Objectives: This study aimed to develop a NOVA-based scoring approach for evaluating ultra- processed food (UPF) intake among Korean adults and to examine its performance. Previous studies have reported that young adults have the highest levels of UPF consumption. Accordingly, this study focused on adults aged 19–40 years and developed scoring components reflecting dietary patterns specific to Korean eating habits. Methods: Using 24-hour dietary recall data from adults aged 19–40 years in the Korea National Health and Nutrition Examination Survey (2021–2023), foods were classified according to the Korean-adapted NOVA system. The top 10 food groups accounting for ≥ 80% of cumulative UPF-derived energy were selected to construct the scoring components. The tool was operationalized using food frequency questionnaire (FFQ) data from the Gangwon cohort study (2022–2024). Intake frequencies were converted into scores ranging from 0 (“rarely or never”) to 5 (“≥ 1 time/day”), and summed to generate the NOVA–UPF score (range: 0–50). Results: Among 237 young adults (aged 20–49 years), the mean NOVA–UPF score was 22.9 ± 8.3. A positive association was observed between the NOVA–UPF score and FFQbased UPF energy intake (Spearman’s ρ = 0.629, P < 0.001). Cross-classification showed that 51.9% were classified into the same tertile and 94.9% into the same or adjacent tertiles, with a weighted kappa coefficient of 0.279. Conclusion This NOVA-based scoring approach may serve as a preliminary tool for assessing UPF intake in Korean young adults. Further refinement and rigorous validation using quantitative dietary assessment methods and more diverse populations are required before broader application.

Background: With increasing life expectancy, the number of older adults with multiple chronic conditions requiring complex medication regimens is growing, raising concerns about polypharmacy and potentially inappropriate medication (PIM) use. This study investigated trends in polypharmacy and PIM use among 66-year-olds in South Korea from 2012 to 2021, considering participant characteristics, to inform interventions and policies. Methods: A repeated cross-sectional study was conducted using the National Health Insurance Services database covering approximately 97% of Koreans. We included 3,397,044 individuals aged 66 who underwent the National Screening Program for Transitional Ages between 2012 and 2021. Polypharmacy was defined as the use of ≥5 medications for ≥90 days annually, hyper-polypharmacy as ≥10 medications, and PIM use as ≥1 PIM for ≥28 days. Trends were analyzed by sex, frailty, comorbidity, income, insurance type, and residence. Results: Polypharmacy prevalence increased from 32.0% in 2012 to 35.4% in 2021, and hyper-polypharmacy also rose. PIM use slightly decreased from 55.7% to 53.7%. Higher rates of polypharmacy and PIM use were observed among rural residents, medical aid beneficiaries, and those with lower income. Despite improvements in comorbidity and frailty, socioeconomic disparities widened, particularly among medical aid beneficiaries. Frequently prescribed PIMs included NSAIDs, PPIs, muscle relaxants, and anxiolytics/hypnotics. Conclusion While PIM use slightly decreased over the study period, it remained above 50%, and polypharmacy prevalence increased among older adults in Korea. Socioeconomic disparities in medication use persist, highlighting the need for targeted interventions and policies to promote safe medication use among vulnerable groups.

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.

Objectives: A campus-based intervention to enhance food literacy (FL) and establish exercise habits among college students was developed and the program’s effectiveness was evaluated. Methods: The 13-session program was developed based on the transtheoretical model and social cognitive theory. Junior and senior students majoring in food and nutrition and physical education were asked to participate as mentors, with freshmen and sophomores from varied majors as mentees. The program encompassed food, nutrition, and exercise lessons including cooking sessions. Data were collected via pre- and post-program surveys using a questionnaire consisting of items on FL and nutrition behaviors and physical fitness measurements. Results: Among 39 participants (35.9% male, 64.1% female), the overall FL score increased significantly from 64.1 to 70.6 post-program (P = 0.001). Significant increases were observed in the nutrition and safety (P < 0.001), cultural and relational (P = 0.023), and socio-ecological (P = 0.001) domains, as well as knowledge (P = 0.001), self-efficacy (P = 0.013), attitude (P < 0.001), and behavior (P = 0.005) items in three domains of FL. Additionally, meal duration increased significantly (P = 0.007) and sit-up performance among female showed a meaningful change (P = 0.046). Changes in dietary behaviors significantly progressed (P = 0.015) while that in exercise habits approached a marginal significance (P = 0.053) after the intervention. Conclusion The results reveal positive changes in FL and some modifications in eating habits, although the program had limited effects on physical activity and fitness measurements. These findings suggest that strategic approaches to foster exercise behavior changes in college students are required. This pilot program can serve as foundational data for improving and expanding multicomponent health promotion programs for this population.

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.

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