Changes in child and adolescent mental health across the COVID-19 pandemic (2018-2023): Insights from general population and clinical samples in the Netherlands (preprint)

Background The COVID-19 pandemic negatively affected child and adolescent mental health and at the end of the pandemic (April 2022) child mental health had not returned to pre-pandemic levels. We investigated whether this observed increase in mental health problems has continued, halted, or reversed after the end of the pandemic in children from the general population and in children in psychiatric care. Methods We collected parent-reported and child-reported data at two additional post-pandemic time points (November/December 2022 and March/April 2023) in children (8-18 years) from two general population samples (N=818-1056 per measurement) and one clinical sample receiving psychiatric care (N=320-370) and compared these with data from before the pandemic. We collected parent-reported data on internalizing and externalizing problems with the Brief Problem Monitor (BPM) and self-reported data on Anxiety, Depressive symptoms, Sleep-related impairments, Anger, Global health, and Peer relations with the Patient-Reported Outcomes Measurement Information System (PROMIS). Results In the general population, parents reported no changes in externalizing problems but did report higher internalizing problems post-pandemic than pre-pandemic. Children also reported increased mental health problems post-pandemic, especially in anxiety and depression, to a lesser extent in sleep-related impairment and global health, and least in anger. In the clinical sample, parents reported higher internalizing, but not externalizing problems post-pandemic compared to the start of the pandemic. Children reported greatest increases in problems in anxiety, depression, and global health, to a lesser extent on sleep-related impairment, and least on anger. Conclusions Child mental health problems in the general population are substantially higher post-pandemic compared to pre-pandemic measurements. In children in psychiatric care mental health problems have increased during the pandemic and are substantially higher post-pandemic than at the start of the pandemic. Longitudinal and comparative studies are needed to assess what the most important drivers of these changes are.

MODELING OF ANTIBODY RESPONSE TO COVID-19 VACCINATIONS IN PATIENTS WITH RHEUMATOID ARTHRITIS

BackgroundUnderstanding the dynamics of humoral immunity after COVID-19 vaccination is crucial in developing vaccination strategies. Antibody response patterns are more complex in patients with rheumatoid arthritis (RA) because of their underlying autoimmunity and immunosuppressive medications. The kinetics of vaccine response in RA patients are not well understood.ObjectivesTo construct a model of antibody response to COVID-19 vaccination in patients with RA.MethodsTwo patient groups were included for the study. The first group was composed of RA patients who were enrolled for influenza vaccination study between Oct 6, 2021 and November 3, 2021, in whom serial serum samples were obtained 0, 4, 16 weeks after vaccination. The second group was consecutively enrolled from outpatient clinic between October 6, 2021 and June 3, 2022, in whom serum sample was obtained once. After collecting data on demographics, vaccination and infection history of COVID-19 were obtained by self-report via questionnaire and data from Korean center for disease control. We then measured antibody titers against receptor binding domain of spike protein (anti-RBD) and nucleocapsid (anti-N), using Chemiluminescence microparticle immunosaasy (Abbott, USA) and Electrochemiluminescence immunoassay (Roche, Germany) respectively. The anti-RBD titer was log-transformed to improve normality. Time from vaccination and log of anti-RBD titer was modeled using fractional polynomial. Covariates including age, sex, BMI, underlying disease and immunosuppressive drugs were analyzed using Generalized Estimating Equations to account for repeated measured from a subject.ResultsA total of 736 patients (1042 samples) were enrolled. After excluding patients who experienced COVID-19 infection before sampling (n=84), those unvaccinated (n=44) and uncertain COVID-19 infection history (n=59), the data on 778 samples from 549 patients were analyzed (Group 1: 125, Group 2: 424). Antibody titer reached peak at 12 days after vaccination and decreased exponentially (Figure 1) which fell to 36.5% from peak after 2 months. Compared to the first vaccination, the 3rd and 4th vaccination significantly shifted anti-RBD antibody response curve (28 times, 95% CI 4~195;32 times 95% CI 4~234, respectively). However, there was no significant shift after the 4th vaccination from the 3rd vaccination (p=0.6405). Multivariable analysis showed that number of vaccinations and sulfasalazine (coefficient: 0.40, 95% CI 0.12~0.68) increased vaccine response but age (coefficient: -0.03, 95% CI -0.04~-0.02), abatacept (coefficient: -2.07, 95% CI -3.30~-0.84) and, JAK inhibitor (coefficient: -0.82, 95% CI -1.34~-0.31) decreased vaccine response.ConclusionAnti-RBD response to COVID-19 vaccination showed a peak at 12 days after vaccination and then exponentially decreased in patient with RA. The antibody response is affected by age and medications used for the treatment of RA.Table 1.ln[RBD (U/ml)]coefficient (univariable)95% CIp-valuecoefficient (multivariable)95% CIp-valuesex (female)0.17-0.22, 0.550.393---age-0.02-0.03, -0.01<.001**-0.03-0.04, -0.02<.001**DM0.11-0.27, 0.500.568---HTN-0.38-0.69, -0.070.018*---CKD0.680.07, 1.290.030*---RA duration (yr)-0.04-0.06, -0.010.001**---Pd (mg/d)-0.06-0.11, 0.000.035*---MTX use-0.23-0.52, 0.050.105---HCQ use0.01-0.28, 0.290.965---SSZ use0.450.07, 0.840.022*0.400.12,0.680.005**LEF use0.00-0.37, 0.370.988---TNF inhibitors use0.29-0.16, 0.730.208---Abatacept use-2.07-3.14, -0.99<.001**-2.07-3.30, -0.840.001**JAK inhibitors use-0.88-1.52, -0.240.007**-0.82-1.34, -0.310.002**Time (months)log(t)-1.96-2.37, -1.54<.001**-1.90-2.29, -1.50<.001**t

The effect of pandemic-related stress on the decision-making process for individual outdoor leisure activities

This study investigates the decision-making process for outdoor leisure activities of the Chinese people in the context of COVID-19. An online survey of residents of Heilongjiang Province was conducted in September and October 2020. In total, 441 questionnaires were returned for empirical analysis. The results reveal that fears of contamination and compulsory checking/reassurance-seeking have had a significant impact on the respondents' goal-directed behavior for nature-based outdoor leisure activities during the pandemic. The theoretical contribution is that extended goal-directed behavior expands with the inclusion of emotional variables and can be used to predict individual outdoor activity intention and decision-making process in the COVID-19 situation relating to leisure. This study provides useful insights for public health ministries and local governments in any country to encourage nature-based outdoor leisure activities as a public health policy for the mental health of the people.

Identifying Optimal Approaches for Sustainable Maritime Education and Training: Addressing Technological, Environmental, and Epidemiological Challenges

Maritime education and training (MET) for seafarers who operate ships has struggled to flexibly adapt to technological and environmental changes. In particular, as social demand for online MET arose due to COVID-19, the need for sustainable MET beyond traditional teaching methods grew exponentially. In order to identify the most optimal MET methods among face-to-face and online methods, this study reviewed the concepts and applications of existing MET methods, grouped them using a fuzzy analytic hierarchy process, and supplemented this structure through a designed survey. The results showed that the online methods had the greatest weight, and the "XR (extended reality) within the metaverse" teaching method had the highest priority. This study identified which MET methods should be prepared for the post-COVID era through quantitative analysis. We confirmed the need for attention to XR within the metaverse as a field of online methods in the future. Furthermore, our findings reveal that online education platforms via metaverse-based "expansion" and "connection" are needed, and pave the way for future research to expand empirical studies on MET satisfaction regarding existing International Maritime Organization model courses.

Experiences of Counselors Who Provided Psychological Support during COVID-19 Disaster: A Qualitative Study

Background: In crisis intervention sites such as infectious disease disasters, counselors are repeatedly exposed, directly or indirectly, to the traumatic experiences of victims. Disaster counseling has a negative effect on coun-selors, which can eventually interfere with the counseling process for disaster victims. Therefore, exploring and understanding the experiences of counselors is necessary to ensure that qualitative counseling for disaster victims can be continuously and efficiently conducted. Objectives: This study investigated the experiences of counselors who participated in mental health counseling as psychological support for victims of the COVID-19 disaster in Korea. Design: This is a qualitative study. Participants: The study participants comprised 18 counselors who had mental health professional qualifications of level 2 or higher and who had provided mental health counseling for COVID-19 confirmed cases and quarantined persons. Methods: Data were collected using focus group interviews from February 21 to May 29, 2021. The duration of each interview was 60-90 min, and the data were analyzed using content analysis. Results: The final theme was "Continuing to walk this road anytime, anywhere." The par-ticipants' experiences were identified in four sub-themes: "being deployed to unprepared counseling," "encoun-tering various difficulties," "feeling full of meaning and value," and "hoping to become a better counselor." Conclusions: In order to continuously provide qualitative counseling in case of an infectious disease disaster such as COVID-19, it is important to develop a qualification and competency strengthening program through educa-tion and training to secure the crisis intervention expertise of counselors according to the characteristics of the disaster. In addition, a psychological support manual for each disaster should be prepared at the national level according to the type of disaster.

Current status of telemedicine in Japan: implications for Korea. TT -:.

Background: Since the coronavirus disease 2019 outbreak, telemedicine has become an important means of providing medical care worldwide. This study aims to highlight the implications of establishing telemedicine policies in Korea. Japan's telemedicine policies were reviewed from the time of the first trial to the present official allowance. Current Concepts: Since telemedicine demonstration work began in 1971, telemedicine in Japan has advanced in four stages. The first stage was the operation of a remote regional comprehensive medical information system from 1971 to 1997. The second stage was when telemedicine was officially institutionalized from 1997 to 2018. The third stage was the time of expansion of telemedicine, from the announcement of the "Guidelines for the Implementation of Proper Online Care" in 2018 to when online first-time examinations were temporarily allowed in 2020. The fourth stage began in 2021 when the "Permanent Establishment of Special Cases for Online Care" was announced, and telemedicine has been officially allowed to supplement face-to-face care. Telemedicine usage was estimated to be about 53.65 million in 2021, and the total number of treatments in Japan in 2021 was estimated to be about 1.32 billion, accounting for about 4.1% of medical care. Discussion and Conclusion(s): For the Korean government to establish telemedicine, it needs to be promoted step by step through discussions with the medical community. Also, an appropriate medical remuneration system needs to be prepared along with guidelines reflecting the opinions of the medical community to secure the safety of telemedicine.Copyright © Korean Medical Association.

A Soft Power Challenge, or an Opportunity? A Big Data Analysis on Chinese Soft Power during COVID-19 Pandemic

The Chinese government's rigorous efforts to enhance its soft power have confronted a major challenge during the COVID-19 pandemic. This study aimed to look at how the Chinese soft power changed throughout the pandemic using English news articles that covered China. The research took a data science approach to investigate the contents of articles using machine-learning-based sentiment analysis and Dirichlet-Multinomial Regression (DMR) analysis. The results show a gradual downturn in overall sentiment and that the topics related to political issues made the most significant impact. Nevertheless, the major increase in referencing Chinese social media implied that the sources of Chinese soft power have been diversified throughout the pandemic. In addition, this research has aimed to engage in major debates around soft power theory. Providing a multi-disciplinary approach for analyzing soft power, this research has tackled the difficulties in the quantitative conceptualization of soft power.

Optimal Path Control of a Patient for Rapid Infection Testing

In this paper, we propose a path control framework for guiding and simulating the patient's path of travel to speed up virus testing in pandemic situations, such as COVID-19. We use geographic information and hospital state information to construct graphs to yield optimal travel paths. Pathfinding algorithms A* and Navigation mesh, which have been widely used, are efficient when applied to control agents in a virtual environment. However, they are not suitable for real-time changing cases such as the COVID-19 environment because they guide only predetermined static routes. In order to receive a virus infection test quickly, there are many factors to consider, such as road traffic conditions, hospital size, number of patient movements, and patient processing time, in addition to guiding the shortest distance. In this paper, we propose a framework for digitally twinning various situations by modeling optimization functions considering various environmental factors in real-world urban maps to handle viral infection tests quickly and efficiently.

Impact of COVID-19 on Local Planning Practices: Focusing on Tactical Urbanism, Slow Streets and Low-Income Communities in Oakland, Los Angeles, San Francisco, Denver, Chicago, and New York

In the face of lockdowns and social distancing measures promulgated as a result of COVID-19, the effects on local planning are quite diverse. One of the effects is planners' use of tactical urbanism in their efforts to improve public health. With tactical urbanism being characterized as incremental, temporary, flexible, and easily implementable, it is appropriate to ask whether tactical urbanism-based strategies can help make underserved communities more healthy in times of pandemic. This chapter addresses that question by examining several examples of tactical programs called Slow Streets, Open Streets, Safe Streets, Essential Places, etc. These programs provide temporary public spaces in the streets for exercise and interaction. These programs are led by local governmental entities such as transportation departments in Oakland, Los Angeles, and San Francisco, California;Denver, Colorado;Chicago, Illinois;and New York, New York. We review literature to understand the relevance of those programs to tactical urbanism, and we investigate how effectively they are helping improve health in low-income communities during COVID-19. We use interdisciplinary literature on public health and healthy community design to ground our investigation. Interviews and internet-based sources complement the research. The study outcomes suggest that the pandemic forced planners to act swiftly, but that their tactical programs are limited in improving the health of disadvantaged population because the programs lack comprehensive community engagement and alignment with longer term plans. We end by identifying areas for improvement (governance) in tactical urbanism;and by suggesting future challenges (cultural shifts in urban planning and design practice including denouncement of racialized practices) that, if overcome, could help facilitate the transformation of cities in a healthy, just, and equitable manner. © The Author(s), under exclusive license to Springer Nature Switzerland AG 2022.

Pretreatments for Microbial Analysis and Evaluation of Hygiene of Wet Towels and Wet Wipes

The demand for hygiene products has increased worldwide since the outbreak of global COVID-19. As the hygiene products market is expanding, it is necessary to manage microbial contamination in wet towels and wet wipes. This study evaluated pretreatment methods for microbial recovery from wet towels and wipes and microbial contamination levels in wet towels and wipes with the pretreatment method. Escherichia coli (NCCP14038 and NCCP14039), Staphylococcus aureus (ATCC25923 and ATCC29213), and Pseudomonas aeruginosa (NCCP10250 and NCCP11229) were inoculated on five fabric materials of wet towels and wet wipes. The recovery rates of the bacteria from wet towels and wet wipes using three pretreatment methods (pummeling, hand shaking, and portion cutting method) were investigated. Using the selected pretreatment method, the contamination levels of E. coli, S. aureus, and P. aeruginosa were evaluated for 238 wet towels and 244 wet wipes, which were collected in April to August, 2019. The presence of toxA and antibiotic resistance of P. aeruginosa isolated from wet towels were evaluated. The overall recovery rates of the pummeling method and hand shaking method were higher than the portion cutting method. Considering the convenience, the pummeling method was used to investigate the microbial contamination in the wet towels and wet wipes. P. aeruginosa was detected in two wet towels at an average of 9.9x102 CFU/towel. E. coli and S. aureus were not detected in both wet towels and wipes. P. aeruginosa isolates showed no resistances to piperacillin, piperacillin-tazobactam, aztreonam, and gentamicin, but had toxA. The results indicate that the pummeling method is the most appropriate pretreatment method for the recovery of microorganisms, and microbial analysis showed that this method could be useful in monitoring microbial contamination in wet towels and wet wipes.

Changes in Tropospheric Nitrogen Dioxide Vertical Column Densities over Japan and Korea during the COVID-19 Using Pandora and MAX-DOAS

We investigated the impact of human activity during COVID-19 on the tropospheric nitrogen dioxide vertical column density (NO2 TropVCD) at three urban sites (Gwangju and Busan in Korea and Yokosuka in Japan) and one remote site (Cape Hedo in Japan) from Multi-Axis Differential Optical Absorption Spectroscopy (MAX-DOAS) and Pandora. Compared to the monthly mean NO2 TropVCD from 2015 to 2018 and in 2019, the values were lower in 2020 due to social distancing in Korea and Japan. High negative relative changes were observed from May to September (-30% to -18%) at the three urban sites;Cape Hedo, a remote site, did not show a significant difference in relative changes between previous years and 2020, suggesting that only anthropogenic emission sources decreased dramatically. In the case of Yokosuka, the 15-day moving average of the NO2 TropVCD exhibited a good relationship with transportation (R = 0.48) and industry (R = 0.54) mobility data. In contrast, the NO2 TropVCD at the Korean sites showed a moderate to low correlation with the industrial sector and insignificant correlations with transportation. The differences in correlations might be caused by the different social distancing policies in Korea (voluntary) and Japan (mandatory). By applying generalized boosted models to exclude meteorological and seasonal effects associated with NO2 TropVCD variations, we revealed that the decreasing trend from 2019 to 2020 was much steeper than that from 2015 to 2020 (a factor of two), and a significant change was identified in January 2020, when the first cases of COVID-19 were observed in both Korea and Japan. This result confirmed that the reduction in NO2 can be largely explained by the NOx emission reduction resulting from social distancing for COVID-19 rather than annual meteorological differences;however, in December 2020, NO2 recovered suddenly to its previous level due to an increase in human activities.

Relationship between COVID-19 infection and erectile dysfunction, a literature review examining the link and proposed mechanisms behind this phenomenon

It is now only in the wake of coronavirus disease 2019 (COVID-19) that we are beginning to understand many of the extra-respiratory manifestations of the condition. There is now growing evidence that erectile dysfunction (ED) is closely linked with the disease. We carry out one of the first literature reviews to consolidate the current evidence of the causal link between COVID-19 and ED and explore the proposed mechanisms that underpin this phenomenon. We carried out a literature search of the databases;PubMed (MEDLINE), Scopus, Web of Science and the Cochrane library. Search time frame was between December 2019 and March 2022. Only studies deemed of acceptable quality were included. Five studies were found highlighting the link between COVID-19 and ED. A further Nineteen studies were utilized to illustrate the proposed biological mechanisms underpinning COVID-19 related ED. Clear evidence has been documented through multiple studies internationally recognizing reduction in erectile scores and reduced sexual activity. It appears there is likely indirect and direct cytopathic effects on endothelial cells, in addition to hormonal and psychosocial factors. The associated ED is likely a result of a multitude of mechanisms including direct and indirect endothelial dysfunction, vasoactive cytokines, endocrine dysregulation, and psychosocial factors. This is the first literature review to delve into the likely underpinning mechanisms of the virus that drive ED.Copyright ©2023 The Author(s). Published by MRE Press.

Incidence and sero-surveillance of feline viruses in Korean cats residing in Gyeonggi-do

Incidences of major feline viral diseases provide basic information for preventing viral disease in cats. Despite the growing interest in feline viral diseases, sero-surveillances have been lacking. In this study, we analyzed the diagnoses of feline viral diseases and conducted a sero surveillance of feline panleukopenia virus (FPV), feline calicivirus (FCV), feline herpesvirus-1 (FHV-1), and feline infectious peritonitis virus (FIPV) in Korean cats. Of the 204 confirmed cases since 2015, the numbers of diagnoses for FPV, FIPV, FCV, feline influenza virus, and FHV-1 were 156, 32, 12, 3, and 1 case, respectively. In total, 200 sera, collected between 2019 and 2021, were screened for the presence of antibodies against FPV, 2 FCVs, FHV-1, and FIPV using a hemagglutination inhibition test and a virus-neutralizing assay (VNA). The overall seropositive rates in cats tested for FPV, the 2 FCVs, FHV-1, and FIPV were 92.5%. 42.0%, 37.0%, 52.0%, and 14.0%, respectively. A low correlation (r = 0.466) was detected between the VNA titers of 2 FCV strains. The highest incidence and seropositive rate of FPV reveal that FPV is circulating in Korean cats. The low r-value between 2 FCVs suggests that a new feline vaccine containing the 2 kinds of FCVs is required.

Prophylactic Corticosteroid Use with Axicabtagene Ciloleucel (Axi-Cel) in Patients (Pts) with Relapsed/ Refractory Large B-Cell Lymphoma (R/R LBCL): 2-Year Follow-up of Zuma-1 Cohort 6

Background: The ZUMA-1 safety management Cohort 6 (N=40), which evaluated whether prophylactic corticosteroids and earlier corticosteroids and/or tocilizumab could improve safety outcomes, demonstrated an improved safety profile (no Grade >=3 cytokine release syndrome [CRS];15% Grade >=3 neurologic events [NEs]) vs pivotal Cohorts 1+2, without compromising response rate or durability (95% ORR, 80% CR rate, and 53% ongoing response rate with >=1 y of follow-up;Oluwole, et al. ASH 2021. 2832). Here, 2-y updated outcomes are reported. Method(s): Eligible pts with R/R LBCL underwent leukapheresis (followed by optional bridging therapy) and conditioning chemotherapy, then a single axi-cel infusion. Pts received corticosteroid prophylaxis (once-daily oral dexamethasone 10 mg on Days 0 [before axi-cel], 1, and 2) and earlier corticosteroids and/or tocilizumab for CRS and NE management vs Cohorts 1+2 (Oluwole, et al. Br J Haematol. 2021). The primary endpoints were incidence and severity of CRS and NEs. Secondary endpoints included ORR (investigator-assessed), duration of response (DOR), progression-free survival (PFS), overall survival (OS), and chimeric antigen receptor (CAR) T-cell levels in blood. Result(s): As of December 16, 2021, the median follow-up time for the 40 treated pts was 26.9 mo. Since the 1-y analysis, no new CRS events were reported (no pts had Grade >=3 CRS to date). The incidence of Grade >=3 NEs increased from 15% to 18%between the 1-y and 2-y analyses. Two new NEs occurred in 2 pts: 1 pt had Grade 2 dementia (onset on Day 685 and ongoing at time of data cutoff;not related to axi-cel) and 1 had Grade 5 axi-cel-related leukoencephalopathy. Since the 1-y analysis, 6 new infections were reported (Grades 1, 2, and 5 COVID-19 [n=1 each], Grade 3 Pneumocystis jirovecii pneumonia [n=1], Grade 3 unknown infectious episode with inflammatory syndrome [n=1], and Grade 2 herpes zoster [n=1]). In total, 8 deaths occurred since the 1-y analysis (progressive disease [n=5], leukoencephalopathy [n=1], and COVID-19 [n=2]). The ORR was 95% (80% CR), which was unchanged from the 1-y analysis. Median DOR and PFS were since reached (25.9 mo [95% CI, 7.8-not estimable] and 26.8 mo [95% CI, 8.7-not estimable], respectively). Median OS was still not reached. Kaplan- Meier estimates of the 2-y DOR, PFS, and OS rates were 53%, 53%, and 62%, respectively. Of 18 pts (45%) in ongoing response at data cutoff, all achieved CR as the best response. By Month 24, 14/20 pts with evaluable samples (70%) had detectable CAR T cells (vs 23/36 pts [64%] in Cohorts 1+2). Conclusion(s): With 2 y of follow-up, the ZUMA-1 Cohort 6 toxicity management strategy continued to demonstrate an improved long-term safety profile of axi-cel in pts with R/R LBCL. Further, responses remained high, durable, and similar to those observed in Cohorts 1+2 (Locke, et al. Lancet Oncol. 2019).Copyright © 2023 American Society for Transplantation and Cellular Therapy

Website Transparency and Information Dissemination among Urology Residency Programs

INTRODUCTION AND OBJECTIVE: Due to the COVID-19 pandemic, urology residency programs have had to adjust their typical practices, including the adoption of virtual recruiting and interviewing. Such efforts have included utilizing social media and improving program websites, which are often the starting point for potential applicants to obtain information about a program. We sought to evaluate the transparency and quality of information dissemination among urology residency program websites. METHOD(S): The websites of all 143 non-military, accredited United States urology residency programs were evaluated for various measures grouped into distinct categories including program priorities, program curriculum, program profiles, program quality of life, medical student opportunities, interview process, selection/exclusion criteria, and social media. Programs that have yet to graduate residents were excluded. Programs were separated based on American Urological Association (AUA) section. Percentage values were determined by the number of programs reporting information on a particular measure. RESULT(S): The most reported category was program profiles (84%), with many programs providing details such as resident hometowns, faculty research interests, and alumni fellowship matches. The least reported category was selection/exclusion criteria (32%), with 8% of programs discussing a minimum/preferred Step 1 score and 23% discussing osteopathic applicants. Program mission/objective statements, training site locations, and current resident and faculty profiles were subcategories reported by greater than 90% of programs. DEI and wellness initiatives/statements were discussed by 45% and 36% of programs, respectively. For virtual opportunities, 21% of programs provided online open house information, and 85% had an active Twitter account with 34% providing direct links. Average AUA overall transparency was 53.7%, with the Northeastern Section highest at 62.4%. CONCLUSION(S): The importance of transparency and quality of information dissemination is greater than ever with the increasing utilization of virtual formats in the residency application process. Our results indicate several areas of improvement that urology residency programs can amend to provide improved transparency for applicants during the application process. (Figure Presented).

Prolonged Viable Viral Shedding in Immunocompromised Patients with Covid-19

Background: Immunocompromised patients with COVID-19 tend to shed viable virus for a prolonged period. Therefore, for moderately or severely immunocompromised patients with COVID-19, CDC recommends an isolation period of at least 20 days and ending isolation in conjunction with serial testing and consultation with an infectious disease specialist. However, data on viral kinetics and risk factors for prolonged viral shedding in these patients are limited. Method(s): From February 1, 2022 to April 1, 2022, we collected weekly saliva samples from immunocompromised patients with COVID-19 admitted to a tertiary hospital in Seoul, South Korea. Genomic and subgenomic RNAs were measured, and virus culture was performed. Result(s): A total of 41 patients were enrolled;29 (70%) were receiving chemotherapy against hematologic malignancies and the remaining 12 (30%) had undergone solid organ transplantation. Of the 41 patients, 14 (34%) had received 3 doses or more of COVID-19 vaccines. Real-time RT-PCR revealed that 7 (17%) were infected with Omicron BA.1, and 33 (80%) with Omicron BA.2. The median duration of viable virus shedding was 4 weeks (IQR 3-6). Patients undergoing B-cell depleting therapy shed viable virus for longer than the comparator (p=0.01). Multivariable analysis showed that 3-dose or more vaccination (HR 0.33, 95% CI 0.12 - 0.93, p = 0.04) and B-cell depleting therapy (HR 12.50, 95% CI 2.44 - 100.00, p = 0.003) independently affected viable virus shedding of SARS-CoV-2. Conclusion(s): Immunocompromised patients with COVID-19 shed viable virus for median 4 weeks. B-cell depleting therapy increases the risk of prolonged viable viral shedding, while completion of a primary vaccine series reduces this risk. Overall distribution of samples according to genomic viral copy number and culture positivity. Red dot indicates positive culture results, whereas blue dot indicated negative culture results. (Figure Presented).

The psychology of vacationers' hotel brand choice in a post-pandemic world

The present study investigated patrons' intricate psychological process for hotel brand choice and preference. This research uncovered hotel selection attributes in shaping brand loyalty through customer experience, brand trust, brand attachment, age, and gender in the post-pandemic world. This paper categorized hotel selection attributes into that vacationers appreciate in the domestic tourism context. The findings indicated the significant effect of hotel selection attributes on customer experience, which in turn affect brand preference. Also, the moderating effect of age was identified in the relationship between hotel selection attributes and customer experience. This research is among the first to revisit hotel selection attributes for domestic tourism amid the pandemic and the way to cultivate the loyalty toward a hotel brand.

Secondary Science Teachers' PCK Components and Subcomponents Specific to the Learning Environment in an Online-offline Mixed Learning Environment

The purpose of this study was to investigate secondary science teachers' PCK components and subcomponents that are specific to online and offline learning environment. Data collection consisted of survey, class observation, and individual interviews of twelve science teachers. This study used a theoretical framework of PCK for deductive data analysis and articulated codes and themes through the following inductive analysis. Data analysis revealed that each of PCK components showed different specificity to the online and offline learning environment. And subcomponents of each PCK component were different according to the specificity of the online and offline learning environment. Teaching orientation toward science had a specific orientation for the online learning environment, i.e., `learning science concept' and `lecture centered instruction.' Knowledge of the science curriculum had online-offline mixed learning environment specific knowledge, i.e., `reorganization of curriculum' and online learning environment specific knowledge, i.e., `development of learning goal' and `science curricular materials.' Knowledge of science teaching strategies had online learning environment specific knowledge, i.e., `topic-specific strategy', `subject-specific strategy', and `interaction strategy' and COVID-19 offline learning environment specific knowledge, i.e., `topic-specific strategy' and `interaction strategy'. Knowledge of student science understanding had online learning environment specific knowledge, i.e., `student preconception', `student learning difficulty', `student motivation and interest', and `student diversity' and COVID-19 offline learning environment specific knowledge, i.e., student learning difficulty'. Knowledge of science assessment had online-offline mixed learning environment specific knowledge and online learning environment specific knowledge, i.e., assessment contents and assessment methods for each.