The Korean Early Childhood Education and Care Panel Study (K-ECEC panel study), commencing in 2021, aimed to collect data related to early life growth and development. In particular, based on Bronfenbrenner’s ecological model, the study aims to collect intrinsic and extrinsic parental factors, educational and caregiving experiences in institutions, and environmental factors from the prenatal stage through infancy, toddlerhood, and early childhood. This is important for understanding child development with varied dimensional aspects. The K-ECEC panel study uses a stratified sampling strategy in order to recruit pregnant women based on regions and numbers of deliveries to individual hospitals. This resulted in the participation of 3,372 women, 95 of whom were from low-income families and 72 from multicultural families. The K-ECEC panel study is based on a household survey collecting information related to pregnancy, birth, and childrearing. The survey included an annual follow-up for individual households of newborns from 2022, and the second round of the survey was conducted in 2023. A total of 2,775 children participated in the first round of the survey, 1,423 of whom were boys. As there are few birth cohort studies considering policy-oriented aspects in Korea, the K-ECEC panel study is expected to provide data to understand childhood trajectories for growth and development. Furthermore, in terms of childcare and education, it is expected to be utilized to evaluate the policy effects of early life and parenting support.

The emergence of Chat Generative Pre-trained Transformer (ChatGPT), a chatbot developed by OpenAI, has garnered interest in the application of generative artificial intelligence (AI) models in the medical field. This review summarizes different generative AI models and their potential applications in the field of medicine and explores the evolving landscape of Generative Adversarial Networks and diffusion models since the introduction of generative AI models. These models have made valuable contributions to the field of radiology. Furthermore, this review also explores the significance of synthetic data in addressing privacy concerns and augmenting data diversity and quality within the medical domain, in addition to emphasizing the role of inversion in the investigation of generative models and outlining an approach to replicate this process. We provide an overview of Large Language Models, such as GPTs and bidirectional encoder representations (BERTs), that focus on prominent representatives and discuss recent initiatives involving language-vision models in radiology, including innovative large language and vision assistant for biomedicine (LLaVa-Med), to illustrate their practical application.This comprehensive review offers insights into the wide-ranging applications of generative AI models in clinical research and emphasizes their transformative potential.

Artificial intelligence (AI) in radiology is a rapidly developing field with several prospective clinical studies demonstrating its benefits in clinical practice. In 2022, the Korean Society of Radiology held a forum to discuss the challenges and drawbacks in AI development and implementation. Various barriers hinder the successful application and widespread adoption of AI in radiology, such as limited annotated data, data privacy and security, data heterogeneity, imbalanced data, model interpretability, overfitting, and integration with clinical workflows. In this review, some of the various possible solutions to these challenges are presented and discussed; these include training with longitudinal and multimodal datasets, dense training with multitask learning and multimodal learning, self-supervised contrastive learning, various image modifications and syntheses using generative models, explainable AI, causal learning, federated learning with large data models, and digital twins.

Purpose: This study examined the current status of counseling services provided by the Korea Counseling Center for Fertility and Depression, analyzing the characteristics of peripartum women and baby-rearing mothers and establishing guidelines for providing psychological support, and suggesting measures for improving the system. Methods: Data on 3,660 peripartum women & their spouses and baby-rearing mothers counseled through the service over the last 4 years were collected and a demographic analysis was conducted. By analyzing the clinical information of 216 peripartum women and 219 baby-rearing mothers who have registered with the Center and received routine counseling services, factors affecting depression were identified. Finally, a paired sample t-test was conducted to verify the effect of counseling services. Results: An overall 20.4% of pregnant women & their spouses were screened for high risk for depression, of whom 27.3% received registered counseling services; further, 26.2% of baby-rearing parents were at high-risk group for depression, of whom 25% received registered counseling services. Results of a logistic regression analysis suggested that, for peripartum women, level of education and conflicts with partner and family were the crucial factors predicting moderate or severe depression. For baby-rearing mothers, obstetric history of spontaneous abortion was the crucial predicting factor. Conclusion For the early detection and prevention of peripartum depression, screening tests that start from early pregnancy should be routinely administered. Further, continuous management—covering the periods before and after childbirth—should be provided by establishing organic ties between domestic projects.

Deep learning-based applications have great potential to enhance the quality of medical services. The power of deep learning depends on open databases and innovation. Radiologists can act as important mediators between deep learning and medicine by simultaneously playing pioneering and gatekeeping roles. The application of deep learning technology in medicine is sometimes restricted by ethical or legal issues, including patient privacy and confidentiality, data ownership, and limitations in patient agreement. In this paper, we present an open platform, MI2RLNet, for sharing source code and various pre-trained weights for models to use in downstream tasks, including education, application, and transfer learning, to encourage deep learning research in radiology. In addition, we describe how to use this open platform in the GitHub environment. Our source code and models may contribute to further deep learning research in radiology, which may facilitate applications in medicine and healthcare, especially in medical imaging, in the near future. All code is available at https://github.com/mi2rl/MI2RLNet.

Background/Aims: We evaluated the miss rates of polyps, adenomas, and advanced neoplasia of polypectomy-referring hospitals and risk factors for missed adenomas. Methods: We compared medical records and electronic images of initial colonoscopies from polypectomy-referring hospitals with those of corresponding therapeutic colonoscopies from Seoul St. Mary’s Hospital obtained from May 2014 to February 2016. Results: A total of 147 patients (56.6 ± 12.1 years, 37 females) were included. The mean number of polyps and adenomas detected on initial colonoscopy was 2.4 ± 1.7 and 1.7 ± 1.4, respectively. The mean number of additionally detected polyps and adenomas per patient during therapeutic colonoscopy was 1.4 ± 1.8 and 1.0 ± 1.5, respectively. Pooled miss rate for polyps, adenomas, and advanced neoplasia was 36%, 37%, and 11%, respectively. Pooled miss rate for adenomas was significantly higher for right-sided, non-pedunculated, and small (< 1 cm) adenomas (p = 0.031, p = 0.000, and p = 0.000, respectively). The miss rate of polyps, adenomas, and advanced neoplasia per patient was 60%, 49%, and 7%, respectively. Multivariate analysis revealed age and number of adenoma on initial colonoscopy were significantly related with risk for adenoma-missing (p = 0.005 and p = 0.023, respectively). Conclusions Among patients referred for polypectomy, adenoma is missed in one of two patients and advanced neoplasm is missed in one of 13. Patients with advanced age or multiple adenoma on initial colonoscopy have a higher possibility of missed adenoma. Total colon exploration should be performed carefully during therapeutic colonoscopy.

Purpose: This study aimed to review the history and examine the current service system of the Korea Counseling Center for Fertility and Depression (KCCFD) by analyzing the characteristics of its users, and to suggest measures to improve the system. Methods: Data on 883 infertile patients counseled through the KCCFD’s counseling service over the last 2 years were collected for a demographic analysis. The clinical information of 396 female subjects who received regular counseling after registration were analyzed to investigate factors influencing depression. Finally, a matching sample t-test was conducted to verify the effects of the counseling service. Results: The screening test showed that 50.7% of the infertile patients in our study were registered at our centers and received registered counseling. A total of 27.6% of the subjects was identified as being at high-risk for depression, and 71.3% of those at high-risk received registered counseling. The logistic regression analysis showed that being a homemaker, having a history of psychiatric disorder, and having undergone in vitro fertilization three or more times were significant factors that predict moderate or more severe depression. The female infertility patients who underwent counseling showed a significant decrease in depression, anxiety, general stress, and infertility stress. Conclusion Screening tests need to be performed prior to assisted reproductive technology if any of the 3 risk factors is present. The rate of registered counseling, regular follow-up using psychological tests, and cross-linkages with affiliated agencies should serve as the metrics for the quality control of the counseling service. Early detection of individuals at high-risk for depression calls for an activated liaison among affiliated agencies and expanded regional centers.

Background: Trauma mortality review is the first step in assessing the quality of the trauma treatment system and provides an important basis for establishing a regional inclusive trauma system. This study aimed to obtain a reliable measure of the preventable trauma death rate in a single province in Korea. Methods: From January to December 2017, a total of 500 sample cases of trauma-related deaths from 64 hospitals in Gyeonggi Province were included. All cases were evaluated for preventability and opportunities for improvement using a multidisciplinary panel review approach. Results: Overall, 337 cases were included in the calculation for the preventable trauma death rate. The preventable trauma death rate was estimated at 17.0%. The odds ratio was 3.97 folds higher for those who arrived within “1–3 hours” than those who arrived within “1 hour.” When the final treatment institution was not a regional trauma center, the odds ratio was 2.39 folds higher than that of a regional trauma center. The most significant stage of preventable trauma death was the hospital stage, during which 86.7% of the cases occurred, of which only 10.3% occurred in the regional trauma center, whereas preventable trauma death was more of a problem at emergency medical institutions. Conclusion The preventable trauma death rate was slightly lower in this study than in previous studies, although several problems were noted during inter-hospital transfer; in the hospital stage, more problems were noted at emergency medical care facilities than at regional trauma centers. Further, several opportunities for improvements were discovered regarding bleeding control.

PURPOSE: Circadian rhythm affects learning process, memory consolidation, and long-term memory. In this study, the alleviating effect of exercise on circadian rhythm disruption-induced memory deficits was investigated. METHODS: BMAL1 knockdown transgenic mice (BMAL1 TG) were used as the BMAL1-TG group and the BMAL1-TG with treadmill exercise group. Female C57BL/6J mice of the same age were used as the wildtype group and the wildtype with treadmill exercise group. The mice in the treadmill exercise groups performed running on a motorized treadmill under the dark-dark conditions for 8 weeks. Short-term memory, nonspatial object memory, and spatial learning memory were determined using stepdown avoidance test, novel object-recognition test, and radial 8-arm maze test. Immunohistochemistry for doublecortin and 5-bromo-2’-deoxyuridine was conducted for the determination of hippocampal neurogenesis. Using the western blot analysis, we determined the expressions of glucocorticoid receptor (GR) and factors related to the neurogenesis and memory consolidation, such as brain-derived neurotrophic factor, tyrosine kinase B, p44/42 mitogen-activated protein kinase, cyclic AMP-responsive element binding protein, phosphatidylinositol 3-kinase, protein kinas B, protein kinase C alpha, early-growth-response gene 1. RESULTS: Circadian rhythm disruption impaired memory function through inhibiting the expressions of GR and the factors related to neurogenesis and memory consolidation. Treadmill exercise improved memory function via enhancing the expressions of GR and above-mentioned factors. CONCLUSIONS Treadmill exercise acts as the zeitgeber that improves memory function under the circadian rhythm disrupted conditions.

PURPOSE: Our study aimed to examine psychometric properties and cross-cultural utility of the Behavior Assessment System for Children-2, Parent Rating Scale-Child (BASC-2 PRS-C) in Korean children. MATERIALS AND METHODS: Two study populations were recruited: a general population sample (n=2115) of 1st to 6th graders from 16 elementary schools and a clinical population (n=219) of 6–12 years old from 5 child psychiatric clinics and an epidemiological sample of autism spectrum disorder. We assessed the validity and reliability of the Korean version of BASC-2 PRS-C (K-BASC-2 PRS-C) and compared subscales with those used for US populations. RESULTS: Our results indicate that the K-BASC-2 PRS-C is a valuable instrument with reliability and validity for measuring developmental psychopathology that is comparable to those in Western population. However, there were some differences noted in the mean scores of BASC-2 PRS-C between Korean and US populations. CONCLUSION: K-BASC-2 PRS-C is an effective and useful instrument with psychometric properties that permits measurement of general developmental psychopathology. Observed Korean-US differences in patterns of parental reports of children's behaviors indicate the importance of the validation, standardization and cultural adaptation for tools assessing psychopathology especially when used in populations different from those for which the instrument was originally created.
Autism Spectrum Disorder ; Behavior Rating Scale ; Child* ; Cross-Cultural Comparison ; Humans ; Parents* ; Psychometrics ; Psychopathology ; Reproducibility of Results