Obesity Is a Related Factor With Severe COVID-19 Pneumonia in Children: A Case Series

A small proportion of children with coronavirus disease 2019 (COVID-19) develop severe pneumonia. We reported the severe COVID-19 pneumonia in children aged <18 years with COVID-19 treated with remdesivir and dexamethasone from August 2021 to November 2021 by a retrospective review of their medical records. Eight children were included (5 males and 3 females). Their median age was 16 years (range: 9 to 17 years) and their median body mass index was 30.5 kg/m2 (range: 22.8–38.5 kg/m2). All patients had fever and dyspnea with hypoxia. Chest radiographic findings were variable and included diffuse or multifocal consolidation, nodules, and ground-glass opacities in the lungs. After receiving intravenous remdesivir and dexamethasone, 7 of the 8 children experienced an improvement in their symptoms within 2 days. In our case series, obesity was present in 6 out of 8 children with severe COVID-19 pneumonia.

Global health diplomacy and North Korea in the COVID-19 era

This article uses global health diplomacy to examine the challenges and opportunities of international health aid to North Korea in the COVID-19 era. It finds that vaccine provision is both within the enlightened self-interest of donor states and meets the global responsibility to address unequal access to vaccines. The COVID-19 pandemic has exposed increasing global inequality in responding to the issues of health. How do we resolve the tension between normative concerns for global responsibility and strategic concerns for national interest in facilitating health aid to vulnerable populations in low-income countries in the COVID-19 era? This article presents global health diplomacy as a conceptual framework that could overcome thedichotomy of humanitarianism and international politics, using health aid to North Korea during COVID-19 as a case-study. Health is a critical component of human dignity and can be a normative motivation for cooperation beyond sovereign borders. However, health is also an important element of national interest and can be a strategic motivation for transnational cooperation. The overlap between the moral and rational spaces in global health diplomacy demonstrates how COVID-19 assistance to North Korea's vulnerable population is in the enlightened self-interest of donors to prevent resurgences of new COVID-19 variants. Moreover, this framework imbues all parties, including aid recipients such as North Korea, with the global cooperative responsibility to address health. In this sense, global health diplomacy can reframe the tensions between humanitarianism and politics, morality and rationality, and cosmopolitanism and nationalism, from antithetical to complementary.

Navigation to Well-being and Work-life Balance for School Principals: Mindfulness-based Approaches

Objective: The COVID-19 pandemic has posed unanticipated complications for leaders in education. One example involves school principals who have been forced to cope with the pandemic on top of performing their everyday work requirements. In this paper, I review the research on workplace stress and provide suggestions for achieving a good work-life balance based on mindfulness practices, chosen from the experience and added stress of school principals in coping with the unprecedented COVID-19 situation. Methods: I draw upon various sources of information, scientific literature, including more than 130 research journals, empirical studies, and field-based published data to inform the results and conclusion. Results: Various mindfulness-based practices, which can be done anywhere and in diverse settings, can be valuable options in managing the need for school leaders to achieve emotional and physical equilibrium, an equilibrium to improve their well-being and work-life balance and help to reduce their stress level. Conclusions: To support school leadership and avoid burnout, it is critical that we recognize this increasingly difficult situation and its consequences on them. A nurturing school climate must be established as we commit to advocate for the development of a sound, flexible work-life balance and resilience in education leaders.

Korean Clinical Nurses’ Emotional Experiences during the COVID-19 Pandemic

Purpose: The purpose of this study was to examine the emotions experienced by Korean clinical nurses during the coronavirus disease 2019 (COVID-19) pandemic and to understand their essential meaning in depth. Methods: A qualitative study was performed using individual in-depth interviews and data were collected from 12 nurses in clinical practice from June 2020 to December 2020. Data were analyzed using the Colaizzi’s phenomenological method. Results: The following three categories were derived: ‘shock of the unprecedented new infectious disease’, ‘hardships caused by the never-ending struggle’, and ‘hope in the midst of hardship’. Conclusion: Based on the results of this study, it was confirmed that there is a need to prepare an appropriate compensation system and emotional support strategies for nurses in the traumatic event of a pandemic. In addition, it is necessary to develop a recovery from trauma and emotional management program to reduce the negative emotional experiences and strengthen the positive emotional experiences. © 2021 The Korean Academy of Psychiatric and Mental Health Nursing.

Changes in the Distribution of Respiratory Microorganisms before and during the COVID-19 Pandemic, Daegu, Korea

Background: Acute respiratory infection (ARI) is the most common infectious disease in all ages and genders worldwide. Respiratory microorganisms such as respiratory viruses, are commonly responsible for causing ARI. COVID-19 is still prevalent in Korea. The implementation of lockdown and strict control measures, the mandatory wearing of masks, and social distancing are critical steps for controlling the risk of COVID-19 spread. This study was conducted to find out how these changes in daily lives impacted the distribution of respiratory microorganisms. Methods: A retrospective study was conducted to identify the incidence and distribution patterns of ARI-causing respiratory microorganisms before (Period.) and during the COVID-19 pandemic (Period.) in terms of detection method, age, month, and season. In particular, data in Periods. and. were compared for eight major kinds of respiratory microorganisms: adenovirus (AdV), human metapneumovirus (HMPV), human rhinovirus/enterovirus (Rhino/Entero), influenza virus (Flu) A, Flu B, human parainfluenza virus (HPIV) 3, respiratory syncytial virus, and Mycoplasma pneumoniae. Results: A total of 27,191 respiratory specimens were tested, of which 5,513 were obtained from children and adolescents (age groups 1. 5) and 21,678 from adults (age group 6). The overall positive rates for at least one respiratory microorganism in Periods. and. were 23.1% (1,199/5,193) and 4.9% (1,070/21,998), respectively (p < 0.001). The overall positive rates in male and female patients were significantly different (8.7% vs. 7.9%;p = 0.016). On the FilmArray (TM) RP assay, positive rates in all age groups decreased significantly in Period. compared with Period.. AdV, Rhino/Entero, and Flu A were detected in all four seasons, but HMPV and HPIV3 were not detected. The overall positive rates on FilmArray and the Flu antigen test in Period. were significantly decreased. In the COVID-19 test, the positive rates were high in March and April 2020, and decreased thereafter, but these increased again in the winter of 2020/2021. Conclusions: Life changes due to COVID-19 pandemic have had a significant impact on the distribution of respiratory microorganisms;our study results might provide useful information on respiratory virus epidemiology.

An Earth-mass planet in a time of COVID-19: KMT-2020-BLG-0414Lb

We report the discovery of KMT-2020-BLG-0414Lb, with a planet-to-host mass ratio q (2) = 0.9-1.2 x 10(-5) = 3-4 circle plus at 1 sigma, which is the lowest mass-ratio microlensing planet to date. Together with two other recent discoveries (4 less than or similar to q/q (circle plus) less than or similar to 6), it fills out the previous empty sector at the bottom of the triangular (log s, log q) diagram, where s is the planet-host separation in units of the angular Einstein radius theta E. Hence, these discoveries call into question the existence, or at least the strength, of the break in the mass-ratio function that was previously suggested to account for the paucity of very low-q planets. Due to the extreme magnification of the event, A (max) similar to 1450 for the underlying single-lens event, its light curve revealed a second companion with q (3) similar to 0.05 and ;log s (3);similar to 1, i.e., a factor similar to 10 closer to or farther from the host in projection. The measurements of the microlens parallax pi (E) and the angular Einstein radius theta E allow estimates of the host, planet and second companion masses, (M (1), M (2), M (3)) similar to (0.3 M (circle dot), 1.0 M (circle plus), 17 M-J ), the planet and second companion projected separations, (a (perpendicular to,2), a (perpendicular to,3)) similar to (1.5, 0.15 or 15) au, and system distance D (L) similar to 1 kpc. The lens could account for most or all of the blended light (I similar to 19.3) and so can be studied immediately with high-resolution photometric and spectroscopic observations that can further clarify the nature of the system. The planet was found as part of a new program of high-cadence follow-up observations of high-magnification events. The detection of this planet, despite the considerable difficulties imposed by COVID-19 (two KMT sites and OGLE were shut down), illustrates the potential utility of this program.

349 The Physical Examination Is Unreliable in Determining the Location of the Ankle Physis in Healthy Children

Study Objectives: Pediatric ankle injuries are a common presentation to the emergency department (ED). The Salter-Harris classification defines a type 1 fracture of the distal fibula as tenderness overlying the physis of the distal fibula without radiographic evidence of a fracture. Our primary objective was to establish the reliability of physical examination performed by pediatric emergency physicians in determining the location of the physis of the distal fibula as compared to a criterion standard using ultrasound. Methods: This was a prospective, observational, single-site study of a convenience sample of pediatric patients aged 4 to 10 years old. It was performed at an urban academic pediatric ED between March 2019 and April 2020. Otherwise healthy children presenting to the ED for reasons other than lower extremity injury were eligible to participate. A pediatric emergency physician or fellow performed a physical examination of the patient’s distal fibula and marked the location of the physis based on his or her examination with a marker. After this, the study investigator (an ultrasound fellow) scanned the distal fibula, established the location of the physis on ultrasound, and used an invisible ink pen to mark the location of the physis. Using an ultraviolet light, the investigator measured the distance between the clinician’s estimated position and the actual sonographic position of the physis. Because the distal fibular physis measures only 3 mm on average, a clinically accurate position was defined a priori as a marked point located within a 5 mm distance of the sonographic marking. We compared the accuracy rate of physical examination to ultrasound landmarking using proportions as well as means with 95% confidence intervals (CI). Using a simulation assuming the participation of at least 15 physicians assessing multiple patients, we calculated a sample size of 90 patients to detect a difference in 70% versus 50% physician accuracy with at least 80% power. Results: Enrolment was stopped early due to the novel coronavirus pandemic, so we were unable to recruit our target sample size of 90 participants. We enrolled 71 patients, of whom 52 (73%) were male. The mean age was 6.7 years and the mean weight was 25.5 kg. Participating pediatric emergency physicians included 18 staff physicians and 2 fellows. The assessments were performed by staff physicians in 60 (85%) patients and by fellows in 11 (15%) patients. Each physician examined a mean of 3.6 patients (range 1-15). The physis of the distal fibula was correctly identified in only 24 patients, yielding an accuracy rate of 34% (95% CI 23%-46%). The mean distance between the physician’s estimated position of the physis and the sonographic position was 7.4 mm (95% CI 6.4-8.4 mm). In a sensitivity analysis where the remaining 19 patient examinations would have all been accurate, the probability of accurate identification was 48% (95 CI 37%-59%). Conclusion: We found that pediatric emergency physicians were only 34% accurate with their physical examination in identifying the physis of the distal fibula. This calls into question the utility of the definition of a type 1 Salter-Harris fracture given that the physical examination is unreliable in identifying the location of the physis of the distal fibula.