PURPOSE: To determine whether disclosure of scoring rubric for objective basic clinical skills can improve the scores on the objective structured clinical examination (OSCE) in medical students. METHODS: Clinical performance score results of one university medical students (study group, n=345) were compared to those of another university (control group, n=1,847). Both groups took identical OSCE exam. OSCE rubric was not revealed to the study group until they were in the last 2 years of medical school. RESULTS: There was no significant difference between before and after disclosure of rubric. However, history taking and physical examination scores of the study group were lower than those of the control group before the disclosure of rubric. After disclosure of rubric, the scores were either unchanged or slightly increased in the control group. Trend analysis of scores demonstrated that history taking and physical examination scores after the disclosure were significantly increased in the study group for 2 years. CONCLUSION: This study revealed that disclosure of basic clinical skills rubric to medical students could enhance their clinical performance, particularly in history taking and physical examination scores.
Clinical Competence* ; Disclosure* ; Humans ; Physical Examination ; Schools, Medical ; Students, Medical

PURPOSE: Academic failure tolerance (AFT) is one of the important psychological concepts in education, but its applications in medical education are rare. Thus, the purpose of this study was to investigate the effect of academic failure tolerance on academic achievement fluctuation among medical school students using a longitudinal research design. METHODS: The subjects were 43 medical students who responded to the AFT test. This study analyzed the longitudinal data of achievement scores up to the 2nd academic year (2012–2013) among students who were divided into academic achievement improvement and decline groups. RESULTS: Comparing the improvement and decline groups' mean academic achievement fluctuation scores demonstrated that behavior and preferred task difficulty showed high scores whereas feeling scores were lower in the improvement group (p<0.05). CONCLUSION: In the improvement group, despite the higher negative feeling scores during academic failure, the students favored the more difficult subjects and were more assiduous in their studies. This will form an important basis for enhancing academic achievement among medical students.
*Achievement ; *Attitude ; *Behavior ; *Education, Medical, Undergraduate ; Educational Measurement ; *Educational Status ; *Emotions ; Humans ; Longitudinal Studies ; Schools, Medical ; *Students, Medical

PURPOSE: Fruit and vegetable juices are known to be rich sources of antioxidants, which have beneficial effects on diseases caused by oxidative stress. The purpose of this study was to directly compare the antioxidant activities of fruit and vegetable juices marketed in Korea. METHODS: We analyzed four fruit juices, two vegetable juices, two yellow-green juices, and six mixed vegetable juices. Antioxidant activities were analyzed using 2,2-diphenyl-1-picrylhydrazyl (DPPH) test, 2,2'-azino-bis(3-ethylbenzothiazoline-6-sulphonate) (ABTS) test, and oxygen radical absorbance capacity (ORAC) assay. Protective effects against DNA damage were determined using an ex vivo comet assay with human lymphocytes. RESULTS: DPPH radical scavenging activities were in the following order: blueberry juice > mixed vegetable C juice > kale juice > mixed vegetable P juice > grape juice. ABTS radical scavenging activities were in the following order: blueberry juice > mixed vegetable C juice > grape juice > mixed vegetable P juice > kale juice. Peroxyl radical scavenging activities as assessed by ORAC assay were in the following order: blueberry juice > kale juice > mixed vegetable C juice > grape juice. Grape or blueberry juice showed strong abilities to prevent DNA damage in lymphocytes, and the difference between them was not significant according to the GSTM1/GSTT1 genotype. CONCLUSION: Antioxidant activities of fruit and vegetable juices and ex vivo DNA protective activity increased in the order of blueberry juice, grape juice, and kale juice, although the rankings were slightly different. Therefore, these juices rich in polyphenols and flavonoids deserve more attention for their high antioxidant capacity.
Antioxidants ; Blueberry Plant ; Brassica ; Comet Assay ; DNA Damage* ; DNA* ; Flavonoids ; Fruit and Vegetable Juices* ; Fruit* ; Genotype ; Humans ; Korea* ; Lymphocytes* ; Oxidative Stress ; Oxygen ; Polyphenols ; Vegetables ; Vitis

BACKGROUND: The sectioned images of a cadaver head made from the Visible Korean project have been used for research and educational purposes. However, the image resolution is insufficient to observe detailed structures suitable for experts. In this study, advanced sectioned images with higher resolution were produced for the identification of more detailed structures. METHODS: The head of a donated female cadaver was scanned for 3 Tesla magnetic resonance images and diffusion tensor images (DTIs). After the head was frozen, the head was sectioned serially at 0.04-mm intervals and photographed repeatedly using a digital camera. RESULTS: On the resulting 4,000 sectioned images (intervals and pixel size, 0.04 mm³; color depth, 48 bits color; a file size, 288 Mbytes), minute brain structures, which can be observed not on previous sectioned images but on microscopic slides, were observed. The voxel size of this study (0.04 mm³) was very minute compared to our previous study (0.1 mm³; resolution, 4,368 × 2,912) and Visible Human Project of the USA (0.33 mm³; resolution, 2,048 × 2,048). Furthermore, the sectioned images were combined with tractography of the DTIs to elucidate the white matter with high resolution and the actual color of the tissue. CONCLUSION: The sectioned images will be used for diverse research, including the applications for the cross sectional anatomy and three-dimensional models for virtual experiments.
Anatomy, Cross-Sectional ; Brain ; Cadaver ; Diffusion ; Diffusion Tensor Imaging ; Female ; Head ; Humans ; White Matter

Objectives: This study examined the association between the experience of disease management education and the use of nutrition labels according to the sociodemographic characteristics and health behaviors of people diagnosed with hypertension and diabetes living in the community. Methods: Among the participants from the Community Health Survey (2018), 74,283 individuals diagnosed with hypertension or diabetes were included in the study population. According to gender, this study evaluated nutrition label use by the experience of disease management education, individual sociodemographic characteristics, and health behavior. Finally, using multiple logistic regression analysis, the association between disease management education and nutrition labels was calculated using the odds ratio (OR) and 95% confidence interval (CI). Results: Males (24.5%) experienced more disease management education than females (22.6%). In addition, younger age, higher education level, and higher equalized personal income experienced more disease management education (P < 0.001). The educational experience rate was higher in the male subjects who did not smoke or were involved in high-risk alcohol consumption (P < 0.001). In addition, the rate of disease management education experience was significantly higher for both men and women who exercised by walking (P < 0.001). The use of nutrition labels was higher in females (9.9%) than males (5.8%), and both males and females were significantly higher in young age, high education, high income, and professional and office positions (P < 0.001). The utilization rate of nutrition labels was high in non-smoking male subjects and high-risk-drinking female subjects. In addition, the utilization rate of nutrition labels was significantly higher in males and females who exercised by walking and those who experienced disease management education (P < 0.001). After adjusting for individual sociodemographic characteristics, health behavior, and disease management education, the use of nutrition labels was high among females (OR 3.19, 95% CI 2.85-3.58), high income (Q4; OR 1.62, 95% CI 1.41-1.87, Q5; OR 1.58, 95% CI 1.37-1.84) and highly educated (high school; OR 2.87, 95% CI 2.62-3.14, above college; OR 5.60, 95% CI 5.02-6.23) while it was low in the elderly (OR 0.43, 95% CI 0.40-0.47), and economically inactive (OR 0.86, 95% CI 0.76-0.96). The use of nutrition labels was high in non-smokers (OR 1.29, 95% CI 1.13-1.48), nonhigh-risk drinkers (OR 1.22, 95% CI 1.08-1.38), and subjects who exercised walking (OR 1.44, 95% CI 1.34-1.54). There was no difference in the utilization rate of nutrition labels according to obesity, and the utilization rate of nutrition labels was significantly higher in subjects who had experienced disease education (OR 1.34, 95% CI 1.24-1.44). Conclusions Education on the use of nutrition labels, which contributes to food selection for healthy eating, might be a tool for dietary management. Moreover, the utilization rate can be a good indicator for predicting the proportion of the population practicing the guide for disease management. Improving the utilization rate of nutrition labels through disease management education can be a useful intervention for people with chronic diseases who need healthy eating habits for disease management and preventing complications, particularly those diagnosed with hypertension and diabetes.

Purpose: During the coronavirus disease 2019 pandemic, many countries have reported sharp drops in the numbers of patients, especially children, seeking emergency care unrelated to the disease. The author investigated the patterns of febrile children’s visits to the emergency department (ED) of a tertiary hospital from 2017 through 2020. Methods: We compared the data of febrile children aged 15 years or younger who visited the ED in 2017-2019 and in 2020 (February through August, each year). Information on the children’s baseline characteristics, the Korean Triage and Acuity Scale 1-2 indicating a high severity, and ED disposition, such as hospitalization, were collected. In addition, we determined the number of children who underwent cancellation, defined as the leave of children without treatment, and the rates of respiratory virus polymerase chain reaction performance and its positivity. Results: In 2020, we noted decreases in the median monthly fever-related ED visits (2017-2019, 326 [interquartile range, 292-425] vs. 2020, 149 [132-182]; P < 0.001) with a shorter median fever duration (2017-2019, 11 [3-27] days vs. 2020, 9 [2-23] days; P < 0.001). However, in the same year, we noted increases in rates of the Korean Triage and Acuity Scale 1-2 (2017-2019, 5.7% vs. 2020, 16.4%; P < 0.001) and hospitalization (2017-2019, 23.5% vs. 2020, 35.7%; P < 0.001). We also noted increases in the number of cancellation and the rate of respiratory virus polymerase chain reaction performance rate, along with a decrease in its positive rate in 2020. Conclusion During the pandemic, the febrile children’s visits to the ED decreased in number. However, the severity remarkably increased, requiring more medical attention.

Purpose: During the coronavirus disease 2019 pandemic, many countries have reported sharp drops in the numbers of patients, especially children, seeking emergency care unrelated to the disease. The author investigated the patterns of febrile children’s visits to the emergency department (ED) of a tertiary hospital from 2017 through 2020. Methods: We compared the data of febrile children aged 15 years or younger who visited the ED in 2017-2019 and in 2020 (February through August, each year). Information on the children’s baseline characteristics, the Korean Triage and Acuity Scale 1-2 indicating a high severity, and ED disposition, such as hospitalization, were collected. In addition, we determined the number of children who underwent cancellation, defined as the leave of children without treatment, and the rates of respiratory virus polymerase chain reaction performance and its positivity. Results: In 2020, we noted decreases in the median monthly fever-related ED visits (2017-2019, 326 [interquartile range, 292-425] vs. 2020, 149 [132-182]; P < 0.001) with a shorter median fever duration (2017-2019, 11 [3-27] days vs. 2020, 9 [2-23] days; P < 0.001). However, in the same year, we noted increases in rates of the Korean Triage and Acuity Scale 1-2 (2017-2019, 5.7% vs. 2020, 16.4%; P < 0.001) and hospitalization (2017-2019, 23.5% vs. 2020, 35.7%; P < 0.001). We also noted increases in the number of cancellation and the rate of respiratory virus polymerase chain reaction performance rate, along with a decrease in its positive rate in 2020. Conclusion During the pandemic, the febrile children’s visits to the ED decreased in number. However, the severity remarkably increased, requiring more medical attention.

The long-term storage of memory requires the finely tuned coordination of intracellular signaling with the transcriptional, translational and epigenetic regulations of gene expression. Among the epigenetic mechanisms, however, we know relatively little about the involvement of chromatin remodeling-dependent control of gene expression in cognitive brain functions, compared with our knowledge of other such mechanisms (for example, histone modifications and DNA methylation). A few recent studies have implicated the Brm/Brg-associated factor (BAF) chromatin-remodeling complex, a mammalian homolog of the yeast Swi/Snf complex, in neuronal structural/functional plasticity and memory formation. The BAF complex was previously known to have a critical role in neurodevelopment, but these recent findings indicate that it also contributes to both cognitive functions in the adult brain and human mental disorders characterized by intellectual disability. In this review, we provide a brief overview of the BAF complexes, introduce recent research findings that link their functions to memory formation, and speculate on the yet-unknown molecular mechanisms that may be relevant to these processes.
Actins/metabolism ; Animals ; *Chromatin Assembly and Disassembly ; Chromosomal Proteins, Non-Histone/metabolism ; DNA-Binding Proteins/metabolism ; Gene Expression Regulation ; Humans ; Learning ; *Memory ; Multiprotein Complexes/metabolism ; Neurons/*metabolism ; Protein Binding ; Signal Transduction ; Transcription Factors/*metabolism

PURPOSE: We aim to identify what potential bias factors affected students' overall course evaluation, and to observe what factors should be considered in the curriculum evaluation system of medical schools. METHODS: This study analyzed students' ratings of preclinical instructions at the Ajou University School of Medicine. The ratings of instructions involved 41 first-year and 45 second-year medical students. RESULTS: There was a statistically significant difference between years of study and ratings' scoring. Learning difficulty, learning amount, student assessment, and teacher preparation from second-year students were significantly higher than first-year students (p<0.05). The analysis results revealed that student assessment was the predictor of ratings from first-year students, while teacher preparation was the predictor of ratings from second-year students. CONCLUSION: We found significant interactions between year of study and the students' rating results. We were able to confirm that satisfaction of instructions factors perceived by medical students were different for the characteristics of courses. Our results may be an important resource for evaluating preclinical curriculums.
Bias (Epidemiology)* ; Curriculum ; Humans ; Learning ; Schools, Medical ; Students, Medical

OBJECTIVE: To prospectively evaluate the diagnostic performance of computer-aided diagnosis (CAD) for detection of thyroid cancers via ultrasonography (US). MATERIALS AND METHODS: This study included 50 consecutive patients with 117 thyroid nodules on US during the period between June 2016 and July 2016. A radiologist performed US examinations using real-time CAD integrated into a US scanner. We compared the diagnostic performance of radiologist, the CAD system, and the CAD-assisted radiologist for the detection of thyroid cancers. RESULTS: The sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and accuracy of the CAD system were 80.0, 88.1, 83.3, 85.5, and 84.6%, respectively, and were not significantly different from those of the radiologist (p > 0.05). The CAD-assisted radiologist showed improved diagnostic sensitivity compared with the radiologist alone (92.0% vs. 84.0%, p = 0.037), while the specificity and PPV were reduced (85.1% vs. 95.5%, p = 0.005 and 82.1% vs. 93.3%, p = 0.008). The radiologist assisted by the CAD system exhibited better diagnostic sensitivity and NPV than the CAD system alone (92.0% vs. 80.0%, p = 0.009 and 93.4% vs. 88.9%, p = 0.013), while the specificities and PPVs were not significantly different (88.1% vs. 85.1%, p = 0.151 and 83.3% vs. 82.1%, p = 0.613, respectively). CONCLUSION: The CAD system may be an adjunct to radiological intervention in the diagnosis of thyroid cancer.
Artificial Intelligence ; Diagnosis* ; Humans ; Prospective Studies ; Sensitivity and Specificity ; Thyroid Gland* ; Thyroid Neoplasms ; Thyroid Nodule* ; Ultrasonography*