Objectives: ：This study was designed to investigate the effect of sleep quality on depression symptoms and the mediating effect of interpretation bias and anxiety symptoms in psychiatric patients. Methods: ：Data accumulated for outpatients and inpatients in the Department of Mental Health Medicine at Hanyang University Guri Hospital were used. The measurement tools were Pittsburgh Sleep Quality Index (PSQI), Ambiguous/Unambiguous Situations Diary-Extended Version (AUSD-EX), Beck Anxiety Inventory (BAI), Beck Depression Inventory-II (BDI-II). Correlation analysis and bootstrapping analysis were conducted using SPSS 25.0 and SPSS Macro based on 162 patient data. Results: ：As a result of the study, the double mediating effect of interpretation bias for Ambiguity and anxiety symptoms was significant in the relationship between sleep quality and depression symptoms. Conclusions ：In this study, it was confirmed that low sleep quality sequentially affects anxiety and depression symptoms through interpretation bias for ambiguity. Based on this, it is expected that the development of other psychiatric symptoms can be prevented by preferentially performing therapeutic intervention on preceding symptoms.

PURPOSE: The quality of problem representation is critical for developing students' problem-solving abilities in problem-based learning (PBL). This study investigates preclinical students' experience with standardized patients (SPs) as a problem representation method compared to using video cases in PBL. METHODS: A cohort of 99 second-year preclinical students from Inje University College of Medicine (IUCM) responded to a Likert scale questionnaire on their learning experiences after they had experienced both video cases and SPs in PBL. The questionnaire consisted of 14 items with eight subcategories: problem identification, hypothesis generation, motivation, collaborative learning, reflective thinking, authenticity, patient-doctor communication, and attitude toward patients. RESULTS: The results reveal that using SPs led to the preclinical students having significantly positive experiences in boosting patient-doctor communication skills; the perceived authenticity of their clinical situations; development of proper attitudes toward patients; and motivation, reflective thinking, and collaborative learning when compared to using video cases. The SPs also provided more challenges than the video cases during problem identification and hypotheses generation. CONCLUSION: SPs are more effective than video cases in delivering higher levels of authenticity in clinical problems for PBL. The interaction with SPs engages preclinical students in deeper thinking and discussion; growth of communication skills; development of proper attitudes toward patients; and motivation. Considering the higher cost of SPs compared with video cases, SPs could be used most advantageously during the preclinical period in the IUCM curriculum.
Cohort Studies ; Curriculum ; Humans ; Learning ; Methods ; Motivation ; Problem-Based Learning* ; Thinking

PURPOSE: The purpose of this study was to explore the relationships among medical students' assessments on peers' group presentations, instructors' assessments of those presentations, and students' educational achievements in other assignments and tests. METHODS: A total of 101 first-year students from a medical school participated in the study. The students' educational achievements in a 4-week long integrated curriculum were analyzed. Student's final grades were comprised of the following education criteria: two written tests (60%), 15 group reports (25%), one individual report (7%), and four group presentations (15%). We compared scores of the group presentation assessed by the peers and the two instructors. Furthermore, we compared peers' assessment scores with each component of the evaluation criteria. RESULTS: Pearson correlation analysis showed significant correlaton for the assessments between peers and instructors (r=0.775, p<0.001). Peer assessment scores also correlated significantly with scores for the group assignments (r=0.777, p<0.001), final grades on the curriculum (r=0.345, p<0.001), and scores for individual assignments (r=0.334, p<0.001); however, no significant correlation was observed between the peer-assessed group presentation scores and the two written test scores. CONCLUSION: Peer assessments may be a reliable and valid method for evaluating medical students' performances in an integrated curriculum, especially if the assessments are used to academic processes, such as presentations, with explicit evaluation and judgment criteria. Peer assessments on group presentations might assess different learning domains compared to written tests that primarily evaluate limited medical knowledge and clinical reasoning.
Curriculum ; Education ; Educational Status ; Group Processes ; Humans ; Judgment ; Learning ; Methods ; Peer Review ; Schools, Medical ; Self-Evaluation Programs ; Students, Medical*

PURPOSE: The aims of this study were to define the necessity and effectiveness of patient safety education during surgical clerkship to develop competency for managing and preventing medical errors. METHODS: Fifty 3rd-year students participated in the patient safety education program during a 4-week surgical clerkship. The students were divided into 4 groups: control group, pretest-only group, education-only group, and pretest and education group. Students were assessed using short essays and an oral exam for reasoning skills, clinical performance exams for patient education and communication skills, and multisource feedback and direct observation of error reporting for real-world problem-solving skills. The results were analyzed with SPSS 14.0K. The reliability (Cronbach alpha) of the entire assessment was 0.893. RESULTS: There was no difference in scores between early and late clerkship groups. Reasoning skills were improved by the pretest. Reasoning, patient education, and error reporting skills were much more developed by patient safety education. Real-world error identification, reporting, and communication did not change after the 4-week course. CONCLUSIONS: Patient safety education during surgical clerkship is necessary and effective. Error prevention and competency management in the real world should developed.
Clinical Clerkship ; Clinical Competence ; Humans ; Medical Errors ; Patient Education as Topic ; Patient Safety ; Safety Management

OBJECTIVE: We sought to determine the predictors of midpalatal suture expansion by miniscrew-assisted rapid palatal expansion (MARPE) in young adults. METHODS: The following variables were selected as possible predictors: chronological age, palate length and depth, midpalatal suture maturation (MPSM) stage, midpalatal suture density (MPSD) ratio, the sella-nasion (SN)-mandibular plane (MP) angle as an indicator of the vertical skeletal pattern, and the point A-nasion-point B (ANB) angle for anteroposterior skeletal classification. For 31 patients (mean age, 22.52 years) who underwent MARPE treatment, palate length and depth, MPSM stage and MPSD ratio from the initial cone-beam computed tomography images, and the SN-MP angle and ANB angle from lateral cephalograms were assessed. The midpalatal suture opening ratio was calculated from the midpalatal suture opening width measured in periapical radiographs and the MARPE screw expansion. Statistical analyses of correlations were performed for the entire patient group of 31 subjects and subgroups categorized by sex, vertical skeletal pattern, and anteroposterior skeletal classification. RESULTS: In the entire patient group, the midpalatal suture opening ratio showed statistically significant negative correlations with age, palate length, and MPSM stage (r = −0.506, −0.494, and −0.746, respectively, all p < 0.01). In subgroup analyses, a strong negative correlation was observed with the palate depth in the skeletal Class II subgroup (r = −0.900, p < 0.05). CONCLUSIONS The findings of this study indicated that age, palate length, and MPSM stage can be predictors of midpalatal suture expansion by MARPE in young adults.

Objective: This study aimed to investigate the validity and reliability of the Korean version of the Brief Irritability Test (BITe) and adapt it for Korean patients with psychiatric disorders. Methods: A total of 296 patients at the Department of Psychiatry of Hanyang University Guri Hospital completed the BITe, Korean Beck Depression Inventory-II, Korean Beck Anxiety Inventory, the Korean version of the State-Trait Anger Expression Inventory, and Barratt Impulsiveness Scale-11. Construct validity was confirmed through exploratory factor analysis (EFA) and confirmatory factor analysis (CFA). Reliability testing included assessments of internal consistency (Cronbach’s α) and item-total correlations. Convergent validity was examined through correlational analyses with variables such as anxiety, depression, anger, and impulsivity. Results: First, the scale had good internal consistency with a Cronbach’s α of 0.88. Second, EFA indicated a single dimensionality of the BITe, and CFA demonstrated a reasonable fit for the single-factor model (comparative fit index=0.97, Tucker-Lewis Index=0.95, normed fit index=0.97, goodness-of-fit index=0.96, root mean square error of approximation=0.12, standardized root mean residual=0.03). Finally, the convergent validity analysis revealed a significant positive correlation with depression, anxiety, and anger, except for anger control, which is a sub-variable of anger. Conclusion The results showed that the Korean version of the BITe had good psychometric properties, and might serve as a valuable tool for assessing irritability in Korean patients with psychiatric disorders.

PURPOSE: Despite recommendations for introducing student internships (SI) in undergraduate medical education in Korea, the feasibility of surgical SIs has not been demonstrated in the Korean context. We thus identified tasks that could be performed by surgical student interns in a Korean education hospital. METHODS: The opinions of surgery clerkship directors of medical schools nationwide, regarding the tasks, symptoms and signs, disease entities, and procedures that student interns could perform in their hospitals, were subjected to descriptive analysis. RESULTS: Out of the 41 medical schools in Korea, 32 responded. Five implemented an optimal-quality SI program. Two schools considered third-year clerkship as SI. The respondents replied that student interns could be involved in basic nonspecific tasks such as history taking, physical examination, medial recording, reporting patients' status, and assisting during surgery. However, more surgery-specific tasks such as perioperative management or caring for a patient with acute abdominal pain were considered difficult for student interns to encounter in the Korean context. CONCLUSION: Surgical educators should determine a specific role for student interns and encourage them to perform surgery-specific tasks. We recommend societal and system support, and curriculum renovation to establish an SI program in Korea.
Abdominal Pain ; Clinical Clerkship ; Clinical Competence ; Curriculum ; Surveys and Questionnaires ; Education ; Education, Medical, Undergraduate ; Humans ; Internship and Residency* ; Korea ; Physical Examination ; Schools, Medical

The efficiency of somatic cell nuclear transfer (NT) in pigs is low and requires enhancement. We identified the most efficient method for zona pellucida (ZP) removal and blastomere aggregation in pigs and investigated whether the aggregation of NT and parthenogenetic activation (PA) of blastomeres could reduce embryonic apoptosis and improve the quality of NT-derived embryos by investigating. Embryonic developmental competence after ZP removal using acid Tyrode's solution or protease (pronase E). The embryonic developmental potential of NT-derived blastomeres was also investigated using well-of-the-well or phytohemagglutinin-L. We analyzed apoptosis in aggregate-derived blastocysts. The aggregation rate of protease-treated embryos was lower than that of Tyrode’s solution-treated embryos (69.2% vs. 88.3%). No significant difference was observed between phytohemagglutinin-L and well-of-the-well (35.7%–38.5%). However, 2P1N showed a higher number of blastocysts compared to 3N (73.8% vs. 24.3%) and an increased blastocyst diameter compared to the control and 1P2N (274 μm vs. 230–234 μm). In blastomeres aggregated using phytohemagglutinin-L, the apoptotic cell ratio was significantly higher in 1P2N and 3N than in 3P (5.91%–6.46% vs. 2.94%, respectively). Our results indicate that aggregation of one NT embryo with two PA embryos improved the rate of blastocysts with increased blastocyst diameter.

Rheumatoid arthritis (RA) is a chronic autoimmune disease that typically results in strong inflammation and bone destruction in the joints. It is generally known that the pathogenesis of RA is linked to cardiovascular and periodontal diseases. Though rheumatoid arthritis and periodontitis share many pathologic features such as a perpetual inflammation and bone destruction, the precise mechanism underlying a link between these two diseases has not been fully elucidated. Collagen-induced arthritis (CIA) mice were orally infected with Porphyromonas gingivalis (Pg) or Pg preincubated with an anti-FimA antibody (FimA Ab) specific for fimbriae that are flexible appendages on the cell surface. Pg-infected CIA mice showed oral microbiota disruption and increased alveolar bone loss and had synovitis and joint bone destruction. However, preincubation with FimA Ab led to a significant reduction in the severity of both oral disease and arthritis. Moreover, FimA Ab attenuated bacterial attachment and aggregation on human gingival and rheumatoid arthritis synovial fibroblasts. In addition, we discovered bacteria may utilize dendritic cells, macrophages and neutrophils to migrate into the joints of CIA mice. These results suggest that disrupting Pg fimbriae function by FimA Ab ameliorates RA.

A wave of new technologies has created opportunities for the cost-effective generation of high-throughput profiles of biological systems, foreshadowing a "data-driven science" era. The large variety of data available from biological research is also a rich resource that can be used for innovative endeavors. However, we are facing considerable challenges in big data deposition, integration, and translation due to the complexity of biological data and its production at unprecedented exponential rates. To address these problems, in 2020, the Korean government officially announced a national strategy to collect and manage the biological data produced through national R&D fund allocations and provide the collected data to researchers. To this end, the Korea Bioinformation Center (KOBIC) developed a new biological data repository, the Korea BioData Station (K-BDS), for sharing data from individual researchers and research programs to create a data-driven biological study environment. The K-BDS is dedicated to providing free open access to a suite of featured data resources in support of worldwide activities in both academia and industry.