Illicit Trade of Prescription Medications Through X (Formerly Twitter) in Japan: Cross-Sectional Study.

BACKGROUND: Nonmedical use of prescription drugs can cause overdose; this represents a serious public health crisis globally. In this digital era, social networking services serve as viable platforms for illegal acquisition of excessive amounts of medications, including prescription medications. In Japan, such illegal drug transactions have been conducted through popular flea market applications, social media, and auction websites, with most of the trades being over-the-counter (OTC) medications. Recently, an emerging unique black market, where individuals trade prescription medications-predominantly nervous system drugs-using a specific keyword ("Okusuri Mogu Mogu"), has emerged on X (formerly Twitter). Hence, these dynamic methods of illicit trading should routinely be monitored to encourage the appropriate use of medications. OBJECTIVE: This study aimed to specify the characteristics of medications traded on X using the search term "Okusuri Mogu Mogu" and analyze individual behaviors associated with X posts, including the types of medications traded and hashtag usage. METHODS: We conducted a cross-sectional study with publicly available posts on X between September 18 and October 1, 2022. Posts that included the term "Okusuri Mogu Mogu" during this period were scrutinized. Posts were categorized on the basis of their contents: buying, selling, self-administration, heads-up, and others. Among posts categorized as buying, selling, and self-administration, medication names were systematically enumerated and categorized using the Anatomical Therapeutic Chemical (ATC) classification. Additionally, hashtags in all the analyzed posts were counted and classified into 6 categories: medication name, mental disorder, self-harm, buying and selling, community formation, and others. RESULTS: Out of 961 identified posts, 549 were included for analysis. Of these posts, 119 (21.7%) referenced self-administration, and 237 (43.2%; buying: n=67, 12.2%; selling: n=170, 31.0%) referenced transactions. Among these 237 posts, 1041 medication names were mentioned, exhibiting a >5-fold increase from the study in March 2021. Categorization based on the ATC classification predominantly revealed nervous system drugs, representing 82.1% (n=855) of the mentioned medications, consistent with the previous survey. Of note, the diversity of medications has expanded to include medications that have not been approved by the Japanese government. Interestingly, OTC medications were frequently mentioned in self-administration posts (odds ratio 23.6, 95% CI 6.93-80.15). Analysis of hashtags (n=866) revealed efforts to foster community connections among users. CONCLUSIONS: This study highlighted the escalating complexity of trading of illegal prescription medication facilitated by X posts. Regulatory measures to enhance public awareness should be considered to prevent illegal transactions, which may ultimately lead to misuse or abuse such as overdose. Along with such pharmacovigilance measures, social approaches that could direct individuals to appropriate medical or psychiatric resources would also be beneficial as our hashtag analysis shed light on the formation of a cohesive or closed community among users.

Characteristics of Japanese physician influencers on Twitter during the COVID-19 pandemic and fact-checking their tweets on COVID-19-related drugs.

BACKGROUND: During the coronavirus disease-2019 (COVID-19) pandemic, segments of the public relied on social media platforms such as Twitter for medical information shared by medical personnel. Although physicians are likely to disseminate more accurate information on Twitter than non-medical individuals, it cannot be taken for granted. As such, tweets written by physicians in Japan should also be scrutinized for accuracy. PURPOSE: The purpose of this study was to create a profile of the most popular physician influencers on Twitter in Japan, and to do a fact-check of their tweets regarding COVID-19-related drugs. DESIGN: This is a retrospective observational study. METHODS: We purchased Twitter data for Japan for the initial 9 months of the COVID-19 pandemic (from January 2020 to September 2020), and extracted tweets with keywords related to COVID-19 at a sampling rate of 3%. The most popular physicians were identified and selected consecutively by searching for the top 1000 accounts using Twitter's search function. These top accounts were considered influencers and their tweets and retweets concerning COVID-19-related drugs were fact-checked against scientific literature. RESULTS: We identified 21 physician influencers with real names: most were male in their 40s and 50s working at private medical facilities. The contents of their tweets were mainly sourced from scientific publications that were current at that time. The fact-check revealed that only one of 50 tweets was not correct while the others had no identifiable inaccuracies. CONCLUSIONS: Except for one tweet, tweets written and retweeted by Japanese physician influencers concerning the COVID-19-related drugs contained predominantly accurate information.

Associations between older adults' social media use behaviors and psychosocial well-being.

BACKGROUND: Research examining associations between social media use behaviors and psychosocial well-being among older adults are limited. AIMS: To explore associations between older adults' social media (social networking services and instant messaging applications) use behaviors and psychosocial well-being. METHODS: This was a secondary data analysis. All data were retrieved from the Taiwan Communication Survey database, an annual survey that examines trends in Taiwanese residents' communication behaviors and social media use. The original investigation was conducted in Taiwan from September to December 2019. Data from 647 older adults aged over 60 years were extracted for the analyses. Social media use behaviors (users/non-users and time spent using), positive psychosocial outcomes (life satisfaction, self-determination, subjective well-being, and happiness), negative psychosocial outcomes (loneliness, depression, and anxiety), and demographic variables were included. RESULTS: Social media users had significantly higher levels of subjective well-being and lower levels of depression, anxiety, and loneliness compared with non-users. Time spent on social networking services was significantly and positively correlated with negative psychosocial outcomes (ß = 0.103, p = 0.044, f2 = 0.011), and it was significantly and inversely correlated with positive psychosocial outcomes (ß = - 0.063, p = 0.049, f2 = 0.004). Time spent using an instant messaging application was significantly positively associated with positive psychosocial outcomes (ß = 0.068, p = 0.031, f2 = 0.005). The proposed path model had an acceptable model fit. DISCUSSION: Study results indicated that older adults' social media use behaviors were associated with their psychosocial well-being. CONCLUSIONS: Older adults are recommended to use social media for appropriate time periods as an important way to promote social engagement for their psychosocial well-being.

The Role of Motivation Systems, Anxiety, and Low Self-Control in Smartphone Addiction among Smartphone-Based Social Networking Service (SNS) Users.

Given that Social Networking Service (SNS) has emerged as the most influential platform, which can lead users to addictive smartphone use, it is necessary to investigate which psychological variables lead smartphone-based SNS users to addictive smartphone use. Still, studies on the relationship between psychological variables and addictive smartphone use among smartphone-based SNS users remain to be explored. Therefore, this study aims to investigate the role of psychological factors on smartphone addiction proneness (SAP). A total of 433 smartphone-based SNS users were collected from 5003 adults in Korea. Data were analyzed with descriptive statistics, Pearson's correlation coefficients, and path analysis using SPSS 21.0 and AMOS 23.0. The results of a parallel-mediation path analysis demonstrated that Behavioral Inhibition (BIS), Behavioral activation (BAS) drive, anxiety, and low self-control directly influenced SAP, separately. BIS and BAS _drive also had significant indirect effects on SAP through the effect of anxiety. BIS and BAS_fun had significant indirect effects on SAP through the effect of low self-control. The study variables accounted for 38.4 of the total variances of SAP. Thus, when establishing interventions to reduce the users' addictive smartphone use, these interactive relationships of the variables should be considered.

Effects of social networking services on academic performance and self-esteem: A cross-sectional study among medical students.

Background: Social networking services (SNS) are a subcategory of social media that provide a useful tool for an individual's practical life and social relations. Since the impact of SNS on students' lives is a relatively neglected topic, we aimed to investigate the effect of social media on academic performance and self-esteem. Methods: A cross-sectional study was conducted with 373 medical students distributed across different academic years. Data was collected and analyzed using measures of central tendency to describe numerical variables, while frequencies and percentages were used for categorical variables. Pearson's chisquared test, Pearson's correlation coefficient, independent sample t-test, and the one-way analysis of variance (ANOVA) were used to identify relationships between the variables. All P values < 0.05 were considered significant using a 95% confidence interval and a 5% margin of error. Results: The majority of our sample believed that SNSs were useful, and 37.5% believed that social media positively affected their academic performance. However, no significant relationship was found between the time spent on social media and the students' grade point average (GPA). Conversely, there was a significant relationship between students' perceived addiction to social media and their self-worth, along with a positive correlation between GPA and self-esteem. Conclusion: Almost half of our participants agreed that social media is a helpful method for finding useful information. Nevertheless, excessive usage has been found to have a harmful effect on the students' health and self-esteem.

Effects of Social Networking Service (SNS) Addiction on Mental Health Status in Chinese University Students: Structural Equation Modeling Approach Using a Cross-sectional Online Survey.

BACKGROUND: Although social networking services (SNSs) have become popular among young people, problematic SNS use has also increased. However, little is known about SNS addiction and its association with SNS use patterns and mental health status. OBJECTIVE: This study aims to test the mediating role of SNS addiction between SNS use patterns and mental health status among Chinese university students in Hong Kong (HK). METHODS: An online cross-sectional survey was conducted using a convenience sampling method. In total, 533 university students (323 [66.9%] female, mean age [SD]=20.87 [2.68] years) were recruited from February to March 2019. Multiple linear regression was used to assess the association between SNS use and SNS addiction. Structural equation modeling (SEM) was performed to examine the pathways and associations among SNS use, SNS addiction, psychosocial status, and mental health status (including anxiety and depressive symptoms). RESULTS: A longer time spent on SNSs per day (>3 h), a longer time spent on each SNS access (≥31 min), a higher frequency of SNS access (≤every 30 min), a longer duration of SNS use before sleeping (≥61 min), and a shorter duration from waking to first SNS use (≤5 min) were significantly associated with a higher level of SNS addiction (adjusted beta [aß]=6.03, 95% CI 4.66-7.40; aß=4.99, 95% CI 3.14-6.83; aß=5.89, 95% CI 4.14-7.64; aß=5.92, 95% CI 4.19-7.65; and aß=3.27, 95% CI 1.73-4.82, respectively). SEM showed a significant mediating effect of SNS addiction in the relationship between SNS use and psychosocial status, and mental health status, including an indirect effect (ß=0.63, 95% CI 0.37-0.93) and the total effect (ß=0.44, 95% CI 0.19-0.72), while the direct effect was insignificant (ß=-0.19, 95% CI -0.49 to 0.08). CONCLUSIONS: SNS use patterns were associated with SNS addiction, and SNS addiction mediated the associations between SNS use, psychosocial status, and mental health status of Chinese university students in HK. The findings suggest that screening for and addressing excessive SNS use are needed to prevent SNS addiction and mental distress among young people.

A questionnaire survey on a feeling of loneliness of the mothers raising children.

AIM: A feeling of isolation childcare mothers' face is a serious social problem in Japan because the relationships with mothers and local communities have grown sparser. The purpose of this study was to clarify the feelings of isolation of mothers during childcare and the factors related to it. METHODS: We conducted a questionnaire survey in Yao City, Osaka. We mailed out a questionnaire survey of 1293 mothers with infants who had either a 4-month or 42-month routine health checkup during the period from September to December of 2018. RESULTS: There was no association between "feeling lonely while raising my child" and the absence of "people who helped raise my children." On the other hand, it was found that the mothers' inner feelings, such as "I wasn't satisfied with my childcare environment" (OR: 2.55, 95% CI: 1.32-4.91, p = 0.0052) or "I lacked confidence in my own childcare abilities" (OR: 6.21, 95% CI: 4.31-8.95, p < 0.0001), were associated with their sense of loneliness. CONCLUSIONS: Mothers' "sense of loneliness" was shown to be best correlated with their dissatisfaction with the environment of their childcare and with their lack of confidence in raising their own children.

12. Social Media Usage and Medical Professionalism How to Teach Online Professionalism / 医学教育

Social media (including social networking service) is now a presence in medical professionalism that cannot be ignored, and this new area is called “online professionalism” or “e-professionalism” . Professional organizations in various countries, such as the American College of Physicians, have issued statements on online professionalism, but the debate has not progressed much in Japan. Regarding the use of social media by physicians, challenges include professional use of social media, management of one’s identity and professional image as a physician, and appropriate electronic communication with patients. Appropriate use of social media can promote knowledge sharing and collaborative learning among medical professionals and contribute to the formation of collective intelligence.

Management of anticoagulant therapy using a portable point-of-care international normalized ratio device and social networking service in a patient with a left ventricular assist device.

Device infection and stroke are still frequently reported as complications of left ventricular assist devices, and strict management of anticoagulation therapy is sometimes difficult at the time of infection status. We report the case of a 55-year-old man with a HeartMate II (Abbott, Inc., Abbott Park, IL, USA) as a bridge to cardiac transplantation. The patient measured his prothrombin time-international normalized ratio (PT-INR) by himself using a point-of-care device at home and reported the result promptly on a social networking service (SNS). Physicians instructed the patient on how to adjust his dose of warfarin based on the result and suggested the next time of measurement on the SNS. Until cardiac transplantation, we adjusted the dose of warfarin 106 times using the SNS because of unexpected PT-INR fluctuations caused by antibiotics. The time in the therapeutic range was maintained at 83.2% without complications, including major bleeding, stroke, or pump replacement; however, there was transient intra-pump thrombosis triggered by severe dehydration due to hyperthyroidism. .

Association among social-networking service usage via smartphone, internet addiction, and psychological stress in Japanese physical therapy university students: a single-university cross-sectional study.

[Purpose] This study aimed to examine the influence of social-networking service usage via smartphone on internet addiction and psychological stress in Japanese university students studying physical therapy. [Participants and Methods] This single-university cross-sectional study involved 247 physical therapy students in the second to fourth years (ages 19 to 22). By use of self-administered questionnaires, we collected information on daily time of smartphone usage, social-networking service usage via smartphone, and daily self-learning time outside of class hours. We assessed internet addiction and psychological stress using the Internet Addiction Test and Stress Response Scale-18, respectively. After excluding twelve participants, we analyzed the data collected for the other 235. [Results] Multiple regression analysis showed an association of the Internet Addiction Test score with gender and daily time of smartphone usage. "Surfing without any purpose", which is one of the purposes of social-networking service usage, and the Internet Addiction Test score were associated with the Stress Response Scale-18 score. Other variables were not associated with the Internet Addiction Test or Stress Response Scale-18 scores. [Conclusion] Our results suggest that gender (males), longer time of smartphones usage, or using social-networking service usage passively cause internet addiction or psychological stress in Japanese physical therapy university students.

A GNSS-Based Crowd-Sensing Strategy for Specific Geographical Areas.

Infectious diseases, such as COVID-19, SARS, MERS, etc., have seriously endangered human safety, economy, and education. During the spread of epidemics, restricting the range of activities of personnel is one of the options for the prevention and treatment of infectious diseases. A global navigation satellite system (GNSS), it can provide accurate coordinates of latitude and longitude to targets with GNSS receivers. However, it is not common to use GNSS coordinates to represent positions in social life. For epidemic management, it is important to know the locations (and addresses) of targets, especially in social life. When there are many targets, it is not easy to efficiently map these coordinates to locations. Therefore, we propose a GNSS-based crowd-sensing strategy for specific geographical areas that can be used to calculate how many targets are in specific geographical areas or whether a target is in a specific area. This strategy is based on the coordinates of latitude and longitude provided by GNSS to find the locations of these coordinates. As simulated data, the data records containing latitude and longitude in a well-known social networking service platform are used. The strategy is also available for mining hot spots or hot areas.

Using photos for public health communication: A computational analysis of the Centers for Disease Control and Prevention Instagram photos and public responses.

This study aims to explore the use of Instagram by the Centers for Disease Control and Prevention, one of the representative public health authorities in the United States. For this aim, all of the photos uploaded on the Centers for Disease Control and Prevention Instagram account were crawled and the content of them were analyzed using Microsoft Azure Cognitive Services. Also, engagement was measured by the sum of numbers of likes and comments to each photo, and sentiment analysis of comments was conducted. Results suggest that the photos that can be categorized into "text" and "people" took the largest share in the Centers for Disease Control and Prevention Instagram photos. And it was found that the Centers for Disease Control and Prevention's major way of delivering messages on Instagram was to imprint key messages that call for actions for better health on photos and to provide the source of complementary information on text component of each post. It was also found that photos with more and bigger human faces had lower level of engagement than the others, and happiness and neutral emotions expressed on the faces in photos were negatively associated with engagement. The features whose high value would make the photos look splendid and gaudy were negatively correlated with engagement, but sharpness was positively correlated.

An assessment of self-reported COVID-19 related symptoms of 227,898 users of a social networking service in Japan: Has the regional risk changed after the declaration of the state of emergency?

BACKGROUND: In the absence of widespread testing, symptomatic monitoring efforts may allow for understanding the epidemiological situation of the spread of coronavirus disease 2019 (COVID-19) in Japan. We obtained data from a social networking service (SNS) messaging application that monitors self-reported COVID-19 related symptoms in real time in Fukuoka Prefecture, Japan. We aimed at not only understanding the epidemiological situation of COVID-19 in the prefecture, but also highlighting the usefulness of symptomatic monitoring approaches that rely on self-reporting using SNS during a pandemic, and informing the assessment of Japan's emergency declaration over COVID-19. METHODS: We analysed symptoms data (fever over 37.5° and a strong feeling of weariness or shortness of breath), reported voluntarily via SNS chatbot by 227,898 residents of Fukuoka Prefecture during March 27 to May 3, 2020, including April 7, when a state of emergency was declared. We estimated the spatial correlation coefficient between the number of the self-reported cases of COVID-19 related symptoms and the number of PCR confirmed COVID-19 cases in the period (obtained from the prefecture website); and estimated the empirical Bayes age- and sex-standardised incidence ratio (EBSIR) of the symptoms in the period, compared before and after the declaration. The number of symptom cases was weighted by age and sex to reflect the regional population distribution according to the 2015 national census. FINDINGS: Of the participants, 3.47% reported symptoms. There was a strong spatial correlation of 0.847 (p < 0.001) at municipality level between the weighted number of self-reported symptoms and the number of COVID-19 cases for both symptoms. The EBSIR at post-code level was not likely to change remarkably before and after the declaration of the emergency, but the gap in EBSIR between high-risk and low-risk areas appeared to have increased after the declaration. INTERPRETATION: While caution is necessary as the data was limited to SNS users, the self-reported COVID-19 related symptoms considered in the study had high epidemiological evaluation ability. In addition, though based on visual assessment, after the declaration of the emergency, regional containment of the infection risk might have strengthened to some extent. SNS, which can provide a high level of real-time, voluntary symptom data collection, can be used to assess the epidemiology of a pandemic, as well as to assist in policy assessments such as emergency declarations. FUNDING: The present work was supported in part by a grant from the Ministry of Health, Labour and Welfare of Japan (H29-Gantaisaku-ippan-009).

Survey of the effects of internet usage on the happiness of Japanese university students.

BACKGROUND: Besides research on psychiatric diseases related to problematic Internet use (PIU), a growing number of studies focus on the impact of Internet on subjective well-being (SWB). However, in previous studies on the relationship between PIU and SWB, there is little data for Japanese people specifically, and there is a lack of consideration for differences in perception of happiness due to cultural differences. Therefore, we aimed to clarify how happiness is interdependent on PIU measures, with a focus on how the concept of happiness is interpreted among Japanese people, and specifically among Japanese university students. METHODS: A paper-based survey was conducted with 1258 Japanese university students. Respondents were asked to fill out self-report scales regarding their happiness using the Interdependent Happiness Scale (IHS). The relationship between IHS and Internet use (Japanese version of the Internet addiction test, JIAT), use of social networking services, as well as social function and sleep quality (Pittsburgh Sleep Quality Index, PSQI) were sought using multiple regression analyses. RESULTS: Based on multiple regression analyses, the following factors related positively to IHS: female gender and the number of Twitter followers. Conversely, the following factors related negatively to IHS: poor sleep, high- PIU, and the number of times the subject skipped a whole day of school. CONCLUSIONS: It was shown that there was a significant negative correlation between Japanese youths' happiness and PIU. Since epidemiological research on happiness that reflects the cultural background is still scarce, we believe future studies shall accumulate similar evidence in this regard.

Using Gamification and Social Incentives to Increase Physical Activity and Related Social Cognition among Undergraduate Students in Shanghai, China.

Gamification and social incentives are promising strategies to increase the effectiveness of web-based physical activity (PA) interventions by improving engagement. In this study, we designed a PA intervention integrating gamification and social incentives based on the most popular social networking service in China, WeChat. A controlled trial involving 52 Chinese undergraduate students was implemented to evaluate the effectiveness of the intervention. Subjects in the intervention group received a 7-week intervention. PA behavior and related social cognitive variables according to the theory of planned behavior were measured at the baseline and after the intervention. Daily physical activity duration was measured during the intervention. The results showed that PA-related subjective norms, perceived behavior control, and intention, as well as self-reported vigorous physical activity and moderate physical activity in the intervention group, were increased after the intervention, compared with the control group (p <0.05). During the intervention, perceived daily physical activity duration in the intervention group was on the rise, while it declined in the control group (p <0.001). The findings indicate that WeChat-based intervention integrating gamification and social incentives could effectively increase subjectively measured PA and related social cognition among Chinese undergraduate students and that it is a promising way to ameliorate the problem of insufficient PA among youths.

Smartphone use and smartphone addiction in middle school students in Korea: Prevalence, social networking service, and game use.

This study aimed to examine smartphone use patterns, smartphone addiction characteristics, and the predictive factors of the smartphone addiction in middle school students in South Korea. According to the Smartphone Addiction Proneness Scale scores, 563 (30.9%) were classified as a risk group for smartphone addiction and 1261 (69.1%) were identified as a normal user group. The adolescents used mobile messengers for the longest, followed by Internet surfing, gaming, and social networking service use. The two groups showed significant differences in smartphone use duration, awareness of game overuse, and purposes of playing games. The predictive factors of smartphone addiction were daily smartphone and social networking service use duration, and the awareness of game overuse.

A classroom SNS to promote reflective activity in programming learning for children.

In recent years, workshops involving programming on computers have been held in elementary education to promote creative thinking. In our experience of conducting programming workshops for children for over 10 years, we cannot have enough time to let them share and reflect on their creative activity, although reflection is one of the important factors for successful experience-based learning. In order to solve this problem, we have developed a classroom SNS (social networking service) system for children to upload a post and share their project. On the SNS site, they can upload three kinds of contents: action view, code view, and comments. We conducted an experiment to examine if children have performed the sharing and reflection activity with the SNS system during a programming workshop. The result shows that the SNS system would promote motivation for children to reflect on their project.

The association of suicide-related Twitter use with suicidal behaviour: a cross-sectional study of young internet users in Japan.

BACKGROUND: Infodemiology studies for suicide prevention have become increasingly common in recent years. However, the association between Twitter use and suicide has only been partially clarified. This study examined the association between suicide-related tweets and suicidal behaviour to identify suicidal young people on the Internet. METHODS: A cross-sectional survey was conducted using Internet survey panels (n=220,848) comprising users in their 20s, through a major Japanese Internet survey company. Final analyses included the data of 1000 participants. RESULTS: Of the participants (n=1000) used in the final analysis, 61.3% were women and the mean age was 24.9 years (SD=2.9, range=20-29). Logistic regression analyses showed that tweeting "want to die" and "want to commit suicide" was significantly related to suicidal ideation and behaviour. Lifetime suicide attempts, the most powerful predictor of future suicide out of all suicidal behaviours, were more strongly associated with tweeting "want to commit suicide" than tweeting "want to die". Having a Twitter account and tweeting daily were not associated with suicidal behaviour. LIMITATIONS: An online panel survey has some inherent biases, such as coverage bias. Respondents were already registered as members of a particular Internet survey company in Japan, which limits the possibility of generalization. CONCLUSIONS: Twitter logs may be used to identify suicidal young Internet users. This study provides a basis for the early identification of individuals at high risk for suicide.

International digestive endoscopy network 2014: turnpike to the future.

Social networks are useful in the study of relationships between individuals or entire populations, and the ties through which any given social unit connects. Those represent the convergence of the various social contacts of that unit. Consequently, the term "social networking service" (SNS) became extremely familiar. Similar to familiar SNSs, International Digestive Endoscopy Network (IDEN) 2014 was based on an international network composed of an impressive 2-day scientific program dealing with a variety of topics for gastrointestinal (GI) diseases, which connects physicians and researchers from all over the world. The scientific programs included live endoscopic demonstrations and provided cutting-edge information and practice tips as well as the latest advances concerning upper GI, lower GI, and pancreatobiliary endoscopy. IDEN 2014 featured American Society for Gastrointestinal Endoscopy-Korean Society of Gastrointestinal Endoscopy (ASGE-KSGE)-joint sessions prepared through cooperation between ASGE and KSGE. Furthermore, IDEN 2014 provided a special program for young scientists called the 'Asian Young Endoscopist Award Forum' to foster networks, with many young endoscopists from Asian countries taking an active interest and participation.

International Digestive Endoscopy Network 2014: Turnpike to the Future

Social networks are useful in the study of relationships between individuals or entire populations, and the ties through which any given social unit connects. Those represent the convergence of the various social contacts of that unit. Consequently, the term "social networking service" (SNS) became extremely familiar. Similar to familiar SNSs, International Digestive Endoscopy Network (IDEN) 2014 was based on an international network composed of an impressive 2-day scientific program dealing with a variety of topics for gastrointestinal (GI) diseases, which connects physicians and researchers from all over the world. The scientific programs included live endoscopic demonstrations and provided cutting-edge information and practice tips as well as the latest advances concerning upper GI, lower GI, and pancreatobiliary endoscopy. IDEN 2014 featured American Society for Gastrointestinal Endoscopy-Korean Society of Gastrointestinal Endoscopy (ASGE-KSGE)-joint sessions prepared through cooperation between ASGE and KSGE. Furthermore, IDEN 2014 provided a special program for young scientists called the 'Asian Young Endoscopist Award Forum' to foster networks, with many young endoscopists from Asian countries taking an active interest and participation.