This study aimed to investigate the dental utilization status, satisfaction with dental treatment, and the need for improvement among pediatric patients with rare diseases in Korea. A survey was conducted from June 2023 to May 2024 among caregivers of patients with rare diseases who visited the pediatric dentistry departments of eight dental institutions. The questionnaire for this study was divided into two sections: 126 caregivers participated in the dental utilization survey, while 91 caregivers completed the survey on satisfaction with dental treatment. Many caregivers believed that the patient’s poor oral health could impact overall health and reported positive functional and psychological changes following dental treatment. However, dental care for these patients presents challenges due to insufficient oral care information, specialized dentists, specialized dental facilities, and insurance coverage. Caregivers identified the need for an increase in specialized dental facilities as the highest priority (42.9%), with many emphasizing the necessity for expanded insurance coverage (38.9%). Notably, caregivers of patients who had undergone dental caries treatment advocated for broader insurance coverage (p = 0.0141), particularly for prosthetic (p = 0.0330) and restorative treatments (p = 0.0129). Furthermore, caregivers of patients with congenital disorders reported a significant economic burden associated with orthodontic treatment (p = 0.0405). Additionally, caregivers emphasized the need for an increase in specialized dentists (33.3%) and improved collaboration with pediatricians (25.4%). This study underscores the critical necessity for tailored policies and comprehensive support systems that reflect the current needs of the dental care system for pediatric patients with rare diseases.

Metastatic bladder cancer has historically been treated with platinum-based chemotherapy as the standard firstline therapy. Since the introduction of cisplatin-based regimens, advancements in treatment strategies have been limited. However, the recent emergence of immune checkpoint inhibitors (ICIs) and antibody-drug conjugates (ADCs) has significantly transformed the treatment landscape. Notably, the combination of enfortumab vedotin (EV) and pembrolizumab has demonstrated considerable clinical benefits, challenging traditional chemotherapy. This review aims to provide an overview of recent advancements in the treatment of metastatic bladder cancer.Current Concepts: Recent phase III clinical trials, notably EV-302/KEYNOTE-A39 and CheckMate 901, have reshaped the first-line management. EV combined with pembrolizumab has shown superior progression-free survival and overall survival compared to platinum-based chemotherapy, establishing it as a new standard of care. Patients ineligible for this regimen due to underlying comorbidities or toxicity may still benefit from alternative options. Such alternatives include platinum-based chemotherapy with ICI maintenance therapy, including avelumab or nivolumab. The selection of treatments should be individualized, taking into account specific patient factors, particularly platinum eligibility, renal function, and performance status.Discussion and Conclusion: The incorporation of ICIs and ADCs into the therapeutic landscape for metastatic bladder cancer has significantly improved patient outcomes. EV plus pembrolizumab has demonstrated substantial survival benefits, establishing it as a preferred first-line regimen for eligible patients. However, not all patients are candidates for this combination, emphasizing the necessity of individualized treatment strategies. Future research should focus on managing treatment-related adverse events and developing personalized therapies to maximizing efficacy while minimizing toxicity.

Antibodies to myelin oligodendrocyte glycoprotein (MOG) are associated with central nervous system demyelination inclusive of optic neuritis and transverse myelitis. MOG antibody may rarely be associated with peripheral nervous system involvement. A 48-year-old woman presented with demyelinating polyneuropathy. She previously suffered from myelitis and optic neuritis and had diagnosed with MOG antibody-associated disease (MOGAD). Polyneuropathies, combined central and inflammatory neuropathies may be associated with MOGAD and may be immunotherapy responsive. Further studies were needed to elucidate the utility of MOG antibody testing in polyneuropathy.

Breast cancer is the most common cancer in women worldwide, and its early detection is critical for improving survival outcomes. As a diagnostic and screening tool, mammography can be less effective owing to the masking effect of fibroglandular tissue, but breast US has good sensitivity even in dense breasts. However, breast US is highly operator dependent, highlighting the need for artificial intelligence (AI)-driven solutions. Unlike other modalities, US is performed using a handheld device that produces a continuous real-time video stream, yielding 12000–48000 frames per examination. This can be significantly challenging for AI development and requires real-time AI inference capabilities. In this review, we classified AI solutions as computer-aided diagnosis and computer-aided detection to facilitate a functional understanding and review commercial software supported by clinical evidence.In addition, to bridge healthcare gaps and enhance patient outcomes in geographically under resourced areas, we propose a novel framework by reviewing the existing AI-based triage workflows including mobile ultrasound.

Purpose: This study aimed to evaluate the performance of a clinical ladder system in a tertiary hospital by examining how nurses' clinical competence and perceptions of the system affect organizational commitment. Methods: The study involved 394 nurses working at a tertiary hospital. Data were collected from May 3 to July 10, 2023, using a self-reported questionnaire. Statistical analyses, including descriptive statistics, independent t-tests, one-way ANOVA, Kruskal-Wallis test, Scheffé post-hoc test, Pearson correlation, and hierarchical regression analysis, were performed using SPSS 27.0. Results: Nurses who applied for promotion to the CN III level and current CN III nurses reported higher clinical competence, perceptions of the clinical ladder system, and organizational commitment than those who did not and those at lower levels (p<.001). A positive correlation existed among all independent variables.Controlling for general characteristics, the effects of clinical competence and perceptions of the clinical ladder system explained 49% of organizational commitment variance (Adjusted R 2 =.49, F=33.43, p<.001). Conclusion Greater clinical competence and positive perceptions of the clinical ladder system are likely to enhance organizational commitment, emphasizing its effectiveness in fostering better organizational outcomes.

Background: Community acquired lower respiratory tract infection (LRTI) is a leading cause for hospitalization in children and important cause for antibiotic prescription. We aimed to describe the aetiology of LRTI in children and analyse factors associated with bacterial or viral infection. Methods: Patients aged < 19 years with a diagnosis of LRTI were identified from the Observational Medical Outcomes Partnership Common Data Model Database of Seoul National University Bundang Hospital from January 2005–July 2019, and their clinical characteristics were obtained from the electronic medical records and retrospectively reviewed. Results: Among 5,924 cases of LRTI, 74.2% were pneumonia and 25.8% were bronchiolitis/ bronchitis. Patients’ median age was 1.8 (interquartile range, 3.1) years and 79.9% were < 5 years old. Pathogens were identified in 37.8%; 69.1% were viral and 30.9% were bacterial/ Mycoplasma pneumoniae. Respiratory syncytial virus was most common (70.9%) among viruses and M. pneumoniae (94.6%) was most common among bacteria. Viral LRTI was associated with winter, age < 2 years, rhinorrhoea, dyspnoea, lymphocytosis, thrombocytosis, wheezing, stridor, chest retraction, and infiltration on imaging. Bacteria/ M. pneumoniae LRTI was associated with summer, age ≥ 2 years, fever, decreased breathing sounds, leucocytosis, neutrophilia, C-reactive protein elevation, and positive imaging findings (consolidation, opacity, haziness, or pleural effusion). Conclusion In children with LRTI, various factors associated with viral or bacterial/ M. pneumoniae infections were identified, which may serve as guidance for antibiotic prescription.

Purpose: This study aimed to evaluate the performance of a clinical ladder system in a tertiary hospital by examining how nurses' clinical competence and perceptions of the system affect organizational commitment. Methods: The study involved 394 nurses working at a tertiary hospital. Data were collected from May 3 to July 10, 2023, using a self-reported questionnaire. Statistical analyses, including descriptive statistics, independent t-tests, one-way ANOVA, Kruskal-Wallis test, Scheffé post-hoc test, Pearson correlation, and hierarchical regression analysis, were performed using SPSS 27.0. Results: Nurses who applied for promotion to the CN III level and current CN III nurses reported higher clinical competence, perceptions of the clinical ladder system, and organizational commitment than those who did not and those at lower levels (p<.001). A positive correlation existed among all independent variables.Controlling for general characteristics, the effects of clinical competence and perceptions of the clinical ladder system explained 49% of organizational commitment variance (Adjusted R 2 =.49, F=33.43, p<.001). Conclusion Greater clinical competence and positive perceptions of the clinical ladder system are likely to enhance organizational commitment, emphasizing its effectiveness in fostering better organizational outcomes.

This study aimed to investigate the dental utilization status, satisfaction with dental treatment, and the need for improvement among pediatric patients with rare diseases in Korea. A survey was conducted from June 2023 to May 2024 among caregivers of patients with rare diseases who visited the pediatric dentistry departments of eight dental institutions. The questionnaire for this study was divided into two sections: 126 caregivers participated in the dental utilization survey, while 91 caregivers completed the survey on satisfaction with dental treatment. Many caregivers believed that the patient’s poor oral health could impact overall health and reported positive functional and psychological changes following dental treatment. However, dental care for these patients presents challenges due to insufficient oral care information, specialized dentists, specialized dental facilities, and insurance coverage. Caregivers identified the need for an increase in specialized dental facilities as the highest priority (42.9%), with many emphasizing the necessity for expanded insurance coverage (38.9%). Notably, caregivers of patients who had undergone dental caries treatment advocated for broader insurance coverage (p = 0.0141), particularly for prosthetic (p = 0.0330) and restorative treatments (p = 0.0129). Furthermore, caregivers of patients with congenital disorders reported a significant economic burden associated with orthodontic treatment (p = 0.0405). Additionally, caregivers emphasized the need for an increase in specialized dentists (33.3%) and improved collaboration with pediatricians (25.4%). This study underscores the critical necessity for tailored policies and comprehensive support systems that reflect the current needs of the dental care system for pediatric patients with rare diseases.

Metastatic bladder cancer has historically been treated with platinum-based chemotherapy as the standard firstline therapy. Since the introduction of cisplatin-based regimens, advancements in treatment strategies have been limited. However, the recent emergence of immune checkpoint inhibitors (ICIs) and antibody-drug conjugates (ADCs) has significantly transformed the treatment landscape. Notably, the combination of enfortumab vedotin (EV) and pembrolizumab has demonstrated considerable clinical benefits, challenging traditional chemotherapy. This review aims to provide an overview of recent advancements in the treatment of metastatic bladder cancer.Current Concepts: Recent phase III clinical trials, notably EV-302/KEYNOTE-A39 and CheckMate 901, have reshaped the first-line management. EV combined with pembrolizumab has shown superior progression-free survival and overall survival compared to platinum-based chemotherapy, establishing it as a new standard of care. Patients ineligible for this regimen due to underlying comorbidities or toxicity may still benefit from alternative options. Such alternatives include platinum-based chemotherapy with ICI maintenance therapy, including avelumab or nivolumab. The selection of treatments should be individualized, taking into account specific patient factors, particularly platinum eligibility, renal function, and performance status.Discussion and Conclusion: The incorporation of ICIs and ADCs into the therapeutic landscape for metastatic bladder cancer has significantly improved patient outcomes. EV plus pembrolizumab has demonstrated substantial survival benefits, establishing it as a preferred first-line regimen for eligible patients. However, not all patients are candidates for this combination, emphasizing the necessity of individualized treatment strategies. Future research should focus on managing treatment-related adverse events and developing personalized therapies to maximizing efficacy while minimizing toxicity.

Antibodies to myelin oligodendrocyte glycoprotein (MOG) are associated with central nervous system demyelination inclusive of optic neuritis and transverse myelitis. MOG antibody may rarely be associated with peripheral nervous system involvement. A 48-year-old woman presented with demyelinating polyneuropathy. She previously suffered from myelitis and optic neuritis and had diagnosed with MOG antibody-associated disease (MOGAD). Polyneuropathies, combined central and inflammatory neuropathies may be associated with MOGAD and may be immunotherapy responsive. Further studies were needed to elucidate the utility of MOG antibody testing in polyneuropathy.