Objectives: This study investigated differences in dietary habits, lifestyle patterns, and feeding- related developmental issues among Korean preschool children based on their parents’ levels of growth concern, and examined the associations between parental growth concern and children’s eating behaviors. Methods: A cross-sectional study was conducted with parents of children aged 1–5 years residing in Gyeonggi Province, Korea. Participants were classified into high, moderate, and low growth concern groups using the children’s dietary screening test. Data were collected on the children’s anthropometric status, lifestyle routines, dietary intake patterns, eating behaviors, and mealtime media exposure. Results: Children in the high growth concern group showed a higher prevalence of underweight; irregular sleep and mealtime routines; and more frequent eating difficulties, including picky eating, slow eating, and oral processing problems. Mealtime media exposure was associated with lower fruit and vegetable intake and higher consumption of processed and sugar-rich foods. Higher parental growth concern did not correlate with healthier dietary or lifestyle outcomes. Conclusion Preschool children’s dietary behaviors and routines differed according to the parents’ levels of growth concern. Higher levels of parental concern were associated with increased feeding difficulties and greater mealtime media exposure. These findings suggest that excessive concern may contribute to maladaptive eating patterns in children. Evidence- based parental guidance and structured nutrition education are essential to promote healthy growth and eating behaviors during early childhood.

Background: Vascular smooth muscle cells (VSMCs) play a crucial role in the development of occlusive vascular diseases through abnormal proliferation and migration. This pathological behavior is closely associated with mitochondrial reactive oxygen species (ROS)-mediated mitochondrial DNA (mtDNA) damage. The mitochondrial carrier protein solute carrier family 25 member 33 (SLC25A33), essential for nucleoside transport, is integral to mtDNA production. This study aimed to investigate the effects of SLC25A33 inhibition on the proliferation and migration of VSMCs, as well as its impact on neointima formation. Methods: VSMCs were isolated from the thoracic aorta of 4-week-old Sprague-Dawley rats. The effects of small interfering RNAinduced silencing of SLC25A33 mRNA on platelet-derived growth factor (PDGF)-induced proliferation and migration of VSMCs were analyzed. The in vivo effects of targeting the SLC25A33 gene on neointima formation were evaluated using a murine carotid artery ligation model by perivascularly applying Lenti-shSLC25A33 with Pluronic F-127 gel. Results: First, we observed an upregulation of the SLC25A33 protein in the carotid artery ligation-induced neointima in mice. Silencing of SLC25A33 suppressed the PDGF-stimulated proliferation and migration of VSMCs and cell cycle progression. Knockdown of SLC25A33 inhibited PDGF-induced production of mtDNA and ROS, consequently inactivating the cyclic GMP-AMP synthesis (cGAS)-stimulator of interferon genes (STING)-TANK-binding kinase 1 (TBK1)-nuclear factor kappa B (NF-κB) pathway. Furthermore, the downregulation of SLC25A33 reduced carotid artery ligation-induced neointima in mice. Conclusion This study suggests that targeting SLC25A33 in VSMCs could be a novel therapeutic strategy to prevent occlusive vascular diseases.

Background/Aims: Cardiovascular disease remains a major cause of mortality in patients with metabolic dysfunction-associated steatotic liver disease (MASLD). This study evaluated the association between subclinical carotid atherosclerosis (SCA) and MASLD or MASLD and increased alcohol intake (MetALD) in asymptomatic individuals. Methods: This cross-sectional study included 56,889 adults undergoing health check-ups in South Korea. Hepatic steatosis was diagnosed by ultrasound, and SCA was defined by carotid plaques or increased intima-media thickness. Liver fibrosis was evaluated using the fibrosis-4 index and elastography. Results: SCA was identified in 13.5%. MASLD and MetALD were significantly associated with SCA in models adjusted for demographic and lifestyle factors (adjusted odds ratio [aOR], 1.26;95% confidence interval [CI], 1.19 to 1.33; aOR, 1.43; 95% CI, 1.30 to 1.58; respectively, p<0.001for both). However, these associations attenuated and lost statistical significance when metabolic risk factors were further adjusted. The risk of SCA increased with greater hepatic steatosis and liver fibrosis severity. In patients with MASLD, aORs were 1.70 (hepatic steatosis index >36),1.23 (fibrosis-4 index ≥1.3), and 1.78 (liver stiffness measurement ≥5.6 kPa), compared to indi-viduals without MASLD. Similar trends were observed in the MetALD group. Additionally, hyper-tension and clustering of ≥3 cardiometabolic risk factors were significantly associated with SCA inthe MASLD group, supporting the role of metabolic burden in SCA development. Conclusions MASLD and MetALD were associated with increased SCA risk, particularly in individuals with hepatic steatosis and fibrosis. These findings suggest that metabolic burden and liver disease severity jointly contribute to subclinical atherosclerosis risk.

Purpose: This study investigated the nursing competency of graduates of 4-year college nursing programs following curriculum reforms. Methods: Participants were nurses with clinical experience ranging from six months to three years at tertiary and general hospitals. Proportional quota sampling was performed based on region and hospital type. Nursing competency among college graduates was examined using university graduates as the reference group; nursing managers evaluated the competencies of both groups. Results: First, the overall nursing competencies of college graduates (4.03±0.49) and university graduates (3.97±0.49) did not differ significantly (t=1.43, p=.154). Second, nursing managers’ evaluations indicated comparable nursing competencies of graduates from colleges (3.68±0.72) and university (3.54±0.64) (t=1.87, p=.062). Conclusion These results suggest that the reform of the 4-year nursing program at colleges successfully achieved its educational goals, equivalent to university training programs. These findings reflect positive educational outcomes achieved through changes in the academic system.

Background: Radioactive iodine treatment (RAIT) is an essential therapy for differentiated thyroid cancer. However, unforeseen complications arising during thyroid hormone withdrawal (THW) can lead to Cancellation of the scheduled treatment. This study aimed to identify cases in which THW-RAIT was discontinued due to THW-related complications and to explore potentially preventable causes to improve patient management. Methods: Among 4,174 patients who underwent THW-RAIT between 2012 and 2024, 39 did not complete the planned treatment. After excluding Cancellations unrelated to THW, 11 (0.26%) patients with unexpected THW-related medical issues were analyzed. Results: The median age of the included patients was 61 years (range, 23 to 70), and 10 were male. The reasons for THW-RAIT Cancellation were hyponatremia (n=1), abnormal liver function (n=1), renal dysfunction (n=3), and combined liver and renal dysfunction (n=6). The patient with hyponatremia was taking a thiazide diuretic. Most cases of liver dysfunction were associated with prior use of herbal medications, whereas renal dysfunction was linked to diuretic or nonsteroidal anti-inflammatory drug use, pre-existing conditions such as single kidney or diabetic nephropathy, or inadequate oral intake during low-iodine preparation. Two cases of concurrent liver and renal dysfunction were attributed to rhabdomyolysis following intense exercise or heavy physical labor. Conclusion Enhanced patient education, comprehensive pre-treatment assessment, and careful avoidance of high-risk medications are essential to prevent THW-related complications and minimize disruptions in RAIT.

Objective: This study aimed to find out the concordance between prescription and performance of neuropsychological tests inadults aged 90 and older. Methods: We analyzed 270 prescriptions of patients aged 90 and older from a single hospital between 2019 and 2025, retrospectively. Prescriptions included Seoul Neuropsychological Screening Battery-Second Edition (SNSB-II), Literacy Independent Cognitive Assessment (LICA), and Korean version of the Severe Impairment Battery (SIB-K). Administration outcomes wereclassified as concordant (as prescribed), substituted (to different battery administered), simplified (just screening test and clinicalinterview), or cancelled (not administered). Floor and ceiling effects were assessed in subtests and subscales of all tests. Results: Overall concordance rate was 52.2%. SNSB-II showed the lowest concordance (33.8%) and LICA demonstrated higher concordance (72.3%). SIB-K showed complete concordance (100%). SNSB-II completers had higher education levels thanLICA and SIB-K completers. Among subsets of SNSB-II, seven showed floor effects and three showed ceiling effects. LICA had floor effects in five and ceiling effect in one. In SIB-K, one showed floor effect and six showed ceiling effects. Conclusion LICA demonstrated good feasibility in this age group. These findings provide evidence for age-appropriate as-sessment protocols.

Background: The management of sexually transmitted infections (STIs) at the national level is necessary for the health and well-being of individuals in society. The purpose of this study was to propose a redesign of the STI surveillance system by collecting opinions from experts. Methods: After the major STIs were reviewed, 1) gonorrhea, 2) chancroid, 3) Mycoplasma genitalium infection, and 4) trichomoniasis were selected as diseases requiring a redesign of the surveillance system through the Delphi method, a technique for solving problems by collecting opinions from experts. The expert panel was selected from experts on STIs (n = 17) and included members of the Korean Association of Urogenital Tract Infection and Inflammation, the Korean Society of Infectious Diseases, and the 3rd advisory committee on STIs. Results: The experts agreed upon the exclusion of surveillance for chancroid on the basis of the low incidence, with an agreement rate of 83%. The experts agreed upon the inclusion of M. genitalium in the surveillance system, with a high agreement rate of 88%. However, there was disagreement among the experts on whether to include trichomoniasis in the surveillance system and whether to switch to a mandatory surveillance system for gonorrhea. Conclusion Although a consensus was not reached in some of the surveys in this study, it involved the collection of various expert opinions. Therefore, policies should be promoted with a prioritized focus on items with high agreement, but items for which no consensus was reached need to be reviewed in greater depth through additional research and investigation.

Background: Basal cell carcinomas (BCCs) are often misdiagnosed as benign lesions, leading to inappropriate laser ablation. Misidentification may cause delays in proper diagnosis and surgical intervention, potentially affecting patient outcomes. Objective: We investigated the percentage of patients with BCC who were inappropriately treated with laser ablation following the introduction of dermoscopic examination reimbursement and analyzed their clinical and histological characteristics. Methods: We retrospectively reviewed the data of 106 patients with histologically confirmed BCC after reimbursement for dermoscopic examinations was implemented. Results: Among the 106 patients pathologically diagnosed with BCC, 11 patients (10.4%) had a history of laser ablation after being misdiagnosed with a benign lesion. All patients had pigmented BCCs on their faces, with the cheeks and nose (36.4% each) being the most frequent sites of involvement. The mean time between laser treatment and hospital visits was 30.9 months, and six patients (54.5%) were diagnosed with BCC within 1∼5 years after laser ablation. Of the 11 patients, six were treated by dermatologists, two by non-dermatologists, and two by non-licensed personnel. Nine patients showed at least one classic dermoscopic pattern, and the most common dermoscopic finding was the presence of multiple blue/gray globules (7/10, 70.0%). No recurrence after wide excision was observed during the last follow-up. Conclusion Despite dermoscopic examination reimbursement, our findings indicate that approximately 10.0% of BCCs are still misdiagnosed as benign lesions, as reported in a previous study. Therefore, when a malignancy is suspected, dermoscopic examination and biopsy should be considered to ensure an accurate diagnosis and facilitate appropriate treatment.

Purpose: Laryngomalacia exhibits diverse morphological patterns, severities, and comorbidities. Defining clinical phenotypes could improve management and prognosis. This study aimed to identify and characterize phenotypes using cluster analysis and to evaluate prognostic factors. Methods: We retrospectively reviewed records of 195 children diagnosed with laryngomalacia between 2014 and 2023 using flexible laryngoscopy or bronchoscopy. Demographics, endoscopic findings, comorbidities, and outcomes up to 1 year of age were collected. Hierarchical cluster analysis was conducted using 10 clinical variables. Results: Four phenotypes emerged: cluster 1 (n= 75, 38.5%), Groningen Laryngomalacia Classification System (GLCS) type 1 dominant-mild; cluster 2 (n= 35, 17.9%), GLCS type 2 dominant-mild; cluster 3 (n= 40, 20.5%), severe with multiple comorbidities; and cluster 4 (n = 45, 23.1%), GLCS combined-type moderate. Distinct clinical courses were observed. Cluster 3 showed the highest rates of surgical intervention (32.5%, P < 0.001), pediatric intensive care unit admission (17.5%, P = 0.016), and Emergency Department (ED) visits (60.0%, P= 0.013) for respiratory problems during the first year. When stratified by comorbidities, children with multiple comorbidities, particularly those with major feeding problems had a higher risk of hospitalization (adjusted odds ratio [aOR], 2.65;95% confidence interval [CI], 1.11–6.33) and ED visits (aOR, 3.17; 95% CI, 1.39–7.23), even after adjusting for sex and severity. Conclusion Four clinically meaningful phenotypes of laryngomalacia were identified from the cluster analysis based on morphology, comorbidities, and disease severity. Children with multiple comorbidities accompanied by feeding problems had the greatest risk of hospitalization and ED visits for respiratory problems within the first year, even after adjusting for the severity of laryngomalacia.