Konkuk University Medical Center

To explore the association between cochlear duct length (CDL) and hearing loss etiologies, and evaluate its impact on cochlear implantation (CI) planning. We conducted a retrospective study on 610 patients (825 ears) who underwent CI at a tertiary center, to identify the etiologies associated with reduced CDL and investigate their influence on electrode selection and surgical outcomes. Patients diagnosed with cochlear nerve deficiency, Waardenburg syndrome (WS) associated with SOX10 variants, enlarged vestibular aqueduct syndrome, and incomplete partition type III exhibited significantly reduced CDL. Of these, WS associated with SOX10 variants exhibited the highest decrease in CDL, often with vestibular malformations. Short CDL poses surgical challenges, necessitating tailored electrode selection for optimal CI outcomes. In SOX10-related WS cases, preoperative imaging and genetic testing can aid in the early detection of the disease, enabling appropriate CI planning. These findings indicate the importance of having a preliminary estimation of CDL based on etiology and the significance of this study.

Lipoprotein(a) [Lp(a)] represents one of cardiovascular medicine's most profound implementation gaps: a genetically determined risk factor affecting 1.5 billion people worldwide, yet historically underutilized in clinical practice despite overwhelming evidence of its importance. This review examines the transformation of Lp(a) from an untreatable genetic burden to a promising therapeutic target through four interconnected perspectives. First, we document the implementation gap, where, despite affecting 20% of the global population, screening remains below 1%. The evolution from selective screening (2018 American College of Cardiology/American Heart Association (ACC/AHA)) to universal measurement (2024 National Lipid Association (NLA) Class I recommendation) reflects growing recognition, yet persistent barriers, including reimbursement challenges, provider knowledge gaps, and laboratory standardization issues, perpetuate underutilization. Second, we synthesize evidence establishing Lp(a)'s dual nature as both a biomarker and a causal factor. Observational studies demonstrate markedly increased cardiovascular risk with elevated Lp(a), while Mendelian randomization confirms causal relationships with coronary heart disease, large-artery stroke, peripheral artery disease, and aortic stenosis, with differential effects on stroke subtypes and non-atherosclerotic outcomes. Third, we examine the transformation from genetic determinism to pharmacological tractability. Despite 70-90% heritability, novel RNA-targeted therapies achieve unprecedented 80-95% reductions, with phase 3 cardiovascular outcome trials (completing 2026-2029) poised to determine whether dramatic Lp(a) lowering translates to clinical benefit. Finally, we provide a practical management algorithm bridging current evidence-based risk stratification with emerging therapies, stratifying patients by Lp(a) levels with corresponding interventions. The Lp(a) story exemplifies how genetic insights and technological innovation can transform immutable disease aspects into treatable conditions, offering a paradigm for precision cardiovascular medicine while highlighting the urgent need to close the gap between scientific knowledge and clinical implementation.

Purpose This paper aims to illustrate how English native speakerism ideology is challenged in a Korean College English course, describing its manifestation in students’ relationships with English and presenting pedagogical interventions to counter it. This paper demonstrates how two theoretical frameworks – English as Lingua Franca and peripheral participation – were integrated to transform the curriculum, with particular focus on listening instruction. Design/methodology/approach Organized in three sections, the first introduces the author’s teaching context, defines native speakerism, and explains its impact on Korean university students. Section 2 demonstrates how the author integrated English as a Lingua Franca and peripheral participation frameworks into classroom practice to counter native speakerism, illustrating specific pedagogical interventions in listening instruction, a critical yet neglected domain in ESL pedagogy. The final section offers reflections on transforming the College English course and makes recommendations for English language educators. Findings The findings reveal that implementing the two frameworks effectively challenges native speakerism by repositioning students as legitimate English users rather than deficient learners. This approach enhanced student confidence and participation, especially in listening instruction, with students reporting greater engagement when building on partial understanding rather than striving for native-like comprehension. Originality/value The paper addresses two critical gaps in native speakerism research. First, while extensive literature critiques this ideology, few studies demonstrate concrete classroom interventions to counter it. This paper provides detailed, replicable pedagogical activities showing how native speakerism may be challenged. Second, it contributes a much-needed teacher narrative in the domain of native speakerism, sharing the author’s first-hand experience of curriculum transformation and offering valuable insights that theory alone cannot provide. Most importantly, it may inspire other educators to take action against native speaker ideologies through their practice.

This study aimed to evaluate the utility of dual-energy CT (DECT)-based two-material decomposition in facilitating the generation of training data for ureter segmentation. This retrospective two-center study included 180 patients who underwent DECT urography between April and July 2020, including 150 from Institution 1 and 30 from Institution 2. Virtual unenhanced (VUE) images were generated from the late excretory phase (LEP) images using a two-material decomposition technique. Ground truth segmentation masks were created by segmenting contrast-filled ureteral regions on LEP images and were then paired with the corresponding VUE images. These VUE images and their corresponding ground truth masks were used to construct training, validation, and test datasets. A deep learning-based segmentation model was developed using the nnU-Net framework. Its performance was evaluated using the Dice coefficient, precision, and recall. In the internal test dataset, the model achieved excellent performance, with a median Dice coefficient of 0.89 (95% CI 0.88-0.90), precision of 0.90 (95% CI 0.88-0.92), and recall of 0.88 (95% CI 0.86-0.91). In contrast, the external validation dataset yielded limited performance, with a median Dice coefficient of 0.43 (95% CI 0.31-0.61) and recall of 0.28 (95% CI 0.18-0.45), while precision remained high at 0.95 (95% CI 0.93-0.96). There were statistically significant differences in all metrics between the internal and external datasets (P < 0.01). DECT-based two-material decomposition is a feasible method for generating training data for ureter segmentation. Although external validation performance was limited, this approach shows promise for ureter segmentation on non-contrast CT scans.

Optic glioma, a slow-growing tumor, is associated with Neurofibromatosis type 1 (NF1) mutations and increased midkine (MDK) production. A connection between asthma and optic glioma has previously been observed, but the mechanisms are unclear. To elucidate the role of asthma in the regulation of glioma formation, we investigated the role of T cells and the subsequent pathways in the regulation of microglia, a key player in the glioma tumor microenvironment (TME). While asthma is often linked to chronic inflammation, our mathematical analysis and experimental evidence suggest that inflammation can play a key role in suppressing the proliferation of optic glioma cells via immune reprogramming of T cells and the delicate control of signaling networks in microglia. Our mathematical model unveils the complex interactions between tumor and immune cells in optic glioma. Our results indicate that asthma-induced T cell reprogramming inhibits tumor growth by promoting the release of decorin and a subsequent suppression of CCR8 and the intercellular binding kinetics in microglia, followed by blocking of CCL5 production in TME via suppression of NFκB. We developed anti-cancer strategies by leveraging this asthma-induced immune regulation.

We investigate the sensitivity of proposed circular electron positron collider (CEPC) and future circular collider in its electron–positron mode (FCC-ee) with a center-of-mass energy of 240 GeV to long-lived dark photons heavier than 2 GeV that are pair produced via the prompt decays of a light scalar mixed with the Standard-Model Higgs boson. We compute the production and decay rates of both the light scalar and the dark photon, and develop two search strategies targeting displaced vertices within the inner tracker of the main detectors. Using Monte Carlo simulations, we evaluate the signal acceptance and projected sensitivity for each strategy. Our results show that, for the scalar-Higgs mixing angle set at 10 − 2 just below the current upper limit, the proposed searches at CEPC and FCC-ee can probe a dark-photon kinetic-mixing parameter several orders of magnitude below existing bounds, for dark photons lighter than half the dark-scalar mass.

Survival outcomes for infants born at 22–23 weeks’ gestation vary widely across neonatal units. This national, prospective cohort study evaluated 919 infants born at 22–23 weeks’ gestation in South Korea between 2013 and 2022, using Korean Neonatal Network data. Infants were categorized based on the level of neonatal care: 785 in lower-level centers (Group A) and 134 in higher-level centers (Group B). Survival was significantly higher in Group B (64.9%) compared to Group A (29.3%) (P < 0.0001). Early deaths occurred more frequently and earlier in Group A. Proactive care—including antenatal corticosteroids, antenatal antibiotics, and immediate surfactant administration—was more common in Group B. Antenatal corticosteroid was significantly associated with reduced risk of death (hazard ratio 0.58; 95% confidence interval, 0.49–0.69; P < 0.0001). The timing of rapid decline in survival was delayed in higher-level centers. In addition, classifying institutions into higher- and lower-level groups according to the survival of infants born at 22–23 weeks’ gestation (≥50% vs. <50%) provides a good reflection of the quality of neonatal care. These findings highlight the importance of proactive care and timely in utero transfer to higher-level units in improving survival for peri-viable infants.Supplementary InformationThe online version contains supplementary material available at 10.1038/s41598-025-28428-1.