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Artificial intelligence, which has been applied as an innovative technology in multiple fields of healthcare, analyzes large amounts of data to assist in disease prediction, prevention, and diagnosis, as well as in patient monitoring. In obstetrics, artificial intelligence has been actively applied and integrated into our daily medical practice. This review provides an overview of artificial intelligence systems currently used for obstetric diagnostic purposes, such as fetal cardiotocography, ultrasonography, and magnetic resonance imaging, and demonstrates how these methods have been developed and clinically applied.

In our previous study, preterm birth after pre-pregnancy partial cervical excision demonstrated abnormal wound healing with an increased muscle-to-collagen ratio at the proximal site of the cervix. We aimed to investigate whether treatment with plasma fibronectin affects the differentiation of mouse uterine cervical fibroblasts into myofibroblasts and mediates a reduction in the incidence of preterm delivery in mice. We examined the gestational period after the administration of lipopolysaccharide in mice subjected to cervical excision and subsequently treated with fibronectin or vehicle. We confirmed that the gestational period was longer in the plasma fibronectin-treated group than in the vehicle-treated control group. In addition, the ratio of α-smooth muscle actin to collagen type I alpha 1 increased after LPS injection in mice subjected to cervical excision, and this increase was suppressed by plasma fibronectin treatment. Plasma fibronectin may serve as a potential therapeutic agent to prevent preterm delivery by inhibiting myogenic differentiation in the cervix.

We aimed to investigate the association between working from home (WFH), depression/anxiety, and work-family conflict (WFC) among Korean workers during the COVID-19 pandemic.We surveyed a total of 1,074 workers online. Depression and anxiety were measured using the Centre for Epidemiologic Studies Depression Scale (CES-D) and Beck Anxiety Inventory (BAI). Mediating effects of WFC on the relationship between WFH and depression/anxiety were examined.The WFH group had higher depression and anxiety scores than the daily commuting group. As WFC increased, the CES-D and BAI scores also increased. A possible mediating effect of WFC on the relationship between WFH and high CES-D and BAI scores was found.We observed a significant difference in depression/anxiety between WFH and daily commute workers, which was mediated by WFC, especially for young, child-growing, and precarious workers.

Objective The aim of this study was to evaluate the changes in twin pregnancy outcomes between 2007 and 2016 in a Korean population.Methods The data for this nationwide population-based study was obtained from the national birth registry of the Korean National Statistical Office and the Health Insurance Review & Assessment Service of Korea. Women with twin pregnancies who gave birth between 2007 and 2016 were included.Results From 2007 to 2016, the rate of twin pregnancies increased (1.37% vs. 1.91%, respectively, P

This study aimed to analyze the reliability and validity of the Vancouver Scar Scale (VSS) and the Withey score after syndactyly release. Over a 3-year period, 13 patients who underwent syndactyly release were evaluated. The mean age at the time of syndactyly release was 12 months (range, 8-18 months), and the mean follow-up period was 29 months (range, 17-52 months). We obtained hand photographs and finger motion videos and collected the satisfaction scores for hand function and cosmesis. Three clinicians evaluated the hand photographs and finger motion video of each patient twice using the VSS and the Withey score. The interobserver and intraobserver reliabilities of the VSS and Withey score were determined using intraclass correlation coefficients (ICCs). The validity of the VSS and Withey score was determined using Spearman's correlation test with the functional and cosmetic satisfaction score. The ICCs for the interobserver reliability of VSS were 0.31 and 0.39 for each measurement, and ICCs for the intraobserver reliability of VSS were 0.46, 0.51, and 0.54 for each observer. The ICCs for the interobserver reliability of the Withey score were 0.74 and 0.70, and the ICCs for the intraobserver reliability of the Withey score were 0.91, 0.74, and 0.96. The Withey score was significantly correlated with the satisfaction score for hand function and hand cosmesis, but the VSS was not. The VSS had poor interobserver reliability and fair intraobserver reliability, whereas the Withey score had good interobserver reliability and excellent intraobserver reliability based on photographic evaluation after syndactyly release.

Given the field's interdisciplinary nature, regional scientists come with a wide spectrum of backgrounds. In this paper, we study the contributions to regional science made by scholars from Japan. First, we briefly examine how Japanese regional scientists came to develop a keen sense towards urban problems. Second, we identify the most influential authors and papers via a citation analysis. The results indicate that scholarly outputs in regional science are reaching a wider audience beyond scientists, while maintaining the order of impact among them. Lastly, we focus on the new economic geography where Japanese scholars have made a significant contribution. Dada la naturaleza interdisciplinaria de este campo, los cientificos regionales cuentan con un espectro diverso de experiencia. En este articulo se estudian las contribuciones a la ciencia regional hecha por academicos de Japon. En primer lugar, se examina brevemente como los cientificos regionales japoneses han llegado a desarrollar una agudeza hacia los problemas urbanos. En segundo lugar, se identifican los autores y articulos mas influyentes por medio de un analisis de citas bibliograficas. Los resultados indican que los resultados academicos de la ciencia regional estan llegando a un publico mas amplio que el de los cientificos, manteniendo al mismo tiempo el orden de impacto entre ellos. Por ultimo, el articulo se centra en la Nueva Geografia Economica, a la que los academicos japoneses han hecho contribuciones importantes. この地域科学という研究分野は学際的な性質があるため、研究者のバックグラウンドは広範にわたる。本稿では、日本の研究者による地域科学への寄与を検討する。はじめに、日本の地域科学者が都市問題に対して鋭い感覚を持つようになった経緯を概観する。次に、引用分析により最も影響力のある研究者と論文を特定する。この結果は、地域科学における学術的成果が、科学者間の影響の秩序を維持しながら、科学者だけでなく他の分野の読者も獲得していることを示している。最後に、日本の研究者が大きく寄与してきた新しい経済地理学に焦点を当てる。

Resection of the underdeveloped digit and reconstruction of the robust digit is the standard treatment option for preaxial polydactyly of the hand. As an underdeveloped digit, the radial component is usually excised, whereas the ulnar component excision is rarely needed. This study aimed to evaluate the surgical results of ulnar component excision and radial component reconstruction in patients with preaxial polydactyly of the hand.We retrospectively reviewed the medical records and radiographs of 809 patients (861 thumbs) who underwent surgery for preaxial polydactyly of the hand from November 2006 to June 2018. Among these, 22 (2.6%) thumbs in which the ulnar component was more hypoplastic or had more severe deformities than the radial component were treated with ulnar component excision and radial component reconstruction. The mean follow-up duration was 49 months (range, 12-142 months). We evaluated the Japanese Society for Surgery of the Hand scores and whether the patients were satisfied with the thumb function and appearance at the final follow-up. We also recorded any complications, such as reoperation.The mean Japanese Society for Surgery of the Hand score was 12.8 (range, 5-17). Six patients had poor results, 7 had fair results, and 2 had good results; however, none of the patients had an excellent result. Satisfaction with thumb function and appearance was reported in 11 (50%) and 6 (27%) cases, respectively. Thirteen of 22 (59.1%) cases involved reoperations, and the most common reason for reoperation was interphalangeal joint deviation of the remaining thumb.Ulnar component excision and radial component reconstruction are rare operative choices in preaxial polydactyly of the hand. Surgeons and patients should be aware that a considerable number of patients treated with this method required reoperations and had low clinical outcome scores.Prognostic IV.

OBJECTIVES This study aimed to investigate the clinico-radiological factors of related future surgical treatment in patients with pediatric flexible flatfoot (FFF) who first visited the orthopedic clinic before the age of 10 years. METHODS Sixty-five patients diagnosed with moderate/severe idiopathic FFF deformity between the ages of 2-10 years were included. We developed prognostic models for the risk of the surgery during the follow-up period. RESULTS Twenty (30.8%) patients required surgical treatment, and all of them underwent calcaneal lengthening osteotomy. Among them, 7 (10.8%) patients required concomitant Achilles-lengthening surgery. Unilateral involvement, older age, smaller calcaneal pitch angle, and higher talo-first metatarsal malalignment were considered high-risk factors for pediatric FFF surgery. Prognostic models identified three prognostic risk groups based on those factors, and survival curves revealed significant differences among the groups. CONCLUSIONS Our prognostic models help predict the failure risk of conservative management of pediatric idiopathic FFF. LEVEL OF EVIDENCE Level III, prognostic study.

Background: The patient acceptable symptom state (PASS) has emerged as a metric for evaluating patient satisfaction after treatment. There is little research on the relationship between sports activity and PASS values after arthroscopic rotator cuff repair (ARCR). Purpose: To (1) introduce the sports activity available state (SAAS) as an indicator of whether sports activities are possible based on patient symptoms after ARCR, (2) investigate the correlation between the SAAS and PASS, (3) predict the SAAS using derived PASS values, and (4) identify factors for achieving the PASS and SAAS. Study Design: Case-control study; Level of evidence, 3. Methods: Included were 201 patients who underwent ARCR between January 2015 and December 2016. At a mean follow-up of 38.7 ± 7.0 months, anchor questions were used to classify patients as SAAS+ (sports group) or SAAS– (nonsports group) and derive the PASS values for the pain visual analog scale (pVAS), American Shoulder and Elbow Surgeons (ASES), and Single Assessment Numeric Evaluation (SANE). The authors analyzed the correlation and difference between PASS and SAAS acquisition, and univariate and multivariate logistic regression analyses were performed to determine factors for PASS and SAAS achievement. Results: The final PASS values for the pVAS, ASES, and SANE were 0.5, 93.5, and 82.5, respectively. A significant correlation existed between PASS and SAAS acquisition (phi correlation coefficient, 0.647; P < .001). Sensitivity and specificity were >0.7 for all outcome scores when predicting SAAS using PASS values. A higher preoperative ASES score was significantly associated with achieving both the SAAS (OR, 1.032 [95% CI, 1.005-1.059]; P = .018) and PASS (OR, 2.556 [95% CI, 1.753-3.726]; P < .001). Diabetes (OR, 0.348 [95% CI, 0.130-0.931], P = .036) and a large to massive tear (OR, 0.378 [95% CI, 0.162-0.884]; P = .025) were significantly negatively associated with achieving the SAAS. Conclusion: The authors found the SAAS to be significantly correlated with the PASS. Also, SAAS was able to be predicted using the PASS value. Patients with higher preoperative ASES scores had higher odds of achieving both the PASS and SAAS, and patients with diabetes and those with large to massive tears had lower odds of achieving the SAAS.

Although there is a high rate of pregnant immigrant women in Korea, little is known regarding their pregnancy outcomes. The aim of this study was to evaluate the pregnancy outcomes of immigrant women in Korea. Data for all pregnant women who gave birth between January 1, 2007 and December 31, 2016 were obtained using the Health Insurance Review and Assessment Service Database. Pregnant women were divided into two groups: Korean and immigrant women. The main outcome measures were adverse pregnancy outcomes including gestational diabetes of mellitus, preeclampsia, cesarean section, placental abrnomalities, and postpartum hemorrhage. The odds of gestational diabetes mellitus, preeclampsia, cesarean section, placental previa, placental abruptio, and postpartum hemorrhage was compared between the two groups. Among 4,439,778 pregnant women who gave birth during the study period, 168,940 (3.8%) were immigrant women. The odds of gestational diabetes mellitus (adjusted OR: 1.24; 95% CI: 1.21, 1.28), and cesarean section (adjusted OR: 1.26; 95% CI: 1.25–1.28)were higher in immigrant women than in Korean women, but the odds of preeclampsia (adjusted OR: 0.84; 95% CI: 0.81–0.86) and postpartum hemorrhage (adjusted OR 0.96, 95% CI 0.94–0.97) was lower in immigrant women than in Korean women. Immigrant women had different pregnancy outcomes. Pregnancy and postpartum management that reflects these characteristics will be necessary for immigrant women.

Background/objective A stem sitting proud (SP) or that above the final rasp position remains in some patients who undergo hip replacement using proximally coated tapered wedge stems. Surgeons may face challenges providing the best fit because of unpredictable SP of proximally coated tapered wedge stems. Zimmer Inc. introduced a new rasp to solve this issue but the clinical results of this rasp have not yet been published. Therefore, our aim was to address the following: (1) What is the stem SP incidence using a proximally coated cementless tapered wedge stem? (2) Does the new rasp system (0-mm rasp) improve seating height? and (3) What are the risk factors of stem SP? Methods We performed a retrospective study with 338 hips, in which Tri-Lock Bone Preservation Stem (BPS) was used in 181 hips and M/L Taper stem was used in 157 hips (82 hips before and 75 hips after 0-mm rasp use). A positive stem SP was defined as a stem proud height of >2 mm. We analysed and compared SP incidence in two stems and M/L Taper stems before and after the 0-mm rasp use. Results An incidence of stem SP was 13% in the Tri-Lock BPS and 15% in the M/L Taper stem before the 0-mm rasp use. Stem SP incidence in the M/L Taper stem substantially decreased after the 0-mm rasp use (4%). The significant risk factor for stem SP was use of the high offset option in Tri-Lock BPS. Conclusion The proximally coated tapered wedge stems present potential problems related to stem SP. The new rasp of the M/L Taper stem showed significant improvement in initial seating height. The translational potential of this article This study was conducted to understand “stem sitting proud” in proximally coated tapered wedge stem as one of the most popular designs nowadays in adult hip joint arthroplasty field. In this study, we aimed to address the incidence of stem proud, investigated the risk factor and introduced the effect of new rasp system which improve stem seating height.

Background This study introduced machine learning approaches to predict newborn’s body mass index (BMI) based on ultrasound measures and maternal/delivery information. Methods Data came from 3159 obstetric patients and their newborns enrolled in a multi-center retrospective study. Variable importance, the effect of a variable on model performance, was used for identifying major predictors of newborn’s BMI among ultrasound measures and maternal/delivery information. The ultrasound measures included biparietal diameter (BPD), abdominal circumference (AC) and estimated fetal weight (EFW) taken three times during the week 21 - week 35 of gestational age and once in the week 36 or later. Results Based on variable importance from the random forest, major predictors of newborn’s BMI were the first AC and EFW in the week 36 or later, gestational age at delivery, the first AC during the week 21 - the week 35, maternal BMI at delivery, maternal weight at delivery and the first BPD in the week 36 or later. For predicting newborn’s BMI, linear regression (2.0744) and the random forest (2.1610) were better than artificial neural networks with one, two and three hidden layers (150.7100, 154.7198 and 152.5843, respectively) in the mean squared error. Conclusions This is the first machine-learning study with 64 clinical and sonographic markers for the prediction of newborns’ BMI. The week 36 or later is the most effective period for taking the ultrasound measures and AC and EFW are the best predictors of newborn’s BMI alongside gestational age at delivery and maternal BMI at delivery.

Background Non-regular workers are steadily increasing on account of improving corporate productivity. They are classified as non-permanent, part-time, or non-typical workers. Non-regular work has a negative impact on workers' physical and mental health. This study analyzed the relationship between non-permanent, part-time and non-typical work and insomnia among Korean wage workers, and investigated the differences and interactions between different work patterns. Methods The Fifth Korean Working Conditions Survey was used in this study. Non-regular work patterns were classified into 7 types: type 1, sole non-permanent; type 2, sole part-time; type 3, sole non-typical; type 4, part-time-non-typical; type 5, non-permanent-non-typical; type 6, non-permanent-part-time; type 7, all inclusive. Insomnia was measured on a scale from "normal sleep" to "insomnia" based on the 3-item Minimal Insomnia Symptom Scale. Multiple logistic regression was used to analyze the association between non-regular work patterns and insomnia among wage workers. Results After multivariate adjustment, a significantly increased odds ratio (OR) for insomnia was found in types 1, 2, 3, 4, 5, 6, and 7 of non-regular work patterns compared to regular work patterns. After stratification for shift and night work, the OR of the group with shift and night work was higher than that of the group without shift and night work. Conclusions Insomnia was significantly associated with non-regular work patterns. This association was prominent in workers with shifts and night work. This finding suggests that proper work patterns may be needed to reduce the risk of insomnia among Korean wage workers and workers who initially had insomnia should consider these results before placement.

This study aims to evaluate the perinatal outcomes of preterm premature rupture of membrane (PPROM) with latency periods at 33 + 0&ndash, 36 + 6 weeks of gestation. This retrospective case-control study included women with singleton pregnancies who delivered at 33 + 0&ndash, 36 + 6 weeks at Korea University Ansan Hospital in South Korea between 2006&ndash, 2019. The maternal and neonatal characteristics were compared between different latency periods (expectant delivery &ge, 72 h vs. immediate delivery &lt, 72 h). Data were compared among 345 women (expectant, n = 39, immediate delivery, n = 306). There was no significant difference in maternal and neonatal morbidities between the groups, despite the younger gestational age in the expectant delivery group. Stratified by gestational weeks, the 34-week infants showed a statistically significant lower exposure to antenatal steroids (73.4% vs. 20.0%, p &lt, 0.001), while the incidence of respiratory distress syndrome (12.8%) and the use of any respiratory support (36.8%) was higher than those in the 33-week infants, without significance. Our study shows that a prolonged latency period (&ge, 72 h) did not increase maternal and neonatal morbidities, and a considerable number of preterm infants immediately delivered at 34 weeks experienced respiratory complications. Expectant management and antenatal corticosteroids should be considered in late preterm infants with PPROM.

Background This study was conducted to determine the association between work-life (WL) balance, effort-reward (ER) imbalance, and depressive mood in Korean wage workers when 2 models were considered simultaneously. Methods We analyzed 26,014 Korean workers including 13,471 men and 12,543 women from the 4th Korean Working Conditions Survey data. Multiple logistic regression was used to analyze the association between WL, ER status, and the depressive mood of Korean workers. We classified the subjects into a total of 4 groups as follows. Group 1: WL and ER status are both "balanced", group 2: WL status is "imbalanced" and ER status is "balanced", group 3: WL status is "balanced" and the ER status is "imbalanced", group 4: WL and ER status are both "imbalanced." Results We found significantly increased odds ratios (ORs) for depressive mood in groups 2, 3, and 4 compared with group 1 after adjusting for the general and occupational characteristics of the subjects in both men and women. We also found that the trend of ORs increased gradually from groups 2 to 4 compared with group 1 in both men and women; group 2: OR: 1.23 (95% confidence interval [CI]: 1.12-1.35), group 3: OR: 1.40 (95% CI: 1.27-1.55), group 4: OR: 1.99 (95% CI: 1.74-2.28) compared with group 1 in men; group 2: OR: 1.28 (95% CI: 1.15-1.42), group 3: OR: 1.45 (95% CI: 1.31-1.59), group 4: OR: 2.04 (95% CI: 1.76-2.36) compared with group 1 in women. Conclusions As a result, we found the association between imbalanced WL, ER status, and depressive mood in Korean workers using 2 models simultaneously. It is important to provide a balanced WL and ER condition to improve the mental health of workers.

The purpose of this prospective study was to investigate the changes in the circulating levels of cathepsin B and D in pregnancy. We obtained longitudinal cathepsin B and D levels in 76 healthy pregnant women in the first and third trimesters and compared these levels with 20 non-pregnant controls. The plasma levels of soluble cathepsin B and D were measured using an enzyme-linked immunosorbent assay kit. The cathepsin D concentrations in the third trimester were significantly higher than that in the first trimester (p

A method of measuring the amplitude ratios and phase differences among the same RF output signals from multiple ports at the same frequency is proposed. A power-combining module is used to couple multiple signals vectorially from the ports. In the proposed method, the amplitude ratios among the RF signals from multiple ports are calculated using the output power of the module to which only one port is connected, and using the S-parameters of the module itself. However, the phase differences among multiple ports cannot be simply represented by the differences between the output power of the module and the ideally combined power, because the impedances of all ports except measuring ports should be perfectly matched. The proposed method uses a parameter that compensates for the impedance mismatches generated at the other ports to achieve precise measurement of the phase differences among multiple ports. The measurement results using the passive component with three ports reveal that the mean errors of the proposed method are 1.26% and 2.15° in the amplitude and phase, respectively, when compared with measurements using the vector network analyzer. The standard deviations of the errors show 1.68% and 1.67° in the amplitude and phase, respectively.

Background & Aims Preeclampsia is a serious multi-systemic disorder leading to maternal and neonatal adverse outcomes. However, little is known about the early markers of this disease. The aim of this study was to investigate the association between pre-pregnancy liver function and the development of preeclampsia. Methods We enrolled 192,571 Korean women who had their first delivery between January 1, 2008, and December 31, 2014, and had undergone a national health screening examination through the National Health Insurance Corporation during 1–2 years before delivery. Results Preeclampsia developed in 3,973 (2.0%) women. The rate of development of preeclampsia was higher in women with abnormal pre-pregnancy liver enzyme levels than in those with normal liver enzyme levels before pregnancy. On multivariate analysis, women with abnormal alanine aminotransferase level before pregnancy had a 1.21-fold increased risk of developing preeclampsia than those with normal alanine aminotransferase level before pregnancy, after adjusting for age, family history of hypertension, hepatitis B virus carrier status, smoking, alcohol status, pre-pregnancy body mass index, and blood pressure. Pre-pregnancy γ-glutamyltransferase and aspartate aminotransferase levels were not associated with the risk of preeclampsia development. Conclusion Abnormal pre-pregnancy alanine aminotransferase level was associated with the development of preeclampsia in a subsequent pregnancy. Further studies are needed to evaluate whether early intervention for liver function before pregnancy can decrease the risk of preeclampsia. This article is protected by copyright. All rights reserved.