Purpose: Congenital hypothyroidism (CH) is a major preventable cause of intellectual disability, particularly in very low birth weight (VLBW) infants, who are at increased risk due to hypothalamic-pituitary-thyroid axis immaturity. Early differentiation between transient CH (TCH) and permanent CH (PCH) is crucial to optimize L-thyroxine (LT4) treatment duration. This study aimed to determine the incidence of PCH among Korean VLBW infants and to identify clinical factors that may aid in distinguishing TCH from PCH. Methods: This retrospective cohort study included VLBW infants diagnosed with CH and treated with LT4 at a single tertiary neonatal intensive care unit between 2011 and 2020. Infants requiring LT4 beyond 3 years were classified as PCH, while those who discontinued earlier were considered TCH. Clinical characteristics, neonatal morbidities, and thyroid-related parameters were compared between the groups. Results: Among 1,292 VLBW infants, 122 (9.4%) were diagnosed with CH. After excluding deaths and those lost to follow-up, 73 infants were included in the final analysis (TCH, n=50; PCH, n=23). The PCH group had a significantly higher mean gestational age and greater LT4 requirements at both 12 and 36 months of age. Major anomalies were more frequently observed in PCH infants, including congenital heart defects. In multivariate analysis, higher gestational age, the presence of major anomalies, screening thyroid-stimulating hormone (TSH) >10 μIU/mL, and higher LT4 dose at 36 months were significantly associated with PCH. Conclusion The incidence of PCH in Korean VLBW infants was relatively higher than that reported in previous studies studies. Screening TSH level and LT4 dose requirements may support individualized follow-up and help distinguish PCH from TCH.

RESULTS: Resveratrol significantly reduced cardiac hypertrophy and remodeling in aging hearts. In addition, resveratrol significantly ameliorated aging-induced mitochondrial dysfunction (e.g., decreased oxygen respiration and increased hydrogen peroxide emission) and mitochondria-dependent apoptotic signaling (the Bax/Bcl-2 ratio, mitochondrial permeability transition pore opening sensitivity, and cleaved caspase-3 protein levels).Resveratrol also significantly attenuated aging-induced apoptosis (determined via cleaved caspase-3 staining and TUNEL-positive myonuclei) in cardiac muscles. CONCLUSION This study demonstrates that resveratrol treatment has a beneficial effect on aging-induced cardiac remodeling by ameliorating mitochondrial dysfunction and inhibiting mitochondria-mediated apoptosis in the heart.

Objectives: This study aimed to explore factors influencing satisfaction with medical services among medically underserved populations at the free medical clinic, providing data to improve free medical services for these populations. Methods: We employed a descriptive correlational study design involving 112 individuals (aged 19 years and older) from medically underserved populations who visited the clinic. Data were collected through face-to-face surveys from September to October 2023, and statistical analyses (t-tests, analysis of variance, Pearson correlation, and hierarchical multiple regression) were used to identify key predictors of satisfaction. Results: Perceived support from healthcare providers emerged as the strongest predictor ofsatisfaction with medical services, demonstrating a significant positive association. While socialsupport was positively correlated with perceived support from healthcare providers, it did not independently predict satisfaction. Conclusion These findings underscore the importance of healthcare provider and social supportin increasing satisfaction with medical services among medically underserved populations.Developing tailored healthcare programs and specialized healthcare provider training are essential strategies to improve healthcare access and outcomes for these vulnerable groups.

Objective: Adult attachment style is linked to how an individual responds to threats or stress and is known to be related to the onset of psychiatric symptoms such as depression. However, as the current assessment of attachment type mainly relies on self-report questionnaires and can be prone to bias, there is a need to incorporate physiological factors along with psychological symptoms and history in this process. We aimed to predict the measurement of two important types of adult attachment with heart rate variability (HRV), early life stress experience, and subjective psychiatric symptoms. Methods: Five hundred eighty-two subjects with depressive disorder were recruited retrospectively from January 2015 to June 2021. The experience of early life stress and psychiatric symptoms were collected, and HRV measures were obtained as input for an ensembled Voting Regressor model of machine learning-based regression models, including linear regression, ElasticNet, Support Vector Machine (SVM), Random Forest, and Extreme Gradient Boosting (XGBoost). Results: Model performances evaluated with R-squared score averaged across 30 seeds were 0.377 and 0.188 for anxious- and avoidant-attachment, respectively. Mean absolute error averaged to 13.251 and 12.083, respectively. Shapley value importance analysis indicated that for both attachment types, the most important feature was the trait-anxiety, followed by emotional abuse, state-anxiety or self-reported depressive symptoms, and fear or helplessness felt in the moment of an early life stressor. Conclusion Our results provide the evidence base that may be utilized in clinical settings to predict the degree of attachment type using bio-psychological factors.

Objective: This study aimed to investigate characteristics of suicide attempters who visited the emergency department to identify physical risk factors and rescue factors, and to assess the impact of social distancing during coronavirus disease-2019 (COVID-19) on suicide attempters. Methods: The study utilized data from the medical records of suicide attempters who visited the Bucheon Regional Emergency Medical Center of Soonchunhyang University Bucheon Hospital for 3 years from 2019 and the consultation records of the Life Love Crisis Response Team. This cross-sectional study analyzed changes in risk and rescue characteristics of suicide attempters before, during, and after the implementation of social distancing policies. The Risk-Rescue Rating Scale (RRRS) was used to assess the risk and rescue of suicide attempters. Results: During the implementation of social distancing, the RRRS for physical risk demonstrated a 1.67-fold increase in low-risk cases, which further escalated to a 2.39-fold increase post-implementation compared to the period prior to social distancing. Additionally, the RRRS indicated that behaviors became 1.44 times less rescued amid social distancing, with increased tendencies to conceal the act to evade detection and a reluctance to seek help (p<0.001). Conclusion Our findings indicate that it is important to develop suicide prevention programs for low-risk suicide attempts and to identify the characteristics of suicide attempts that occur during large-scale social isolation, such as infectious diseases, in order to develop strategies for suicide prevention in the future.

This study explores the development, roles, and key initiatives of the Regional Environmental Health Centers in Korea, detailing their evolution through four distinct phases and their impact on environmental health policy and local governance. It chronicles the establishment and transformation of these centers from their inception in May 2007, through four developmental stages. Originally named Environmental Disease Research Centers, they were subsequently renamed Environmental Health Centers following legislative changes. The analysis includes the expansion in the number of centers, the transfer of responsibilities to local governments, and the launch of significant projects such as the Korean Children’s Environmental Health Study (Ko-CHENS ). During the initial phase (May 2007–February 2009), the 10 centers concentrated on research-driven activities, shifting from a media-centered to a receptor-centered approach. In the second phase, prompted by the enactment of the Environmental Health Act, six additional centers were established, broadening their scope to address national environmental health issues. The third phase introduced Ko-CHENS, a 20-year national cohort project designed to influence environmental health policy by integrating research findings into policy frameworks. The fourth phase marked a decentralization of authority, empowering local governments and redefining the centers' roles to focus on regional environmental health challenges. The Regional Environmental Health Centers have significantly evolved and now play a crucial role in addressing local environmental health issues and supporting local government policies. Their capacity to adapt and respond to region-specific challenges is essential for the effective implementation of environmental health policies, reflecting geographical, socioeconomic, and demographic differences.

The purpose of this review is to provide a comprehensive guide for managing older adult patients with shoulder diseases, specifically rotator cuff tears and osteoarthritis, and to explore effective nonsurgical treatment options. Chronic rotator cuff tears are typically degenerative, whereas acute tears result from trauma. A key feature of these tears is tendon degeneration accompanied by type III collagen predominance, predisposing tears to progression. Osteoarthritis in the glenohumeral joint arises from wear-and-tear changes that compromise cartilage integrity, leading to pain and restricted motion. Accurate clinical assessment and imaging, including plain radiographs, ultrasonography, and MRI, facilitate diagnosis and guide treatment. The physic-al examination emphasizes range of motion, rotator cuff strength, and scapular stability. Management strategies prioritize pain relief, function preservation, and improving mobility. Nonsurgical modalities, including exercise, manual therapy, and activity modification, constitute first-line treatments, especially for older adults. Pharmacological approaches involve NSAIDs, corticosteroid injections, and neuropathic pain medications. Steroid injections have short-term benefits, but repeated treatments may compromise tissue integrity. Platelet-rich plasma is a regenerative option that may improve tendon healing, but mixed findings highlight the need for further investigation. A structured physical therapy program focusing on range of motion and strengthening is essential, with alternative interventions used judiciously. Patients should be counseled regarding the potential progression of tears and the possible need for future surgical intervention if nonsurgical methods are unsuccessful. Multimodal approaches, including joint mobilization and personalized exercise regimens, hold potential for optimizing functional outcomes and supporting independence in older adults.

Helicobacter pylori causes gastric cancer and peptic ulcers, and eradication therapy can reduce the incidence of cancer in high-risk groups. In Korea, discrepancies between the reimbursement criteria and clinical guidelines create clinical challenges. This study investigated the perceptions and practices of experts regarding H. pylori testing during upper gastrointestinal endoscopy and any subsequent eradication therapy. An anonymous 8-question survey was conducted among 51 experts attending the 2024 Korean College of Helicobacter and Upper Gastrointestinal Research Summer Workshop. Only 2% of the experts tested all patients. Testing was performed in 54% of patients with a family history of gastric cancer, 32% of those with atrophic gastritis, 42% of those with dyspeptic symptoms, and 62% of those with iron-deficiency anemia. Among patients with suspected infections (based on endoscopic findings) and eligible for selective reimbursement, 82% underwent H. pylori testing. Age did not influence testing decisions for 60% of the experts, and 57% considered factors other than age when deciding on eradication therapy. The practices of the experts varied depending on the patient’s clinical condition and economic burden. Aligning clinical guidelines with the reimbursement criteria is necessary to reduce confusion and ensure appropriate patient care.

This study explores the development, roles, and key initiatives of the Regional Environmental Health Centers in Korea, detailing their evolution through four distinct phases and their impact on environmental health policy and local governance. It chronicles the establishment and transformation of these centers from their inception in May 2007, through four developmental stages. Originally named Environmental Disease Research Centers, they were subsequently renamed Environmental Health Centers following legislative changes. The analysis includes the expansion in the number of centers, the transfer of responsibilities to local governments, and the launch of significant projects such as the Korean Children’s Environmental Health Study (Ko-CHENS ). During the initial phase (May 2007–February 2009), the 10 centers concentrated on research-driven activities, shifting from a media-centered to a receptor-centered approach. In the second phase, prompted by the enactment of the Environmental Health Act, six additional centers were established, broadening their scope to address national environmental health issues. The third phase introduced Ko-CHENS, a 20-year national cohort project designed to influence environmental health policy by integrating research findings into policy frameworks. The fourth phase marked a decentralization of authority, empowering local governments and redefining the centers' roles to focus on regional environmental health challenges. The Regional Environmental Health Centers have significantly evolved and now play a crucial role in addressing local environmental health issues and supporting local government policies. Their capacity to adapt and respond to region-specific challenges is essential for the effective implementation of environmental health policies, reflecting geographical, socioeconomic, and demographic differences.