As the school-age population declines, decisions on how small-scale schools organize their foodservice operations have become an important administrative issue. In practice, these decisions still rely heavily on limited criteria such as enrollment size or cost efficiency, while the actual operational capacity of schools is often overlooked. As a result, a structural gap persists between policy decisions and on-site foodservice realities. This paper proposes a decision-making framework for more balanced judgments on whether small-scale schools should retain or change their foodservice operation type. Based on a systematic literature review, the evaluation indicators were refined through a Delphi survey of experts, and their relative importance was estimated using the analytic hierarchy process (AHP). Consequently, 33 indicators were finalized across five domains: human resources, physical resources, finance and procurement, foodservice quality and satisfaction, and policy and education. The AHP results showed that human resources (0.3035) and physical resources (0.2235) were weighted more heavily than financial considerations. Applying the pareto principle, 16 core indicators accounting for approximately 70% of the total weight were selected and applied to case schools, clearly distinguishing schools with similar enrollment sizes but different operational conditions. In conclusion, school foodservice decisions should move beyond single-indicator judgments and instead be grounded in a multidimensional assessment of core operational capacity.

Purpose: Tandem autologous stem cell transplantation (tASCT) is a viable option for high-risk multiple myeloma (MM) patients. Minimal residual disease (MRD), a real-time surrogate marker of disease burden, serves as a valuable measure of treatment response. This study evaluated the impact of tASCT on MRD dynamics in MM patients. Methods: We analyzed data from a multicenter registry of 28 patients who underwent tASCT as frontline treatment between January 2019 and October 2024. Eligibility criteria included undergoing two ASCTs within one year, having MRD positivity before tASCT, and completing follow-up MRD assessment. Patients were stratified into two groups:extensive MRD clearance (≥ 50% reduction, n = 18) and modest MRD clearance (< 50% reduction, n = 10). Results: Across the entire cohort, mean MRD decreased from 0.111% pre-tASCT to 0.056% post-tASCT. Three patients achieved MRD negativity, 20 had reductions without negativity, and five experienced increases. The extensive clear‑ ance group showed significant MRD reduction (0.152% to 0.017%) and longer progression-free survival (PFS: 37.7 vs.16.3 months, p = 0.013) compared with the modest clearance group, in which MRD increased (0.175% to 0.830%).Overall survival did not differ significantly. Conclusions tASCT provides clinical benefit for MRD-positive MM patients, particularly those achieving significant MRD reduction. These findings support tASCT as a feasible approach for MRD-positive patients following initial ASCT.

Background: The coronavirus disease 2019 (COVID-19) pandemic has led to socio-economic issues, highlighting the importance of strengthening health systems for future infectious diseases. This study aims to analyze the relationship between health system preparedness, response levels, and COVID-19 fatality rates across 194 countries. Methods: This study examined various indicators of national health system preparedness and response, including health service delivery, health workforce, health information systems, essential medicines and health products, health financing, and leadership and governance. Results: A correlation was found between the health system and the COVID-19 case fatality rate (CFR). Further examination of specific indicators within health service delivery, health workforce, health information systems, health financing, and leadership/governance showed significant correlations with the CFR. Multiple regression analysis, considering aging and urbanization rates, identified reproductive/maternalewborn and child health, infectious diseases, nursing and midwifery personnel density, birth registration coverage, and out-of-pocket health expenditure as significant factors affecting the CFR. Conclusion Countries with strong health system indicators experience lower case fatality rate from COVID-19. Strengthening access to essential health services, increasing healthcare personnel and resources, ensuring reliable health information, and bolstering overall health systems are crucial for preparedness against future infectious diseases.

A male mixed-breed dog of unknown age was presented with a history of bloody diarrhea and cachexia. Toxocara canis in vomitus was identified by a parasitologist. Hematology revealed low hematocrit, eosinophilia, and low albumin. Computed tomography (CT) revealed an enlarged pulmonary artery with an irregular wall, micronodules in the lung, and vicarious excretion of contrast medium to small intestine. CT scan was helpful for identifying lung lesions and the central organs of larval migration and also show vicarious excretion of contrast medium to the small intestine in T. canis infection.

Background: With the development of the information technology industry and the increasing importance of health information, there is a need to analyze the current certification system for health information management education. This study compared and analyzed the health information management education accreditation system between the Republic of Korea and the United States. Methods: Descriptive analysis and quantitative methodologies were used to compare the education accreditation system and understand the current status of health information management curriculum run by universities in the Republic of Korea and the United States. Results: Regardless of the academic year, the Republic of Korea had one certification system based on subject-based criteria. However, the United States had a certification system for associate, baccalaureate, and master’s degree programs with competency-based criteria. The accreditation system was different in terms of the way the curriculum is certified and the options for the different levels of university degree programs. Conclusion Accordingly, it is necessary to consider improving the quality of health information management personnel at different levels by improving the current accreditation system and differentiating the curriculum according to the degree program levels in the Republic of Korea.

OBJECTIVES: This study aimed to investigate North Korean refugees' knowledge of mental illnesses and treatments and analyze the factors affecting this knowledge. METHODS: Subjects were selected via a snowball sampling method, and the survey outcomes of 152 North Korean refugee participants were analyzed. The factors affecting knowledge of mental illnesses were analyzed via a regression analysis by constructing a multivariate model with mental illness knowledge score as the dependent variable. RESULTS: The North Korean refugees' mental illness scores ranged from 3 to 24 points, with an average score of 13.0. Regarding the factors that influence mental illness knowledge, the subjects with South Korean spouses and those who had spent more time in South Korea had higher knowledge scores. Furthermore, the subjects who considered the mental health of North Korean refugees to be a serious issue revealed lower knowledge scores than those who did not believe it was a serious issue. The subjects who visit psychiatric clinics showed higher knowledge scores than those who do not. The South Korean subjects who had at least a college education exhibited higher scores than did those without advanced education. The subjects who are satisfied with life in South Korea manifested a higher mental illness knowledge score than those who are not. CONCLUSIONS: This study is significant as being the first study to ever measure and evaluate the level of North Korean refugees' knowledge of mental illnesses. In addition, the evaluations of North Korean refugees' mental illness knowledge and influencing factors while residing in South Korea created basic data that formed the foundation of an effort to enhance mental health literacy and provide proper mental health services. The results of this study can be utilized to solve mental health problems that might frequently occur during the unification process of North and South Korea in the future.
Adult ; Aged ; Democratic People's Republic of Korea ; Female ; *Health Knowledge, Attitudes, Practice ; Humans ; Literacy ; Male ; *Mental Health ; Middle Aged ; Refugees/*psychology ; Republic of Korea ; Surveys and Questionnaires

It was sometimes difficult to differentiate between acute-onset chronic inflammatory demyelinating polyneuropathy (A-CIDP) and subacute inflammatory demyelinating polyneuropathy (SIDP). The CNS involvement of these polyneuropathies has rarely reported in the literature. We present the case of a 42-year-old man who developed rapidly developing inflammatory demyelinating polyneuropathy followed by right optic neuritis. This case showed progressive motor weakness and sensory dysfunction with time to nadir at 8 weeks, demyelination in nerve conduction study, no other etiology of neuropathy, no relapse during follow-up of 18 months, good response to steroid and complete recovery which favor SIDP more than A-CIDP. We experienced the case of SIDP associated with optic neuritis.
Demyelinating Diseases ; Follow-Up Studies ; Neural Conduction ; Optic Neuritis ; Polyneuropathies ; Recurrence