Objective: To explain process of developing basic veterinary clinical performance guidelines, based on frequently observable clinical manifestations, thereby supporting competencybased veterinary education in Korea. Methods: A structured review of learning outcomes established by Korean Association of Veterinary Medical Colleges (KAVMC) was conducted by a planning committee including veterinary educators, practitioners, and advisory members. Owner-oriented descriptions were used to frame each performance task, and each was mapped to corresponding learning outcomes. These tasks were aligned with learning outcomes recommended by the KAVMC to support the development of communication, clinical reasoning, and performance-related competencies among veterinary students, thereby enhancing day-one clinical readiness. Results: In total, 63 clinical manifestations for a guidebook format that can be used for clinical education were identified and categorized by organ systems that are described in language understandable to animal owners. Conclusions and Relevance: The basic veterinary clinical performance guidelines based on common clinical manifestations would serve as a vital component in veterinary education to reinforce core graduation competencies.

Objective: This study aimed to compare aneuploidy rates and clinical outcomes between trophectoderm biopsy at fresh blastocyst (biopsy-fresh) followed by vitrification and biopsy at vitrified-warmed blastocyst (biopsy-vitri) followed by next day transfer (without re-vitrification). Methods: This retrospective study included 844 patients undergoing 844 cycles conducted from August 2019 to December 2023. Preimplantation genetic testing for aneuploidy (PGT-A) was performed via trophectoderm biopsy using array comparative genomic hybridization or next-generation sequencing for comprehensive 24-chromosome screening. Patients were divided into two groups based on the blastocyst status at the time of biopsy: the biopsy-fresh group (531 patients) and the biopsy-vitri group (313 patients). Results: The clinical pregnancy rate was significantly higher in the biopsy-fresh group compared to the biopsy-vitri group (58.7% vs. 45.6%; odds ratio [OR], 1.695; 95% confidence interval [CI], 1.215 to 2.364; p=0.002). Furthermore, the biopsy-fresh group showed higher implantation rates (45.6% vs. 32.1%; OR, 1.767; 95% CI, 1.274 to 2.451; p=0.002), ongoing pregnancy or live birth rates per cycle (48.0% vs. 35.8%; OR, 1.652; 95% CI, 1.177 to 2.319; p=0.004), and rates of good-quality blastocysts (57.1% vs. 32.1%, p<0.001) compared with the biopsy-vitri group. Miscarriage rates did not differ significantly between the groups (18.2% vs. 21.4%; OR, 0.818; 95% CI, 0.457 to 1.465; p=0.501). Conclusion Biopsy at fresh blastocyst demonstrated superior clinical outcomes compared with biopsy at vitrified-warmed blastocyst, likely due to better embryo quality. Both biopsy at fresh blastocyst and vitrified-warmed blastocyst remain viable options for PGT-A, with biopsy at vitrified-warmed blastocyst serving as a practical alternative. Embryo quality and euploid status continue to be critical considerations for embryo transfer selection.

Objective: Recognizing discrimination as a significant public health risk during the coronavirus disease 2019 (COVID-19) pandemic, which coincided with increased drug use and heightened awareness of structural disparities in the United States, we investigated its association with the odds of drug use in a large and diverse cohort from the All of Us Research Program. Methods: In this cross-sectional study, data from 68,976 participants completed the COVID-19 participant experiences (COPE) survey. We applied logistic regression models with propensity score-based overlap weighting to examine associations between everyday discrimination and drug use. Self-reported everyday discrimination score and drug use were the primary exposure and outcome measures, respectively. Results: Of the 67,662 COPE respondents (mean [standard deviation] age, 57.5 [15.9] years; female sex at birth, 43,658 [64.5%]), we identified 15,493 participants with no reported discrimination and 15,493 participants with reported discrimination, after overlap weighting. The odds of drug use in those who reported discrimination was 1.38 (95% confidence interval, 1.32–1.43), with a dose-dependent association based on discrimination score. Participants who experienced discrimination had significantly higher odds of using drugs and this association was particularly pronounced in those under 40 years of age, those assigned female sex at birth, current smokers, individuals undergoing chemotherapy or immunotherapy, and those experiencing unemployment or COVID-19/flu-like symptoms. Conclusion This relationship was observed across various types of drugs and different reasons for discrimination, and it was particularly pronounced in specific subgroups. These findings provide critical evidence for developing targeted preventive interventions; however, further longitudinal studies for causality are warranted.

The surgical management of empyema (excluding those caused by mycobacterium tuberculosis and non-tuberculous mycobacteria) is rapidly evolving towards minimally invasive, precise, and stepwise approaches. The traditional three-stage classification (exudative, fibrinopurulent, and organizing) has limitations in guiding dynamic clinical decision-making. For the first time, this consensus explicitly identifies two critical junctures in the pathological progression of empyema: "early transformation" (stage Ⅰ to Ⅱ) and "late transformation" (stage Ⅱ to Ⅲ), and thereby constructs a corresponding "identification-early warning-intervention" stepwise therapeutic framework. The consensus emphasizes that proactive debridement via video-assisted thoracoscopic surgery should be performed during the early transformation phase to halt disease progression. Conversely, during the late transformation phase, therapeutic goals should be rationally adjusted to prioritize adequate drainage, avoiding futile pleural decortication. Moreover, the consensus underscores the pivotal role of precise perioperative etiological diagnosis (e.g. metagenomic nest-generation sequencing) and standardized anti-infective therapy. Integrating practical experiences from multiple thoracic surgery centers in China and relevant evidence-based literature, this consensus formulates recommendations on the precise definitions of staging, surgical indications for each phase, key technical points, perioperative management, and training systems. It aims to promote the standardized and individualized surgical management of empyema, ultimately optimizing patient prognosis.

Background: and Purpose The Treat Stroke to Target (TST) was a randomized clinical trial involving French and Korean patients demonstrating that a lower low-density lipoprotein cholesterol (LDL-C, <70 mg/dL) target group (LT) experienced fewer cerebro-cardiovascular events than a higher target (90–110 mg/dL) group (HT). However, whether these results can be applied to Asian patients with different ischemic stroke subtypes remains unclear. Methods: Patients from 14 South Korean centers were analyzed separately. Patients with ischemic stroke or transient ischemic attack with evidence of atherosclerosis were randomized into LT and HT groups. The primary endpoint was a composite of ischemic stroke, myocardial infarction, coronary or cerebral revascularization, and cardiovascular death. Results: Among 712 enrolled patients, the mean LDL-C level was 71.0 mg/dL in 357 LT patients and 86.1 mg/dL in 355 HT patients. The primary endpoint occurred in 24 (6.7%) of LT and in 31 (8.7%) of HT group patients (adjusted hazard ratio [HR]=0.78; 95% confidence interval [CI]=0.45–1.33, P=0.353). Cardiovascular events alone occurred significantly less frequently in the LT than in the HT group (HR 0.26, 95% CI 0.09–0.80, P=0.019), whereas there were no significant differences in ischemic stroke events (HR 1.12, 95% CI 0.60–2.10, P=0.712). The benefit of LT was less apparent in patients with small vessel disease and intracranial atherosclerosis than in those with extracranial atherosclerosis. Conclusion In contrast to the French TST, the outcomes in Korean patients were neutral. Although LT was more effective in preventing cardiovascular diseases, it was not so in stroke prevention, probably attributed to the differences in stroke subtypes. Further studies are needed to elucidate the efficacy of statins and appropriate LDL-C targets in Asian patients with stroke.

BACKGROUND/OBJECTIVES: The Omega-3 Index (O3I), which is the total eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA) in erythrocytes as a percentage of total fatty acids (FAs), is associated with fish intake. O3I also varies with body mass index, age, sex, and dietary factors other than the intake of n-3 polyunsaturated fatty acids (PUFAs). This study examined the relationship between the dietary intake of total fat and FA classes, and O3I, specifically regarding EPA+DHA intake. SUBJECTS/METHODS: Data on dietary intake and serum FAs from 2,370 participants (1,192 males and 1,178 females) aged 18–79 yrs, collected during the 2011–2012 National Health and Nutrition Examination Survey, were used in this study. The O3I was estimated from the serum EPA+DHA content. RESULTS: In the total population, O3I showed an inverse correlation with the intake of total fat (r = -0.417), saturated FAs (SFAs; r = -0.423), and monounsaturated fatty acids (MUFAs; r = -0.412) (P < 0.01). Similar relationships were observed among males. However, in females, only SFA intake was correlated with O3I (r = -0.386, P < 0.05). In contrast, no correlation was observed between n-6 PUFA intake and O3I. Multivariable regression analysis also showed that a 1% increment in energy provided by total fat, SFA, and MUFA corresponded to reductions of 0.019, 0.055, and 0.035 units in O3I, respectively (P < 0.01). Both SFA and MUFA intakes mediated the negative relationship between total fat intake and O3I in the total population and males. However, MUFA were not significant mediators in women. CONCLUSION The intakes of total fat, SFA, and MUFA negatively influenced O3I, independent of n-3 PUFA intake.

Methods: Twelve consecutive patients underwent single-level BELIF for lumbar degenerative disease. The technique involves two small portals, one each for endoscopy and instruments. A large PEEK cage was inserted through a posterolateral approach. Clinical outcomes, including a Visual Analog Scale for back and leg pain, the Oswestry Disability Index, and the European Quality of Life-5 Dimensions, were assessed preoperatively and at 3, 6, and 12 months postoperatively. Fusion status was evaluated using computed tomography (CT) at 12 months. Results: The mean patient age was 69.1±7.2 years, with operations predominantly at the L4–5 level (83%). The mean operation time was 149.7±37.4 minutes, and the average surgical drainage was 201.4±59.7 mL. All clinical outcome measures showed significant improvement at 12 months (p<0.05). Fusion was achieved in 83.3% of patients. Cage subsidence (>1 mm) occurred in one patient (8.3%). Complications included one case each of incidental durotomy, wrong-site surgery, and wound dehiscence and three cases of asymptomatic hematoma. Conclusions BELIF using a large PEEK cage demonstrated promising clinical outcomes and fusion rates. The technique offers enhanced visualization and enables direct neural decompression while minimizing tissue trauma. The use of a large PEEK cage may contribute to improved stability and reduced subsidence risk.

Methods: Twelve consecutive patients underwent single-level BELIF for lumbar degenerative disease. The technique involves two small portals, one each for endoscopy and instruments. A large PEEK cage was inserted through a posterolateral approach. Clinical outcomes, including a Visual Analog Scale for back and leg pain, the Oswestry Disability Index, and the European Quality of Life-5 Dimensions, were assessed preoperatively and at 3, 6, and 12 months postoperatively. Fusion status was evaluated using computed tomography (CT) at 12 months. Results: The mean patient age was 69.1±7.2 years, with operations predominantly at the L4–5 level (83%). The mean operation time was 149.7±37.4 minutes, and the average surgical drainage was 201.4±59.7 mL. All clinical outcome measures showed significant improvement at 12 months (p<0.05). Fusion was achieved in 83.3% of patients. Cage subsidence (>1 mm) occurred in one patient (8.3%). Complications included one case each of incidental durotomy, wrong-site surgery, and wound dehiscence and three cases of asymptomatic hematoma. Conclusions BELIF using a large PEEK cage demonstrated promising clinical outcomes and fusion rates. The technique offers enhanced visualization and enables direct neural decompression while minimizing tissue trauma. The use of a large PEEK cage may contribute to improved stability and reduced subsidence risk.