Yonsei University College of Medicine (YUCM) adopted a criterion-referenced assessment (CRA) system in 2014. Six cohorts have graduated over the past decade under CRA. Positive impacts on student wellness and academic achievement were observed during the system’s initial years, and this study therefore aimed to analyze the changing perceptions of graduating students who experienced CRA to reflect YUCM’s experience of CRA implementation and suggest future directions and insights. Utilizing self-reporting graduation survey data of 621 graduates from 2018 to 2023, eight items regarding perceptions of CRA were examined with analysis of variance to explore changes in perceptions among the graduates, and short answers were also reviewed to investigate keywords and main themes. The CRA grading system positively influenced students’ learning motivation, level of class participation, cooperative attitudes, and self-directed attitudes. In particular, students’ perceptions of cooperative attitudes significantly improved from 2018 (3.97) to 2023 (4.46). The system also had a positive impact on students’ interest in conducting research from 2018 (3.04) to 2023 (3.56). Students’ perceptions of validity significantly increased from 2018 (3.40) to 2023 (3.92), and the perceptions of reliability also increased from 2018 (3.38) to 2023 (3.65), although the inter-year changes were not statistically significant. This study on graduating students’ changing perceptions of the CRA at YUCM aligned with the intended goals and context of its introduction and implementation. Ongoing improvements in fairness and reliability are required to enhance students’ perceptions of the system’s credibility, necessitating ongoing education and improvement efforts. Further studies on the positive and negative factors influencing perceptions of CRA are required to derive insights for system improvement.

Yonsei University College of Medicine (YUCM) adopted a criterion-referenced assessment (CRA) system in 2014. Six cohorts have graduated over the past decade under CRA. Positive impacts on student wellness and academic achievement were observed during the system’s initial years, and this study therefore aimed to analyze the changing perceptions of graduating students who experienced CRA to reflect YUCM’s experience of CRA implementation and suggest future directions and insights. Utilizing self-reporting graduation survey data of 621 graduates from 2018 to 2023, eight items regarding perceptions of CRA were examined with analysis of variance to explore changes in perceptions among the graduates, and short answers were also reviewed to investigate keywords and main themes. The CRA grading system positively influenced students’ learning motivation, level of class participation, cooperative attitudes, and self-directed attitudes. In particular, students’ perceptions of cooperative attitudes significantly improved from 2018 (3.97) to 2023 (4.46). The system also had a positive impact on students’ interest in conducting research from 2018 (3.04) to 2023 (3.56). Students’ perceptions of validity significantly increased from 2018 (3.40) to 2023 (3.92), and the perceptions of reliability also increased from 2018 (3.38) to 2023 (3.65), although the inter-year changes were not statistically significant. This study on graduating students’ changing perceptions of the CRA at YUCM aligned with the intended goals and context of its introduction and implementation. Ongoing improvements in fairness and reliability are required to enhance students’ perceptions of the system’s credibility, necessitating ongoing education and improvement efforts. Further studies on the positive and negative factors influencing perceptions of CRA are required to derive insights for system improvement.

Yonsei University College of Medicine (YUCM) adopted a criterion-referenced assessment (CRA) system in 2014. Six cohorts have graduated over the past decade under CRA. Positive impacts on student wellness and academic achievement were observed during the system’s initial years, and this study therefore aimed to analyze the changing perceptions of graduating students who experienced CRA to reflect YUCM’s experience of CRA implementation and suggest future directions and insights. Utilizing self-reporting graduation survey data of 621 graduates from 2018 to 2023, eight items regarding perceptions of CRA were examined with analysis of variance to explore changes in perceptions among the graduates, and short answers were also reviewed to investigate keywords and main themes. The CRA grading system positively influenced students’ learning motivation, level of class participation, cooperative attitudes, and self-directed attitudes. In particular, students’ perceptions of cooperative attitudes significantly improved from 2018 (3.97) to 2023 (4.46). The system also had a positive impact on students’ interest in conducting research from 2018 (3.04) to 2023 (3.56). Students’ perceptions of validity significantly increased from 2018 (3.40) to 2023 (3.92), and the perceptions of reliability also increased from 2018 (3.38) to 2023 (3.65), although the inter-year changes were not statistically significant. This study on graduating students’ changing perceptions of the CRA at YUCM aligned with the intended goals and context of its introduction and implementation. Ongoing improvements in fairness and reliability are required to enhance students’ perceptions of the system’s credibility, necessitating ongoing education and improvement efforts. Further studies on the positive and negative factors influencing perceptions of CRA are required to derive insights for system improvement.

Yonsei University College of Medicine (YUCM) adopted a criterion-referenced assessment (CRA) system in 2014. Six cohorts have graduated over the past decade under CRA. Positive impacts on student wellness and academic achievement were observed during the system’s initial years, and this study therefore aimed to analyze the changing perceptions of graduating students who experienced CRA to reflect YUCM’s experience of CRA implementation and suggest future directions and insights. Utilizing self-reporting graduation survey data of 621 graduates from 2018 to 2023, eight items regarding perceptions of CRA were examined with analysis of variance to explore changes in perceptions among the graduates, and short answers were also reviewed to investigate keywords and main themes. The CRA grading system positively influenced students’ learning motivation, level of class participation, cooperative attitudes, and self-directed attitudes. In particular, students’ perceptions of cooperative attitudes significantly improved from 2018 (3.97) to 2023 (4.46). The system also had a positive impact on students’ interest in conducting research from 2018 (3.04) to 2023 (3.56). Students’ perceptions of validity significantly increased from 2018 (3.40) to 2023 (3.92), and the perceptions of reliability also increased from 2018 (3.38) to 2023 (3.65), although the inter-year changes were not statistically significant. This study on graduating students’ changing perceptions of the CRA at YUCM aligned with the intended goals and context of its introduction and implementation. Ongoing improvements in fairness and reliability are required to enhance students’ perceptions of the system’s credibility, necessitating ongoing education and improvement efforts. Further studies on the positive and negative factors influencing perceptions of CRA are required to derive insights for system improvement.

Yonsei University College of Medicine (YUCM) adopted a criterion-referenced assessment (CRA) system in 2014. Six cohorts have graduated over the past decade under CRA. Positive impacts on student wellness and academic achievement were observed during the system’s initial years, and this study therefore aimed to analyze the changing perceptions of graduating students who experienced CRA to reflect YUCM’s experience of CRA implementation and suggest future directions and insights. Utilizing self-reporting graduation survey data of 621 graduates from 2018 to 2023, eight items regarding perceptions of CRA were examined with analysis of variance to explore changes in perceptions among the graduates, and short answers were also reviewed to investigate keywords and main themes. The CRA grading system positively influenced students’ learning motivation, level of class participation, cooperative attitudes, and self-directed attitudes. In particular, students’ perceptions of cooperative attitudes significantly improved from 2018 (3.97) to 2023 (4.46). The system also had a positive impact on students’ interest in conducting research from 2018 (3.04) to 2023 (3.56). Students’ perceptions of validity significantly increased from 2018 (3.40) to 2023 (3.92), and the perceptions of reliability also increased from 2018 (3.38) to 2023 (3.65), although the inter-year changes were not statistically significant. This study on graduating students’ changing perceptions of the CRA at YUCM aligned with the intended goals and context of its introduction and implementation. Ongoing improvements in fairness and reliability are required to enhance students’ perceptions of the system’s credibility, necessitating ongoing education and improvement efforts. Further studies on the positive and negative factors influencing perceptions of CRA are required to derive insights for system improvement.

Objective: To compare short- and long-term dentoalveolar, skeletal, and rotational changes evaluated by Björk’s structural method of superimposition between children with Class II malocclusion treated by functional appliances and untreated matched controls. Methods: Seventy-nine prepubertal or pubertal children (mean age, 11.57 ± 1.40 years) with Class II malocclusion were included. Thirty-four children were treated using an activator with a high-pull headgear (Z-activator), while 28 were treated using an activator without a headgear (E-activator). Seventeen untreated children were included as controls. Lateral cephalograms were obtained before treatment (T1), after functional appliance treatment (T2), and after retention in the postpubertal phase (T3). Changes from T1 to T2 and T1 to T3 were compared between the treated groups and control group using multiple linear regression analysis. Results: Relative to the findings in the control group at T2, the sagittal jaw relationship (subspinalenasion- pogonion, p < 0.001), maxillary prognathism (sella-nasion-subspinale, p < 0.05), and condylar growth (p < 0.001) exhibited significant improvements in the Z- and E-activator groups, which also showed a significantly increased maxillary incisor retraction (p < 0.001) and decreased overjet (p < 0.001). Only the E-activator group exhibited significant backward rotation of the maxilla at T2 (p < 0.01). The improvements in the sagittal jaw relationship (p < 0.01) and dental relationship (p < 0.001) remained significant at T3. Condylar growth and jaw rotations were not significant at T3. Conclusions Functional appliance treatment in children with Class II malocclusion can significantly improve the sagittal jaw relationship and dental relationships in the long term.

Pancreatic acinar cell carcinoma (ACC) is a rare neoplasm accounting less than 1% of malignant pancreatic tumors. A 47-year-old male patient visited the emergency room with epigastric pain. Computed tomography or magnetic resonance imaging revealed a 4.7-cm heterogeneously enhanced solid and cystic mass with internal necrosis located in the head of the pancreas. Radiological diagnosis was borderline malignancy such as neuroendocrine tumor or solid pseudopapillary neoplasm. Two months later, the necrotic mass in the pancreas head had grown up to 11 cm, compressing the duodenum, superior mesenteric vein, and proximal transverse colon. Pylorus preserving pancreatoduodenectomy with segmental resection of transverse colon was performed. Histopathological examination revealed that the tumor was pancreatic ACC. The patient recovered without any complication and was doing well without recurrence for 12 months after surgery.

Hemophagocytic lymphohistiocytosis (HLH), associated with acute myelocytic leukemia (AML), is a very rare disease. We here report a case of HLH occurring after induction chemotherapy for AML. AML-associated HLH can be triggered by AML itself, by chemotherapeutic agents, or by infectious complications. Our patient developed a high-grade fever of unknown cause, bilateral pulmonary infiltrates, and shock after successful treatment of AML with induction chemotherapy, and had high serum ferritin, hypertriglyceridemia, hypofibrinogenemia, hemophagocytic histiocytes in bone marrow, low natural killer cell activity, and elevated soluble interleukin-2 receptor levels. A diagnosis of HLH was made. Dexamethasone, cyclosporine, and etoposide were given and allogeneic hematopoietic stem cell transplantation was performed. Careful suspicion of HLH may be warranted if a patient experiences fever of unknown etiology, high ferritin levels, and liver dysfunction during AML treatment.
Bone Marrow ; Cyclosporine ; Dexamethasone ; Diagnosis ; Etoposide ; Ferritins ; Fever ; Hematopoietic Stem Cell Transplantation ; Histiocytes ; Humans ; Hypertriglyceridemia ; Induction Chemotherapy* ; Interleukin-2 ; Killer Cells, Natural ; Leukemia, Myeloid, Acute* ; Liver Diseases ; Lymphohistiocytosis, Hemophagocytic* ; Rare Diseases ; Shock

OBJECTIVE: The Ubiquitous Spaced Retrieval-based Memory Advancement and Rehabilitation Training (USMART) program was developed by transforming the spaced retrieval-based memory training which consisted of 24 face-to-face sessions into a self-administered program with an iPAD app. The objective of this study was to evaluate the feasibility and efficacy of USMART in elderly subjects with mild cognitive impairment (MCI). METHODS: Feasibility was evaluated by checking the satisfaction of the participants with a 5-point Likert scale. The efficacy of the program on cognitive functions was evaluated by the Korean version of the Consortium to Establish a Registry for Alzheimer's Disease Neuropsychological Assessment Battery before and after USMART. RESULTS: Among the 10 participants, 7 completed both pre- and post-USMART assessments. The overall satisfaction score was 8.0+/-1.0 out of 10. The mean Word List Memory Test (WLMT) scores significantly increased after USMART training after adjusting for age, educational levels, baseline Mini-Mental Status Examination scores, and the number of training sessions (pre-USMART, 16.0+/-4.1; post-USMART, 17.9+/-4.5; p=0.014, RM-ANOVA). The magnitude of the improvements in the WLMT scores significantly correlated with the number of training sessions during 4 weeks (r=0.793; p=0.033). CONCLUSION: USMART was effective in improving memory and was well tolerated by most participants with MCI, suggesting that it may be a convenient and cost-effective alternative for the cognitive rehabilitation of elderly subjects with cognitive impairments. Further studies with large numbers of participants are necessary to examine the relationship between the number of training sessions and the improvements in memory function.
Aged ; Alzheimer Disease ; Cognitive Therapy ; Computer User Training ; Dementia ; Education* ; Humans ; Learning ; Memory* ; Mild Cognitive Impairment ; Rehabilitation*

Objectives: This study aimed to propose an efficient mental health service plan to be implemented during epidemics by identifying the mental health characteristics of people who have returned from countries with large-scale coronavirus disease-2019 (COVID-19) outbreaks. Methods: We analyzed the mental health evaluation scale data submitted by 504 quarantined people who had returned from countries hit by the COVID-19 pandemic from January to April 2020 through a government support project. Results: The average age of the study group was 35.6±8.72 years, and males accounted for 67.1% and females 32.9% of the total subjects. The screening score for post-traumatic stress disorder was met by 12.1% of the subjects. Moderate to high level of depression and anxiety symptoms were seen in 10.7% and 7.0%, respectively. Also, 2.2% of the group complained of clinical level somatization symptoms, and 1.4% were evaluated as being at a high risk of suicide. The average scores and the proportion of subjects at high risk on all scales were significantly higher in female than in male. In a comparison by age, the average score of post-traumatic stress symptoms was significantly higher in subjects in their 20s than those in their 50s, and the proportion of the subjects at high risk for post-traumatic stress symptoms also showed a significant variation between age groups. However, there were no significant differences by age with respect to depression, anxiety, somatic symptoms, and suicidal tendencies. Conclusion During an epidemic, the mental health problems of people may increase, and the risk appears to be higher in female and young adults. Therefore, in addition to strong protection policies, a customized support system for each target group is required.