Background: Acute deterioration of patients in general wards often leads to major adverse events (MAEs), including unplanned intensive care unit transfers, cardiac arrest, or death. Traditional early warning scores (EWSs) have shown limited predictive accuracy, with frequent false positives. We conducted a prospective observational external validation study of an artificial intelligence (AI)-based EWS, the VitalCare - Major Adverse Event Score (VC-MAES), at a tertiary medical center in the Republic of Korea. Methods: Adult patients from general wards, including internal medicine (IM) and obstetrics and gynecology (OBGYN)—the latter were rarely investigated in prior AI-based EWS studies—were included. The VC-MAES predictions were compared with National Early Warning Score (NEWS) and Modified Early Warning Score (MEWS) predictions using the area under the receiver operating characteristic curve (AUROC), area under the precision-recall curve (AUPRC), and logistic regression for baseline EWS values. False-positives per true positive (FPpTP) were assessed based on the power threshold. Results: Of 6,039 encounters, 217 (3.6%) had MAEs (IM: 9.5%, OBGYN: 0.26%). Six hours prior to MAEs, the VC-MAES achieved an AUROC of 0.918 and an AUPRC of 0.352, including the OBGYN subgroup (AUROC, 0.964; AUPRC, 0.388), outperforming the NEWS (0.797 and 0.124) and MEWS (0.722 and 0.079). The FPpTP was reduced by up to 71%. Baseline VC-MAES was strongly associated with MAEs (P<0.001). Conclusions The VC-MAES significantly outperformed traditional EWSs in predicting adverse events in general ward patients. The robust performance and lower FPpTP suggest that broader adoption of the VC-MAES may improve clinical efficiency and resource allocation in general wards.

Objectives: Eveningness predominates in adolescence. Morningness has been reported to be associated with mental toughness via resilience. Morningness could be related to healthy sleep habits and a good personality. Methods: Sleep-related behaviors, such as weekend oversleep, social jetlag, and daytime sunlight exposure between 10:00 and 15:00, were evaluated using sleep-related questionnaires. Morningness-eveningness questionnaire, insomnia severity index, Epworth sleepiness scale, hospital anxiety and depression scale and defense style questionnaire were used. This study includes 1,610 high school students. Results: Multiple linear regression analysis revealed that morningness is predicted by male sex (β=0.115, t=4.769, p<0.001) and greater adaptive (β=0.092, t=3.506, p<0.001) and self-suppressive defense styles (β=0.072, t=2.192, p=0.029) and lesser immature defense styles (β=-0.163, t=-4.782, p<0.001) after controlling for age, sleep quality, depression, anxiety. Morningness is also predicted by greater sublimation (β=0.09, t=3.541, p<0.001) and reaction formation (β=0.112, t=4.488, p<0.001) and lesser consumption (β=-0.062, t=-2.501, p=0.012), passive aggression (β=-0.101, t=-3.747, p<0.001) and withdrawal (β=-0.084, t=-2.955, p=0.003), and male sex (β=0.117, t=4.896, p<0.001) after controlling for age, sleep quality, depression, and anxiety. Conclusion Morniness in adolescence may be related to a positive personality. Promoting morningness might be related to healthy development in personality.

This study aimed to elucidate the clinical characteristics of patients diagnosed with toxoplasmosis in Korea. We collected and analyzed the specific research data of 5,917 patients from the Health Insurance Review and Assessment (HIRA; 2007–2020) and 533 electronic medical records (EMRs; 2003–2021) of Korean patients. The HIRA data showed that toxoplasmosis is an endemic disease that occurs constantly in Korea, with a large proportion of patients complaining of ocular symptoms. Of the 533 patients for whom EMR data were available, 54.6% were diagnosed with toxoplasmosis; ocular toxoplasmosis (35.7%), congenital toxoplasmosis (4.7%), cerebral toxoplasmosis (4.1%), pulmonary toxoplasmosis (0.4%), and toxoplasma hepatitis (0.6%), in order of frequency. In ocular cases, 54.4% of the patients had diverse ocular pathologies. Toxoplasmosis in Korea is characterized by a high frequency of ocular symptoms, most patients are adults, and 51.8% of patients with seropositivity were positive for IgG, suggesting prior infection. This study highlights that patients with ocular symptoms are included in the major diagnosis group for acquired toxoplasmosis in Korea.

Objectives: Eveningness predominates in adolescence. Morningness has been reported to be associated with mental toughness via resilience. Morningness could be related to healthy sleep habits and a good personality. Methods: Sleep-related behaviors, such as weekend oversleep, social jetlag, and daytime sunlight exposure between 10:00 and 15:00, were evaluated using sleep-related questionnaires. Morningness-eveningness questionnaire, insomnia severity index, Epworth sleepiness scale, hospital anxiety and depression scale and defense style questionnaire were used. This study includes 1,610 high school students. Results: Multiple linear regression analysis revealed that morningness is predicted by male sex (β=0.115, t=4.769, p<0.001) and greater adaptive (β=0.092, t=3.506, p<0.001) and self-suppressive defense styles (β=0.072, t=2.192, p=0.029) and lesser immature defense styles (β=-0.163, t=-4.782, p<0.001) after controlling for age, sleep quality, depression, anxiety. Morningness is also predicted by greater sublimation (β=0.09, t=3.541, p<0.001) and reaction formation (β=0.112, t=4.488, p<0.001) and lesser consumption (β=-0.062, t=-2.501, p=0.012), passive aggression (β=-0.101, t=-3.747, p<0.001) and withdrawal (β=-0.084, t=-2.955, p=0.003), and male sex (β=0.117, t=4.896, p<0.001) after controlling for age, sleep quality, depression, and anxiety. Conclusion Morniness in adolescence may be related to a positive personality. Promoting morningness might be related to healthy development in personality.

This study aimed to elucidate the clinical characteristics of patients diagnosed with toxoplasmosis in Korea. We collected and analyzed the specific research data of 5,917 patients from the Health Insurance Review and Assessment (HIRA; 2007–2020) and 533 electronic medical records (EMRs; 2003–2021) of Korean patients. The HIRA data showed that toxoplasmosis is an endemic disease that occurs constantly in Korea, with a large proportion of patients complaining of ocular symptoms. Of the 533 patients for whom EMR data were available, 54.6% were diagnosed with toxoplasmosis; ocular toxoplasmosis (35.7%), congenital toxoplasmosis (4.7%), cerebral toxoplasmosis (4.1%), pulmonary toxoplasmosis (0.4%), and toxoplasma hepatitis (0.6%), in order of frequency. In ocular cases, 54.4% of the patients had diverse ocular pathologies. Toxoplasmosis in Korea is characterized by a high frequency of ocular symptoms, most patients are adults, and 51.8% of patients with seropositivity were positive for IgG, suggesting prior infection. This study highlights that patients with ocular symptoms are included in the major diagnosis group for acquired toxoplasmosis in Korea.

This study aimed to elucidate the clinical characteristics of patients diagnosed with toxoplasmosis in Korea. We collected and analyzed the specific research data of 5,917 patients from the Health Insurance Review and Assessment (HIRA; 2007–2020) and 533 electronic medical records (EMRs; 2003–2021) of Korean patients. The HIRA data showed that toxoplasmosis is an endemic disease that occurs constantly in Korea, with a large proportion of patients complaining of ocular symptoms. Of the 533 patients for whom EMR data were available, 54.6% were diagnosed with toxoplasmosis; ocular toxoplasmosis (35.7%), congenital toxoplasmosis (4.7%), cerebral toxoplasmosis (4.1%), pulmonary toxoplasmosis (0.4%), and toxoplasma hepatitis (0.6%), in order of frequency. In ocular cases, 54.4% of the patients had diverse ocular pathologies. Toxoplasmosis in Korea is characterized by a high frequency of ocular symptoms, most patients are adults, and 51.8% of patients with seropositivity were positive for IgG, suggesting prior infection. This study highlights that patients with ocular symptoms are included in the major diagnosis group for acquired toxoplasmosis in Korea.

Objectives: Eveningness predominates in adolescence. Morningness has been reported to be associated with mental toughness via resilience. Morningness could be related to healthy sleep habits and a good personality. Methods: Sleep-related behaviors, such as weekend oversleep, social jetlag, and daytime sunlight exposure between 10:00 and 15:00, were evaluated using sleep-related questionnaires. Morningness-eveningness questionnaire, insomnia severity index, Epworth sleepiness scale, hospital anxiety and depression scale and defense style questionnaire were used. This study includes 1,610 high school students. Results: Multiple linear regression analysis revealed that morningness is predicted by male sex (β=0.115, t=4.769, p<0.001) and greater adaptive (β=0.092, t=3.506, p<0.001) and self-suppressive defense styles (β=0.072, t=2.192, p=0.029) and lesser immature defense styles (β=-0.163, t=-4.782, p<0.001) after controlling for age, sleep quality, depression, anxiety. Morningness is also predicted by greater sublimation (β=0.09, t=3.541, p<0.001) and reaction formation (β=0.112, t=4.488, p<0.001) and lesser consumption (β=-0.062, t=-2.501, p=0.012), passive aggression (β=-0.101, t=-3.747, p<0.001) and withdrawal (β=-0.084, t=-2.955, p=0.003), and male sex (β=0.117, t=4.896, p<0.001) after controlling for age, sleep quality, depression, and anxiety. Conclusion Morniness in adolescence may be related to a positive personality. Promoting morningness might be related to healthy development in personality.

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: This study aimed to evaluate the effects of kombucha on the surface of composite resins and to examine thedegradation-inhibiting effect of adding calcium to kombucha. Methods: Six experimental groups were established, with three types of liquid kombucha: one with 3% added calcium,carbonated water as a positive control, and mineral water as a negative control. The pH and titratable acidity values of the experimental groups were measured. The samples were filled with condensed composite resin and placed in the experimental drinks for 5, 15, 30, and 60 minutes. The Vickers microhardness of the surface was measured before and after immersion, and the changes were compared. Results: The pH values of the experimental group were I’m alive (2.87±0.02), Hollys (2.95±0.01), Ediya (2.99±0.01), I’m alive +3% Ca (4.09±0.01), carbonated water (4.66±0.01), and mineral water (7.67±0.02). I’m alive (–12.35) showed the largest reduction in surface hardness, followed by Hollys (–9.78), carbonated water (–7.97), I’m alive +3% Ca (–7.82), Ediya (–7.60), and mineral water (–1.56). In the Vickers microhardness measurements, all experimental groups, except for the mineral water group, showed significant differences (p＜0.05). The scanning electron microscope results showed that the experimental group and positive control had rough surfaces and micropores. Conclusion The surface hardness was significantly reduced in all experimental groups except for water. In particular, in the caseof kombucha with low pH, the reduction rate increased, weakening the physical properties of the material. In addition, the reduction rate of surface hardness was lower in kombucha with added calcium, and it is believed that drinking kombucha containing calcium can minimize the erosion of dental materials.

Background: This study aimed to evaluate the effects of kombucha on the surface of composite resins and to examine thedegradation-inhibiting effect of adding calcium to kombucha. Methods: Six experimental groups were established, with three types of liquid kombucha: one with 3% added calcium,carbonated water as a positive control, and mineral water as a negative control. The pH and titratable acidity values of the experimental groups were measured. The samples were filled with condensed composite resin and placed in the experimental drinks for 5, 15, 30, and 60 minutes. The Vickers microhardness of the surface was measured before and after immersion, and the changes were compared. Results: The pH values of the experimental group were I’m alive (2.87±0.02), Hollys (2.95±0.01), Ediya (2.99±0.01), I’m alive +3% Ca (4.09±0.01), carbonated water (4.66±0.01), and mineral water (7.67±0.02). I’m alive (–12.35) showed the largest reduction in surface hardness, followed by Hollys (–9.78), carbonated water (–7.97), I’m alive +3% Ca (–7.82), Ediya (–7.60), and mineral water (–1.56). In the Vickers microhardness measurements, all experimental groups, except for the mineral water group, showed significant differences (p＜0.05). The scanning electron microscope results showed that the experimental group and positive control had rough surfaces and micropores. Conclusion The surface hardness was significantly reduced in all experimental groups except for water. In particular, in the caseof kombucha with low pH, the reduction rate increased, weakening the physical properties of the material. In addition, the reduction rate of surface hardness was lower in kombucha with added calcium, and it is believed that drinking kombucha containing calcium can minimize the erosion of dental materials.