Purpose: The Dr. LEE Jong-wook Fellowship Program, established by the Korea Foundation for International Healthcare (KOFIH), aims to strengthen healthcare capacity in partner countries. The aim of the study was to develop new performance evaluation indicators for the program to better assess long-term educational impact across various courses and professional roles. Methods: A 3-stage process was employed. First, a literature review of established evaluation models (Kirkpatrick’s 4 levels, context/input/process/product evaluation model, Organization for Economic Cooperation and Development Assistance Committee criteria) was conducted to devise evaluation criteria. Second, these criteria were validated via a 2-round Delphi survey with 18 experts in training projects from May 2021 to June 2021. Third, the relative importance of the evaluation criteria was determined using the analytic hierarchy process (AHP), calculating weights and ensuring consistency through the consistency index and consistency ratio (CR), with CR values below 0.1 indicating acceptable consistency. Results: The literature review led to a combined evaluation model, resulting in 4 evaluation areas, 20 items, and 92 indicators. The Delphi surveys confirmed the validity of these indicators, with content validity ratio values exceeding 0.444. The AHP analysis assigned weights to each indicator, and CR values below 0.1 indicated consistency. The final set of evaluation indicators was confirmed through a workshop with KOFIH and adopted as the new evaluation tool. Conclusion The developed evaluation framework provides a comprehensive tool for assessing the long-term outcomes of the Dr. LEE Jong-wook Fellowship Program. It enhances evaluation capabilities and supports improvements in the training program’s effectiveness and international healthcare collaboration.

Purpose: The Dr. LEE Jong-wook Fellowship Program, established by the Korea Foundation for International Healthcare (KOFIH), aims to strengthen healthcare capacity in partner countries. The aim of the study was to develop new performance evaluation indicators for the program to better assess long-term educational impact across various courses and professional roles. Methods: A 3-stage process was employed. First, a literature review of established evaluation models (Kirkpatrick’s 4 levels, context/input/process/product evaluation model, Organization for Economic Cooperation and Development Assistance Committee criteria) was conducted to devise evaluation criteria. Second, these criteria were validated via a 2-round Delphi survey with 18 experts in training projects from May 2021 to June 2021. Third, the relative importance of the evaluation criteria was determined using the analytic hierarchy process (AHP), calculating weights and ensuring consistency through the consistency index and consistency ratio (CR), with CR values below 0.1 indicating acceptable consistency. Results: The literature review led to a combined evaluation model, resulting in 4 evaluation areas, 20 items, and 92 indicators. The Delphi surveys confirmed the validity of these indicators, with content validity ratio values exceeding 0.444. The AHP analysis assigned weights to each indicator, and CR values below 0.1 indicated consistency. The final set of evaluation indicators was confirmed through a workshop with KOFIH and adopted as the new evaluation tool. Conclusion The developed evaluation framework provides a comprehensive tool for assessing the long-term outcomes of the Dr. LEE Jong-wook Fellowship Program. It enhances evaluation capabilities and supports improvements in the training program’s effectiveness and international healthcare collaboration.

Purpose: The Dr. LEE Jong-wook Fellowship Program, established by the Korea Foundation for International Healthcare (KOFIH), aims to strengthen healthcare capacity in partner countries. The aim of the study was to develop new performance evaluation indicators for the program to better assess long-term educational impact across various courses and professional roles. Methods: A 3-stage process was employed. First, a literature review of established evaluation models (Kirkpatrick’s 4 levels, context/input/process/product evaluation model, Organization for Economic Cooperation and Development Assistance Committee criteria) was conducted to devise evaluation criteria. Second, these criteria were validated via a 2-round Delphi survey with 18 experts in training projects from May 2021 to June 2021. Third, the relative importance of the evaluation criteria was determined using the analytic hierarchy process (AHP), calculating weights and ensuring consistency through the consistency index and consistency ratio (CR), with CR values below 0.1 indicating acceptable consistency. Results: The literature review led to a combined evaluation model, resulting in 4 evaluation areas, 20 items, and 92 indicators. The Delphi surveys confirmed the validity of these indicators, with content validity ratio values exceeding 0.444. The AHP analysis assigned weights to each indicator, and CR values below 0.1 indicated consistency. The final set of evaluation indicators was confirmed through a workshop with KOFIH and adopted as the new evaluation tool. Conclusion The developed evaluation framework provides a comprehensive tool for assessing the long-term outcomes of the Dr. LEE Jong-wook Fellowship Program. It enhances evaluation capabilities and supports improvements in the training program’s effectiveness and international healthcare collaboration.

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.

Background: Guselkumab is a monoclonal antibody that selectively blocks the p19 subunit of interleukin-23. It has shown good efficacy and safety profile in several clinical trials of plaque psoriasis. However, studies on the efficacy of guselkumab in patients treated with other biologics are lacking. Objective: We aimed to investigate the efficacy and safety profile of guselkumab in patients with moderate-to-severe plaque psoriasis. We also compared the efficacy of guselkumab between biologic-naïve (Bio-Naïve) and biologicexperienced (Bio-Ex) patients. Methods: This multicenter, retrospective study included 72 patients treated with guselkumab. The patients’ clinical characteristics and psoriasis area and severity index (PASI) scores were recorded at each visit. The PASI90 and PASI100 responses and mean PASI scores were compared between the Bio-Naïve and Bio-Ex groups. Results: Fifty-five Bio-Naïve patients and 17 Bio-Ex patients were included in the study. At week 20, there were no significant differences in the PASI90 (64.2% vs. 53.8%) and PASI100 (28.3% vs. 15.4%) responses between the groups. However, at weeks 36 and 44, the PASI90 response (week 36: 89.2% vs. 36.4% and week 44: 97.8% vs. 63.6%) and the PASI100 response (week 36: 64.9% vs. 18.2% and week 44: 68.9% vs. 27.3%) were significantly higher in the Bio-Naïve group (p＜0.05). There were no differences in PASI90 and PASI100 responses between the groups in terms of other clinical characteristics and comorbidities at week 20. Conclusion The efficacy of guselkumab remained consistent among patients in whom other biologics had failed. However, the efficacy was slightly lower in the Bio-Ex group than in the Bio-Naïve group.

Purpose: The coronavirus disease 2019 pandemic saw many restrictions on the provision of emergency medical service (EMS) training through actual field trips (AFTs), requiring a search for alternatives. This study aimed to assess trainees’ reactions to virtual field trips (VFTs) and determine the characteristics of instructional design for successful VFTs using edited videos and expert interviews. Methods: This study evaluated Uzbekistan trainees’ reactions to the VFT of EMS training using questionnaires in three categories: satisfaction, relevance, and engagement. Factors of satisfaction and dissatisfaction were identified through open-ended questions. Results: A total of 286 trainees responded to the survey during 15 educational sessions conducted from 2020 to 2022. The trainees’ responses to the VFT were positive. Overall mean scores were 4.65±0.49, 4.63±0.50, and 4.63±0.50 out of 5 points for satisfaction, relevance, and engagement, respectively. The trainees reported that the most interesting and helpful videos concerned the introduction of an EMS training curriculum and the observation of training facilities, such as the simulation centers of educational institutes. The leading causes of satisfaction were (1) authenticity of the VFTs, (2) easy-to-understand content, and (3) relevance to the job. The trainees suggested that Uzbek or Russian voice-overs would be better than subtitles in the video clip for focusing on VFT. Conclusion In situations where AFTs are not available, VFTs using edited videos and expert interviews are a good alternative to EMS education. Based on these results, it is possible that AFTs could be replaced by VFTs using qualified videos with designed instructions as a distance learning method under specific conditions.

Background/Aims: The association between symptomatic knee osteoarthritis (OA) and higher cardiovascular disease (CVD) mortality is established; however, findings from studies that utilized regression analysis were limited, attributed to the strong association between OA and metabolic risk factors. This study aimed to evaluate the association between knee OA and mortality through propensity score matching. Methods: This was a cohort study including Korean National Health and Nutrition Examination Survey (2010–2013) participants aged ≥ 50 years. By linking the survey data to cause of death data (through 2019) from Statistics Korea, mortality and cause-specific mortality data were obtained. Radiographic knee OA (ROA) was defined as bilateral Kellgren–Lawrence grade ≥ 2. Propensity score matching (1:1) was conducted between asymptomatic ROA, knee pain, and symptomatic ROA groups and normal groups, balancing the confounding factors. Time to death was analyzed using Cox proportional hazard modeling. Results: A higher CVD mortality was observed in the symptomatic ROA group, but not in others; the risk estimates were asymptomatic ROA (hazard ratio [HR] 1.12; 95% confidence interval [CI] 0.77–1.65), knee pain (HR 0.61; 95% CI 0.27–1.38), and symptomatic ROA (HR 1.39; 95% CI 0.89–2.17). No association was found between the all-cause/cancer mortality and other groups. Conclusions When propensity score matching controls metabolic risk factor imbalances, the association between symptomatic knee OA and higher CVD mortality was weaker compared to results of prior studies that used regression adjustment. The results may be more precise estimates of the total risk of knee OA for mortality in Koreans.

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.