Objective: To investigate the associations between T2-weighted imaging (T2WI) features and clinicopathologic characteristics in invasive breast cancer, as well as their relationship with treatment response to neoadjuvant chemotherapy (NAC). Materials and Methods: This retrospective study included 179 women with invasive breast cancer who underwent preoperative 3T breast MRI between November 2020 and February 2021. Intratumoral T2 signal intensity (SI) and peritumoral edema were graded on T2WI, and T2 relaxation times were calculated both including and excluding necrotic or cystic areas. T2 relaxation times were compared across T2 SI grades using the Kruskal–Wallis test. Associations between T2 features and clinicopathologic factors were assessed using chi-square tests and logistic regression analyses. In patients who received NAC (n = 68), associations between T2 features and NAC outcomes were also evaluated. Results: Higher intratumoral T2 SI and peritumoral edema grades were significantly associated with longer T2 relaxation times (P < 0.001). Intratumoral T2 SI grades were associated with higher clinical T category, axillary lymph node metastasis, and tumor multiplicity (all P < 0.05). Longer intratumoral T2 relaxation times were associated with higher clinical T category, hormone receptor (HR) negativity, and the triple-negative subtype (all P < 0.05), even after excluding necrotic or cystic areas.Higher peritumoral edema grades were associated with advanced clinical T category, HR negativity, and the triple-negative subtype (all P < 0.05). T2 relaxation times of peritumoral edema showed no significant associations, except with higher clinical T category (P = 0.005) and estrogen receptor status (P = 0.030). In the NAC subgroup, higher intratumoral T2 SI grades and longer T2 relaxation times were significantly associated with disease progression during NAC (P < 0.05), but not with non-pathologic complete response. Peritumoral edema showed no significant association with NAC outcomes (P > 0.05). Conclusion T2-weighted MRI features were associated with clinicopathologic factors, including clinical T category, HR status, triple-negative subtype, and disease progression during NAC.

Objective: To investigate whether reader training improves the performance and agreement of radiologists in interpreting unenhanced breast magnetic resonance imaging (MRI) scans using diffusion-weighted imaging (DWI). Materials and Methods: A study of 96 breasts (35 cancers, 24 benign, and 37 negative) in 48 asymptomatic women was performed between June 2019 and October 2020. High-resolution DWI with b-values of 0, 800, and 1200 sec/mm 2 was performed using a 3.0-T system. Sixteen breast radiologists independently reviewed the DWI, apparent diffusion coefficient maps, and T1-weighted MRI scans and recorded the Breast Imaging Reporting and Data System (BI-RADS) category for each breast. After a 2-h training session and a 5-month washout period, they re-evaluated the BI-RADS categories. A BI-RADS category of 4 (lesions with at least two suspicious criteria) or 5 (more than two suspicious criteria) was considered positive.The per-breast diagnostic performance of each reader was compared between the first and second reviews. Inter-reader agreement was evaluated using a multi-rater κ analysis and intraclass correlation coefficient (ICC). Results: Before training, the mean sensitivity, specificity, and accuracy of the 16 readers were 70.7% (95% confidence interval [CI]: 59.4–79.9), 90.8% (95% CI: 85.6–94.2), and 83.5% (95% CI: 78.6–87.4), respectively. After training, significant improvements in specificity (95.2%; 95% CI: 90.8–97.5; P = 0.001) and accuracy (85.9%; 95% CI: 80.9–89.8; P = 0.01) were observed, but no difference in sensitivity (69.8%; 95% CI: 58.1–79.4; P = 0.58) was observed. Regarding inter-reader agreement, the κ values were 0.57 (95% CI: 0.52–0.63) before training and 0.68 (95% CI: 0.62–0.74) after training, with a difference of 0.11 (95% CI: 0.02–0.18; P = 0.01). The ICC was 0.73 (95% CI: 0.69–0.74) before training and 0.79 (95% CI: 0.76–0.80) after training (P = 0.002). Conclusion Brief reader training improved the performance and agreement of interpretations by breast radiologists using unenhanced MRI with DWI.

Objectives: ：This study aims to confirm the effectiveness of a school-based very-short-term dialectical be-havior therapy-skills training (DBT-ST) program for preventing self-harm among children and adolescents, considering factors such as age, sex, self-harm history, and methods of program implementation. Methods: ：The study was conducted from September 2021 to December 2023, targeting 1,012 elementary and middle school students in the Chungcheong region. Changes in responses to the Depressed Mood Questionnaire(RDQ), the Difficulties in Emotion Regulation Scale-16 (DERS-16), ‘future self-harm possibility’ scores wereanalyzed and compared before and after the program, based on age, sex, self-harm history, and methods of program implementation. Results: ：Overall, participants showed a decrease in the ‘rumination(RDQ) scale’ (t=10.49, p<0.001), ‘reversescored distraction (RDQ)’ (t=10.67, p<0.001) and the total DERS-16 (t=5.56, p<0.001) as well as a decrease in ‘future self-harm possibility’ score (t=4.26, p<0.001). Both elementary and middle school students showed decrease in ’rumination (RDQ)’ and distraction (RDQ), but only middle school students showed a decrease in theDERS-16 and most sub-scales. Regardless of sex, self-harm history, or methods of program implementation, adecrease in ’rumination (RDQ)’, distraction (RDQ) and the total DERS-16 scale and most sub-scales decreased. Conclusions ：Our program appears to be effective as a primary prevention program for preventing self-harm among children and adolescents in a school setting.

Objectives: ：This study aims to confirm the effectiveness of a school-based very-short-term dialectical be-havior therapy-skills training (DBT-ST) program for preventing self-harm among children and adolescents, considering factors such as age, sex, self-harm history, and methods of program implementation. Methods: ：The study was conducted from September 2021 to December 2023, targeting 1,012 elementary and middle school students in the Chungcheong region. Changes in responses to the Depressed Mood Questionnaire(RDQ), the Difficulties in Emotion Regulation Scale-16 (DERS-16), ‘future self-harm possibility’ scores wereanalyzed and compared before and after the program, based on age, sex, self-harm history, and methods of program implementation. Results: ：Overall, participants showed a decrease in the ‘rumination(RDQ) scale’ (t=10.49, p<0.001), ‘reversescored distraction (RDQ)’ (t=10.67, p<0.001) and the total DERS-16 (t=5.56, p<0.001) as well as a decrease in ‘future self-harm possibility’ score (t=4.26, p<0.001). Both elementary and middle school students showed decrease in ’rumination (RDQ)’ and distraction (RDQ), but only middle school students showed a decrease in theDERS-16 and most sub-scales. Regardless of sex, self-harm history, or methods of program implementation, adecrease in ’rumination (RDQ)’, distraction (RDQ) and the total DERS-16 scale and most sub-scales decreased. Conclusions ：Our program appears to be effective as a primary prevention program for preventing self-harm among children and adolescents in a school setting.

Objectives: ：This study aims to confirm the effectiveness of a school-based very-short-term dialectical be-havior therapy-skills training (DBT-ST) program for preventing self-harm among children and adolescents, considering factors such as age, sex, self-harm history, and methods of program implementation. Methods: ：The study was conducted from September 2021 to December 2023, targeting 1,012 elementary and middle school students in the Chungcheong region. Changes in responses to the Depressed Mood Questionnaire(RDQ), the Difficulties in Emotion Regulation Scale-16 (DERS-16), ‘future self-harm possibility’ scores wereanalyzed and compared before and after the program, based on age, sex, self-harm history, and methods of program implementation. Results: ：Overall, participants showed a decrease in the ‘rumination(RDQ) scale’ (t=10.49, p<0.001), ‘reversescored distraction (RDQ)’ (t=10.67, p<0.001) and the total DERS-16 (t=5.56, p<0.001) as well as a decrease in ‘future self-harm possibility’ score (t=4.26, p<0.001). Both elementary and middle school students showed decrease in ’rumination (RDQ)’ and distraction (RDQ), but only middle school students showed a decrease in theDERS-16 and most sub-scales. Regardless of sex, self-harm history, or methods of program implementation, adecrease in ’rumination (RDQ)’, distraction (RDQ) and the total DERS-16 scale and most sub-scales decreased. Conclusions ：Our program appears to be effective as a primary prevention program for preventing self-harm among children and adolescents in a school setting.

Objectives: ：This study aims to confirm the effectiveness of a school-based very-short-term dialectical be-havior therapy-skills training (DBT-ST) program for preventing self-harm among children and adolescents, considering factors such as age, sex, self-harm history, and methods of program implementation. Methods: ：The study was conducted from September 2021 to December 2023, targeting 1,012 elementary and middle school students in the Chungcheong region. Changes in responses to the Depressed Mood Questionnaire(RDQ), the Difficulties in Emotion Regulation Scale-16 (DERS-16), ‘future self-harm possibility’ scores wereanalyzed and compared before and after the program, based on age, sex, self-harm history, and methods of program implementation. Results: ：Overall, participants showed a decrease in the ‘rumination(RDQ) scale’ (t=10.49, p<0.001), ‘reversescored distraction (RDQ)’ (t=10.67, p<0.001) and the total DERS-16 (t=5.56, p<0.001) as well as a decrease in ‘future self-harm possibility’ score (t=4.26, p<0.001). Both elementary and middle school students showed decrease in ’rumination (RDQ)’ and distraction (RDQ), but only middle school students showed a decrease in theDERS-16 and most sub-scales. Regardless of sex, self-harm history, or methods of program implementation, adecrease in ’rumination (RDQ)’, distraction (RDQ) and the total DERS-16 scale and most sub-scales decreased. Conclusions ：Our program appears to be effective as a primary prevention program for preventing self-harm among children and adolescents in a school setting.

Objectives: ：This study aims to confirm the effectiveness of a school-based very-short-term dialectical be-havior therapy-skills training (DBT-ST) program for preventing self-harm among children and adolescents, considering factors such as age, sex, self-harm history, and methods of program implementation. Methods: ：The study was conducted from September 2021 to December 2023, targeting 1,012 elementary and middle school students in the Chungcheong region. Changes in responses to the Depressed Mood Questionnaire(RDQ), the Difficulties in Emotion Regulation Scale-16 (DERS-16), ‘future self-harm possibility’ scores wereanalyzed and compared before and after the program, based on age, sex, self-harm history, and methods of program implementation. Results: ：Overall, participants showed a decrease in the ‘rumination(RDQ) scale’ (t=10.49, p<0.001), ‘reversescored distraction (RDQ)’ (t=10.67, p<0.001) and the total DERS-16 (t=5.56, p<0.001) as well as a decrease in ‘future self-harm possibility’ score (t=4.26, p<0.001). Both elementary and middle school students showed decrease in ’rumination (RDQ)’ and distraction (RDQ), but only middle school students showed a decrease in theDERS-16 and most sub-scales. Regardless of sex, self-harm history, or methods of program implementation, adecrease in ’rumination (RDQ)’, distraction (RDQ) and the total DERS-16 scale and most sub-scales decreased. Conclusions ：Our program appears to be effective as a primary prevention program for preventing self-harm among children and adolescents in a school setting.

Purpose: Although previous research showed the importance of safety culture on health care workers' speaking up behaviors, it is not clear how particular safety culture domains are associated with the speaking up behaviors of hospital staff. Also, researchers have suggested that health care workers’ speaking up behaviors vary by profession, but there has been limited research into such differences. Thus, this study examined differences in perceptions of patient safety culture and the promotive and prohibitive speaking up behaviors of health care workers by profession and investigated the relationships between patient safety culture and the two types of speaking up behaviors. Methods: A descriptive correlational study was conducted using secondary data collected through an online survey of health care workers at a private, nonprofit, tertiary-level teaching hospital in South Korea. The sample (N = 831) consisted of nurses (54.0%), physicians (13.0%), and other licensed and unlicensed hospital personnel (33.0%). Analyses of variance were conducted to examine differences in study variables by profession. Hierarchical regression analyses were conducted to evaluate the effects of the seven patient safety culture factors on promotive and prohibitive voice after controlling for tenure and profession. Results: Perceptions of safety culture and promotive voice behaviors were higher for physicians compared with nurses. Communication openness, reporting patient adverse events, and unit supervisors' and hospital managements’ support for patient safety were significant predictors of both types of voice behaviors. Conclusion Hospital administrators and unit managers should create a supportive environment where staff feel free to voice their concerns and suggestions. They should also pay attention to the varying perspectives held by different groups of hospital workers and their different voice behaviors. Knowing which dimensions of patient safety culture are most strongly related to health care workers’ voice behaviors can guide patient safety improvement activities in health care organizations.