Eun Jae Ko

Camera-based sensing may provide a scalable approach to quantifying hand function in children with cerebral palsy (CP), but fine grasp patterns remain challenging because of occlusion, small anatomical structures, and complex hand–obobject interactions. This study investigated a single-camera AI-based framework for classifying the developmentally ordered grasp patterns of the Quality of Upper Extremity Skills Test (QUEST). Grasp-of-Cereal and Grasp-of-Cube tasks performed by 41 children with CP were recorded with a single RGB camera and analyzed using MediaPipe hand landmarks, SAM2-based hand segmentation, YOLOv9 object localization, and a 3D DenseNet-121 classifier. Trial-level accuracy, severity-weighted accuracy (SWA), and quadratic weighted kappa (QWK) were estimated with participant-level bootstrap 95% confidence intervals (CIs). Accuracy was 0.84 (95% CI, 0.750–0.914) for Cereal and 0.85 (0.795–0.901) for Cube; SWA was 0.922 and 0.907, and QWK was 0.579 and 0.756, respectively. Therapist inter-rater QWK (0.883 and 0.838) is reported as a descriptive reference only. Cereal macro-F1 (0.534) and balanced accuracy (0.494) indicated uneven class performance. Development and test recordings were temporally separated but not participant-independent; for Cube, 39 of the 41 children contributing development data also contributed follow-up test recordings. These findings support the feasibility of longitudinal within-cohort grasp classification but do not establish generalization to previously unseen children.

Background Electrical stimulation (ES) has emerged as a promising non-pharmacological approach for promoting neuronal survival, regeneration, and neuroplasticity. We aimed to determine whether applying ES to brain cells promotes cell viability and how it impacts the expression of brain-derived neurotrophic factor (BDNF), relaxin-3, B-cell lymphoma-2 (bcl-2), and caspase-3. The ultimate objective is to facilitate future in vivo studies.Materials and Methods We used SH-SY5Y cells derived from the human neuroblastoma cell line. Cells were categorized into four groups: control, control with ES, oxygen and glucose deprivation/reperfusion (OGD/R), and OGD/R with ES. ES was administered at an intensity of 100 mV/mm for one hour per day. Cell viability was assessed using the WST-1 assay, while protein expression was analyzed by Western blotting and immunocytochemistry.Results ES enhanced cell viability in SH-SY5Y cells. Furthermore, the expression of BDNF, a protein known for its neuroprotective effects, was increased in the OGD/R group that received ES. Additionally, in the electrically stimulated groups, expression levels of relaxin-3, a neuropeptide involved in regulating key functions including arousal and bcl-2, an anti-apoptotic marker, were both increased. However, caspase-3, an apoptosis-related marker, decreased following ES in both the control and OGD/R groups.Conclusions This study demonstrated that direct current ES enhances cell survival and modulates key neuroprotective biomarkers in SH-SY5Y cells under ischemic-like conditions. These findings provide evidence supporting the therapeutic potential of ES and may serve as a valuable basis for future in vivo studies aimed at exploring its clinical applicability in neuroprotection.

Background: Advances in neonatal care have substantially improved the survival of preterm infants; however, longitudinal changes in caregiver psychological well-being and infant temperament during follow-up remain incompletely understood. This study aimed to characterize changes in caregiver psychological measures and infant temperament from enrollment through 12 months corrected age (CA) and to explore their clinical and socioeconomic correlates. Methods: This prospective longitudinal cohort study included 35 preterm infant–parent dyads assessed at enrollment (mean CA, 2.3 ± 1.3 months), 6 months CA, and 12 months CA. The same parent completed measures of depressive symptoms (Korean Beck Depression Inventory-II [K-BDI-II]), parenting stress (Korean Parenting Stress Index, Fourth Edition [K-PSI-4]), general self-efficacy, and infant temperament (Infant Behavior Questionnaire–Revised [IBQ-R]) across available assessments. Developmental outcomes were assessed using the Bayley Scales of Infant Development, Second Edition (BSID-II) at 12 months CA. Longitudinal changes were analyzed using linear mixed-effects models with false discovery rate (FDR) correction across the eight domain-level questionnaire outcomes comprising the main longitudinal analysis family; additional analyses were exploratory. Results: K-BDI-II depressive symptom scores (FDR q = 0.022) and K-PSI-4 Parent-domain stress (q = 0.011) decreased over time, whereas Total Stress, Child-domain stress, and general self-efficacy did not change significantly. Infant Surgency/Extraversion (q < 0.008) and Negative Affectivity (q = 0.008) increased, whereas Orienting/Regulation did not change significantly. No associations between clinical or socioeconomic characteristics and study outcomes remained significant after FDR correction. At 12 months CA, K-PSI-4 Total Stress was positively correlated with parent-reported infant Negative Affectivity (r = 0.47, q = 0.039). Conclusions: Caregiver psychological measures and infant temperament showed distinct longitudinal changes from enrollment through 12 months CA following preterm birth. Repeated assessment of caregiver psychological well-being may complement developmental follow-up of preterm infants. These within-cohort findings, particularly the exploratory associations, require confirmation in larger and more diverse longitudinal cohorts.

Cerebral palsy (CP) is a non-progressive disorder of the developing brain that leads to motor impairment and activity limitations [1], with an estimated prevalence of 2.1 per 1000 live births [2]. ...

Background/Objectives: Preterm infants often experience impaired swallowing function, and objective assessments for this population remain limited. In this prospective single-center study, we aimed to propose and validate an automated framework that quantitatively assesses neonatal sucking behavior by tracking facial key points in bottle feeding videos. Methods: Fifty-eight preterm infants (corrected age [CA] ≤ 2 months) were enrolled, and 2 min videos of bottle-feeding were recorded. Certified therapists manually evaluated the videos using the Neonatal Oral Motor Assessment Scale (NOMAS), and an artificial intelligence (AI)-based analysis classified the videos into the following three groups: Normal, Disorganization, and Dysfunction. At 12 months CA, developmental outcomes were assessed using the Mental Development Index (MDI) and the Psychomotor Development Index (PDI) of the Bayley Scales of Infant Development, Second Edition (BSID-II). Results: Among the 58 infants, the AI-based tool correctly classified 47 and misclassified 11. The classification accuracy was 82.76 for the Normal group, 82.76 for Disorganization, and 96.55 for Dysfunction. The mean PDI was lower in the Dysfunction group than in other groups; however, the differences were not statistically significant. Conclusions: This novel AI-based video analysis demonstrates preliminary potential as a noninvasive tool for evaluating sucking behavior in preterm infants, potentially enabling early identification of dysphagia even by non-specialists in the neonatal intensive care unit (NICU) without hazard exposure. This feasibility study demonstrates preliminary technical viability of a video-based framework for neonatal sucking behavior assessment; however, further validation is required before clinical implementation.

Background/Objectives: Feeding and swallowing difficulties are common in young children with cerebral palsy (CP), yet no validated tool has been available in Korea for those under 3 years. The Mini-Eating and Drinking Ability Classification System (Mini-EDACS) was designed for children aged 18–36 months. This study aimed to translate the Mini-EDACS into Korean and evaluate its reliability and validity. Methods: Translation followed international guidelines, including forward–backward translation and Delphi consensus with experts in pediatric dysphagia. Forty-eight children with CP (mean age 27.1 ± 5.0 months) were assessed. Caregivers and speech–language pathologists (SLPs) independently rated Mini-EDACS and assistance levels. Inter-rater reliability was examined using Cohen’s κ. Construct validity was tested by Spearman’s correlations with the Gross Motor Function Classification System (GMFCS), Mini-MACS, the Communication Function Classification System (CFCS), the Visual Function Classification System (VFCS), and the Functional Oral Intake Scale for Children (FOIS-C). Results: Agreement between caregivers and SLPs was excellent (κ = 0.90; weighted κ = 0.98). Assistance-level ratings also showed almost perfect concordance (κ = 0.97). Mini-EDACS correlated strongly with FOIS-C (ρ = −0.86, p < 0.001) and with assistance levels (ρ = 0.81, p < 0.001). Moderate-to-strong positive correlations were observed with GMFCS (ρ = 0.56), Mini-MACS (ρ = 0.64), CFCS (ρ = 0.61), and VFCS (ρ = 0.61), supporting construct validity. Conclusions: The Korean Mini-EDACS is a reliable and valid tool for classifying eating and drinking abilities in children with CP under 3 years. It enables standardized communication between caregivers and clinicians, complements existing functional classification systems, and may facilitate earlier identification and intervention for feeding difficulties.

Objectives: Preterm infants are at increased risk for delayed language development. This study aimed to investigate the impact of vocalization at 12 months on language abilities at 24 months in preterm infants and to assess whether early vocalization can serve as a predictor of later language outcomes.Methods: A longitudinal study was conducted with 31 preterm infants assessed at 12 and 24 months. At 12 months, vocalizations were evaluated via a caregiver interview tool and categorized into precanonical, canonical, and word stages, with percentage scores calculated for each. At 24 months, receptive and expressive language quotients were measured using standardized assessments.Results: Preterm infants demonstrated the highest scores in the precanonical stage at 12 months, with lower scores in the canonical and word stages. The canonical vocalization scores at 12 months were significantly correlated with receptive and expressive language quotients at 24 months, while precanonical vocalizations showed no significant correlations. Additionally, canonical vocalization scores significantly predicted expressive language abilities at 24 months. However, subcomponents of the canonical stage did not individually predict language outcomes.Conclusion: Canonical vocalization at 12 months is closely associated with expressive language development at 24 months in preterm infants. Early assessment of vocalization may be a useful tool for identifying infants at risk for language delays, enabling timely intervention.

This study proposed a reliable and convenient methodology to assess rectus femoris (RF) and gastrocnemius muscles using ultrasound in critically ill patients. The focus was on reliability and convenience, considering both intra- and inter-observer reliability in the ICU and outpatient clinical settings. The RF and gastrocnemius muscles of 23 patients in the ICU were assessed using ultrasound. Two assessors, an expert and a novice, performed measurements across 2 consecutive days. Muscle thickness (MT), cross-sectional area (CSA), and echogenicity were measured in the RF, while MT, echogenicity, and pennate angle were measured in the gastrocnemius. The intra-class correlation coefficient (ICC) was assessed for intra- and inter-rater reliability for all markers. Intra- and inter-observer reliability was almost perfect (ICC > 0.80) for all markers, irrespective of the assessor’s expertise. The CSA of the RF muscle exhibited the highest reliability (ICC > 0.95). MT of the gastrocnemius also demonstrated high intra- and inter-observer reliability (ICC > 0.91). In echogenicity measurements, gastrocnemius showed the highest (ICC > 0.91) intra- and inter-observer reliability. Ultrasound measurement of RF and gastrocnemius muscles in critically ill patients using the proposed methods demonstrated almost perfect reliability in both muscle mass and quality measurements. These methodologies, prioritizing convenience and reliability, could be employed for evaluating muscle status and changes in ICU settings and outpatient follow-ups.

Aims: To develop and evaluate a novel AI-based video analysis tool for the quantitative assessment of “Places Pegs in” and “Blue Board” tasks in the Bayley Scales of Infant Development (BSID-II). Methods: A prospective cohort study was conducted from February 2022 to December 2022, including children aged 12–42 months referred for suspected developmental delay. Participants were evaluated using the BSID-II, and their performances on the two tasks were video recorded and analyzed with the novel tool. Sensitivity and specificity were determined by comparing the tool’s results to standard BSID-II assessments by therapists. Data collected included total time, number of trials, successful trials, and time and spatial intervals for each trial. Children were classified into typically developing (TD) (MDI ≥ 85) and developmental delay (DD) (MDI < 85) groups based on their mental developmental index (MDI). Results: A total of 75 children participated in the study, and the mean values of MDI and PDI for the enrolled children were 88.9 ± 18.7 and 80.0 ± 16.7. The “Places Pegs in” had 86.5% sensitivity and 100% specificity; the “Blue Board” had 96.9% sensitivity and 89.5% specificity. Differences in cumulative successes over time were observed between age groups and TD and DD groups. The tool automatically calculated maximum successes at specific time points. Interpretation: The AI-based tool showed high predictive accuracy for BSID-II tasks in children aged 12–42 months, indicating potential utility for developmental assessments.

Objectives: This study explored how group-based early parent education impacts development in preterm infants. Methods: This retrospective cohort study, with a historical control group, included preterm infants (n = 246) with corrected ages (CAs) of 0–3 months. Those visiting the clinic between July 2017 and December 2018 formed the control group (n = 145), whereas those visiting between January 2019 and February 2020 (n = 101) constituted the education group. The education group received six education sessions performed by a physical therapist, and two sessions conducted by an occupational therapist at CAs of 0–6 months. Assessments included the following: Alberta Infant Motor Scale at CA 3, 6, 9, and 12 months; Bayley Scales of Infant Development II at CA 12 and 24 months; and the Sequenced Language Scale for Infants at CA 24 months. Results: The education group, which initially showed greater developmental delay than the control group, showed no significant delay after education sessions. Developmental improvements were more prominent in infants born before 28 weeks’ gestational age, and in infants with no, or mild, brain injury. Conclusions: Group-based early parent education improved development at CA 24 months in preterm infants, especially in infants born before 28 weeks gestational age, and in infants with no, or mild, brain injury. This approach may enhance developmental outcomes in preterm infants.