Impact of an Evidence-Based Large Language Model (LLM) Diagnostic Decision Support System: A Randomised Controlled Trial.

Generative artificial intelligence (AI) influences clinical decision-making in healthcare by analyzing medical data and proposing personalized treatment options based on patient records. However, generative AI limited due to its inability to provide accurate evidence. Therefore, this study aims that the influence of AI-generated diagnostic suggestions on emergency healthcare providers' diagnostic patterns and decision-making, and evaluates the correlation between clinicians' adoption and diagnosis accuracy.

Communication challenges and experiences between parents and providers in South Korean paediatric emergency departments: a qualitative study to define AI-assisted communication agents.

Objectives: This study aimed to explore communication challenges between parents and healthcare providers in paediatric emergency departments (EDs) and to define the roles and functions of an artificial intelligence (AI)-assisted communication agent that could bridge existing gaps.

Design: A qualitative study using in-depth interviews and affinity diagram methodology to analyse interview data.

Setting: A tertiary paediatric ED in South Korea.

Advancing Clinical Chatbot Validation Using AI-Powered Evaluation With a New 3-Bot Evaluation System: Instrument Validation Study.

Background: The health care sector faces a projected shortfall of 10 million workers by 2030. Artificial intelligence (AI) automation in areas such as patient education and initial therapy screening presents a strategic response to mitigate this shortage and reallocate medical staff to higher-priority tasks. However, current methods of evaluating early-stage health care AI chatbots are highly limited due to safety concerns and the amount of time and effort that goes into evaluating them.

A Mixed Reality-Based Telesupervised Ultrasound Education Platform on 5G Network Compared to Direct Supervision: Prospective Randomized Pilot Trial.

Background: Ultrasound education is transitioning from in-person training to remote methods using mixed reality (MR) and 5G networks. Previous studies are mainly experimental, lacking randomized controlled trials in direct training scenarios.

Objective: This study aimed to compare an MR-based telesupervised ultrasound education platform on private 5G networks with traditional in-person training for novice doctors.

Adoption of Augmented Reality in Educational Programs for Nurses in Intensive Care Units of Tertiary Academic Hospitals: Mixed Methods Study.

Background: In the wake of challenges brought by the COVID-19 pandemic to conventional medical education, the demand for innovative teaching methods has surged. Nurse training, with its focus on hands-on practice and self-directed learning, encountered significant hurdles with conventional approaches. Augmented reality (AR) offers a potential solution to addressing this issue.

Neuroblastoma: an ongoing cold front for cancer immunotherapy.

Neuroblastoma is the most frequent extracranial childhood tumour but effective treatment with current immunotherapies is challenging due to its immunosuppressive microenvironment. Efforts to date have focused on using immunotherapy to increase tumour immunogenicity and enhance anticancer immune responses, including anti-GD2 antibodies; immune checkpoint inhibitors; drugs which enhance macrophage and natural killer T (NKT) cell function; modulation of the cyclic GMP-AMP synthase-stimulator of interferon genes pathway; and engineering neuroblastoma-targeting chimeric-antigen receptor-T cells. Some of these strategies have strong preclinical foundation and are being tested clinically, although none have demonstrated notable success in treating paediatric neuroblastoma to date.

Incidence and Mortality Trends in Critically Ill Children: A Korean Population-Based Study.

Background: Monitoring mortality trends can help design ways to improve survival, but observation of national mortality trends in critically ill children is lacking for the Korean population.

Methods: We analyzed the incidence and mortality trends of children younger than 18 years admitted to an intensive care unit (ICU) from 2012 to 2018 using the Korean National Health Insurance database. Neonates and neonatal ICU admissions were excluded.

Virtual, augmented, and mixed reality: potential clinical and training applications in pediatrics.

Background: COVID-19 pandemic has significantly impacted the field of medical training, necessitating innovative approaches to education and practice. During this period, the use of novel technologies like virtual reality (VR), augmented reality (AR), and mixed reality (MR) has become increasingly vital. These technologies offer the advantage of transcending the limitations of time and space, thus enabling medical professionals to access various personalized programs for both education and service delivery.

Using Real-Time Interaction Analysis to Explore Human-Robot Interaction.

Despite the increasing presence of social robots (SRs) in Human-Robot Interaction, there are few studies that quantify these interactions and explore children's attitudes by analyzing real-time data as they communicate with SRs. Therefore, we attempted to explore the interaction between pediatric patients and SRs by analyzing the interaction log collected from real-time. This study is a retrospective analysis of data collected in a prospective study conducted on 10 pediatric cancer patients at tertiary hospitals in Korea.

Trends in Incidences and Survival Rates in Pediatric In-Hospital Cardiopulmonary Resuscitation: A Korean Population-Based Study.

Background Although the outcome of cardiopulmonary resuscitation (CPR) is still unsatisfactory, there are few studies about temporal trends of in-hospital CPR incidence and mortality. We aimed to evaluate nationwide trends of in-hospital CPR incidence and its associated risk factors and mortality in pediatric patients using a database of the Korean National Health Insurance between 2012 and 2018. Methods and Results We excluded neonates and neonatal intensive care unit admissions.

Deep-learning-based personalized prediction of absolute neutrophil count recovery and comparison with clinicians for validation.

Neutropenia and its complications are major adverse effects of cytotoxic chemotherapy. The time to recovery from neutropenia varies from patient to patient, and cannot be easily predicted even by experts. Therefore, we trained a deep learning model using data from 525 pediatric patients with solid tumors to predict the day when patients recover from severe neutropenia after high-dose chemotherapy.

Effect of life-sustaining treatment decision law on pediatric in-hospital cardiopulmonary resuscitation rate: A Korean population-based study.

Aim: The 2018 life-sustaining treatment (LST) decision law is expected to improve end-of-life quality in Korea. This study evaluated the national effect of the LST decision law on the cardiopulmonary resuscitation (CPR) rate among pediatric patients who died during hospital admission.

Methods: This retrospective cohort study was based on the Korean National Health Insurance database.

Factors Associated with the Underuse of Sedatives and Neuromuscular Blocking Agents for Pediatric Emergency Endotracheal Intubation in Korea.

Purpose: Rapid sequence intubation (RSI) using sedatives and neuromuscular blocking agents (NMBAs) is recommended for pediatric emergency endotracheal intubation (ETI), but is not frequently performed in Korea. This study aimed to verify factors associated with the underuse of RSI medications.

Materials And Methods: This multicenter retrospective study reviewed patients aged under 18 years who underwent an ETI within 24 hours of arrival at the emergency department between 2016 and 2019.

Impact of Intubator's Training Level on First-Pass Success of Endotracheal Intubation in Acute Care Settings: A Four-Center Retrospective Study.

(1) Background: First-pass success (FPS) of endotracheal intubation is more challenging in children than in adults. We aimed to identify factors associated with FPS of intubation in acute care settings. (2) Methods: We analyzed data of children aged <10 years who underwent intubation within ≤24 h of arrival at four Korean emergency departments (2016−2019).

An Augmented Reality-Based Guide for Mechanical Ventilator Setup: Prospective Randomized Pilot Trial.

Background: Recently, the demand for mechanical ventilation (MV) has increased with the COVID-19 pandemic; however, the conventional approaches to MV training are resource intensive and require on-site training. Consequently, the need for independent learning platforms with remote assistance in institutions without resources has surged.

Objective: This study aimed to determine the feasibility and effectiveness of an augmented reality (AR)-based self-learning platform for novices to set up a ventilator without on-site assistance.

Influenza Vaccine Effectiveness in Children at the Emergency Department during the 2018-2019 Season: the First Season School-aged Children Were Included in the Korean Influenza National Immunization Program.

Background: For the 2018-2019 season, the national influenza immunization program expanded to cover children aged from 6 months to 12 years in Korea. This study aimed to analyze vaccine effectiveness (VE) against influenza in children visiting the pediatric emergency room at a tertiary hospital during the 2018-2019 season.

Methods: Patients tested for influenza antigens from October 1st 2018 to May 31st 2019 at the pediatric emergency room of Samsung Medical Center were included.

Clinical Significance of Segmental Chromosomal Aberrations in Patients with Neuroblastoma: First Report in Korean Population.

Background: This study aimed to investigate the incidence and clinical significance of segmental chromosomal aberrations (SCAs) in Korean patients with neuroblastoma.

Methods: Patients diagnosed with neuroblastoma from 2012 to 2018 were included for retrospective review. Fluorescence in situ hybridization (FISH) was used to analyze four SCAs ( amplification, 1p deletion, 11q deletion, and 17q gain).

Safety and immune cell kinetics after donor natural killer cell infusion following haploidentical stem cell transplantation in children with recurrent neuroblastoma.

Introduction: Under the hypothesis that early natural killer cell infusion (NKI) following haploidentical stem cell transplantation (haplo-SCT) will reduce relapse in the early post-transplant period, we conducted a pilot study to evaluate the safety and feasibility of NKI following haplo-SCT in children with recurrent neuroblastoma who failed previous tandem high-dose chemotherapy and autologous SCT.

Methods: We used the high-dose 131I-metaiodobenzylguanidine and cyclophosphamide/fludarabine/anti-thymocyte globulin regimen for conditioning and infused 3 × 107/kg of ex-vivo expanded NK cells derived from a haploidentical parent donor on days 2, 9, and 16 post-transplant. Interleukin-2 was administered (1 × 106 IU/m2/day) subcutaneously to activate infused donor NK cells on days 2, 4, 6, 9, 11, 13, 16, 18, and 20 post-transplant.

Predictors of survival in patients with high-risk neuroblastoma who failed tandem high-dose chemotherapy and autologous stem cell transplantation.

Objective: This study aims to explore prognostic factors for high-risk neuroblastoma patients with response failure to tandem high-dose chemotherapy and autologous stem cell transplantation (HDCT/auto-SCT).

Methods: Survival outcomes were compared according to characteristics at initial diagnosis, at relapse/progression, and after relapse/progression in patients who experienced relapse/progression after tandem HDCT/auto-SCT from 2006 to 2018.

Results: Forty-nine patients experienced relapse/progression after tandem HDCT/auto-SCT during the study period: 43 received salvage treatment and 30 underwent allogeneic SCT (allo-SCT) after reinduction treatment.

Outcomes of mechanical ventilation according to WIND classification in pediatric patients.

Background: The outcomes of weaning processes are not well known in pediatric patients, and the International Conference Classification on weaning from mechanical ventilation showed limited application. We evaluate the relationship between the new Weaning according to a New Definition (WIND) classification and outcome in pediatric patients.

Methods: We conducted a retrospective cohort study in a tertiary pediatric intensive care unit (ICU).

Clinical significance of MYCN amplification in patients with high-risk neuroblastoma.

Background: This study investigated the clinical significance of MYCN amplification within high-risk neuroblastoma (NB).

Methods: Medical records of 135 patients who were diagnosed with high-risk NB from 2004 to 2016 were reviewed.

Results: Fifty-one (38%) patients had MYCN amplified tumors, and the remaining 84 (62%) had nonamplified tumors.

Clinical Significance of Tyrosine Hydroxylase mRNA Transcripts in Peripheral Blood at Diagnosis in Patients with Neuroblastoma.

Purpose: The purpose of this study is to investigate the clinical significance of tyrosine hydroxylase (TH) expression in peripheral blood (PB) at diagnosis in patients with neuroblastoma.

Materials And Methods: mRNA expression in PB was measured by reverse transcription quantitative real-time polymerase chain reaction in 210 patients who were newly diagnosed with neuroblastoma from July 2005 to June 2015 and the clinical significance of expression in PB at diagnosis was evaluated.

Results: expression was positive in 60 patients (28.