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Background: COVID-19 causes significant morbidity and mortality, albeit with considerable heterogeneity among affected individuals. It remains unclear which host factors determine disease severity and survival. Given the propensity of clonal hematopoiesis (CH) to promote inflammation in healthy individuals, we investigated its effect on COVID-19 outcomes. Method(s): We performed a multi-omics interrogation of the genome, epigenome, transcriptome, and proteome of peripheral blood mononuclear cells from COVID-19 patients (n=227). We obtained clinical data, laboratory studies, and survival outcomes. We determined CH status and TET2-related DNA methylation. We performed single-cell proteogenomics to understand clonal composition in relation to cell phenotype. We interrogated single-cell gene expression in isolation and in conjunction with DNA accessibility. We integrated these multi-omics data to understand the effect of CH on clonal composition, gene expression, methylation of cis-regulatory elements, and lineage commitment in COVID-19 patients. We performed shRNA knockdowns to validate the effect of one candidate transcription factor in myeloid cell lines. Result(s): The presence of CH was strongly associated with COVID-19 severity and all-cause mortality, independent of age (HR 3.48, 95% CI 1.45-8.36, p=0.005). Differential methylation of promoters and enhancers was prevalent in TET2-mutant, but not DNMT3A-mutant CH. TET2- mutant CH was associated with enhanced classical/intermediate monocytosis and single-cell proteogenomics confirmed an enrichment of TET2 mutations in these cell types. We identified celltype specific gene expression changes associated with TET2 mutations in 102,072 single cells (n=34). Single-cell RNA-seq confirmed the skewing of hematopoiesis towards classical and intermediate monocytes and demonstrated the downregulation of EGR1 (a transcription factor important for monocyte differentiation) along with up-regulation of the lncRNA MALAT1 in monocytes. Combined scRNA-/scATAC-seq in 43,160 single cells (n=18) confirmed the skewing of hematopoiesis and up-regulation of MALAT1 in monocytes along with decreased accessibility of EGR1 motifs in known cis-regulatory elements. Using myeloid cell lines for functional validation, shRNA knockdowns of EGR1 confirmed the up-regulation of MALAT1 (in comparison to wildtype controls). Conclusion(s): CH is an independent prognostic factor in COVID-19 and skews hematopoiesis towards monocytosis. TET2-mutant CH is characterized by differential methylation and accessibility of enhancers binding myeloid transcriptions factors including EGR1. The ensuing loss of EGR1 expression in monocytes causes MALAT1 overexpression, a factor known to promote monocyte differentiation and inflammation. These data provide a mechanistic insight to the adverse prognostic impact of CH in COVID-19.
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Much uncertainty remains about effective messaging to boost public support for COVID-19 mitigation efforts, especially among people of color. We investigate the relationship between interview language and expressed support for COVID-19 public health protocols among Latinos: America's largest ethnic group. Prior work establishes that interview language shapes opinions by cognitively structuring which considerations people use to express attitudes. Yet other work suggests interview language shapes opinions by activating specific cultural norms associated with a tongue. We predicted that interviewing in Spanish (versus English) would boost support for COVID-19 protocols by activating pro-social norms known to be strongly associated with that language. We uncover null support for this prediction in a pre-registered experiment on bilingual Latino adults (N = 1645). Instead, we find that Latinos assigned to interview in Spanish report weaker support for COVID-19 protocols, regardless of which cultural norms are primed. We discuss implications for COVID-19 attitudes in linguistically diverse polities.
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This study aims to empirically investigate how sport media consumption influences the relationships among the spatially explicit risks of COVID-19, resilience, and positive and negative affect, considering social class. To achieve this, we employed an integrated approach using spatial and aspatial analyses. The findings indicated that the negative effects of the spatially explicit risks of COVID-19 on resilience are mitigated by sport media consumption. In turn, an increased level of resilience enhances positive affect and reduces negative affect. Moreover, consumers in the upper class showed a more pronounced resilience process through sport media consumption than those in the lower class. This study contributes to the knowledge regarding the sport -resilience association by identifying the moderating effect of sport media consumption within social classes and addressing the spatially explicit risks of COVID-19. The present findings provide a basis for sport-based resilience strategies in times of adversity.
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This paper contains an introduction to industrial problems, solutions, and results conducted with the Korea Association of Machinery Industry. The client company commis-sioned the problem of upgrading the method of identifying global supply risky items. Accord-ingly, the factors affecting the supply and demand of imported items in the global supply chain were identified and the method of selecting risky items was studied and delivered. Through research and discussions with the client companies, it is confirmed that the most suitable fac-tors for identifying global supply risky items are 'import size', 'import dependence', and 'trend abnormality'. The meaning of each indicator is introduced, and risky items are selected us-ing export/import data until October 2022. Through this paper, it is expected that countries and companies will be able to identify global supply risky items in advance and prepare for risks in the new normal situation: the economic situation caused by infectious diseases such as the COVID-19 pandemic;and the export/import regulation due to geopolitical problems. The client company will include in his report, the method presented in this paper and the risky items selected by the method.
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The COVID-19 crisis provided an opportunity for information professionals to rethink the role of information in individuals' decision making such as vaccine uptake. Unlike previous studies, which often considered information as a single factor among others, this study examined the impact of the quantity and trustworthiness of information on people's adoption of information for vaccination decisions based on the information adoption model. We analyzed COVID-19 Preventive Behavior Survey data collected by the Massachusetts Institute of Technology from Facebook users (N = 82,213) in 15 countries between October 2020 and March 2021. The results of logistic regression analyses indicate that reasonable quantity and trustworthiness of information were positively related to COVID-19 vaccination intent. But excessive and less than the desired amount of information was more likely to have negative impacts on vaccination intent. The degrees of trust in the mediums and in the sources were associated with the level of vaccine acceptance. But the effects of trustworthiness accorded to information sources showed variations across sources and mediums. Implications for information professionals and suggestions for policies are discussed. © 2023 Association for Information Science and Technology.
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This study aimed to build an machine learning based model to predict the COVID-19 severity and reveal risk factors related to COVID-19 severity based on laboratory testing and clinical data for 420 participants, using tree-based models such as XGBoost, LightGBM, random forest. We calculated the Odds Ratios (OR) to investigate whether the top-ranked features were statistically significant for severity classification, turning out that high sensitivity C-reactive protein (hs-CRP) was the most important feature for determining of COVID-19 severity and XGBoost model showed the highest performance in classifying COVID-19 severity and healthy controls with F1score (0.84) and AUC (0.87). We expect that our results are of considerable significance for early screening for diagnosing COVID-19 severity, which, in turn, assist in further retrospective research for uncommon infectious diseases. © 2023 IEEE.
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This study aims to explore the franchisor social support required for franchisees to overcome the undesirable COVID-19 pandemic and examine the influences of franchisor social support on franchisees' resilience and intention to retain business during the COVID-19 pandemic. The researchers employed a PLS-SEM to estimate the model, using 168 valid responses from restaurant franchisees in South Korea who survived the COVID-19 pandemic. The findings demonstrate that the franchisor's affective and appraisal support have a positive and significant influence on franchisees' resilience but do not have significant effects on the intention to retain business. Moreover, the research findings identify that the franchisor's informational and instrumental support does not have significant impacts on franchisee resilience but positive and significant effects on the intention to retain business. The findings also highlight that franchisees' resilience plays a role as a full mediator in the association between franchisor's affective support and franchisees' intention to retain business. However, resilience does not mediate the relationships between the other resources of social support from the franchisor and the franchisees' intention to retain business. The researchers discuss the theoretical contributions and practical suggestions in the conclusion section based on the interesting findings. © 2023 The Authors
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The medical field has undergone many changes since the start of the coronavirus disease 19 (COVID-19) pandemic. In small-and medium-sized hospitals that lack negative pressure facilities for operating rooms, it is impossible to operate on patients infected with COVID-19. As a result, many patients requiring emergency surgery experience serious complications or die. The authors performed intravenous regional anesthesia (IVRA) and emergency surgery in an isolation room on three patients who needed prompt surgical management for upper extremity arterial injuries but could not enter the operating room due to COVID-19 infection. Anesthesia was successful in all cases. A minor anesthetic complication occurred in one patient, who recovered spontaneously. IVRA is a relatively safe and easy method for anesthesia. More-over, since the tourniquet is inflated before anesthesia, it is well-suited for patients with arterial injury. The method is simple and therefore easy to perform in an isolation room where space and manpower are limited. IVRA can be a good option in emergency surgery for upper extremity artery injury. © 2023 Korean Wound Management Society.
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In November 2019, the coronavirus disease-2019 (COVID-19) outbreak was first reported. The infection of COVID-19 has rapidly spread worldwide. Some have unapparent or mild symptoms, but some patients have fatal forms including respiratory or multiple organ failure. In March 2020, the World Health Organization announced COVID-19 as pandemic disease. The COVID-19 pandemic is a sudden, difficult-to-control, and severe disease that can also appear to patients in dermatology. However, understanding disease and experience with it is still insufficient. Therefore, we would like to review patients with fungal infections in the COVID-19 pandemic era. Copyright © 2020 by The Korean Society for Medical Mycology. All right reserved.
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Devices for the filtration and sterilization of indoor spaces have been widely used owing to the outbreak of the novel coronavirus disease 2019 (COVID-19). There is a need for a standard method to test the effectiveness of such devices. In this study, we aimed to identify important factors that must be considered while evaluating the efficiency of air purifiers in a large chamber. Investigation of the distribution characteristics of airborne viruses in the large chamber show that they were evenly distributed. Natural (gravitational) reduction of airborne viruses in the large chamber was also investigated. We found that the airborne-virus removal efficiency of an air purifier in a large chamber should be evaluated after 40 min for better accuracy because the concentration of airborne viruses rapidly decreased within the first 40 min and the settling velocity reduced after 40 min. In addition, the minimum standard deviation of airborne-virus removal efficiency of air purifier was 1.9% with a natural reduction time of 40 min. Moreover, the sampling efficiencies of three types of samplers were compared. The impactor showed the highest sampling efficiency (4.8 x 104-5.1 x 104 PFU/m3-min) and a small standard deviation (0.9 x 104 PFU/m3-min). Copyright © The Author(s) 2023.
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Purpose One of the representative social activities that affects successful aging is volunteer work. The purpose of this study is to examine the effects of volunteer activity characteristics and social support on successful aging and the mediating effects of volunteer satisfaction and gender differences, along with the relationships among these variables. The characteristics of volunteer activities consists of the number of monthly hours and the level of motivation to participate. Existing studies (Kim & Choi, 2012;Lee, 2009) found that the frequency of volunteering and the motivation to participate influenced the volunteer satisfaction of older adults. Hwang (2010) revealed that volunteer satisfaction was positively associated with successful aging. Social support has also been found to be positively related to both volunteer satisfaction (Moon, 2015) and successful aging (Gyasi & Phillips, 2020). Based on these findings, volunteer satisfaction is expected to play a mediating role in the relationship between volunteering characteristics and successful aging. Meanwhile, elderly males and females with different life courses may have a gap in terms of volunteering and social support. These gender differences can have a significant effect on successful aging. Furthermore, volunteer satisfaction can differ depending on social network size and the degree of social support, which in turn directly or indirectly affect successful aging. Another purpose of this study is to help make policies and practical recommendations to improve volunteer satisfaction through technology (smart phones, Internet, ICT) for both males and females. Method A self-administered survey was given to elderly people aged 60 and older living in Gwangju and Jeolla Province, South Korea. 542 participants that are currently volunteering or regularly participated in volunteer work for more than 6 months were included in this study. The SPSS 25.0 program for data analysis, descriptive statistics, correlation, and hierarchal linear regression was used to analyze the effects on the main variables of successful aging. Apart from regression analysis, structural equation modelling (SEM) was used to test the mediating effects of volunteer satisfaction and gender differences on the mediating model. Results and Discussion The results obtained in this study showed that the mean score for successful aging was 3.87 (range: 1~5), and that the successful aging score of males (3.92) was significantly higher than that of females (3.82). Males (3.54, range 1~5) had a significantly higher volunteer motivation than females (3.40). The mean scores for the size of the social network (3.11, range 1~5), social support (3.66, range 1~5), volunteer satisfaction (4.06, range 1~5) showed no gender differences. In this study, purposive motivation, the size of friend/neighbor networks and family support can be used to predict the successful aging of males and females. When examining mediating effects, volunteer satisfaction was found to have a full mediation effect on the relationship between the motivation to participate in volunteering and successful aging for both males and females. On the other hand, volunteer satisfaction was found to have a partial mediation effect on the relationship between social support from family and friends/neighbors and successful aging for both males and females. In terms of gender differences, volunteer satisfaction only had a partial mediation effect on the male group when the size of the social network affected successful aging. Meanwhile, the size of family/relative networks had a positive effect on the successful aging of women. Based on the research results, it is necessary to provide online volunteer programs that incorporates both education and counseling. Since there has been an increase in the number of chatbot services used in caring for the elderly, a method to expand the volunteering areas for managing chatbot services is also needed. Mobile phone education should also be provided to help senior volunteers understand how to operate and m nage this service. It is also recommended that video programs be created to enable elderly men to build mutual relationships with a diverse group of friends and neighbors in the community as well as their family during COVID-19 era. In addition, online programs that regularly organize family gathering should be provided so that women can interact with family members. Finally, there is a need for measures to increase access to programs where women can participate in community service through internet-based technology. © 2022, Gerontechnology. All Rights Reserved.
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INTRODUCTION: Severe pneumonia is a common indication for admission to the pediatric intensive care unit (PICU) and a leading cause of morbidity and mortality. The lack of epidemiology and outcome data from Asia is a barrier to improving outcomes of severe pneumonia in the region. METHOD(S): This is a prospective multicenter cohort study carried out from April 2019 to April 2022. Fifteen PICUs participated in this study under the Pediatric Acute & Critical Care Medicine Asian Network. Epidemiological, microbiological and outcome data were collected up to hospital discharge. Univariate logistic regression analysis were conducted to explore the association between potential risk factors and severe outcomes [acute respiratory distress syndrome (ARDS) and PICU mortality]. Multivariable analysis was performed withforward stepwise logistic regression adjusted for sites and COVID-19 pandemic including variables with p< 0.05 in univariate model. RESULT(S): There were 786 children with severe pneumonia in PICU with mean (standard deviation) age 2.8 (3.9) years. 384/786 (48.9%) had comorbidities;126/786 (16.0%) had a history of prematurity (gestational age < 37 weeks). Admission Pediatric Index of Mortality 3 (PIM3) and Pediatric Logistic Organ Dysfunction 2 (PELOD2) score were 16.2 (22.9) and 4.1(4.6). A sole viral or bacterial pathogen was identified in 179/786 (22.4%) and 165/786 (21.0%). Co-infections occurred in 114/786 (14.5%) patients. ARDS and mortality occurred in 156/786 (20.1%) and 70/786(8.9%) patients. In the multivariable model, risk factors for ARDS included PIM3 [adjusted odds ratio (aOR) [95% confidence interval (CI)] of 1.02 (1.01, 1.03)], PELOD2 [aOR 1.08 (95%CI 1.02, 1.13)] and involvement of 4 quadrants on chest-x-ray, [aOR 2.69 (95%CI 1.39, 5.18)]. Risk factors for mortality included PIM 3 [aOR 1.03 (95%CI 1.01, 1.04)], involvement of 4 quadrants on chest-x-ray [aOR 2.72 (95%CI 1.10, 6.73)], bacterial [aOR 2.61 (95%CI 1.00, 6.82)], fungus or mycobacterium [aOR 12.30 (95%CI 1.45, 104.57)] and co-infections [aOR 2.72 (95%CI 1.10, 10.35)]. CONCLUSION(S): The rate of ARDS and mortality in severe pneumonia admitted to PICU in Asia was high. Risk factors for poor outcomes were admission severity scores, generalized X-ray involvement and identification of bacteria, fungus/mycobacteria or co-infections.
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Energy consumption in the home increases recently due to the extremely hot or cold weather. Because of COVID 19, many people stay in the home and energy consumption in the home is increasing very much. Moreover, many homes are using new electric home appliances such as dishwasher or washer dryer which consumes much electric energy for a long duration. To reduce electric energy consumption and use energy more efficiently, the usage pattern of the home appliance should be analyzed. In the paper, we propose a pattern analysis method of the home appliance using Boosting technique. Boosting method is a sort of ensemble machine learning algorithm and is based on the decision tree. The correlation between home appliance usage can be analyzed with the result of feature importance in boosting algorithm. To verify the method, we analyzed the electric usage record in the UK with boosting algorithm. © 2022 IEEE.
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Leukocytoclastic vasculitis after the BNT162b2 vaccine and ChAdOxl nCoV-19 Corona Virus vaccine [recombinant] has been observed. Herein, we report two cases of leukocytoclastic vasculitis that developed after the ChAdOxl-S [recombinant] vaccination. A 61-year-old and a 52-year-old woman presented with pruritic purpuric macules and papules on both lower legs. The patients had been vaccinated with the ChAdOxl-S [recombinant] vaccine. The histopathological analyses were consistent with a diagnosis of leukocytoclastic vasculitis. They were treated with oral prednisolone and improved within 1 month of treatment. We assume that the rash had arisen from the deposition of spike protein at the skin tissue induced by the viral vector of the COVID-19 vaccine or hyperimmune responses by excipients present in vaccine preparations. To our knowledge, our cases would be the first Korean cases of leukocytoclastic vasculitis after the ChAdOxl-S [recombinant] vaccination. © 2022 Korean Dermatological Association. All rights reserved.
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COVID-19 has forced anatomists to perform non-face-to-face education using lecture videos. A Korean anatomist has given (white and black) board lectures and distributed lecture videos to the public for many years. This study was to verify the effects of open board lecture videos in the anatomy field. A questionnaire survey was carried out with the help of medical students who were exposed to the board lecture videos. The video provider uploaded the lecture videos on YouTube, where the viewing numbers were counted. At a medical school where the video provider belonged, the students mainly watched the lecture videos before the anatomy class. The watching hours of the lecture videos were related to the written examination scores. Students gave positive and negative comments on the board lectures. At the other two medical schools, students partly watched the lecture videos regardless of the teacher who delivered the lectures. The results suggested that students understood the board lectures themselves. On YouTube, the lecture videos were viewed by approximately 1,000 students. This paper introduces the desirable aspects of open board lecture videos on anatomy. The videos could enhance the quality of both students and teacher.
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Introduction: Vaccines revolutionised the management of COVID19. Nevertheless, they lack efficacy in high-risk or vulnerable groups (e.g., immunosuppressed patients), who may not mount an appropriate immune response. Monoclonal antibodies represent the gold-standard agents for such cases;but they are limited by availability, need for parenteral administration and the risk for viral escape because of spike protein mutations. Therefore, there is a pressing need for new prophylactic agents less prone to resistance.The viral receptor ACE2 represents an ideal target as it is essential for viral entry and transmission and because being a host protein it is not affected by viral mutations. However, the regulation of ACE2 remains elusive, due to the lack of appropriatein vitromodels. Cholangiocytes show one of the highest ACE2 expression levels in the body, representing an ideal platform for these studies. Here, we use cholangiocyte organoids as proof-of-principleto identify that the bile acid receptor FXR regulates ACE2 expression and SARS-CoV-2 infectionin vitro. We validate these findings in lung and gut organoids, animal models, human organs perfusedex situand patient cohorts. Aims & Methods: 1. Identify pathways controlling the transcriptional regulation of ACE2 2. Identify drugs modulating these pathways as novel prophylactic and therapeutic agents for COVID19. Organoids were propagated using established protocols. Marker expression was assessed using single-cell RNA sequencing, QPCR, and immunofluorescence. FXR binding on DNA was assessed with chromatin immunoprecipitation. SARS-CoV-2 was isolated from bronchoalveolar lavage of a COVID19 patient. Syrian golden hamsters were infected via direct inoculation and QPCR on oral swab, nasal turbinate and lung samples was used to measure SARS-CoV-2 infection. Human livers and lungs not used for transplantation were perfusedex-situusing normothermic perfusion. Nasopharyngeal swabs were used to measure ACE2 expression in nasal epithelial cells of healthy individuals taking UDCA at the standard therapeutic dose of 15 mg/kg/day. Patient registry data were compared using propensity score matching for sex, age, diabetes, NAFLD and Child- Turcotte-Pugh score. Result(s): We identified that FXR directly regulates ACE2 transcription in cholangiocyte organoids, while FXR inhibition with the approved drug ursodeoxycholic acid (UDCA), reduced ACE2 expression and SARS-CoV-2 infectionin vitro. We confirmed this mechanism in organoids from other COVID19-affected tissues, including the respiratory and intestinal systems. We validated our findingsin vivoin Syrian golden hamsters, showing that treatment with UDCA downregulates ACE2 and prevents SARS-CoV-2 infection. We confirmed that UDCA reduces ACE2 and SARS-CoV-2 infection in human lungs and livers perfusedex-situ. We performed a clinical study demonstrating that UDCA lowers ACE2 levels in the nasal epithelium of 6 healthy volunteers. Finally, we identified a correlation between UDCA and better clinical outcomes (hospitalisation, ICU admission and death) in COVID19 patients receiving UDCA for cholestatic diseases using the COVID-Hep and SECURELiver registry data. Conclusion(s): We identified FXR as a novel regulator of ACE2 expression. Using a bench-to-bedside approach combining in vitroand in vivomodels, exsituperfused human organs and clinical data we showed that FXR inhibition prevents or reduces SARS-CoV-2 infection and identified UDCA as an approved, cost-effective drug which could be repurposed for COVID19, paving the road for future clinical trials.