The national licensing examination is used to evaluate the medical competency at the time of graduation, however no study has been performed on the validity of traditional Korean medicine license examination yet. The purpose of this study was to develop learning analytics using item response theory (IRT) to examine the validity and academic competency of the mock test of the national licensing exam. Classical test theory and IRT were used to evaluate the validity of test items, and IRT was used for test validity and competency analysis. The correlation between competency score of 12 subjects was analyzed using Pearson’s correlation. The distribution of students’ latent competencies was examined by gender and administrative group using a Kernel density map, Latent Profile Analysis, and χ2. The guessing parameter of 340 items was relatively high, and the information level of 12 subjects were relatively low. Significant correlations (r = 0.49–0.83, p < 0.05) were observed between the competency scores of total and 12 subjects. Two (high and low) latent academic competency groups were identified based on the competency score of 12 subjects. The low academic competency group requiring intensive management has a significantly higher frequency of male students with the experience of academic fail in the seven-year course. This study presented the quantitative learning analytics for the national licensing exam of traditional Korean medicine. The multifaceted item and test validities of the mock license test were provided, and an evidence-based approach to competency-based student management and national licensing exam of traditional Korean medicine was suggested.

Purpose: This study examined the evaluation indicators and frameworks for assessing the effectiveness of the Center for Children’s and Social Welfare Foodservice Management. Methods: A qualitative research design was used, including focus group discussions and indepth interviews cond1ucted with 26 stakeholders, such as center staff, community nutrition experts, and performance evaluation specialists. The interviews were recorded with the participants’ consent, and the transcribed data were analyzed using framework analysis to identify key patterns. Results: The findings highlight several critical issues in the current evaluation framework, including over-reliance on satisfaction surveys, insufficient utilization of checklist data, and a lack of long-term outcome measures. The participants recommended improving satisfaction surveys by diversifying the respondents and refining methodologies. Systematic data management was also highlighted as essential, particularly for data collected by center nutritionists during site visits. These data are crucial for evaluating the effectiveness of overseeing and educating cooks and staff in children’s and social welfare facilities. For the long-term outcome indicators, the participants suggested integrating national health datasets to monitor the food consumption patterns, such as fruit and vegetable intake or sugar-sweetened beverage consumption among children, and tracking medical expenses or hospitalization rates for elderly daycare center users. Well-designed intervention studies were recommended to develop more robust evaluation indicators, particularly for assessing the impact of the centers on the health and quality of life of the elderly. Conclusion Therefore, comprehensive and standardized evaluation systems should be implemented to enhance operational efficiency and service quality. The proposed evaluation scheme can better evaluate and support the health and well-being of vulnerable populations, including children, the elderly, and individuals with disabilities, by aligning these systems with the centers’ mission of ensuring safe and nutritious food services.

Purpose: This study examined the evaluation indicators and frameworks for assessing the effectiveness of the Center for Children’s and Social Welfare Foodservice Management. Methods: A qualitative research design was used, including focus group discussions and indepth interviews cond1ucted with 26 stakeholders, such as center staff, community nutrition experts, and performance evaluation specialists. The interviews were recorded with the participants’ consent, and the transcribed data were analyzed using framework analysis to identify key patterns. Results: The findings highlight several critical issues in the current evaluation framework, including over-reliance on satisfaction surveys, insufficient utilization of checklist data, and a lack of long-term outcome measures. The participants recommended improving satisfaction surveys by diversifying the respondents and refining methodologies. Systematic data management was also highlighted as essential, particularly for data collected by center nutritionists during site visits. These data are crucial for evaluating the effectiveness of overseeing and educating cooks and staff in children’s and social welfare facilities. For the long-term outcome indicators, the participants suggested integrating national health datasets to monitor the food consumption patterns, such as fruit and vegetable intake or sugar-sweetened beverage consumption among children, and tracking medical expenses or hospitalization rates for elderly daycare center users. Well-designed intervention studies were recommended to develop more robust evaluation indicators, particularly for assessing the impact of the centers on the health and quality of life of the elderly. Conclusion Therefore, comprehensive and standardized evaluation systems should be implemented to enhance operational efficiency and service quality. The proposed evaluation scheme can better evaluate and support the health and well-being of vulnerable populations, including children, the elderly, and individuals with disabilities, by aligning these systems with the centers’ mission of ensuring safe and nutritious food services.

Purpose: This study examined the evaluation indicators and frameworks for assessing the effectiveness of the Center for Children’s and Social Welfare Foodservice Management. Methods: A qualitative research design was used, including focus group discussions and indepth interviews cond1ucted with 26 stakeholders, such as center staff, community nutrition experts, and performance evaluation specialists. The interviews were recorded with the participants’ consent, and the transcribed data were analyzed using framework analysis to identify key patterns. Results: The findings highlight several critical issues in the current evaluation framework, including over-reliance on satisfaction surveys, insufficient utilization of checklist data, and a lack of long-term outcome measures. The participants recommended improving satisfaction surveys by diversifying the respondents and refining methodologies. Systematic data management was also highlighted as essential, particularly for data collected by center nutritionists during site visits. These data are crucial for evaluating the effectiveness of overseeing and educating cooks and staff in children’s and social welfare facilities. For the long-term outcome indicators, the participants suggested integrating national health datasets to monitor the food consumption patterns, such as fruit and vegetable intake or sugar-sweetened beverage consumption among children, and tracking medical expenses or hospitalization rates for elderly daycare center users. Well-designed intervention studies were recommended to develop more robust evaluation indicators, particularly for assessing the impact of the centers on the health and quality of life of the elderly. Conclusion Therefore, comprehensive and standardized evaluation systems should be implemented to enhance operational efficiency and service quality. The proposed evaluation scheme can better evaluate and support the health and well-being of vulnerable populations, including children, the elderly, and individuals with disabilities, by aligning these systems with the centers’ mission of ensuring safe and nutritious food services.

Duchenne and Becker muscular dystrophies (DMD and BMD, respectively) are X-linked neuromuscular disorders characterized by progressive muscle weakness and severe skeletal muscle degeneration. BMD is a milder form with a later onset. Patients with BMD tend to survive much longer than those with DMD. The differentiation between DMD and BMD is important in the genetic counseling of affected patients and their families. Since muscle biopsies are invasive procedures, the differential diagnosis of BMD and DMD is often dependent on the mutation identified in the DMD gene in affected patients. However, when a novel DMD mutation is identified, the differential diagnosis should be based on muscle biopsy findings with other clinical findings. Here we describe two Korean patients with BMD confirmed by muscle biopsy and genetic testing. Two novel exonic deletions in the DMD gene were identified.
Biopsy ; Diagnosis, Differential ; Exons ; Genetic Counseling ; Genetic Testing ; Humans ; Muscle Weakness ; Muscle, Skeletal ; Muscular Dystrophies* ; Muscular Dystrophy, Duchenne*

To develop a convenient promoter analysis system for fungi, a null-pigment mutant (NPG) of Aspergillus nidulans was used with the 4′-phosphopantetheinyl transferase (PPTase) gene, npgA, which restores the normal pigmentation in A. nidulans, as a new reporter gene. The functional organization of serially deleted promoter regions of the A. nidulans trpC gene and the Cryphonectria parasitica crp gene in filamentous fungi was representatively investigated to establish a novel fungal promoter assay system that depends on color complementation of the NPG mutant with the PPTase npgA gene. Several promoter regions of the trpC and crp genes were fused to the npgA gene containing the 1,034-bp open reading frame and the 966-bp 3’ downstream region from the TAA, and the constructed fusions were introduced into the NPG mutant in A. nidulans to evaluate color recovery due to the transcriptional activity of the sequence elements. Serial deletion of the trpC and crp promoter regions in this PPTase reporter assay system reaffirmed results in previous reports by using the fungal transformation step without a laborious verification process. This approach suggests a more rapid and convenient system than conventional analyses for fungal gene expression studies.
Aspergillus nidulans* ; Aspergillus* ; Complement System Proteins ; Fungi ; Genes, Fungal ; Genes, Reporter ; Open Reading Frames ; Pigmentation ; Promoter Regions, Genetic ; Transferases*

OBJECTIVE: To investigate the risk factors for fall in the elderly population residing in rural areas of Korea and provide useful data for their prevention. METHODS: As part of farmers’ health promotion project, a retrospective study was conducted with a total of 350 elderly people recruited from March 2016 to December 2016. These subjects were divided into two groups: 254 non-fallers and 96 fallers. A person who fell to the floor at least once in the past year was defined as a faller. Participants were asked to visit the hospital once. The demographic characteristics, social environment, and educational levels were surveyed using a questionnaire. Physical examination was performed in the following order: cognitive function, lower leg strength and torque, body composition, and knee image test. RESULTS: Statistically significant factors for falls in univariate analysis were female gender, age, living alone, educational level less than middle school, skeletal muscle mass, Mini-Mental State Exam, knee osteoarthritis, hip torque, hip power mean, knee torque, and knee power mean. Multivariate analysis was performed to identify variables most relevant to falls among statistically significant factors in univariate logistic analysis. It was confirmed that female gender and age of 70–79 years were statistically significant factors related to falls. CONCLUSION: Female gender and elderly status (70–79 years) are important risk factors for falls in rural areas underscoring the need for special attention when considering risk factors for falls among the elderly living in rural areas.
Accidental Falls ; Aged ; Body Composition ; Cognition ; Female ; Health Promotion ; Hip ; Humans ; Knee ; Korea ; Leg ; Multivariate Analysis ; Muscle, Skeletal ; Osteoarthritis, Knee ; Physical Examination ; Retrospective Studies ; Risk Assessment ; Risk Factors ; Sociological Factors ; Torque

Background and Objectives: Large clinical studies of sodium/glucose cotransporter 2 (SGLT2) inhibitors have shown a significant beneficial effect on heart failure-associated hospitalization and cardiovascular events. As SGLT2 is known to be absent in heart cells, improved cardiovascular outcomes are thought to be accounted for by the indirect effects of the drug. We sought to confirm whether such benefits were mediated through SGLT2 expressed in the heart using myocardial infarction (MI) model. Methods: Mice pre-treated with empagliflozin (EMPA), an SGLT2 inhibitor, showed a significantly reduced infarct size compared with the vehicle group three days post-MI.Interestingly, we confirmed SGLT2 localized in the infarct zone. The sequential changes of SGLT2 expression after MI were also evaluated. Results: One day after MI, SGLT2 transiently appeared in the ischemic areas in the vehicle group and increased until 72 hours. The appearance of SGLT2 was delayed and less in amount compared with the vehicle group. Additionally, there was a significant difference in metabolites, including glucose and amino acids in the 1 H nuclear magnetic resonance analysis between groups. Conclusions Our work demonstrates that SGLT2 is transiently expressed in heart tissue early after MI and EMPA may directly operate on SGLT2 to facilitate metabolic substrates shifts.

Background and Objectives: Large clinical studies of sodium/glucose cotransporter 2 (SGLT2) inhibitors have shown a significant beneficial effect on heart failure-associated hospitalization and cardiovascular events. As SGLT2 is known to be absent in heart cells, improved cardiovascular outcomes are thought to be accounted for by the indirect effects of the drug. We sought to confirm whether such benefits were mediated through SGLT2 expressed in the heart using myocardial infarction (MI) model. Methods: Mice pre-treated with empagliflozin (EMPA), an SGLT2 inhibitor, showed a significantly reduced infarct size compared with the vehicle group three days post-MI.Interestingly, we confirmed SGLT2 localized in the infarct zone. The sequential changes of SGLT2 expression after MI were also evaluated. Results: One day after MI, SGLT2 transiently appeared in the ischemic areas in the vehicle group and increased until 72 hours. The appearance of SGLT2 was delayed and less in amount compared with the vehicle group. Additionally, there was a significant difference in metabolites, including glucose and amino acids in the 1 H nuclear magnetic resonance analysis between groups. Conclusions Our work demonstrates that SGLT2 is transiently expressed in heart tissue early after MI and EMPA may directly operate on SGLT2 to facilitate metabolic substrates shifts.

Purpose: Assessing the status of metastasis in sentinel lymph nodes (SLNs) by pathologists is an essential task for the accurate staging of breast cancer. However, histopathological evaluation of sentinel lymph nodes by a pathologist is not easy and is a tedious and time-consuming task. The purpose of this study is to review a challenge competition (HeLP 2018) to develop automated solutions for the classification of metastases in hematoxylin and eosin–stained frozen tissue sections of SLNs in breast cancer patients. Materials and Methods: A total of 297 digital slides were obtained from frozen SLN sections, which include post–neoadjuvant cases (n = 144, 48.5%) in Asan Medical Center, South Korea. The slides were divided into training, development, and validation sets. All of the imaging datasets have been manually segmented by expert pathologists. A total of 10 participants were allowed to use the Kakao challenge platform for six weeks with two P40 GPUs. The algorithms were assessed in terms of the AUC (area under receiver operating characteristic curve). Results: The top three teams showed 0.986, 0.985, and 0.945 AUCs for the development set and 0.805, 0.776, and 0.765 AUCs for the validation set. Micrometastatic tumors, neoadjuvant systemic therapy, invasive lobular carcinoma, and histologic grade 3 were associated with lower diagnostic accuracy. Conclusion In a challenge competition, accurate deep learning algorithms have been developed, which can be helpful in making frozen diagnosis of intraoperative sentinel lymph node biopsy. Whether this approach has clinical utility will require evaluation in a clinical setting