Pharmacogenomic variations may significantly influence responses to commonly prescribed stroke medications. Despite accumulating evidence, genetic testing has not yet been widely integrated into stroke care. This review summarizes current evidence and provides practical guidance for clinical implementation. Pharmacogenomic studies and clinical guidelines related to antiplatelet agents, anticoagulants, and statins were reviewed, with particular emphasis on East Asian populations. Substantial evidence supports genotype-guided use of clopidogrel (CYP2C19), warfarin (CYP2C9, VKORC1, CYP4F2), and statins (SLCO1B1, ABCG2). For aspirin, PTGS1/2 and PEAR1 variants have been investigated; however, current data remain insufficient for clinical application. Regarding direct oral anticoagulants (DOACs), candidate genes such as ABCB1 and CES1 demonstrate pharmacokinetic associations, though robust clinical outcome data are lacking. Distinct allele frequencies in East Asians—such as higher prevalence of CYP2C19 and ABCG2 variants—underscore the need for population-specific strategies. Beyond single-gene approaches, polygenic risk scores, pharmacogenomic panels, and integration with multi-omics data and artificial intelligence represent promising directions for personalized therapy. Pharmacogenomic testing can enhance stroke pharmacotherapy, particularly in populations with high frequencies of actionable variants. Broader implementation requires rapid testing platforms, clinician education, tailored clinical guidelines, and real-world validation of aspirin, DOACs, and multi-gene approaches. Future research should expand population-specific studies and integrate pharmacogenomics within the broader framework of precision medicine to ensure equitable clinical benefit.

Purpose: This cross-sectional study aimed to identify factors influencing the intention for continual fertility treatments among women undergoing assisted reproductive technology (ART). Methods: A total of 197 women were recruited through convenience sample from fertility hospitals in Gyeonggi-do and Busan, South Korea. Data were collected using a self-report questionnaire incorporating measures of uncertainty; Depression Anxiety Stress Scales; Fatigue Severity Scale; Coping Scale for Infertility-Women; spousal support; treatment environment; and intention for continual fertility treatment. Descriptive statistics, chi-square tests, t-tests, and logistic regression analysis were conducted using IBM SPSS 26.0. Results: As many as 70.6% of the participants expressed an intention for continual fertility treatments. Logistic regression analysis revealed that factors such as uncertainty (odds ratio [OR] = 0.44, 95% confidence interval [CI] 0.20~0.95), active coping (OR = 4.04, 95% CI 1.11~14.71), treatment environment (OR = 2.77, 95% CI 1.26~6.07), and the duration of marriage (OR = 2.61, 95% CI 1.24~5.49) were significantly related with this intention. Conclusion These findings underscore the significance of uncertainty management, having proactive coping strategies, having supportive treatment environments, and considering the duration of marriage concerning women’s intention for continual fertility treatment in the context of ART. The implications of these results extend to the development of nursing intervention programs aimed at providing crucial support for women undergoing ART and seeking to continue their infertility treatment.

Purpose: We evaluated the accuracy and usefulness of self-assessment of visual acuity (VA) using a smartphone application for Korean users and explored its potential application in screening eye diseases. Methods: In total, 52 participants aged ≥ 20 years were included in the study. Of these participants, 31 used Jin Yong-Han’s VA chart and the smartphone application to measure their distant visual acuity (DVA), whereas 21 used Han Chun-Seok’s near visual acuity chart and the application to measure their near visual acuity (NVA). The results and time required for VA measurement using both methods were compared. VA was converted to logarithm of the minimum angle of resolution (logMAR) for analysis. The voice recognition rate of the application for numbers 2-9 was assessed. Results: The mean NVA was 0.29 ± 0.28 using Han’s chart and 0.30 ± 0.43 using the application with no significant difference (p = 1.00). The mean DVA was 0.19 ± 5.89 using Jin's chart and 0.20 ± 0.27 using the application with no significant difference (p = 0.19). The average time spent for measuring NVA and DVA was 19 seconds (s) using Han’s and Jin's charts, whereas it was 42 and 38 s for measuring NVA and DVA using the application. The voice recognition rate of the application was 87% on average for numbers 2-9, with the highest rate for number 7 (79%) and the lowest rate for number 4 (91%). Conclusions Self-assessment of VA using a smartphone application exhibited similar results to conventional VA measurement methods. Although the measurement time varied, DVA and NVA could be measured at home using a smartphone, and would be particularly useful for those who have difficulty visiting a hospital.

Objective: Although Ghana National Ambulance Service (NAS) personnel are being assigned to various scenes following formal training for 1 or 2 years, it is unclear if they have sufficient capacity to handle lengthy and long-distance patient transport in various emergencies. This study examined this through an analysis of referral patients in a typical rural area of Ghana and a survey of NAS personnel. Methods: Cases of the patient group transported by NAS personnel were abstracted from the referral patients’ chart of Worawora Government Hospital (Oti region, Ghana). These charts were analyzed according to age, sex, diagnosis, and outcome. A self-assessment survey was also conducted to estimate the confidence NAS personnel had in their abilities. Results: According to the records from the Worawora Government Hospital, from January to June 2021, 770 patients were admitted, including 126 obstetrics and gynecology patients (18.0%) and 124 trauma patients (17.7%). Sixty-nine patients (9.8%) who had already been transferred from lower-level hospitals were re-transferred to teaching hospitals. Among these, 33 were trauma patients (47.8%). In the survey, NAS personnel showed high confidence in the patient evaluation section, but they showed relatively low confidence in treating obstetrics and gynecology patients. Conclusion NAS personnel in the Oti region frequently encounter obstetrics and gynecology patients, as well as trauma patients, but they appear to lack the knowledge and skills required to transport such patients. Supplementation of knowledge and technical education in these fields is essential to ensure proper prehospital management.

Objective: This study analyzed the characteristics and accident patterns of electric scooter accidents using in-depth survey data from 23 hospital emergency rooms (ER) in Korea. The characteristics of accident types were examined depending on alcohol consumption. Methods: An in-depth investigation was conducted on ER patients involved in electric scooter accidents between 2014 and 2021. The research focused on variables such as age, time of ER visit, alcohol use, emergency room discharge outcome, injury severity, and areas of injury. Results: One thousand nine hundred and sixty-two electric scooter injuries were examined. The riders belonged predominantly to the 20-39 years age group (60.40%), and most were males (69.67%). Visits to the ER peaked between 6 pm and 12 am (36.29%). Alcohol was implicated in 24.52% of the accidents. Head and neck injuries occurred commonly (60.70%). The number of accidents increased from 4 to 843. Moreover, alcohol-related incidents surged annually, except during 2014-2015. The alcohol use group comprised more males than the non-alcohol use group (79.42% vs. 66.51%). Accidents occurred more commonly in the 20-39 years age group (76.92% vs. 55.03%), and a higher proportion of emergency room visits occurred between 0 am and 6 am (58.84% vs. 39.43%). Cases with severe Excess Mortality Ratio-adjusted Injury Severity Scores were more frequent (29.29% vs. 12.97%), and head and neck injuries were more common (83.78% vs. 53.21%). Conclusion The regulations for licensing, alcohol use, and helmet compliance should be enforced to reduce the incidence of alcohol-related electric scooter accidents in the younger population.

Objective: This study aimed to determine the clinical advantage of spindle-view intracytoplasmic sperm injection (SVICSI; a novel technology) over conventional intracytoplasmic sperm injection (cICSI) in patients with poor ovarian response (POR) and previous implantation failure. Methods: The study included 37 patients who underwent SVICSI followed by fresh embryo transfer (FET) at a single fertility clinic from January to December 2022, 58 patients who underwent cICSI followed by FET at the same fertility clinic from January to December 2021 as a control group. All study participants met the Bologna criteria for POR and had at least three or more previous failed embryo transfers. Results: The number of blastocyst transfers was significantly higher in the SVICSI group than in the cICSI group. A good-quality cleavage embryo rate, blastocyst rate, and good-quality blastocyst rate were also significantly higher in the SVICSI group than in the cICSI group. There were no significant differences in the rates of fertilization, implantation, clinical pregnancy, or clinical abortion between the two groups. Conclusion In patients with POR, those who underwent SVICSI appeared to have better embryos than those who underwent cICSI. However, whether SVICSI improved clinical outcomes such as implantation and pregnancy rates cannot be proven.

Tegoprazan is a novel potassium-competitive acid blocker that treats gastric acid-related diseases. Clarithromycin was widely used as one of various regimens for eradicating Helicobacter pylori. This study compared the pharmacokinetic and safety profile of tegoprazan and clarithromycin between combination therapy and monotherapy to evaluate the potential drug-drug interaction. An open-label, randomized, 6-sequence, 3-period crossover study was conducted in 24 healthy subjects. According to the assigned sequence, the subject was administered the assigned treatment during 5 days in each period. PK parameters of tegoprazan and clarithromycin administered in combination were compared with those of the respective monotherapies. The co-administration of tegoprazan with clarithromycin increased maximum steady-state plasma concentration (C ss,max ) and area under the plasma concentration-time curve in dosing interval at steady-state (AUC ss,tau ) of tegoprazan (1.6-fold in C ss,max and 2.5-fold in AUC ss,tau ) and M1 (2.0-fold in C ss,max , 2.5-fold in AUC ss,tau ) than tegoprazan alone. The C ss,max and AUC sss,tau of 14-hydroxyclarithromycin increased 1.8- and 2.0-fold in co-administration, respectively. The AUC ss.tau of clarithromycin was slightly increased in co-administration, but C ss,max was not changed. Combination of tegoprazan and clarithromycin and those of the respective monotherapies were tolerated in 24 healthy subjects. There may exist drug interaction that lead to reciprocal increase in plasma drug concentrations when tegoprazan and clarithromycin were administrated in combination and no safety concerns were raised. It is suggested that an in-depth analysis of the concentrationresponse relationship is necessary to determine whether these concentration changes warrant clinical action.

Objective: The aim of the present study was to evaluate the associations between hematologic parameters related to systemic inflammation and insulin resistance-associated metabolic parameters in women with polycystic ovary syndrome (PCOS). Methods: Eighty-two women between the ages of 18 and 35 years who were diagnosed with PCOS were included in this study. A 2-hour 75-g oral glucose tolerance test (OGTT) was administered to all study participants; fasting and postprandial glucose and insulin levels were measured simultaneously during the 2-hour OGTT. Hematologic parameters were derived from a standard complete blood count and a differential count of fasting-state blood samples. The correlations between hematologic parameters and insulin resistance-associated clinical and metabolic parameters were evaluated using the Spearman rank correlation and partial correlation coefficients. Hematologic parameters related to systemic inflammation were compared between the two groups, categorized by the presence or absence of insulin resistance. Results: Significant differences in the absolute neutrophil count, absolute monocyte count, platelet count, and neutrophil-lymphocyte ratio were found between the insulin-resistant group and insulin-nonresistant group. Correlation analysis found that all hematological parameters, except for the platelet-lymphocyte ratio, were associated with at least one insulin resistance-associated metabolic parameter. However, these significant correlations between hematological and metabolic parameters were attenuated after controlling for the effects of other covariates using partial correlation analysis. Conclusion The association between hematologic parameters indicative of systemic inflammation and insulin resistance-associated metabolic parameters seems to be strongly influenced by other anthropometric covariates in women with PCOS.

Objectives: Intraoperative navigation reduces the risk of major complications and increases the likelihood of optimal surgical outcomes. This paper presents an augmented reality (AR)-based simulation technique for ventriculostomy that visualizes brain deformations caused by the movements of a surgical instrument in a three-dimensional brain model. This is achieved by utilizing a position-based dynamics (PBD) physical deformation method on a preoperative brain image. Methods: An infrared camera-based AR surgical environment aligns the real-world space with a virtual space and tracks the surgical instruments. For a realistic representation and reduced simulation computation load, a hybrid geometric model is employed, which combines a high-resolution mesh model and a multiresolution tetrahedron model. Collision handling is executed when a collision between the brain and surgical instrument is detected. Constraints are used to preserve the properties of the soft body and ensure stable deformation. Results: The experiment was conducted once in a phantom environment and once in an actual surgical environment. The tasks of inserting the surgical instrument into the ventricle using only the navigation information presented through the smart glasses and verifying the drainage of cerebrospinal fluid were evaluated. These tasks were successfully completed, as indicated by the drainage, and the deformation simulation speed averaged 18.78 fps. Conclusions This experiment confirmed that the AR-based method for external ventricular drain surgery was beneficial to clinicians.