The Korean Basketball League(KBL) holds an annual draft to allow teams to select new players, mostly graduates from the elite college basketball teams even though some are from high school teams. In sports games, many factors might influence the success of an athlete. In addition to possessing excellent physical and technical factors, success in a sports game is also influenced by remarkable psychological factors. Several studies reported that elite sports players can control their anxiety during competition, which may lead to better performance. In particular, the temperament and characteristics of players have been regarded as crucial determinants of the player’s performance and goal. In this regard, numerous studies suggest that personality is considered to be an important predictor of long-term success in professional sports

Based on previous reports and studies, we hypothesized that physical status, temperament and characteristics, and neurocognitive functions of basketball players could predict the result of KBL draft selection. Especially, temperament and characteristics were associated with the result of KBL selection. The basketball performances including average scores and average rebound were associated with emotional perception and mental rotation.

We recruited the number of 44 college elite basketball players(KBL selection, n=17; Non-KBL selection, n=27), and the number of 35 age-matched healthy comparison subjects who major in sports education in college. All participants were assessed with the Temperament and Character Inventory(TCI), Sports Anxiety Scales(SAS), Beck Depression Inventory(BDI), Perceived Stress Scale (PSS-10), Trail Making Test(TMT), and Computerized Neuro-cognitive Test(CNT) for Emotional Perception and Mental Rotation.

Current results showed that physical status, temperament and characteristics, and Neurocognitive functions of college basketball players could predict the KBL draft selection. Among temperament and characteristics, novelty seeking and reward dependence were associated with KBL draft selection. The basketball performances including average scores and average rebound were associated with emotional perception and mental rotation.

In order to be a good basketball player for a long time, it was confirmed that temperamental factors and Neurocognitive factors were very closely related. Furthermore, it is also judged that these results can be used as basic data to predict potential professional basketball players.

None Declared

Vascular abnormalities have been frequently reported in elderly adults as a potential risk factor of late-life depression. However, it is still unclear whether stenosis of cerebral arteries may increase risk of depression in the elderly.

Study participants were 365 patients 65 years or older with depressive disorder who had undergone brain MRI and angiography (MRA) which were assessed by trained radiologists, and the 15-item Geriatric Depression Scale (GDS-15) and the Mini Mental State Examination (MMSE), and blood glucose and lipid profiles.

Of the 365 subjects, 108 had at least one location of cerebral artery stenosis (29.59%). Stenosis was associated with age, marital status, infarction, and atherosclerosis. In multivariable linear regression analysis of different locations of stenosis among the whole sample, only bilateral middle cerebral artery (MCA) stenosis was found to have a significant association with higher GDS-15 score (p= 0.0138), and more than 8 scores in the GDS-15 (p= 0.0045), but no significant associations with ACA (anterior cerebral artery), PCA (posterior cerebral artery) or ICA (internal carotid artery). In multivariable linear logistic analysis of different locations among patients with at least one cerebral artery stenosis, left MCA was found to be significantly related to higher GDS-15 scores but not with right MCA (p = 0.0202).

MCA stenosis is significantly associated with severity of depression in elderly adults with cerebral artery stenosis, especially in those with left MCA stenosis.

• Patients with cerebral artery stenosis found with brain magnetic resonance angiography (MRA) were associated with higher depression severity.

• Stenosis of both left and right middle cerebral artery (MCA) was associated with greater depression severity, with left MCA stenosis having a greater influence on depression severity than right MCA stenosis.

• Higher depression severity in patients with MCA stenosis suggests that depression in elderly patients is mediated at least in part by vascular pathology of MCA supplied regions and careful investigation and management of cerebral artery stenosis and their risk factors may help reduce the severity of depression in elderly patients who visit psychiatrists.

Although various clinical indicators of suicide have been recorded, the previous suicide attempt is meaningful as one of the most robust risk factors predicting subsequent suicide attempts but there are lacking in biomarkers for evaluating suicide attempts. This study aimed to analyze the correlation of changes in oxygenated hemoglobin concentration with lifetime suicide attempt during verbal fluency test.

A total of 60 patients with major depressive disorder (MDD) were enrolled. Demographic, clinical, physical, and psychological evaluations were conducted. We evaluated the suicidal behaviors through MINI suicidality item. We indicated verbal fluency test to examine prefrontal activation during the cognitive execution while fNIRS was observed.

54 of enrolled patient with MDD (23 those with a lifetime history of suicide attempt; 31 those without a lifetime history of suicide attempt) are eligible for the subject. The patients were 35.19% of those with a lifetime history of suicide attempt. The values of the changes in oxygenated hemoglobin involving the entire regions of prefrontal cortex were smaller in those with a lifetime history of suicide attempt. The biggest difference is in right VMPFC, the mean score of those with a lifetime history of suicide attempt and those without a lifetime history of suicide attempt were 0.095(SD, 1.032) and 0.610(SD, 1.038) although the statistically non-significance. We discovered that a small value of changes in oxygenated hemoglobin was related to lifetime suicide attempt through multivariable logistic regression analysis. After adjusting for age, sex, years of education, and HAMD, there was a significant difference in the right VMPFC [OR = 0.491(95% CI=0.235~0.916), p = 0.036].

Study result indicated that the values of the changes in oxygenated hemoglobin were smaller in who attempted suicide before during cognitive execution. The adjusted regression analysis was presented significant result in right VMPFC. Therefore, the changes in oxygenated hemoglobin measured by fNIRS can be applied as a biomarker for suicidal behavior such as lifetime suicide attempt.

Although, attempts to apply virtual reality (VR) in mental healthcare are rapidly increasing, it is still unclear whether VR relaxation can reduce stress more than conventional biofeedback.

Participants consisted of 83 healthy adult volunteers with high stress, which was defined as a score of 20 or more on the Perceived Stress Scale-10 (PSS-10). This study used an open, randomized, crossover design with baseline, stress, and relaxation phases. During the stress phase, participants experienced an intentionally generated shaking VR and serial-7 subtraction. For the relaxation phase, participants underwent a randomly assigned relaxation session on day 1 among VR relaxation and biofeedack, and the other type of relaxation session was applied on day 2. We compared the StateTrait Anxiety Inventory-X1 (STAI-X1), STAI-X2, the Numeric Rating Scale (NRS), and physiological parameters including heart rate variability (HRV) indexes in the stress and relaxation phases.

A total of 74 participants were included in the analyses. The median age of participants was 39 years, STAI-X1 was 47.27 (SD = 9.92), and NRS was 55.51 (SD = 24.48) at baseline. VR and biofeedback significantly decreased STAI-X1 and NRS from the stress phase to the relaxation phase, while the difference of effect between VR and biofeedback was not significant. However, there was a significant difference in electromyography, LF/HF ratio, LF total, and NN50 between VR relaxation and biofeedback

VR relaxation was effective in reducing subjectively reported stress in individuals with high stress.

Virtual Reality (VR)-based Biofeedback (BF), a relatively new intervention, is rapidly increasing for the treatment of mood disorders. However, research on whether VR-based BF is more effective than traditional BF is still lacking.

A total of 131 adults from the community enrolled in the study. Participants scored ≥10 on Patient Health Questionnaire-9 (PHQ-9) or ≥9 on Panic Disorder Severity Scale (PDSS) were randomly assigned to VR or BF group. Those who have not met the criteria of PHQ-9 and PDSS were classified as the control group. All participants visited three times across 3 months and received either VR-based or conventional BF intervention. The control group received the same treatment as the VR group. Also, on each visit, the participants completed Montgomery-Asberg Depression Rating Scale (MADRS), State-Trait Anxiety Inventory (STAI), and Visual Analogue Scale (VAS).

The analysis included 118 participants in total (VR: 40, BF: 38, Control: 40). There was no significant difference in demographic variables among the 3 groups. After the treatment, VR and BF groups exhibited significant decreases in MADRS, PHQ-9, STAI, and VAS compared to the baseline within each group (p<0.005). Importantly, compared to the BF group, the VR group showed a significantly greater decrease in STAI (p<0.05). Further analyses revealed that scores of MADRD, PHQ-9, STAI, and VAS also significantly decreased in highly stressed group compared to the control group.

Findings suggest that the application of VR-based BF was effective in reducing anxiety and depressive symptoms in highly stressed people. Compared to conventional BF, VR-based BF can be a cost-effective treatment option especially for relieving anxiety.

Critical congenital heart disease (CCHD) refers to a group of heart defects that cause serious, life-threatening symptoms in the neonatal period and requires timely surgical or catheter interventions. We tried to explore current status of CCHD burden and the effect of early diagnosis of CCHD to mortality using the Korean national health insurance (NHI) data.

We analyzed the national health insurance (NHI) data from 2014 to 2018. We identified CCHD patients using the diagnosis codes and intervention codes from the claim data and the prevalence, mortality and medical expenditure of CCHD were analyzed. We linked neonatal data with their mother’s medical claim data and developed retrospective cohort data set for analyzing the effect of early diagnosis to mortality and related outcomes of CCHD treatment.

The annual prevalence of neonatal CCHD in Korea was 0.144% percent. A total of 2,241 CCHD neonates, 1,546 (69.0%) underwent cardiac ultrasound within three days after birth, and mothers of 419 neonates had a record of prenatal fetal ultrasound (18.7%). In our comparison of neonates diagnosed with CCHD within three days of birth with those diagnosed with CCHD on or after day 4 of birth, the probability of early diagnosis increased for preterm infants and infants with low birth rate. Regarding mortality rate, most types of CCHD showed a significantly higher mortality rate in the early diagnosis group.

The reason for the high mortality rate despite a high early diagnosis rate pertains to the high percentage of patients with severe conditions that induce a serious heart rate within three days of birth. More than half of the neonates with CCHD were found to have not undergone a prenatal fetal ultrasound, rendering this an important policy target.

Critical congenital heart disease (CCHD) refers to a group of heart defects that cause serious, life-threatening symptoms in the neonatal period and requires timely surgical or catheter interventions. We reviewed evidence for incorporating a mandatory neonatal CCHD screening test as a national public health project for all neonates born in Korea by analyzing the validity and cost-effectiveness of neonatal CCHD screening using pulse oximetry in Korea.

We performed a rapid literature review to establish models for the diagnostic accuracy and economic evaluation of pulse oximetry. Also, we analyzed the prevalence, mortality, and medical expenditure for different types of CCHD using the national health insurance (NHI) data. We analyzed the cost-effectiveness of pulse oximetry by comparing the group of neonates who received a combination of a physical examination and pulse oximetry, and group of neonates who only received a physical examination. For the cost-effectiveness analysis for the CCHD screening test in this study, we used a duration of one year, diagnostic accuracy as the clinical endpoint, and Life Year Gain (LYG) as the effectiveness indicator.

We used recent systematic review he pooled sensitivity can be enhanced from 76.5 percent (pulse oximetry alone) to 92 percent (combined with physical examination). We used a total of 2,334 neonates with CCHD data for the economic model. Our analysis revealed that adding pulse oximetry to the routine neonatal physical examination leads to 2.34 of LYG and a cost difference of USD1,080,602, showing a ICER of KRW610,063,240 (USD461,857)/LYG.

Considering the benefit of LYG and cost of reducing the complications and after effects of newborns with CCHD who survived early diagnosis, it is considered to be worthwhile in Korea for a mandatory screening test.

Patients with mental illness are vulnerable to severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection because of behavioural changes associated with cognitive deterioration, especially without their caregivers. While studies have reported that SARS-CoV-2 infection risk and severe clinical outcomes are high among patients with mental illness, there is a lack of quantitative research supporting this claim. This study investigates if SARS-CoV-2 infection and coronavirus disease 2019 (COVID-19)-related death are higher in patients with mental illness than among those without a mental disorder.

A cohort study was conducted using the COVID-19 database of the National Health Insurance Service in South Korea. A total of 123 480 patients aged ⩾20 years who visited a hospital between 1 January 2020 and 30 May 2020 were analysed. Mental disorder diagnoses and types were determined based on 2019 medical records, and a multivariate logistic regression model was used to calculate the odds ratios (ORs) for SARS-CoV-2 infection and deaths.

The ORs for SARS-CoV-2 infection (OR 1.58; 95% CI 1.45–1.71) and COVID-19-related death (OR 2.18; 95% CI 1.57–3.04) were high among patients with mental illness. The OR of SARS-CoV-2 infection was higher among patients with severe mental illness (OR 2.60; 95% CI 2.21–3.06), dementia (OR 1.90; 95% CI 1.62–2.22) and substance use disorder (OR 4.98, 95% CI 3.60–6.88). The OR for COVID-19-related death was high among patients with severe mental illness (OR 3.53; 95% CI 1.82–6.83) and dementia (OR 2.12; 95% CI 1.39–3.22).

Patients with mental illness are at high risk for SARS-CoV-2 infection and COVID-19-related death. Behavioural changes associated with cognitive deterioration and long-term care facility residence increase SARS-CoV-2 infection risk, and severe medical conditions and delayed treatment increase the COVID-19-related mortality risk in patients with mental illness. Patients with mental illness are a priority target population for COVID-19 prevention and treatment, and it is important to plan prevention measures that address their needs.

We quantitatively assessed the fit failure rate of N95 respirators according to the number of donning/doffing and hours worn.

Experimental study.

A tertiary-care referral center in South Korea.

In total, 10 infection control practitioners participated in the fit test.

The first experiment comprised 4 consecutive 1-hour donnings and fit tests between each donning. The second experiment comprised 2 consecutive 3-hour donnings and fit tests between each donning. The final experiment comprised fit tests after an 1-hour donning or a 2-hour donning.

For 1-hour donnings, 60%, 70%, and 90% of the participants had fit failures after 2, 3, and 4 consecutive donnings, respectively. For 3-hour donnings, 50% had fit failure after the first donning and 70% had failures after 2 consecutive donnings. All participants passed the fit test after refitting whenever fit failure occurred. The final experiment showed that 50% had fit failure after a single use of 1 hour, and 30% had fit failure after a single use of 2 hours.

High fit-failure rates were recorded after repeated donning and extended use of N95 respirators. Caution is needed for reuse (≥1 time) and extended use (≥1 hour) of N95 respirators in high-risk settings such as those involving aerosol-generating procedures. Although adequate refitting may recover the fit factor, the use of clean gloves and strict hand hygiene afterward should be ensured when touching the outer surfaces of N95 respirators for refitting.

To investigate the impacts of depression screening, diagnosis and treatment on major adverse cardiac events (MACEs) in acute coronary syndrome (ACS).

Prospective cohort study including a nested 24-week randomised clinical trial for treating depression was performed with 5–12 years after the index ACS. A total of 1152 patients recently hospitalised with ACS were recruited from 2006 to 2012, and were divided by depression screening and diagnosis at baseline and 24-week treatment allocation into five groups: 651 screening negative (N), 55 screening positive but no depressive disorder (S), 149 depressive disorder randomised to escitalopram (E), 151 depressive disorder randomised to placebo (P) and 146 depressive disorder receiving medical treatment only (M).

Cumulative MACE incidences over a median 8.4-year follow-up period were 29.6% in N, 43.6% in S, 40.9% in E, 53.6% in P and 59.6% in M. Compared to N, screening positive was associated with higher incidence of MACE [adjusted hazards ratio 2.15 (95% confidence interval 1.63–2.83)]. No differences were found between screening positive with and without a formal depressive disorder diagnosis. Of those screening positive, E was associated with a lower incidence of MACE than P and M. M had the worst outcomes even compared to P, despite significantly milder depressive symptoms at baseline.

Routine depression screening in patients with recent ACS and subsequent appropriate treatment of depression could improve long-term cardiac outcomes.

This research investigated patients who underwent surgery for a dilated aorta associated with a connective tissue disease or inflammatory vasculitis in children and adolescents.

The medical records of 11 patients who underwent aortic surgery for dilatation resulting from a connective tissue disease or inflammatory vasculitis between 2000 and 2017 were retrospectively reviewed.

The median age and body weight of the patients were 9.6 years (range 5.4 months–15.5 years) and 25.8 kg (range 6.8–81.5), respectively. The associated diseases were Marfan syndrome (n = 3), Loeys-Dietz syndrome (n = 3), Kawasaki disease (n = 1), Takayasu arteritis (n = 1), PHACE syndrome (n = 1), tuberous sclerosis (n = 1), and unknown (n = 1). The most common initially affected area was the ascending aorta. During the 66.4 ± 35.9 months of follow-up, two Marfan syndrome patients died, and four patients (one Marfan syndrome and three Loeys-Dietz syndrome) had repeated aortic operation. Except for one patient, the functional class was well maintained in all patients who were followed up.

Cases of surgical treatment for a dilated aorta associated with a connective tissue disease and inflammatory vasculitis are rare in children and adolescents at our institution. Most of the patients in this study showed a tolerable postoperative course. However, the aorta showed progressive dilation over time even after surgical treatment, especially in patients with Loeys-Dietz syndrome. In these patients, close and more frequent regular follow-up is required.