Background: The growing number of elderly individuals living alone presents a major social issue, encompassing loneliness, isolation, economic and health challenges, and increased risk of suicide. This study aimed to identify factors associated with suicide risk among elderly individuals living alone in Jeju. Methods: A total of 4,742 participants completed questionnaires to assess their sociodemographic characteristics. Depressive symptoms were evaluated using the Short Form Geriatric Depression Scale-Korean version (sGDS-K), with a cutoff score of eight indicating the presence of depressive symptoms. Suicide risk was assessed using the MiniInternational Neuropsychiatric Interview-Plus. Multivariate logistic regression analysis was performed to identify significant correlates of suicide risk. Results: Multivariate logistic regression analysis identified the following factors as significantly associated with suicide risk: poor subjective health status (odds ratio [OR]=1.590, 95% confidence interval [CI]: 1.137-2.224), current drinking (OR=1.511, 95% CI: 1.119-2.042), hypertension (OR=1.419, 95% CI: 1.133-1.778), and sGDS scores ≥8 (OR=4.318, 95% CI: 3.408-5.469). Conclusion This study highlights the importance of intensive mental health services and socioeconomic support in preventing suicide among elderly individuals living alone. Targeted interventions should focus on those who have poor subjective health status, are current drinkers, have hypertension, or exhibit depressive symptoms.

Background: The Field Epidemiology Training Program Frontline, initiated by the Korea Disease Control and Prevention Agency in 2019, aims to enhance the competencies of infectious disease practitioners across 17 regions in South Korea. With the September 2024 amendment to the Infectious Disease Prevention Act mandating infectious disease prevention and crisis response training for government employees who are associated with infectious diseases responses, there is an urgent need to assess and optimize the effectiveness and cost-efficiency of such competency-based education programs amidst constraints of budget and manpower. Methods: This study examined the educational needs and priorities of public health competencies among infectious disease practitioners. The competency framework for Infectious Disease Response Practitioners (IDRP) in South Korea was used to evaluate the validity, importance, and performance level of competencies for infectious disease response personnel. For the training needs analysis, differences in performance by group were analyzed, and an importance performance analysis (IPA) was conducted using the Borich Needs Assessment based on the IPA matrix to derive training priorities. Results: The analysis revealed a significant gap between perceived importance and selfreported performance levels in most competencies, especially epidemiologic methods.Competencies related to safety and ethics, fieldwork, and crisis management have high importance and performance ratings, indicating a need for ongoing training. Of the 27 competencies, the IPA identified specific training needs and priorities, suggesting eight competencies for focused intervention to strengthen the capacity of IDRPs. Conclusion The IDRP competency framework in South Korea plays a pivotal role in establishing a standardized, competency-based approach to training IDRP. The identified gaps and training priorities highlight the need for continued curriculum development and the integration of real-world, field-based scenarios into training programs.

Purpose: Pattern electroretinogram (PERG) is used to evaluate the function of retinal ganglion cells. However, the amplitude of PERG is quite small, making the examination challenging to perform. Waveform noise may be minimized by applying various filters. We aimed to investigate the effect of 50-Hz filters on PERG test results. Methods: This is the retrospective observational study. PERG tests were performed using the RETI-scan system according to the International Society for Clinical Electrophysiology of Vision guidelines. Three types of 50-Hz filters (soft, middle, and hard) were applied. The differences in parameters (N35 peak time, P50 peak time, N95 peak time, P50 amplitude, N95 amplitude, and N95 to P50 ratio) were analyzed. Based on the provided normal range, the changes from normal to abnormal range or vice versa were investigated. Results: A total of 24 waveforms were analyzed. After filtering, the P50 and N95 amplitudes showed a significant reduction of 8% to 15% (P50 amplitude: 5.1 ± 2.7 μV without filter, 4.6 ± 2.3 μV with 50-Hz soft filter, 4.3 ± 2.1 μV with 50-Hz middle filter, 4.3 ± 2.1 μV with 50-Hz hard filter; N95 amplitude: 7.2 ± 4.2 μV without filter, 6.6 ± 3.8 μV with 50-Hz soft filter, 6.3 ± 3.6 μV with 50-Hz middle filter, 6.1 ± 3.6 μV with 50-Hz hard filter). This pattern was more prominent in normal subjects. All latencies except the N35 peak time exhibited no differences between the tests. The N95 to P50 ratio decreased after 50-Hz middle and hard filtering. Considering the normative data, switching between normal and abnormal results was rare. Conclusions Although peak time was not significantly affected, amplitude was significantly reduced after using 50-Hz filters. Thus, 50-Hz filters can smoothen the waveform. Nevertheless, caution must be exercised while taking readings.

Background and Objectives: The Valsalva test, although commonly utilized to assess the Eustachian tube function, is limited by drawbacks such as inconsistent pressure increases in the nasal cavity. Thus we introduced the “Popper test,” a tympanic membrane inflation test using the automatic middle ear inflation device known as middle ear inflation device (MEID), to explore its viability as an alternative to the Valsalva test.Subjects and Method We sampled 80 ears from patients between June 1, 2023, and August 1, 2023. Each patient underwent both the Valsalva and Popper tests using the MEID. Participants were divided into three categories: the “unable” group (patients who could not follow the Valsalva maneuver) and the “successful” and “unsuccessful” groups (patients whose attempts at the Valsalva or Popper tests either successed or failed). Success or failure was determined using an otoscope to assess the bulging of the tympanic membrane. Results: Of the 68 ears with normal middle ear pressure, 30.9% (21 ears) showed an inability to perform the Valsalva test, 45.6% (31 ears) successfully inflated the tympanic membrane via the Valsalva test, and 23.5% (16 ears) failed. Conversely, the Popper test resulted in an 88.2% (60 ears) success rate for inflating the tympanic membrane, with only 11.8% (8 ears) failing. Conclusion Variability observed in the Valsalva test outcomes may be attributed to individual differences and the instructor’s technique. MEID, as utilized in the Popper test, offers a promising alternative to the Valsalva test, potentially enhancing the reliability by minimizing individual variation. However, the diagnostic performance may be dependent on the properties of the MEID.

Background: The growing number of elderly individuals living alone presents a major social issue, encompassing loneliness, isolation, economic and health challenges, and increased risk of suicide. This study aimed to identify factors associated with suicide risk among elderly individuals living alone in Jeju. Methods: A total of 4,742 participants completed questionnaires to assess their sociodemographic characteristics. Depressive symptoms were evaluated using the Short Form Geriatric Depression Scale-Korean version (sGDS-K), with a cutoff score of eight indicating the presence of depressive symptoms. Suicide risk was assessed using the MiniInternational Neuropsychiatric Interview-Plus. Multivariate logistic regression analysis was performed to identify significant correlates of suicide risk. Results: Multivariate logistic regression analysis identified the following factors as significantly associated with suicide risk: poor subjective health status (odds ratio [OR]=1.590, 95% confidence interval [CI]: 1.137-2.224), current drinking (OR=1.511, 95% CI: 1.119-2.042), hypertension (OR=1.419, 95% CI: 1.133-1.778), and sGDS scores ≥8 (OR=4.318, 95% CI: 3.408-5.469). Conclusion This study highlights the importance of intensive mental health services and socioeconomic support in preventing suicide among elderly individuals living alone. Targeted interventions should focus on those who have poor subjective health status, are current drinkers, have hypertension, or exhibit depressive symptoms.

The prevalence of postpartum depression (PPD) in Asia is reported to range from 13.53% to 22.31%. However, there remains a gap in the identification of PPD, particularly regarding cultural cutoff points. Therefore, the purpose of this scoping review was to determine the prevalence and associated factors of PPD in Eastern, South-eastern, Western, and Southern Asian countries and analyze the cutoff points of the Edinburgh Postnatal Depression Scale (EPDS) used across these countries. Following Arksey and O'Malley’s five-step scoping review framework, the population was defined as mothers, the concept as the EPDS, and the context as the Asian region. A literature search was conducted using PubMed, Embase, CINAHL, PsycINFO, and Web of Science. The data analysis focused on demographic characteristics, EPDS cutoffs and features, PPD prevalence, and its associated factors. Nineteen studies were selected. Most countries used translated versions of the EPDS with demonstrated reliability and validity. The cutoff scores varied, with most using scores of 10 or higher. The prevalence of PPD ranged from 5.1% to 78.7%. Key associated factors for PPD included cultural factors such as relationships with in-laws and preferences for the newborn’s sex. To improve the accuracy of PPD screening in Asia, the EPDS should be used consistently, and appropriate cutoff criteria must be established. In addition, prevention strategies and programs that reflect the cultural characteristics and social context of Asia need to be developed for the early detection and prevention of PPD.

Purpose: Adjuvant treatment for craniopharyngioma after surgery is controversial. Adjuvant external beam radiation therapy (EBRT) can increase the risk of long-term sequelae. Stereotactic radiosurgery (SRS) is used to reduce treatment-related toxicity.In this study, we compared the treatment outcomes and toxicities of adjuvant therapies for craniopharyngioma. Materials and Methods: We analyzed patients who underwent craniopharyngioma tumor removal between 2000 and 2017. Of the 153 patients, 27 and 20 received adjuvant fractionated EBRT and SRS, respectively. We compared the local control (LC), progression-free survival (PFS), and overall survival between groups that received adjuvant fractionated EBRT, SRS, and surveillance. Results: The median follow-up period was 77.7 months. For SRS and surveillance, the 10-year LC was 57.2% and 57.4%, respectively. No local progression was observed after adjuvant fractionated EBRT. One patient in the adjuvant fractionated EBRT group died owing to glioma 94 months after receiving radiotherapy (10-year PFS: 80%). The 10-year PFS was 43.6% and 50.7% in the SRS and surveillance groups, respectively. The treatment outcomes significantly differed according to adjuvant treatment in nongross total resection (GTR) patients. Additional treatment-related toxicity was comparable in the adjuvant fractionated EBRT and other groups. Conclusion Adjuvant fractionated EBRT could be effective in controlling local failure, especially in patients with non-GTR, while maintaining acceptable treatment-related toxicity.

Objective: Recently, various mental health promotion programs using virtual reality (VR) technology have been tried in the psychiatric field. Considering the importance of mental health in pregnant women, VR-assisted mental health promotion programs for pregnant women are needed to be developed. This study aimed to prospectively investigate the efficacy of a VR-assisted mental health promotion program for pregnant women. Methods: Fifty-five pregnant women were participated in this study. Mental health states such as depression, anxiety, perceived stress, and quality of life were assessed by Patient Health Questionnaire-9 (PHQ-9), Generalized Anxiety Disorder-7 (GAD-7), Perceived Stress Scale, and World Health Organization Quality of Life Scale Abbreviated Version (WHOQOL-BREF) before and after using VR program treatment. Based on the mental health types of pregnant women classified by cluster analysis, the effects of the VR program were analyzed by paired t test and Wilcoxon signed rank test. Results: The VR program significantly reduced PHQ-9 (p = 0.033) and GAD-7 (p = 0.046) scores, and significantly increased WHOQOL-BREF (p = 0.026) score of the participants. Additionally, when classifying the mental health types of pregnant women, the VR program was significantly effective to improve depression, anxiety, and quality of life in the most severe group based on the cluster analysis. Conclusion The results of this study suggest that VR program may be effective to improve the mental health of pregnant women. Particularly, VR programs for the high-risk group of depression might be the most effective. Therefore, VR-assisted mental health promotion programs could be useful for managing the mental health in pregnant women.

Background/Aims: The incidence of steatotic liver disease (SLD) is increasing across all age groups as the incidence of obesity increases worldwide. The existing noninvasive prediction models for SLD require laboratory tests or imaging and perform poorly in the early diagnosis of infrequently screened populations such as young adults and individuals with healthcare disparities. We developed a machine learning-based point-of-care prediction model for SLD that is readily available to the broader population with the aim of facilitating early detection and timely intervention and ultimately reducing the burden of SLD. Methods: We retrospectively analyzed the clinical data of 28,506 adults who had routine health check-ups in South Korea from January to December 2022. A total of 229,162 individuals were included in the external validation study. Data were analyzed and predictions were made using a logistic regression model with machine learning algorithms. Results: A total of 20,094 individuals were categorized into SLD and non-SLD groups on the basis of the presence of fatty liver disease. We developed three prediction models: SLD model 1, which included age and body mass index (BMI); SLD model 2, which included BMI and body fat per muscle mass; and SLD model 3, which included BMI and visceral fat per muscle mass. In the derivation cohort, the area under the receiver operating characteristic curve (AUROC) was 0.817 for model 1, 0.821 for model 2, and 0.820 for model 3. In the internal validation cohort, 86.9% of individuals were correctly classified by the SLD models. The external validation study revealed an AUROC above 0.84 for all the models. Conclusions As our three novel SLD prediction models are cost-effective, noninvasive, and accessible, they could serve as validated clinical tools for mass screening of SLD.