Efficacy of distance training program for cardiopulmonary resuscitation utilizing smartphone application and home delivery system.

AIM OF THE STUDY: Community cardiopulmonary resuscitation (CPR) education is important for laypersons. However, during the COVID-19 pandemic, with social distancing, conventional face-to-face CPR training was unavailable. We developed a distance learning CPR training course (HEROS-Remote) using a smartphone application that monitors real-time chest compression quality and a home delivery collection system for mannikins. This study aimed to evaluate the efficacy of the HEROS-Remote course by comparing chest compression quality with that of conventional CPR training. METHODS: We applied layperson CPR education with HEROS-Remote and conventional education in Seoul during the COVID-19 pandemic. Both groups underwent a 2-min post-training chest compression test, and we tested non-inferiority. Chest compression depth, rate, complete recoil, and composite chest compression score was measured. Trainees completed a satisfaction survey on CPR education and delivery. The primary outcome was the mean chest compression depth. RESULTS: A total of 180 trainees were enrolled, with 90 assigned to each training group. Chest compression depth of HEROS-Remote training showed non-inferiority to that of conventional training (67.4 vs. 67.8, p = 0.78), as well as composite chest compression score (92.7 vs. 95.5, p = 0.16). The proportions of adequate chest compression depth, chest compression rate, and chest compressions with complete chest recoil were similar in both training sessions. In the HEROS-Remote training, 90% of the trainees were satisfied with CPR training, and 96% were satisfied with the delivery and found it convenient. CONCLUSION: HEROS-Remote training was non-inferior to conventional CPR training in terms of chest compression quality. Distance learning CPR training using a smartphone application and mannikin delivery had high user satisfaction and was logistically feasible.

The effect of regional distribution of isolation rooms in emergency departments on ambulance travel time during the COVID-19 pandemic.

OBJECTIVE: The number and distribution of isolation rooms in Korea differ by region. The distribution of isolation beds in emergency departments may have affected ambulance travel time and burden on emergency medical service (EMS) during the COVID-19 pandemic. METHODS: This retrospective observational study analyzed EMS records in four regions of the Gyeonggi Province, Korea, from January 01, 2019 to December 31, 2020. The main exposure was the number of emergency department isolation rooms in each region. The primary outcome was call-to-return time for the EMS. The interaction effect of the number of regional isolation rooms on the call-to-return time during the COVID-19 pandemic was analyzed using a generalized linear model (GLM) and logistic regression. RESULTS: A total of 781,246 cases was included in the analyses. During the COVID-19 pandemic, the call-to-scene time (before 8 minutes vs. after 9 minutes, P<0.05) and call-to-return time (before 46 minutes vs. after 52 minutes, P<0.05) for emergency patients increased significantly compared to before the pandemic. As the number of regional isolation rooms increased, the effect of COVID-19 on the call-to-return time decreased significantly in the multivariable GLM with an interaction term (with 10.14 isolation rooms per million population: adjusted exponential ß coefficient [exp(ß)], 1.33; with 12.24 isolation rooms per million population: adjusted exp(ß), 1.18). As the number of regional isolation rooms increased, the effect of COVID-19 on the call-to-scene time decreased significantly in the multivariable GLM with an interaction term (with 10.14 isolation rooms per million population: adjusted exp(ß), 1.20; with 12.24 isolation rooms per million population: adjusted exp(ß), 1.09). CONCLUSION: During the pandemic, the increases in call-to-return time and call-to-scene time were smaller in regions with more isolation rooms per population.

Epidemiology of patients who died in the emergency departments and need of end-of-life care in Korea from 2016 to 2019.

The need of palliative care at the end-of-life in the emergency departments (ED) is growing. The study aims to investigate the epidemiology of patients who died during care in ED using nationwide database, and to estimate the need for palliative care in the ED. A retrospective observational study was conducted using the National Emergency Department Information System (NEDIS) database. Patients who died during ED care between 2016 and 2019 were included. Palliative care-eligible disease was defined as cancer (C00-C99 of ICD-10), chronic respiratory disease (CRD, J44-J46), chronic liver disease (CLD, K70-K77), and heart failure (HF, I50). Among the 36,538,486 ED visits during 4 years, 34,086 ED deaths were included. The crude incidence rate of ED deaths per 100,000 person-year was steady between 16.6 in 2016 and 16.3 in 2019 (p-for-trend = 0.067). Only 3370 (9.9%) ED deaths were injury, while 30,716 (90.1%) deaths were related to diseases. The most common ED diagnosis was cardiac arrest (22.1%), followed by pneumonia (8.6%) and myocardial infarction (4.7%). In cases of disease-related ED deaths, about 34.0% stayed longer than 8 h in the ED (median (interquartile range): 4.5 (1.9-11.7) h) and 44.2% received cardiopulmonary resuscitation (CPR) at end-of-life time. A quarter of the disease-related ED deaths were diagnosed with palliative care eligible disease: cancer (16.9%), CLD (3.8%), HF (3.5%), and CRD (1.4%). Cancer patients received less CPR (23.4%) and stayed longer in the ED (median (interquartile range): 7.3 (3.2-15.9) h). Over the past 4 years, more than 30,000 patients, including 5200 cancer patients, died during care in the ED. A quarter of disease-related ED death were patients with palliative care-eligible condition and more than 30% of them stayed longer than 8 h in the ED before death. It is time to discuss about need of palliative care in the ED.

Application of Convolutional Neural Network (CNN) to Recognize Ship Structures

The purpose of this paper is to study the recognition of ships and their structures to improve the safety of drone operations engaged in shore-to-ship drone delivery service. This study has developed a system that can distinguish between ships and their structures by using a convolutional neural network (CNN). First, the dataset of the Marine Traffic Management Net is described and CNN’s object sensing based on the Detectron2 platform is discussed. There will also be a description of the experiment and performance. In addition, this study has been conducted based on actual drone delivery operations—the first air delivery service by drones in Korea.

Impact of the COVID-19 Pandemic on the Incidence and Characteristics of Patients with Psychiatric Illnesses Visiting Emergency Departments in Korea.

The global coronavirus disease 2019 (COVID-19) pandemic has had wide-ranging effects on the mental health of the public. This study aimed to investigate the impact of the COVID-19 pandemic on the characteristics of psychiatric patients who visited emergency departments (ED) during this time. A cross-sectional study was conducted including patients visiting 402 nationwide EDs from 27 January 2020 to 29 June 2020 (22 weeks; during-COVID) and the corresponding period in 2019 (28 January 2019 to 30 June 2019, 22 weeks; before-COVID) to control for seasonal influences. Among the 6,210,613 patients who visited the ED, 88,520 (2.5%) patients who visited before the pandemic and 73,281 (2.7%) patients who visited during the pandemic had some kind of psychiatric illness. The incidence rates of psychiatric self-harm increased from 0.54 before the pandemic to 0.56 during the pandemic per 1,000,000 person-days (p = 0.04). Age- and sex-standardized rates of psychiatric illnesses per 100,000 ED visits increased during the pandemic (rate differences (95% CIs); 45.7 (20.1-71.4) for all psychiatric disorders and 42.2 (36.2-48.3) for psychiatric self-harm). The incidence of psychiatric self-harm and the proportion of psychiatric patients visiting EDs increased during the COVID-19 pandemic.

Antibody Responses One Year after Mild SARS-CoV-2 Infection.

Understanding the long-term kinetics of antibodies in coronavirus disease 2019 (COVID-19) is essential in interpreting serosurvey data. We investigated the antibody response one year after infection in 52 mildly symptomatic patients with severe acute respiratory syndrome-coronavirus-2 (SARS-CoV-2) infection, using three commercial immunoassays and a surrogate virus neutralization test (sVNT) kit. Anti-N pan-immunoglobulin (Ig), anti-S IgG, and anti-S1 IgG were detected in 43 (82.7%), 44 (84.6%), and 30 (57.7%), respectively. In 49 (94.2%), the antibody could be detected by either anti-N pan-Ig or anti-S IgG assay. In the sVNT, 30 (57.7%) had positive neutralizing activity. Despite waning immunity, SARS-CoV-2 antibodies can be detected up to one year after infection, even in mild COVID-19 patients.

The Psychological Burden of COVID-19 Stigma: Evaluation of the Mental Health of Isolated Mild Condition COVID-19 Patients.

BACKGROUND: The objective of this article is to assess the mental health issues of the mild condition coronavirus disease 2019 (COVID-19) patients admitted to a community treatment center (CTC) in Korea. METHODS: A total of 107 patients admitted to a CTC were included as the study population, and their mental health problems including depression (patient health questionnaire-9), anxiety (generalized anxiety disorder scale-7), post-traumatic stress disorder (PTSD) (PTSD checklist-5) and somatic symptoms (by patient health questionnaire-15) were evaluated every week during their stay. The stigma related to COVID-19 infection was evaluated with an adjusted version of the Middle East respiratory syndrome (MERS) stigma scale. RESULTS: During the first week of isolation, the prevalence of more-than-moderate depression was 24.3%, more-than-moderate anxiety was 14.9%, more-than-moderate somatic symptoms was 36.5% and possible PTSD was 5.6% of total population. For depression and anxiety, previous psychiatric history and stigma of COVID-19 infection were significant risk factors. For PTSD, previous psychiatric history and stigma of COVID-19 infection as well as total duration of isolation were found to be significant risk factors. Prevalence of depression, anxiety and possible PTSD remained similar across the four weeks of observations, though the prevalence of severe depression, increased after four weeks of stay. Somatic symptoms seemed to decrease during their stay. CONCLUSION: The results suggest that social mitigation of COVID-19 related stigma, as well as care of patients with pre-existing mental health problems are important mental health measures during this crisis period. It is also important that clinical guidelines and public health policies be well balanced over the protection of the public and those quarantined to minimize the negative psychosocial consequences from isolation of the patients.

Antibody Responses 8 Months after Asymptomatic or Mild SARS-CoV-2 Infection.

Waning humoral immunity in coronavirus disease patients has raised concern over usefulness of serologic testing. We investigated antibody responses of 58 persons 8 months after asymptomatic or mildly symptomatic infection with severe acute respiratory syndrome coronavirus 2. For 3 of 4 immunoassays used, seropositivity rates were high (69.0%-91.4%).

Operation and Management of Seoul Metropolitan City Community Treatment Center for Mild Condition COVID-19 Patients.

BACKGROUND: In response to the disaster of coronavirus disease 2019 (COVID-19) pandemic, Seoul Metropolitan Government (SMG) established a patient facility for mild condition patients other than hospital. This study was conducted to investigate the operation and necessary resources of a community treatment center (CTC) operated in Seoul, a metropolitan city with a population of 10 million. METHODS: To respond COVID-19 epidemic, the SMG designated 5 municipal hospitals as dedicated COVID-19 hospitals and implemented one CTC cooperated with the Boramae Municipal Hospital for COVID-19 patients in Seoul. As a retrospective cross-sectional observational study, retrospective medical records review was conducted for patients admitted to the Seoul CTC. The admission and discharge route of CTC patients were investigated. The patient characteristics were compared according to route of discharge whether the patient was discharged to home or transferred to hospital. To report the operation of CTC, the daily mean number of tests (reverse transcription polymerase chain reaction and chest X-ray) and consultations by medical staffs were calculated per week. The list of frequent used medications and who used medication most frequently were investigated. RESULTS: Until May 27 when the Seoul CTC was closed, 26.5% (n = 213) of total 803 COVID-19 patients in Seoul were admitted to the CTC. It was 35.7% (n = 213) of 597 newly diagnosed patients in Seoul during the 11 weeks of operation. The median length of stay was 21 days (interquartile range, 12-29 days). A total of 191 patients (89.7%) were discharged to home after virologic remission and 22 (10.3%) were transferred to hospital for further treatment. Fifty percent of transferred patients were within a week since CTC admission. Daily 2.5-3.6 consultations by doctors or nurses and 0.4-0.9 tests were provided to one patient. The most frequently prescribed medication was symptomatic medication for COVID-19 (cough/sputum and rhinorrhea). The next ranking was psychiatric medication for sleep problem and depression/anxiety, which was prescribed more than digestive drug. CONCLUSION: In the time of an infectious disease disaster, a metropolitan city can operate a temporary patient facility such as CTC to make a surge capacity and appropriately allocate scarce medical resource.

Now as a Liminal Space, Writing as a Patchwork: Autoethnographic Reflections on the Self in the Middle of the Pandemic

In the middle of the COVID-19 pandemic, I came to think about the role of my identity in my scholarship. Drawing on liminality as a conceptual apparatus, this autoethnography displays multiple layers of the self, that is, thresholding, passing, and daydreaming. Moving everyday encounters into parts of discourses, I consider how the self is always in full of uncertainty, wandering, rather than being fixed. I end with reflecting on the writing process: autoethnographic writing has been continual process to capture multiple liminal moments into a patchwork;it becomes possible by distancing the observing-self from the observed-self, however temporal those are.

COVID-19 and the workplace: Implications, issues, and insights for future research and action.

The impacts of COVID-19 on workers and workplaces across the globe have been dramatic. This broad review of prior research rooted in work and organizational psychology, and related fields, is intended to make sense of the implications for employees, teams, and work organizations. This review and preview of relevant literatures focuses on (a) emergent changes in work practices (e.g., working from home, virtual teamwork) and (b) emergent changes for workers (e.g., social distancing, stress, and unemployment). In addition, potential moderating factors (demographic characteristics, individual differences, and organizational norms) are examined given the likelihood that COVID-19 will generate disparate effects. This broad-scope overview provides an integrative approach for considering the implications of COVID-19 for work, workers, and organizations while also identifying issues for future research and insights to inform solutions. (PsycInfo Database Record (c) 2021 APA, all rights reserved).

Antibody Responses to SARS-CoV-2 at 8 Weeks Postinfection in Asymptomatic Patients.

We compared levels of severe acute respiratory syndrome coronavirus 2 neutralizing antibodies in recovery plasma from 7 completely asymptomatic coronavirus disease patients with those in symptomatic patients in South Korea. We found that serologic diagnostic testing was positive for 71% (5/7) of completely asymptomatic patients, but neutralizing antibody response occurred in all 7 patients.

Selecting coronavirus disease 2019 patients with negligible risk of progression: early experience from non-hospital isolation facility in Korea.

BACKGROUND/AIMS: As the novel coronavirus (coronavirus disease 2019 [COVID-19]) outbreak progresses rapidly, staying home is recommended for suspected patients; however, the safety of this recommendation is uncertain. In Korea, non-hospital facilities called "living and treatment centers (LTCs)" have been established since 5 March 2020. The LTCs provided a unique opportunity to evaluate the safety of selection criteria for low-risk groups. METHODS: Between 5 March and 9 April 2020, patients with COVID-19 who met the following criteria were admitted to the LTC; alert, age below 65 years old, no underlying disease or well-controlled underlying disease, body temperature below 38.0°C, whether taking antipyretics or not, and no dyspnea. Patients were closely observed by doctors or nurses' interviews twice a day and transferred to hospitals when symptoms worsened. RESULTS: A total of 113 patients were admitted to the LTC; 52.2% were female, with a median age of 25 years (interquartile range, 21.5 to 39.5). Of 113 patients, 54 (47.8%) were asymptomatic at diagnosis, and 15 (13.3%) had no symptoms until they were released from isolation. During the follow-up period, two (1.8%) patients were transferred to a hospital but did not progress to severe status during hospitalization. CONCLUSION: The risk of progression was negligible in COVID-19 patients who met the admission criteria for LTC at the time of diagnosis. LTCs could be a safe alternative considering shortage of hospital beds.