Rectal cancer, which accounts for approximately 40% of colorectal cancers, remains a major clinical concern. Recent advances in diagnostic imaging, surgical techniques, radiotherapy, and systemic treatment have steadily improved rectal cancer outcomes. Considering this, the Korean Rectal Cancer Multidisciplinary (KRCM) Committee has aimed to provide clinicians and policymakers with up-to-date, evidence-based clinical practice guidelines to support optimal decision-making, reflecting current evidence, the Korean healthcare context, and patient values and preferences. The Clinical Practice Guidelines for Rectal Cancer version 2.0 were developed through multidisciplinary collaboration with related academic societies, building upon and updating the KRCM Clinical Practice Guidelines version 1.0 (titled “Multidisciplinary guidelines for the management of rectal cancer”). These consensus guidelines of the KRCM were established based on a comprehensive literature review, evidence synthesis, with recommendation development guided by the GRADE (Grading of Recommendations Assessment, Development and Evaluation) methodology, and consideration of applicability in real-world clinical practice under the national health insurance system. Each recommendation has been presented with its strength and level of evidence.

Background: This study compared the performance of different versions of generative artificial intelligence (AI) using items fromthe National Examination for Dental Hygienists and evaluated the potential and limitations of ChatGPT as a learning support tool in dental hygiene education. Methods: A total of 200 items from the 2021 National Examination for Dental Hygienists were analyzed. For ChatGPT-4 andChatGPT-4o, both Korean and English versions of the items were entered to calculate accuracy. Problem-solving items were also converted into open-ended questions to assess response accuracy and classify error types. Results: ChatGPT-4o demonstrated higher overall accuracy than ChatGPT-4, with accuracy exceeding 75% for Korean items.Accuracy for English items was lower, with a notable decline in the Medical Law and Regulations domain. Although ChatGPT-4o showed improved performance on open-ended problem-solving items, several responses still contained logical and informational errors. Conclusion Accuracy improved with newer ChatGPT model versions, particularly for recall-oriented items, although substantialperformance differences remained between Korean and English inputs. Persistent logical errors in problem-solving items indicate limited suitability for tasks requiring clinical judgment. These findings highlight the need for students to critically evaluate AI-generated responses and for educators to remain attentive to the rapid evolution of generative AI to ensure its appropriate, continuously updated use in dental hygiene education.

Background: This study aimed to assess the Geriatric Oral Health Assessment Index (GOHAI) based on oral health-relatedbehaviors and oral health status among older adults in Gangneung-si. Methods: A total of 77 adults aged 65 years or older in Gangneung-si who voluntarily participated in an oral health care programwere included. GOHAI was administered as a self-reported questionnaire to evaluate oral health-related quality of life (OHRQoL).GOHAI consists of 12 items rated on a six-point Likert scale, with higher scores indicating better oral health and higher QoL.Assessment items included general characteristics, systemic disease, oral health-related behaviors, and tooth and periodontal status. The Shapiro–Wilk test was used to assess normality prior to comparing GOHAI scores across independent variables.Depending on normality results, differences in mean scores were analyzed using the independent samples t-test, one-way analysis of variance, or the Mann–Whitney U test. Results: The highest-scoring item was “Did your teeth or dentures bother you when you wanted to speak?”, whereas the lowest-scoring item was “Were you pleased or happy looking at your teeth, gums, or dentures?” A significant difference was observed according to the number of remaining teeth; participants with 20 or more teeth had higher GOHAI scores (41.86±5.22) than those with 19 or fewer teeth (38.33±3.83; p=0.046). Conclusion Significant differences in GOHAI scores were found in relation to systemic disease and the number of remaining teeth.These findings can support the development of strategies and policies to improve OHRQoL in older adults in Gangneung-si.

Rare endocrine diseases are complex conditions that require lifelong specialized care due to their chronic nature and associated long-term complications. In Korea, a lack of nationwide data on clinical practice and outcomes has limited progress in patient care. Therefore, the Multicenter Networks for Ideal Outcomes of Pediatric Rare Endocrine and Metabolic Disease (OUTSPREAD) study was initiated. This study involves 30 centers across Korea. The study aims to improve the long-term prognosis of Korean patients with rare endocrine diseases by collecting comprehensive clinical data, biospecimens, and patient-reported outcomes to identify complications and unmet needs in patient care. Patients with childhood-onset pituitary, adrenal, or gonadal disorders, such as craniopharyngioma, congenital adrenal hyperplasia (CAH), and Turner syndrome were prioritized. The planned enrollment is 1,300 patients during the first study phase (2022–2024). Clinical, biochemical, and imaging data from diagnosis, treatment, and follow-up during 1980–2023 were retrospectively reviewed. For patients who agreed to participate in the prospective cohort, clinical data and biospecimens will be prospectively collected to discover ideal biomarkers that predict the effectiveness of disease control measures and prognosis. Patient-reported outcomes, including quality of life and depression scales, will be evaluated to assess psychosocial outcomes. Additionally, a substudy on CAH patients will develop a steroid hormone profiling method using liquid chromatography-tandem mass spectrometry to improve diagnosis and monitoring of treatment outcomes. This study will address unmet clinical needs by discovering ideal biomarkers, introducing evidence-based treatment guidelines, and ultimately improving long-term outcomes in the areas of rare endocrine and metabolic diseases.

Background: Atrial fibrillation (AF) is associated with increased risks of adverse events including stroke and all-cause death. Understanding the pattern of causes of death (COD) with the relative risks in patients with AF compared to the non-AF population is essential in planning optimal care for patients with AF. We aimed to analyze the COD and its relative risks in patients with AF, using a nationwide population-based cohort. Methods: Using the Korean nationwide claims database, people aged 40 or older who received health examinations in 2009 were included if they had no missing values (n = 6,877,929).In total the study included 40,585 people with AF and 6,837,344 without AF. COD was defined by International Classification of Diseases, Tenth Revision, Clinical Modification (ICD-10-CM) diagnostic codes. Comparison between the AF and non-AF groups was performed with Multivariate Cox proportional regression model. Results: In the AF group, cardiovascular diseases were the most common COD, causing 39.8% of all deaths, compared with 19.0% for non-AF subjects. The AF group was associated with a higher risk of death from cardiovascular and cerebrovascular diseases by almost 3-fold than the matched non-AF group (hazard ratios [HR], 3.082; 95% confidence intervals [CIs], 2.963–3.205 for cardiovascular diseases; HR, 2.981; 95% CI, 2.799–3.175 for cerebrovascular diseases, all P < 0.001). Among patients with AF, the risks of all-cause, cardiovascular, and cerebrovascular death were well-stratified by CHA2DS2 -VASc scores. The risk of cerebrovascular death was 11 times higher among patients with a CHA2DS2 -VASc score ≥ 7. Conclusion Compared to non-AF individuals, patients with AF had a higher risk of death from cardiovascular and cerebrovascular diseases, and the mortality risks were wellstratified by the CHA2DS2 -VASc score. Integrated care management of cardiovascular and cerebrovascular diseases for patients with AF might help mitigate mortality.

Background: Atrial fibrillation (AF) is associated with increased risks of adverse events including stroke and all-cause death. Understanding the pattern of causes of death (COD) with the relative risks in patients with AF compared to the non-AF population is essential in planning optimal care for patients with AF. We aimed to analyze the COD and its relative risks in patients with AF, using a nationwide population-based cohort. Methods: Using the Korean nationwide claims database, people aged 40 or older who received health examinations in 2009 were included if they had no missing values (n = 6,877,929).In total the study included 40,585 people with AF and 6,837,344 without AF. COD was defined by International Classification of Diseases, Tenth Revision, Clinical Modification (ICD-10-CM) diagnostic codes. Comparison between the AF and non-AF groups was performed with Multivariate Cox proportional regression model. Results: In the AF group, cardiovascular diseases were the most common COD, causing 39.8% of all deaths, compared with 19.0% for non-AF subjects. The AF group was associated with a higher risk of death from cardiovascular and cerebrovascular diseases by almost 3-fold than the matched non-AF group (hazard ratios [HR], 3.082; 95% confidence intervals [CIs], 2.963–3.205 for cardiovascular diseases; HR, 2.981; 95% CI, 2.799–3.175 for cerebrovascular diseases, all P < 0.001). Among patients with AF, the risks of all-cause, cardiovascular, and cerebrovascular death were well-stratified by CHA2DS2 -VASc scores. The risk of cerebrovascular death was 11 times higher among patients with a CHA2DS2 -VASc score ≥ 7. Conclusion Compared to non-AF individuals, patients with AF had a higher risk of death from cardiovascular and cerebrovascular diseases, and the mortality risks were wellstratified by the CHA2DS2 -VASc score. Integrated care management of cardiovascular and cerebrovascular diseases for patients with AF might help mitigate mortality.

Rare endocrine diseases are complex conditions that require lifelong specialized care due to their chronic nature and associated long-term complications. In Korea, a lack of nationwide data on clinical practice and outcomes has limited progress in patient care. Therefore, the Multicenter Networks for Ideal Outcomes of Pediatric Rare Endocrine and Metabolic Disease (OUTSPREAD) study was initiated. This study involves 30 centers across Korea. The study aims to improve the long-term prognosis of Korean patients with rare endocrine diseases by collecting comprehensive clinical data, biospecimens, and patient-reported outcomes to identify complications and unmet needs in patient care. Patients with childhood-onset pituitary, adrenal, or gonadal disorders, such as craniopharyngioma, congenital adrenal hyperplasia (CAH), and Turner syndrome were prioritized. The planned enrollment is 1,300 patients during the first study phase (2022–2024). Clinical, biochemical, and imaging data from diagnosis, treatment, and follow-up during 1980–2023 were retrospectively reviewed. For patients who agreed to participate in the prospective cohort, clinical data and biospecimens will be prospectively collected to discover ideal biomarkers that predict the effectiveness of disease control measures and prognosis. Patient-reported outcomes, including quality of life and depression scales, will be evaluated to assess psychosocial outcomes. Additionally, a substudy on CAH patients will develop a steroid hormone profiling method using liquid chromatography-tandem mass spectrometry to improve diagnosis and monitoring of treatment outcomes. This study will address unmet clinical needs by discovering ideal biomarkers, introducing evidence-based treatment guidelines, and ultimately improving long-term outcomes in the areas of rare endocrine and metabolic diseases.

Background: The population of Gangneung City in South Korea has shown a gradual increase in the proportion of individuals aged 65 years and older, and the most frequently reported diseases for several years have consistently been periodontal diseases, including gingivitis and periodontitis. The regional imbalance in the distribution of dental personnel and resources has emerged as a problem of inequality in the use of dental care. It has been advocated to identify areas with disadvantages in dental care and develop public dental policies based on that. This study aimed to develop a customized oral healthcare program for local seniors based on a Public-Private-Academic Partnership, and to evaluate the oral health status of older adults in Gangneung City. Methods: The participants were residents aged 60 years and above in Gangneung City. A questionnaire including general information, systemic health status, and oral health status was administered to the participants. In addition, oral healthcare and education tailored to each individual’s health status were provided once or twice based on their oral health status. The collected data were analyzed using IBM SPSS Statistics 25 for descriptive statistical analysis. Results: Among the older adults in Gangneung City, 75% had at least one prosthesis and exhibited symptoms of gingivitis or periodontitis. Additionally, the modified sulcus bleeding index decreased among participants who underwent the program twice.Over 90% of the participants expressed satisfaction with the program. Conclusion The program appeared to contribute positively to the oral health promotion among local seniors. Further oral healthcare programs should focus on seniors in rural and old urban areas to reduce disparities in oral health across regions.

Background: To train dental hygienists to utilize knowledge in practice, an integrated curriculum based on the competencies of dental hygienists is expanding; however, in the field of basic dental hygiene the curriculum is still fragmented and based on segmented knowledge. This study developed an integrated curriculum based on the competencies of dental hygienists in Anatomy, Histology & Embryology, Physiology, which are subjects for basic dental hygiene that have high linkage and overlap. Methods: After selecting the learning objectives for the integrated curriculum from those of Anatomy, Histology & Embryology, Physiology, the duties of the dental hygienist in relation to the learning objectives were analyzed. Learning objectives were combined with the duties of a dental hygienist to derive competencies for an integrated curriculum. Referring to the syllabus and learning objectives for each subject, the weekly educational content, learning objectives, and credits of the integrated curriculum were derived. After conducting a Delphi survey to validate the competency and content of the derived integrated curriculum, an integrated curriculum was developed. Results: By using the first and second Delphi surveys, four competencies were developed for dental hygienists that can be achieved through an integrated basic dental hygiene curriculum. In addition, an integrated curriculum including the courses Anatomy, Histology & Embryology, Physiology, Structure and Function of the Human Body/Head/Neck, and Structure and Function of the Oral Cavity was established. Conclusion This study presents a specific example for developing a competency-based integrated curriculum that can be used as a framework to derive a competency-based integrated curriculum among subjects that can be integrated according to the linkage of learning contents and the competencies that can be achieved.

Background: This study aimed to evaluate ChatGPT’s performance accuracy in responding to questions from the national dentalhygienist examination. Moreover, through an analysis of ChatGPT’s incorrect responses, this research intended to pinpoint the predominant types of errors. Methods: To evaluate ChatGPT-3.5’s performance according to the type of national examination questions, the researchers classified 200 questions of the 49th National Dental Hygienist Examination into recall, interpretation, and solving type questions. The researchers strategically modified the questions to counteract potential misunderstandings from implied meanings or technical terminology in Korea. To assess ChatGPT-3.5’s problem-solving capabilities in applying previously acquired knowledge, the questions were first converted to subjective type. If ChatGPT-3.5 generated an incorrect response, an original multiple-choice framework was provided again. Two hundred questions were input into ChatGPT-3.5 and the generated responses were analyzed.After using ChatGPT, the accuracy of each response was evaluated by researchers according to the types of questions, and the types of incorrect responses were categorized (logical, information, and statistical errors). Finally, hallucination was evaluated when ChatGPT provided misleading information by answering something that was not true as if it were true. Results: ChatGPT’s responses to the national examination were 45.5% accurate. Accuracy by question type was 60.3% for recall and 13.0% for problem-solving type questions. The accuracy rate for the subjective solving questions was 13.0%, while the accuracy for the objective questions increased to 43.5%. The most common types of incorrect responses were logical errors 65.1% of all. Of the total 102 incorrectly answered questions, 100 were categorized as hallucinations. Conclusion ChatGPT-3.5 was found to be limited in its ability to provide evidence-based correct responses to the Korean nationaldental hygiene examination. Therefore, dental hygienists in the education or clinical fields should be careful to use artificial intelligence-generated materials with a critical view.