Objectives: This study aimed to examine the current status of foodservice management and nutrition education practices, and the needs for individuals with developmental disabilities in welfare centers in Seoul and Gyeonggi, South Korea, and to compare the differences according to dietitians’ level of understanding of developmental disabilities. Methods: A cross-sectional survey was conducted among dietitians working at 65 welfare centers, and data from 45 centers were analyzed. The questionnaire assessed general characteristics, foodservice operations, nutrition education practices, perceived needs, and the understanding of developmental disabilities. Participants were classified into high- (n = 17) and low-understanding (n = 28) groups based on their self-rated understanding of developmental disabilities. Data were analyzed using IBM SPSS Statistics 29.0 (IBM Corp.). Results: All centers provided one daily meal (lunch), with one cook serving an average of 116 individuals. Only 11.1% of centers implemented nutrition education, primarily limited due to insufficient time and low expectations regarding the effectiveness of nutrition education. Overall, no significant differences were observed between the two groups in most aspects of foodservice management and nutrition education practices, although some specific items showed significant differences. The high-understanding group reported a significantly greater perceived need for nutrition education and placed higher importance on rapport-building and situational response skills. These findings suggest that structural constraints, including staffing, budget, and limited resources, may play a greater role than individual- level understanding in shaping foodservice and nutrition education practices. Conclusion Welfare centers showed limited capacity to provide tailored foodservice and systematic nutrition education for adults with developmental disabilities. Strengthening staffing standards, improving foodservice environments, and developing standardized educational materials that consider communication levels are necessary. Moreover, expanding professional training opportunities for dietitians and establishing institutional support systems are essential to enhance sustainable nutrition education practices.

Objectives: Consumer demand is growing for more rigorous hygiene management within foodservice establishments. The aim of this study was to provide customized data specific to each foodservice establishment, thereby informing policy formulation to improve hygiene management levels. Methods: We surveyed 310 managers of directly managed foodservice establishments (excluding franchises) that were subject to hygiene inspections by the Chungbuk Provincial Office in Korea between September 1 and 27, 2023. Additionally, 30 investigators trained in methods for evaluating the hygiene management levels of foodservice establishments objectively assessed 310 establishments using evaluation sheets. All 310 managers provided consent and personally completed the questionnaires. Data from 277 managers were included in the analysis. General characteristics were analyzed with descriptive statistics in IBM SPSS Statistics 28 (IBM Corp.). Univariate normality verification, measurement model verification, structural model verification, and mediation effect significance analysis were conducted using R’s lavaan package (version 4.3.2.). Results: Managers’ willingness to perform duties had a positive influence on hygiene management level (0.224), enthusiasm for hygiene (0.661), awareness of hygiene compliance (0.616), mandatory perception of the system (0.568), trust in local governments (0.406), and attention to consumers (0.558). In the relationship between managers’ willingness to perform duties and hygiene management level, mandatory perception of the system had a negative mediating effect (–0.223), while trust in local governments had a positive mediating effect (0.264). Conclusion Structural equation modeling was used to identify the complex pathways by which foodservice establishment managers’ willingness to perform duties, mediated by their human factors, influences their hygiene management level. Accordingly, policy implications were presented, suggesting that the hygiene management level of foodservice establishments could be enhanced by increasing managers’ willingness to perform their duties, and that a shift from mandatory regulations by local governments to support-oriented systems that foster trust in local governments is necessary.

Background: Menopausal status can increase the risk of cardiocerebrovascular diseases (CCVDs) in women with type 2 diabetes mellitus (T2DM). Regular exercise is well-known to reduce this risk. This study explored the impact of exercise on CCVD and mortality in women with T2DM according to their menopausal status. Methods: A total of 32,477 premenopausal and 53,690 postmenopausal Korean women with T2DM aged 40 to 60 years from a national health examination cohort (2009 to 2018) were included. We evaluated risks for stroke, myocardial infarction (MI), and mortality based on exercise intensity. Cox proportional hazard regression analyses were performed to obtain the adjusted hazard ratio (aHR) and 95% confidence interval. Results: Exercise reduced stroke, MI, and mortality risks in women with T2DM, regardless of menopausal status. The highest effects of aHR compared to the sedentary group were 0.68 for stroke, 0.66 for MI, and 0.81 for mortality. Postmenopausal women experienced significant MI risk reductions at most exercise intensities, with the greatest reduction in the ≥1,500 metabolic equivalent of task score group unlike premenopausal women. However, stroke and mortality risk reductions in postmenopausal women were less pronounced compared to premenopausal women. Conclusion Exercise reduces CCVD risk in women with T2DM across menopausal status. Postmenopausal women with T2DM had more benefits from exercise on MI but fewer benefits on stroke and mortality than premenopausal women. In premenopausal women with T2DM, exercise was not associated with a lower MI risk.

Background/Aims: The absence of standardized clinical minimum inhibitory concentration (MIC) breakpoints for Helicobacter pylori infection has resulted in inconsistent resistance definitions, even within the same research group in Korea. Therefore, establishing epidemiological cutoff values (ECOFFs) is essential for standardization. Methods: The MIC distributions for antibiotics commonly used against H. pylori infection in South Korea were analyzed from 2015 to 2023. A total of 5,925 primary H. pylori isolates were collected from five data sources, and MIC values were determined using the serial 2-fold agar dilution method. The ECOFFinder program was used to establish ECOFFs for six antibiotics. Results: The tentative ECOFFs for amoxicillin and clarithromycin were 0.125 μg/mL. The ECOFFs for levofloxacin, metronidazole, and tetracycline were 0.5, 8.0, and 0.25 μg/mL, respec-tively. The ECOFF for rifabutin could not be determined due to insufficient data. On the basis of these ECOFFs, the resistance rate was 17.9% for amoxicillin, 31.9% for clarithromycin, 40.9% for levofloxacin, 24.7% for metronidazole, and 11.5% for tetracycline. Conclusions This comprehensive analysis defined regional antibiotic resistance patterns and established Korea-specific ECOFFs, providing a foundation for determining clinical breakpoints and optimizing H. pylori eradication strategies.

Janus kinase (JAK) inhibitors are an important treatment option for ulcerative colitis, providing rapid onset of action, oral administration, and efficacy even after biologic failure. The 3 approved agents—tofacitinib, filgotinib, and upadacitinib—differ in JAK isoform selectivity, leading to clinically meaningful differences in efficacy and safety. Evidence from network meta-analyses, clinical trials, and real-world studies consistently shows that upadacitinib provides the highest efficacy for induction and maintenance of remission, whereas filgotinib demonstrates the most favorable safety profile. The strong efficacy of upadacitinib and tofacitinib is particularly relevant in patients with severe disease, including acute severe ulcerative colitis, and upadacitinib maintains high efficacy regardless of prior advanced therapy exposure. JAK inhibitors also benefit extraintestinal manifestations. Although risks such as herpes zoster, serious infection, thromboembolism, and major cardiovascular events differ among agents, long-term data suggest generally acceptable safety when used appropriately. Intraclass JAK-to-JAK cycling is feasible, with about half of patients achieving steroid-free clinical remission in retrospective cohorts. Based on mechanistic, clinical, and real-world evidence, filgotinib may be a first-line option for patients with lower disease activity or when safety is a priority, whereas upadacitinib or tofacitinib may be preferred in higher disease activity. Strategically selecting agents may improve durability and outcomes.

Purpose: We aimed to investigate the prevalence and genotype distribution of human papillomavirus (HPV) among Korean males and explore implications for targeted vaccination strategies. Materials and Methods: A total of 44,065 males underwent HPV testing between March 2014 and February 2022 using the Anyplex™ II HPV 28 system, detecting 19 high-risk (HR) and 9 low-risk (LR) HPV types. Additionally, data from 507 male patients at local clinic (2017–2022) were analyzed to compare genotype prevalence between those with (WAT group) and without (WAT X group) genital warts. Results: Overall HPV positivity was 59.1%. HPV 6 (33.3%) and HPV 11 (11.0%) were the most prevalent LR genotypes, while HPV 16 (5.2%) dominated HR infection. Multiple HPV genotype co-infection occurred in 49.3% of positive cases, with 11.3% involving multiple HR types. Younger males (teens, 20s) exhibited higher HR-HPV positivity, although total HPV positivity peaked in the 40s (60.1%). Non–9-valent HR genotypes (HPV 53, 51, 39, 66) accounted for 27.6%–35.0% of infections annually. At local clinic, HPV 43 was significantly associated with genital warts (p=0.017). Conclusions These data support including males in national HPV vaccination strategies using the current 9-valent vaccine and underscore the need for ongoing genotype surveillance to monitor non‑vaccine high‑risk types and inform public health policy, and support inclusion of males in national HPV vaccination strategies using the current 9‑valent vaccine.

Background: and Purpose To compare the epidemiological and clinical features of the rare patients with cerebral autosomal dominant arteriopathy with subcortical infarcts and leukoencephalopathy (CADASIL) with age- and sex-matched controls in a nationwide cohort from South Korea. Methods: This observational cohort study analyzed newly diagnosed CADASIL patients aged at least 20 years and matched controls using data from the National Health Information Database for 2004–2022. The cumulative incidence of CADASIL was assessed by age and sex, and compared between regions. Neurologic and systemic diseases were compared between the CADASIL and control groups. Results: The study analyzed 816 CADASIL patients and 816 age- and sex-matched controls aged 56.8±15.2 years (mean±standard deviation), among whom 48.3% were male. The cumulative incidence of CADASIL was 1.86 per 100,000 people (95% confidence interval [CI]=1.85– 1.87 per 100,000), and peaked at 60–69 years of age. In terms of regional distribution, the incidence was highest for Jeju, at 39.67 per 100,000 (95% CI 37.84–41.49 per 100,000). Neurologic diseases were more frequent in CADASIL patients, including Alzheimer’s disease (33.1% vs.20.0%), vascular dementia (84.9% vs. 5.0%), epilepsy (34.6% vs. 15.9%), stroke (70.7% vs. 27.6%), parkinsonism (18.9% vs. 11.0%), and depression (60.8% vs. 44.9%). Systemic diseases such as diabetes mellitus (78.9% vs. 68.9%) were also more common in CADASIL patients, while cancer (27.9% vs. 38.7%) and myocardial infarction (10.0% vs. 13.6%) were less common than in controls. The onset ages of all diseases were lower in CADASIL patients. Conclusions This study has provided a precise nationwide estimate of the CADASIL incidence and its regional distribution in South Korea. CADASIL patients showed higher incidence rates and earlier onsets of diverse clinical manifestations.

Purpose: Asthma is characterized by chronic type 2/eosinophilic inflammation in the airway mucosa. This study aimed to explore the clinical value of 2 cutoffs of blood eosinophil counts (≥ 300/μL and ≥ 150/μL) in eosinophilic asthma, with relation to eosinophilderived neurotoxin (EDN), a surrogate marker of eosinophilic activity. Methods: To compare clinical features and eosinophil-related mediators according to 2 cutoffs of peripheral blood eosinophil counts (≥ 300/μL and ≥ 150/μL), 137 adult asthmatics who had maintained antiasthmatic medications, including inhaled corticosteroid and long-acting beta 2 agonist, without biologics, were enrolled. EDN levels in serum, urine and sputum were measured by enzymelinked immunosorbent assay. Results: Patients with asthma and higher blood eosinophil counts ( ≥ 300/μL) had a higher prevalence of severe asthma, chronic rhinosinusitis, partly controlled/uncontrolled status, and higher levels of sputum eosinophils and EDN in serum/sputum than those with lower blood eosinophil counts (< 300/μL). When compared between patients with asthma having higher blood eosinophils ( ≥ 150/μL) and those with lower eosinophils ( < 150/μL), there were no differences in symptom severity, control status or lung function parameters. Conclusion These findings suggest that blood eosinophil count ≥ 300/μL may identify asthma patients at higher risk for severity and heightened eosinophil activity, supporting its utility as a biomarker in a real clinical setting.

Background/Aims: This study investigated the clinical efficacy of low-dose mepolizumab (100 mg) in controlling severe eosinophilic asthma, aiming to induce eosinophilic granulomatosis with polyangiitis (EGPA) remission and reduce systemic steroid usage. Additionally, we constructed a basic frame for our longitudinal EGPA cohort by collecting serial blood samples before, during, and after mepolizumab treatment in EGPA patients. Methods: We conducted a 2-year prospective observational cohort study in patients with uncontrolled severe eosinophilic asthma and refractory EGPA who used systemic steroids (≥ 7.5 mg/day of prednisolone) or other immunosuppressant drugs for at least 6 months. All patients were treated with 100 mg of mepolizumab every 4 weeks for 1 year to control severe eosinophilic asthma and then were followed for an additional 1 year to monitor their disease course. We analyzed total systemic steroid use and EGPA remission/relapse during the study period. Results: Three EGPA patients were included in this study and completed 16 study visits over a 2-year period. After 1 year of treatment with mepolizumab (100 mg monthly), all 3 patients were able to reduce their maintenance dose of systemic steroids, with 2 patients completely discontinuing use. These 2 patients achieved EGPA remission during mepolizumab treatment, and their remission status remained stable for 1 year after they stopped receiving the medication. Conclusions Low-dose mepolizumab treatment demonstrated clinical efficacy in reducing the maintenance dose of systemic steroids required for severe refractory EGPA. While not all patients achieved EGPA remission with low-dose mepolizumab, some did, and their remission persisted even after treatment discontinuation.