did TKA patients.There were no statistically significant differences in terms of postoperative range of movement,revision,failure,operation time,and patient satisfaction.Conclusions:In terms of clinical efficacy,there was no obvious advantage of UKA over TKA in the surgical treatment of knee OA when considering the minimal clinically important difference.The main advantage of UKA over TKA is that it leads to fewer complications and a shorter length of hospital stay.It is ideal to perform prospective studies with longer follow-up periods to fully evaluate the long-term efficacy and safety of the two procedures in the future.展开更多
Background The patterns of cancer burden in children,adolescents and young adults are distinct from those in the general adult population,underscoring the importance of developing targeted research and interventions.T...Background The patterns of cancer burden in children,adolescents and young adults are distinct from those in the general adult population,underscoring the importance of developing targeted research and interventions.Thus,we analyzed global,regional,and national cancer mortality trends via the World Health Organization(WHO)Mortality Database among children aged 0–14 years and adolescents and young adults aged 15–34 across 77 WHO Member States.Methods Age-standardized country-specific cancer mortality rates(deaths per 100,000)and years of life lost between 1990 and 2021 were estimated via a locally weighted scatterplot smooth curve.We analyzed the associations between socioeconomic indices and mortality rates for 21 types of cancer.Furthermore,we conducted a decomposition analysis to understand the factors influencing mortality rates for these 21 types of cancer.Results Between 1990 and 2021,the age-standardized cancer mortality rate decreased from 12.35%[95%confidence interval(CI)11.81%–12.88%]to 4.83%(95%CI 4.12%–5.54%)by−3.29%per year.However,progress in reducing death rates has been heterogeneous in terms of country income,cancer site,and geography.In particular,the decrease in burden was most pronounced in North America;however,cervical and testicular cancer mortality is elevated in Africa,Latin America,and the Caribbean.While the major contributors to children’s cancer mortality(leukemia,brain,and bone tumors)have remained unchanged for the past three decades,a significant decrease in respiratory tract cancer and an increase in colorectal cancer have led to a transition in the cancer profile in adolescents and young adults.Additionally,infection-related cancers are inversely correlated with socioeconomic indices;notably,colorectal cancer appears to have no correlation with these indices.We also revealed significant changes in mortality trends during the COVID-19 pandemic,which were more pronounced in children.Finally,a decomposition analysis revealed that the decrease in the number of cancer deaths worldwide between 1990 and 2021 may be attributed primarily to age-specific mortality rather than population growth or aging.Conclusions From 1990 to 2021,a significant decreasing trend in cancer mortality in the young population,especially in high-income countries,was observed.However,progress in reducing death rates has been heterogeneous by country income,cancer site,and geography,indicating disparities in control efforts across countries.Future studies are needed to address the exposures responsible for the heterogeneity of cancer burden and the changing cancer profile in this age group.展开更多
Background Adolescent drug use poses significant public health challenges worldwide,with detrimental effects on mental and physical health.Most existing research focuses on Western countries,holding a gap in understan...Background Adolescent drug use poses significant public health challenges worldwide,with detrimental effects on mental and physical health.Most existing research focuses on Western countries,holding a gap in understanding drug use in low-and middle-income countries.Thus,we aimed to assess the prevalence of cannabis and amphetamine or methamphetamine use among school-going adolescents aged 12–15 years across 47 countries globally.Methods We used data from the Global School-based Student Health Survey from 47 countries(2009–2018)to analyze cannabis and amphetamine/methamphetamine use and age at first drug use among adolescents(n=220,362).A meta-analysis utilizing random-effects models estimated prevalence rates and weighted linear regression analyzed trends.Student’s t tests were used to compare two-subgroup categories,while one-way ANOVA was employed for analyses involving the four-subgroup category.Stratification analysis by sex,World Bank income category,region,and country-specific characteristics based on World Health Organization data were also performed.Results The study included a total of 220,362 school-going adolescents aged 12–15 years(49.96%girls)from 47 countries.The overall prevalence of cannabis use was 7.02%[95%confidence interval(CI)6.16–7.89],with higher usage among boys[9.20%(95%CI 8.05–10.36)]compared to girls[4.20%(95%CI 3.68–4.72)].Amphetamine/methamphetamine use prevalence was 4.05%(95%CI 3.51–4.60),also higher among boys[5.14%(95%CI 4.45–5.84)]than girls[2.34%(95%CI 2.00–2.69)].The region of the Americas exhibited the highest prevalence of cannabis use[11.31%(95%CI 8.44–14.17)],while the African region showed the highest prevalence of amphetamine use[4.34%(95%CI 3.14–5.53)].High-income countries reported the highest prevalence of cannabis use[9.45%(95%CI,6.06 to 12.84)],whereas low-income countries had the lowest[3.46%(95%CI 2.01–4.91)].Higher prevalence rates were associated with countries having higher homicide rates,better sanitation services,and higher health expenditures.Conclusions Cannabis use among adolescents is more prevalent than amphetamine or methamphetamine use,with significant sex differences showing higher prevalence among boys.The highest prevalence of cannabis use was observed in Latin America,while Africa exhibited the highest rates of amphetamine use.Findings from the present study indicate a need for public policies and programs targeting adolescents to effectively reduce adolescent drug use.展开更多
Background The coronavirus disease 2019(COVID-19)pandemic,a global health crisis,profoundly impacted all aspects of daily life.Adolescence,a pivotal stage of psychological and social development,is heavily influenced ...Background The coronavirus disease 2019(COVID-19)pandemic,a global health crisis,profoundly impacted all aspects of daily life.Adolescence,a pivotal stage of psychological and social development,is heavily influenced by the psychosocial and socio-cultural context.Hence,it is imperative to thoroughly understand the psychosocial changes adolescents experienced during the pandemic and implement effective management initiatives.Data sources We examined the incidence rates of depressive and anxiety disorders among adolescents aged 10–19 years globally and regionally.We utilized data from the Global Burden of Diseases,Injuries,and Risk Factors Study(GBD)2021 to compare pre-pandemic(2018–2019)and pandemic(2020–2021)periods.Our investigation covered 204 countries and territories across the six World Health Organization regions.We conducted a comprehensive literature search using databases including PubMed/MEDLINE,Scopus,and Google Scholar,employing search terms such as“psychosocial”,“adolescent”,“youth”,“risk factors”,“COVID-19 pandemic”,“prevention”,and“intervention”.Results During the pandemic,the mental health outcomes of adolescents deteriorated,particularly in terms of depressive and anxiety disorders.According to GBD 2021,the incidence rate of anxiety disorders increased from 720.26[95%uncertainty intervals(UI)=548.90–929.19]before the COVID-19 pandemic(2018–2019)to 880.87 per 100,000 people(95%UI=670.43–1132.58)during the COVID-19 pandemic(2020–2021).Similarly,the incidence rate of major depressive disorder increased from 2333.91(95%UI=1626.92–3138.55)before the COVID-19 pandemic to 3030.49 per 100,000 people(95%UI=2096.73–4077.73)during the COVID-19 pandemic.This worsening was notably pronounced in high-income countries(HICs).Rapid environmental changes,including heightened social anxiety,school closures,economic crises,and exacerbated racism,have been shown to adversely affect the mental well-being of adolescents.Conclusions The abrupt shift to remote learning and the absence of in-person social interactions heightened feelings of loneliness,anxiety,sadness,and stress among adolescents.This change magnified existing socioeconomic disparities,posing additional challenges.These complexities profoundly impact adolescents’well-being,especially vulnerable groups like those from HICs,females,and minorities.Acknowledging the underreporting bias in low-to middle-income countries highlights the importance of addressing these mental health alterations in assessments and interventions within these regions as well.Urgent interventions are crucial as the pandemic-induced mental stress may have lasting effects on adolescents’mental health.展开更多
Background Suicide is the second leading cause of death in young people worldwide and is responsible for about 52,000 deaths annually in children and adolescents aged 5-19 years.Familial,social,psychological,and behav...Background Suicide is the second leading cause of death in young people worldwide and is responsible for about 52,000 deaths annually in children and adolescents aged 5-19 years.Familial,social,psychological,and behavioral factors play important roles in suicide risk.As traumatic events such as the COVID-19 pandemic may contribute to suicidal behaviors in young people,there is a need to understand the current status of suicide in adolescents,including its epidemiology,associated factors,the influence of the pandemic,and management initiatives.Data sources We investigated global and regional suicide mortality rates among children and adolescents aged 5-19 years using data from the Global Burden of Diseases,Injuries,and Risk Factors Study(GBD)2019.The suicide mortality rates from 1990 to 2019 were examined in 204 countries and territories across six World Health Organization(WHO)regions.Additionally,we utilized electronic databases,including PubMed/MEDLINE and Scopus,and employed various combinations of terms such as“suicide”,“adolescents”,“youth”,“children”,“risk factors”,“COVID-19 pandemic”,“prevention”,and“intervention”to provide a narrative review on suicide within the pediatric population in the post-pandemic era.Results Despite the decreasing trend in the global suicide mortality rate from 1990 to 2019,it remains high.The mortality rates from suicide by firearms or any other specified means were both greater in males.Additionally,Southeast Asia had the highest suicide rate among the six WHO regions.The COVID-19 pandemic seems to contribute to suicide risk in young people;thus,there is still a strong need to revisit appropriate management for suicidal children and adolescents during the pandemic.Conclusions The current narrative review integrates up-to-date knowledge on suicide epidemiology and the effects of the COVID-19 pandemic,risk factors,and intervention strategies.Although numerous studies have characterized trends in suicide among young people during the pre-pandemic era,further studies are required to investigate suicide during the pandemic and new strategies for suicide prevention in the post-pandemic era.It is necessary to identify effective prevention strategies targeting young people,particularly those at high risk,and successful treatment for individuals already manifesting suicidal behaviors.Care for suicidal children and adolescents should be improved with parental,school,community,and clinical involvement.展开更多
Introduction Antibiotic use for acute otitis media(AOM)is one of the major sources of antimicrobial resistance.However,the effective minimal antibiotic duration for AOM remains unclear.Moreover,guidelines often recomm...Introduction Antibiotic use for acute otitis media(AOM)is one of the major sources of antimicrobial resistance.However,the effective minimal antibiotic duration for AOM remains unclear.Moreover,guidelines often recommend broad ranges(5-10 days)of antibiotic use,yet the clinical impact of such a wide window has not been assessed.Methods We systematically searched PubMed/MEDLINE,Embase,Scopus,Web of Science,and Cochrane Library from database inception to 6 October 2021.Network meta-analysis was conducted on randomized controlled trials that assessed antibiotic treatment for AOM in children(PROSPERO CRD42020196107).Results For amoxicillin and amoxicillin-clavulanate,7-day regimens were noninferior to 10-day regimens in clinical responses[amoxicillin:risk ratio(RR)0.919(95%CI 0.820-1.031),amoxicillin-clavulanate:RR 1.108(0.957-1.282)],except for≤2 years.For the third-generation cephalosporins,7-day and 10-day regimens had similar clinical responses compared to placebo[7-day:RR 1.420(1.190-1.694),10-day:RR 1.238(1.125-1.362)compared to placebo].However,5-day regimens of amoxicillin-clavulanate and third-generation cephalosporins were inferior to 10-day regimens.Compared to amoxicillin,a shorter treatment duration was tolerable with amoxicillin-clavulanate.Conclusions Our findings indicated that 1O days of antibiotic use may be unnecessarily long,while the treatment duration should be longer than 5 days.Otherwise,5-day regimens would be sufficient for a modest treatment goal.Our findings revealed that the current wide range of recommended antibiotic durations may have influenced the clinical outcome of AOM,and a narrower antibiotic duration window should be re-established.展开更多
Background The exact influence of the COVID-19 pandemic on sexual intercourse and usage of contraception remains largely uncharted territory.To bridge this gap in knowledge,we conducted a comprehensive,cross-sectional...Background The exact influence of the COVID-19 pandemic on sexual intercourse and usage of contraception remains largely uncharted territory.To bridge this gap in knowledge,we conducted a comprehensive,cross-sectional examination of long-term trends in the prevalence of sexual intercourse and usage of contraception among South Korean adolescents from 2006 to 2022.Methods In our research,we drew upon data encompassing 1,138,799 South Korean adolescents aged 12 to 18 years,derived from the Korean Youth Risk Behavior Web-based Survey(KYRBS)over a period spanning from 2006 to 2022.We focused on the prevalence of sexual intercourse,contraception utilization,and the underlying associated factors among this demographic.The KYRBS data was collected using a complex sampling strategy to determine the national prevalence estimates and shifts in prevalence before(2006-2019)and during(2020-2022)the COVID-19 pandemic era.Results During the pre-pandemic period,a decrease in adolescent sexual intercourse was observed(6.34%in 2006,5.53%in 2012,and 5.87%in 2019).However,in the post-pandemic period(2020-2022),there was a surge in sexual intercourse(4.55%in 2020 and 6.20%in 2022).This evident alteration in sexual intercourse trajectory between pre-and post-pandemic periods was statistically significant[βdiff,0.950;95%confidence interval(CI),0.756-1.144].Regarding contraceptive use among South Korean adolescents,there was an increase in the pre-COVID-19 pandemic phase across all demographic segments(14.61%in 2006,22.30%in 2012,and 47.69%in 2022)but a notable decline when compared with the pre-and post-pandemic periods(βdiff,-0.319;95%CI,-0.454 to-0.184).Additionally,during the study period,a decrease in sexual intercourse was observed in the pre-pandemic period(β,-0.129;95%CI,-0.148 to-0.110),followed by an increase in the post-pandemic period(β,0.821;95%CI,0.627 to 1.014).This shift is highlighted by an effect size of 0.96[weighted odds ratio(wOR);95%CI,0.92 to 1.00],indicating a substantial change in adolescent sexual behaviors across study periods.Conclusions The increase in sexual intercourse and decrease in usage of contraception observed in our study between the pre-and post-COVID-19 periods suggests a potential threat to sexual health among South Korean adolescents.This trend emphasizes the ongoing necessity of raising awareness about adolescent sexual behavior in South Korea.展开更多
Background Researches on the mental health of Korean adolescents during COVID-19 have largely focused on those from monocultural families,but there is limited data on sadness,suicidal ideation,and suicide attempts in ...Background Researches on the mental health of Korean adolescents during COVID-19 have largely focused on those from monocultural families,but there is limited data on sadness,suicidal ideation,and suicide attempts in multicultural adolescents.Methods This nationwide serial cross-sectional study included 688,708 adolescents aged 12–18 years who participated in the Korean Youth Risk Behavior Web-based Survey from 2011 to 2022.We compared and analyzed the prevalence of sadness,suicidal ideation,and suicide attempts among multicultural and monocultural adolescents.Multicultural adolescents were defined as those with at least one non-Korean parent.Results In 2021,the prevalence of sadness among multicultural adolescents was 31.86%[95%confidence interval(CI)30.00–33.71],suicidal ideation 17.17%(15.74–18.61),and suicide attempts 4.25%(3.51–4.99).Among monocultural adolescents,the prevalence rates were 26.09%(25.50–26.69)for sadness,12.41%(11.97–12.85)for suicidal ideation,and 1.92%(1.76–2.67)for suicide attempts.Adolescents from multicultural backgrounds were found to have higher rates of sadness,suicidal ideation,and suicide attempts.In the general population,these rates had decreased during the pre-pandemic period but increased after the onset of the pandemic then stabilized from 2020 to 2021.Female gender,smoking,alcohol use,and low school performance emerged as significant risk factors.However,no distinct risk factors specifically linked to suicide attempts were identified.Joinpoint regression analysis results aligned with the beta slope values in the main findings,reflecting a consistent pattern across both analyses.Conclusions This study revealed that sadness,suicidal ideation,and suicide attempts increased during the pandemic,reversing a pre-pandemic decline.Multicultural adolescents faced these issues more than monocultural ones,underlining the need for targeted public health measures to support at-risk adolescents during pandemics.展开更多
Background Although smoking is classified as a risk factor for severe COVID-19 outcomes,there is a scarcity of studies on prevalence of smoking during the COVID-19 pandemic.Thus,this study aims to analyze the trends o...Background Although smoking is classified as a risk factor for severe COVID-19 outcomes,there is a scarcity of studies on prevalence of smoking during the COVID-19 pandemic.Thus,this study aims to analyze the trends of prevalence of smoking in adolescents over the COVID-19 pandemic period.Methods The present study used data from middle to high school adolescents between 2005 and 2021 who participated in the Korea Youth Risk Behavior Web-based Survey(KYRBS).We evaluated the smoking prevalence(ever or daily)by year groups and estimated the slope in smoking prevalence before and during the pandemic.Results A total of 1,137,823 adolescents participated in the study[mean age,15.04 years[95%confidence interval(CI)15.03-15.06];and male,52.4%(95%CI 51.7-53.1)].The prevalence of ever smokers was 27.7%(95%CI 27.3-28.1)between 2005 and 2008 but decreased to 9.8%(95%CI 9.3-10.3)in 2021.A consistent trend was found in daily smokers,as the estimates decreased from 5.4%(95%CI 5.2-5.6)between 2005 and 2008 to 2.3%(95%CI 2.1-2.5)in 2021.However,the downward slope in the overall prevalence of ever smokers and daily smokers became less pronounced in the COVID-19 pandemic period than in the pre-pandemic period.In the subgroup with substance use,the decreasing slope in daily smokers was significantly more pronounced during the pandemic than during the pre-pandemic period.Conclusions The proportion of ever smokers and daily smokers showed a less pronounced decreasing trend during the pandemic.The findings of our study provide an overall understanding of the pandemic's impact on smoking prevalence in adolescents.展开更多
Background Although previous studies have provided data on early pandemic periods of alcohol and substance use in adolescents,more adequate studies are needed to predict the trends of alcohol and substance use during ...Background Although previous studies have provided data on early pandemic periods of alcohol and substance use in adolescents,more adequate studies are needed to predict the trends of alcohol and substance use during recent periods,including the mid-pandemic period.This study investigated the changes in alcohol and substance use,except tobacco use,throughout the pre-,early-,and mid-pandemic periods in adolescents using a nationwide serial cross-sectional survey from South Korea.Methods Data on 1,109,776 Korean adolescents aged 13–18 years from 2005 to 2021 were obtained in a survey operated by the Korea Disease Control and Prevention Agency.We evaluated adolescents’alcohol and substance consumption prevalence and compared the slope of alcohol and substance prevalence before and during the COVID-19 pandemic to see the trend changes.We define the pre-COVID-19 period as consisting of four groups of consecutive years(2005–2008,2009–2012,2013–2015,and 2016–2019).The COVID-19 pandemic period is composed of 2020(early-pandemic era)and 2021(midpandemic era).Results More than a million adolescents successfully met the inclusion criteria.The weighted prevalence of current alcohol use was 26.8%[95%confidence interval(CI)26.4–27.1]from 2005 to 2008 and 10.5%(95%CI 10.1–11.0)in 2020 and 2021.The weighted prevalence of substance use was 1.1%(95%CI 1.1–1.2)from 2005 to 2008 and 0.7%(95%CI 0.6–0.7)between 2020 and 2021.From 2005 to 2021,the overall trend of use of both alcohol and drugs was found to decrease,but the decline has slowed since COVID-19 epidemic(current alcohol use:βdiff 0.167;95%CI 0.150–0.184;substance use:βdiff 0.152;95%CI 0.110–0.194).The changes in the slope of current alcohol and substance use showed a consistent slowdown with regard to sex,grade,residence area,and smoking status from 2005 to 2021.Conclusion The overall prevalence of alcohol consumption and substance use among over one million Korean adolescents from the early and mid-stage(2020–2021)of the COVID-19 pandemic showed a slower decline than expected given the increase during the prepandemic period(2005–2019).展开更多
基金supported by the Basic Science Research Program through the National Research Foundation of Korea,funded by the Ministry of Education(RS-2024-00460379).
文摘Objective Despite the global decrease in influenza infections during the coronavirus disease 2019(COVID-19)pandemic,seasonal influenza remains a significant health issue.South Korea,known for its robust pandemic response and high influenza vaccination rates,offers a unique context for examining changes in vaccination trends during the pandemic.Using nationally representative data,we aimed to understand the impact of the pandemic on influenza vaccination behavior over a 12-year period and to identify vulnerable groups.Methods We analyzed influenza vaccination rates in South Korea between 2011-2022,focusing on pandemic-related impacts.The data of 2,426,139 adults(≥19 years)from the Korea Community Health Survey were used to assess demographic and sociological factors influencing vaccination behaviors.Results We observed an increase in influenza vaccination rates during the pre-COVID-19 period from 2011-2013(weighted prevalence:46.68%[95%confidence interval(CI):46.55-46.82])to 2017-2019(weighted prevalence:52.50%[95%CI:52.38-52.63]).However,a significant decline was observed in 2022,the late-COVID-19 pandemic period(weighted prevalence:55.78%[95%CI:55.56-56.01]),compared with the mid-pandemic period in 2021(weighted prevalence:59.12%[95%CI:58.91-59.32]),particularly among populations traditionally prioritized for influenza vaccination,including older adults(≥65 years)and patients with chronic diseases and low educational and income levels.Conclusion The influenza vaccination rate in South Korea was significantly affected by the COVID-19 pandemic,showing a notable decrease among vulnerable demographic groups.This suggests the need for targeted public health strategies to address vaccine hesitancy and improve vaccination rates,particularly among high-risk populations.
文摘Purpose:The aim of the present study was to assess both the credibility and strength of evidence arising from systematic reviews with meta-analyses of observational studies on handgrip strength and health outcomes.Methods:An umbrella review of systematic reviews with meta-analyses of observational studies was conducted.We assessed meta-analyses of observational studies based on random-effect summary effect sizes and their p values,95%prediction intervals,heterogeneity,small-study effects,and excess significance.We graded the evidence from convincing(Class I)to weak(Class IV).Results:From 504 articles returned in a search of the literature,8 systematic reviews were included in our review,with a total of 11 outcomes.Overall,nine of the 11 of the outcomes reported nominally significant summary results(p<0.05),with 4 associations surviving the application of the more stringent p value(p<106).No outcome presented convincing evidence.Three associations showed Class II evidence(i.e.,highly suggestive):(1)higher handgrip values at baseline were associated with a minor reduction in mortality risk in the general population(n=34 studies;sample size=1,855,817;relative risk=0.72,95%confidence interval(95%CI):0.670.78),(2)cardiovascular death risk in mixed populations(n=15 studies;relative risk=0.84,95%CI:0.780.91),and(3)incidence of disability(n=7 studies;relative risk=0.76,95%CI:0.660.87).Conclusion:The present results show that handgrip strength is a useful indicator for general health status and specifically for early all-cause and cardiovascular mortality,as well as disability.To further inform intervention strategies,future research is now required to fully understand mechanisms linking handgrip strength scores to these health outcomes.
基金The Italian National Research Council(CNR)supported the ILSA project from 1991 to 1998 as part of the“Progetto Finalizzato Invecchiamento”Since 1999,the Italian CNR,the“Biology of Aging”Strategic Project and the Ministero della Sanità,through the program“Epidemiology of the Elderly”of the Istituto Superiore di Sanitàand the“Estimates of Health Needs of the Elderly”Special Programme of the Tuscany Region have been supporting the ILSA project.
文摘Background Cardiac arrhythmias are common conditions in older people.Unfortunately,there is limited literature on associations between cardiac arrhythmias and physical performance or disability.We therefore aimed to prospectively investigate associations between cardiac arrhythmias and changes in disability and physical performance during 8 years of follow-up,using data from the Italian Longitudinal Study on Aging(ILSA).Methods Cardiac arrhythmias diagnosis was posed through a screening phase,confirmed by a physician.The onset of disability in activities of daily living(ADL)and the changes in several physical performance tests during follow-up were considered as outcomes.Fully-adjusted and propensity-score Cox Proportional Hazard models and mixed models were used for exploring associations between cardiac arrhythmia and the outcomes of interest.Results The prevalence of cardiac arrhythmia at baseline was 23.3%.People reporting cardiac arrhythmia at the baseline were significantly older,more frequently male,smokers and reported a higher presence of all medical conditions investigated(hypertension,heart failure,angina,myocardial infarction,diabetes,stroke),but no difference in dementia,Parkinsonism,cognitive or mood disorder.Cardiac arrhythmia at baseline was significantly associated with the incidence of disability in ADL(HR=1.23;95%:CI:1.01–1.50;P=0.0478 in propensity score analyses;HR=1.28;95%CI:1.01–1.61;P=0.0401 in fully adjusted models).Cardiac arrhythmia at baseline was also associated with a significant worsening in balance test(P=0.0436).Conclusions The presence of cardiac arrhythmia at baseline was associated with a significant higher risk of disability and of worsening in some physical performance tests,particularly those relating to balance.Screening and frequently assessing physical performance in older people affected by cardiac arrhythmia can be important to prevent a loss of physical performance,with further,potential,complications of medical management.
基金supported by grants from the National Natural Science Foundation of China(Grant#31671150)Guangdong Province Key Project(Grant#2018B030335001).
文摘Objective:This study aimed to examine(1)the independent effects of hypoxia on cognitive function and(2)the effects of exercise on cognition while under hypoxia.Methods:Design:Systematic review with meta-analysis.Data sources:PubMed,Scopus,Web of Science,PsychInfo,and SPORTDiscus were searched.Eligibility criteria for selecting studies:randomized controlled trials and nonrandomized controlled studies that investigated the effects of chronic or acute exercise on cognition under hypoxia were considered(Aim 2),as were studies investigating the effects of hypoxia on cognition(Aim 1).Results:In total,18 studies met our inclusionary criteria for the systematic review,and 12 studies were meta-analyzed.Exposure to hypoxia impaired attentional ability(standardized mean difference(SMD)=-0.4),executive function(SMD=-0.18),and memory function(SMD=-0.26),but not information processing(SMD=0.27).Aggregated results indicated that performing exercise under a hypoxia setting had a significant effect on cognitive improvement(SMD=0.3,95%confidence interval:0.14-0.45,I^2=54%,p<0.001).Various characteristics(e.g.,age,cognitive task type,exercise type,exercise intensity,training type,and hypoxia level)moderated the effects of hypoxia and exercise on cognitive function.Conclusion:Exercise during exposure to hypoxia improves cognitive function.This association appears to be moderated by individual and exercise/hypoxia-related characteristics.
文摘Background:Hospitalized patients recovering from coronavirus disease 2019(COVID-19)may experience disability and suffer from significant physical and mental impairment requiring physical rehabilitation following their discharge.However,to date,no attempt has been made to collate and synthesize literature in this area.Objective:This systematic review examines the outcomes of different physical rehabilitation interventions tested in COVID-19 patients who were discharged from hospital.Search strategy:A systematic search of MEDLINE/PubMed,CINAHL,Scopus and medRxiv was conducted to identify articles published up to March 2022.Inclusion criteria:This systematic review included studies of outpatient rehabilitation programs for people recovering from COVID-19 who received physical activity,exercise,or breathing training to enhance or restore functional capacity,pulmonary function,quality of life,and mental health or function.Data extraction and analysis:Selection of included articles,data extraction,and methodological quality assessments were conducted by two review authors respectively,and consensus was reached through discussion and consultation with a third reviewer.Finally,we review the outcomes of studies based on four categories including:(1)functional capacity,(2)pulmonary function,(3)quality of life,and(4)mental health status.Results:A total of 7534 titles and abstracts were screened;10 cohort studies,4 randomized controlled trials and 13 other prospective studies involving 1583 patients were included in our review.Early physical rehabilitation interventions applied in COVID-19 patients who were discharged from the hospital improved multiple parameters related to functional capacity,pulmonary function,quality of life and mental health status.Conclusion:Physical rehabilitation interventions may be safe,feasible and effective in COVID-19 patients discharged from the hospital,and can improve a variety of clinically relevant outcomes.Further studies are warranted to determine the underlying mechanisms.
基金supported by a grant of the Korea Health Technology R&D Project through the Korea Health Industry Development Institute(KHIDI)funded by the Ministry of Health&WelfareRepublic of Korea[grant number:HV22C0233]。
文摘The coronavirus disease 2019(COVID-19)pandemic has raised concerns about the mental health and social well-being of youth,including its potential to increase or exacerbate substance use behaviors[1].Among adolescents,the COVID-19pandemic has resulted in limited face-to-face school contact and thus missed milestones in preventing alcohol and substance use.
文摘This paper presents a TCAD-based methodology to enable Design-Technology Co-Optimization(DTCO)of advanced semiconductor memories.After reviewing the DTCO approach to semiconductor devices scaling,we introduce a multi-stage simulation flow to study the deviceto-circuit performance of advanced memory technologies in presence of statistical and process variability.We present a DRAM example to highlight the DTCO enablement for both memory and periphery.Our analysis demonstrates how the evaluation of different possible technology improvements and design combinations can be carried out to maximize the benefits of continuous technology scaling for a given set of manufacturing equipment.
基金This work was supported by the National Natural Science Foundation of China(Nos.82072506,82272611,92268115)National Key R&D Program of China(No.2019YFA0111900)+6 种基金Provincial Clinical Medical Technology Innovation Project of Hunan(Nos.2023SK2024,2020SK53709)Hunan Young Talents of Science and Technology(No.2021RC3025)Provincial Natural Science Foundation of Hunan(No.20203060)National Natural Science Foundation of Hunan Province(No.2023JJ30949)Program of Health Commission of Hunan Province(No.202204074879)Wu Jieping Medical Foundation(No.320.6750.2020-03-14)National Clinical Research Center for Geriatric Disorders(Xiangya Hospital,Nos.2021KFJJ02,2021LNJJ05).
文摘Background:The choice of unicompartmental knee arthroplasty(UKA)vs.total knee arthroplasty(TKA)in the surgical treatment of knee osteoarthritis(KOA)remains controversial.This study aimed to perform a systematic review and meta-analysis of randomized controlled trials(RCTs)to compare the clinical results of UKA and TKA for treating unicompartmental KOA.Methods:PubMed,Embase,and the Cochrane Library were systematically searched for articles published up to January 2,2023.The literature was rigorously screened to include only RCTs comparing UKA and TKA for unicompartmental KOA.A systematic review and meta-analysis were performed to calculate the mean difference(MD),relative risk(RR),and 95%confidence interval(CI)according to the Cochrane standards.Results:Thirteen publications involving 683 UKAs and 683 TKAs were analyzed.Except for one study with a follow-up period of 15 years,all outcome measures reported were within 5 years of follow-up.Meta-analysis showed better knee recovery(MD:1.23;95%CI:1.01–1.45;P<0.001),greater knee function(MD:1.78;95%CI:0.34–3.22;P=0.020),less pain(MD:0.75;95%CI:0.43–1.06;P<0.001),and better health status(MD:3.75;95%CI:0.81–6.69;P=0.010)after UKA than TKA.However,considering the minimal clinically important difference values for these variables,the findings were not clinically relevant.Moreover,UKA patients had fewer complications(RR:0.59;95%CI:0.45–0.78;P<0.001)and shorter hospital stays(MD:–0.89;95%CI:–1.57 to–0.22;P=0.009)than did TKA patients.There were no statistically significant differences in terms of postoperative range of movement,revision,failure,operation time,and patient satisfaction.Conclusions:In terms of clinical efficacy,there was no obvious advantage of UKA over TKA in the surgical treatment of knee OA when considering the minimal clinically important difference.The main advantage of UKA over TKA is that it leads to fewer complications and a shorter length of hospital stay.It is ideal to perform prospective studies with longer follow-up periods to fully evaluate the long-term efficacy and safety of the two procedures in the future.
基金supported by the MSIT(Ministry of Science and ICT),South Korea,under the ITRC(Information Technology Research Center)support program(IITP-2024-RS-2024-00438239)supervised by the IITP(Institute for Information and Communications Technology Planning and Evaluation,RS-2024-00509257,Global AI Frontier Lab).
文摘Background The patterns of cancer burden in children,adolescents and young adults are distinct from those in the general adult population,underscoring the importance of developing targeted research and interventions.Thus,we analyzed global,regional,and national cancer mortality trends via the World Health Organization(WHO)Mortality Database among children aged 0–14 years and adolescents and young adults aged 15–34 across 77 WHO Member States.Methods Age-standardized country-specific cancer mortality rates(deaths per 100,000)and years of life lost between 1990 and 2021 were estimated via a locally weighted scatterplot smooth curve.We analyzed the associations between socioeconomic indices and mortality rates for 21 types of cancer.Furthermore,we conducted a decomposition analysis to understand the factors influencing mortality rates for these 21 types of cancer.Results Between 1990 and 2021,the age-standardized cancer mortality rate decreased from 12.35%[95%confidence interval(CI)11.81%–12.88%]to 4.83%(95%CI 4.12%–5.54%)by−3.29%per year.However,progress in reducing death rates has been heterogeneous in terms of country income,cancer site,and geography.In particular,the decrease in burden was most pronounced in North America;however,cervical and testicular cancer mortality is elevated in Africa,Latin America,and the Caribbean.While the major contributors to children’s cancer mortality(leukemia,brain,and bone tumors)have remained unchanged for the past three decades,a significant decrease in respiratory tract cancer and an increase in colorectal cancer have led to a transition in the cancer profile in adolescents and young adults.Additionally,infection-related cancers are inversely correlated with socioeconomic indices;notably,colorectal cancer appears to have no correlation with these indices.We also revealed significant changes in mortality trends during the COVID-19 pandemic,which were more pronounced in children.Finally,a decomposition analysis revealed that the decrease in the number of cancer deaths worldwide between 1990 and 2021 may be attributed primarily to age-specific mortality rather than population growth or aging.Conclusions From 1990 to 2021,a significant decreasing trend in cancer mortality in the young population,especially in high-income countries,was observed.However,progress in reducing death rates has been heterogeneous by country income,cancer site,and geography,indicating disparities in control efforts across countries.Future studies are needed to address the exposures responsible for the heterogeneity of cancer burden and the changing cancer profile in this age group.
基金supported by the MSIT(Ministry of Science and ICT),Korea,under the ITRC(Information Technology Research Center)support program(IITP-2024-RS-2024-00438239)supervised by the IITP(Institute for Information&Communications Technology Planning&Evaluation)and AI Excellence Global Innovative Leader Education Program(RS-2022-00143911).
文摘Background Adolescent drug use poses significant public health challenges worldwide,with detrimental effects on mental and physical health.Most existing research focuses on Western countries,holding a gap in understanding drug use in low-and middle-income countries.Thus,we aimed to assess the prevalence of cannabis and amphetamine or methamphetamine use among school-going adolescents aged 12–15 years across 47 countries globally.Methods We used data from the Global School-based Student Health Survey from 47 countries(2009–2018)to analyze cannabis and amphetamine/methamphetamine use and age at first drug use among adolescents(n=220,362).A meta-analysis utilizing random-effects models estimated prevalence rates and weighted linear regression analyzed trends.Student’s t tests were used to compare two-subgroup categories,while one-way ANOVA was employed for analyses involving the four-subgroup category.Stratification analysis by sex,World Bank income category,region,and country-specific characteristics based on World Health Organization data were also performed.Results The study included a total of 220,362 school-going adolescents aged 12–15 years(49.96%girls)from 47 countries.The overall prevalence of cannabis use was 7.02%[95%confidence interval(CI)6.16–7.89],with higher usage among boys[9.20%(95%CI 8.05–10.36)]compared to girls[4.20%(95%CI 3.68–4.72)].Amphetamine/methamphetamine use prevalence was 4.05%(95%CI 3.51–4.60),also higher among boys[5.14%(95%CI 4.45–5.84)]than girls[2.34%(95%CI 2.00–2.69)].The region of the Americas exhibited the highest prevalence of cannabis use[11.31%(95%CI 8.44–14.17)],while the African region showed the highest prevalence of amphetamine use[4.34%(95%CI 3.14–5.53)].High-income countries reported the highest prevalence of cannabis use[9.45%(95%CI,6.06 to 12.84)],whereas low-income countries had the lowest[3.46%(95%CI 2.01–4.91)].Higher prevalence rates were associated with countries having higher homicide rates,better sanitation services,and higher health expenditures.Conclusions Cannabis use among adolescents is more prevalent than amphetamine or methamphetamine use,with significant sex differences showing higher prevalence among boys.The highest prevalence of cannabis use was observed in Latin America,while Africa exhibited the highest rates of amphetamine use.Findings from the present study indicate a need for public policies and programs targeting adolescents to effectively reduce adolescent drug use.
基金supported by the National Research Foundation of Korea grant funded by the Korea government(MSIT,RS-2023-00248157)The funding agencies had no role in the design and conduct of the study+2 种基金collection,management,analysis,or interpretation of the datapreparation,review,or approval of the manuscriptor the decision to submit the manuscript for publication.
文摘Background The coronavirus disease 2019(COVID-19)pandemic,a global health crisis,profoundly impacted all aspects of daily life.Adolescence,a pivotal stage of psychological and social development,is heavily influenced by the psychosocial and socio-cultural context.Hence,it is imperative to thoroughly understand the psychosocial changes adolescents experienced during the pandemic and implement effective management initiatives.Data sources We examined the incidence rates of depressive and anxiety disorders among adolescents aged 10–19 years globally and regionally.We utilized data from the Global Burden of Diseases,Injuries,and Risk Factors Study(GBD)2021 to compare pre-pandemic(2018–2019)and pandemic(2020–2021)periods.Our investigation covered 204 countries and territories across the six World Health Organization regions.We conducted a comprehensive literature search using databases including PubMed/MEDLINE,Scopus,and Google Scholar,employing search terms such as“psychosocial”,“adolescent”,“youth”,“risk factors”,“COVID-19 pandemic”,“prevention”,and“intervention”.Results During the pandemic,the mental health outcomes of adolescents deteriorated,particularly in terms of depressive and anxiety disorders.According to GBD 2021,the incidence rate of anxiety disorders increased from 720.26[95%uncertainty intervals(UI)=548.90–929.19]before the COVID-19 pandemic(2018–2019)to 880.87 per 100,000 people(95%UI=670.43–1132.58)during the COVID-19 pandemic(2020–2021).Similarly,the incidence rate of major depressive disorder increased from 2333.91(95%UI=1626.92–3138.55)before the COVID-19 pandemic to 3030.49 per 100,000 people(95%UI=2096.73–4077.73)during the COVID-19 pandemic.This worsening was notably pronounced in high-income countries(HICs).Rapid environmental changes,including heightened social anxiety,school closures,economic crises,and exacerbated racism,have been shown to adversely affect the mental well-being of adolescents.Conclusions The abrupt shift to remote learning and the absence of in-person social interactions heightened feelings of loneliness,anxiety,sadness,and stress among adolescents.This change magnified existing socioeconomic disparities,posing additional challenges.These complexities profoundly impact adolescents’well-being,especially vulnerable groups like those from HICs,females,and minorities.Acknowledging the underreporting bias in low-to middle-income countries highlights the importance of addressing these mental health alterations in assessments and interventions within these regions as well.Urgent interventions are crucial as the pandemic-induced mental stress may have lasting effects on adolescents’mental health.
基金supported by the National Research Foundation of Korea(NRF)grant funded by the Korean government(MSIT,RS-2023-00248157).The funding agencies had no role in the design and conduct of the study,collection,management,analysis,or interpretation of the data,preparation,review,or approval of the manuscript,or the decision to submit the manuscript for publication.
文摘Background Suicide is the second leading cause of death in young people worldwide and is responsible for about 52,000 deaths annually in children and adolescents aged 5-19 years.Familial,social,psychological,and behavioral factors play important roles in suicide risk.As traumatic events such as the COVID-19 pandemic may contribute to suicidal behaviors in young people,there is a need to understand the current status of suicide in adolescents,including its epidemiology,associated factors,the influence of the pandemic,and management initiatives.Data sources We investigated global and regional suicide mortality rates among children and adolescents aged 5-19 years using data from the Global Burden of Diseases,Injuries,and Risk Factors Study(GBD)2019.The suicide mortality rates from 1990 to 2019 were examined in 204 countries and territories across six World Health Organization(WHO)regions.Additionally,we utilized electronic databases,including PubMed/MEDLINE and Scopus,and employed various combinations of terms such as“suicide”,“adolescents”,“youth”,“children”,“risk factors”,“COVID-19 pandemic”,“prevention”,and“intervention”to provide a narrative review on suicide within the pediatric population in the post-pandemic era.Results Despite the decreasing trend in the global suicide mortality rate from 1990 to 2019,it remains high.The mortality rates from suicide by firearms or any other specified means were both greater in males.Additionally,Southeast Asia had the highest suicide rate among the six WHO regions.The COVID-19 pandemic seems to contribute to suicide risk in young people;thus,there is still a strong need to revisit appropriate management for suicidal children and adolescents during the pandemic.Conclusions The current narrative review integrates up-to-date knowledge on suicide epidemiology and the effects of the COVID-19 pandemic,risk factors,and intervention strategies.Although numerous studies have characterized trends in suicide among young people during the pre-pandemic era,further studies are required to investigate suicide during the pandemic and new strategies for suicide prevention in the post-pandemic era.It is necessary to identify effective prevention strategies targeting young people,particularly those at high risk,and successful treatment for individuals already manifesting suicidal behaviors.Care for suicidal children and adolescents should be improved with parental,school,community,and clinical involvement.
文摘Introduction Antibiotic use for acute otitis media(AOM)is one of the major sources of antimicrobial resistance.However,the effective minimal antibiotic duration for AOM remains unclear.Moreover,guidelines often recommend broad ranges(5-10 days)of antibiotic use,yet the clinical impact of such a wide window has not been assessed.Methods We systematically searched PubMed/MEDLINE,Embase,Scopus,Web of Science,and Cochrane Library from database inception to 6 October 2021.Network meta-analysis was conducted on randomized controlled trials that assessed antibiotic treatment for AOM in children(PROSPERO CRD42020196107).Results For amoxicillin and amoxicillin-clavulanate,7-day regimens were noninferior to 10-day regimens in clinical responses[amoxicillin:risk ratio(RR)0.919(95%CI 0.820-1.031),amoxicillin-clavulanate:RR 1.108(0.957-1.282)],except for≤2 years.For the third-generation cephalosporins,7-day and 10-day regimens had similar clinical responses compared to placebo[7-day:RR 1.420(1.190-1.694),10-day:RR 1.238(1.125-1.362)compared to placebo].However,5-day regimens of amoxicillin-clavulanate and third-generation cephalosporins were inferior to 10-day regimens.Compared to amoxicillin,a shorter treatment duration was tolerable with amoxicillin-clavulanate.Conclusions Our findings indicated that 1O days of antibiotic use may be unnecessarily long,while the treatment duration should be longer than 5 days.Otherwise,5-day regimens would be sufficient for a modest treatment goal.Our findings revealed that the current wide range of recommended antibiotic durations may have influenced the clinical outcome of AOM,and a narrower antibiotic duration window should be re-established.
基金supported by the National Research Foundation of Korea(NRF)grant funded by the Korea government(MSIT,RS-2023-00248157).
文摘Background The exact influence of the COVID-19 pandemic on sexual intercourse and usage of contraception remains largely uncharted territory.To bridge this gap in knowledge,we conducted a comprehensive,cross-sectional examination of long-term trends in the prevalence of sexual intercourse and usage of contraception among South Korean adolescents from 2006 to 2022.Methods In our research,we drew upon data encompassing 1,138,799 South Korean adolescents aged 12 to 18 years,derived from the Korean Youth Risk Behavior Web-based Survey(KYRBS)over a period spanning from 2006 to 2022.We focused on the prevalence of sexual intercourse,contraception utilization,and the underlying associated factors among this demographic.The KYRBS data was collected using a complex sampling strategy to determine the national prevalence estimates and shifts in prevalence before(2006-2019)and during(2020-2022)the COVID-19 pandemic era.Results During the pre-pandemic period,a decrease in adolescent sexual intercourse was observed(6.34%in 2006,5.53%in 2012,and 5.87%in 2019).However,in the post-pandemic period(2020-2022),there was a surge in sexual intercourse(4.55%in 2020 and 6.20%in 2022).This evident alteration in sexual intercourse trajectory between pre-and post-pandemic periods was statistically significant[βdiff,0.950;95%confidence interval(CI),0.756-1.144].Regarding contraceptive use among South Korean adolescents,there was an increase in the pre-COVID-19 pandemic phase across all demographic segments(14.61%in 2006,22.30%in 2012,and 47.69%in 2022)but a notable decline when compared with the pre-and post-pandemic periods(βdiff,-0.319;95%CI,-0.454 to-0.184).Additionally,during the study period,a decrease in sexual intercourse was observed in the pre-pandemic period(β,-0.129;95%CI,-0.148 to-0.110),followed by an increase in the post-pandemic period(β,0.821;95%CI,0.627 to 1.014).This shift is highlighted by an effect size of 0.96[weighted odds ratio(wOR);95%CI,0.92 to 1.00],indicating a substantial change in adolescent sexual behaviors across study periods.Conclusions The increase in sexual intercourse and decrease in usage of contraception observed in our study between the pre-and post-COVID-19 periods suggests a potential threat to sexual health among South Korean adolescents.This trend emphasizes the ongoing necessity of raising awareness about adolescent sexual behavior in South Korea.
基金supported by the National Research Foundation of Korea(NRF)grant funded by the Korean Government(MSIT,RS-2023-00248157)the MSIT(Ministry of Science and ICT),Korea,under the ITRC(Information Technology Research Center)support program(IITP-2024-RS-2024-00438239)supervised by the IITP(Institute for Information&Communications Technology Planning&Evaluation).
文摘Background Researches on the mental health of Korean adolescents during COVID-19 have largely focused on those from monocultural families,but there is limited data on sadness,suicidal ideation,and suicide attempts in multicultural adolescents.Methods This nationwide serial cross-sectional study included 688,708 adolescents aged 12–18 years who participated in the Korean Youth Risk Behavior Web-based Survey from 2011 to 2022.We compared and analyzed the prevalence of sadness,suicidal ideation,and suicide attempts among multicultural and monocultural adolescents.Multicultural adolescents were defined as those with at least one non-Korean parent.Results In 2021,the prevalence of sadness among multicultural adolescents was 31.86%[95%confidence interval(CI)30.00–33.71],suicidal ideation 17.17%(15.74–18.61),and suicide attempts 4.25%(3.51–4.99).Among monocultural adolescents,the prevalence rates were 26.09%(25.50–26.69)for sadness,12.41%(11.97–12.85)for suicidal ideation,and 1.92%(1.76–2.67)for suicide attempts.Adolescents from multicultural backgrounds were found to have higher rates of sadness,suicidal ideation,and suicide attempts.In the general population,these rates had decreased during the pre-pandemic period but increased after the onset of the pandemic then stabilized from 2020 to 2021.Female gender,smoking,alcohol use,and low school performance emerged as significant risk factors.However,no distinct risk factors specifically linked to suicide attempts were identified.Joinpoint regression analysis results aligned with the beta slope values in the main findings,reflecting a consistent pattern across both analyses.Conclusions This study revealed that sadness,suicidal ideation,and suicide attempts increased during the pandemic,reversing a pre-pandemic decline.Multicultural adolescents faced these issues more than monocultural ones,underlining the need for targeted public health measures to support at-risk adolescents during pandemics.
基金supported by a grant of the Korea Health Technology R&D Project through the Korea Health Industry Development Institute(KHIDI),funded by the Ministry of Health&Welfare,Republic of Korea(grant number:HV22C0233)the National Research Foundation of Korea(NRF)grant funded by the Korea government(NRF2021R1I1A2059735)。
文摘Background Although smoking is classified as a risk factor for severe COVID-19 outcomes,there is a scarcity of studies on prevalence of smoking during the COVID-19 pandemic.Thus,this study aims to analyze the trends of prevalence of smoking in adolescents over the COVID-19 pandemic period.Methods The present study used data from middle to high school adolescents between 2005 and 2021 who participated in the Korea Youth Risk Behavior Web-based Survey(KYRBS).We evaluated the smoking prevalence(ever or daily)by year groups and estimated the slope in smoking prevalence before and during the pandemic.Results A total of 1,137,823 adolescents participated in the study[mean age,15.04 years[95%confidence interval(CI)15.03-15.06];and male,52.4%(95%CI 51.7-53.1)].The prevalence of ever smokers was 27.7%(95%CI 27.3-28.1)between 2005 and 2008 but decreased to 9.8%(95%CI 9.3-10.3)in 2021.A consistent trend was found in daily smokers,as the estimates decreased from 5.4%(95%CI 5.2-5.6)between 2005 and 2008 to 2.3%(95%CI 2.1-2.5)in 2021.However,the downward slope in the overall prevalence of ever smokers and daily smokers became less pronounced in the COVID-19 pandemic period than in the pre-pandemic period.In the subgroup with substance use,the decreasing slope in daily smokers was significantly more pronounced during the pandemic than during the pre-pandemic period.Conclusions The proportion of ever smokers and daily smokers showed a less pronounced decreasing trend during the pandemic.The findings of our study provide an overall understanding of the pandemic's impact on smoking prevalence in adolescents.
基金supported by a grant of the Korea Health Technology R&D Project through the Korea Health Industry Development Institute(KHIDI)funded by the Ministry of Health&Welfare,Republic of Korea(grant number:HV22C0233 and grant number:HI22C1976)The funders had no role in study design,data collection,data analysis,data interpretation,or writing of the report.
文摘Background Although previous studies have provided data on early pandemic periods of alcohol and substance use in adolescents,more adequate studies are needed to predict the trends of alcohol and substance use during recent periods,including the mid-pandemic period.This study investigated the changes in alcohol and substance use,except tobacco use,throughout the pre-,early-,and mid-pandemic periods in adolescents using a nationwide serial cross-sectional survey from South Korea.Methods Data on 1,109,776 Korean adolescents aged 13–18 years from 2005 to 2021 were obtained in a survey operated by the Korea Disease Control and Prevention Agency.We evaluated adolescents’alcohol and substance consumption prevalence and compared the slope of alcohol and substance prevalence before and during the COVID-19 pandemic to see the trend changes.We define the pre-COVID-19 period as consisting of four groups of consecutive years(2005–2008,2009–2012,2013–2015,and 2016–2019).The COVID-19 pandemic period is composed of 2020(early-pandemic era)and 2021(midpandemic era).Results More than a million adolescents successfully met the inclusion criteria.The weighted prevalence of current alcohol use was 26.8%[95%confidence interval(CI)26.4–27.1]from 2005 to 2008 and 10.5%(95%CI 10.1–11.0)in 2020 and 2021.The weighted prevalence of substance use was 1.1%(95%CI 1.1–1.2)from 2005 to 2008 and 0.7%(95%CI 0.6–0.7)between 2020 and 2021.From 2005 to 2021,the overall trend of use of both alcohol and drugs was found to decrease,but the decline has slowed since COVID-19 epidemic(current alcohol use:βdiff 0.167;95%CI 0.150–0.184;substance use:βdiff 0.152;95%CI 0.110–0.194).The changes in the slope of current alcohol and substance use showed a consistent slowdown with regard to sex,grade,residence area,and smoking status from 2005 to 2021.Conclusion The overall prevalence of alcohol consumption and substance use among over one million Korean adolescents from the early and mid-stage(2020–2021)of the COVID-19 pandemic showed a slower decline than expected given the increase during the prepandemic period(2005–2019).
