Background: Predicting the risk of osteoporotic fractures is vital for prevention. Traditional methods such as the Fracture Risk Assessment Tool (FRAX) model use clinical factors. This study examined the predictive power of the FRAX score and machine-learning algorithms trained on FRAX parameters. Methods: We analyzed the data of 2,147 female participants from the Ansan cohort study. The FRAX parameters employed in this study included age, sex (female), height and weight, current smoking status, excessive alcohol consumption (>3 units/d of alcohol), and diagnosis of rheumatoid arthritis. Osteoporotic fracture was defined as one or more fractures of the hip, spine, or wrist during a 10-year observation period. Machine-learning algorithms, such as gradient boosting, random forest, decision tree, and logistic regression, were employed to predict osteoporotic fractures with a 70:30 training-to-test set ratio. We evaluated the area under the receiver operating characteristic curve (AUROC) scores to assess and compare the performance of these algorithms with the FRAX score. Results: Of the 2,147 participants, 3.5% experienced osteoporotic fractures. Those with fractures were older, shorter in height, and had a higher prevalence of rheumatoid arthritis, as well as higher FRAX scores. The AUROC for the FRAX was 0.617. The machine-learning algorithms showed AUROC values of 0.662, 0.652, 0.648, and 0.637 for gradient boosting, logistic regression, decision tree, and random forest, respectively. Conclusion This study highlighted the immense potential of machine-learning algorithms to improve osteoporotic fracture risk prediction in women when complete FRAX parameter information is unavailable.

This document is the third part of the guidelines for the interpretation and post-processing of cardiac magnetic resonance (CMR) studies. These consensus recommendations have been developed by a Consensus Committee of the Korean Society of Cardiovascular Imaging (KOSCI) to standardize the requirements for image interpretation and post-processing of CMR. This third part of the recommendations describes tissue characterization modules, including perfusion, late gadolinium enhancement, and T1- and T2 mapping. Additionally, this document provides guidance for visual and quantitative assessment, consisting of “What-to-See,” “How-To,” and common pitfalls for the analysis of each module. The Consensus Committee hopes that this document will contribute to the standardization of image interpretation and post-processing of CMR studies.

Cardiovascular magnetic resonance imaging (CMR) is expected to be increasingly used in Korea due to technological advances and the expanded national insurance coverage of CMR assessments. For improved patient care, proper acquisition of CMR images as well as their accurate interpretation by well-trained personnel are equally important. In response to the increased demand for CMR, the Korean Society of Cardiovascular Imaging (KOSCI) has issued interpretation guidelines in conjunction with the Korean Society of Radiology. KOSCI has also created a formal Committee on CMR guidelines to create updated practices. The members of this committee review previously published interpretation guidelines and discuss the patterns of CMR use in Korea.
Angiography ; Heart ; Insurance Coverage ; Korea ; Magnetic Resonance Imaging ; Patient Care

Cardiac magnetic resonance (CMR) imaging is widely used in many areas of cardiovascular disease assessment. This is a practical, standard CMR protocol for beginners that is designed to be easy to follow and implement. This protocol guideline is based on previously reported CMR guidelines and includes sequence terminology used by vendors, essential MR physics, imaging planes, field strength considerations, MRI-conditional devices, drugs for stress tests, various CMR modules, and disease/symptom-based protocols based on a survey of cardiologists and various appropriate-use criteria. It will be of considerable help in planning and implementing tests. In addressing CMR usage and creating this protocol guideline, we particularly tried to include useful tips to overcome various practical issues and improve CMR imaging. We hope that this document will continue to standardize and simplify a patient-based approach to clinical CMR and contribute to the promotion of public health.
Cardiovascular Diseases ; Commerce ; Exercise Test ; Heart ; Hope ; Magnetic Resonance Imaging ; Public Health

BACKGROUND/OBJECTIVES: This study evaluated whether a mobile health (mHealth) application can instigate healthy behavioral changes and improvements in metabolic disorders in individuals with metabolic abnormalities. SUBJECTS/METHODS: Participants were divided into an mHealth intervention group (IG), which used a mobile app for 24 weeks, and a conventional IG. All mobile apps featured activity monitors, with blood pressure and glucose monitors, and body-composition measuring devices. The two groups were compared after 24 weeks in terms of health-behavior practice rate and changes in the proportion of people with health risks, and health behaviors performed by the IG that contributed to reductions in more than one health risk factor were analyzed using multiple logistic regression. RESULTS: Preference for low-sodium diet, reading nutritional facts, having breakfast, and performing moderate physical activity significantly increased in the mHealth IG. Furthermore, the mHealth IG showed a significant increase of eight items in the mini-dietary assessment; particularly, the items “I eat at least two types of vegetables of various colors at every meal” and “I consume dairies, such as milk, yogurt, and cheese, every day.” The proportion of people with health risks, with the exception of fasting glucose, significantly decreased in the mHealth IG, while only the proportion of people with at-risk triglycerides and waist circumference of females significantly decreased in the control group. Finally, compared to those who did not show improvements of health risks, those who showed improvements of health risks in the mHealth IG had an odds ratio of 1.61 for moderate to vigorous physical activity, 1.65 for “I do not add more salt or soy sauce in my food,” and 1.77 for “I remove fat in my meat before eating.” CONCLUSIONS: The findings suggest that the additional use of a community-based mHealth service through a mobile application is effective for improving health behaviors and lowering metabolic risks in Koreans.
Blood Pressure ; Breakfast ; Cheese ; Delivery of Health Care ; Diet ; Diet, Sodium-Restricted ; Disease Management ; Fasting ; Female ; Glucose ; Health Behavior ; Humans ; Logistic Models ; Meat ; Milk ; Mobile Applications ; Motor Activity ; Odds Ratio ; Public Health ; Risk Factors ; Smartphone ; Soy Foods ; Telemedicine ; Triglycerides ; Vegetables ; Waist Circumference ; Yogurt

Cardiovascular magnetic resonance imaging (CMR) is expected to be increasingly used in Korea due to technology advances and the expanded national insurance coverage of these tests. For improved patient care, it is crucial not only that CMR images are properly acquired but that they are accurately interpreted by well-trained personnel. In response to the increased demand for CMR, the Korean Society of Cardiovascular Imaging (KOSCI) has issued interpretation guidelines in conjunction with the Korean Society of Radiology (KSR). KOSCI has also created a formal Committee on CMR Guidelines to write updated practices. The members of this Committee review previously published interpretation guidelines and discuss the patterns of CMR use in Korea.
Angiography ; Heart ; Insurance Coverage ; Korea ; Magnetic Resonance Imaging ; Patient Care

Cardiac magnetic resonance (CMR) imaging is widely used in many areas of cardiovascular disease assessment. This is a practical, standard CMR protocol for beginners that is designed to be easy to follow and implement. This protocol guideline is based on previously reported CMR guidelines and includes sequence terminology used by vendors, essential MR physics, imaging planes, field strength considerations, MRI-conditional devices, drugs for stress tests, various CMR modules, and disease/symptom-based protocols based on a survey of cardiologists and various appropriate-use criteria. It will be of considerable help in planning and implementing tests. In addressing CMR usage and creating this protocol guideline, we particularly tried to include useful tips to overcome various practical issues and improve CMR imaging. We hope that this document will continue to standardize and simplify a patient-based approach to clinical CMR and contribute to the promotion of public health.
Cardiovascular Diseases ; Commerce ; Exercise Test ; Heart ; Hope ; Magnetic Resonance Imaging ; Public Health

This document is the third part of the guidelines for the protocol, the interpretation and post-processing of cardiac magnetic resonance (CMR) studies. These consensus recommendations have been developed by the Consensus Committee of the Korean Society of Cardiovascular Imaging to standardize the requirements for image interpretation and post-processing of CMR. This third part of the recommendations describes tissue characterization modules, including perfusion, late gadolinium enhancement, and T1- and T2 mapping. Additionally, this document provides guidance for visual and quantitative assessment consisting of “What-to-See,” “How-To,” and common pitfalls for the analysis of each module. The Consensus Committee hopes that this document will contribute to the standardization of image interpretation and post-processing of CMR studies.
Consensus ; Gadolinium ; Hope ; Magnetic Resonance Imaging ; Perfusion

OBJECTIVES: Epidemiological studies in other countries show that a low intake of omega-3 fatty acids (FAs) increases the risk of depression or suicidality. However, no studies have investigated the associations of suicidality with omega-3 FAs in Korea. Hence, this cross-sectional study aimed to investigate the effects of omega FAs on suicidality in the general South Korean population. METHODS: The data in this study were sourced from adults (n=215,860) who completed the Sixth Korea National Health and Nutrition Examination Survey (KNHANES VI), and the associations between omega FAs and suicidality were analyzed using multivariate logistic regressions. RESULTS: Our results demonstrated that high omega-3 FA intake was associated with a decreased risk of suicide (OR=0.83, 95% CI : 0.71–0.98) and the high omega-6 to omega-3 FA ratio was associated with an increased risk of suicide (OR=1.25, 95% CI : 1.02–1.54). Additionally, a high intake of omega-3 FAs was associated with a decreased risk of suicide in men, but not in women (OR=0.72, 95% CI : 0.59–0.88). CONCLUSIONS Overall, our findings suggest that a lower intake of omega-3 FA is associated with the increased risk of suicidality in the general Korean population, especially in men.

BACKGROUND: The influence of socioeconomic status (SES) on weight status varies depending on the countries' levels of social and economic development. There are many studies on a risk of adolescent obesity according to familial SES in Korea. However, it is not clarified what effects familial SES has on a risk of underweight in Korean adolescents. This study investigated the distribution of weight status including obesity and underweight according to familial SES in Korean adolescents. METHODS: This cross-sectional study involved 63,741 adolescents who participated in the 2016 Korea Youth Risk Behavior Wed-based Survey. The data on height, weight, familial SES, current smoking status, current alcohol intake, physical activity, breakfast skipping, perceived stress, depressive mood, and living with family were obtained through online questionnaires. The assessment of familial SES was based on perceived household economic status and parental education level. RESULTS: In boys, low household economic status was related to a high proportion of obesity (odds ratio [OR] 1.14, 95% confidence interval [CI] 1.04–1.25) and underweight (OR 1.31, 95% CI 1.14–1.51). Girls with low household economic status were more likely to be obese (OR 1.81, 95% CI 1.61–2.03) and overweight (OR 1.41, 95% CI 1.23–1.60) but, although not statistically significant, less likely to be underweight (OR 0.88, 95% CI 0.75–1.04). CONCLUSIONS: This study showed that adolescents with low familial SES were at a high risk of obesity and underweight. A risk of underweight was increased in boys with low familial SES but in girls with high familial SES.
Adolescent ; Breakfast ; Cross-Sectional Studies ; Economic Development ; Education ; Family Characteristics ; Female ; Humans ; Korea ; Motor Activity ; Obesity ; Overweight ; Parents ; Pediatric Obesity ; Risk-Taking ; Smoke ; Smoking ; Social Class ; Thinness