Effectiveness of the COVID-19 vaccine in the Honam region of the Republic of Korea

Objectives@#In 2021, the effectiveness of the COVID-19 vaccine was analyzed among people living in the Honam region (Gwangju, Jeollanam-do, Jeollabuk-do, and Jeju) of the Republic of Korea. And we investigated changes in the dominant virus strain. @*Methods@#This study used the data provided by the Korean Ministry of the Interior and Safety for individuals ≥12 years old in the Honam region, and the Integrated Disease and Health Management System of the Korea Centers for Disease Control and Prevention for COVID-19-vaccinated individuals as of December 31, 2021. Statistical analyzes were performed using IBM SPSS ver. 23.0. The occurrence of confirmed cases by vaccination status, the relative risk, and vaccine effectiveness by vaccine type were calculated. @*Results@#In 2021, the COVID-19 vaccination rate in Honam was 88.6%. The overall vaccine effectiveness (after 2 and 3 doses) was 98.7% (p98%, and the effect among persons who received 2 doses was >90% regardless of the vaccine type. Although vaccine effectiveness decreased because of reduced antibody levels over time (as observed in breakthrough infections), receiving a booster dose restored the neutralizing antibody levels.

The influence of eHealth literacy, reproductive health knowledge, and self-esteem on health-promoting behaviors in early adult women: a cross-sectional survey

The purpose of this study was to investigate the influence of eHealth literacy, reproductivehealth knowledge, and self-esteem on early adult women’s health-promoting behaviors (HPB). Thisstudy was based on Pender’s health promotion model as a theoretical underpinning.Methods: Early adult women aged 18 to 35 years (n=165) were recruited by posting advertisements on social network sites for a student club and a faith-based community in Ansan, Korea. Willing individuals were invited to participate in the online survey from June 1 to June 30, 2022. Standardized instruments were used to measure HPB, eHealth literacy, reproductive health knowledge,and self-esteem. General characteristics included income level, perceived subjective health, and internet usage time. The collected data were analyzed using the independent t-test, one-way analysisof variance, Pearson correlation coefficients, and multiple regression.Results: The mean age of the respondents was 21.97±3.87 years. The total HPB score was 120.69,corresponding to a moderate level; and the total scores for eHealth literacy (30.24), knowledge ofreproductive health (23.04), and self-esteem (35.62) were higher than the midpoint. The model explained 53.3% of variance in HPB, and self-esteem (β=.48, p<.001) was the most influential factor.Other influential factors were, in descending order, higher economic level, higher subjective healthstatus, greater eHealth literacy, and less internet use time (<2 hours/day).Conclusion: In order to promote the health of early adult women, counseling or programs that positively improve self-esteem appear promising, and eHealth literacy should be considered as a way topromote HPB using information technology.

Volumetric Splenomegaly in Patients With Polycythemia Vera

Background@#Non-palpable splenomegaly in patients with polycythemia vera (PV) has seldom been addressed. In this retrospective study, we evaluated non-palpable, volumetric splenomegaly defined based on age- and body surface area (BSA)–matched criteria in patients with PV diagnosed according to the 2016 World Health Organization diagnostic criteria. @*Methods@#Patients with PV who underwent abdominal computed tomography (CT) and who had palpable splenomegaly at diagnosis from January 1991 to December 2020 at Chungnam National University Hospital were enrolled. The spleen volume of each patient was determined by volumetric analysis of abdominal CT and adjusted for the patient’s age and BSA. Then the degree of splenomegaly was classified as no splenomegaly, borderline volumetric splenomegaly, overt volumetric splenomegaly, or palpable splenomegaly. @*Results@#Of the 87 PV patients enrolled, 15 (17.2%) had no splenomegaly, whereas 17 (19.5%), 45 (51.7%), and 10 (11.5%) had borderline volumetric, overt volumetric, and palpable splenomegaly, respectively. The degree of splenomegaly did not affect the cumulative incidence of thrombotic vascular events (10-year incidence: 7.7%, 0%, 22.3%, and 50.7%, respectively, P = 0.414). By contrast, splenomegaly tended to adversely affect myelofibrotic transformation (10-year cumulative incidence: 0%, 0%, 7.1%, and 30.3%, respectively, P = 0.062). Moreover, the cumulative incidence of myelofibrotic transformation was significantly higher in patients with overt volumetric or palpable splenomegaly than those with no or borderline volumetric splenomegaly (10-year incidence: 0% vs. 10.3%, respectively; 15-year incidence: 0% vs. 26.3%, respectively, P = 0.020). Overall survival (OS) differed among patients with different degrees of splenomegaly (15-year OS: 100%, 78.6%, 71.7%, and 51.9%, respectively, P = 0.021). @*Conclusion@#The degree of splenomegaly, including volumetric splenomegaly, based on ageand BSA-matched reference spleen volumes at diagnosis reflects disease progression in PV patients. Therefore, volumetric splenomegaly should be evaluated at the time of diagnosis and taken into consideration when predicting the prognosis of patients with PV.

Validity and Reliability of the Korean Version of Assessment of Health Literacy in Breast and Cervical Cancer Screening

Purpose@#Health literacy is a significant determinant of health and health behaviors such as cancer screening. Despite its significance, there are limited instruments available to assess health literacy targeting Koreans. The purpose of this study was to test the psychometric properties of Korean translation of a validated health literacy instrument in cancer screening—Korean version of assessment of health literacy in breast and cervical cancer screening (K-AHL-C). @*Methods@#A total of 555 women aged 20~65 participated in the online survey study. Of 52 items addressing five domains included in the original version, we focused on 36 items addressing three key domains closely associated with cancer screening: familiarity, health navigation, and comprehension. @*Results@#During content validation, two items from the health navigation domain were removed, yielding 34 items. Using Rasch analysis and confirmatory factor analysis, we found the evidence of construct validity of K-AHL-C. The Korean version was also significantly correlated with measures of Functional Health Literacy scale, cancer prevention behaviors, and subjective health status, suggesting convergent validities respectively. Finally, K-AHL-C had acceptable reliability coefficients (α) ranging from 0.71 to 0.92 for each domain and the total scale. @*Conclusion@#These psychometric properties support the K-AHL-C is a valid and reliable instrument for measuring Koreans’ health literacy in cancer screening. Also it is expected to use the instrument to detect breast and cervical cancer early and improve the screening rate, and ultimately to contribute to the promotion of women's health and women's health nursing practice.

Risk Factors of the High-Risk Pregnancy and Association with Particulate Matter

Purpose@#High-risk pregnancy, resulting in major complications, such as abortion, gestational hypertension, and preterm labor, are on the rise, requiring intervention. Increased concentration of particulate matter that is 10 μg per cubic meter or less in diameter (PM10) due to increased air pollution and industrialization has recently been noted as a risk factor for health problems, and prior studies have reported that PM10 is related to abortion, gestational hypertension, and preterm labor. @*Methods@#This study used data from the Korean medical panel between 2008 and 2016 to identify 879 women with normal pregnancies and 301 women diagnosed with high-risk pregnancies. The association between high-risk pregnancy and PM10 was analyzed using the annual average regional concentration during the same period by the Korea Environment Corporation. @*Results@#At 35 years of age or older, the risk of abortion (p<0.001; 95% confidence interval [CI], 1.43–2.71) and preterm labor increased (p<0.05; 95% CI, 0.33–0.90). Married pregnant women were at a high risk of preterm labor (p<0.05; 95% CI, 0.25–0.98), and the prevalence of gestational hypertension was high in the metropolitan area (p<0.05; 95% CI, 12.09–25.93). On comparing the average annual concentration of particulate matter according to the level of atmospheric ventilation of the Korea Environment Corporation using a cutoff of ≤50 μg/m3, the probability of preterm labor was 2.2 times higher in groups exposed to particulate matter concentration of ≥50 μg/m3 (p<0.01; 95% CI, 1.49–3.25). @*Conclusion@#PM10 was related to preterm labor, and the risk of preterm labor was high if the average annual concentration of PM10 in the individual’s residential area exceeded 50 μg/m3.

New genotype classification and molecular characterization of canine and feline parvoviruses

Background@#Canine parvovirus (CPV) and feline panleukopenia (FPV) cause severe intestinal disease and leukopenia. @*Objectives@#In Korea, there have been a few studies on Korean FPV and CPV-2 strains. We attempted to investigate several genetic properties of FPV and CPV-2. @*Methods@#Several FPV and CPV sequences from around world were analyzed by Bayesian phylo-geographical analysis. @*Results@#The parvoviruses strains were newly classified into FPV, CPV 2-I, CPV 2-II, and CPV 2-III genotypes. In the strains isolated in this study, Gigucheon, Rara and Jun belong to the FPV, while Rachi strain belong to CPV 2-III. With respect to CPV type 2, the new genotypes are inconsistent with the previous genotype classifications (CPV-2a, -2b, and -2c). The root of CPV-I strains were inferred to be originated from a USA strain, while the CPV-II and III were derived from Italy strains that originated in the USA. Based on VP2 protein analysis, CPV 2-I included CPV-2a-like isolates only, as differentiated by the change in residue S297A/N. Almost CPV-2a isolates were classified into CPV 2-III, and a large portion of CPV-2c isolates was classified into CPV 2-II. Two residue substitutions F267Y and Y324I of the VP2 protein were characterized in the isolates of CPV 2-III only. @*Conclusions@#We provided an updated insight on FPV and CPV-2 genotypes by molecular-basedand our findings demonstrate the genetic characterization according to the new genotypes.

Diffuse Sclerosing Variant of Papillary Thyroid Carcinoma in a Child: A Case Report

The diffuse sclerosing variant of papillary thyroid carcinoma (DSPTC) is uncommon. Herein, we report a rare case of DSPTC in a 9-year-old girl who initially presented with a painless diffuse goiter. Thyroid peroxidase antibody testing yielded positive results, and the initial clinical diagnosis was Hashimoto's thyroiditis. However, thyroid ultrasonography revealed characteristic findings of DSPTC, which was confirmed through the postoperative histopathological diagnosis. Although thyroid cancers are rare in the pediatric population, DSPTC should be included in the differential diagnosis of goiter in these patients. Moreover, ultrasonography may prevent a diagnostic delay and facilitate the detection of a concomitant malignancy.

Hepatic Toxocariasis with Atypical CT and MR Imaging Findings: a Case Report

Hepatic toxocariasis is a type of visceral larva migrans caused by the migration of second-stage larvae of certain nematodes such as Toxocara canis to the liver. Histologically, the condition is characterized by granulomatous lesions containing eosinophils and inflammatory cells. We report a case of hepatic toxocariasis with atypical clinical and radiologic findings presenting as distinct, solitary hepatic nodule detected in a middle-aged woman.

Extrinsic Compression of the Left Main Coronary Artery by a Huge Aortic Arch Aneurysm Mimicking Acute Coronary Syndrome

No abstract available.

Linear programming method to construct equated item sets for the implementation of periodical computer-based testing for the Korean Medical Licensing Examination / 보건의료교육평가

PURPOSE: This study aimed to identify the best way of developing equivalent item sets and to propose a stable and effective management plan for periodical licensing examinations. METHODS: Five pre-equated item sets were developed based on the predicted correct answer rate of each item using linear programming. These pre-equated item sets were compared to the ones that were developed with a random item selection method based on the actual correct answer rate (ACAR) and difficulty from item response theory (IRT). The results with and without common items were also compared in the same way. ACAR and the IRT difficulty were used to determine whether there was a significant difference between the pre-equating conditions. RESULTS: There was a statistically significant difference in IRT difficulty among the results from different pre-equated conditions. The predicted correct answer rate was divided using 2 or 3 difficulty categories, and the ACAR and IRT difficulty parameters of the 5 item sets were equally constructed. Comparing the item set conditions with and without common items, including common items did not make a significant contribution to the equating of the 5 item sets. CONCLUSION: This study suggested that the linear programming method is applicable to construct equated-item sets that reflect each content area. The suggested best method to construct equated item sets is to divide the predicted correct answer rate using 2 or 3 difficulty categories, regardless of common items. If pre-equated item sets are required to construct a test based on the actual data, several methods should be considered by simulation studies to determine which is optimal before administering a real test.

Clinical Nurses' Resilience Skills for Surviving in a Hospital Setting: A Q-methodology Study

PURPOSE: Resilience relates to coping with stressful hospital environment. The purpose of this study was to identify the types of resilience skills of clinical nurses for surviving in a hospital setting. METHODS: The Q methodology was used as it helps analyze the participants' subjective perspective on each item. Participants were 32 registered nurses who sorted 38 selected Q statements that were then plotted on a normal distribution using a 9-point scale. The subjective perspectives on the resilience of clinical nurses were analyzed using the PC-QUANAL program. RESULTS: This study revealed four types of resilience in clinical nurses, accounting for 65.2% of the variance: Type I: Reality-harmonic type; Type II: Own will type; Type III: Professionalism-oriented type; and Type IV: Relation-oriented type. CONCLUSION: The present findings suggest the need to develop interventions for improving clinical nurses' resilience according to their types. Following further investigation of nurses' resilience, it may be necessary for organizations to develop several resilience strategies.

Factors Influencing Patient Privacy Protection Behavior among Nursing Students / 한국간호교육학회지

PURPOSE: The purpose of this study was to identify factors influencing patient privacy protection behavior among nursing students and examine the relationships between these factors. METHODS: Participants in this study were 144 nursing students who have experienced clinical practice. The data were analyzed using descriptive statistics, one-way ANOVA, Scheffe test, Pearson's correlation coefficient, and multiple regression with IBM SPSS Win 23.0 program. RESULTS: Professional self-concept and ethical values were factors influencing patient privacy protection behavior among nursing students. These variables explained 21.9% of the variance for patient privacy protection behavior. A higher level of patient privacy protection behavior was associated with higher levels of professional self-concept and ethical values. CONCLUSION: The findings demonstrate that strategies for enhancing patient privacy protection behaviors of nursing students should include methods for forming images of positive nurses and firming ethical values.

Linear programming method to construct equated item sets for the implementation of periodical computer-based testing for the Korean Medical Licensing Examination / 보건의료교육평가

PURPOSE@#This study aimed to identify the best way of developing equivalent item sets and to propose a stable and effective managementplan for periodical licensing examinations.@*METHODS@#Five pre-equated item sets were developed based on the predicted correct answer rate of each item using linear programming. These pre-equated item sets were compared to the ones that were developed with a random item selection method based on the actual correct answer rate (ACAR) and difficulty from item response theory (IRT). The results with and without common items were also compared in the same way. ACAR and the IRT difficulty were used to determine whether there was a significant difference between the pre-equating conditions.@*RESULTS@#There was a statistically significant difference in IRT difficulty among the results from different pre-equated conditions. The predicted correct answer rate was divided using 2 or 3 difficulty categories, and the ACAR and IRT difficulty parameters of the 5 item sets were equally constructed. Comparing the item set conditions with and without common items, including common items did not make a significant contribution to the equating of the 5 item sets.@*CONCLUSION@#This study suggested that the linear programming method is applicable to construct equated-item sets that reflect each content area. The suggested best method to construct equated item sets is to divide the predicted correct answer rate using 2 or 3 difficulty categories, regardless of common items. If pre-equated item sets are required to construct a test based on the actual data, several methods should be considered by simulation studies to determine which is optimal before administering a real test.

Mechanisms of quinolone resistance in Escherichia coli isolated from companion animals, pet-owners, and non-pet-owners

The present study investigated the prevalence and mechanisms of fluoroquinolone (FQ)/quinolone (Q) resistance in Escherichia (E.) coli isolates from companion animals, pet-owners, and non-pet-owners. A total of 63 E. coli isolates were collected from 104 anal swab samples, and 27 nalidixic acid (NA)-resistant isolates were identified. Of those, 10 showed ciprofloxacin (CIP) resistance. A plasmid-mediated Q resistance gene was detected in one isolate. Increased efflux pump activity, as measured by organic solvent tolerance assay, was detected in 18 NA-resistant isolates (66.7%), but was not correlated with an increase in minimum inhibitory concentration (MIC). Target gene mutations in Q resistance-determining regions (QRDRs) were the main cause of (FQ)Q resistance in E. coli. Point mutations in QRDRs were detected in all NA-resistant isolates, and the number of mutations was strongly correlated with increased MIC (R = 0.878 for NA and 0.954 for CIP). All CIP-resistant isolates (n = 10) had double mutations in the gyrA gene, with additional mutations in parC and parE. Interestingly, (FQ)Q resistance mechanisms in isolates from companion animals were the same as those in humans. Therefore, prudent use of (FQ)Q in veterinary medicine is warranted to prevent the dissemination of (FQ)Q-resistant bacteria from animals to humans.

A Model for Predicting Career Satisfaction of Nurses Experiencing Rotation

PURPOSE: This study aimed to present and test a structural model for describing and predicting the factors affecting subjective career satisfaction of nurses experiencing rotation and to develop human resources management strategies for promoting their career satisfaction related to rotation. METHODS: In this cross-sectional study, we recruited 233 nurses by convenience sampling who had over 1 year of career experience and who had experienced rotation at least once at G university hospital. Data were collected from August to September in 2016 using self-reported questionnaires. The exogenous variables consisted of rotation perception and rotation stress. Endogenous variables consisted of career growth opportunity, work engagement, and subjective career satisfaction. A hypothetical model was tested by asymptotically distribution-free estimates, and model goodness of fit was examined using absolute fit, incremental fit measures. RESULTS: The final model was approved and had suitable fit. We found that subjective career satisfaction was directly affected by rotation stress (β=.20, p=.019) and work engagement (β=.58, p<.001), indirectly affected by rotation perception (β=.43, p<.001) through career growth opportunity and work engagement. However, there was no total effect of rotation stress on subjective career satisfaction (β=−.09, p=.270). Career growth opportunity directly and indirectly affected subjective career satisfaction (β=.29, p<.001; β=.28, p<.001). These variables accounted for 65% of subjective career satisfaction. CONCLUSION: The results of this study suggest that it is necessary to establish systematic and planned criteria for rotation so that nurses can grow and develop through sustained work and become satisfied with their career.

Isolation and characterization of antimicrobial-resistant Escherichia coli from national horse racetracks and private horse-riding courses in Korea

Limited information is available regarding horse-associated antimicrobial resistant (AR) Escherichia (E.) coli. This study was designed to evaluate the frequency and characterize the pattern of AR E. coli from healthy horse-associated samples. A total of 143 E. coli (4.6%) were isolated from 3,078 samples collected from three national racetracks and 14 private horse-riding courses in Korea. Thirty of the E. coli isolates (21%) showed antimicrobial resistance to at least one antimicrobial agent, and four of the AR E. coli (13.3%) were defined as multi-drug resistance. Most of the AR E. coli harbored AR genes corresponding to their antimicrobial resistance phenotypes. Four of the AR E. coli carried class 1 integrase gene (intI1), a gene associated with multi-drug resistance. Pulsed-field gel electrophoretic analysis showed no genetic relatedness among AR E. coli isolated from different facilities; however, cross-transmissions between horses or horses and environments were detected in two facilities. Although cross-transmission of AR E. coli in horses and their environments was generally low, our study suggests a risk of transmission of AR bacteria between horses and humans. Further studies are needed to evaluate the risk of possible transmission of horse-associated AR bacteria to human communities through horse riders and horse-care workers.

Patterns and Factors associated with Complementary and Alternative Medicine Use among Korean Postpartum Women

PURPOSE: This study was conducted to identify the pattern and factors associated with women's use of complementary and alternative medicine (CAM) during postpartum in Korea. METHODS: With a descriptive survey design, data of 423 postpartum women were collected via online and offline surveys. RESULTS: A total of 251 women (59.3%) reported CAM use during postpartum. Eating animal-based foods (65.3%), plant-based health foods (52.2%), and using oriental medicine (31.8%) were commonly used in postpartum women. The reason for using CAM were physical recovery (39.1%), breastfeeding (29.7%), weight loss (24.8%), prevention of postpartum complications (5.1%), and others (1.3%). People who recommended CAM use was mainly family (41.3%), and expense of using CAM was 751,188 Korea won. Most women discussed CAM use with doctor (44.9%), and 29.3% of women didn't even consult CAM use with health care providers. Most of (72.3%) women were satisfied with CAM use. Higher level of education and monthly income, being employed, primipara, normal range of gestational weight gain, no abortion experience, and no maternal complication were significantly associated with CAM use in postpartum women. CONCLUSION: Results of this study were somewhat different from those of western research. Findings offer baseline data of CAM use in postpartum women, and health care providers need to understand it when they care for them.

Diffuse Infiltrative Splenic Lymphoma: Diagnostic Efficacy of Arterial-Phase CT

OBJECTIVE: To evaluate the diagnostic performance of obliteration of normal heterogeneous enhancement of the spleen (ONHES) on arterial phase (AP) computed tomography (CT) images in diffuse infiltrative splenic lymphoma (DISL). MATERIALS AND METHODS: One hundred and thirty-six patients with lymphoma who had undergone two-phase (arterial and portal venous) abdominal CT were included in this study. We retrospectively evaluated the diagnostic performance of ONHES on AP CT in diagnosing DISL. Two observers evaluated ONHES on AP CT using the 5-point confidence level and assessed the presence or absence of subjective splenomegaly on axial CT images. Another two observers measured the splenic index as proposed by objective CT criteria. Statistical analysis included interobserver agreement and diagnostic performance of CT findings. RESULTS: Eleven of the 136 patients with lymphoma had DISL. The area under the receiver operating characteristic curve of ONHES (0.948 for observer 1 and 0.922 for observer 2) was superior to that of the splenic index (0.872 for observer 3 and 0.877 for observer 4), but the difference was not statistically significant (p > 0.05). The diagnostic performance of ONHES in conjunction with subjective splenomegaly showed higher diagnostic performance, as compared with subjective splenomegaly alone (accuracy: 100% and 85.3% for observer 1, 98.5% and 87.5% for observer 2; positive predictive value: 100% and 35.5% for observer 1, 90.9% and 39.3% for observer 2, respectively). CONCLUSION: Obliteration of normal heterogeneous enhancement of the spleen in conjunction with subjective splenomegaly can improve the diagnostic performance for DISL. Our results suggest that ONHES on AP CT images could be useful as an adjunctive diagnostic indicator of DISL in patients with lymphoma.

Pancreatic Arteriovenous Malformation as an Unusual Cause of Chronic Gastrointestinal Bleeding in a Patient with Early Gastric Cancer: Multimodality Imaging Spectrum with Pathologic Correlation

Arteriovenous malformation (AVM) of the pancreas is extremely rare, although it may be increasingly diagnosed due to the widespread use of cross-sectional imaging of the abdomen. Early diagnosis of this disease is important to prevent delay of treatment and resulting fatal complications. We report a rare case of pancreatic AVM in a 48-year-old man who presented with severe chronic anemia and early gastric cancer, which made diagnosis challenging. Imaging findings, including ultrasound, computed tomography, and magnetic resonance imaging, are shown, as well as the pathologic features.

The Role of Dendritic Cells in Central Tolerance

Dendritic cells (DCs) play a significant role in establishing self-tolerance through their ability to present self-antigens to developing T cells in the thymus. DCs are predominantly localized in the medullary region of thymus and present a broad range of self-antigens, which include tissue-restricted antigens expressed and transferred from medullary thymic epithelial cells, circulating antigens directly captured by thymic DCs through coticomedullary junction blood vessels, and peripheral tissue antigens captured and transported by peripheral tissue DCs homing to the thymus. When antigen-presenting DCs make a high affinity interaction with antigen-specific thymocytes, this interaction drives the interacting thymocytes to death, a process often referred to as negative selection, which fundamentally blocks the self-reactive thymocytes from differentiating into mature T cells. Alternatively, the interacting thymocytes differentiate into the regulatory T (Treg) cells, a distinct T cell subset with potent immune suppressive activities. The specific mechanisms by which thymic DCs differentiate Treg cells have been proposed by several laboratories. Here, we review the literatures that elucidate the contribution of thymic DCs to negative selection and Treg cell differentiation, and discusses its potential mechanisms and future directions.