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Purpose: This study aimed to identify the factors that affect post-traumatic growth among frontline nurses during a COVID-19 pandemic. Methods: This study included 187 nurses working in nationally designated infectious disease hospitals as participants. Data were collected from January 11 to March 2, 2021 using structured questionnaires. Independent t-tests, one-way ANOVA, Pearson correlation coefficients, and hierarchical multiple regressions were performed to examine influencing factors of post-traumatic growth. Results: Posst-traumatic growth was positively correlated with traumatic event experience (r=.26, p<.001), post-traumatic stress (r=.32, p<.001), supervisor support (r=.39, p<.001), and colleague support (r=.36, p<.001). Factors affecting post-traumatic growth were emotional support of supervisors (β=.76, p<.001) and evaluative support of colleagues (β=.46, p<.018). Overall, approximately 40.0% of the variability in post-traumatic growth was explained by these two variables. Conclusion: To increase emotional support of supervisors and evaluative support of colleagues, the most influential factors for post-traumatic growth of frontline nurses who fought against COVID-19, a positive culture must be established. This includes horizontal communication, a safe working environment, and securing of appropriate nurse to patient ratio. © 2022 Korean Academy of Nursing Administration
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After the COVID-19 pandemic, cyberattacks are increasing as non-face-to-face environments such as telecommuting and telemedicine proliferate. Cyberattackers exploit vulnerabilities in remote systems and endpoint devices in major enterprises and infrastructures. To counter these attacks, fast detection and response are essential because advanced persistent threat (APT) attacks intelligently infiltrate endpoint devices for long periods and spread to large-scale environments. However, because conventional security systems are signature-based, fast detection of APT attacks is challenging, and it is difficult to respond flexibly to the environment. In this study, we propose an APT fast detection and response technique using open-source tools that improves the efficiency of existing endpoint information protection systems and swiftly detects the APT attack process. Performance test results based on realistic scenarios using the open-source APT attack library and MITER ATT&CK indicated that fast detection was possible with higher accuracy for the early stages of APT attacks in scenarios where endpoint attack detectors are interworking environments. © 2022 The Authors
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BACKGROUND: Disinfection is one of the most effective ways to block the rapid transmission of severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2). Due to the prolonged coronavirus disease 2019 (COVID-19) pandemic, disinfectants have become crucial to prevent person-to-person transmission and decontaminate hands, clothes, facilities and equipment. However, there is a lack of accurate information on the virucidal activity of commercial disinfectants. AIM: To evaluate the virucidal efficacy of 72 commercially available disinfectants constituting 16 types of ingredients against SARS-CoV-2. METHODS: SARS-CoV-2 was tested with various concentrations of disinfectants at indicated exposure time points as recommended by the manufacturers. The 50% tissue culture infectious dose assay was used to calculate virus titre, and trypan blue staining and CCK-8 were used to assess cell viability after 3-5 days of SARS-CoV-2 infection. FINDINGS: This study found that disinfectants based on 83% ethanol, 60% propanol/ethanol, 0.00108-0.0011% sodium dichloroisocyanurate and 0.497% potassium peroxymonosulfate inactivated SARS-CoV-2 effectively and safely. Although disinfectants based on 0.05-0.4% benzalkonium chloride (BAC), 0.02-0.07% quaternary ammonium compound (QAC; 1:1), 0.4% BAC/didecyldimethylammonium chloride (DDAC), 0.28% benzethonium chloride concentrate/2-propanol, 0.0205-0.14% DDAC/polyhexamethylene biguanide hydrochloride (PHMB) and 0.5% hydrogen peroxide inactivated SARS-CoV-2 effectively, they exhibited cytotoxicity. Conversely, disinfectants based on 0.04-4% QAC (2:3), 0.00625% BAC/DDAC/PHMB, and 0.0205-0.14% and 0.0173% peracetic acid showed approximately 50% virucidal efficacy with no cytotoxicity. Citric acid (0.4%) did not inactivate SARS-CoV-2. CONCLUSION: These results indicate that most commercially available disinfectants exert a disinfectant effect against SARS-CoV-2. However, re-evaluation of the effective concentration and exposure time of certain disinfectants is needed, especially citric acid and peracetic acid.
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The ongoing COVID-19 pandemic necessitated platform diversification and the revitalization of interactive performance (the metaverse), a new paradigm for the performing arts. In 2019, the authors implemented an online, audience-participatory, interactive dance performance content using AI. This study analyzed the effect of the metaverse on performance content in terms of performer–audience interaction, examining the distinction between face-to-face performances using AI-based Korean dance content on the metaverse platform. Interactive metaverse performances break free from the unidirectional limitations of traditional face-to-face performances, which can only be viewed, and enables audiences guide the performance by expressing emotions through VR avatars during the performance and expressing opinions through chats. This study sought to derive a meaningful application plan after confirming the usefulness and limitations of metaverse convergence with the performing arts by focusing on an interactive Korean dance performance. The findings should enhance performing arts content development and academic and industrial values. © 2022, The Author(s), under exclusive license to Springer Nature Switzerland AG.
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The palatine tonsils (hereinafter referred to as "tonsils") serve as a reservoir for viral infections and play roles in the immune system's first line of defense. The aims of this study were to establish tonsil epithelial cell-derived organoids and examine their feasibility as an ex vivo model for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection. The tonsil organoids successfully recapitulated the key characteristics of the tonsil epithelium, including cellular composition, histologic properties, and biomarker distribution. Notably, the basal layer cells of the organoids express molecules essential for SARS-CoV-2 entry, such as angiotensin-converting enzyme 2 (ACE2), transmembrane serine protease 2 (TMPRSS2) and furin, being susceptible to the viral infection. Changes in the gene expression profile in tonsil organoids revealed that 395 genes associated with oncostatin M signaling and lipid metabolism were highly upregulated within 72 h after SARS-CoV-2 infection. Notably, remdesivir suppressed the viral RNA copy number in organoid culture supernatants and intracellular viral protein levels in a dosedependent manner. Here, we suggest that tonsil epithelial organoids could provide a preclinical and translational research platform for investigating SARS-CoV-2 infectivity and transmissibility or for evaluating antiviral candidates.
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Background: The recent novel coronavirus disease (COVID-19) pandemic has led to restrictions in physical activity. We evaluated the impact of risk perception on physical activity, and its impact on kidney function in chronic kidney disease (CKD) patients during the pandemic. Method(s): A population of CKD patients registered in a SKETCH (Study on Kidney disease and EnvironmenTal Chemicals, Clinical Trial No. NCT04679168) cohort recruited from June 2020 to October 2020 was included in the study. Patients were followed-up every 3 months for a year. We obtained risk perception and physical activity information by a questionnaire survey. Physical exercise, 3-times/week, was categorized into three groups according to the frequency of positive response during 5 visits: group 1, 0-2;group 2, 3-4;group 3, 5. We used Logistic regression analysis to identify the significance of risk perception to physical activity. The cox-proportional hazard model was used to identify the significance of physical activity for kidney function. Result(s): A total of 262 patients were included, and the mean age was 60.5+/-12.8 years old. Mean eGFR was 43.4+/-20.9 mL/min/1.73 m2, and there were 220 (84.0%) with eGFR <60 mL/min/1.73m2. There were 122 (46.6%) of patients who showed higher risk perception for COVID-19 infection. After adjustment with age, sex, comorbidities, and laboratory results, higher risk perception was significantly associated with decreased physical activity (adjusted OR 0.44, 95% CI, 0.23, 0.84). During 364.8+/-38.6 days, 52 (19.8%) patients showed decreased kidney function with decreasing eGFR >=30%. Group 1 showed a significantly increased risk for kidney dysfunction (adjusted HR 3.36, 95% CI 1.23, 9.20). This result was prominent in age over 60, male sex, patients with hypertension. Conclusion(s): Decreased physical activity related to higher risk-perception, and that was significantly increased risk for kidney dysfunction. Healthcare provider needs to consider a new strategy to encourage physical activity irrespective of risk perception.
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Objective: There is a growing interest in subacute thyroiditis (SAT), as this self-limited inflammatory thyroid disorder can be one of the manifestations of SARS-CoV-2 infection or side effects of COVID-19 vaccination. However, studies comparing the clinical characteristics of the SAT patients before and after the onset of COVID-19 pandemic have been scarce. Here, we tried to evaluate the clinical difference of the SAT patients before and after the onset of COVID-19 pandemic. Method(s): A retrospective study was conducted with SAT patients (n = 51) who visited our outpatient clinic between 2011 and 2021. All the patients were diagnosed as SAT with the modified criteria proposed by Stasiak et al., and all of them had at least two times of thyroid ultrasonographies (initial visit and after resolution). The patients were divided into two groups based on the date of the first reported COVID-19 infection (31 patients before and 20 patients after the first reported infection in South Korea, 8th, January 2020), and comparison study was performed. Result(s): Clinical characteristics such as sex and age were similar between the SAT patients before and after the COVID-19 pandemic. Laboratory tests including thyroid function tests, thyroid autoantibodies, complete blood count, inflammatory markers (ESR, CRP) also showed no significant difference. Moreover, the proportion of patients who had bilateral involvement on thyroid ultrasonography, who showed hypothyroid phase during their clinical course and who had persistent hypothyroidism requiring levothyroxine replacement were comparable between the two SAT groups. In addition, the proportion of SAT patients who took prednisolone, their cumulative doses and treatment periods were similar between the groups divided based on the onset of COVID-19 pandemic. Thyroid volumes at initial visit and after resolution also showed no significant difference between the two subgroups. Conclusion(s): This study shows that the clinical characteristics of SAT patients have not been notably changed during the COVID-19 pandemic. Further studies comparing the SAT patients before the SARS-CoV-2 pandemic and SAT patients associated with COVID-19 infection are needed to clarify the association between SARSCoV-2 and SAT in more detail.
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Coronavirus disease 2019 (COVID-19) has been a global pandemic for over 2 years. During the Omicron (B.1.1.529) variant-predominant period in South Korea, confirmed cases among children and adolescents surged. This review found that, although younger children may be less susceptible to COVID-19 than adolescents, more research is needed on the role of children and adolescents in the disease’s spread. Detailed epidemiological information about the transmissibility of the novel severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) strain in children and adolescents is currently scarce, and more research is needed on the role of children and adolescents in disease’s spread. There may be a difference in the proportion of cases with severe disease requiring hospitalization depending on the dominant mutant strain;however, COVID-19 generally presents with a mild-to-moderate course in children aged 5–11 years old.
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Purpose This study aims to explore the influence of different types of cleanliness information provided on the Airbnb platform (hosts' sanitation labels, Airbnb cleaning protocol and previous guests' reviews) on guests' trust and behavioral intentions. Design/methodology/approach This study uses an online scenario-based experimental design. A two-step approach was applied to discover the proposed relationships by assessing the measurement model fit and validity of the constructs with confirmatory factor analysis and testing study hypotheses with structural equation modeling. Findings The results demonstrate that three types of cleanliness information (i.e. provided by Airbnb's hosts, platform and customer reviews) had statistically significant effects on customers' trust and behavioral intentions. Practical implications The research results provide practical recommendations for Airbnb hosts and peer-to-peer accommodation platforms on using several types of textual and visual cleanliness information to influence guests' attitudes and behavioral intentions. Originality/value This study advances knowledge by introducing new factors affecting guests' trust and behavioral intentions in peer-to-peer accommodation settings and differentiating the effects of different sources of cleanliness information and different types of guests' trust.
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Purpose: This study aimed to identify the relationship between job complexity, infection prevention environment, and nursing intention for patients with emerging infectious diseases, with a focus on the mediating effect of job crafting in hospitals dedicated to coronavirus disease 2019 (COVID-19). Methods: The study surveyed 202 nurses with at least 3 months of work experience who encountered COVID-19 patients at a dedicated COVID-19 hospital. The collected data were analyzed using IBM SPSS/WIN 25.0, and the mediating effect was analyzed through the SPSS PROCESS macro, using regression analysis. Results: It was demonstrated that job crafting fully mediated the relationship between job complexity and nursing intention for patients with emerging infectious diseases. Furthermore, this study showed that job crafting partially mediated the relationship between infection prevention environment and nursing intention for patients with emerging infectious diseases. Conclusion: It was confirmed that job crafting of nurses in a hospital dedicated to COVID-19 was an important mediating factor in their nursing intention for patients with emerging infectious diseases, and this finding is expected to support efforts to further improve nursing intention for patients with emerging infectious diseases. © 2022 Korean Academy of Fundamentals of Nursing.
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Background. Infection control measures against the coronavirus disease 2019 (COVID-19) within a hospital often rely on expert experience and intuition due to the lack of clear guidelines. This study surveyed current strategies for the prevention of the spread of COVID-19 in medical institutions. Methods. Upon systematic review of the guidelines at the national level, 14 key topics were selected. Six hospitals were provided an open survey that assessed their responses to these topics between August 11 and 25, 2020. Using these data, an online questionnaire was developed and sent to the infection control teams of 46 hospitals in South Korea. The survey was conducted between January 31, 2021, and February 20, 2021. Results. All 46 hospitals responded to the survey, and 24 hospitals (52.2%) had treated 100 or more cases of COVID-19. All hospitals operated screening clinics, and the criteria were respiratory symptoms (100%), fever (97.8%), and epidemiological association (93.5%). It was found that 89.1% (41/46) of hospitals allowed symptomatic patients to visit their general outpatient clinics if fever or respiratory symptoms were not associated with COVID-19. Most hospitals (87.2%;34/39) conducted polymerase chain reaction (PCR) tests for all hospitalized patients. Moreover, 76.1% (35/46) of hospitals implemented preemptive isolation policies for hospitalized patients, of which 97.1% (34/35) were released from isolation after a single negative PCR test. A little over half of the hospitals (58.7%;27/46) treated patients that met the national criteria for release from isolation but consistently had positive PCR results. Of these hospitals, 63% (17/27) used N95/KF94 masks, and 40.7% (11/27) used surgical masks without other personal protective equipment for treating them. Most hospitals (76.9%;20/26) accommodated them in shared rooms when the cycle threshold value of the PCR test was more than a certain value (34.6%;9/26), or after a certain period that satisfied the national criteria (26.9%;7/26). Finally, 76.1% (35/46) of hospitals performed emergency procedures or operations on suspected patients. Conclusion. Various guidelines were being applied by each medical institution, but there was a lack of an explicit set of national guidelines to support them.
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Background: Although the use of remdesivir and systemic corticosteroids have reduced deaths from COVID-19, COVID-19 still has a high mortality rate. Aims: To know the effectiveness of the combined use of remdesivir and regdanvimab (CT-P59) in patients with severe COVID-19. Methods: From March to early May 2021, 124 severe COVID-19 patients were admitted to Ulsan University Hospital (Ulsan, Korea), and received oxygen therapy and remdesivir. Among them, 25 were administered regdanvimab before oxygen/remdesivir. We retrospectively compared the outcomes of the two groups: remdesivir alone group (n = 99 [79.8%]) vs. regdanvimab/remdesivir group (n = 25 [20.2%]). Results: The oxygen-free days at day 28 (primary outcome), defined as the number of days a patient was alive and oxygen-free for 28 days from oxygen/remdesivir start, were significantly higher in regdanvimab/remdesivir group (mean ± SD [standard deviation]: 19.36 ± 7.87 vs. 22.72 ± 3.66, P = 0.003). The association between the regdanvimab/ remdesivir group and the oxygen-free days was also significant in multivariate analysis (logistic regression), where the initial SpO2/FiO2 ratio (severity index) was adjusted. Further, in the regdanvimab/remdesivir group, the lowest SpO2/FiO2 ratio during treatment was significantly higher (mean ± SD: 237.05 ± 89.68 vs. 295.63 ± 72.74, P = 0.003), and the Kaplan-Meier Estimate of oxygen supplement days in surviving patients (at day 28) were significantly shorter (mean ± SD: 8.24 ± 7.43 vs. 5.28 ± 3.66, P (log-rank test) = 0.024). Conclusions: In severe COVID-19 patients, clinical outcomes could be improved by using regdanvimab in addition to remdesivir.
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Background: The recent novel coronavirus disease (COVID-19) pandemic has led to unprecedented changes in behavior. We evaluated the current status of precautionary behavior and physical activity in chronic kidney disease (CKD) patients during the COVID-19 pandemic. Methods: A population of CKD patients (n=306) registered in a SKETCH (Study on Kidney disease and EnvironmenTal Chemicals, Clinical Trial No. NCT04679168) cohort recruited from June 2020 to October 2020 was included in the study. We conducted a questionnaire survey related to (1) risk perception of COVID-19, (2) hygienic behavior, (3) social distancing, and (4) physical activity during the past year (before the pandemic) and during the pandemic. To compare behaviors before and during the COVID-19 pandemic, the Wilcoxon-signed rank test was used. Logistic regression analysis was conducted to identify the relative factors related to risk recognition or behavior changes. Results: There were 187 (61.1%) patients with eGFR <45 mL/min/1.73 m2. This population showed a higher degree of risk perception for COVID-19 than the general population. During the pandemic, social distancing and hygiene-related behavior was significantly increased (P <0.001). The frequency of exercise was decreased only among those with regular exercise, without diabetes, or with a lower Charlson comorbidity index (CCI) (P <0.001), with no change among the other groups. Socioeconomic status and comorbidities significantly affected behavioral characteristics regardless of the category. Age was the most significant determinant of risk perception among CKD patients. Education and income were significantly associated with precautionary behaviors such as staying at home and hand sanitizer use. Also, patients with higher CCI status significantly increased their frequency of exercise (adjusted OR 2.10, 95% CI 1.01-4.38). Conclusions: CKD patients showed higher risk-perception with active precautionary behavioral changes than the general population. Healthcare providers should be aware of the characteristics to comprise precautionary behavior without reducing the physical activity.
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SETTING: Five referral hospitals, South Korea.OBJECTIVE: To assess epidemiological changes in TB before and during the COVID-19 pandemic.DESIGN: This was a multicentre cohort study of 3,969 patients diagnosed with TB.RESULTS: We analysed 3,453 patients diagnosed with TB prior to the COVID-19 pandemic (January 2016-February 2020) and 516 during the pandemic (March-November 2020). During the pandemic, the number of patients visits declined by 15% from the previous 4-year average, and the number of patients diagnosed with TB decreased by 17%. Patients diagnosed during the pandemic were older than those diagnosed before the pandemic (mean age, 60.2 vs. 56.6 years, P < 0.001). The proportion of patients to have primary TB at a younger age (births after 1980) among those diagnosed with TB was significantly lower during the pandemic than before (17.8% in 2020 vs. 23.5% in 2016, 24.0% in 2017, 22.5% in 2018, 23.5% in 2019; P = 0.005).CONCLUSIONS: The COVID-19 pandemic resulted in a reduction in the number of visits to respiratory departments, leading to fewer patients being diagnosed with TB. However, our results suggest that universal personal preventive measures help to suppress TB transmission in regions with intermediate TB burden.