This study examines the impact of medical artificial intelligence (AI) on physician workload and the quality of patient care. A meta-analysis of empirical studies found that AI significantly reduces physician workload and diagnostic time by automating repetitive interpretation and documentation processes, freeing clinicians to focus solely on patients. Automated generative AI-based electronic medical record systems reduce documentation time by approximately 40%, while voice recognition and AI scribing technologies reduce patient charting time by 28.8%. This reduces administrative burden, a major cause of physician burnout, by more than 30%. In radiology, AI-based interpretation reduced the interpretation time for abnormal contrast-enhanced brain CT lesions by 11.23%, the interpretation time for lung lesions by 52.82%, and the analysis time for peripheral blood smears by 61%. Importantly, these time savings occur naturally and, in some cases, improve diagnostic accuracy for major diseases (e.g., lung nodules, brain lesions, and breast cancer). Furthermore, AI minimizes the workload of interpretation through its automatic filtering function. This includes a 77.4%–86.7% reduction in review time for pulmonary nodules, a 51.3%–72.9% reduction in endometrial slide screening time, and an 86% saving in manual review time for epilepsy electroencephalography evaluation. These findings confirm that AI is establishing itself as a reliable tool that simultaneously improves physician efficiency, diagnostic efficiency, and clinical accuracy. Therefore, future healthcare policies regarding AI should not simply focus on expanding the workforce, but should adopt a strategic approach, optimizing resource efficiency and building a more resilient healthcare system.

Background and Objectives: Cardiac arrhythmia is highly prevalent in hypertrophic cardiomyopathy (HCM), but its relation to genotype has not been well established.We investigated the arrhythmia manifestations according to genotype in HCM patients. Methods: This single-center, retrospective study included 119 patients with HCM who underwent genetic testing using a next-generation sequencing panel. Incidence of cardiac arrhythmias and long-term outcomes were analyzed according to the presence of pathogenic variants (PVs). Results: PVs related to HCM were identified in 45 (37.8%) patients. Presentation of sustained ventricular tachycardia (VT) prior to HCM diagnosis was more prevalent in the PV-positive group. During a median follow-up of 45.9 months, the incidence of sustained VT was significantly higher in the PV-positive group (11.1% vs. 1.4%, hazard ratio, 8.71; 95% confidence interval, 1.02–74.61). A new implantable cardioverter defibrillator insertion rate was comparable in the 2 groups, but appropriate shocks were delivered in only 4 patients in the PV-positive group (8.9% vs. 0%, P = 0.037). Incidence of bradyarrhythmias requiring pacemaker and new-onset atrial fibrillation (AF) was not significantly different between the 2 groups. Among 56 patients with AF, there was no significant difference in treatment strategies in the 2 groups. However, sinus rhythm was maintained over the last 6 months of follow-up in 4/17 (23.5%) patients in the PV-positive group and 24/39 (61.5%) patients in the PV-negative group (P = 0.031). Conclusions Patients with PVs related to HCM exhibited higher incidence of life-threatening VTs. While overall AF incidence was similar between the groups, the presence of PVs was significantly associated with poorer rhythm outcomes of AF.

suggest that some reproductive factors associated with BC differ across ethnicities and time trends, perhaps due to the prevalence of reproductive factors and the baseline hazard of BC.

The da Vinci Single-Port (SP) robotic system (Intuitive Surgical) was developed to enable true single-incision surgery while preserving the dexterity and precision of advanced robotic platforms. Since its clinical introduction, the SP system has generated growing interest in colorectal surgery, particularly for procedures performed in anatomically confined spaces.However, clinical evidence remains limited and heterogeneous. This narrative review summarizes the current clinical applications, technical considerations, and perioperative outcomes of the da Vinci SP system in the treatment of colorectal cancer. Available literature—predominantly from South Korea and selected centers in the United States—suggests that SP surgery is technically feasible for both colon and rectal cancer. In colon cancer, outcomes appear comparable to conventional laparoscopic and multiport robotic approaches, albeit with longer operative times during early experience. In rectal cancer, SP surgery demonstrates distinct technical advantages, including single docking, reduced incision burden, and favorable short-term outcomes, particularly for low anterior resection and intersphincteric resection. Pathologic outcomes, including lymph node yield and resection margins, are oncologically acceptable across reported series.While early results support the safety and feasibility of SP colorectal surgery, long-term oncologic outcomes and highlevel comparative evidence remain lacking. Further prospective studies are warranted to define optimal indications and establish the long-term value of this emerging platform.

Genetic variation in the leptin receptor (LEPR) gene has been implicated in metabolic regulation, while the gut microbiome and circulating metabolites are increasingly recognized as mediators of host metabolic phenotype. However, the systems-level interactions among LEPR genotypes, gut microbial composition, and serum metabolomic profiles remain poorly understood, particularly in healthy individuals. We conducted a cross-sectional study involving 37 healthy Korean adults. Three LEPR single nucleotide polymorphisms (rs1137101, rs1173100, rs790419) were genotyped. Untargeted metabolomics of fasting serum was performed using gas chromatography–time-of-flight mass spectrometry, and gut microbiome composition was profiled by 16S rRNA gene sequencing. Statistical analysis included principal component analysis, Mann–Whitney U tests, and Spearman correlations. Network analysis integrating microbiome, metabolomic, and clinical phenotype data was conducted using Cytoscape. A total of 54 serum metabolites were identified. LEPR genotypes, particularly rs1137101 and rs1173100, were associated with differences in metabolites such as pimelic acid, malonic acid, and 2,4-dihydroxybutyric acid. Firmicutes negatively correlated with saturated fatty acids and organic acids, whereas Actinobacteria positively correlated with cholesterol and amino acids. Network analysis revealed indole-3-acetate and cholesterol as central nodes linking microbial taxa with body mass index and leptin levels. However, no direct molecular pathways connecting leptin or its receptor were identified. LEPR genetic variation is associated with distinct serum metabolomic patterns and microbiome–host networks in healthy adults. Although no direct leptin signaling links were found, network-level associations suggest indirect genetic influences on metabolic states through microbiome–metabolome interactions.These findings advance understanding of personalized metabolic regulation and gene–microbiome interplay.

Objective: Extracorporeal cardiopulmonary resuscitation (ECPR) is increasingly used for refractory cardiac arrest, but its prognostic determinants in emergency department (ED) settings remain unclear. This study investigated the predictors of survival and the prognostic value of lactate and bilirubin in ECPR patients treated at a single university hospital. Methods: Adult ECPR patients treated in a single university hospital ED from 2018 to 2023 were reviewed retrospectively. The clinical variables, laboratory markers, and procedural factors were collected from medical records. Univariate and multivariate logistic regression analyses were performed, and lactate/bilirubin were assessed by quartiles to examine the dose-response trends. Results: Fifty-eight patients were included, of whom 25 (43.1%) survived to discharge. Older age, higher lactate, and elevated bilirubin were associated with mortality, and all three remained independent predictors in multivariate analysis (age odds ratio [OR], 0.93; lactate OR, 0.97; bilirubin OR, 0.41). Survival declined markedly across the lactate (68.8%→0%) and bilirubin quartiles (60.0%→13.3%; P for trend <0.01). The cardiopulmonary resuscitation (CPR) to extracorporeal membrane oxygenation (ECMO) time was shorter in the survivors than the non-survivors (39.9±18.9 min vs. 51.8±23.2 min; P=0.069), whereas the door to ECMO time did not differ. Conclusion Higher lactate and bilirubin concentrations, advanced age, and prolonged CPR to ECMO time were independently associated with poor outcomes after ECPR. Early ECMO initiation and prompt metabolic correction may improve survival in cardiac arrest patients receiving ECPR in the ED.

Background and Objectives: Several real-world studies have been done in patients with nonvalvular atrial fibrillation (NVAF); however, information on its safety profile in patients with renal impairment is limited. XARENAL, a real-world study, aimed to prospectively investigate the safety profile of rivaroxaban in patients with NVAF with renal impairment (creatinine clearance [CrCl], 15–49 mL/min). Methods: XARENAL is an observational single-arm cohort study in renal impairment NVAF patients. Patients were followed up approximately every 3 months for 1 year or until 30 days following early discontinuation. The primary endpoint was major bleeding events. All adverse events, symptomatic thromboembolic events, treatment duration, and renal function change from baseline were the secondary endpoints. Results: XARENAL included 888 patients from 29 study sites. Overall, 713 (80.3%) had moderate renal impairment (CrCl, 30–49 mL/min), and 175 (19.7%) had severe renal impairment (CrCl, 15–29 mL/min) with a mean estimated glomerular filtration rate (eGFR) of 45.2±13.0 mL/min/1.73 m 2 . The mean risk scores were 3.3±1.4 and 1.7±0.9 for CHA 2 DS 2 -VASc score and HAS-BLED score, respectively. An incidence proportion of 5.6% (6.2 events per 100 patient-years) developed major bleeding; however, fatal bleeding occurred in 0.5% (0.5 events per 100 patient-years). The mean change in the eGFR was 2.22±26.47 mL/min/1.73 m 2 per year. Conclusions XARENAL observed no meaningful differences in major bleeding events from other previous findings as well as renal function changes in rivaroxaban-treated NVAF patients with renal impairment, which is considered to be acceptable in clinical practice.

Four soluble factors—putrescine, glucosamine, nicotinamide, and signal transducer and activator of transcription 3 (STAT3) inhibitor BP-1-102—were shown to differentiate bone marrow mononucleated cells (BMNCs) into functional insulin-producing cells (IPCs) in vitro. Transplantation of these IPCs improved hyperglycemia in diabetic mice. However, the role of endogenous BMNC regeneration in this effect was unclear. This study aimed to evaluate the effect of these factors on in vivo BMNC differentiation into IPCs in diabetic mice. Mice were orally administered the factors for 5 days, twice at 2-week intervals, and monitored for 45–55 days. Glucose tolerance, glucose-stimulated insulin secretion, and pancreatic insulin content were measured. Chimeric mice harboring BMNCs from insulin promoter luciferase/green fluorescent protein (GFP) transgenic mice were used to track endogenous BMNC fate. These factors lowered blood glucose levels, improved glucose tolerance, and enhanced insulin secretion. Immunostaining confirmed IPCs in the pancreas, showing the potential of these factors to induce β-cell regeneration and improve diabetes treatment.

Background: Active surveillance (AS) has emerged as a viable management strategy for low-risk papillary thyroid microcarcinoma (PTMC), following pioneering trials at Kuma Hospital and the Cancer Institute Hospital in Japan. Numerous prospective cohort studies have since validated AS as a management option for low-risk PTMC, leading to its inclusion in thyroid cancer guidelines across various countries. From 2016 to 2020, the Multicenter Prospective Cohort Study of Active Surveillance on Papillary Thyroid Microcarcinoma (MAeSTro) enrolled 1,177 patients, providing comprehensive data on PTMC progression, sonographic predictors of progression, quality of life, surgical outcomes, and cost-effectiveness when comparing AS to immediate surgery. The second phase of MAeSTro (MAeSTro-EXP) expands AS to low-risk papillary thyroid carcinoma (PTC) tumors larger than 1 cm, driven by the hypothesis that overall risk assessment outweighs absolute tumor size in surgical decision-making. Methods: This protocol aims to address whether limiting AS to tumors smaller than 1 cm may result in unnecessary surgeries for low-risk PTCs detected during their rapid initial growth phase. By expanding the AS criteria to include tumors up to 1.5 cm, while simultaneously refining and standardizing the criteria for risk assessment and disease progression, we aim to minimize overtreatment and maintain rigorous monitoring to improve patient outcomes. Conclusion This study will contribute to optimizing AS guidelines and enhance our understanding of the natural course and appropriate management of low-risk PTCs. Additionally, MAeSTro-EXP involves a multinational collaboration between South Korea and Australia. This cross-country study aims to identify cultural and racial differences in the management of low-risk PTC, thereby enriching the global understanding of AS practices and their applicability across diverse populations.