The recent healthcare crisis in South Korea has exposed structural vulnerabilities in essential and regional care, vulnerabilities that are largely driven by a fee-for-service system prioritizing quantitative expansion over quality. This study addresses the urgent need for an artificial intelligence (AI)-driven digital transformation to sustain universal health coverage in the context of rapid demographic change.Current concepts: We propose an AI-driven healthcare system that shifts the care paradigm from reactive treatment toward proactive prevention. Central to this framework is the establishment of a “National Health Data Lakehouse,” a cloud-based infrastructure designed to enable real-time integration of electronic health records and personal health records. We further outline implementation strategies for AI Copilots supporting clinical decision-making, population health management platforms, and the digital transformation of public hospitals, with particular emphasis on ensuring data interoperability and security.Discussion and conclusion: This digital transformation enables a transition toward value-based purchasing and strengthens healthcare delivery through AI-assisted screening and the establishment of regional medical innovation centers. To realize this vision, comprehensive policy reforms are required, including strengthened data governance, clear legal frameworks addressing AI-related liability, and rational reimbursement models aligned with value-based care principles. Ultimately, an AI-integrated national strategy is essential for building a sustainable, equitable, and patient-centered healthcare ecosystem.

Background: This study aimed to investigate 1) long-term outcomes of deep brain stimulation (DBS), such as mortality after DBS as well as the causes of death, 2) demographic and socioeconomic factors influencing mortality, and 3) comorbidities affecting mortality after DBS in patients with Parkinson’s disease (PD). Methods: This study analyzed the National Health Insurance Service-National Health Information Database. Data on patients with PD diagnosis codes from 2002 to 2019 were extracted and analyzed. Data on the causes of death were obtained by linking the causes of death to data from Statistics Korea. The Kaplan-Meier method with the log-rank test was used for survival analysis. Multivariate Cox regression analyses were used to estimate hazard ratios (HRs) and their 95% confidence intervals. Regarding comorbidities such as PD dementia and fracture, which did not satisfy the assumption for the proportional HR, timedependent Cox analysis with the Mantel-Byar method was used. Results: From 2005 to 2017, among 156,875 patients diagnosed with PD in Korea, 1,079 patients underwent DBS surgery, and 251 (23.3%) had died by 2019. The most common cause of death (47.1%) was PD. In the multivariate Cox regression analysis, the higher the age at diagnosis and surgery, the higher the mortality rate. The men and medical aid groups had significantly higher mortality rates. PD dementia and fracture were identified as risk factors for mortality. Conclusion Older age at diagnosis and surgery, being male, the use of medical aid, and the comorbidity of dementia and fractures were associated with a higher risk of mortality after DBS in patients with PD. Neurologists should consider these risk factors in assessing the prognosis of PD patients undergoing DBS.

Objective: The aim of this study was to estimate the progress of insomnia prevalence and incidence over the past several years. Also, this study compared survival rates between individuals with and without insomnia. Methods: The National Health Insurance Service-National Sample Cohort (NHIS-NSC) from 2002–2013 was used for this study. Prevalent cases of insomnia were defined using ICD-10 codes F51.0 or G47.0, or a prescription of sedatives. Cox’s proportional hazard analysis was conducted to compare survival rates between insomnia patients and people without insomnia. Results: In 2013, there were 46,167 (5.78%) insomnia patients over 20 years old in this cohort. Insomnia was more common among women and the elderly. Annual incidence over the past several years remained steady but the prevalence increased. The survival of insomnia patients was lower than that of people without insomnia, and the hazard ratio for overall mortality was 1.702 (p<0.001). Conclusion This large-scale population-based cohort study provided current epidemiologic indicators of insomnia in the Korean general population.

Pilomatricoma, also known as calcifying epithelioma of Malherbe, is a benign adnexal skin tumor arising from hair matrix cells. Clinically, pilomatricoma typically presents as a firm, bluish or red colored, deep-seated nodule with overlying normal skin. Several variants of pilomatricoma have been described including perforating, extruding, bullous, melanocytic, giant, keratoacanthoma-like, exophytic, lymphangiectatic, familial, anetodermic, and multiple. Among these, an extruding variant has been very rarely reported. A 10-year-old girl presented with a 2-month history of a rapid-growing, solitary, firm, skin-colored to pinkish, pedunculated papule with a central crusted perforation on the left cheek. Based on the clinical and histological findings, we made a diagnosis of exophytic pilomatricoma with perforating figure. She had no signs of recurrence of the lesion for 8 months after removal.

A method of rapidly decaying livestock carcasses is sought through Corine glutamicum, and furthermore, lysosomes are used to remove toxic microorganisms from livestock carcasses. The landfill was constructed on a laboratory scale. Optimized growth conditions of C. glutamicum that could quickly decay livestock carcasses were determined. Lysosomes were extracted from egg whites and used to treat contaminated soil to confirm their antimicrobial activities. Condition of C. glutamicum was activated, regardless both anaerobic and aerobic conditions, soil exists and, to be close to the optimum conditions as possible temperatures, moisture content was about 1/10 of the culture. Lysosomes were found to be effective in clearing soil contamination. C. glutamicum can accelerate the decay of livestock carcasses. A combination of C. glutamicum and lysomes could be used to treat soil contamination caused by decomposition of livestock.
Burial* ; Corynebacterium glutamicum* ; Corynebacterium* ; Egg White ; Livestock* ; Lysosomes ; Methods ; Soil* ; Waste Disposal Facilities

OBJECTIVE: The present study aimed to examine the potential mediating effect of income level on the association between noise exposure and insomnia. METHODS: 706 individuals were evaluated in conjunction with 2014 noise map data from Seoul, South Korea. Cross-sectional analysis was performed to examine differences in noise level according to household income, while three separate logistic regression models were used to examine factors influencing insomnia. Odds ratios (ORs) were calculated after adjusting for depression, anxiety, auditory acuity and noise sensitivity in the first model. Analyses were adjusted for sociodemographic variables in the second model, lifestyle factors and medical illnesses in the third model. RESULTS: Noise level was significantly associated with an increased risk of insomnia in the low-income group, although no such association was observed in the high-income group. Groups exposed to >60 dB of noise (Lden; day-evening-night equivalent) exhibited a 1.79-fold increase in the incidence of insomnia relative to those exposed to <50 dB. The result was significant after adjusting sociodemographic variables, although not significant when adjusted for lifestyle factors and medical illnesses. CONCLUSION: Individuals with low income may be more vulnerable to the deleterious effects of noise exposure on health. Various aspects including income should be considered to ascertain the influence of noise on insomnia.
Anxiety ; Cross-Sectional Studies ; Depression ; Family Characteristics ; Incidence ; Korea ; Life Style ; Logistic Models ; Mental Health ; Negotiating ; Noise* ; Odds Ratio ; Seoul ; Sleep Initiation and Maintenance Disorders*

The objective of this study was to determine toxicities of four parabens (methyl paraben, MP; ethyl paraben, EP; n-propyl paraben, PP; and n-butyl paraben; BP) and their mixtures to two aquatic microorganisms, Daphnia magna and Aliivibrio fischeri. Parabens are one of the widely used preservatives for personal care products, such as cosmetics, pharmaceuticals and food also. First, each paraben was treated to D. magna to measure the toxicity levels as LC₂₀ and LC₅₀. The results showed their value of MP (25.2 mg/L, 73.4 mg/L), EP (18.4 mg/L, 43.7 mg/L), PP (10.4 mg/L, 21.1 mg/L) and BP (3.3 mg/L, 11.2 mg/L). Then, each of the parabens was treated to A. fischeri and calculated their EC₂₀ and EC₅₀ by bioluminescence inhibition test. The results showed the values of MP (2.93 mg/L, 16.8 mg/L), EP (1.18 mg/L, 6.74 mg/L), PP (0.51 mg/L, 5.85 mg/L) and BP (0.21 mg/L, 2.34 mg/L). These four parabens belong to the group classified as being ‘harmful to aquatic organisms’ (above 10 mg/L, below 100 mg/L). After measuring the toxicity, EC₂₀ values of two or more parabens were tested in order to investigate their toxicity. A total of ten combinations of four parabens were tested. As a result, the bioluminescence inhibition test of A. fischeri showed that the toxicity of mixture parabens was stronger than that of a single compound and combinations of three parabens showed the highest bioluminescence inhibition. These results showed that independent toxicity of paraben was maintained. Therefore, it can be predictable that the toxicity of paraben is getting stronger by the addition of other parabens.
Aliivibrio fischeri* ; Aliivibrio* ; Daphnia* ; Humans ; Parabens*

A method of rapidly decaying livestock carcasses is sought through Corine glutamicum, and furthermore, lysosomes are used to remove toxic microorganisms from livestock carcasses. The landfill was constructed on a laboratory scale. Optimized growth conditions of C. glutamicum that could quickly decay livestock carcasses were determined. Lysosomes were extracted from egg whites and used to treat contaminated soil to confirm their antimicrobial activities. Condition of C. glutamicum was activated, regardless both anaerobic and aerobic conditions, soil exists and, to be close to the optimum conditions as possible temperatures, moisture content was about 1/10 of the culture. Lysosomes were found to be effective in clearing soil contamination. C. glutamicum can accelerate the decay of livestock carcasses. A combination of C. glutamicum and lysomes could be used to treat soil contamination caused by decomposition of livestock.
Burial ; Corynebacterium glutamicum ; Corynebacterium ; Egg White ; Livestock ; Lysosomes ; Methods ; Soil ; Waste Disposal Facilities

The objective of this study was to determine toxicities of four parabens (methyl paraben, MP; ethyl paraben, EP; n-propyl paraben, PP; and n-butyl paraben; BP) and their mixtures to two aquatic microorganisms, Daphnia magna and Aliivibrio fischeri. Parabens are one of the widely used preservatives for personal care products, such as cosmetics, pharmaceuticals and food also. First, each paraben was treated to D. magna to measure the toxicity levels as LC₂₀ and LC₅₀. The results showed their value of MP (25.2 mg/L, 73.4 mg/L), EP (18.4 mg/L, 43.7 mg/L), PP (10.4 mg/L, 21.1 mg/L) and BP (3.3 mg/L, 11.2 mg/L). Then, each of the parabens was treated to A. fischeri and calculated their EC₂₀ and EC₅₀ by bioluminescence inhibition test. The results showed the values of MP (2.93 mg/L, 16.8 mg/L), EP (1.18 mg/L, 6.74 mg/L), PP (0.51 mg/L, 5.85 mg/L) and BP (0.21 mg/L, 2.34 mg/L). These four parabens belong to the group classified as being ‘harmful to aquatic organisms’ (above 10 mg/L, below 100 mg/L). After measuring the toxicity, EC₂₀ values of two or more parabens were tested in order to investigate their toxicity. A total of ten combinations of four parabens were tested. As a result, the bioluminescence inhibition test of A. fischeri showed that the toxicity of mixture parabens was stronger than that of a single compound and combinations of three parabens showed the highest bioluminescence inhibition. These results showed that independent toxicity of paraben was maintained. Therefore, it can be predictable that the toxicity of paraben is getting stronger by the addition of other parabens.
Aliivibrio fischeri ; Aliivibrio ; Daphnia ; Humans ; Parabens

The authors flagged that the Funding information in the Declarations was incorrect.