A case of vocal cord gnathostomiasis diagnosed with sectional morphologies in a histopathological specimen from a Chinese woman living in Korea

This study aimed to describe a rare case of gnathostomiasis in the vocal cord. A 54-year-old Chinese woman living in Korea visited with a chief complaint of voice change at the outpatient department of otorhinolaryngology in Hallym Sacred Heart Hospital, Hallym University on August 2, 2021. She had eaten raw conger a few weeks before the voice change developed, but her medical history and physical examinations demonstrated neither gastrointestinal symptoms nor other health problems. A round and red cystic lesion, recognized in the anterior part of the right vocal cord, was removed using forceps and scissors through laryngeal microsurgery. The histopathological specimen of the cyst revealed 3 cross-sections of a nematode larva in the lumen of the cyst wall composed of inflammatory cells and fibrotic tissues. They differ in diameter, from 190 μm to 235 μm. They showed characteristic cuticular layers with tegumental spines, somatic muscle layers, and gastrointestinal tracts such as the esophagus and intestine. Notably, intestinal sections consisted of 27-28 lining cells containing 0-4 nuclei per cell. We tentatively identified the nematode larva recovered from the vocal cord cystic lesion as the third-stage larva of Gnathostoma, probably G. nipponicum or G. hispidum, based on the sectional morphologies.

Recent Issues in Medical Journal Publishing and Editing Policies: Adoption of Artificial Intelligence, Preprints, Open Peer Review, Model Text Recycling Policies, Best Practice in Scholarly Publishing 4th Version, and Country Names in Titles

In Korea, many editors of medical journal are also publishers; therefore, they need to not only manage peer review, but also understand current trends and policies in journal publishing and editing. This article aims to highlight some of these policies with examples. First, the use of artificial intelligence tools in journal publishing has increased, including for manuscript editing and plagiarism detection. Second, preprint publications, which have not been peer-reviewed, are becoming more common. During the COVID-19 pandemic, medical journals have been more willing to accept preprints to adjust rapidly changing pandemic health issues, leading to a significant increase in their use. Third, open peer review with reviewer comments is becoming more widespread, including the mandatory publication of peer-reviewed manuscripts with comments. Fourth, model text recycling policies provide guidelines for researchers and editors on how to appropriately recycle text, for example, in the background section of the Introduction or the Methods section. Fifth, journals should take into account the recently updated 4th version of the Principles of Transparency and Best Practice in Scholarly Publishing, released in 2022. This version includes more detailed guidelines on journal websites, peer review processes, advisory boards, and author fees. Finally, it recommends that titles of human studies include country names to clarify the cultural context of the research. Each editor must decide whether to adopt these six policies for their journals. Editor-publishers of society journals are encouraged to familiarize themselves with these policies so that they can implement them in their journals as appropriate.

Cause-of-death statistics in 2020 in the Republic of Korea

Background: This study analyzed the causes of death in the Korean population in 2020.Methods: Cause-of-death data for 2020 from Statistics Korea were examined based on the Korean Standard Classification of Diseases and Causes of Death, 7th revision and the International Statistical Classification of Diseases and Related Health Problems, 10th revision.Results: In total, 304,948 deaths occurred, reflecting an increase of 9,838 (3.3%) from 2019. The crude death rate (the number of deaths per 100,000 people) was 593.9, corresponding to an increase of 19.0 (3.3%) from 2019. The 10 leading causes of death, in descending order, were malignant neoplasms, heart diseases, pneumonia, cerebrovascular diseases, intentional self-harm, diabetes mellitus, Alzheimer disease, liver diseases, hypertensive diseases, and sepsis. Cancer accounted for 27.0% of deaths. Within the category of malignant neoplasms, the top 5 leading organs of involvement were the lung, liver, colon, stomach, and pancreas. Sepsis was included in the 10 leading causes of death for the first time. Mortality due to pneumonia decreased to 43.3 (per 100,000 people) from 45.1 in 2019. The number of deaths due to severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) was 950, of which 54.5% were in people aged 80 or older.Conclusion: These changes reflect the continuing increase in deaths due to diseases of old age, including sepsis. The decrease in deaths due to pneumonia may have been due to protective measures against SARS-CoV-2. With the concomitant decrease in fertility, 2020 became the first year in which Korea’s natural total population decreased.

Journal metrics, document network, and conceptual and social structures of the Korean Journal of Anesthesiology from 2017 to July 2022: a bibliometric study

BACKGROUND

This study aimed to identify the directions of research published in the Korean Journal of Anesthesiology (KJA) and identify the main topics and journal network through a bibliometric analysis. The results can be reflected in strategies for the journal's promotion to a top-ranking journal in the anesthesiology category.

METHODS

KJA articles from January 1, 2017 to September 11, 2022 were retrieved from the Web of Science Core Collection on September 11, 2022, and analyzed using Biblioshiny. Journal metrics, the document network, the conceptual structure, and social structures were elucidated.

RESULTS

Out of 525 articles, fewer than half (48.6%) were from Korean corresponding authors. The impact factor steeply increased from 2.316 in 2019 to 5.167 in 2021. The Hirsch index of KJA was 24. A co-occurrence network of Keywords Plus showed four clusters of central keywords: surgery, management, anesthesia, and mortality. The conceptual structure map of Keywords Plus showed a main cluster of anesthesia and analgesia, while another minor cluster included intubation and induction. The co-citation network demonstrated that KJA was in the same cluster of anesthesiology journals. The collaboration network of the authors' countries showed that Korean authors collaborated mainly with researchers in the United States and Canada.

CONCLUSIONS

These results show KJA's developmental process of promotion to a top-tier journal in the anesthesiology category. Furthermore, the following strategies are suggested for journal promotion: recruitment of articles on emerging and highly citable topics; and more active collaboration of society members with researchers worldwide.

Are ChatGPT’s knowledge and interpretation ability comparable to those of medical students in Korea for taking a parasitology examination?: a descriptive study

This study aimed to compare the knowledge and interpretation ability of ChatGPT, a language model of artificial general intelligence, with those of medical students in Korea by administering a parasitology examination to both ChatGPT and medical students. The examination consisted of 79 items and was administered to ChatGPT on January 1, 2023. The examination results were analyzed in terms of ChatGPT’s overall performance score, its correct answer rate by the items’ knowledge level, and the acceptability of its explanations of the items. ChatGPT’s performance was lower than that of the medical students, and ChatGPT’s correct answer rate was not related to the items’ knowledge level. However, there was a relationship between acceptable explanations and correct answers. In conclusion, ChatGPT’s knowledge and interpretation ability for this parasitology examination were not yet comparable to those of medical students in Korea.

Statistical analysis of the cause of death in Korea in 2019

Background: This study aimed to present and analyze the causes of death in the Korean population in 2019.Methods: Based on the Korean Standard Classification of Diseases and Causes of Death and the International Statistical Classification of Diseases and Related Health Problems, 10th revision, cause-of-death data for 2019 from Statistics Korea were examined.Results: There were 295,110 total deaths, a decrease of 3,710 (-1.27%) from 2018. The crude death rate (the number of deaths per 100,000 people) was 574.8, a decrease of 7.6 (-1.3%) from 2018. The top ten causes of death, in descending order, were malignant neoplasms, heart disease, pneumonia, cerebrovascular disease, intentional self-harm, diabetes mellitus, Alzheimer disease, liver disease, chronic lower respiratory disease, and hypertension. Within the malignant neoplasm category, the top five organs affected were the lung, liver, colon, stomach, and pancreas (in the same order as in 2018). Alzheimer disease moved up from ninth to seventh on the list of leading causes of death in 2018. Among women, it ranked as the fifth leading cause of death, while pneumonia became the third leading cause of death.Conclusion: These changes reflect the increasing number of women > 65 years who are vulnerable to cognitive impairment and infectious diseases. The Korean government must urgently take preventive and therapeutic measures against dementia, especially Alzheimer disease.

Predictive factors for treatment failure in reducing alcoholic consumption by case management in alcoholics living in permanent rental apartments

Introduction

Based on the results showing that there are more alcoholics in the low-income bracket, case management (CM) for such cases was initiated in 2011. As a result, the treatment failure rate was identified between 43-44% based on the WHO criteria.

Objectives

We investigated the predictive factors for the treatment failure to maximize successful CM treatment.

Methods

Thirty-nine subjects from Sasang-gu and Saha-gu treated by four social workers using CM were included in this study. Failure was defined when the level of risk was maintained or increased as per the WHO criteria. The clinical characteristics of the subjects including their age and gender were collected.

Results

Typically, 17 (43.6%) subjects demonstrated treatment failure by the CM (TF). Compared with the subjects who were treated successfully (n=22; TS), TF maintained abstinence in shorter periods in terms of the longest abstinent period compared with TS while CM (28.24±.99 vs. 76.82±.27, p=.025). The higher population in TF did not make an effort to quit drinking compared with TS while CM (41.2% vs.13.6%, p=.051). Also, more TF stayed with their family members compared with TS (58.8% vs. 31.8%, p=.092).

Conclusions

The results showed that shorter abstinence periods and the absence of efforts initiated to quit drinking while CM, and living with family members were the predictive factors for failure in treating alcoholics by the CM. It is presumed that influencing patients to quit drinking and encouraging them to abstain for longer periods are crucial to attaining successful treatment.

Disclosure

No significant relationships.

Promotion to Top-Tier Journal and Development Strategy of the Annals of Laboratory Medicine for Strengthening its Leadership in the Medical Laboratory Technology Category: A Bibliometric Study

Background

A bibliometric analysis of the Annals of Laboratory Medicine (ALM) was performed to understand its position in the medical laboratory technology category and to suggest a developmental strategy.

Methods

Journal metrics, including the number of articles by publication type, country of authors, total citations, 2-year impact factor, country of cited authors, journals citing ALM, and Hirsch-index, were obtained from the Journal Citation Report and Web of Science Core Collection. Target data included ALM content in the Web of Science from January 1, 2012, to October 5, 2021. Bibliometric analysis was performed using Biblioshiny.

Results

The impact factor increased from 1.481 in 2013 to 3.464 in 2020. Authors belonging to the USA, China, and Korea cited ALM articles the most. Plos One, Scientific Reports, and Frontiers in Microbiology most frequently cited ALM, besides ALM itself. The Hirsch-index was 34. The co-occurrence network of Keyword Plus indicated four clusters diagnosis, identification, prevalence, and risk. The conceptual structure map of Keyword Plus based on multiple correspondence analysis showed two clusters bacterial susceptibility at the bench and clinical courses. The co-citation network showed that ALM was in the cluster of the New England Journal of Medicine, The Lancet, JAMA, and the Annals of Internal Medicine. The collaboration network showed that Korean authors collaborated mainly with authors from the USA, Germany, and Italy.

Conclusions

The journal’s promotion to an international top-tier journal has been successful. “Principles of transparency and best practice in scholarly publishing” and a preprint policy are yet to be added.

Validation of a modified version of Interpersonal Reactivity Index for medical students using Rasch analysis

Construct: Empathy has been accepted to interweave both cognitive aspects (the ability to put oneself in another person's place), and affective (or emotional) aspects, indicating an emotional reaction or response to another person's emotional state. Literature supports the positive influences of empathy on doctor-patient relationship, patient satisfaction, and positive clinical outcomes. Background: Many studies have dealt with the development of empathy measurement tools for physicians and medical students. A frequently used empathy measuring instrument for medical students is the "Interpersonal Reactivity Index" (IRI) which was designed to measure the multi-dimensional aspects of empathy in the general adult population. Most previous literature which validated IRI for medical students has used factor analysis, whilst studies applying Rasch models have been limited. Our study aimed to investigate the psychometric properties of a modified version of IRI for medical students using Rasch analysis. Approach: Medical students (1,293) from 15 medical schools in South Korea participated in an online questionnaire consisting of 28 items of the Korean translated version of IRI. We applied exploratory factor analysis (EFA) using polychoric correlation matrix to determine the optimal number of factors followed by Rasch analysis and McDonald's Omega calculation. Findings: The adapted IRI-MS (IRI for medical students) consisted of 17 items in four dimensions: empathic concern (5), fictitious situation (4), perspective taking (4), and personal distress (4). The overall fit of IRI-MS revealed an acceptable goodness-of-fit for all 17 items and a positive point measure correlation for all items. Reliability indices from the Rasch modeling and McDonald's Omega values of all four dimensions were satisfactory for research. We found the Wright-Andrich maps and category probability curves of the IRI's four dimensions to be less than optimal in measuring empathy levels with adequate precision. Conclusions: Rasch analysis of IRI-MS fell short from being able to prove satisfactory validity in measuring the multidimensional nature of empathy in medical students. However, our study applying Rasch analysis may serve as groundwork for future studies, to further develop from the shortcomings of our findings.

Burnout of Faculty Members of Medical Schools in Korea

BACKGROUND

There is no national survey on medical school faculty members' burnout in Korea. This study aimed to investigate burnout levels and explore possible factors related to burnout among faculty members of Korean medical schools.

METHODS

An anonymous online questionnaire was distributed to 40 Korean medical schools from October 2020 to December 2020. Burnout was measured by a modified and revalidated version of the Maslach Burnout Inventory-Human Service Survey.

RESULTS

A total of 996 faculty members participated in the survey. Of them, 855 answered the burnout questions, and 829 completed all the questions in the questionnaire. A significant number of faculty members showed a high level of burnout in each sub-dimension: 34% in emotional exhaustion, 66.3% in depersonalization, and 92.4% in reduced personal accomplishment. A total of 31.5% of faculty members revealed a high level of burnout in two sub-dimensions, while 30.5% revealed a high level of burnout in all three sub-dimensions. Woman faculty members or those younger than 40 reported significantly higher emotional exhaustion and depersonalization. Long working hours (≥ 80 hours/week) showed the highest reduced personal accomplishment scores (F = 4.023, P = 0.018). The most significant stressor or burnout source was "excessive regulation by the government or university." The research was the most exasperating task, but the education was the least stressful.

CONCLUSION

This first nationwide study alerts that a significant number of faculty members in Korean medical schools seem to suffer from a high level of burnout. Further studies are necessary for identifying the burnout rate, related factors, and strategies to overcome physician burnout.

Document Network and Conceptual and Social Structures of Clinical Endoscopy from 2015 to July 2021 Based on the Web of Science Core Collection: A Bibliometric Study

Background/Aims

The present study investigated the relevance and network of institutions, keywords, and authors’ countries of the articles in Clinical Endoscopy published from 2015 to May 2021 based on the Web of Science Core Collection.

Methods

The Web of Science Core Collection was searched with the term Clinical Endoscopy as the publication title on July 12, 2021. All 776 citations published from 2015 to May 2021 and 2,964 articles citing those 776 articles were analyzed using Biblioshiny.

Results

The corresponding authors were from 73 countries. Document coupling showed that the colorectal cancer-colonoscopyrandomized controlled trial cluster had the most significant impact and highest centrality. There were 442 articles with corresponding authors from Korea (57.0%). The number of collaborative works by Korean authors with the authors of other countries was 33 (7.5%). The articles were cited 2,964 times by corresponding authors from 37 countries.

Conclusions

The above results show that Clinical Endoscopy has published several studies on gastrointestinal endoscopy. A large proportion of citations (84.7 %) were from outside Korea, indicating that the journal content is useful for global physicians. Collaborative work between authors from Korea and other countries should be encouraged to promote the journal.

Reliability, Validity, and Unidimensionality of the Korean Version of the Pornography Craving Questionnaire Based on the Classical Test Theory and Item Response Theory

OBJECTIVE

This study aimed to evaluate the reliability and validity of the Korean version of the Pornography Craving Questionnaire (K-PCQ) using classical test theory and item response theory.

METHODS

The goodness of fit test and differential item functioning (DIF) analysis based on the Rasch model, confirmatory factor analysis (CFA), exploratory factor analysis (EFA), and correlation analysis were used to test its reliability and validity.

RESULTS

Response data from 226 students were analyzed. According to the goodness of fit test, the outfit mean square value of only one item, Item 11, was greater than 2. The CFA results revealed that all items of the K-PCQ measured a single construct. The EFA results revealed that the K-PCQ had excellent internal reliability. The DIF analysis results showed that the measurement of pornography craving using the K-PCQ did not differ based on gender. The result of Poly-DIMTEST supported the unidimensionality of the K-PCQ. The cut-off value of pornography craving was suggested as a measure of -0.0908 which corresponds to 46 (54.8%) out of a maximum score of 84.

CONCLUSION

The items of the K-PCQ are unidimensional and have good reliability and validity. The K-PCQ will be useful in clinical practice and research as a screening tool for pornography craving.

Comparison of diagnostic performance of the ACR and Kwak TIRADS applying the ACR TIRADS' size thresholds for FNA

OBJECTIVE

To investigate the diagnostic performances and unnecessary fine-needle aspiration (FNA) rates of two point-scale based TIRADS and compare them with a modified version using the ACR TIRADS' size thresholds.

METHODS

Our Institutional Review Board approved this retrospective study and waived the requirement for informed consent. A total of 2106 thyroid nodules 10 mm or larger in size in 2084 patients with definitive cytopathologic findings were included. Ultrasonography categories were assigned according to each guideline. We applied the ACR TIRADS' size thresholds for FNA to the Kwak TIRADS and defined it as the modified Kwak TIRADS (mKwak TIRADS). Diagnostic performances and unnecessary FNA rates were evaluated for both the original and modified guidelines.

RESULTS

Of the original guidelines, the ACR TIRADS had higher specificity, accuracy, and area under the receiver operating characteristic curve (AUC) (63.1%, 68.9%, and 0.748, respectively). When the size threshold of the ACR TIRADS was applied to the Kwak TIRADS, the resultant mKwak TIRADS had higher specificity, accuracy, and AUC (64.7%, 70.3%, and 0.765, respectively) than the ACR TIRADS. The mKwak TIRADS also had a lower unnecessary FNA rate than the ACR TIRADS (54.8% and 56.4%, respectively). The false-negative rate of the Kwak TIRADS was the lowest (1.9%) among all TIRADS.

CONCLUSION

The modified Kwak TIRADS incorporating the size thresholds of the ACR TIRADS showed higher diagnostic performance and a lower unnecessary FNA rate than the original point-scale based TIRADS.

KEY POINTS

• Of the original guidelines, the ACR TIRADS had the highest specificity, accuracy, and area under the receiver operating characteristic curve (AUC) (63.1%, 68.9%, and 0.748, respectively). • When the size threshold of the ACR TIRADS was applied to the Kwak TIRADS, the resultant modified version of Kwak TIRADS had higher specificity, accuracy, and AUC (64.7%, 70.3%, and 0.765, respectively) than the ACR TIRADS. • The false-negative rate of the Kwak TIRADS was the lowest (1.9%) among all TIRADS.

Follow-Up Intervals for Breast Imaging Reporting and Data System Category 3 Lesions on Screening Ultrasound in Screening and Tertiary Referral Centers

Objective

To assess the appropriate follow-up interval, and rate and timepoint of cancer detection in women with Breast Imaging Reporting and Data System (BI-RADS) 3 lesions on screening ultrasonography (US) according to the type of institution.

Materials and Methods

A total of 1451 asymptomatic women who had negative or benign findings on screening mammogram, BI-RADS 3 assessment on screening US, and at least 6 months of follow-up were included. The median follow-up interval was 30.8 months (range, 6.8–52.9 months). The cancer detection rate, cancer detection timepoint, risk factors, and clinicopathological characteristics were compared between the screening and tertiary centers. Nominal variables were compared using the chi-square or Fisher's exact test and continuous variables were compared using the independent t test or Mann-Whitney U test.

Results

In 1451 women, 19 cancers (1.3%) were detected; two (0.1%) were diagnosed at 6 months and 17 (1.2%) were diagnosed after 12.3 months. The malignancy rates were both 1.3% in the screening (9 of 699) and tertiary (10 of 752) centers. In the screening center, all nine cancers were invasive cancers and diagnosed after 12.3 months. In the tertiary center, two were ductal carcinomas in situ and eight were invasive cancers. Two of the invasive cancers were diagnosed at 6 months and the remaining eight cancers newly developed after 13.1 months.

Conclusion

One-year follow-up rather than 6-month follow-up may be suitable for BI-RADS 3 lesions on screening US found in screening centers. However, more caution is needed regarding similar findings in tertiary centers where 6-month follow-up may be more appropriate.

How Annals of Dermatology Has Improved the Scientific Quality and Ethical Standards of its Articles in the Two-Year Period since October 2018

Annals of Dermatology has not been deposited in PubMed Central (PMC) since October 2018 due to inadequate scientific quality, including the absence of informed consent in three case reports with patients' photos. This study examined the readiness of Annals of Dermatology to be deposited in PMC again by analyzing the 13 issues published from October 2018 to August 2020. The journal's scientific quality and ethical standards were assessed, and adherence to these standards was documented. In total, 259 articles were analyzed for ethical standards, including institutional review board (IRB) approval, an informed consent statement, and disclosure of conflicts of interest. Scientific quality was also checked for each article. Of the 129 original articles or brief reports presenting research on human subjects or human-derived materials, 111 studies received IRB approval and/or obtained informed consent. The other seven studies were data analyses or studies of purchased cultured cells. One study that used a post-circumcision foreskin sample contained no statement describing permission from the patient's family, but the researchers were found to have obtained informed consent. In all 152 case presentations, the authors obtained informed consent. All seven animal experiments received Institutional Animal Care and Use Committee approval. One review article did not disclose conflicts of interest, but this was an editorial error. Two systematic reviews adopted the PRISMA guidelines. In conclusion, the present publication policies, scientific quality, and ethical standards of the journal are top-tier internationally. Annals of Dermatology may be ready to apply to PMC again.

Diagnostic performances and unnecessary US-FNA rates of various TIRADS after application of equal size thresholds

We compared the diagnostic performances and unnecessary FNA rates of several guidelines and modified versions using the size threshold of the ACR TIRADS. Our Institutional Review Board approved this retrospective study and waived the requirement for informed consent and all methods were performed in accordance with the Declaration of Helsinki. A total of 1,384 thyroid nodules in 1,301 patients with definitive cytopathologic findings were included. US categories were assigned according to each guideline. We applied the size threshold suggested by the ACR TIRADS for FNA to the Kwak, ATA and EU guidelines and defined these modified guidelines as the modified Kwak (mKwak), modified ATA (mATA) and modified EU (mEU) guidelines. Diagnostic performances and unnecessary FNA rates of all guidelines were evaluated. Of 1,384 thyroid nodules, 291 (21%) were malignant. Among the original guidelines, the ACR TIRADS had the highest specificity, accuracy, LR and AUC (62.2%, 66%, 2.128 and 0.713). The mKwak, mATA and mEU guidelines had higher specificity, accuracy, LR and AUC (P < 0.001 for all), and fewer unnecessary FNAs, compared with their original guidelines. Among all original and modified guidelines, the mKwak guideline had the highest specificity, accuracy, LR and AUC (64%, 68.6%, 2.389 and 0.75). The unnecessary FNA rate was the lowest with the mKwak guideline (61.1%). The highest sensitivity was observed with the ATA guideline (98.6%). After incorporating the size threshold of the ACR TIRADS to other TIRADS, all guidelines showed higher diagnostic accuracy and lower unnecessary FNA rates than their original versions. The mKwak guideline showed the best diagnostic performances.

Cause-of-death statistics in 2018 in the Republic of Korea

This study aimed to present and analyze the causes of death in the Korean population in 2018 through an analysis of cause-of-death data from Statistics Korea, which are classified based on the International Statistical Classification of Diseases and Related Health Problems, 10th revision and the Korean Standard Classification of Diseases and Causes of Death. The total number of deaths was 298,820, reflecting an increase of 13,286 (4.7%) from 2017. The crude death rate was 582.5 per 100,000 population, which was an increase of 25.1 (4.5%) from 2017. The 10 leading causes of death, in order, were malignant neoplasms, heart diseases, pneumonia, cerebrovascular diseases, intentional self-harm, diabetes mellitus, liver diseases, chronic lower respiratory diseases, Alzheimer disease, and hypertensive diseases. Within the category of malignant neoplasms, the top five leading organs of involvement were the lung, liver, colon, stomach, and pancreas. Colon cancer was ranked as the third leading cause of death among malignant neoplasms. The most notable characteristics of the 2018 cause-of-death statistics were the ranking of pneumonia as the third leading cause of death, the inclusion of Alzheimer disease in the top 10 causes of death, and the exclusion of transport accidents from the 10 leading causes of death, which is a result that has not been seen since comparable statistics were first published in 1983. These changes reflect the increase of people over 65 years of age, who are vulnerable to infectious diseases.

Position of Ultrasonography in the scholarly journal network based on bibliometrics and developmental strategies for it to become a top-tier journal

PURPOSE

This study aimed to clarify the present position of Ultrasonography in the scholarly journal network with a variety of bibliometric indicators. Furthermore, developmental strategies for Ultrasonography to become a top-tier journal are suggested.

METHODS

The following bibliometric indicators were analyzed: number of citable articles, countries of authors, total cites, impact factor, Hirsch index, authors' countries and source titles of citing articles, and the titles of sources cited by articles in Ultrasonography.

RESULTS

The annual number of citable articles was consistently 40 from 2014 to 2019. The number of countries of authors increased to 22 in 2018-2019. The numbers of total cites reached 632 in Web of Science, 595 in Scopus, and 552 in the Crossref metadata in 2019. The estimated 2-year impact factor soared from 2.15 in 2016 to 3.20 in 2019. The Hirsch index was 20 in both Scopus and the Web of Science Core Collection. Authors from 76 countries cited Ultrasonography. The number of source titles of citing articles was 668, and the number of source titles cited by articles in Ultrasonography was 1,246.

CONCLUSION

The above bibliometric results show that Ultrasonography has become a top-tier journal in its field. Ultrasonography furnishes an example of how after changing its language policy to English-only, a local society journal became a highly cited journal in a short period of time. For further development of the journal, adoption of a data-sharing policy is recommended. Furthermore, indexation in MEDLINE should be pursued in the near future.

Transitions in Problematic Internet Use: A One-Year Longitudinal Study of Boys

OBJECTIVE

Longitudinal studies may help elucidate the factors associated with Problematic Internet Use (PIU); however, little prospective research has been conducted on the subject. The aim of the current study was to prospectively examine PIU in children/adolescents and identify the possible risk factors associated with transitions in PIU severity.

METHODS

650 middle-school boys were surveyed at two points one year apart and assessed for PIU using the Internet Addiction Proneness Scale for Youth (KS-II) and on other psychological characteristics.

RESULTS

We found that 15.3% at baseline and 12.4% at one year met the criteria for at-risk/high-risk PIU (ARHRPIU). Both the persistent-ARHRPIU and emerging-ARHRPIU groups revealed greater depressive, motor impulsive, and smart-phone-addiction tendencies than the remitting-ARHRPIU group or the persistent low-risk group. In addition, we found that individuals exhibiting higher hyperkinetic attention-deficit/hyperactivity disorder (ADHD) scores were less likely to remit from ARHRPIU, and that individuals exhibiting more ADHD-related cognitive dysfunction and reporting fewer Internet-game-free days were more likely to demonstrate an emergence of ARHRPIU.

CONCLUSION

The present findings support previous studies in that specific negative-health features are linked to transitions in ARHRPIU. Furthermore, these findings suggest that intervention is needed and may be best targeted at specific groups of youths.

Molecular Identification of Anisakis Larvae Extracted by Gastrointestinal Endoscopy from Health Check-up Patients in Korea

Anisakiasis is a zoonotic disease induced by anisakid nematodes, and endoscopic inspection is used for a diagnosis or remedy for it. Anisakis simplex, Anisakis physeteris, and Pseudoterranova decipiens had been reported to be the major species causing human infections, particularly, in Japan. However, in Korea, recent studies strongly suggested that Anisakis pegreffii is the major species of human infections. To support this suggestion, we collected anisakid larvae (n=20) from 20 human patients who were undergone gastrointestinal endoscopy at a health check-up center in Korea, and molecular identification was performed on the larvae using PCR-RFLP analysis and gene sequencing of rDNA ITS regions and mtDNA cox2. In addition, anisakid larvae (n=53) collected from the sea eel (Astroconger myriaster) were also examined for comparison with those extracted from humans. The results showed that all human samples (100%) were identified as A. pegreffii, whereas 90.7% of the samples from the sea eel were A. pegreffii with the remaining 9.3% being Hysterothylacium aduncum. Our study confirmed that A. pegreffii is the predominant species causing human anisakiasis in Korea, and this seems to be due to the predominance of this larval type in the fish (sea eels) popularly consumed by the Korean people. The possibility of human infection with H. aduncum in Korea is also suggested.

Advances in Serological Diagnosis of Taenia solium Neurocysticercosis in Korea

Cysticercosis, a parasitic disease caused by Taenia solium metacestode (TsM), has a major global public health impact in terms of disability-adjusted life years. The parasite preferentially infects subcutaneous tissue, but may invade the central nervous system, resulting in neurocysticercosis (NC). NC is an important neglected tropical disease and an emerging disease in industrialized countries due to immigration from endemic areas. The prevalence of taeniasis in Korea declined from 0.3%–12.7% during the 1970s to below 0.02% since the 2000s. A survey conducted from 1993 to 2006 revealed that the percentage of tested samples with high levels of specific anti-TsM antibody declined from 8.3% to 2.2%, suggesting the continuing occurrence of NC in Korea. Modern imaging modalities have substantially improved the diagnostic accuracy of NC, and recent advances in the molecular biochemical characterization of the TsM cyst fluid proteome also significantly strengthened NC serodiagnosis. Two glycoproteins of 150 and 120 kDa that induce strong antibody responses against sera from patients with active-stage NC have been elucidated. The 150 kDa protein showed hydrophobic-ligand binding activities and might be critically involved in the acquisition of host-derived lipid molecules. Fasciclin and endophilin B1, both of which play roles in the homeostatic functions of TsM, showed fairly high antibody responses against calcified NC cases. NC is now controllable and manageable. Further studies should focus on controlling late-onset intractable seizures and serological diagnosis of NC patients infected with few worms. This article briefly overviews diagnostic approaches and discusses current issues relating to NC serodiagnosis.

Protection of Personal Information in Medical Journal Publications

It aimed to present the definition of personal information based on Korean laws that protect personal information and the process of protection of personal information in journal publishing based on the guidelines of the International Committee of Medical Journal Editors and Committee of Publication Ethics. Two Korean laws relate to the protection of personal information in human subject research: the Personal Information Protection Act and the Bioethics and Safety Act. These laws were enacted to prevent the unauthorized use of Koreans' personal information including medical information. Personal information can be divided into personally identifiable information including resident registration numbers and sensitive information including health information. To protect personal information in journal publishing, institutional review board (IRB) approval and obtaining informed consent from patients is recommended or mandatory in clinical studies. However, retrospective chart reviews may be exempted from IRB approval, while obtaining informed consent is recommended for all case reports. Journal policies may vary with regard to whether a copy of the informed consent form is collected from authors, since the Committee of Publication Ethics guideline does not specifically recommend collecting it. In discussions of adopting clinical data-sharing policies, transfer of data including nonidentifiable personal information to another country is an unresolved issue. Furthermore, a public data repository site should be established in Korea for data to be deposited. To protect subjects' privacy and to prevent legal issues potentially arising from privacy concerns, editors and publishers should do their best to publish articles with appropriate oversight on subjects' personal information.

Goodness of fit of the items used in the 2nd cycle of evaluation and accreditation of medical schools by the Korea Institute of Medical Education and Evaluation based on the Rasch model

PURPOSE

Since 2004, the Korea Institute of Medical Education and Evaluation has been responsible for the evaluation and accreditation of medical schools in Korea. The 2nd cycle of evaluations was conducted from 2007 to 2011. The present study aimed at testing the goodness of fit of the items used in the 2nd cycle of evaluation and accreditation based on the Rasch model.

METHODS

Dichotomous data on 40 medical schools were analyzed using Winsteps, a tool based on the Rasch model that includes goodness-of-fit testing.

RESULTS

Two of the 109 items had an outfit mean square exceeding 2.0. The other 107 items showed a goodness of fit in the acceptable range for the outfit mean square. All items were in the acceptable range in terms of the infit mean square. Furthermore, 1 school had an outfit mean square exceeding 2.0, while all schools were in the acceptable range for the infit mean square. An outfit mean square value over 2.0 means that an item is a outlier. Therefore, 2 items showed an extreme response relative to the overall response. Meanwhile, the finding of an outfit mean square over 2.0 for 1 school means that it showed extraordinary responses to specific items, despite its excellent overall competency.

CONCLUSION

The goodness of fit of the items used for evaluation and accreditation by the Korea Institute of Medical Education and Evaluation should be checked so that they can be revised appropriately. Furthermore, the outlier school should be investigated to determine why it showed such an inappropriate goodness of fit.

The relationship of individual examinee characteristics and acceptability of smart device-based testing to test score in the practice test of the Korea Emergency Medicine Technician Licensing Examination

PURPOSE

Smart device-based testing (SBT) began to be introduced in the Republic of Korea's high-stakes examination system, starting with the Korea Emergency Medicine Technician Licensing Examination (KEMTLE) in December 2017. In order to minimize how variation in examinees' environment may affect the test score, it aimed to identify any variables related to individual characteristics and acceptability that are related to the examinees' test scores in the SBT practice test.

METHODS

Out of 569 candidate students who were administered the KEMTLE on September 12, 2015, 560 students responded to the survey questionnaire on the acceptability of SBT after the examination. The questionnaire addressed 8 individual characteristics: 2 satisfaction, 9 convenience, and 9 preference items. Comparison analysis between individual variables was performed. Furthermore, generalized linear model (GLM) analysis to find the effect of individual characteristics and acceptability of SBT on test score were conducted.

RESULTS

Among those who preferred SBT compared to paper-and-pencil testing, test scores were higher for male participants (M=4.36, SD=0.72) than for female participants (M=4.21, SD=0.73). According to GLM, no variables evaluated, including gender, experiences of CBT(Computer based test), SBT, and using a tablet PC, were statistically significantly different by total score, scores on multimedia items, or scores on text items.

CONCLUSION

The variables of individual characteristics and acceptability of SBT did not affect the SBT practice test scores of emergency medicine technician students in Korea. Adoption of SBT for the KEMTLE should be possible to execute without interference from the variables examined in this study.

Molecular Genetic Findings of Spirometra decipiens and S. ranarum in Korea

The taxonomy of Spirometra species has been controversial despite the medical and veterinary importance. Currently, only a few Spirometra species are considered valid species in the genus Spirometra. In the present study, the distribution of Spirometra species obtained from animals in Korea were identified by molecular analysis of the mitochondrial cytochrome c oxidase I (cox1) gene. A total of 28 Spirometra species specimens were analyzed. These were all collected between 1973 and 2008 in the Republic of Korea. Mitochondrial cox1 sequences were examined for a total of 28 specimens comprising 14 S. decipiens and 14 S. ranarum. The difference in partial cox1 sequences (316 bp) between S. erinaceieuropaei (KJ599680) and S. ranarum (this study) was 9.3%, while that between S. decipiens (KJ599679) and S. ranarum (this study) was 2.2%. Genetic analyses identified 2 Spirometra species in animals such as cat, leopard cat, dog, duck and snake in Korea as S. decipiens and S. ranarum. S. decipiens and S. ranarum were present in Gyeongnam Province (P), Jeonnam P, Gangwon P, Chungbuk P, and Seoul. S. decipiens was found in tadpoles, snakes, ducks, cats, leopard cats and dogs, while S. ranarum was found in cats and dogs. The ratio of S. decipiens:S. ranarum calculated from the molecular data was 14:14 (or 1:1). These results indicate that S. decipiens and S. ranarum are sympatrically distributed in Korea.