Purpose
The psoas–lumbar vertebral index (PLVI), a marker of central sarcopenia measured using computed tomography (CT) or magnetic resonance imaging (MRI), has been linked to the development of postherpetic neuralgia (PHN). Whether PLVI predicts short-term pain relief after pulsed radiofrequency (pRF) treatment of the dorsal root ganglion (DRG) in established PHN remains unknown. This pilot study examined the association between PLVI and the reduction in numeric rating scale (NRS) pain scores 1 month after pRF.
Methods
Patients with PHN who underwent DRG pRF and had CT or MRI scans available for PLVI measurement were retrospectively reviewed. Correlations of the NRS reduction rate with PLVI and other variables were assessed, with 95% confidence intervals (CIs). Patients were divided into low- and high-PLVI groups using sex-specific medians and compared; multivariable regression was adjusted for sex. A supplementary responder analysis used thresholds of ≥30% and ≥50% reduction.
Results
In 19 patients, NRS scores decreased from 4.8±1.7 to 3.2±1.7, with a reduction rate of 29.3%±34.0%. PLVI was not significantly correlated with the reduction rate (r=−0.17; 95% CI, −0.58 to 0.31; P=0.49); neither the reduction rate (P=0.71) nor responder rates differed between the low- and high-PLVI groups. Male sex was associated with a smaller reduction (adjusted B=−47.2 percentage points; 95% CI, −90.9 to −3.5; P=0.036), although the unadjusted group comparison was not significant (Welch P=0.051) and 15 variables were tested without correction for multiple comparisons.
Conclusion
This pilot cohort showed no detectable association between PLVI and short-term pain relief after pRF; its small size precludes establishing the absence of an association. The exploratory sex difference warrants investigation in larger prospective studies with comprehensive sarcopenia assessment.

Purpose
Healthcare planning and resource allocation require accurate estimates of the burden of motor neuron diseases (MNDs). This study evaluated the global impact of MNDs from 1990 to 2021 as part of the Global Burden of Disease (GBD) Study 2021.
Methods
GBD 2021 data were used to assess the global burden of MNDs from 1990 to 2021 in terms of prevalence, incidence, disability-adjusted life years (DALYs), and deaths. The relationship between MND burden and the Socio-demographic Index (SDI) was also examined.
Results
Globally, MNDs accounted for 272,732 prevalent cases (95% uncertainty interval [UI], 236,195–313,676), 64,178 incident cases (95% UI, 58,506–70,270), 1,040,566 DALYs (95% UI, 963,064–1,123,956), and 39,082 deaths (95% UI, 35,757–42,433) in 2021. The corresponding age-standardized rates per 100,000 people were 3.31 (95% UI, 2.86–3.80) for prevalence, 0.46 (95% UI, 0.42–0.49) for mortality, and 12.17 (95% UI, 11.24–13.15) for DALYs. From 1990 to 2021, the numbers of prevalent and incident cases increased, but their age-standardized rates decreased by 1.36% and 4.69%, respectively. By contrast, the age-standardized mortality rate increased by 19.84%. MND burden was generally higher in regions with a high SDI, although rates in high-income Asia Pacific were relatively low compared with those in regions with similar SDI values.
Conclusion
From 1990 to 2021, the absolute burden of MNDs increased, age-standardized prevalence and incidence rates declined slightly, and mortality-related burden increased. These trends underscore the need for evidence-based national and global healthcare planning. Geographic variation in MND burden may reflect regional differences in the roles of sociodemographic and genetic factors.

Irritant contact dermatitis (ICD) is the most common form of contact dermatitis and a leading cause of occupational skin disease, but remains underrecognized relative to allergic contact dermatitis (ACD). Direct chemical or physical injury to the epidermal barrier causes ICD, which can develop in anyone when exposure intensity or duration exceeds the skin’s repair capacity. ICD is increasingly understood to involve more than barrier disruption: it is an innate immune-mediated inflammatory disorder involving keratinocyte-derived cytokines, neutrophil recruitment, C-C motif chemokine ligand 2–C-C motif chemokine receptor 2–interleukin-1β signaling, Toll-like receptor 3, and inflammasome activation. Host factors, particularly atopic dermatitis and filaggrin loss-of-function variants, further influence susceptibility. Clinical phenotypes range from acute irritant reactions to chronic cumulative dermatitis, and occupational wet work is a major preventable exposure. Distinguishing ICD from ACD is difficult because their clinical and histopathological features overlap, they may coexist, and ICD-related barrier damage may facilitate subsequent allergic sensitization. Diagnosis therefore requires assessment of exposure history, lesion distribution, symptom quality, and temporal course, with patch testing when ACD is suspected. Molecular biomarker panels and noninvasive imaging or barrier-assessment techniques may improve diagnostic precision, but remain investigational. Management should prioritize identifying and removing irritants, reducing exposure, implementing appropriate protective measures, and restoring the epidermal barrier. Recognizing ICD as a distinct clinical entity, rather than simply a diagnosis of exclusion, is essential for accurate diagnosis and effective management of contact dermatitis in clinical practice.

Purpose
Neck pain is a leading musculoskeletal cause of disability in the United States. This study aimed to assess temporal, geographic, and demographic disparities in its burden across US states from 1990 to 2021.
Methods
Global Burden of Disease 2021 data for all 50 US states and the District of Columbia were analyzed for 1990–2021. Counts and age-standardized rates per 100,000 population for prevalence, incidence, and years lived with disability (YLD) were compared by region, state, sex, age group, and sociodemographic index (SDI) level.
Results
In 2021, neck pain accounted for 9,430,000 (95% uncertainty interval [UI], 7,400,000–11,590,000) prevalent cases, 1,900,000 (95% UI, 1,490,000–2,320,000) incident cases, and 920,000 (95% UI, 620,000–1,300,000) YLD, increases of 41.17%, 37.44%, and 38.72%, respectively, from 1990. Although age-standardized incidence increased globally by 1.18% (0.07%–2.39%) over 1990–2021, the United States had small declines in age-standardized incidence (−0.11%; 95% UI, −0.18% to −0.06%), prevalence (−0.20%; 95% UI, −0.32% to −0.10%), and YLD (−1.12%; 95% UI, −2.02% to −0.22%). Neck pain rates were highest in the District of Columbia, Georgia, and Delaware and lowest in North Carolina, Alaska, and Wyoming. The burden peaked at ages 40–49 years and was higher in females. Age-standardized YLD rates for neck pain were significantly positively correlated with the SDI (Spearman’s ρ=0.601, P<0.001).
Conclusion
The geographic and demographic disparities in neck pain burden across US states indicate a need for targeted interventions.

Large language models (LLMs) are increasingly used to write and edit scientific manuscripts; however, their fluency can obscure mismatches between linguistic claim strength and evidential support. This tutorial examines such mismatches through the lens of epistemic integrity, defined as accurate alignment of scientific statements with the quality, strength, and scope of the underlying evidence. It presents sentence-level epistemic markers that require careful human judgment, including reporting verbs, hedges, tense choices, evaluative adjectives and adverbs, and local scope markers. Inappropriate modification of these features can overstate or understate certainty, strengthen or weaken a claim beyond what the evidence warrants, or distort an author’s intended emphasis. The tutorial also addresses discourse-level issues, including the need to clearly distinguish between results and interpretation, shifts in certainty across manuscript sections, consistency in scope limitations, and cumulative changes in evaluative tone. Because LLMs cannot independently assess study design, methodological limitations, disciplinary conventions, or evidential sufficiency, polished revisions may introduce epistemic miscalibration even when they are grammatically correct. Editors should therefore evaluate not only local wording but also the consistency of claims across the manuscript. Human editorial expertise remains essential for preserving rhetorical coherence, evidential accuracy, and scientific integrity in artificial intelligence–assisted academic writing, alongside attention to grammar, style, clarity, and readability.

Purpose
This study aimed to address gaps in Korean Standard Series (KSS) information, highlight allergens with increasing patch test positivity, describe potential sources encountered in daily life, and provide guidance on selecting allergen-free alternatives.
Methods
Relevant information was identified from KSS patient instruction sheets (Chemotechnique, Sweden), T.R.U.E. TEST patient instruction sheets (SmartPractice, United States), the Contact Dermatitis Institute allergen database, the American Contact Dermatitis Society allergen information sheets, and searches of the PubMed database. English-language review articles, case series, and case reports identified using keywords related to the 25 KSS allergens were selected.
Results
Information was updated for the following allergens: nickel, cobalt, potassium dichromate, balsam of Peru, paraben mix, N-isopropyl-N'-phenyl-p-phenylenediamine, formaldehyde, p-tert-butylphenol formaldehyde resin, methylchloroisothiazolinone/methylisothiazolinone, colophonium, imidazolidinyl urea, and 2-mercaptobenzothiazole. Emerging sources included electronic devices, personal protective equipment, including masks whose use increased during the COVID-19 (coronavirus disease 2019) pandemic, nail products, and children’s toy slime. In addition, occupational allergen information sheets were developed for hairdressers, healthcare workers, dentists, dental hygienists, and cooks. The Korean-language allergen sheets are provided in the Supplementary Materials.
Conclusion
Because the KSS has not been revised for more than 2 decades, emerging allergen sources may be inadequately represented in the existing patient information. Accordingly, updated patient instruction sheets were developed to improve patient understanding and facilitate the practical application of patch test results.

An 83-year-old woman presented with a 10-day history of sudden-onset diplopia in the left eye, with no preceding trauma or anticoagulant use. Initial orbital magnetic resonance imaging (MRI) on day 10 revealed a well-circumscribed retrobulbar lesion along the left inferior rectus muscle. The lesion showed heterogeneous T1 hyperintensity, low-to-intermediate T2 signal, and no definite solid enhancement, raising concern for a hemorrhagic orbital mass or neoplasm. Serial noncontrast computed tomography (CT) on days 20 and 49 showed progressive decreases in lesion size and attenuation. Follow-up MRI on day 180 confirmed complete spontaneous resolution, with no residual abnormality or underlying neoplasm. This case demonstrates that serial CT and MRI can guide safe conservative management of spontaneous retrobulbar hematoma and help avoid unnecessary surgery in clinically stable patients.

Purpose
Clinical fieldwork in genetic counseling education is constrained by limited training sites, shortages of clinical supervisors, and administrative burdens. Simulation-based learning, including role-play, has therefore been used to support development of counseling competencies. This study described the development, implementation, operational structure, and feasibility of a role-play-based practicum in a graduate genetic counseling program.
Methods
This retrospective descriptive report was based on Genetic Counseling Practicum, a spring 2024 course for 11 third-semester students in a graduate genetic counseling program in South Korea. Twenty-two role-play scenarios were developed, including 11 hereditary cancer cases and 11 pediatric or adult genetic disorder cases. The scenarios simulated pretest and posttest encounters during a 6-week, 2-block practicum. Students alternated between counselor and counselee roles, recorded sessions outside class time, and received domain-guided peer and faculty feedback.
Results
The scenarios covered patient ages from infancy to late adulthood and included somatic and germline pathogenic variants, a negative multigene panel result, and chromosomal or epigenetic abnormalities. All 22 planned sessions were completed and recorded as scheduled, and all 11 students completed their assigned sessions. The planned assignment, recording, review, and feedback procedures were completed without documented omissions. Approximately 11 scheduled class hours were devoted to feedback, and no external clinical sites or supervisors were required.
Conclusion
This study presents an operationally feasible model for a role-play-based practicum with diverse scenarios in a graduate genetic counseling curriculum. It may serve as a practical reference for programs considering similar simulation-based training.

Pneumocephalus is a rare complication of neuraxial procedures and is usually associated with inadvertent dural puncture or the use of air during epidural space identification. Epiduroscopic epidural neuroplasty (EEN) is performed without air injection and permits direct visualization of the epidural space; therefore, pneumocephalus after this procedure is extremely uncommon. A 71-year-old woman with a history of lumbar spine surgery underwent EEN via a caudal approach without sedation. No dural puncture was identified during the procedure. Approximately 12 hours later, she developed a non-orthostatic headache. Brain computed tomography revealed pneumocephalus in the basal cistern and left lateral ventricle. Her symptoms improved with oxygen therapy but worsened 5 days later despite radiologic resolution of the pneumocephalus. Suspected cerebrospinal fluid (CSF) leakage was treated with an epidural blood patch, which resolved her symptoms. Pneumocephalus may occur after EEN without clinically or endoscopically recognized dural injury and may coexist with CSF leakage; an occult microdural defect cannot be excluded as the underlying mechanism. Prompt imaging should be considered in patients who develop early or atypical postprocedural headache.

Purpose
Rectus sheath block (RSB) is a simple abdominal wall block that can be readily applied. This study evaluated the postoperative analgesic efficacy of ultrasound-guided bilateral RSB in robotic single-site gynecologic surgery.
Methods
Sixty patients were randomly assigned to the RSB group (n=30) or the control group (n=30). After induction of general anesthesia, patients in the RSB group received ultrasound-guided bilateral RSB with 30 mL of 0.25% ropivacaine. Pain intensity was assessed using a verbal numerical rating scale (VNRS) at 0, 1, 6, 12, 24, and 48 hours postoperatively. Intravenous patient-controlled analgesia was provided to all patients, and fentanyl was administered as rescue analgesia on request.
Results
VNRS scores at 0, 1, and 6 hours were significantly lower in the RSB group than in the control group (all P<0.05). Rescue fentanyl use in the post-anesthesia care unit was also significantly lower in the RSB group than in the control group (19.8±21.0 μg vs. 46.3±27.6 μg, P<0.001). Subgroup analysis showed that RSB was associated with lower VNRS scores in patients undergoing ovarian surgery or myomectomy, whereas no significant difference was observed in patients undergoing hysterectomy.
Conclusion
Ultrasound-guided bilateral RSB reduced early postoperative pain and rescue analgesic requirements after robotic single-site gynecologic surgery.

Appendiceal mucinous adenocarcinoma is a rare gastrointestinal malignancy that may metastasize to the ovaries and closely mimic advanced primary ovarian cancer, creating diagnostic and therapeutic challenges. A 61-year-old postmenopausal woman presented with postmenopausal bleeding, abdominal distension, abdominal pain, and weight loss. Imaging demonstrated bilateral adnexal masses with omental caking and ascites, suggestive of advanced ovarian malignancy. Cancer antigen 125 was elevated, and carcinoembryonic antigen (CEA) levels were markedly increased. She had a history of acute appendicitis 1 year earlier. Biopsy revealed mucinous adenocarcinoma with signet-ring cells. Endoscopic evaluation was unremarkable. Despite neoadjuvant chemotherapy for presumed ovarian cancer, the disease progressed, necessitating cytoreductive surgery. Histopathological examination demonstrated bilateral mucinous adenocarcinoma with peritoneal spread. Immunohistochemistry showed positivity for cytokeratin 20, caudal-type homeobox 2, and special AT-rich sequence-binding protein 2 and negativity for cytokeratin 7 and paired-box gene 8, supporting an appendiceal origin. She was started on fluorouracil, leucovorin, and oxaliplatin chemotherapy. Metastatic appendiceal carcinoma can closely resemble primary ovarian malignancy. Bilateral mucinous ovarian tumors with elevated CEA levels and poor chemotherapy response should prompt evaluation for a gastrointestinal primary tumor.

Purpose
This study aimed to characterize co-occurrence patterns, statistical associations, and phenotypic clusters of clinical manifestations reported in human toxocariasis case reports indexed in PubMed from 2005 through 2025, inclusive.
Methods
PubMed-indexed case reports from 2005 through 2025 were identified using the query (“Toxocariasis” OR “Toxocara”) AND “Case Reports” [Publication Type] AND 2005:2025[dp] AND ffrft[Filter]. Free full-text articles were retrieved through PubMed Central and other links indexed in PubMed using the ffrft filter. After 7 nonhuman reports and 5 reports without objective diagnostic confirmation were excluded, 139 case reports were included. Antigravity was used to support data extraction, standardization, statistical analysis, and figure generation. Clinical features were mapped to standardized symptom and organ-involvement variables. Pairwise co-occurrence was assessed using 2×2 contingency tables and Fisher’s exact test; association strength was measured using Pearson correlation coefficients; and k-means clustering was used to identify distinct clinical phenotypes.
Results
Four principal clusters were identified: subclinical disease, ocular larva migrans, visceral larva migrans, and neurotoxocariasis/multisystemic disease. The ocular larva migrans and visceral larva migrans clusters were largely distinct, whereas ocular features were frequently co-reported in the neurotoxocariasis/multisystemic cluster. Eosinophilia was strongly associated with systemic manifestations, including fever, dyspnea, cough, pruritus, hepatomegaly, headache, and meningitis, but was not significantly associated with ocular features. Neurotoxocariasis-related features, including headache, meningitis, and seizures, clustered closely.
Conclusion
This artificial intelligence-assisted scoping review identified exploratory clinical association and clustering patterns in human toxocariasis case reports. These findings may support clinical awareness, but they require validation in curated clinical datasets before they are used for diagnosis, risk stratification, or practice guidance.

Primary leiomyosarcoma of the breast is an extremely rare malignancy, accounting for less than 1% of all breast tumors. Diagnosis is challenging because its morphology overlaps with that of other spindle cell lesions, and standardized treatment guidelines are currently unavailable. A 44-year-old woman presented with a rapidly enlarging, firm, 15×15 cm mass in the left breast. She had previously undergone surgery elsewhere, with diagnoses of leiomyoma and desmoid-type fibromatosis. Imaging demonstrated a lobulated mass without evidence of metastasis. Excision revealed pleomorphic spindle cells arranged in intersecting fascicles, with necrosis and dermal invasion. Primary breast leiomyosarcoma was confirmed by immunohistochemistry, which demonstrated smooth muscle actin and desmin positivity and negative staining for pancytokeratin, p63, S100, CD34, and BCL2. The patient underwent modified radical mastectomy followed by adjuvant radiotherapy and chemotherapy. Primary breast leiomyosarcoma is a rare entity that remains diagnostically challenging. Immunohistochemistry is essential for accurate diagnosis, and optimal management requires a dedicated multidisciplinary approach.

Probiotics have gained increasing clinical attention as adjunctive treatment for lower gastrointestinal disorders. However, evidence supporting their therapeutic efficacy remains limited, particularly with regard to sex-related differences. This expert review provides evidence-based insights and practical recommendations for the use of probiotics in patients with irritable bowel syndrome (IBS), functional constipation (FC), and Clostridioides difficile infection (CDI), considering possible sex-related differences. Evidence from randomized controlled trials and meta-analyses indicates that probiotics can modestly improve global symptoms, abdominal pain, and bloating in IBS and enhance bowel movement frequency and stool consistency in FC. However, these effects are strain-specific and heterogeneous. Although clinical studies on probiotics in IBS have not confirmed significant sex-related differences, experimental animal studies using stress-induced IBS models have demonstrated sex-dependent responses to specific probiotic strains, supporting the biological plausibility of such differences. For CDI, the efficacy of probiotics in preventing primary or recurrent infections remains inconsistent across large trials, and current guidelines usually do not recommend their routine use. However, sex- and age-related immunologic differences support the clinical differences of CDI. Probiotics are generally considered safe for healthy individuals, although caution is advised in patients who are immunocompromised or critically ill. Clinicians should select probiotic products based on strain-specific clinical evidence, adequate viable doses, patient characteristics and sex. In conclusion, probiotics might play a role as adjunctive therapy for IBS and FC, with variability in responses influenced by microbial, host, and potential sex-related factors. Further research is needed to establish optimized personalized probiotic strategies.

We present a rare case of a 68-year-old woman who experienced dizziness, nausea, vomiting, and imbalance for 2 months. Imaging studies, including magnetic resonance imaging, magnetic resonance angiography, and digital subtraction angiography, revealed an intrasellar course of the persistent trigeminal artery (PTA) with atherosclerotic changes. Additionally, hypoplasia of the basilar artery and left vertebral artery was observed. The anatomically rare intrasellar PTA, combined with atherosclerosis and vertebrobasilar hypoplasia, likely contributed to compromised posterior circulation and the patient’s symptoms. This case highlights the importance of considering vascular anomalies and the associated pathological changes in patients with otherwise unexplained posterior circulation symptoms.

Elastofibroma dorsi is a rare, benign soft tissue tumor that typically arises in the infrascapular region. Although it is often asymptomatic, some patients experience pain or a snapping sensation during shoulder movement, which warrants surgical excision. We report a symptomatic case in a middle-aged male patient, highlighting the diagnostic imaging features and surgical management of this condition.

Itching is a representative manifestation of urticaria. However, under certain conditions, urticaria may be characterized by nociceptive sensations, such as stinging or tingling, either instead of or in addition to itching. Three patients with chronic urticaria (CU) who experienced nociceptive pain accompanied by itching were identified and treated with immunoglobulin/histamine complex (IHC) therapy. Nociceptive pain resolved along with improvement in CU symptoms after 8 injections of IHC in the first patient and after 4 injections in the second and third patients. Nociceptive pain may present as a symptom of CU. The clinical characteristics of the transition from itching to nociceptive pain, together with the observed outcomes of IHC therapy, appear to support the intensity theory explaining this shift, which may be mediated by histamine. Further clinical and basic immunological studies are warranted to clarify the underlying mechanisms.

Citations

• Histamine-Mediated Syndrome (HMS): Beyond Allergy and Therapeutic Potential of Immunoglobulin/Histamine Complex (IHC)
  Hyuk Soon Kim, Geunwoong Noh
  International Journal of Molecular Sciences.2026; 27(10): 4494.     CrossRef

Methylenetetrahydrofolate reductase (MTHFR) gene mutations, particularly homozygous mutations, have been associated with a higher incidence of venous thrombosis, coronary heart disease, and obstetric complications. We report the case of a 41-year-old man who presented with multiple vascular thrombotic events over a period of 4–5 years, including deep vein thrombosis with pulmonary thromboembolism, cerebral venous thrombosis and posterior circulation stroke. The patient was found to have elevated serum homocysteine levels and subsequently underwent genetic testing for MTHFR mutations after other potential prothrombotic conditions were excluded. This case is notable because compound heterozygous mutations of the MTHFR gene (C677T and A1298C) were identified in association with recurrent vascular thrombotic events. Management focused on long-term anticoagulation and supplementation with vitamin B6, vitamin B12, and folic acid.

When the physician–government conflict was triggered by the Korean government’s plan to increase medical school enrollment by 2,000 students, the government proposed the establishment of a "Jokbo Sharing Center." In Korean medical education, jokbo refers to collections of previous examination questions, summarized notes, and anticipated topics compiled by senior students and transmitted across cohorts. Their scope extends beyond preclinical education and written examinations to include practical tips and informal norms passed down during clinical clerkships and internship rotations. More than a mere compilation of study resources, jokbo functions as a form of hidden curriculum within medical education. As a learning culture that has emerged organically among students, it operates implicitly beneath the formal curriculum. The creation and sharing of jokbo can foster solidarity and a sense of belonging, and may serve as a process through which students begin to internalize the professional culture essential to their future roles as physicians. Nevertheless, reliance on jokbo- based learning may undermine the depth and quality of learning over time, impeding critical thinking, problem-solving skills, and the acquisition of integrated medical knowledge. Unregulated distribution of such materials also raises concerns about examination fairness, and their reproduction without faculty consent raises legitimate ethical concerns. At the same time, given their demonstrable educational benefits, some argue for institutionalizing jokbo through transparent procedures for constructive use in medical education. Despite its widespread presence, research on jokbo remains virtually nonexistent. This study aims to establish a scholarly and policy foundation for discussion of jokbo in Korean medical education by reviewing international cases of examination material sharing and providing a comprehensive analysis of jokbo in Korea.

Cardiovascular disease, particularly ischemic heart disease, remains a leading cause of death worldwide. Although advances in pharmacological and device-based therapies have improved clinical outcomes, effective strategies for myocardial repair and regeneration remain limited. T-cadherin, a glycosylphosphatidylinositol-anchored atypical cadherin, has recently been identified as a functional receptor for both low-density lipoprotein cholesterol and adiponectin, a cardioprotective adipokine. Notably, the interaction between T-cadherin and adiponectin has emerged as a key regulator of exosome biogenesis and paracrine signaling within cardiovascular tissues. Exosomes are nanosized extracellular vesicles that carry protective molecular cargo, including microRNAs and proteins, and contribute to anti-inflammatory, antifibrotic, and angiogenic effects in the ischemic myocardium. However, their clinical translation is challenged by factors such as variability in yield, heterogeneity of exosome populations, and inefficient tissue targeting. Enhancing endogenous exosome production through the T-cadherin–adiponectin pathway may therefore offer a novel cell-free therapeutic strategy. This review explores the biological roles of T-cadherin and adiponectin in cardiovascular diseases, their regulatory influence on exosome formation, and the future potential of leveraging this axis for myocardial repair and regeneration.

Purpose
Human papillomavirus is the dominant etiological factor underlying atypical cervical squamous epithelial cell abnormalities and cervical carcinoma. Currently, only a limited number of drugs targeting specific biomarkers in cervical cancer are available. This study aimed to assess the expression of estrogen receptor (ER), human epidermal growth factor receptor 2 (HER2), and the Ki-67 proliferative index (Ki-67) in p16-positive cervical squamous premalignant and malignant lesions, which may help clarify the potential role of targeted therapies in cervical cancer. Methods: In p16-positive, histologically proven premalignant and malignant cervical lesions, ER, HER2, and Ki-67 expression were evaluated according to predefined criteria. Results: p16 showed strong nuclear and cytoplasmic positivity in 54 of 56 cases. Patchy nuclear positivity was mainly observed in low-grade squamous intraepithelial lesion (LSIL) cases (2/56). Ki-67 demonstrated a variable proliferative index ranging from 5% to 95% across all cases, with higher indices predominantly observed in squamous cell carcinomas (SCC). ER positivity in LSIL, high-grade squamous intraepithelial lesion, and SCC was 100% (2/2), 66.7% (10/15), and 46.15% (18/39), respectively. HER2 expression was predominantly negative, observed in 78.6% (44/56) of cases, equivocal in 17.8% (10/56), and positive in 3.6% (2/56). Both HER2-positive cases were SCC. ER and HER2 interpretations were analyzed and were not significantly correlated with clinical or pathological parameters. Conclusion: ER positivity decreased with progression of cervical squamous lesions, and HER2 expression was rare in cervical squamous neoplasia. No statistically significant correlation was identified between ER or HER2 expression and clinicopathological parameters. The findings of the current study may help fill gaps in the existing literature and provide essential foundational knowledge for optimizing emerging therapeutic strategies, including ER- and HER2-related therapies.

Purpose
Endoscopic vacuum therapy (EVT) has emerged as a highly effective approach for managing gastrointestinal transmural defects and may offer advantages over traditional methods, such as stenting. This study evaluated the clinical outcomes of EVT for gastrointestinal transmural defects resulting from leakages, perforations, and fistulas.
Methods
We retrospectively reviewed patients who underwent EVT for gastrointestinal transmural defects at Ewha Womans University Medical Center between February 2018 and September 2025 and analyzed clinical outcomes, adverse events, and risk factors associated with adverse events.
Results
Fourteen patients were included (mean age, 63.9 years; 85.7% male). Stomach surgery was the most common etiology (50.0%), and malignancy accounted for 71.4% of cases. The median number of EVT sessions was 2.5, and the mean interval from the index event to the first EVT session was 10.5 days. EVT achieved a 100% technical success rate, with no 30-day mortality; there was 1 in-hospital death (7.1%), 2 cases of stricture (14.3%), and 1 major bleeding event (7.1%). Adverse events were observed more frequently in patients who underwent ≥3 EVT sessions (57.1%) compared with those who underwent <3 sessions, in whom no adverse events occurred.
Conclusion
This study suggests that EVT is a safe and effective treatment for gastrointestinal transmural defects, with high technical success rates. The number of EVT sessions and the timing of treatment initiation appeared to be associated with complications and overall clinical outcomes.

A 28-year-old woman developed drug-induced tachycardia in the left lateral decubitus (LLD) position following intravenous administration of glycopyrrolate. The tachycardia was unresponsive to esmolol, labetalol, and fentanyl but resolved unexpectedly after the tidal volume was reduced from 8 to 6 mL/kg. Drug-induced tachycardia or arrhythmia occurring in the LLD position under mechanical ventilation may be attenuated by adopting a low tidal volume ventilation strategy (6 mL/kg).

Citations

• Glycopyrrolate
  
  Reactions Weekly.2026; 2102(1): 94.     CrossRef

Patients with congenital insensitivity to pain and anhidrosis (CIPA) exhibit an inability to perceive pain, recurrent fractures, self-mutilation, and impaired thermoregulation, which lead to severe complications and high morbidity. Children with CIPA often sustain multiple unnoticed fractures that may be mistaken for child abuse because of the presence of fractures at different stages of healing. If unrecognized or inadequately managed, these injuries can cause permanent damage. We report the case of a 9-year-old boy who presented with recurrent fractures, chronic osteomyelitis, heterotrophic ossification, and gangrene. This case underscores the need for heightened awareness among healthcare providers regarding the clinical manifestations and management challenges of CIPA. It also emphasizes the importance of early diagnosis, meticulous follow-up, and a multidisciplinary approach to optimize outcomes and prevent severe complications in affected children.

Purpose
This review aims to synthesize the most up-to-date evidence on effective lifestyle prescriptions for managing patients with obesity in the primary care setting.
Methods
A comprehensive literature search was conducted through June 2025 using major domestic and international databases, including PubMed, Google Scholar, and RISS, as well as the websites of relevant academic societies. The search strategy employed keywords such as “obesity,” “primary care,” “lifestyle intervention,” “diet,” “exercise,” and “behavioral therapy” in both English and Korean.
Results
Effective obesity management should be grounded in the new paradigm of adiposity-based chronic disease, which focuses on preventing and treating the medical complications associated with excessive fat accumulation. The essential components of a successful lifestyle prescription comprise 3 pillars: diet, exercise, and behavioral therapy. An individualized dietary plan that achieves an energy deficit of 500–750 kcal is fundamental. Exercise prescriptions should recommend a combination of aerobic and resistance training, along with strategies to minimize sedentary time. In behavioral therapy, high-intensity behavioral counseling, the 6A model (ask, assess, advise, agree, assist, arrange), self-monitoring, and cognitive-behavioral therapy techniques have all demonstrated efficacy.
Conclusion
Primary care physicians are not only capable but also uniquely positioned to lead long-term, patient-centered obesity management. Their comprehensive and integrative perspective makes them one of the most efficient and scalable resources in addressing the obesity epidemic.

Citations

• Obesity Management in Primary Care: Clinical Approaches and Policy Implications in the Era of Incretin-Based Therapies
  Chung-woo Lee
  Korean Journal of Family Practice.2026; 16(2): 81.     CrossRef
• Nutrition and Chronic Disease Management for the Clinical Endocrinologist: Leveraging the Malnutrition-Based Chronic Disease Model
  Jeffrey I. Mechanick
  Endocrine Practice.2026;[Epub]     CrossRef

Hypertension is one of the leading chronic diseases globally and a major contributor to cardiovascular morbidity and mortality. Despite advances in pharmacological therapy, medication alone remains limited in achieving optimal control. This review synthesizes recent hypertension management guidelines, including those from the European Society of Cardiology (ESC, 2024), American Heart Association/American College of Cardiology (AHA/ACC, 2025), Taiwan Society of Cardiology/Hypertension Society (2022), and Korean Society of Hypertension (KSH, 2018). All guidelines consistently emphasize sodium restriction, weight reduction, regular exercise, moderation of alcohol intake, smoking cessation, and adoption of healthy dietary patterns such as the Dietary Approaches to Stop Hypertension, Mediterranean, or culturally adapted diets. The ESC 2024 guideline elevates lifestyle modification to Class I, Level A, specifying targets for sodium (<2 g/day) and potassium (≥3.5 g/day). The AHA/ACC 2025 guideline provides quantitative estimates, reporting approximately 1/1 mm Hg blood pressure reduction per kilogram of weight loss, and incorporates newer strategies such as glucagon-like peptide-1 receptor agonists and bariatric surgery when lifestyle measures alone are insufficient. Taiwan’s 2022 guideline frames recommendations under the S-ABCDE (sodium restriction, alcohol limitation, body weight reduction, cigarette cessation, diet adaptation, exercise adoption) mnemonic and uniquely includes genetic factors such as ALDH2 polymorphisms. The KSH 2018 guideline emphasizes salt restriction (<6 g/day), maintaining a body mass index <25 kg/m2, and adherence to traditional Korean diets. Lifestyle modification remains the cornerstone of hypertension prevention and management, particularly in primary care. Future directions should focus on integrating these approaches with pharmacotherapy, digital health strategies, and personalized prescriptions.

Citations

• Association of Lifestyle Factors With Blood Pressure Control Among Hypertensive U.S. Adults: An Analysis of the National Ambulatory Medical Care Survey (NAMCS) 2010–2015
  Moses C Odoeke, Afi T Djaba, Adedoyin Olawoye, Taiwo G Adekanmbi, Hillary C Ugwu, O. B Bomide, Kosisochi E Achara
  Cureus.2026;[Epub]     CrossRef
• Lifestyle Interventions for Blood Pressure Control: A Narrative Review of Global Evidence and Indonesian Perspectives
  Hery Kurniawan, Avril Bella Audyna
  Journal of Tropical Pharmacy and Chemistry .2026; 10(1): 57.     CrossRef
• Nutraceuticals for the Management of Cardiovascular Health: A Mechanistic and Evidence-Based Review Focusing on Atherosclerosis and Hypertension
  Phaniendra Alugoju, Charanraj Goud Alladi, Nyshadham Chaitanya, Luxitaa Goenka, Kishoree Kumaree, Sudarshan SJ, Krishnaswamy Duraisamy, Naeem Ullah
  Nutrients.2026; 18(14): 2226.     CrossRef

This study aimed to provide a comprehensive understanding of aging with disability among polio survivors who continue to live with long-term sequelae. Although poliomyelitis has been eradicated in most regions, survivors entering older age face a dual challenge, as age-related decline overlaps with pre-existing impairments, creating a need for integrated management strategies. This narrative review examined the epidemiology, clinical manifestations, and late effects of polio, with particular attention to post-polio syndrome, secondary musculoskeletal disorders, and other systemic conditions. International and Korean studies were compared to highlight similarities and contextual differences. Polio survivors frequently experience accelerated functional decline due to post-polio syndrome, fatigue, pain, musculoskeletal disorders (e.g., arthritis, osteoporosis, fractures), and cardiopulmonary dysfunction. Approximately 64% report major falls, with 35% sustaining fractures, often at vulnerable sites such as the hip or distal femur. Psychological distress, sleep disturbances, metabolic syndrome, and cardiovascular disease are also prevalent, further compounding frailty. In Korea, where most survivors are now over 60 years of age, epidemiological patterns differ from those of Western cohorts; however, systematic investigations remain limited. Polio survivors exemplify the dual burden of aging and long-term disability, underscoring the need to move beyond fragmented, symptom-focused care toward integrated, life course–oriented approaches. Anticipating and managing late effects, strengthening preventive strategies, and ensuring equitable healthcare access are essential for maintaining function, independence, and quality of life. Lessons drawn from polio survivors offer valuable insights for understanding aging with disability more broadly.

Citations

• A silent epidemic? Poliomyelitis, disability burden, and social impact in Turkey (1942–1968)
  Ayşe Erkmen, Nevim Tüzün, Osman Erkmen
  BMC Public Health.2026;[Epub]     CrossRef

Fragility fractures, particularly hip fractures, represent a major public health concern among older adults and are associated with high morbidity, mortality, functional decline, and socioeconomic burden. Cognitive impairment is common in older adults with hip fractures and contributes to increased fracture risk, poor postoperative outcomes, delayed recovery, and higher rates of institutionalization. This review aimed to examine rehabilitation strategies for older adults with hip fractures, with a specific focus on considerations for those with cognitive impairment. Evidence suggests that individuals with mild-to-moderate cognitive impairment can achieve meaningful functional gains through structured, intensive, multidisciplinary rehabilitation programs incorporating progressive resistance training, balance and mobility exercises, and individualized approaches tailored to cognitive and physical abilities. However, the implementation of such programs is often hindered by insufficient staff training and awareness in dementia-specific rehabilitation, limited resources, and the lack of standardized protocols defining eligibility, intensity, and adaptation. Optimizing outcomes requires structured, tailored rehabilitation protocols, enhanced staff education, interprofessional collaboration, and proactive management of delirium and secondary fracture prevention through fracture liaison services, while concurrently addressing systemic barriers such as resource constraints. Integrated, coordinated care across the continuum is essential to maximize recovery, independence, and quality of life in older adults with hip fractures and cognitive impairment.

Citations

• Encouraging recovery or avoiding risk? A proposed clinical framework for rehabilitation decision-making after fragility fractures
  Mariam A. Ibrahim, Hager Abdelzaher, Ahmed Abdullah Alghamdi, Abdulaziz Khalid Bakhaider, Osama Farouk, Mohammad Kamal Abdelnasser
  Injury.2026; 57(6): 113195.     CrossRef
• Management of hip fracture in older adults with cognitive impairment: a narrative review
  Hao Rao, Li Luo, Jialing Cheng, Gang Wu, Hongmei Zhang, Xuxing Zhang, Jian Qin, Zidong Wang
  Frontiers in Public Health.2026;[Epub]     CrossRef
• Does an Innovative PT Program Targeting Mobility Benefit Veterans With Executive Function Deficit?
  Elisa F. Ogawa, Rebekah Harris, Ildiko Halasz, William Milberg, Jonathan F. Bean
  Journal of the American Geriatrics Society.2026; 74(8): 2373.     CrossRef
• Early recovery after surgery in frailty and hip fracture: where are we now?
  Ben Ollivere, Katie E. Rollins
  Bone & Joint 360.2026; 15(3): 7.     CrossRef
• Peri-operative nutrition in femoral neck fracture arthroplasty: a pragmatic framework to mitigate dual-hit catabolism and improve outcomes
  Leonard Muhango, Dyllan B. Geldenhuys, Nena Elebo, Winifred Mukiibi, Nkhodiseni Sikhauli, Jurek R.T. Pietrzak
  Orthopedic Reviews.2026;[Epub]     CrossRef
• Beyond bone density: toward an integrated bone– muscle–function framework for fragility fracture prevention
  Shengzhu Lu, Chaodong Liu, Yinyao Gou, Hao Liu
  Frontiers in Medicine.2026;[Epub]     CrossRef
• Apathy as a Predictor of Functional Recovery in Older Adults With Hip Fracture: A Multicentre Prospective Study
  Kazuya Takeda, Mineko Wada, Ryouichi Nakamura, Junko Okajima, Manami Harada, Yuiko Nishiguchi, Hideaki Sakai, Masaru Sakai, Yuri Kanemoto, Miwako Tsunematsu, Hideaki Hanaoka
  Psychogeriatrics.2026;[Epub]     CrossRef
• Sarcopenia and cognitive impairment after hip fracture in older adults: a narrative review and conceptual rehabilitation framework
  Qi Han, Hong-zhao Bai
  Frontiers in Medicine.2026;[Epub]     CrossRef

Pediatric anesthesia presents unique challenges due to children’s distinct physiological and anatomical characteristics, including variations in drug metabolism, airway structure, and respiratory and circulatory regulation. Despite significant advances in patient safety that have reduced anesthesia-related mortality over recent decades, the declining pediatric population has made specialized training and clinical practice increasingly difficult. This narrative review addresses practical aspects of pediatric anesthesia, emphasizing patient monitoring, airway management, and recent clinical advances. Oxygen supply targets in children require careful titration to ensure adequate tissue oxygenation while avoiding oxygen toxicity and its associated complications, such as bronchopulmonary dysplasia and retinopathy of prematurity. Quantitative monitoring of neuromuscular blockade, such as with train-of-four stimulation, is essential to prevent postoperative respiratory complications. Temperature monitoring is equally critical in pediatric surgery because children and neonates are highly susceptible to intraoperative hypothermia. Airway management in infants and young children is complicated by anatomical differences, and while video laryngoscopy offers advantages, evidence for its benefits in neonates remains inconclusive. Extubation strategies must be individualized, taking into account risks such as laryngospasm and airway obstruction, as both deep and awake extubation have demonstrated comparable safety profiles. Emerging modalities, such as transfontanelle ultrasonography, provide real-time cerebral blood flow assessment and enhance perioperative brain monitoring. Regional anesthesia techniques in neonates and infants reduce exposure to general anesthetics and facilitate faster recovery but require meticulous technique and monitoring to ensure safety. Multidisciplinary collaboration and effective communication with parents are essential to achieving optimal outcomes.

Citations

• The Pediatric Anesthesia Parent Satisfaction (PAPS) Questionnaire: A Focused Review of its Development, Validation, Cross-Cultural Adaptation, and Clinical Utility
  Seni Potsangbam, Rupesh M Thete, Abdelaziz Yehya, Sanjot Ninave, Tuhin Mistry, Abhijit Nair
  Cureus.2026;[Epub]     CrossRef

Globally, rapid population aging—particularly in Korea—has extended life expectancy but not proportionally extended healthy life expectancy, resulting in longer periods of illness or disability and a higher demand for complex medical and social care. Therefore, prolonging healthy life and improving health-related quality of life have become primary objectives in geriatric medicine and rehabilitation. Geriatric rehabilitation is a critical intervention aimed at optimizing the functioning of older adults and pre-morbidly frail individuals who have lost independence due to acute illness or injury. For many older patients, the goal shifts from complete recovery to achieving a new equilibrium, maximizing autonomy despite greater dependency. Geriatric rehabilitation also targets key geriatric syndromes such as frailty, recognizing it as a dynamic and potentially reversible state that provides a crucial “time window” for intervention. This review summarizes the core principles and structural elements essential for geriatric rehabilitation, emphasizing the implementation challenges within the Korean healthcare system. Unlike the European consensus, which supports structured inpatient and outpatient services with seamless transitions of care guided by Comprehensive Geriatric Assessment, the Korean healthcare system remains fragmented and heavily centered on acute hospitals. This highlights the urgent need for a systematic model to integrate care facilities and strengthen interprofessional collaboration to support community-based “aging in place.” Effective geriatric rehabilitation requires multidisciplinary teams and multifaceted approaches to optimize quality of life, social participation, and independent living. Despite its importance, substantial awareness gaps and policy barriers persist, underscoring an urgent call to action.

Citations

• MOST FREQUENTLY ASKED QUESTIONS BY OLDER ADULTS IN GERIATRIC REHABILITATION: EVALUATING LARGE LANGUAGE MODELS AS A SOURCE OF INFORMATION
  Uğur SÖZLÜ, Selim Mahmut GÜNAY, Sevda Demir TÜRE, Gül ÖZKAZANÇ
  Turkish Journal of Geriatrics.2026;[Epub]     CrossRef
• Analysis of Research Hotspots and Trends in Rehabilitation of Disabled Elderly Based on CiteSpace
  鸿 张
  Advances in Clinical Medicine.2026; 16(07): 96.     CrossRef
• Effects of High-Intensity Interval Training in Older Adults: A Systematic Review of Randomized and Non-Randomized Intervention Studies
  Paula Moreira, Sérgio Ferreira, Nuno Domingos Garrido, António M. Monteiro, Pedro Afonso, Alexandra Malheiro, Joana Ribeiro, Pedro Forte
  Journal of Clinical Medicine.2026; 15(17): 6701.     CrossRef
• Current Knowledge and Gaps in Geriatric Rehabilitation among Physical and Rehabilitation Medicine Specialists
  Paolo Capodaglio, Eleftheria Antoniadou, Mooyeon Oh-Park, Walter R. Frontera, Der-Sheng Han, Carmen M. Terzic, Anne Felicia Ambrose, Francesca Gimigliano, Marta Supervia Pola, Yesim Gokce Kutsal, Dale C. Strasser, Vu Q Nguyen, Jonathan F. Bean, Vanessa Se
  Annals of Geriatric Medicine and Research.2026; 30(3): 305.     CrossRef

Diabetes mellitus is a complex chronic disease with a rapidly increasing global prevalence. For this condition, non-pharmacological lifestyle modification is as important as pharmacological treatment. This review aims to comprehensively examine lifestyle prescriptions for diabetes across multiple domains to integrate current insights and understanding. In medical nutrition therapy, which is central to diabetes treatment and management, excessive carbohydrate intake should be restricted, while individualized consumption of high-quality carbohydrates, protein, and unsaturated fatty acids is recommended. Intake of added sugars and sodium should also be limited. Physical activity should similarly be tailored to the individual, with a combination of aerobic exercise and resistance training recommended. Careful consideration of hypoglycemia risk and diabetes complications is essential. Additional strategies include limitations on uninterrupted sedentary time to less than 30 minutes, maintenance of a healthy body weight, smoking cessation, alcohol abstinence, sleep health improvements, and attention to psychosocial care. In primary care settings, patient-specific assessment, multidisciplinary lifestyle prescriptions, and education to support behavior modification are expected to play a pivotal role in the treatment and management of diabetes.

Citations

• Knowledge, attitude, and practice of allied healthcare professionals about lifestyle medicine for diabetes: A cross-sectional study
  Mona Mohamed Taha, Shaima A Alothman, Rana Alawafi, Rahaf Mohammed Alshareef, Sarah Mohammed Al-Subaie, Najd Abdullah AlKhushaiban, Najd A Al-Salem, Asmaa Rafeeq, Ali Mohamed Ali Ismail
  WORK: A Journal of Prevention, Assessment & Rehabilitation.2026;[Epub]     CrossRef

South Korea is experiencing a rapid demographic transition, with the proportion of older adults projected to exceed 20% by 2025. This unprecedented pace has intensified the demand for healthcare and social support, creating complex challenges in the management of multimorbidity, frailty, and functional dependency. Historically, Korea has relied on a rigid, provider-centered model, with healthcare financed through National Health Insurance and long-term care through long-term care insurance. Although these systems expanded service availability, they also entrenched fragmentation between long-term care hospitals and nursing homes. Recent reforms mark a paradigm shift toward person-centered, integrated care. The Community Care pilot programs (2019–2022) and the Integrated Community Care Support Act (2024) introduced coordinated models that link healthcare, housing, and social services under local government leadership. Evidence from domestic and international studies underscores the risks of prolonged institutionalization and highlights the benefits of integrated approaches, including reduced hospitalizations, improved functional independence, and higher satisfaction among older adults and their families. At the same time, experiences from Korea and Japan suggest that institutional care remains indispensable for individuals with high medical needs or at the end of life, emphasizing the need for balanced strategies. Successful implementation of the 2026 reforms will require redefining the role of institutions, expanding community-based alternatives, developing a professional care manager workforce, achieving interoperability of data systems, and undertaking financing reforms to align incentives. Beyond structural change, embedding a cultural ethos that values dignity, autonomy, and personhood will be essential. Korea’s evolving model not only responds to urgent demographic challenges but also offers lessons for other aging societies.

Citations

• Narrative nursing to address negative emotions, body image disturbance, and satisfaction in patients after axillary odor surgery: a sequential explanatory mixed-methods study
  Jianhua Tan, Jianfei Zhang, Kaixi Tan, Qiao Hu, Chuqing Wang
  Frontiers in Medicine.2026;[Epub]     CrossRef
• Dynamics of satisfaction and health data of patients over 65 years old after integration of care assistants into mobile medical teams
  D.R. Davidov, I.B. Shikina, D.S. Oprishchenko
  Russian Journal of Preventive Medicine.2026; 29(8): 38.     CrossRef

Generative artificial intelligence (GenAI), including large language models such as GPT-4 and image-generation tools like DALL-E, is rapidly transforming the landscape of medical education. These technologies present promising opportunities for advancing personalized learning, clinical simulation, assessment, curriculum development, and academic writing. Medical schools have begun incorporating GenAI tools to support students’ self-directed study, design virtual patient encounters, automate formative feedback, and streamline content creation. Preliminary evidence suggests improvements in engagement, efficiency, and scalability. However, GenAI integration also introduces substantial challenges. Key concerns include hallucinated or inaccurate content, bias and inequity in artificial intelligence (AI)-generated materials, ethical issues related to plagiarism and authorship, risks to academic integrity, and the potential erosion of empathy and humanistic values in training. Furthermore, most institutions currently lack formal policies, structured training, and clear guidelines for responsible GenAI use. To realize the full potential of GenAI in medical education, educators must adopt a balanced approach that prioritizes accuracy, equity, transparency, and human oversight. Faculty development, AI literacy among learners, ethical frameworks, and investment in infrastructure are essential for sustainable adoption. As the role of AI in medicine expands, medical education must evolve in parallel to prepare future physicians who are not only skilled users of advanced technologies but also compassionate, reflective practitioners.

Citations

• Using virtual reality to support the transition from preclinical to clinical training in paediatric dentistry
  Marion Lautier, Faustine Béal, Amélie Reibel Domergue, Sophie Jung, François Clauss, Marion Strub
  BMC Medical Education.2026;[Epub]     CrossRef
• Generative and Large-Scale Artificial Intelligence in Exercise and Sports Medicine: A Narrative Review
  Bokyoung Kim, Junseok Kang, Yun Jae Jung, Jihyun Ahn
  The Asian Journal of Kinesiology.2026; 28(1): 58.     CrossRef
• Bridging the Implementation Gap in Medical AI Education: 3-Lever Framework for Concurrent Reform
  Sherrie L Kelly, Melissa Forgie, Mark C Walker
  JMIR Medical Education.2026; 12: e88778.     CrossRef
• A dialectical lens for AI and medical humanities: advancing responsible augmented humanism in Digital Public Health
  Sifan Chen, Zining Peng, Nian Liu
  Frontiers in Public Health.2026;[Epub]     CrossRef
• Artificial Intelligence in Psychiatry Training: Comparative Insights from Nine Large Language Models Across Cultural and Exam Contexts
  Yusuf Selman Çelik, Nagihan Özer, Makbule Esen Öksüzoğlu, Şeyma Selcen Macit, Hande Günal Okumuş, Meryem Kaşak, Ayşegül Efe, Yusuf Öztürk
  Psychiatric Quarterly.2026;[Epub]     CrossRef
• AI-supported case-based learning in medical education: a comprehensive scoping review
  Syed Hani Abidi, Joseph Almazan, Olaoluwa Fabiyi, Fatin Zehra, Muhammad Tariq
  Frontiers in Medicine.2026;[Epub]     CrossRef
• Evaluation of the Effectiveness of Psychological First Aid Training for Community Nurses in China: A Quasi‐Experimental Study on Knowledge and Skills Enhancement
  Yazhou He, Yulan Ding, Jiaqin Yan, Xiaoning Xiong, Shan Huang, Sijian Li
  Nursing Open.2026;[Epub]     CrossRef
• Generative AI–Assisted Microlearning for Erectile Dysfunction Myth Reduction: Single-Center Pre–Post Quasi-Experimental Study
  Ali Can Albaz, Oğuzcan Erbatu, Okan Yiğit, Oktay Üçer, Gökhan Temeltaş, Talha Müezzinoğlu
  JMIR Formative Research.2026; 10: e88818.     CrossRef
• Implementation of artificial intelligence in the 2025 medical parasitology course at Hallym University
  Eun Hee Ha
  Journal of Educational Evaluation for Health Professions.2026; 23: 4.     CrossRef
• Bridging theory and practice in generative artificial intelligence for medical education: insights from clinical teaching experience
  Yoo Kyung Lee
  Ewha Medical Journal.2026; 49(2): e16.     CrossRef
• Design and Evaluation of a Faculty Development Workshop Series on Integrating Generative Artificial Intelligence in Medical Education: Mixed Methods Pilot Study
  Rajalakshmi Anand, Nicole Bowers, Mange Festo Manyama
  JMIR Medical Education.2026; 12: e89815.     CrossRef
• An exploration of undergraduate nursing students' heavy use of generative artificial intelligence in academic practice: A descriptive phenomenological study
  Xiaoqing Wang, Kai Yu, Weiliang Wang, Jiyue Li, Yuexian Shi
  International Journal of Nursing Studies.2026; 180: 105557.     CrossRef
• Use of large language models for providing automated feedback in medical imaging education: a systematic review
  Mustafa Mohammed Al-Mashhadani, Faika Ajaz, Shaista Salman Guraya, Farah Ennab
  Frontiers in Medicine.2026;[Epub]     CrossRef
• Generative artificial intelligence and large language models in competency-based medical education: applications, challenges, and future directions
  In Hwa Jeong, Heeyoung Kim, Hyunyong Hwang
  Kosin Medical Journal.2026; 41(2): 114.     CrossRef
• The role of artificial intelligence in personalising the teaching process at medical universities
  Daniel Ślęzak
  Humanities & Social Sciences Reviews.2026; 14(2): 67.     CrossRef
• The Pocket Tutor - Generating Competency-Based Clinical Vignettes with Artificial Intelligence for Medical Postgraduate Competitive Exam Preparation
  Swapnil Banerjee, Manisha Agarwal
  Galore International Journal of Health Sciences and Research.2026; : 69.     CrossRef
• Benefits and challenges of integrating generative AI in health technology education—a case study
  Minna Pikkarainen, Marko Lukic, Safora Johanssen, Wilfried Admiraal, Arild Berg, Yngve Røe
  Frontiers in Education.2026;[Epub]     CrossRef
• Benchmarking five large language models in medical genetics: a bilingual comparative evaluation using published and novel expert-authored questions
  Özge Beyza Gündoğdu Öğütlü, Benjamin D. Solomon, Yusuf Selman Çelik
  Frontiers in Medicine.2026;[Epub]     CrossRef
• Epistemología de la praxis médica en la era de la inteligencia artificial: metacognición, metodologías activas y personalización del aprendizaje por competencias en el siglo XXI
  Fernando Vanegas Lara, Mariel Gonzalez-Calatayud, Omar Hassiri Gómez Gómez, Roberto Méndez Pérez
  Educación Médica.2026; 27(6): 101246.     CrossRef
• Use of Expert-Validated AI-Generated Forensic Images in Case-Based Learning and Clinical Reasoning Among Undergraduate Medical Students: A Two-Arm Educational Intervention Study
  Priyanka Chahal, Abhishek Sharma, Arindam Chatterjee
  Cureus.2026;[Epub]     CrossRef
• Inteligencia artificial y razonamiento clínico en educación médica: una revisión sistemática
  Rafael Emiliano Sulca Quispe, Juan Miguel Purilla Janto, María del Rosario Jáuregui-Figueroa, María del Rosario Figueroa Bejarano De Jauregui
  Revista Simón Rodríguez.2026; 6(13): 1.     CrossRef

Perioperative pain management has shifted from standardized, procedure-based protocols toward individualized, patient-centered approaches. Inadequate pain control can result in short-term adverse outcomes, including delayed ambulation, prolonged hospitalization, and increased complications, as well as long-term sequelae such as chronic persistent postsurgical pain. Early models of preemptive and preventive analgesia emphasized pain relief primarily through the use of opioids. Growing concern about opioid-related adverse effects established the basis for multimodal and opioid-sparing strategies. Nevertheless, with the onset of the global opioid crisis, heightened awareness of the risks of opioid overuse has fueled interest in opioid-free techniques. However, evidence does not demonstrate that opioid-free methods are superior to opioid-sparing approaches. This underscores the importance of returning to the central goals of enhanced recovery after surgery: early restoration of function and reduction of complications. Within this framework, personalized pain management has emerged as a practical paradigm that tailors interventions to individual characteristics, including comorbidities, psychological status, pain sensitivity, and recovery objectives. This review outlines the rationale, current practices, and future directions of personalized perioperative pain management and proposes a framework for integrating new strategies into clinical care.

Citations

• Personalized Multimodal and Opioid-Sparing Analgesia for Postoperative Pain Management: Enhancing Recovery and Addressing the Post-Discharge Gap
  Marie Louise Sezerano, Emery Niyonkuru
  Journal of Pain Research.2026; Volume 19: 1.     CrossRef
• Future directions in anesthesia: expanding the role of anesthetic drugs in sedation, analgesia, and recovery
  Min Kyoung Kim, Hyun Kang
  Journal of the Korean Medical Association.2026; 69(4): 294.     CrossRef
• Effect of lidocaine on acute pain after modified radical mastectomy: a secondary analysis of a randomized trial
  Jiao Liu, Wenjuan Zhang, Xiaohui Li, Danting Jia, Zhixia Bai, Xuexin Chen
  Frontiers in Medicine.2026;[Epub]     CrossRef
• Digital Pain Medicine in the Era of Precision Healthcare: Integrating Artificial Intelligence, Wearable Biosensors, and Predictive Analytics for Personalized Pain Management
  Dr. A. Devasena, Dr. Glad Mohesh, Sujit Kumar Sadhukhan, Dr. Shivendra Pal Singh
  PAIN, JOINTS, SPINE.2026; 16(6S): 736.     CrossRef

The integration of regional anesthesia (RA) with general anesthesia (GA) has become a central component of multimodal strategies to improve perioperative pain management. This approach not only enhances analgesic efficacy but also reduces opioid requirements and mitigates opioid-related adverse effects. By targeting peripheral or neuraxial nociceptive pathways, RA attenuates the surgical stress response and decreases central sensitization, complementing the systemic actions of GA. The combined application of RA and GA has shown substantial benefits across a wide range of surgical procedures, including abdominal, thoracic, orthopedic, and pediatric operations. Reported advantages include improved hemodynamic stability, enhanced pulmonary function, earlier ambulation, faster gastrointestinal recovery, and greater patient satisfaction. Moreover, recent evidence indicates a positive association between effective postoperative pain control and long-term outcomes, such as reduced incidence of persistent postsurgical pain, better functional independence, and even improved immune function and survival following cancer surgery. The development of sustained-release local anesthetic delivery systems, which provide localized and prolonged analgesia, further extends the benefits of RA-GA integration into the postoperative period. This review summarizes the mechanistic rationale, clinical applications, and future directions of RA-GA combinations in modern surgical care, with special emphasis on their role in enhanced recovery after surgery protocols.

Citations

• Results and Future Perspectives of the Sustainable Anesthesia Project: A Large-Scale, Real-World Implementation Study at the Largest Spanish Private Healthcare Provider
  Juan Acha-Ganderias, María del Pino Henríquez-de Armas, Luis Enrique Muñoz-Alameda, Ion Cristóbal, Cristina Caramés, Leticia Moral-Iglesias
  Healthcare.2026; 14(3): 300.     CrossRef
• Effect of transcutaneous electrical nerve stimulation on patients after coronary artery bypass grafting: a systematic review and meta-analysis
  Enyu Zhang, Jihe Kang, Yan Liu, Lulu Wang, Bo Wan, Xiaoling Li
  Frontiers in Cardiovascular Medicine.2026;[Epub]     CrossRef
• From repair to reconstruction: a holistic perspective in abdominal wall hernia surgery
  Xin-liang Hou, Ting Zeng, Xu Wang, Li-ye Tan
  Frontiers in Surgery.2026;[Epub]     CrossRef
• Future directions in anesthesia: expanding the role of anesthetic drugs in sedation, analgesia, and recovery
  Min Kyoung Kim, Hyun Kang
  Journal of the Korean Medical Association.2026; 69(4): 294.     CrossRef
• Letter to the Editor re: “Opioid prescribing patterns and the effect of chronic kidney disease in pediatric urology population: A retrospective cohort analysis”
  Yashkumar Kiranbhai Rajvi, Mohit Kumar, Shubham Singh
  Journal of Pediatric Urology.2026; 22(5): 105964.     CrossRef
• Integrating Regional Anesthesia and Early Physiotherapy for Enhanced Recovery Following Joint and Spine Surgery: Advances, Challenges, and Future Directions
  Dr.Y.Praveen Kumar, Dr. Pallavi Yellarthi, Dr. Sujata Haridas Nair (PT), Dr Akshay Sreedharan, Vasantakumarnaik N.K, Singireddy Dattakshaya, Dr Rutambhara Sahu
  PAIN, JOINTS, SPINE.2026; 16(6S): 875.     CrossRef
• Intraoperative opioid-sparing effect of a quadratus lumborum block using low-concentration bupivacaine and dexmedetomidine in cats undergoing ovariohysterectomy
  Fumihiko Takusagawa, Yoshimi Takusagawa, Taro Kimura
  Journal of Feline Medicine and Surgery.2026;[Epub]     CrossRef
• Regional Analgesia Strategies for Hybrid Angioplasty of Lower Extremity Vessels: A Comparative Analysis of Neuraxial and Ultrasound-Guided Peripheral Anesthesia Techniques
  Volodymyr I. Cherniy, Vitalii S. Myrona, Yuriy M. Hupalo, Olena Ye. Shved
  Ukrainian Journal of Cardiovascular Surgery.2026; 34(3): 65.     CrossRef
• Erector spinae plane block for postoperative analgesia after hip surgery: a systematic review and meta-analysis of randomized controlled trials
  Mashour Ibrahim A. Alsherie, Rashed K. Alrashed, Saad Khalid Alsaleh, Khalid A. Rifadah, Bassam Khalifah S. Alkhalifah, Omar Abdulilah O. Binmadi, Abdulaziz Ibrahim Almughamis, Yahya Saeed B. Alqahtani, Naser Bader Alenezi, Khaled Al Khaledi, Abdullah AlG
  Pain Management.2026; : 1.     CrossRef

Non‑operative management, particularly the watch and wait (WW) strategy, has emerged as an alternative to total mesorectal excision for selected patients with locally advanced rectal cancer who achieve a clinical complete response (cCR) after neoadjuvant treatment. This narrative review examines oncologic outcomes, functional and quality‑of‑life benefits, diagnostic challenges, and surveillance requirements associated with WW compared to radical surgery. Evidence from randomized trials and international registries indicates that WW provides overall and disease-free survival rates comparable to those of surgery, provided that stringent selection criteria and intensive surveillance are maintained for 3 to 5 years. Local regrowth occurs in 15%–40% of patients—most commonly within 24 months—but salvage surgery is curative in over 90% of cases and restores oncologic equivalence. Nevertheless, distant metastasis is more frequent in patients who experience regrowth, underscoring the importance of early detection and the need for optimized systemic therapy. Accurate determination of cCR remains the primary limitation; digital rectal examination, high‑resolution magnetic resonance imaging, and endoscopy, even when combined, cannot reliably exclude microscopic residual disease. Total neoadjuvant therapy increases cCR rates to 30%–60% and expands the pool of WW candidates, but also intensifies the need for standardized response definitions and surveillance algorithms. WW offers organ preservation and quality‑of‑life improvements without compromising survival in carefully selected patients, provided that multidisciplinary teams ensure rigorous response assessment and lifelong monitoring. Future advances in imaging, molecular biomarkers, and individualized risk stratification are expected to further enhance the safety of WW and expand eligibility to a broader patient population.

Citations

• Surgical Management of Metachronous Liver Metastasis after Watch-and-Wait Strategy in Rectal Cancer Patients with Complete Response: A Case Report
  A. Burlaka, A. Mykytyuk, V. Bezverkhnyi, B. Sorokin, D. Makhmudov, V. Skyba
  Experimental Oncology.2026; 48(1): 59.     CrossRef
• Prognostic and Predictive Role of Circulating Tumor DNA in Locally Advanced Rectal Cancer Managed With Total Neoadjuvant Therapy: A Systematic Review
  Faizan Bashir, Qurat‐ul‐Aine Bhat, Jayden Allegakoen, Dorsa Shekouh, Sajida Zaiter
  Health Science Reports.2026;[Epub]     CrossRef

Purpose
This study aimed to describe mortality trends in the Republic of Korea in 2022 by analyzing total deaths, crude and age-standardized mortality rates, as well as age- and sex-specific patterns and changes in cause-specific mortality. The analysis updates previous reports with newly available data from 2022.
Methods
A repeated cross-sectional analysis was performed using nationwide death certificate data collected through municipal administrative offices. Deaths occurring in 2022 were aggregated from reports filed over a 16-month period, spanning January 2022 to April 2023. Causes of death were classified according to the World Health Organization’s International Classification of Diseases. Quality assurance was ensured through administrative record linkage across 22 databases and validation using an independent infant mortality survey. Descriptive statistics were employed to summarize the findings.
Results
In 2022, Korea recorded 372,939 deaths (the highest annual total since 1983), corresponding to a crude death rate of 727.6 per 100,000 population. This increase contributed to a net population decline of 123,751. Mortality rates rose across most age groups, with particularly marked increases among those aged 1–9 and those aged 80 or older. Coronavirus disease 2019 (COVID-19) became the third leading cause of death (31,280 deaths; 61.0 per 100,000), driven largely by the Omicron variant and heightened infection rates among older adults. Pancreatic cancer overtook stomach cancer in the mortality rankings. There were sharp increases in deaths attributed to Alzheimer’s disease and diabetes. Although deaths from intentional self-harm declined, suicide remained a significant cause of death among younger individuals.
Conclusion
Korea experienced a record-high mortality rate in 2022, largely due to the impacts of COVID-19 and ongoing population aging. Notable shifts in cause-specific mortality were observed, including increases in deaths from Alzheimer’s disease, diabetes, and pancreatic cancer, underscoring evolving public health challenges.

Citations

• Factors Associated With Examinations for Diabetic Complications During the COVID-19 Epidemic
  Si A Choi, Mi Ah Han, So Yeon Ryu
  Asia Pacific Journal of Public Health.2026; 38(4): 315.     CrossRef
• Association between heavy metal exposure and high-sensitivity C-reactive protein in the elderly: Korea National Health and Nutrition Examination Survey (KNHANES) 2016–2017
  Jongwon Jung, Ji Young Ryu
  Annals of Occupational and Environmental Medicine.2026; 38: e13.     CrossRef
• Impact of the Life-Sustaining Treatment Decisions Act on End-of-Life Care in the Emergency Department
  Young Woo Um, Hee Eun Kim, Ji Eun Hwang, Seung Hyun Kang, Jae Hyuk Lee, You Hwan Jo
  Journal of Palliative Medicine.2026; 29(10): 1394.     CrossRef
• Self-Rated Health Associated with Chronic Diseases and Types of Physical Activity Among Middle-Aged and Older Adults: A Cross-Sectional Study Using Explainable Machine Learning
  Tong Yang, Yongchul Choi, Yonghwan Kim, Munku Song
  Journal of Clinical Medicine.2026; 15(18): 7100.     CrossRef

Purpose
This study evaluated the feasibility and performance of a deep learning approach utilizing the Korean Medical BERT (KM-BERT) model for the automated classification of underlying causes of death within national mortality statistics. It aimed to assess predictive accuracy throughout the cause-of-death coding workflow and to identify limitations and opportunities for further artificial intelligence (AI) integration.
Methods
We performed a retrospective prediction study using 693,587 death certificates issued in Korea between January 2021 and December 2022. Free-text fields for immediate, antecedent, and contributory causes were concatenated and fine-tuned with KM-BERT. Three classification models were developed: (1) final underlying cause prediction (International Classification of Diseases, 10th Revision [ICD-10] code) from certificate inputs, (2) tentative underlying cause selection based on ICD-10 Volume 2 rules, and (3) classification of individual cause-of-death entries. Models were trained and validated using 2021 data (80% training, 20% validation) and evaluated on 2022 data. Performance metrics included overall accuracy, weighted F1 score, and macro F1 score.
Results
On 306,898 certificates from 2022, the final cause model achieved 62.65% accuracy (F1-weighted, 0.5940; F1-macro, 0.1503). The tentative cause model demonstrated 95.35% accuracy (F1-weighted, 0.9516; F1-macro, 0.4996). The individual entry model yielded 79.51% accuracy (F1-weighted, 0.7741; F1-macro, 0.9250). Error analysis indicated reduced reliability for rare diseases and for specific ICD chapters, which require supplementary administrative data.
Conclusion
Despite strong performance in mapping free-text inputs and selecting tentative underlying causes, there remains a need for improved data quality, administrative record integration, and model refinement. A systematic, long-term approach is essential for the broad adoption of AI in mortality statistics.

Purpose
This study aimed to assess the spatiotemporal associations between air pollution and emergency room visits for cardiovascular and cerebrovascular diseases in South Korea using a graph autoencoder (GAE). A multivariate graph-based approach was used to uncover seasonal and regional variations in pollutant–disease relationships.
Methods
We collected monthly data from 2022 to 2023, including concentrations of 6 air pollutants (SO2, NO2, O3, CO, PM10, and PM2.5) and emergency room visits for 4 disease types: cardiac arrest, myocardial infarction, ischemic stroke, and hemorrhagic stroke. Pearson correlation coefficients were used to construct adjacency matrices, which, along with normalized feature matrices, were used as inputs to the GAE. The model was trained separately for each month and region to estimate the strength of pollutant–disease associations.
Results
The pollutant–disease network structures exhibited clear seasonal variations. In winter, strong associations were observed between O3, NO2, and all disease outcomes. In spring, PM2.5 and PM10 were strongly linked to cardiac and stroke-related visits. These connections weakened during summer but became more pronounced in autumn, especially for NO2 and cardiac arrest. Urban areas displayed denser and stronger associations than non-urban areas.
Conclusion
Our findings underscore the necessity for season- and region-specific air quality management strategies. In winter, focused control of O3 and NO2 is needed in urban areas, while in spring, PM mitigation is required in urban and selected rural regions. Autumn NO2 control may be especially beneficial in non-urban areas. Spatiotemporally tailored interventions could reduce the burden of air pollution-related emergency room visits.

Purpose
This study developed and validated a deep learning model for the automated early detection of androgenetic alopecia (AGA) using trichoscopic images, and evaluated the model’s diagnostic performance in a Korean clinical cohort.
Methods
We conducted a retrospective observational study using 318 trichoscopic scalp images labeled by board-certified dermatologists according to the Basic and Specific (BASP) system, collected at Ewha Womans University Medical Center between July 2018 and January 2024. The images were categorized as BASP 0 (no hair loss) or BASP 1–3 (early-stage hair loss). A ResNet-18 convolutional neural network, pretrained on ImageNet, was fine-tuned for binary classification. Internal validation was performed using stratified 5-fold cross-validation, and external validation was conducted through ensemble soft voting on a separate hold-out test set of 20 images. Model performance was measured by accuracy, precision, recall, F1-score, and area under the curve (AUC), with 95% confidence intervals (CIs) calculated for hold-out accuracy.
Results
Internal validation revealed robust model performance, with 4 out of 5 folds achieving an accuracy above 0.90 and an AUC above 0.93. In external validation on the hold-out test set, the ensemble model achieved an accuracy of 0.90 (95% CI, 0.77–1.03) and an AUC of 0.97, with perfect recall for early-stage hair loss. No missing data were present, and the model demonstrated stable convergence without requiring data augmentation.
Conclusion
This model demonstrated high accuracy and generalizability for detecting early-stage AGA from trichoscopic images, supporting its potential utility as a screening tool in clinical and teledermatology settings.

Citations

• Trichoscopy and Computational Models for Hair and Scalp Disorders: Image Analysis, Quantification, and Clinical Integration
  Corrado Zengarini, Nico Curti, Stephano Cedirian, Luca Rapparini, Francesca Pampaloni, Alessandro Pileri, Francesco Durazzi, Martina Mussi, Michelangelo La Placa, Bianca Maria Piraccini, Michela Starace
  Applied Sciences.2026; 16(7): 3199.     CrossRef
• Hair Follicle Biology and Signaling in Female Pattern Hair Loss: A Neuroendocrine Biomarker Perspective Integrated With Artificial Intelligence–Driven Precision Diagnostics
  Debraj Shome, Debalina Bose, Raji Patil, Rinky Kapoor, Esmael Ahmed, Depti Bellani, Riya Shahare, Suraiya Saleem
  Dermatologic Therapy.2026;[Epub]     CrossRef
• Research and application of digital technology in the diagnosis and treatment of androgenetic alopecia
  Xi Wei, Jingjing Wang, Yicheng Zhang, Xiaojun Yan, Yating Xiao, Yutong Ci, Xiaoling Luo, Xue Wang
  Frontiers in Digital Health.2026;[Epub]     CrossRef
• Artificial intelligence in trichology: A systematic review of current applications in diagnosis, severity assessment, and treatment monitoring
  Shada Khalid Alanazi, Maha Mohammed Alkharisi, Hind Bader Alshalhoob, Waad Abdulelah Alduraywish, Sarah Anwar Almulla, Lubna Abdullatif Alnajim, Lama Nawaf Alanazi, Ahmed Anwar Almulla, Sadeem Lafi Alanazi, Ibrahim Alfuraih
  DIGITAL HEALTH.2026;[Epub]     CrossRef
• How Can Clinicians Leverage Vibe Coding for Machine Learning and Deep Learning Research?
  Yoonhwan Lee, Sun Huh
  Endocrinology and Metabolism.2025; 40(5): 659.     CrossRef

Purpose
Internal ribosome entry site (IRES) elements, present in both viral and cellular messenger RNAs (mRNAs), facilitate cap-independent translation by recruiting ribosomes to internal regions of mRNA. This study aimed to investigate the impact of inserting G-quadruplex and hairpin structures into the 5' untranslated region (UTR) and poly(A) sequences on the translation efficiency of the encephalomyocarditis virus (EMCV) IRES, using an IRES-based RNA platform encoding OX40L, 4-1BBL, and GFP.
Methods
G-quadruplex and hairpin structures, derived from HIV-1 (human immunodeficiency virus type 1) or custom-designed, were synthesized and inserted into the 5' UTR and poly(A) tail regions of EMCV IRES vectors. These constructs were amplified by polymerase chain reaction, ligated into plasmids, and transcribed in vitro. B16 melanoma, TC-1 tumor, and HEK293 cells were transfected with these RNA constructs. Protein expression levels were assessed at 6, 12, and 24 hours post-transfection by flow cytometry and fluorescence microscopy. Statistical analyses employed one-way analysis of variance with the Dunnett test.
Results
The insertion of G-quadruplex and hairpin structures altered RNA secondary structure, significantly reducing protein expression. In the 5' UTR, the G-quadruplex nearly abolished OX40L expression (1.18%±0.41% at 6 hours vs. 18.23%±0.16% for control), while the hairpin structure reduced it (16.29%±1.46% vs. 22.84%±1.17%). In the poly(A) tail region, both structures decreased GFP expression across all cell lines (4.86%±1.35% to 7.27%±0.32% vs. 39.56%±2.07% in B16 cells).
Conclusion
Inserting G-quadruplex and hairpin structures into EMCV IRES UTRs inhibits translation efficiency, suggesting the need for precise RNA structure modeling to enhance IRES-mediated translation.

Purpose
This study compares 3 deep learning models (UNet, TransUNet, and MIST) for left atrium (LA) segmentation of cardiac computed tomography (CT) images from patients with congenital heart disease (CHD). It investigates how architectural variations in the MIST model, such as spatial squeeze-and-excitation attention, impact Dice score and HD95.
Methods
We analyzed 108 publicly available, de-identified CT volumes from the ImageCHD dataset. Volumes underwent resampling, intensity normalization, and data augmentation. UNet, TransUNet, and MIST models were trained using 80% of 97 cases, with the remaining 20% employed for validation. Eleven cases were reserved for testing. Performance was evaluated using the Dice score (measuring overlap accuracy) and HD95 (reflecting boundary accuracy). Statistical comparisons were performed via one-way repeated measures analysis of variance.
Results
MIST achieved the highest mean Dice score (0.74; 95% confidence interval, 0.67–0.81), significantly outperforming TransUNet (0.53; P<0.001) and UNet (0.49; P<0.001). Regarding HD95, TransUNet (9.09 mm) and MIST (5.77 mm) similarly outperformed UNet (27.49 mm; P<0.0001). In ablation experiments, the inclusion of spatial attention did not further enhance the MIST model’s performance, suggesting redundancy with existing attention mechanisms. However, the integration of multi-scale features and refined skip connections consistently improved segmentation accuracy and boundary delineation.
Conclusion
MIST demonstrated superior LA segmentation, highlighting the benefits of its integrated multi-scale features and optimized architecture. Nevertheless, its computational overhead complicates practical clinical deployment. Our findings underscore the value of advanced hybrid models in cardiac imaging, providing improved reliability for CHD evaluation. Future studies should balance segmentation accuracy with feasible clinical implementation.

Purpose
This study developed and evaluated a feature-based ensemble model integrating the synthetic minority oversampling technique (SMOTE) and random undersampling (RUS) methods with a random forest approach to address class imbalance in machine learning for early diabetes detection, aiming to improve predictive performance.
Methods
Using the Scikit-learn diabetes dataset (442 samples, 10 features), we binarized the target variable (diabetes progression) at the 75th percentile and split it 80:20 using stratified sampling. The training set was balanced to a 1:2 minority-to-majority ratio via SMOTE (0.6) and RUS (0.66). A feature-based ensemble model was constructed by training random forest classifiers on 10 two-feature subsets, selected based on feature importance, and combining their outputs using soft voting. Performance was compared against 13 baseline models, using accuracy and area under the curve (AUC) as metrics on the imbalanced test set.
Results
The feature-based ensemble model and balanced random forest both achieved the highest accuracy (0.8764), followed by the fully connected neural network (0.8700). The ensemble model had an excellent AUC (0.9227), while k-nearest neighbors had the lowest accuracy (0.8427). Visualizations confirmed its superior discriminative ability, especially for the minority (high-risk) class, which is a critical factor in medical contexts.
Conclusion
Integrating SMOTE, RUS, and feature-based ensemble learning improved classification performance in imbalanced diabetes datasets by delivering robust accuracy and high recall for the minority class. This approach outperforms traditional resampling techniques and deep learning models, offering a scalable and interpretable solution for early diabetes prediction and potentially other medical applications.

Citations

• Development and validation of an explainable prediction model for schistosomiasis seropositivity: a population-based screening study in Hunan Province, China
  Yu Zhou, Ling Tang, Mao Zheng, Benjiao Hu, Yanfeng Gong, Liyun Zhu, Liang Shi, Lei Lin, Xinran Yang, Pin Long, Yue Chen, Qingwu Jiang, Yibiao Zhou
  International Journal for Parasitology.2026; 56(7): 104766.     CrossRef
• Developing SHAP interpretable machine learning models for assessing biopsychosocial risk in female drug users: a small sample study
  Xiao Wang, Mingjian Gao, Jialin Gao, Fei Geng, Xiqing Yuan, Xinyu Cheng, Qiulian Xing, Yu Ming, Gancheng Zhu, Huimin Shi, Peng Wang
  Frontiers in Psychiatry.2026;[Epub]     CrossRef
• Multiclass Prediction of Stroke-Hypertension Comorbidity Using Soft Voting Ensemble with SMOTE Evaluation: A National Stroke Hospital Study in Sumatra
  Arinda Mahadesyawardani, Nur Chamidah, Renatalia Fika, Marisa Rifada, I Nyoman Budiantara, Bayu Satria Wiratama, Muhammad Anshari Ali, Norma Latif Fitriyani, Naufal Ramadhan Al Akhwal Siregar
  Journal of Multidisciplinary Applied Natural Science.2026;[Epub]     CrossRef
• Leaving behind fond memories, I am stepping away from my role as editor of the Ewha Medical Journal after finalizing this issue's theme
  Sun Huh
  Ewha Medical Journal.2025; 48(4): e51.     CrossRef

Purpose
Accurate prediction of blood glucose variability is crucial for effective diabetes management, as both hypoglycemia and hyperglycemia are associated with increased morbidity and mortality. However, conventional predictive models rely primarily on patient-specific biometric data, often neglecting the influence of patient–provider interactions, which can significantly impact outcomes. This study introduces Cyclic Dual Latent Discovery (CDLD), a deep learning framework that explicitly models patient–provider interactions to improve prediction of blood glucose levels. By leveraging a real-world intensive care unit (ICU) dataset, the model captures latent attributes of both patients and providers, thus improving forecasting accuracy.
Methods
ICU patient records were obtained from the MIMIC-IV v3.0 critical care database, including approximately 5,014 instances of patient–provider interaction. The CDLD model uses a cyclic training mechanism that alternately updates patient and provider latent representations to optimize predictive performance. During preprocessing, all numeric features were normalized, and extreme glucose values were capped at 500 mg/dL to mitigate the effect of outliers.
Results
CDLD outperformed conventional models, achieving a root mean square error of 0.0852 on the validation set and 0.0899 on the test set, which indicates improved generalization. The model effectively captured latent patient–provider interaction patterns, yielding more accurate glucose variability predictions than baseline approaches.
Conclusion
Integrating patient–provider interaction modeling into predictive frameworks can increase blood glucose prediction accuracy. The CDLD model offers a novel approach to diabetes management, potentially paving the way for artificial intelligence-driven personalized treatment strategies.

Citations

• Artificial Intelligence Algorithms for Insulin Management and Hypoglycemia Prevention in Hospitalized Patients—A Scoping Review
  Eileen R. Faulds, Melanie Natasha Rayan, Matthew Mlachak, Kathleen M. Dungan, Ted Allen, Emily Patterson
  Diabetology.2026; 7(1): 19.     CrossRef

Purpose
This study aimed to leverage Shapley additive explanation (SHAP)-based feature engineering to predict appendix cancer. Traditional models often lack transparency, hindering clinical adoption. We propose a framework that integrates SHAP for feature selection, construction, and weighting to enhance accuracy and clinical relevance.
Methods
Data from the Kaggle Appendix Cancer Prediction dataset (260,000 samples, 21 features) were used in this prediction study conducted from January through March 2025, in accordance with TRIPOD-AI guidelines. Preprocessing involved label encoding, SMOTE (synthetic minority over-sampling technique) to address class imbalance, and an 80:20 train-test split. Baseline models (random forest, XGBoost, LightGBM) were compared; LightGBM was selected for its superior performance (accuracy=0.8794). SHAP analysis identified key features and guided 3 engineering steps: selection of the top 15 features, construction of interaction-based features (e.g., chronic severity), and feature weighting based on SHAP values. Performance was evaluated using accuracy, precision, recall, and F1-score.
Results
Four LightGBM model configurations were evaluated: baseline (accuracy=0.8794, F1-score=0.8691), feature selection (accuracy=0.8968, F1-score=0.8860), feature construction (accuracy=0.8980, F1-score=0.8872), and feature weighting (accuracy=0.8986, F1-score=0.8877). SHAP-based engineering yielded performance improvements, with feature weighting achieving the highest precision (0.9940). Key features (e.g., red blood cell count and chronic severity) contributed to predictions while maintaining interpretability.
Conclusion
The SHAP-based framework substantially improved the accuracy and transparency of appendix cancer predictions using LightGBM (F1-score=0.8877). This approach bridges the gap between predictive power and clinical interpretability, offering a scalable model for rare disease prediction. Future validation with real-world data is recommended to ensure generalizability.

Citations

• Feature engineering and explainable artificial intelligence for state of health estimation of Lithium-ion batteries
  Tugba Tetik
  Journal of Energy Storage.2026; 144: 119873.     CrossRef
• Evaluating the limitations of gradient boosting and SHAP in predicting magnetite separation performance in PLIMS
  Arif Mustafa, Yoshiyasu Takefuji
  Powder Technology.2026; 471: 122108.     CrossRef
• Research on a machine learning-based predictive model for postoperative neurological dysfunction in acute Stanford type A aortic dissection
  Lun Li, Ruiyi Wang, Lei Qin, Xiaoyong Jing, Junming Zhu
  Frontiers in Medicine.2026;[Epub]     CrossRef
• Enhancing prognostic model interpretability for advanced engine failure prediction using prognostic metrics and explainable AI
  R. Avsar
  The Aeronautical Journal.2026; 130(1347): 1683.     CrossRef
• Leveraging explainable artificial intelligence to improve advanced driver assistance systems through driver eye-tracking interpretation
  Methusela Sulle, Gurcan Comert, Kamrul Islam, Jun Deng, Negash Begashaw, Varghese Vaidyan
  Digital Engineering.2026; 10: 100101.     CrossRef
• A leakage-controlled and SHAP driven machine learning framework for paediatric respiratory disease classification using Indian hospital EHR data
  Anusha Prashanth Shetty, Surendra Shetty, Pavan Hegde, Shwetha Shetty, Nagaraja Shetty
  BMC Medical Informatics and Decision Making.2026;[Epub]     CrossRef
• Predictors of quality of life in OCD: Machine-derived features beyond expert consensus
  Max Thorsson, Angela Trujillo, Maritza J. Romero, Jonathan Irreño-Sotomonte, Tania Borda, Raquel M. Zepeda-Burgos, Mayra C. Martinez Mallen, Beatriz Moyano, Jacey L. Anderberg, Josselyn S. Muñoz, Hannah C. Moore, Renee M. Frederick, Dayan Berrones, Vaness
  Comprehensive Psychiatry.2026; 151: 152737.     CrossRef
• Uncovering Key Factors of Student Performance in Math: An Explainable Deep Learning Approach Using TIMSS 2019 Data
  Abdelamine Elouafi, Ilyas Tammouch, Souad Eddarouich, Raja Touahni
  Information.2025; 16(6): 480.     CrossRef
• Concurrent high-grade appendiceal mucinous neoplasm and adenocarcinoma: a unique case report and literature review
  Mohammed N AlAli, Jawad S Alnajjar, Mohamed S Essa, Arwa F Alrasheed, Ruba M Alzuhairi, Nouf A Alromaih, Sadiq M Amer, Mohammed Sbaih
  Journal of Surgical Case Reports.2025;[Epub]     CrossRef
• Infrared window properties of AB₂C₄ (A=Zn; B In, Ga; C Te, Se) materials via machine learning and density functional theory
  Changcheng Chen, Chunlian Xiong, Xinhui Zhang, Chunling Zhang, Yue Cheng, Weijun Wang, Wenkang Yu, Xunzhe Zhang, Jinkang Yu, Zhengjun Wang, Xiaoning Guan, Jiangzhou Xie, Yaxin Xu, Gang Liu, Pengfei Lu
  Journal of Alloys and Compounds.2025; 1044: 184560.     CrossRef
• Advanced Computational Modeling and Machine Learning for Risk Stratification, Treatment Optimization, and Prognostic Forecasting in Appendiceal Neoplasms
  Jawad S. Alnajjar, Faisal A. Al-Harbi, Ahmed Khalifah Alsaif, Ghaida S. Alabdulaaly, Omar K. Aljubaili, Manal Alquaimi, Arwa F. Alrasheed, Mohammed N. AlAli, Maha A. Alghamdi, Ahmed Y. Azzam
  Healthcare.2025; 13(23): 3074.     CrossRef

This review examines the bidirectional relationship between periodontitis and systemic health conditions, offering an integrated perspective based on current evidence. It synthesizes epidemiological data, biological mechanisms, and clinical implications to support collaborative care strategies recognizing oral health as a key component of overall wellness. Periodontitis affects 7.4% to 11.2% of adults worldwide, and its prevalence increases with age. Beyond its local effects, including gingival inflammation, periodontal pocket formation, and alveolar bone loss, periodontitis is associated with various systemic conditions. Emerging evidence has established links with obesity, diabetes mellitus, cardiovascular disease, chronic kidney disease, inflammatory bowel disease, rheumatoid arthritis, respiratory diseases, adverse pregnancy outcomes, certain malignancies, neurodegenerative diseases, psychological disorders, and autoimmune conditions. These associations are mediated by 3 primary mechanisms: dysbiotic oral biofilms, chronic low-grade systemic inflammation, and the dissemination of periodontal pathogens throughout the body. The pathophysiology involves elevated levels of pro-inflammatory cytokines (including interleukin 6, tumor necrosis factor alpha, and C-reactive protein), impaired immune function, oxidative stress, and molecular mimicry. Periodontal pathogens, particularly Porphyromonas gingivalis, are crucial in initiating and sustaining systemic inflammatory responses. Treatment of periodontitis has demonstrated measurable improvements in numerous systemic conditions, emphasizing the clinical significance of these interconnections. Periodontitis should be understood as more than just a localized oral disease; it significantly contributes to the overall systemic inflammatory burden, with implications for general health. An integrated, multidisciplinary approach to prevention, early detection, and comprehensive treatment is vital for optimal patient outcomes. Healthcare providers should acknowledge oral health as an essential element of systemic well-being.

Citations

• Cannabinoid Signaling and Autophagy in Oral Disease: Molecular Mechanisms and Therapeutic Implications
  Undral Munkhsaikhan, Md Ataur Rahman, Alivia Shasteen, Karima Ait-Aissa, Amal M. Sahyoun, Rajat Das Gupta, Modar Kassan, Ehsanul Hoque Apu, Ammaar H. Abidi
  International Journal of Molecular Sciences.2026; 27(1): 525.     CrossRef
• Oral health status and esophageal diseases: Univariate and multivariate Mendelian randomization analyses
  Ziyuan Xu, Xi Zou, Shenlin Liu
  Medicine.2026; 105(7): e47590.     CrossRef
• Periodontitis promotes intestinal inflammation through gut microbiota–mediated suppression of GPR109A
  Xinyue Wang, Zhonghan Xu, Yujie Yao, Hui Jia, Meng Du, Shuangzheng Wang, Fuhua Yan, Lili Li
  Frontiers in Cellular and Infection Microbiology.2026;[Epub]     CrossRef
• Oral and cardiometabolic health through the lens of biobanks and large-scale epidemiologic research
  Nada Tawfig Hashim, Rasha Babiker, Vivek Padmanabhan, Md Sofiqul Islam, Sivan Padma Priya, Nallan C. S. K. Chaitanya, Riham Mohammed, Shahistha Parveen Dasnadi, Ayman Ahmed, Bakri Gobara Gismalla, Muhammed Mustahsen Rahman
  Frontiers in Oral Health.2026;[Epub]     CrossRef
• In-situ gel systems for periodontitis: advances in localized drug delivery and regenerative therapy
  Afrasim Moin, Sateesha Shivally Boregowda, Ranjitha S, Gokul Chowdappa, Rajamma Abburu Jayaramu, Shivanand K
  Journal of Drug Targeting.2026; 34(9): 1640.     CrossRef
• PD‐L1+ Senescent Macrophages Reshape the Immune Microenvironment of Periodontitis via PI3K/AKT Pathway Activation
  Shanshan Ren, Haokun Mo, Lulu Chen, Wei Liao, Yao Yang, Luyao Ran, Ai Tian
  Oral Diseases.2026;[Epub]     CrossRef
• Artificial intelligence and immersive digital technologies in periodontal education: a systematic review
  Yiping Wei, Ying Li, Wenjie Hu, Jun Kang, Ziyao Han, Min Zhen, Cui Wang
  Frontiers in Oral Health.2026;[Epub]     CrossRef
• The Promise and Challenges of Mesenchymal Stem Cell-Derived Extracellular Vesicles in Periodontal Disease
  Jonghoe Byun
  Pathogens.2026; 15(4): 420.     CrossRef
• In Vitro Inhibition of Pathogens by Polyols: Optical Density-Based Screening and Implications for the Oral–Systemic Axis
  Mark Cannon, Bradley S. Stevenson
  Microorganisms.2026; 14(4): 884.     CrossRef
• Dental Interventions for Stroke Prevention—A Narrative Review of Literature
  Anita Siewko, Szymon J. Jurga, Maksymilian A. Brzezicki, Izabela Wojtasz, Anita Nowak, Gabriel Slonina, Iwona Towpik, Lukasz Dzieciuchowicz, Radoslaw Kazmierski
  Neurology and Clinical Neuroscience.2026; 14(5): 345.     CrossRef
• Molecular Insights into Oral Manifestations in Sjögren’s Disease
  Konstantina Xanthopoulou, Anna Siatra, Konstantinos I. Tosios, Eleni-Marina Kalogirou
  International Journal of Molecular Sciences.2026; 27(9): 4144.     CrossRef
• Multifunctional CHB@CM hydrogel for periodontal therapy attenuates the progression of periodontitis-aggravated chronic kidney disease by regulating the TLR2/4/NF-κB signaling pathway
  Yuanxiang Liu, Lei Chen, Zhipeng Li, Ruoxuan Huang, Chengwu Liu, Rui Guo, Runheng Liu, Chuan Zou
  Chemical Engineering Journal.2026; 539: 176990.     CrossRef
• The Biochemical Impact of Lifestyle, Diet, Stress, and Obesity on Oral Health in University Students: A Narrative Review
  Anjana Goyal, Aahana Rai, Khushi Singh, Ankita Bhardwaj, Shrishti Aggarwal, Priyanka Kunwar, Alishba Z. Khan
  Journal of International Oral Health.2026; 18(3): 185.     CrossRef
• Multi-Omics Integration Reveals the Genetic Mechanisms of Periodontitis and Predicts Therapeutic Drugs
  Ruoyan Cao, Shuangshuang Xu, Junhao Xiang, Beilei Qu, Zichao Zhuang, Tengda Chu
  International Dental Journal.2026; 76(4): 109678.     CrossRef
• The Oral-Systemic Axis: A Narrative Review of Inflammatory Mechanisms Linking Periodontitis to Cardiovascular Disease, Diabetes and Adverse Pregnancy Outcomes
  Andrea Toledo Lopez, Joanna Guzman, Yemille Zarruk, Aliany Moreno Pelaez, Adriana Rey, Ivonne Acosta Guarirapa
  Journal of Clinical Medical Research.2026; 7(2): 1.     CrossRef
• Metabolic Risk Signals in Periodontal Clinics: Cross-Sectional Associations of PISA with hs-CRP and HOMA-IR
  Maria-Alexandra Martu, Ioana Martu, Sorina Mihaela Solomon, Ionut Luchian, Silvia Martu, Liliana Pasarin, Diana-Maria Anton, Monica Mihaela Scutariu, Cezar-Ilie Foia, Elena-Odette Luca, Irina-Georgeta Sufaru
  Diagnostics.2026; 16(13): 1972.     CrossRef
• Periodontitis and MASLD: a narrative review of the direct oral-hepatic pathway
  Hai He, Zishuai Chen, Hengxiang Liu, Xiaohua Zhang, Zhiqiang Li, Tianzhu Song, Zifan Wang
  Frontiers in Cellular and Infection Microbiology.2026;[Epub]     CrossRef
• Oral and dental health as a predictor of low birth weight; a diagnostic cross-sectional study
  Yalda Azimzadeh Moghaddam
  Journal of Preventive Epidemiology.2026; 11(2): e39309.     CrossRef
• Acetyl-CoA metabolism in skeletal biology and bone disorders: From mechanisms to therapeutic implications
  Qianyu Yang, Runlin Shi, Chenyang Zhang, Wei Sun, Guangjin Chen
  Pharmacological Research.2026; 231: 108346.     CrossRef
• Periodontal medicine at the crossroads of education and practice: insights from a student survey
  R Arvinth Vishnu, P. Sujitha, J. Vinodhini, S. Kumar, M.Z.U. Huqh, A. Pruksametanan, T. Noor, S. Selvaraj
  Endodontics Today.2026; 24(3): 491.     CrossRef
• Ulcerative colitis-driven gut dysbiosis exacerbates periodontal bone loss through the gut–oral axis /Th17/Treg imbalance
  Yue Huang, Yu Hu, Yifei Zhao, Yuerui Li, Yunkun Liu, Miao Wang, Qian Wang, Huan Hu
  npj Biofilms and Microbiomes.2026;[Epub]     CrossRef
• Overlapping expression characteristics of ubiquitination-related genes in periodontitis and renal cell carcinoma: transcriptomic analysis and experimental validation
  Xiaofeng Guo, Peiyao Liu, Lijuan Zhang, Yuxin Zhang, Wenbo Zhai, Weilun Zhang, Chengzhi Zhang, Dong Liu, Jing Shi, Lei Pang
  BMC Oral Health.2026;[Epub]     CrossRef
• The convergence of nanotechnology and biomarker science: paving the way for precision periodontics
  Ridhi Kuhar, Kashish Madaan, Ishwerpreet Kaur Jawanda, Seema Kumari
  Periodontal and Implant Research.2026;[Epub]     CrossRef
• Functional mechanisms, current applications, and future perspectives of dairy products in oral health
  Miao Wang, Qian Wang, Bin Chen, Jianguo Liu
  Frontiers in Public Health.2026;[Epub]     CrossRef
• Salivary Extracellular Vesicle Proteome as a Molecular Bridge Between Periodontitis and Neurodegeneration: Mechanisms, Biomarkers, and Therapeutic Opportunities
  Md. Azhar, Rishabha Malviya, Vandana, Phool Chandra, Sathvik Belagodu Sridhar, Javedh Shareef, Tarun Wadhwa, Daniel Arockiam
  ASN Neuro.2026;[Epub]     CrossRef
• Recent advances in pulmonary tuberculosis, the application of deep learning to medical topics, and highlights from this issue of Ewha Medical Journal
  Hae-Sun Chung
  Ewha Medical Journal.2025; 48(2): e16.     CrossRef
• The Correlations Between Diabetes Mellitus and Oro-Maxillofacial Disorders: A Statistical Perspective
  Ionut Catalin Botezatu, Mihaela Salceanu, Ana Emanuela Botez, Cristina Daniela Dimitriu, Oana Elena Ciurcanu, Claudiu Topoliceanu, Elena-Carmen Cotrutz, Maria-Alexandra Martu
  Dentistry Journal.2025; 13(8): 373.     CrossRef
• Association between periodontal disease and Alzheimer's disease: a scoping review
  Xiaocui Zhang, Xin Huang, Mengdie Chang
  Frontiers in Aging Neuroscience.2025;[Epub]     CrossRef
• Salivary Investigation of the Complex Relationship between NLRP3 Inflammasome, Leptin and Total Antioxidant Capacity in the Context of Periodontal Disease
  Iulia I. Stanescu-Spinu, Ilinca Radu , Tudor C. Spinu , Daniela Miricescu , Anca S. Dumitriu , Brandusa F. Mocanu , Silviu C. Badoiu , Anca M. Coricovac , Andreea C. Didilescu
  Romanian Journal of Military Medicine.2025; 128(6): 536.     CrossRef
• Four-Year Longitudinal Epidemiological Study on the Association Between a Multi-Item Saliva Testing System and Oral and Gut Microbiota
  Satoshi Sato, Daisuke Chinda, Keita Mikami, Masakazu Tobinai, Nao Ishidoya, Keisuke Furusawa, Kaede Miyashiro, Kenta Yoshida, Chikara Iino, Kaori Sawada, Tatsuya Mikami, Shigeyuki Nakaji, Koichi Murashita, Hirotake Sakuraba
  Microorganisms.2025; 13(11): 2483.     CrossRef
• Oral microbiota in hemodialysis patients; a narrative review on recent ideas
  Mayyadah Hameed Rashid, Haifaa Abdulameer Radhi, Aseel Abdulameer Radhi
  Journal of Renal Injury Prevention.2025; 14(4): e38685.     CrossRef

Purpose
This study aimed to identify the types of human rights violations and the associated psychological trauma experienced by North Korean defectors. It also examined the impact of trauma on the defectors’ interpersonal relationships, employment, and overall quality of life, while evaluating existing psychological support policies to suggest potential improvements.
Methods
A multidisciplinary research team conducted an observational survey and in-depth interviews with approximately 300 North Korean defectors residing in South Korea from June to September 2017. Standardized measurement tools, including the Post-Traumatic Stress Disorder (PTSD) Checklist (PCL-5), Patient Health Questionnaire-9 (PHQ-9), Generalized Anxiety Disorder Scale-7 (GAD-7), and Short Form-8 Health Survey (SF-8), were employed. Statistical analyses consisted of frequency analysis, cross-tabulation, factor analysis, and logistic regression.
Results
The findings revealed a high prevalence of human rights violations, such as public executions (82%), forced self-criticism (82.3%), and severe starvation or illness (62.7%). Additionally, there were elevated rates of PTSD (56%), severe depression (28.3%), anxiety (25%), and insomnia (23.3%). Defectors who resided in China before entering South Korea reported significantly worse mental health outcomes and a lower quality of life. Moreover, trauma was strongly and negatively correlated with social adjustment, interpersonal relationships, employment stability, and overall well-being.
Conclusion
An urgent revision of existing policies is needed to incorporate specialized, trauma-informed care infrastructures within medical institutions. Furthermore, broad societal education to reduce stigma and enhance integration efforts is essential to effectively support the psychological well-being and social integration of North Korean defectors.

Citations

• Recent advances in pulmonary tuberculosis, the application of deep learning to medical topics, and highlights from this issue of Ewha Medical Journal
  Hae-Sun Chung
  Ewha Medical Journal.2025; 48(2): e16.     CrossRef

Heart failure (HF) represents a significant global health burden characterized by high morbidity, mortality, and healthcare utilization. Traditional in-person care models face considerable limitations in providing continuous monitoring and timely interventions for HF patients. Telemedicine—defined as the remote delivery of healthcare via information and communication technologies—has emerged as a promising solution to these challenges. This review examines the evolution, current applications, clinical evidence, limitations, and future directions of telemedicine in HF management. Evidence from randomized controlled trials and meta-analyses indicates that telemedicine interventions can improve guideline-directed medical therapy implementation, reduce hospitalization rates, improve patient engagement, and potentially decrease mortality among HF patients. Remote monitoring systems that track vital signs, symptoms, and medication adherence allow for the early detection of clinical deterioration, enabling timely interventions before decompensation occurs. Despite these benefits, telemedicine implementation faces several barriers, including technological limitations, reimbursement issues, digital literacy gaps, and challenges in integrating workflows. Future directions include developing standardized guidelines, designing patient-centered technologies, and establishing hybrid care models that combine virtual and in-person approaches. As healthcare systems worldwide seek more efficient and effective strategies for managing the growing population of individuals with HF, telemedicine offers a solution that may significantly improve patient outcomes and quality of life.

Citations

• Telemonitoring in Heart Failure: A Review of Monitoring Techniques and Clinical Outcomes
  Sara Szukalska, Marta Karczewska, Kamil Wróblewski, Karolina Lichwala, Lukasz Siwek, Angelika Samborska, Barbara Balajewicz, Paulina Wróblewska
  Cureus.2026;[Epub]     CrossRef
• Analyzing Vital Sign Variability in Remote Monitoring as a Predictor of 31-Day Heart Failure Readmission: A Retrospective Cohort Study
  Adeel Arif, Anshul Kumar, Michelle Elsener, Kyle Egan, Farrukh N. Jafri
  Telemedicine and e-Health.2026; 32(7): 701.     CrossRef
• Digital Technologies in Cardiology: From Continuous Monitoring to Predictive Medicine
  Simona Steliana Tudor, Ionela Daniela Ferțu , Caterina Nela Dumitru , Bogdan-Viorel Vîlceleanu , Alexandru Mihai Popescu, Silviu Ionel Dumitrescu, Alice Elena Munteanu
  Romanian Journal of Military Medicine.2026; 129(3): 285.     CrossRef
• A Pragmatic Low-Cost Digital Support Pathway for GDMT Optimization in Ambulatory HFrEF: An Exploratory 6-Month Matched Cohort Study
  Miruna Popovici, Nilima Rajpal Kundnani, Marius Papurica, Anca-Raluca Dinu, Victor Buciu, Ovidiu Horea Bedreag, Elena Sîrbu, Dorel Sandesc, Simona Ruxanda Dragan
  Healthcare.2026; 14(12): 1675.     CrossRef
• Recent advances in pulmonary tuberculosis, the application of deep learning to medical topics, and highlights from this issue of Ewha Medical Journal
  Hae-Sun Chung
  Ewha Medical Journal.2025; 48(2): e16.     CrossRef
• Impact of Telemedicine Technologies on Treatment Adherence in Patients with Chronic Heart Failure: a Systematic Review and Meta-Analysis
  A. A. Garanin, O. A. Rubanenko, Yu. A. Trusov, D. V. Senyushkin, A. V. Kolsanov
  Kardiologiia.2025; 65(10): 27.     CrossRef
• Telehealth Impact on Patient Outcome in Heart Failure Patients: A Narrative Synthesis Review
  Angela Hatton, Jo-Anne Harvey, Nutan Maurya, Dhanya Varghese, Josephine Sau Fan Chow
  Journal of Service Science and Management.2025; 18(06): 411.     CrossRef

Purpose
This study aimed to investigate whether proteins present in the molting membranes of third-stage (L3) Anisakis larvae could serve as potential risk factors for allergic reactions.
Methods
Third-stage larvae (L3) of Anisakis spp. were primarily collected from mackerels and cultured in vitro to yield both molting membranes and fourth-stage (L4) larvae. Major soluble proteins in the molting membranes were identified using SDS-PAGE (sodium dodecyl sulfate–polyacrylamide gel electrophoresis). Crude antigens extracted from L3, L4, and the molting membranes were subsequently evaluated by western blotting using sera from Anisakis-infected rabbits and patients with eosinophilia.
Results
Antigens derived from the molting membranes reacted with sera from Anisakis-infected rabbits as well as with sera from 7 patients with eosinophilia of unknown origin. These findings suggest that unidentified proteins in the molting membranes of Anisakis L3 may contribute to early allergic reactions, particularly in patients sensitized by specific molecular components.
Conclusion
Our results indicate that proteins present in the molting membranes of third-stage Anisakis spp. larvae may be associated with allergic responses. Further studies are required to confirm the correlation between these membranes and Anisakis-induced allergies.

Citations

• Persistent asymptomatic eosinophilia after raw seafood exposure with normal IgE: a case report
  Wen He, Juzhang Li, Jianfeng Zhang, Qiaozhen Wu
  Frontiers in Immunology.2026;[Epub]     CrossRef
• Recent advances in pulmonary tuberculosis, the application of deep learning to medical topics, and highlights from this issue of Ewha Medical Journal
  Hae-Sun Chung
  Ewha Medical Journal.2025; 48(2): e16.     CrossRef

Recent advancements in tuberculosis treatment research emphasize innovative strategies that enhance treatment efficacy, reduce adverse effects, and adhere to patient-centered care principles. As tuberculosis remains a significant global health challenge, integrating new and repurposed drugs presents promising avenues for more effective management, particularly against drug-resistant strains. Recently, the spectrum concept in tuberculosis infection and disease has emerged, underscoring the need for research aimed at developing treatment plans specific to each stage of the disease. The application of precision medicine to tailor treatments to individual patient profiles is crucial for addressing the diverse and complex nature of tuberculosis infections. Such personalized approaches are essential for optimizing therapeutic outcomes and improving patient adherence—both of which are vital for global tuberculosis eradication efforts. The role of tuberculosis cohort studies is also emphasized, as they provide critical data to support the development of these tailored treatment plans and deepen our understanding of disease progression and treatment response. To advance these innovations, a robust tuberculosis policy framework is required to foster the integration of research findings into practice, ensuring that treatment innovations are effectively translated into improved health outcomes worldwide.

Citations

• Protocol of a Nationwide Observational Cohort Study for Long-Term Impacts on Lung Health and Life after Tuberculosis in Korea (LIFE-TB)
  Chiwook Chung, Jinsoo Min, Doosoo Jeon, Yong-Soo Kwon, Jeongha Mok, Hyung Woo Kim, Youngmok Park, Young Ae Kang
  Tuberculosis and Respiratory Diseases.2026; 89(1): 86.     CrossRef
• Research hotspots, intellectual structures, and emerging themes in national tuberculosis program studies: a multi-dimensional analysis of global trends and directions
  Siddig Ibrahim Abdelwahab, Manal Mohamed Elhassan Taha, Hazem Mathkour, Edrous Alamer, Saleh Mohammad Abdullah, Saeed Alshahrani, Nizar A. Khamjan, Abdullah Farasani, Ahmed S. Alamer, Jobran M. Moshi, Khaled A. Sahli, Mohammed Jeraiby, Marwa Qadri, Abdulw
  Journal of Public Health.2026;[Epub]     CrossRef
• Post-tuberculosis Health: A Holistic Perspective on Multisystem Sequelae and Long-Term Wellbeing
  Jinsoo Min, Yoolwon Jeong, Hyung Woo Kim, Hongjo Choi, Hojoon Sohn, Marc Lipman, Ju Sang Kim
  Tuberculosis and Respiratory Diseases.2026; 89(2): 202.     CrossRef
• Incidence and Predictors of Tuberculosis Among Adults Living With HIV/AIDS on Antiretroviral Therapy in Central Gondar Zone, Northwest Ethiopia: A Multicenter Retrospective Follow-Up Study
  Wabiw Addis, Adugnaw Zeleke, Solomon Gedlu Nigatu, Jember Ayelgne Beyene
  Journal of the International Association of Providers of AIDS Care (JIAPAC).2026;[Epub]     CrossRef
• Recent advances in pulmonary tuberculosis, the application of deep learning to medical topics, and highlights from this issue of Ewha Medical Journal
  Hae-Sun Chung
  Ewha Medical Journal.2025; 48(2): e16.     CrossRef