Objective: We investigated the distribution of AI viruses in fecal samples from wild bird habitats (and nearby poultry-farm areas) surveyed between September and March from 2019 to 2025 and identified associated epidemiological risk factors. Methods: Samples were screened for influenza A (M, H5, H7) genes using real-time reverse transcription polymerase chain reaction (PCR), subjected to virus isolation in embryonated chicken eggs, and subtyped by PCR and sequencing. Host species were identified through DNA barcoding. Relative risks (RRs) with 95% confidence intervals were estimated for province, month, and waterfowl density. Results: Overall prevalence of HPAI and low pathogenic AI (LPAI) virus was 0.10% and 3.21%, respectively. HPAI virus was continuously isolated since 2020–2021, except 2019– 2020, while LPAI prevalence steadily increased (3.01%–4.35%). Twelve hemagglutinin (H1–H12) subtypes were identified in 1,722 isolates, and H3 (16.5%) was the most prevalent, followed by H5 (11.1%) and H7 (5.2%). LPAI H5N3 (55.7%) and H7N7 (75.5%) were the predominant H5 and H7 subtypes, respectively. Detection was higher in western coastal provinces, and higher mallard/spot-billed duck density and sampling in September– December were associated with increased risk. Conclusions and Relevance: Continued surveillance of migratory-bird habitats can provide early warning of HPAIV incursions and support targeted biosecurity measures in high-risk regions and seasons.

Background: and Purpose: To assess the long-term effectiveness, safety, and economic viability of recently approved Alzheimer’s disease (AD) therapies, as well as to evaluate the real-world application of novel diagnostics among AD patients with diverse comorbidities, comprehensive real-world data (RWD) analysis is essential. The Korean JOint RegistrY for ALZheimer’s Treatment and Diagnostics (JOY-ALZ) endeavors to create a registry of RWD derived from clinical practice on new diagnostic methods and therapeutic agents for AD introduced in Korea since 2021. Methods: Participants must fulfill all the following: 1) be at least 19 years old; 2) be actively receiving, scheduled to initiate, or undergoing evaluation for any AD disease-modifying treatment; 3) have completed amyloid positron emission tomography or cerebrospinal fluid AD immunoassay (a positive result is not essential for participation); 4) have a clinical classification of cognitively unimpaired, mild cognitive impairment, or probable AD dementia. Data generated during routine care is segmented into a minimum dataset, extended dataset, and research-only dataset requiring extra consent. Assessments encompass clinical, cognitive, functional, neurobehavioral, neuroimaging, and biomarker evaluations, in addition to systematic monitoring of new AD treatments and their safety.Data are collected and monitored at baseline, at semiannual intervals during the initial 2 years, and then annually up to 2034. To date, 46 medical centers will participate in JOY-ALZ. Conclusions JOY-ALZ is expected to promote understanding of the long-term clinical outcomes, safety, and cost-effectiveness of recently introduced diagnostics and treatments for AD, thereby supporting the progress of precision medicine in AD care and diagnosis.

Background and Objectives: Primary prevention (PP) implantable cardioverter-defibrillator (ICD) therapy for ischemic cardiomyopathy (ICM) is underused in Asian countries, including South Korea. Both clinical and hospital factors may influence appropriate ICD use. We evaluated whether determinants of PP ICD implantation differ by hospital implantation volume. Methods: In this prospective, multicenter observational registry (blinded for review), patients eligible for PP ICD were enrolled. Factors associated with ICD implantation—clinical characteristics and hospital-level systems—were examined across 4 large-volume hospitals (≥ 15 implants during the study) and 12 small-volume hospitals (< 15). Multivariable logistic regression identified independent predictors. Results: Among 3,083 ICM patients (2,403 men; median age 70 years), PP ICD implantation rates were 10.8% in large-volume and 5.7% in small-volume hospitals. Across groups, male sex and chronic kidney disease independently predicted ICD implantation. Regarding hospital factors, non-monetary incentives for referral were the sole independent predictor in large-volume centers (odds ratio [OR], 3.55; 95% confidence interval [CI], 2.07–6.10;P < 0.001). In small-volume centers, heart failure conferences (OR, 12.73; 95% CI, 1.72–94.37;P = 0.013), structured education systems (OR, 11.72; 95% CI, 2.45–56.12; P = 0.02), and pacemaker clinics (OR, 11.4; 95% CI, 2.24–58.39; P = 0.003) were independently associated with implantation. Conclusions Clinical predictors of PP ICD use were consistent across hospital volumes, but hospital-level determinants differed. Referral incentives characterized large-volume centers, whereas conferences, education systems, and pacemaker clinics were key in smallvolume centers. Tailored institutional strategies by hospital volume may help close the PP ICD underuse gap and improve evidence-based implementation.

Objectives: Clinical examination is considered the gold standard for monitoring periodontal disease. However, it requires significant resources. Self-reported assessment serves as a useful method for screening periodontal diseases in different cohorts. We aimed to evaluate the validity of a selfreported questionnaire for the surveillance of periodontal disease among Korean adults. Methods: The participants were 120 patients aged ≥19 years old who were examined using the community periodontal index. The questionnaire comprised 10 questions, translated from an English-version, that was used to identify periodontitis. The predictiveness of the measures from the self-reported questions was assessed by multivariable logistic regression modeling using the area under the receiver operating characteristic curve (AUROC), sensitivity, and specificity. Results: For item 3, “Have you ever had treatment for gum disease, such as scaling and root planning”, the adjusted odds ratio was 4.65; 95% confidence interval, 1.22-17.67; and AUROC, 0.82. The sensitivity and specificity of this item were, 0.93 and 0.42, respectively. In Kendall’s Tau-b correlation analysis, items 1 (“Have gum disease”) and 10 Periodontal treatment and surgery under anesthesia”) had the strongest correlations with item 3, with correlation coefficients of 0.48 and 0.42, respectively. A model combining items 1, 3, and 10, adjusted for demographic variables, resulted in an AUROC of 0.86, sensitivity of 0.86, and specificity of 0.26. Conclusions An adapted Korean version (“Have gum disease”, “Treatment for gum disease, such as scaling and root planning”, and “periodontal treatment under anesthesia”) of the self-reported questionnaire demonstrated its capacity for epidemiological surveillance of periodontal disease in this study cohort.

Background: Healthcare-associated infections impose a significant burden on antibiotic usage, healthcare expenditures, and morbidity. Therefore, it is crucial to revise policies to minimize such losses. This nationwide survey aimed to evaluate infection prevention and control (IPC) components in healthcare facilities and encourage improvements in acute care hospitals with inadequate infection prevention settings. This study aims to enhance the infection control capabilities of healthcare facilities. Methods: From December 27, 2021, to May 13, 2022, we conducted a survey of 1,767 acute care hospitals in the Republic of Korea. A survey was conducted to evaluate the infection control components in 1,767 acute care hospitals. Infection control officers provided direct responses to a systematically developed questionnaire. Subsequently, 10% of the respondents were randomly selected for the site investigation. Results: Overall, 1,197 (67.7%) hospitals responded to the online survey. On-site investigations were conducted at 125 hospitals. Hospitals with ≥ 150 beds are advised to have an IPC team under Article 3 of the Medical Service Act; however, only 87.0% (598/687) of hospitals with ≥ 100 beds had one. Conversely, 22.7% (116/510) of hospitals with < 100 beds had an IPC team. Regulations for hand hygiene, waste management, healthcare worker protection and safety, environmental cleaning, standard precautions, and prevention of the transmission of multidrug-resistant pathogens were present in 84.2%, 80.1%, 77.4%, 76.2%, 75.8%, and 63.5% of the hospitals, respectively. Hospitals with < 100 beds had low availability of all categories of standard operating procedures. Conclusion This study is the first national survey of acute care hospitals in the Republic of Korea. The data presented in the current study will improve the understanding of IPC status and will help establish a survey system. Our survey provides a basis for improving policies related to IPC in healthcare facilities.

Objectives: Clinical examination is considered the gold standard for monitoring periodontal disease. However, it requires significant resources. Self-reported assessment serves as a useful method for screening periodontal diseases in different cohorts. We aimed to evaluate the validity of a selfreported questionnaire for the surveillance of periodontal disease among Korean adults. Methods: The participants were 120 patients aged ≥19 years old who were examined using the community periodontal index. The questionnaire comprised 10 questions, translated from an English-version, that was used to identify periodontitis. The predictiveness of the measures from the self-reported questions was assessed by multivariable logistic regression modeling using the area under the receiver operating characteristic curve (AUROC), sensitivity, and specificity. Results: For item 3, “Have you ever had treatment for gum disease, such as scaling and root planning”, the adjusted odds ratio was 4.65; 95% confidence interval, 1.22-17.67; and AUROC, 0.82. The sensitivity and specificity of this item were, 0.93 and 0.42, respectively. In Kendall’s Tau-b correlation analysis, items 1 (“Have gum disease”) and 10 Periodontal treatment and surgery under anesthesia”) had the strongest correlations with item 3, with correlation coefficients of 0.48 and 0.42, respectively. A model combining items 1, 3, and 10, adjusted for demographic variables, resulted in an AUROC of 0.86, sensitivity of 0.86, and specificity of 0.26. Conclusions An adapted Korean version (“Have gum disease”, “Treatment for gum disease, such as scaling and root planning”, and “periodontal treatment under anesthesia”) of the self-reported questionnaire demonstrated its capacity for epidemiological surveillance of periodontal disease in this study cohort.

Background: Healthcare-associated infections impose a significant burden on antibiotic usage, healthcare expenditures, and morbidity. Therefore, it is crucial to revise policies to minimize such losses. This nationwide survey aimed to evaluate infection prevention and control (IPC) components in healthcare facilities and encourage improvements in acute care hospitals with inadequate infection prevention settings. This study aims to enhance the infection control capabilities of healthcare facilities. Methods: From December 27, 2021, to May 13, 2022, we conducted a survey of 1,767 acute care hospitals in the Republic of Korea. A survey was conducted to evaluate the infection control components in 1,767 acute care hospitals. Infection control officers provided direct responses to a systematically developed questionnaire. Subsequently, 10% of the respondents were randomly selected for the site investigation. Results: Overall, 1,197 (67.7%) hospitals responded to the online survey. On-site investigations were conducted at 125 hospitals. Hospitals with ≥ 150 beds are advised to have an IPC team under Article 3 of the Medical Service Act; however, only 87.0% (598/687) of hospitals with ≥ 100 beds had one. Conversely, 22.7% (116/510) of hospitals with < 100 beds had an IPC team. Regulations for hand hygiene, waste management, healthcare worker protection and safety, environmental cleaning, standard precautions, and prevention of the transmission of multidrug-resistant pathogens were present in 84.2%, 80.1%, 77.4%, 76.2%, 75.8%, and 63.5% of the hospitals, respectively. Hospitals with < 100 beds had low availability of all categories of standard operating procedures. Conclusion This study is the first national survey of acute care hospitals in the Republic of Korea. The data presented in the current study will improve the understanding of IPC status and will help establish a survey system. Our survey provides a basis for improving policies related to IPC in healthcare facilities.

Heart failure (HF) is a major cause of mortality and morbidity in South Korea, imposing substantial physical, emotional, and financial burdens on patients and society. Despite the high burden of symptom and complex care needs of HF patients, palliative care and hospice services remain underutilized in South Korea due to cultural, institutional, and knowledge-related barriers. This position statement from the Korean Society of Heart Failure emphasizes the need for integrating palliative and hospice care into HF management to improve quality of life and support holistic care for patients and their families. By clarifying the role of palliative care in HF and proposing practical referral criteria, this position statement aims to bridge the gap between HF and palliative care services in South Korea, ultimately improving patient-centered outcomes and aligning treatment with the goals and values of HF patients.

Purpose: We aimed to evaluate the effect of long-term oral OM-89 therapy on the urinary microflora in patients with urolithiasis. Materials and Methods: Patients underwent surgical removal of urinary stones followed by no OM-89 treatment for six months or daily OM-89 administration. Urine culture and urinary polymerase chain reaction (PCR) were performed at the baseline visit (V1) and at 2 months (V2) and 6 months (V3) after the operation. Results: A total of 113 patients completed the study. The rate of urinary bacteria detection by urine culture at V3 did not differ between OM-89 treated and untreated groups (p>0.999); however, the PCR detection rate tended to be higher in OM-89 untreated group than in OM-89 treated group (p=0.052). Escherichia coli and Enterococcus spp. were the bacteria most commonly detected via both urine culture and PCR at all timepoints. Risk factors for the detection of bacteria by urine culture at V3 were positive culture at V1 (p=0.048) and female sex (p=0.048), whereas positive PCR at V3 was associated with female sex (p=0.023), positive PCR at V2 (p<0.001), and no OM-89 treatment (p=0.038). The use of OM-89 was associated with decreased rates of bacterial detection by PCR at V2 and a further decrease at V3. Conclusions Long-term immunization with OM-89 could further decrease the frequency of urinary bacterial colonization after surgical removal of urinary stones. OM-89 could be used as a complementary therapy if a retrieved stone is suspected to be related to infection.

Objectives: Clinical examination is considered the gold standard for monitoring periodontal disease. However, it requires significant resources. Self-reported assessment serves as a useful method for screening periodontal diseases in different cohorts. We aimed to evaluate the validity of a selfreported questionnaire for the surveillance of periodontal disease among Korean adults. Methods: The participants were 120 patients aged ≥19 years old who were examined using the community periodontal index. The questionnaire comprised 10 questions, translated from an English-version, that was used to identify periodontitis. The predictiveness of the measures from the self-reported questions was assessed by multivariable logistic regression modeling using the area under the receiver operating characteristic curve (AUROC), sensitivity, and specificity. Results: For item 3, “Have you ever had treatment for gum disease, such as scaling and root planning”, the adjusted odds ratio was 4.65; 95% confidence interval, 1.22-17.67; and AUROC, 0.82. The sensitivity and specificity of this item were, 0.93 and 0.42, respectively. In Kendall’s Tau-b correlation analysis, items 1 (“Have gum disease”) and 10 Periodontal treatment and surgery under anesthesia”) had the strongest correlations with item 3, with correlation coefficients of 0.48 and 0.42, respectively. A model combining items 1, 3, and 10, adjusted for demographic variables, resulted in an AUROC of 0.86, sensitivity of 0.86, and specificity of 0.26. Conclusions An adapted Korean version (“Have gum disease”, “Treatment for gum disease, such as scaling and root planning”, and “periodontal treatment under anesthesia”) of the self-reported questionnaire demonstrated its capacity for epidemiological surveillance of periodontal disease in this study cohort.