Objective: To present workplace‐based entrustable professional activities (EPAs) assessment data from the first 2 years of the EMYWAY platform in otolaryngology residency training in Taiwan.Study Design: Two‐year cross‐sectional study.Setting: Otolaryngology training programs.Methods: In 2020, the Taiwan Society of Otorhinolaryngology–Head and Neck Surgery (TSO‐HNS) developed a workplace‐based assessment (WBA) framework with 11 EPAs, integrating milestones to evaluate resident competency. In 2021, TSO‐HNS piloted the EMYWAY platform for WBAs, which includes an EPA‐based assessment workflow, coaching feedback, and a dashboard displaying residents' entrustment‐supervision levels. Data are analyzed annually for accreditation and curriculum enhancement. This study reports on the pilot year and the first full‐scale year of implementation.Results: Eleven programs participated in the pilot year. Subsequently, 362 faculty members and 274 resident physicians from 34 programs nationwide engaged with EMYWAY. In the full‐scale year from August 2022 to July 2023, 9805 responses were recorded, primarily from surgical theaters (45.9%; 4502/9805) and third‐year residents (23.8%; 2331/9805). The most frequently evaluated EPAs were “head and neck” (17.5%; 1716/9805), “sinonasal” (13.5%; 1324/9805), and “ear” (12.2%; 1193/9805), with task complexity increasing with resident seniority (P < .0001). A positive correlation was found between residents' self‐assessments and faculty members' ratings (r = 0.531; P < .001). Over 98.2% of residents and 88.4% of faculty members provided substantial feedback (>10 words). Analysis of WBAs reported by training programs identified faculty development targets and teaching‐intensive tasks.Conclusion: EMYWAY effectively documents workplace learning and tracks resident competency progression. Continuous improvement of WBA quality is essential for advancing the competency‐based medical education ecosystem.

Background/Objectives: Progressive collapsing foot deformity (PCFD) is driven by multiplanar peritalar instability. This study evaluated the clinical and radiographic outcomes of a standardized four-component reconstruction protocol designed to facilitate immediate postoperative weight-bearing in Stage 1a/1b PCFD. Methods: This single-center retrospective study included 20 patients treated between 2015 and 2023 with medializing calcaneal osteotomy, spring ligament repair, flexor digitorum longus (FDL) tendon transfer with internal brace augmentation, and subtalar arthroereisis. Clinical (VAS, AOFAS) and radiographic parameters (anteroposterior and lateral Meary angles, calcaneal pitch, and talonavicular coverage angle) were assessed longitudinally, with subgroup analysis comparing implant removal versus retention. Results: The protocol yielded significant overall improvements. Mean VAS decreased by 4.37 points (p < 0.001), and final AOFAS reached 84.7 ± 7.6 at the final follow-up. Although subtalar arthroereisis was removed in 45% of patients due to symptomatic irritation, subgroup analysis revealed no significant loss of radiographic correction (p > 0.05). Notably, a significant interaction effect was observed for VAS scores (p = 0.002) and AOFAS scores (p = 0.041), with the removal group demonstrating a pronounced functional recovery trajectory following explantation. No major complications occurred. Conclusions: A standardized four-in-one reconstruction provides reliable multiplanar correction in Stage 1a/1b PCFD. The maintenance of structural alignment despite a high implant removal rate supports the role of arthroereisis as a temporary but valuable adjunct for early mobilization. This strategy offers a reproducible framework for joint-preserving PCFD management.

Background Systemic lupus erythematosus (SLE) is an autoimmune disease characterized by diverse clinical manifestations with multi-organ damage and an increased risk of mortality. Several clinical characteristics have been identified as predictors of overall mortality in patietns with SLE, including oragan damage, time from onset to diagnosis > 1 year, nephropathy, male gender, older age of onset, high Systemic Lupus Eythematosus Disease Activity Index (SLEDAI) scores and high Age-adjusted Charlson Comorbidity Index (ACCI) scores. However, whether trajectories of dsDNA and C3, two of the frequently monitored immune profiles, are associated with mortality among patients with SLE is still unknow. We aimed to assess the association of mortality with dual trajectories of dsDNA and C3 within two years in a large Taiwanese lupus cohort. Objectives We aimed to assess the association of mortality with dual trajectories of dsDNA and C3 within two years in a large Taiwanese lupus cohort. Methods The study linked electronic medical record data at Taichung Veterans Genral hospital to the file of Cause of Death Data from the National Health Insurance Research Database managed by Center for Helath and Welfare Data Science in Taiwan. From Jan 1, 2000 to Mar 31, 2021, we identified 4850 patients with SLE who were followed up at TCVGH. We excluded 131 patients who were dead and 364 patients who were lost to follow-up withing 2 years. We also excluded 1999 patients who did not have at less 2 records of paired dsDNA and C3 data ever 3 months during the first two-years. We finally included 2,356 patients for trajectories analysis. The first 2 years of follow-up was used to establish trajectories of dsDNA and C3. We calculated the man ± standard deviation of dsDNA and C3 for the eight 3-month intervals and we used these data separately for trajectory determination, which was by group-based trajectory analysis with a latent class growth model, fitting the SAS Proc Traj procedure. We classified patients with SLE into 4 groups (G) based on dual trajectories of dsDNA and C3: G1- lowest dsDNA and second highest C3 trajectory (41.6%); G2- lowest dsDNA and highest C3 trajectory (32.0%); G3- second highest dsDNA and second highest C3 trajectory (19.2%); group 4, highest dsDNA and lowest C3 trajectory (7.1%). The relative risk of mortality was estimated using Cox proportional hazard model adjusting for age, gender, hypertension, diabetes mellitus and hyperlipidemia, shown as hazard ratios (HRs) with 95% confidence intervals (CIs). Results The proportions of female in G1-G4 were 88.0%, 87.0%, 86.7% and 84.0% respectively. The mean age in G1-G4 were 37.6 years, 41.3 years, 36.4 years and 34.7 years respectively. The mortality rates were highest in G1 (6.24 cases per 1,000 person-years), followed by G2 (5.90 cases per 1,000 person-years), G3 (5.04 cases per 1,000 person-years) and G4 (4.19 cases per 1,000 person-years). After adjusting for potential confounders, the risk of mortality in G1 was significantly higher in G2 (HR, 1.67; 95% CI, 1.10–2.53; p = 0.016), but not in G3 (HR, 1.16; 95% CI, 0.66–2.05; p = 0.605) and G4 (HR, 1.22; 95% CI, 0.51–2.91; p = 0.659) as compared to that in G2. Other significant independent predictors of mortality included age (HR, 1.05; 95% CI, 1.04–1.06; p < 0.001) and hypertension (HR, 1.83; 95% CI, 1.14–2.95; p = 0.013). Trajectories of dsDNA during the first two years in four groups. Trajectories of C3 during the first two years in four groups. Conclusion This single center study revealed that SLE patients with lowest dsDNA and second highest C3 trajectory had a significantly higher risk of mortality than SLE patients with lowest dsDNA and highest C3 trajectory. REFERENCES: NIL. Acknowledgements: NIL. Disclosure of Interests None Declared.