The need to implement vegetarian meal plans in school meals to promote sustainable eating among adolescents is increasing. This study examined students’ perceptions of a vegetarian day, and its association with dietary quality. This study surveyed 372 adolescents (230 males, 142 females) in Daejeon, Korea, assessing their perceptions of a vegetarian day and their nutrition quotient for adolescents (NQ-A). The perception of a vegetarian day was 3.21 out of 5, showing no significant gender difference. Among all participants, the item “I think a vegetarian day will help students’ health” received the highest score (3.67). The item “I think a vegetarian day is about respecting the diversity of students” scored significantly higher among females than males, whereas the item “It is better to include meat substitutes as well as mixed grains, beans, vegetables and fruits on a vegetarian day” scored lower among females than males. Correlation analysis showed that the perceptions of a vegetarian day were significantly positively associated with the total NQ-A score and the moderation domain score in all participants. Based on these findings, efforts should be made to enhance the positive perceptions of a vegetarian day among adolescents while exploring various approaches to its effective implementation.

The need to implement vegetarian meal plans in school meals to promote sustainable eating among adolescents is increasing. This study examined students’ perceptions of a vegetarian day, and its association with dietary quality. This study surveyed 372 adolescents (230 males, 142 females) in Daejeon, Korea, assessing their perceptions of a vegetarian day and their nutrition quotient for adolescents (NQ-A). The perception of a vegetarian day was 3.21 out of 5, showing no significant gender difference. Among all participants, the item “I think a vegetarian day will help students’ health” received the highest score (3.67). The item “I think a vegetarian day is about respecting the diversity of students” scored significantly higher among females than males, whereas the item “It is better to include meat substitutes as well as mixed grains, beans, vegetables and fruits on a vegetarian day” scored lower among females than males. Correlation analysis showed that the perceptions of a vegetarian day were significantly positively associated with the total NQ-A score and the moderation domain score in all participants. Based on these findings, efforts should be made to enhance the positive perceptions of a vegetarian day among adolescents while exploring various approaches to its effective implementation.

Background: Skipping breakfast is associated with an increased risk of chronic inflammatory diseases. This study aimed to examine the association between breakfast-eating habits and inflammation, using high-sensitivity C-reactive protein (hs-CRP) as a marker. Methods: A total of 4,000 Korean adult males with no history of myocardial infarction, angina, stroke, diabetes, rheumatoid arthritis, cancer, or current smoking were included. Data from the 2016–2018 Korea National Health and Nutrition Examination Survey were used for analysis. The frequency of breakfast consumption was assessed through a questionnaire item in the dietary survey section asking participants about their weekly breakfast consumption routines over the past year. Participants were categorized into two groups, namely “0–2 breakfasts per week” and “3–7 breakfasts per week”; hs-CRP concentrations were measured through blood tests. Results: Comparing between the “infrequent breakfast consumption (0–2 breakfasts per week)” and “frequent breakfast consumption (3–7 breakfasts per week)” groups, the mean hs-CRP was found to be significantly higher in the “infrequent breakfast consumption” group, even after adjusting for age, body mass index, physical activity, alcohol consumption, systolic blood pressure, blood pressure medication, fasting blood glucose, and triglycerides (mean hs-CRP: frequent breakfast consumption, 1.36±0.09 mg/L; infrequent breakfast consumption, 1.17±0.05 mg/L; P-value=0.036). Conclusion Less frequent breakfast consumption was associated with elevated hs-CRP levels. Further large-scale studies incorporating adjusted measures of daily eating patterns as well as food quality and quantity are required for a deeper understanding of the role of breakfast in the primary prevention of chronic inflammatory diseases.

Purpose: To evaluate the feasibility and utility of deep learning-based computer-aided diagnosis (DL-CAD) for the detection of pulmonary nodules on coronary artery calcium (CAC)-scoring computed tomography (CT). Materials and Methods: This retrospective study included 273 patients (aged 63.9±13.2 years; 129 men) who underwent CACscoring CT. A DL-CAD system based on thin-section images was used for pulmonary nodule detection, and two independent junior readers reviewed the standard CAC-scoring CT scans with and without referencing DL-CAD results. A reference standard was established through the consensus of two experienced radiologists. Sensitivity, positive predictive value, and F1-score were assessed on a per-nodule and per-patient basis. The patients’ medical records were monitored until November 2023. Results: A total of 269 nodules were identified in 129 patients. With DL-CAD assistance, the readers’ sensitivity significantly improved (65% vs. 80% for reader 1; 82% vs. 86% for reader 2; all p<0.001), without a notable increase in the number of false-positives per case (0.11 vs. 0.13, p=0.078 for reader 1; 0.11 vs. 0.11, p>0.999 for reader 2). Per-patient analysis also enhanced sensitivity with DL-CAD assistance (73% vs. 84%, p<0.001 for reader 1; 89% vs. 91%, p=0.250 for reader 2). During follow-up, lung cancer was diagnosed in four patients (1.5%). Among them, two had lesions detected on CAC-scoring CT, both of which were successfully identified by DL-CAD. Conclusion DL-CAD based on thin-section images can assist less experienced readers in detecting pulmonary nodules on CACscoring CT scans, improving detection sensitivity without significantly increasing false-positives.

Purpose: Early identification of patients at risk for acute respiratory failure (ARF) could help clinicians devise preventive strategies. Analyzing biosignals with artificial intelligence (AI) can uncover hidden information and variability within time series. We aimed to develop and validate AI models to predict ARF within 72 h after emergency department admission, primarily using highresolution biosignals collected within 4 h of arrival. Materials and Methods: Our AI model, built on convolutional recurrent neural networks, combines biosignal feature extraction and sequence modeling. The model was developed and internally validated with data from 5284 admissions [1085 (20.5%) positive for ARF], and externally validated using data from 144 admissions [7 (4.9%) positive for ARF] from another institution. We defined ARF as the application of advanced respiratory support devices. Results: Our AI model performed well in predicting ARF, achieving area under the receiver operating characteristic curve (AUROC) of 0.840 and 0.743 in internal and external validations, respectively. It outperformed the Modified Early Warning Score (MEWS) and XGBoost models built only with clinical variables. High predictive ability for mortality was observed, with AUROC up to 0.809. A 10% increase in AI prediction scores was associated with 1.44-fold and 1.42-fold increases in ARF risk and mortality risk, respectively, even after adjusting for MEWS and demographic variables. Conclusion Our AI model demonstrates high predictive accuracy and significant associations with clinical outcomes. Our AI model has the potential to promptly aid in triage decisions. Our study shows that using AI to analyze biosignals advances disease detection and prediction.

Background: Although an appropriate weight management strategy is essential for obese individuals, weight loss can have adverse effects on bone mineral density (BMD). We conducted a systematic review of randomized controlled trials to evaluate changes in BMD after the implementation of various weight loss strategies. Methods: The PubMed, Embase, Web of Science, and Cochrane Library databases were searched to find articles published from database inception until June 2023. Randomized controlled trials of various treatments for obese patients that reported changes in BMD were selected. The primary outcome was BMD of the whole body, lumbar spine, and total hip, measured using dual X-ray absorptiometry. Results: Eighteen randomized controlled trials involving 2,510 participants with obesity were included in the analysis. At follow-up examination, the BMD of the lumbar spine decreased significantly after metabolic surgery (mean difference [MD]= –0.40 g/cm2 ; 95% confidence interval [CI], –0.73 to –0.07; I2 = 0%); lifestyle and pharmacological interventions did not result in a significant decrease in BMD at any location. Metabolic surgery also produced the most substantial difference in weight, with an MD of –3.14 (95% CI, –3.82 to –2.47). Conclusion This meta-analysis is the first to examine the effects of all categories of anti-obesity strategies, including the use of anti-obesity medications, on BMD. Bariatric metabolic surgery can have adverse effects on BMD. Moreover, medications can be used as a treatment for weight loss without compromising bone quality.

Purpose: This study aimed to investigate the effects of postnatal systemic corticosteroids on neurodevelopment in very low birth weight (VLBW) preterm infants. Methods: This was a population-based study of the Korean Neonatal Network of VLBW infant born at 23+0 and 31+6 weeks of gestation between 2013 and 2020. VLBW preterm infants assessed using the Bayley Scales of Infant and Toddler Development, third edition (BSID-III) at 18–24 months of corrected age and 3 years of age were enrolled. The primary outcomes were BSID-III scores and neurodevelopmental delays, with scores of <85. Socioeconomic status and clinical variables were adjusted for using multivariate regression analyses. Results: In total, 517 infants were enrolled in this study. Among the 216 (41.8%) infants who received postnatal systemic corticosteroids, the rate of cognitive delay was significantly higher at 18–24 months of corrected age than at 3 years of age. The rates of language and motor delays were significantly higher both at 18–24 months of corrected age and at 3 years of age. When multivariate logistic regression was performed, postnatal systemic corticosteroid use was significantly associated with cognitive delay at 18–24 months of corrected age, but not at 3 years of age. There was no significant association between postnatal systemic corticosteroid use and language or motor delay at 18-24 months of corrected age or at 3 years of age after multivariate logistic regression. Conclusion Postnatal systemic corticosteroid use in VLBW preterm infants increased the risk of cognitive delay at 18–24 months of corrected age, but not at 3 years.

Objective: Apnea in newborns is defined as a respiratory pause of 20 seconds or longer, or apnea accompanied by bradycardia or cyanosis. To date, research on neonatal apnea has focused on premature infants born within 34 weeks of gestation. The aim of this study is to present clinical significance of apnea in full-term infants compared with late premature infants born over 34 weeks of gestation. Methods: In a retrospective study, we reviewed medical records of neonates born over 34 weeks of gestation hospitalized for apnea and their mothers from November 2020 to May 2024. A total of 124 neonates were collected and divided into full-term infants (n=54) and late preterm infants (n=70) groups. Results: The mean gestational age of full-term and late preterm infants was 38 +5 weeks and 35 +2weeks, and the mean birth weight was 3.16 kg and 2.14 kg. Apnea was associated with diseases in 44.4% of full-term infants and 38.6% of late preterm infants. The rates of multiple births, small for gestational age, and cesarean section deliveries were significantly higher in late preterm infants.Apnea occurred significantly earlier and recovered faster in full-term infants. Neurologic disease was significantly more occurred in full-term infants (P=0.021). Especially, cerebral infarction and seizure were diagnosed only in full-term infants. Conclusion Apnea occurred earlier in full-term infants and severe neurologic diseases were significantly more found in full-term infants compared with late preterm infants. A close examination is needed in full-term infants with apnea.

Fine particulate matter (FPM) is a major component of air pollution and has emerged as a significant global health concern owing to its adverse health effects. Previous studies have investigated the correlation between bone health and FPM through cohort or review studies. However, the effects of FPM exposure on bone health are poorly understood. This study aimed to investigate the effects of FPM on bone health and elucidate these effects in vitro and in vivo using mice. Micro-CT analysis in vivo revealed FPM exposure decreased bone mineral density, trabecular bone volume/total volume ratio, and trabecular number in the femurs of mice, while increasing trabecular separation. Histological analysis showed that the FPM-treated group had a reduced trabecular area and an increased number of osteoclasts in the bone tissue. Moreover, in vitro studies revealed that low concentrations of FPM significantly enhanced osteoclast differentiation. These findings further support the notion that short-term FPM exposure negatively impacts bone health, providing a foundation for further research on this topic.

Background: Skipping breakfast is associated with an increased risk of chronic inflammatory diseases. This study aimed to examine the association between breakfast-eating habits and inflammation, using high-sensitivity C-reactive protein (hs-CRP) as a marker. Methods: A total of 4,000 Korean adult males with no history of myocardial infarction, angina, stroke, diabetes, rheumatoid arthritis, cancer, or current smoking were included. Data from the 2016–2018 Korea National Health and Nutrition Examination Survey were used for analysis. The frequency of breakfast consumption was assessed through a questionnaire item in the dietary survey section asking participants about their weekly breakfast consumption routines over the past year. Participants were categorized into two groups, namely “0–2 breakfasts per week” and “3–7 breakfasts per week”; hs-CRP concentrations were measured through blood tests. Results: Comparing between the “infrequent breakfast consumption (0–2 breakfasts per week)” and “frequent breakfast consumption (3–7 breakfasts per week)” groups, the mean hs-CRP was found to be significantly higher in the “infrequent breakfast consumption” group, even after adjusting for age, body mass index, physical activity, alcohol consumption, systolic blood pressure, blood pressure medication, fasting blood glucose, and triglycerides (mean hs-CRP: frequent breakfast consumption, 1.36±0.09 mg/L; infrequent breakfast consumption, 1.17±0.05 mg/L; P-value=0.036). Conclusion Less frequent breakfast consumption was associated with elevated hs-CRP levels. Further large-scale studies incorporating adjusted measures of daily eating patterns as well as food quality and quantity are required for a deeper understanding of the role of breakfast in the primary prevention of chronic inflammatory diseases.