Objective: This study investigated potential relationships between the kinetics of nucleolar precursor bodies (NPBs) in the pronucleus and developmental morphokinetics and euploidy in human preimplantation genetic testing for aneuploidy (PGT-A) cycles. Methods: The morphokinetic analysis of 200 blastocysts obtained from 53 PGT-A cycles was performed retrospectively in a time-lapse incubator. At the time of pronuclear breakdown (PNBD), we categorized the blastocysts into two groups based on the kinetic degree of clustering NPBs at the interface of the two pronuclei: clustered NPBs (CL) and non-clustered NPBs (NCL). We then compared morphokinetic parameters, abnormal behavioral events, and the rate of aneuploidy between the two groups. Results: Pronuclear fading and the first cleavage occurred earlier in the NCL group than in the CL group. However, the initiation of blastocyst formation and blastocyst expansion was delayed in the NCL group relative to the CL group. No differences were found in the rate of abnormal cleavage events, such as multinucleation at the 2-cell stage, direct cleavage from one to three cells, and from two to five cells between the CL and NCL groups. However, the fragmentation rate at the 8-cell stage was higher in the NCL group than in the CL group (10.3% vs. 1.9%, p<0.05). Additionally, the euploid rate in the CL group was significantly higher than in the NCL group (37.9% vs. 12.4%, p<0.05). Conclusion These results demonstrate the effectiveness of combining NPB clustering at PNBD with morphokinetics as a parameter for selecting embryos with higher developmental potential in in vitro fertilization.

Objective: This study investigated potential relationships between the kinetics of nucleolar precursor bodies (NPBs) in the pronucleus and developmental morphokinetics and euploidy in human preimplantation genetic testing for aneuploidy (PGT-A) cycles. Methods: The morphokinetic analysis of 200 blastocysts obtained from 53 PGT-A cycles was performed retrospectively in a time-lapse incubator. At the time of pronuclear breakdown (PNBD), we categorized the blastocysts into two groups based on the kinetic degree of clustering NPBs at the interface of the two pronuclei: clustered NPBs (CL) and non-clustered NPBs (NCL). We then compared morphokinetic parameters, abnormal behavioral events, and the rate of aneuploidy between the two groups. Results: Pronuclear fading and the first cleavage occurred earlier in the NCL group than in the CL group. However, the initiation of blastocyst formation and blastocyst expansion was delayed in the NCL group relative to the CL group. No differences were found in the rate of abnormal cleavage events, such as multinucleation at the 2-cell stage, direct cleavage from one to three cells, and from two to five cells between the CL and NCL groups. However, the fragmentation rate at the 8-cell stage was higher in the NCL group than in the CL group (10.3% vs. 1.9%, p<0.05). Additionally, the euploid rate in the CL group was significantly higher than in the NCL group (37.9% vs. 12.4%, p<0.05). Conclusion These results demonstrate the effectiveness of combining NPB clustering at PNBD with morphokinetics as a parameter for selecting embryos with higher developmental potential in in vitro fertilization.

Objective: This study investigated potential relationships between the kinetics of nucleolar precursor bodies (NPBs) in the pronucleus and developmental morphokinetics and euploidy in human preimplantation genetic testing for aneuploidy (PGT-A) cycles. Methods: The morphokinetic analysis of 200 blastocysts obtained from 53 PGT-A cycles was performed retrospectively in a time-lapse incubator. At the time of pronuclear breakdown (PNBD), we categorized the blastocysts into two groups based on the kinetic degree of clustering NPBs at the interface of the two pronuclei: clustered NPBs (CL) and non-clustered NPBs (NCL). We then compared morphokinetic parameters, abnormal behavioral events, and the rate of aneuploidy between the two groups. Results: Pronuclear fading and the first cleavage occurred earlier in the NCL group than in the CL group. However, the initiation of blastocyst formation and blastocyst expansion was delayed in the NCL group relative to the CL group. No differences were found in the rate of abnormal cleavage events, such as multinucleation at the 2-cell stage, direct cleavage from one to three cells, and from two to five cells between the CL and NCL groups. However, the fragmentation rate at the 8-cell stage was higher in the NCL group than in the CL group (10.3% vs. 1.9%, p<0.05). Additionally, the euploid rate in the CL group was significantly higher than in the NCL group (37.9% vs. 12.4%, p<0.05). Conclusion These results demonstrate the effectiveness of combining NPB clustering at PNBD with morphokinetics as a parameter for selecting embryos with higher developmental potential in in vitro fertilization.

Purpose: This study aimed to explore customer perspectives of nursing services in tertiary hospitals. Methods: The data comprised mobile Voice Of Customer (VOC) data related to “nursing” or “nurses” generated from June 25, 2019, to December 31, 2022, in a tertiary hospital. A total of 44,727 VOC data points were collected, of which 4,040 were selected for the final analysis. Text network analysis and topic modeling were conducted using NetMiner 4.5.1. Results: Topic modeling identified five topics for positive aspects and four topics for areas requiring improvement.The positive aspects were: 1) sincere nursing care; 2) rapid response from professional medical staff; 3) teamwork for delivering customer-centric services; 4) provision and coordination of system-based healthcare services; and 5) customer-focused responsiveness. The areas requiring improvement were: 1) demand for skilled nursing care tailored to customer expectations; 2) demand for enhanced communication and reduced mechanical responses; 3) demand for appropriate handling of diverse situations; and 4) demand for overall improvements to the healthcare system, including reservation systems. Conclusion These results may be used to enhance customer and patient experiences in tertiary hospitals and are necessary for utilization from a hospital management perspective.

Purpose: This study aimed to explore customer perspectives of nursing services in tertiary hospitals. Methods: The data comprised mobile Voice Of Customer (VOC) data related to “nursing” or “nurses” generated from June 25, 2019, to December 31, 2022, in a tertiary hospital. A total of 44,727 VOC data points were collected, of which 4,040 were selected for the final analysis. Text network analysis and topic modeling were conducted using NetMiner 4.5.1. Results: Topic modeling identified five topics for positive aspects and four topics for areas requiring improvement.The positive aspects were: 1) sincere nursing care; 2) rapid response from professional medical staff; 3) teamwork for delivering customer-centric services; 4) provision and coordination of system-based healthcare services; and 5) customer-focused responsiveness. The areas requiring improvement were: 1) demand for skilled nursing care tailored to customer expectations; 2) demand for enhanced communication and reduced mechanical responses; 3) demand for appropriate handling of diverse situations; and 4) demand for overall improvements to the healthcare system, including reservation systems. Conclusion These results may be used to enhance customer and patient experiences in tertiary hospitals and are necessary for utilization from a hospital management perspective.

Purpose: This study aimed to explore customer perspectives of nursing services in tertiary hospitals. Methods: The data comprised mobile Voice Of Customer (VOC) data related to “nursing” or “nurses” generated from June 25, 2019, to December 31, 2022, in a tertiary hospital. A total of 44,727 VOC data points were collected, of which 4,040 were selected for the final analysis. Text network analysis and topic modeling were conducted using NetMiner 4.5.1. Results: Topic modeling identified five topics for positive aspects and four topics for areas requiring improvement.The positive aspects were: 1) sincere nursing care; 2) rapid response from professional medical staff; 3) teamwork for delivering customer-centric services; 4) provision and coordination of system-based healthcare services; and 5) customer-focused responsiveness. The areas requiring improvement were: 1) demand for skilled nursing care tailored to customer expectations; 2) demand for enhanced communication and reduced mechanical responses; 3) demand for appropriate handling of diverse situations; and 4) demand for overall improvements to the healthcare system, including reservation systems. Conclusion These results may be used to enhance customer and patient experiences in tertiary hospitals and are necessary for utilization from a hospital management perspective.

Purpose: This study aimed to explore customer perspectives of nursing services in tertiary hospitals. Methods: The data comprised mobile Voice Of Customer (VOC) data related to “nursing” or “nurses” generated from June 25, 2019, to December 31, 2022, in a tertiary hospital. A total of 44,727 VOC data points were collected, of which 4,040 were selected for the final analysis. Text network analysis and topic modeling were conducted using NetMiner 4.5.1. Results: Topic modeling identified five topics for positive aspects and four topics for areas requiring improvement.The positive aspects were: 1) sincere nursing care; 2) rapid response from professional medical staff; 3) teamwork for delivering customer-centric services; 4) provision and coordination of system-based healthcare services; and 5) customer-focused responsiveness. The areas requiring improvement were: 1) demand for skilled nursing care tailored to customer expectations; 2) demand for enhanced communication and reduced mechanical responses; 3) demand for appropriate handling of diverse situations; and 4) demand for overall improvements to the healthcare system, including reservation systems. Conclusion These results may be used to enhance customer and patient experiences in tertiary hospitals and are necessary for utilization from a hospital management perspective.

Background: s/Aims: Reported incidence of extrahepatic bile duct cancer is higher in Asians than in Western populations. Korea, in particular, is one of the countries with the highest incidence rates of extrahepatic bile duct cancer in the world. Although research and innovative therapeutic modalities for extrahepatic bile duct cancer are emerging, clinical guidelines are currently unavailable in Korea. The Korean Society of Hepato-Biliary-Pancreatic Surgery in collaboration with related societies (Korean Pancreatic and Biliary Surgery Society, Korean Society of Abdominal Radiology, Korean Society of Medical Oncology, Korean Society of Radiation Oncology, Korean Society of Pathologists, and Korean Society of Nuclear Medicine) decided to establish clinical guideline for extrahepatic bile duct cancer in June 2021. Methods: Contents of the guidelines were developed through subgroup meetings for each key question and a preliminary draft was finalized through a Clinical Guidelines Committee workshop. Results: In November 2021, the finalized draft was presented for public scrutiny during a formal hearing. Conclusions The extrahepatic guideline committee believed that this guideline could be helpful in the treatment of patients.

Background/Aims: The recent update on Selecting Therapeutic Targets in Inflammatory Bowel Disease initiative has added a decrease in fecal calprotectin (FC) to an acceptable range as an intermediate target for Crohn’s disease (CD). We aimed to investigate whether postinduction FC could predict future persistent remission (PR) and endoscopic healing (EH) after 1 year of treatment with infliximab (IFX) in pediatric patients with CD. Methods: This multicenter retrospective observational study included pediatric patients with CD who were followed up for at least 1 year after starting IFX. The association of postinduction FC with PR and EH was investigated. Results: A total of 132 patients were included in this study. PR and EH were observed in 71.2% (94/132) and 73.9% (82/111) of the patients, respectively. In multivariate logistic regression analysis, only the postinduction FC level was associated with PR (odds ratio [OR], 0.26; 95% confidence interval [CI], 0.08 to 0.66; p=0.009). The FC levels at initiation of IFX and postinduction were significantly associated with EH (OR, 0.73; 95% CI, 0.53 to 0.99; p=0.044 and OR, 0.20; 95% CI, 0.06 to 0.49; p=0.002, respectively). According to the receiver operating characteristic curve analysis, the optimal cutoff level for postinduction FC associated with PR was 122 mg/kg, and that associated with EH was 377 mg/kg. Conclusions Postinduction FC was associated with PR and EH after 1 year of treatment with IFX in pediatric patients with CD. Our findings emphasize the importance of FC as an intermediate target in the treat-to-target era.

Background: Achieving a definitive genetic diagnosis of unexplained multiple congenital anomalies (MCAs) in neonatal intensive care units (NICUs) infants is challenging because of the limited diagnostic capabilities of conventional genetic tests. Although the implementation of whole genome sequencing (WGS) has commenced for diagnosing MCAs, due to constraints in resources and faculty, many NICUs continue to utilize chromosomal microarray (CMA) and/or karyotyping as the initial diagnostic approach. We aimed to evaluate the diagnostic efficacy of WGS in infants with MCAs who have received negative results from karyotyping and/or CMA. Methods: In this prospective study, we enrolled 80 infants with MCAs who were admitted to a NICU at a single center and had received negative results from CMA and/or karyotyping.The phenotypic characteristics were classified according to the International Classification of Diseases and the Human Phenotype Ontology. We assessed the diagnostic yield of trioWGS in infants with normal chromosomal result and explored the process of diagnosing by analyzing both phenotype and genotype. Also, we compared the phenotype and clinical outcomes between the groups diagnosed with WGS and the undiagnosed group. Results: The diagnostic yield of WGS was 26% (21/80), of which 76% were novel variants.There was a higher diagnostic yield in cases of craniofacial abnormalities, including those of the eye and ear, and a lower diagnostic yield in cases of gastrointestinal and genitourinary abnormalities. In addition, higher rates of rehabilitation therapy and gastrostomy were observed in WGS-diagnosed infants than in undiagnosed infants. Conclusion This prospective cohort study assessed the usefulness of trio-WGS following chromosomal analysis for diagnosing MCAs in the NICU and revealed improvements in the diagnostic yield and clinical utility of WGS.