Purpose: This study aimed to address the shift toward competency-based education and the planned 2028 “Integrated Nursing” National Licensing Examination (NLE), this study aimed to establish structural alignment among NLE domains, the seven integrated nursing competencies (INCs), and curriculum goals, with a particular focus on implementing symptom-based clinical reasoning (SBCR). Methods: This Delphi-based methodological study included seven content experts for content validity index (CVI) assessment and 24 nursing education experts who participated in a consensus workshop. The item-level CVI and the scale-level CVI/average were calculated to confirm the linkage between INCs and NLE domains. In addition, qualitative analysis of workshop materials and meeting records was conducted to derive 10 integrated learning topics and to develop an SBCR educational model for the key symptom of headache, grounded in Miller’s Clinical Competence Pyramid (levels 2–4). Results: The analysis confirmed the validity of integrating the INCs within the overall curriculum structure. The resulting framework delineates staged learning objectives and core clinical questions designed to systematically enhance clinical reasoning, promote safe nursing practice, and support professional reflection within a unified curriculum. Conclusion This study provides a practical foundation for nursing curriculum redesign by facilitating a transition from fragmented, subject-based instruction to a holistic, patient-centered SBCR model. This approach aligns with the requirements of the integrated NLE and is expected to contribute to meaningful improvements in actual clinical competency.

BACKGROUND/OBJECTIVES: Obesity is a complex metabolic disorder characterized by excessive adipose tissue accumulation, dysregulated lipid metabolism, and insulin resistance, leading to an increased risk of metabolic disease. While Withania somnifera (AS) and Chrysanthemum zawadskii Herbich var. latilobum (Maxim.) Kitamura (C) have traditionally been used for their metabolic regulatory properties, their combined effects on adipogenesis, lipogenesis, lipolysis, and insulin signaling remain unexplored. Therefore, this study aimed to evaluate the anti-obesity effects of AS, C, and their optimal combination (ASC) in 3T3-L1 adipocytes by investigating their impact on lipid metabolism and glucose homeostasis.MATERIALS/METHODS: Following adipogenic differentiation, 3T3-L1 adipocytes were treated with AS, C, and ASC at different concentrations. RESULTS: AS, C, and ASC significantly inhibited adipogenesis by downregulating cyclic adenosine monophosphate (cAMP) response element-binding protein, peroxisome proliferator-activated receptor gamma, CCAAT/enhancer-binding proteins alpha and beta phosphorylation, thereby reducing lipid accumulation in adipocytes. They also suppressed lipogenesis by downregulating the expression of dephosphorylated acetyl-CoA carboxylase, fatty acid synthase, and lipoprotein lipase. In contrast, they markedly enhanced lipolysis, as evidenced by increased hormone-sensitive lipase and protein kinase A expression, along with elevated glycerol release and cAMP levels. Furthermore, AS, C, and ASC activated energy metabolism pathways, as indicated by the upregulation of AMP-activated protein kinase, uncoupling protein 1, and carnitine palmitoyltransferase 1A, suggesting a transition toward enhanced mitochondrial fatty acid oxidation. Notably, AS, C, and ASC significantly improved insulin signaling by restoring insulin receptor substrate 1, phosphoinositide 3-kinase, and Akt phosphorylation, while upregulating glucose transporter type 4 expression, indicating enhanced glucose uptake. Among all treatments, ASC showed relatively greater efficacy compared to AS or C alone, suggesting a potential additive effect. CONCLUSION These findings demonstrate that ASC effectively modulates multiple metabolic pathways in adipocytes, including adipogenesis, lipogenesis, lipolysis, energy metabolism, and insulin signaling, to exert its anti-obesity effects.

Purpose: High-cost novel therapies for multiple myeloma (MM) require evaluation of efficacy and cost-effectiveness. Materials and Methods: This study developed a methodology to assess cost-effectiveness using nationwide data from 11,450 newly diagnosed MM patients. A novel algorithm was applied to identify lines of therapy (LoT). Results: The number of newly diagnosed MM patients increased significantly, from 873 in 2010 to 1,464 in 2019 (p < 0.001). Advancing LoT was associated with shorter time to next treatment (TTNT) and overall survival (OS) (p < 0.001), while all-cause medical costs increased with each LoT (p < 0.001). Bortezomib-melphalan-prednisolone was the most common frontline regimen for transplant-ineligible patients (29.2%), while bortezomib-thalidomide-dexamethasone was most used for transplant-eligible patients (11.3%). Daratumumab monotherapy demonstrated superior second TTNT (7.8 vs. 5.2 months) and OS (8.5 vs. 5.3 months) compared to standard care in heavily treated MM patients, with statistical significance maintained after cost adjustment. For subsequent therapies following daratumumab, a methodology was developed to estimate required medical costs using the incremental cost-effectiveness ratio (ICER): Expected cost ($)=ICER×(Expected life expectancy–0.567)+35,601. Conclusion This study provides a novel cost-effectiveness framework linking treatment efficacy and real-world costs, supporting predictions of societal costs for future MM therapies.

The multi-decade household humidifier disinfectant poisoning tragedy (HHDT) in South Korea highlights the importance of investigating government failures. This study aims to identify and discuss key failures and shortcomings in the South Korean authorities’ approach to regulating humidifier disinfectants (HDs) and monitoring cases of chemical poisoning. We reviewed both the HD risk prevention measures that the South Korean Ministry of Environment (KME) should have implemented under the Toxic Chemicals Control Act (TCCA) (1991–2013).Polyhexamethylene guanidine phosphate (PHMG), a new chemical, was approved for use as a disinfectant under the TCCA. KME declared PHMG non-hazardous based solely on preproduction documentation provided by the industry. In addition, the Korea Disease Control and Prevention Agency (KDCPA) failed to detect the HHDT that had accumulated each year for more than a decade. KME’s neglect of its responsibilities, coupled with KDCPA’s lack of chemical poisoning surveillance systems, led to the accumulation of widespread HHDT.

This study analyzed dental treatments under general anesthesia at the Department of Pediatric Dentistry of Pusan National University Dental Hospital from 2014 to 2023. The study results indicated an increased use of general anesthesia, primarily for younger patients, highlighting the increasing need for specialized healthcare professionals in pediatric dentistry. The study population predominantly consisted of male patients and those residing in Gyeongsangnam-do province. The most common treatment for dental caries was restorative, followed by surgical procedures and orthodontic interventions. The number of surgical procedures abruptly increased after 2020. However, pulp treatments and restorations using stainless steel or zirconia crowns decreased over time, with increased resin restorations. Individuals with disabilities more frequently undergo repeat dental procedures under general anesthesia, indicating potential barriers to access for this population. This study emphasizes the need for comprehensive and equitable dental care for all individuals, particularly those with disabilities. Future research should focus on expanding the scope of the analysis to include multiple institutions and exploring long-term outcomes of patients receiving dental treatment under general anesthesia to inform policy development and best practices in pediatric dentistry.

This study examined the transverse relationship between the maxilla and mandible in children with mixed dentition. The study focused on the primary second molar and the permanent first molar in relation to the anteroposterior skeletal patterns using cone-beam computed tomography (CBCT). A total of 102 patients from the Pediatric Dentistry Department at Pusan Dental Hospital were classified into three skeletal groups (Class I, Ⅱ, Ⅲ) based on the ANB angle (angle formed by A-point-nasion-B-point). CBCT scans were analyzed to assess the transverse dimensions of basal bone and dento-alveolar measurements. The results showed that Class Ⅲ patients exhibited a significantly narrower maxillary basal bone compared with Class I and Ⅱ patients. The mandibular basal width was not significantly different between the classes. For primary second molars, Class Ⅲ patients showed significantly narrower maxillary alveolar bone width at the root bifurcation level (51.7 ± 2.5 mm, p < 0.05) compared with Class I and II patients. For permanent first molars, the maxillary occlusal fossa distance was smallest in Class II (45.4 ± 2.4 mm, p < 0.05), and was significantly different from Class I and Class Ⅲ. Maxillary first molar inclination was more lingually inclined in Class Ⅱ patients (99.0 ± 4.2°, p < 0.05) compared with Class Ⅲ patients, whereas Class Ⅲ patients exhibited more buccal inclination. This study highlights the correlation between transverse discrepancies and anteroposterior skeletal classifications, with Class Ⅲ showing a narrower maxillary base and Class Ⅱ patients presenting greater lingual compensation. These findings may aid pediatric dentists in diagnosing transverse relationships in mixed dentition.

This study aims to analyze anatomical and structural changes related to abnormal eruption of the maxillary first premolar in children, focusing on the correlation between maxillary sinus pneumatization volume and positional shifts in the premolar and canine. Twenty-nine children, with Hellman dental age IIIA, exhibiting unilateral abnormal eruption of the maxillary first premolar, were selected. Maxillary sinus morphology and the positions of tooth buds were assessed through CBCT images, and 3D-scanned diagnostic models were used to evaluate the upper arch form. The affected and control sides were compared in terms of sinus pneumatization and the positions of the first premolar and canine tooth buds. Maxillary sinus pneumatization on the affected side was significantly increased (p = 0.0202), while no significant difference was found in the total sinus volume (p = 0.9694). On the affected side, the apex of the first premolar was positioned more anteriorly (p = 0.0029) and more palatally (p = 0.0011) than that on the unaffected side. Additionally, the apex of the canine was positioned more posteriorly on the affected side compared to that on the unaffected side (p = 0.0039). Model analysis revealed that the anteroposterior total arch length on the affected side was longer than that on the control side (p < 0.0001), while the transverse width did not show any statistically significant difference. These findings suggest a potential relationship between maxillary sinus pneumatization and the abnormal eruption path of the first premolar, as well as possible effects on the eruption of canines.

Frailty is a condition marked by a progressive decline in physiological functioning due to aging, leading to increased disease morbidity and rising healthcare costs. Therefore, it is important to prevent frailty through proper management. Not only does a lack of physical activity contribute to frailty, but inadequate dietary intake, resulting from decreased appetite and malabsorption, is also a significant risk factor. This study aimed to develop a 16-week algorithm to assess the nutritional risks associated with frailty, provide personalized nutritional solutions, and manage frailty risk factors through continuous monitoring and periodic reassessment. A total of 20 indicators were selected to create a nutritional health score. The selected indicators encompassed nutritional risk factors for frailty, disease history, and hematological factors. Reassessments were designed to occur at four-week intervals to revise personalized management goals and adjust solutions. Metrics were prioritized to provide a personalized solution. A user-friendly monitoring system was developed that leveraged voice recognition technology to determine compliance. It is anticipated that the algorithm will serve several purposes. First, this outcome will allow us to help prevent and delay the onset of frailty by utilizing a mobile app. Second, it will reduce the time and economic costs associated with nutritional management. Finally, it will facilitate future professional counseling and monitoring.

The multi-decade household humidifier disinfectant poisoning tragedy (HHDT) in South Korea highlights the importance of investigating government failures. This study aims to identify and discuss key failures and shortcomings in the South Korean authorities’ approach to regulating humidifier disinfectants (HDs) and monitoring cases of chemical poisoning. We reviewed both the HD risk prevention measures that the South Korean Ministry of Environment (KME) should have implemented under the Toxic Chemicals Control Act (TCCA) (1991–2013).Polyhexamethylene guanidine phosphate (PHMG), a new chemical, was approved for use as a disinfectant under the TCCA. KME declared PHMG non-hazardous based solely on preproduction documentation provided by the industry. In addition, the Korea Disease Control and Prevention Agency (KDCPA) failed to detect the HHDT that had accumulated each year for more than a decade. KME’s neglect of its responsibilities, coupled with KDCPA’s lack of chemical poisoning surveillance systems, led to the accumulation of widespread HHDT.

This study analyzed dental treatments under general anesthesia at the Department of Pediatric Dentistry of Pusan National University Dental Hospital from 2014 to 2023. The study results indicated an increased use of general anesthesia, primarily for younger patients, highlighting the increasing need for specialized healthcare professionals in pediatric dentistry. The study population predominantly consisted of male patients and those residing in Gyeongsangnam-do province. The most common treatment for dental caries was restorative, followed by surgical procedures and orthodontic interventions. The number of surgical procedures abruptly increased after 2020. However, pulp treatments and restorations using stainless steel or zirconia crowns decreased over time, with increased resin restorations. Individuals with disabilities more frequently undergo repeat dental procedures under general anesthesia, indicating potential barriers to access for this population. This study emphasizes the need for comprehensive and equitable dental care for all individuals, particularly those with disabilities. Future research should focus on expanding the scope of the analysis to include multiple institutions and exploring long-term outcomes of patients receiving dental treatment under general anesthesia to inform policy development and best practices in pediatric dentistry.