Purpose: This study assessed the validity of the hospital standardized mortality ratio (HSMR) risk-adjusted model by comparing models that include clinical information and the current model based on administrative information in South Korea. Materials and Methods: The data of 53976 inpatients were analyzed. The current HSMR risk-adjusted model (Model 1) adjusts for sex, age, health coverage, emergency hospitalization status, main diagnosis, surgery status, and Charlson Comorbidity Index (CCI) using administrative data. As candidate variables, among clinical information, the American Society of Anesthesiologists score, Acute Physiology and Chronic Health Evaluation (APACHE) II, Simplified Acute Physiology Score (SAPS) 3, present on admission CCI, and cancer stage were collected. Surgery status, intensive care in the intensive care unit, and CCI were selected as proxy variables among administrative data. In-hospital death was defined as the dependent variable, and a logistic regression analysis was performed. The statistical performance of each model was compared using C-index values. Results: There was a strong correlation between variables in the administrative data and those in the medical records. The C-index of the existing model (Model 1) was 0.785; Model 2, which included all clinical data, had a higher C-index of 0.857. In Model 4, in which APACHE II and SAPS 3 were replaced with variables recorded in the administrative data from Model 2, the C-index further increased to 0.863. Conclusion The HSMR assessment model improved when clinical data were adjusted. Simultaneously, the validity of the evaluation method could be secured even if some of the clinical information was replaced with the information in the administrative data.

Purpose: This study assessed the validity of the hospital standardized mortality ratio (HSMR) risk-adjusted model by comparing models that include clinical information and the current model based on administrative information in South Korea. Materials and Methods: The data of 53976 inpatients were analyzed. The current HSMR risk-adjusted model (Model 1) adjusts for sex, age, health coverage, emergency hospitalization status, main diagnosis, surgery status, and Charlson Comorbidity Index (CCI) using administrative data. As candidate variables, among clinical information, the American Society of Anesthesiologists score, Acute Physiology and Chronic Health Evaluation (APACHE) II, Simplified Acute Physiology Score (SAPS) 3, present on admission CCI, and cancer stage were collected. Surgery status, intensive care in the intensive care unit, and CCI were selected as proxy variables among administrative data. In-hospital death was defined as the dependent variable, and a logistic regression analysis was performed. The statistical performance of each model was compared using C-index values. Results: There was a strong correlation between variables in the administrative data and those in the medical records. The C-index of the existing model (Model 1) was 0.785; Model 2, which included all clinical data, had a higher C-index of 0.857. In Model 4, in which APACHE II and SAPS 3 were replaced with variables recorded in the administrative data from Model 2, the C-index further increased to 0.863. Conclusion The HSMR assessment model improved when clinical data were adjusted. Simultaneously, the validity of the evaluation method could be secured even if some of the clinical information was replaced with the information in the administrative data.

Purpose: This study assessed the validity of the hospital standardized mortality ratio (HSMR) risk-adjusted model by comparing models that include clinical information and the current model based on administrative information in South Korea. Materials and Methods: The data of 53976 inpatients were analyzed. The current HSMR risk-adjusted model (Model 1) adjusts for sex, age, health coverage, emergency hospitalization status, main diagnosis, surgery status, and Charlson Comorbidity Index (CCI) using administrative data. As candidate variables, among clinical information, the American Society of Anesthesiologists score, Acute Physiology and Chronic Health Evaluation (APACHE) II, Simplified Acute Physiology Score (SAPS) 3, present on admission CCI, and cancer stage were collected. Surgery status, intensive care in the intensive care unit, and CCI were selected as proxy variables among administrative data. In-hospital death was defined as the dependent variable, and a logistic regression analysis was performed. The statistical performance of each model was compared using C-index values. Results: There was a strong correlation between variables in the administrative data and those in the medical records. The C-index of the existing model (Model 1) was 0.785; Model 2, which included all clinical data, had a higher C-index of 0.857. In Model 4, in which APACHE II and SAPS 3 were replaced with variables recorded in the administrative data from Model 2, the C-index further increased to 0.863. Conclusion The HSMR assessment model improved when clinical data were adjusted. Simultaneously, the validity of the evaluation method could be secured even if some of the clinical information was replaced with the information in the administrative data.

Purpose: This study assessed the validity of the hospital standardized mortality ratio (HSMR) risk-adjusted model by comparing models that include clinical information and the current model based on administrative information in South Korea. Materials and Methods: The data of 53976 inpatients were analyzed. The current HSMR risk-adjusted model (Model 1) adjusts for sex, age, health coverage, emergency hospitalization status, main diagnosis, surgery status, and Charlson Comorbidity Index (CCI) using administrative data. As candidate variables, among clinical information, the American Society of Anesthesiologists score, Acute Physiology and Chronic Health Evaluation (APACHE) II, Simplified Acute Physiology Score (SAPS) 3, present on admission CCI, and cancer stage were collected. Surgery status, intensive care in the intensive care unit, and CCI were selected as proxy variables among administrative data. In-hospital death was defined as the dependent variable, and a logistic regression analysis was performed. The statistical performance of each model was compared using C-index values. Results: There was a strong correlation between variables in the administrative data and those in the medical records. The C-index of the existing model (Model 1) was 0.785; Model 2, which included all clinical data, had a higher C-index of 0.857. In Model 4, in which APACHE II and SAPS 3 were replaced with variables recorded in the administrative data from Model 2, the C-index further increased to 0.863. Conclusion The HSMR assessment model improved when clinical data were adjusted. Simultaneously, the validity of the evaluation method could be secured even if some of the clinical information was replaced with the information in the administrative data.

Purpose: This study assessed the validity of the hospital standardized mortality ratio (HSMR) risk-adjusted model by comparing models that include clinical information and the current model based on administrative information in South Korea. Materials and Methods: The data of 53976 inpatients were analyzed. The current HSMR risk-adjusted model (Model 1) adjusts for sex, age, health coverage, emergency hospitalization status, main diagnosis, surgery status, and Charlson Comorbidity Index (CCI) using administrative data. As candidate variables, among clinical information, the American Society of Anesthesiologists score, Acute Physiology and Chronic Health Evaluation (APACHE) II, Simplified Acute Physiology Score (SAPS) 3, present on admission CCI, and cancer stage were collected. Surgery status, intensive care in the intensive care unit, and CCI were selected as proxy variables among administrative data. In-hospital death was defined as the dependent variable, and a logistic regression analysis was performed. The statistical performance of each model was compared using C-index values. Results: There was a strong correlation between variables in the administrative data and those in the medical records. The C-index of the existing model (Model 1) was 0.785; Model 2, which included all clinical data, had a higher C-index of 0.857. In Model 4, in which APACHE II and SAPS 3 were replaced with variables recorded in the administrative data from Model 2, the C-index further increased to 0.863. Conclusion The HSMR assessment model improved when clinical data were adjusted. Simultaneously, the validity of the evaluation method could be secured even if some of the clinical information was replaced with the information in the administrative data.

Background: This study investigates the hypothesis that the red, doughnut-shaped discs in Gustav Klimt’s iconic painting ‘The Kiss’ represent red blood cells (RBCs). The purpose is to explore the artistic and anatomical significance of these elements, examining how Klimt may have integrated contemporary scientific discoveries into his work to convey deeper symbolic meanings. Methods: This interdisciplinary study employed a combination of medical and art history approaches, including biographical analysis, literature review and a questionnaire survey to assess viewer’s perceptions of the red discs in ‘The Kiss.’ The survey compared responses to the original painting with those to an experimentally altered version, where the red discs were removed, with the objective of determining the significance of these red discs in the artwork. The survey was conducted among 300 visitors at the Ulsan International Art Fair.Among the visitors, 69.3% of the participants were female, and the most common age group was 30–49 years old. Results: Historical research and literature analysis revealed that the red disc-shaped patterns on the woman’s dress in Klimt’s painting closely resemble RBCs as depicted in early 20thcentury scientific literature and encyclopedias. This suggests that Klimt, likely influenced by his interactions with medical scientists, intentionally incorporated contemporary scientific imagery into his artwork. The survey results indicated that 86.7% of participants recognized the painting as ‘The Kiss,’ demonstrating high familiarity with the piece. Comparisons between the original and altered versions of the painting revealed that viewers perceived notable differences in feeling, color perception, mood, and lighting. Conclusion This study demonstrates that Klimt intentionally incorporated RBC-like motifs into his paintings, using them not only to convey anatomical symbolism and emotional depth but also as dynamic elements within a mosaic pattern. These red elements energize not only the female figure in ‘The Kiss’ but the entire composition. Klimt’s work reveals his skill in merging scientific concepts with visual and emotional expression, showcasing an innovative approach to embedding complex medical and emotional meanings through the use of symbolic imagery.

Background: This study investigates the hypothesis that the red, doughnut-shaped discs in Gustav Klimt’s iconic painting ‘The Kiss’ represent red blood cells (RBCs). The purpose is to explore the artistic and anatomical significance of these elements, examining how Klimt may have integrated contemporary scientific discoveries into his work to convey deeper symbolic meanings. Methods: This interdisciplinary study employed a combination of medical and art history approaches, including biographical analysis, literature review and a questionnaire survey to assess viewer’s perceptions of the red discs in ‘The Kiss.’ The survey compared responses to the original painting with those to an experimentally altered version, where the red discs were removed, with the objective of determining the significance of these red discs in the artwork. The survey was conducted among 300 visitors at the Ulsan International Art Fair.Among the visitors, 69.3% of the participants were female, and the most common age group was 30–49 years old. Results: Historical research and literature analysis revealed that the red disc-shaped patterns on the woman’s dress in Klimt’s painting closely resemble RBCs as depicted in early 20thcentury scientific literature and encyclopedias. This suggests that Klimt, likely influenced by his interactions with medical scientists, intentionally incorporated contemporary scientific imagery into his artwork. The survey results indicated that 86.7% of participants recognized the painting as ‘The Kiss,’ demonstrating high familiarity with the piece. Comparisons between the original and altered versions of the painting revealed that viewers perceived notable differences in feeling, color perception, mood, and lighting. Conclusion This study demonstrates that Klimt intentionally incorporated RBC-like motifs into his paintings, using them not only to convey anatomical symbolism and emotional depth but also as dynamic elements within a mosaic pattern. These red elements energize not only the female figure in ‘The Kiss’ but the entire composition. Klimt’s work reveals his skill in merging scientific concepts with visual and emotional expression, showcasing an innovative approach to embedding complex medical and emotional meanings through the use of symbolic imagery.

Background: This study investigates the hypothesis that the red, doughnut-shaped discs in Gustav Klimt’s iconic painting ‘The Kiss’ represent red blood cells (RBCs). The purpose is to explore the artistic and anatomical significance of these elements, examining how Klimt may have integrated contemporary scientific discoveries into his work to convey deeper symbolic meanings. Methods: This interdisciplinary study employed a combination of medical and art history approaches, including biographical analysis, literature review and a questionnaire survey to assess viewer’s perceptions of the red discs in ‘The Kiss.’ The survey compared responses to the original painting with those to an experimentally altered version, where the red discs were removed, with the objective of determining the significance of these red discs in the artwork. The survey was conducted among 300 visitors at the Ulsan International Art Fair.Among the visitors, 69.3% of the participants were female, and the most common age group was 30–49 years old. Results: Historical research and literature analysis revealed that the red disc-shaped patterns on the woman’s dress in Klimt’s painting closely resemble RBCs as depicted in early 20thcentury scientific literature and encyclopedias. This suggests that Klimt, likely influenced by his interactions with medical scientists, intentionally incorporated contemporary scientific imagery into his artwork. The survey results indicated that 86.7% of participants recognized the painting as ‘The Kiss,’ demonstrating high familiarity with the piece. Comparisons between the original and altered versions of the painting revealed that viewers perceived notable differences in feeling, color perception, mood, and lighting. Conclusion This study demonstrates that Klimt intentionally incorporated RBC-like motifs into his paintings, using them not only to convey anatomical symbolism and emotional depth but also as dynamic elements within a mosaic pattern. These red elements energize not only the female figure in ‘The Kiss’ but the entire composition. Klimt’s work reveals his skill in merging scientific concepts with visual and emotional expression, showcasing an innovative approach to embedding complex medical and emotional meanings through the use of symbolic imagery.

Background: This study investigates the hypothesis that the red, doughnut-shaped discs in Gustav Klimt’s iconic painting ‘The Kiss’ represent red blood cells (RBCs). The purpose is to explore the artistic and anatomical significance of these elements, examining how Klimt may have integrated contemporary scientific discoveries into his work to convey deeper symbolic meanings. Methods: This interdisciplinary study employed a combination of medical and art history approaches, including biographical analysis, literature review and a questionnaire survey to assess viewer’s perceptions of the red discs in ‘The Kiss.’ The survey compared responses to the original painting with those to an experimentally altered version, where the red discs were removed, with the objective of determining the significance of these red discs in the artwork. The survey was conducted among 300 visitors at the Ulsan International Art Fair.Among the visitors, 69.3% of the participants were female, and the most common age group was 30–49 years old. Results: Historical research and literature analysis revealed that the red disc-shaped patterns on the woman’s dress in Klimt’s painting closely resemble RBCs as depicted in early 20thcentury scientific literature and encyclopedias. This suggests that Klimt, likely influenced by his interactions with medical scientists, intentionally incorporated contemporary scientific imagery into his artwork. The survey results indicated that 86.7% of participants recognized the painting as ‘The Kiss,’ demonstrating high familiarity with the piece. Comparisons between the original and altered versions of the painting revealed that viewers perceived notable differences in feeling, color perception, mood, and lighting. Conclusion This study demonstrates that Klimt intentionally incorporated RBC-like motifs into his paintings, using them not only to convey anatomical symbolism and emotional depth but also as dynamic elements within a mosaic pattern. These red elements energize not only the female figure in ‘The Kiss’ but the entire composition. Klimt’s work reveals his skill in merging scientific concepts with visual and emotional expression, showcasing an innovative approach to embedding complex medical and emotional meanings through the use of symbolic imagery.

Background: Risk factors for developing medication-related osteonecrosis of the jaw (MRONJ) include the gen‑ eral condition of the patient, smoking habit, poor oral hygiene, and the type, duration, and administration route of the drug, dentoalveolar surgery, such as implant placement. This study aimed to discuss whether implants may induce osteonecrosis in older patients receiving long-term medication and to analyze the radiological pattern of the bone necrosis. Methods: This study included 33 patients diagnosed with dental implant-associated medication-related osteonecro‑ sis of the jaw. Data regarding the medical history, type of medication used, durations of administration, laboratory test results, onset of bone necrosis since implant placement, type of opposing teeth, and radiological pattern of the bone necrosis on cone-beam computed tomography were recorded in patients with and without implants. Results: The most commonly used drug was bisphosphonate, with an average duration of use of 61.37 (± 53.72) months. The laboratory results showed average serum C-terminal cross-linking telopeptide (CTX) level of 0.23 ng/ mL, vitamin D, 23.42 ng/mL, and osteocalcin, 4.92 ng/mL. Osteonecrosis occurred after an average of 51.03 (± 39.75) months following implant placement. Radiological evaluation revealed obvious sequestration in the implant-absent group, and the formation of a unit sequestration with an implant fixture (en bloc) was observed in the implant-pre‑ sent group. The patients underwent surgical treatment of sequestrectomy and explantation. Conclusion Implant placement, especially loading, may be considered a potential risk factor for the development of osteonecrosis in patients undergoing antiresorptive treatment.