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Thromboelastography (TEG) and rotational thromboelastometry (ROTEM) are point-of-care viscoelastic tests of whole blood that provide real-time analyses of coagulation. TEG and ROTEM are often used to guide blood product administration in the trauma and surgical settings. These tests are increasingly being explored for their use in other disease states encountered in critically ill patients and in the management of antithrombotic medications. As the medication experts, pharmacists should be familiar with how to interpret and apply viscoelastic tests to disease state and medication management. The purpose of this narrative review is to provide a primer for pharmacists on viscoelastic tests and their interpretation and to explore non-trauma indications for viscoelastic testing in critical care. Literature evaluating the use of TEG and ROTEM for patients with acute and chronic liver disease, ischemic and hemorrhagic stroke, myocardial infarction, cardiac arrest, coronavirus disease 2019, and extracorporeal membrane oxygenation are described. Current applications of viscoelastic tests by pharmacists and potential future roles of critical care pharmacists in expanding the use of viscoelastic tests are summarized.Copyright © 2023 The Authors. JACCP: Journal of the American College of Clinical Pharmacy published by Wiley Periodicals LLC on behalf of Pharmacotherapy Publications, Inc.
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Objectives: We would like to report a case in which a COVID-19 patient who was transferred to our hospital due to a lack of medical resources due to the COVID-19 outbreak in Daegu, South Korea, on February, 2020, underwent double lung transplantation after 110 days with VV-ECMO support and performed double lung re-transplantation 865 days after lung transplantation. Method(s): ECMO was performed on a total of 69 patients with COVID-19-related acute circulatory/ respiratory failure from February 2020 to December 2022. Among them, 16 patients were registered for lung transplantation, and 5 out of 16 registered patients performed lung transplants. One in five people who performed lung transplantation performed retransplantation on the 865thday after transplantation. Result(s): A 52-year-old female patient was transferred to our hospital, and VV-ECMO was performed the next day. The double lung transplantation was performed 112 days after hospitalization and was discharged 238 days after surgery. 668 days after lung transplantation, home O2 was applied as bronchitis obliterans syndrome, and her lung function deteriorated rapidly later, and re-transplantation was decided. In the patient;s HLA test, HLA class I cPRA% was 32% and HLA class II cPRA% was 100%. Desensitization was performed six times plasmapheresis with administrating Botezomib and immunoglobulin, and then re-transplantation was performed on the 865th day after lung transplantation. The patient has maintained her daily life without any special complications other than the occurrence of central DI after surgery. The pathological findings of the lung previously transplanted to the patient were acute rejection (ISHLT grade A2), chronic airway rejection (ISHLT grade C1, B0), and chronic vascular rejection (ISHLT grade D1). Conclusion(s): The long term result of patients who performed lung transplantation with COVID 19 related respiratory failure is still unknown. Therefore, even patients who have undergone long-term VV-ECMO support due to COVID 19 related respiratory failure are expected to achieve good results if lung transplantation is needed by carefully approaching and treating with a multidisciplinary approach.
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This study was conducted to prepare the basic data for the development of practical nursing intervention programs for nursing college students who have been confirmed with COVID-19 since its outbreak in Korea. The subjects of this study were 70 nursing students at the University of Nursing located in Seoul, Gangwon-do, and Gyeonggi-do, Chungcheongnam-do. The data were collected from April 1st through April 30th, 2022, and analyzed it using the content analysis method. The experience of the nursing students infected with COVID-19 was classified and analyzed to draw a total of 187 significant statements and 36 categories. When establishing an infectious disease prevention program for nursing students and developing a practical nursing intervention program, it is necessary to focus on the preventive activities that emphasize personal aspects such as infection control, health management, and self-management, and to strengthen social support systems and improve quality of life. © 2023 The Authors. Published by IASE.
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Intro: The need for re-use of gloves as an alternative to single use was raised in times of resource shortages because during the coronavirus disease 2019 pandemic, marked increase in healthcare associated infection was reported, which might owing to shortage of personal protective equipment. we aimed to evaluate the risk of microbial transmission by comparing residual microorganism after multiple patient contact according to with or without gloves in clinical practice. Method(s): Three researchers made rounds of patients while touching the same area successively followed by alcohol-based hand rub: one with bare hands, one with single gloves, and one with double gloves. Hand imprints were obtained before and after rounds, and cultured to count colony-forming units (CFU). The number of colonies was compared between groups in a semi-quantitative manner by hand area. Finding(s): Mean CFU counts after round were 10.06 for bare hands, 31.22 for single-gloved hands, and 49.67 for double-gloved hands (p=0.084). The most commonly identified microorganism after rounding was coagulase-negative Staphylococci (77.8%, 42/54), followed by Bacillus species (62.9%, 34/54). Carbapenem-resistant Acinetobacter baumannii was confirmed from a pair of double-gloved hand specimens after the rounds. That round included a patient with the same organism with the same antibiotic susceptibility results. More microorganisms were remained after alcohol-based hand rub on gloved hands than on bare hands. Conclusion(s): From our results, the possibility of microbial transmission seems more likely in gloved hands than in bare hands even after alcohol-based hand rub. Therefore, we do not recommend the re-use of gloves after alcohol-based hand hygiene.Copyright © 2023
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The coronavirus disease 2019 (COVID-19) pandemic has prompted the implementation of social distancing policies worldwide, limiting participation in exercise and substantially impacting health behaviors. In accordance with the theory of planned behavior (TPB), the present study aimed to develop a model for predicting the intent to participate in exercise and engage in health behaviors among Korean men using the perception of COVID-19 risk as an exogenous variable. We analyzed data obtained from 374 Korean men who had completed a 32-item, online questionnaire. Structural equation modeling was performed to evaluate the effect of attitudes, subjective norms, and perceived behavioral control (PBC) on the intention to participate in exercise and health behaviors using COVID-19 risk perception as an antecedent variable. COVID-19 risk perception exerted significant negative effects on the attitude toward exercise participation (beta = -0.857, p < 0.001), subjective norms associated with exercise participation (beta = -0.862, p < 0.001), and PBC related to exercise (beta = -0.738, p < 0.001). In addition, both attitude (beta = 0.213, p < 0.001) and subjective norms (beta = 0.168, p = 0.001) exerted significant effects on the intention to participate in exercise. PBC also exerted significant effects on the intention to participate in exercise (beta = 0.580, p < 0.001) and health behaviors (beta = 0.461, p < 0.001). Lastly, the intention to participate in exercise exerted a significant effect on health behaviors (beta = 0.400, p < 0.001). The data indicated that, among TPB variables, PBC exerted the greatest influence on the intention to participate in exercise and had a significant effect on engagement in health behaviors. The current findings support TPB as an important theoretical model for predicting the intention to participate in exercise and patterns of health behavior among Korean men during the COVID-19 pandemic. Our study also highlights the importance of addressing PBC when designing interventions to promote exercise participation and health behaviors among Korean men.Copyright ©2023 The Author(s).
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This study investigates the effectiveness of an upper-room UVGI system in a small classroom. Mixing ventilation can increase virus removal when combined with a UVGI system more effectively than displacement ventilation combined with a UVGI system, especially in cases where the ventilation rate is low. © 2022 17th International Conference on Indoor Air Quality and Climate, INDOOR AIR 2022. All rights reserved.
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Given the updated, ongoing recommendations for the COVID vaccine series and booster for children ages 6 months and older yet vaccine coverage remaining at less than 50% among children, it is critical for public health communicators to understand sources of vaccine hesitance among parents. A national survey of parents identifies the mediating effects of vaccine anxiety, safety, and fear on the relationships between COVID-19 threat and efficacy with behavioral intentions to vaccinate. Anxiety mediated the relationships between both threat and efficacy with parents'behavioral intentions to vaccinate their children. Vaccine anxiety, safety, and fear mediated parents' decisions to vaccinate themselves. Theoretical and applied implications are reviewed. Copyright 2023 Authors.
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Background: This study analyzed the causes of death in the Korean population in 2020. Method(s): Cause-of-death data for 2020 from Statistics Korea were examined based on the Korean Standard Classification of Diseases and Causes of Death, 7th revision and the International Statistical Classification of Diseases and Related Health Problems, 10th revision. Result(s): In total, 304,948 deaths occurred, reflecting an increase of 9,838 (3.3%) from 2019. The crude death rate (the number of deaths per 100,000 people) was 593.9, corresponding to an increase of 19.0 (3.3%) from 2019. The 10 leading causes of death, in descending order, were malignant neoplasms, heart diseases, pneumonia, cerebrovascular diseases, intentional self-harm, diabetes mellitus, Alzheimer disease, liver diseases, hypertensive diseases, and sepsis. Cancer accounted for 27.0% of deaths. Within the category of malignant neoplasms, the top 5 leading organs of involvement were the lung, liver, colon, stomach, and pancreas. Sepsis was included in the 10 leading causes of death for the first time. Mortality due to pneumonia decreased to 43.3 (per 100,000 people) from 45.1 in 2019. The number of deaths due to severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) was 950, of which 54.5% were in people aged 80 or older. Conclusion(s): These changes reflect the continuing increase in deaths due to diseases of old age, including sepsis. The decrease in deaths due to pneumonia may have been due to protective measures against SARS-CoV-2. With the concomitant decrease in fertility, 2020 became the first year in which Korea's natural total population decreased.Copyright © Korean Medical Association.
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Background: Coronavirus disease (COVID-19), first reported at the end of 2019, is characterized by a broad spectrum of clinical manifestations ranging from asymptomatic to multi-organ dysfunction. These symptoms may persist even after the acute phase has passed. Post-acute COVID-19 syndrome (long-COVID) is a condition characterized by COVID-19 symptoms that persist for longer than two months after infection. Fatigue, muscle and joint pain, dyspnea, cognitive impairment, and anxiety are the most common symptoms of long-COVID. Given the substantial impact of COVID-19 sequelae on the quality of life of its survivors, as well as its socioeconomic burden, proactive measures are required. Current Concepts: Following the identification of long-COVID characteristics and symptoms, patient-centered care based on vaccination, COVID-19 medications, and digital healthcare is recommended. Furthermore, people who are more vulnerable to long-COVID, such as those with respiratory dysfunctions or the older adults, require more specialized and attentive management. Big data and artificial intelligence will hopefully enable a more Discussion and Conclusion: Infectious diseases threaten our lives constantly, as evidenced by the recent COVID-19 pandemic and its lingering consequences. A novel virus can emerge at any time and place, resulting in substantial clinical and economic loss. At this stage, it is crucial to establish prompt and effective strategies against long-COVID, as well as against potential pandemics.
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China has recently declared its role as a leading developing country in actively practicing carbon neutrality. In fact, its carbon-neutral policy has accelerated from a gradual and macroscopic perspective and has been actively pursued given the changes not only in the overall social system but also in its impact on various stakeholders. This study analyzed the patterns of carbon neutrality (CN) and the actors of policy promotion in China from a long-term perspective. It collected policy discourses related to CN posted on Chinese websites from 2000 to 2022 and conducted text mining and network analysis. The results revealed that the pattern of CN promotion in China followed an exploration-demonstration-industrialization-digitalization model, similar to other policies. Moreover, the policy promotion sector developed in the direction of unification-diversification-specialization. Analysis of policy promotion actors found that enterprises are the key driver of continuous CN. In addition, the public emerged as a critical actor in promoting CN during the 12th-13th Five-Year Plans (2011-2020). Moreover, the central government emerged as a key driving actor of CN during the 14th Five-Year Plan. This was a result of the emphasis on efficiency in the timing and mission process of achieving CN. Furthermore, based on the experience of COVID-19, the rapid transition of Chinese society toward CN emphasizes the need for a central government with strong executive power. Based on these results, this study presents constructive suggestions for carbon-neutral development in China.
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The dockless e-scooter sharing service is rapidly spreading, replacing existing transportation, and improving last-mile accessibility. User segmentation with travel regularity and segment-level behavior analysis, which are already conducted in public transit, also benefits e-scooter sharing service to enhance service quality and increase usage. In this work, we group e-scooter users according to their travel regularity and identify each group's usage characteristics. Through the dockless e-scooter usage data, as operated in six cities in South Korea, travel regularity measured by users' repetitive departure time and destination is discovered and spatiotemporal usage patterns are identified. We divide e-scooter users into three groups by type of travel regularity: irregular user, spatially regular user, and regular user. Regular users more frequently use e-scooters, travel shorter distances, and walk longer distances to find an e-scooter than other groups. It is also revealed that the use in morning peak hours only occurs in the regular user group. By decomposing the temporal patterns of spatially regular and regular users, we discover that spatially regular users are composed of daytime, evening peak, and nighttime users. In contrast, regular users are composed of morning peak, evening peak, and lockdown (restriction in response to COVID-19 pandemic) peak users. This research suggests user segmentation based on travel regularity in e-scooter sharing services, enabling multiple strategies to be drawn to retain users with high regularity and convert users with low regularity to regular users.
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The purpose of this study was to understand the phenomenon of marital conflict during the coronavirus disease (COVID-19) emergency in South Korea by adapting the vulnerability-stress-adaptation model (VSA;Karney and Bradbury 1995). The public emergency of COVID-19 and social distancing policies caused emotional distress, so-cial isolation, lack of support, and economic crisis in families, increasing the risk of marital conflict. Eleven wo-men who reported experiencing severe marital conflict during the COVID-19 pandemic were interviewed by tele-phone. The interview data were analyzed through directed content analysis. The women experienced 1) malad-aptation to sudden life changes, 2) family role confusion, 3) economic crisis, and 4) invasion of personal space. These adverse experiences, along with the influence of their spouses' personality traits, led to reduced physical and psychological interaction between the partners and severance of their relationship. Attention must be paid to the mental health and well-being of families to prevent their dissolution. There is an urgent need for com-munity-based psychological intervention and support for families who are house-bound for long periods. Addi-tionally, government policies are necessary to lighten or share the childcare burden on families during the crisis, so women are not compelled to take career breaks.
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The freight rate is a representative variable in the shipping market and is characterized by a cyclical re-lationship. Even though downturns in the shipping market, such as the shipping industry recession in the 1980s, the global financial crisis in 2008 and COVID-19 crisis in 2020, recur, few studies have analyzed the dynamic relationship between supply and demand in terms of its effect on freight rates. Thus, this study classifies the factors affecting fluctuations in dry cargo freight rates into demand, supply, and freight rate specific demand factors, which play the most important role in managing risk in the shipping market. Based on the recursive structural vector autoregressive (recursive SVAR) model, we analyze the historical con-tributions of the effects of each factor across different time periods. Two main findings are summarized as follows: first, we identify the dynamic relationship between factors affecting BDI in the shipping market, and reveal that the magnitude and direction of factors are different. Second, we verify that in an extreme situation in which freight rates exceed the normal range, the market is overheated, and freight rates are therefore determined by the freight rate specific demand of market participants rather than by the actual supply and demand.(c) 2023 The Authors. Production and hosting by Elsevier B.V. on behalf of The Korean Association of Shipping and Logistics, Inc. This is an open access article under the CC BY-NC-ND license (http://creative-commons.org/licenses/by-nc-nd/4.0/).
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Attentions for medical assistance services to isolated patients have increased due to recent infectious diseases. In the isolation case, telemedicine service is valuable because of no direct contact between infected patients and medical staff. This work proposes a pan-tilt-zoom (PTZ) camera control system that provides convenience for medical staff during telemedicine. Our automatic camera controller tracks the region while maintaining the best viewpoint when medical staff selects a region of interest, e.g., a patient's symptoms or wounds. In order to develop the system, several attributes of object trackers suitable for the proposed control system were explored. Based on the evaluations of object trackers, we found that the scale-variance property of object trackers is significant to our PTZ controller. As a result, the proposed approach using a scale-variant object tracker can control the pan, tilt, and zoom to support a convenient telemedicine service without annoying manual viewpoint control.
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Background: This study analyzed the causes of death in the Korean population in 2020.Methods: Cause-of-death data for 2020 from Statistics Korea were examined based on the Korean Standard Classification of Diseases and Causes of Death, 7th revision and the International Statistical Classification of Diseases and Related Health Problems, 10th revision.Results: In total, 304,948 deaths occurred, reflecting an increase of 9,838 (3.3%) from 2019. The crude death rate (the number of deaths per 100,000 people) was 593.9, corresponding to an increase of 19.0 (3.3%) from 2019. The 10 leading causes of death, in descending order, were malignant neoplasms, heart diseases, pneumonia, cerebrovascular diseases, intentional self-harm, diabetes mellitus, Alzheimer disease, liver diseases, hypertensive diseases, and sepsis. Cancer accounted for 27.0% of deaths. Within the category of malignant neoplasms, the top 5 leading organs of involvement were the lung, liver, colon, stomach, and pancreas. Sepsis was included in the 10 leading causes of death for the first time. Mortality due to pneumonia decreased to 43.3 (per 100,000 people) from 45.1 in 2019. The number of deaths due to severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) was 950, of which 54.5% were in people aged 80 or older.Conclusion: These changes reflect the continuing increase in deaths due to diseases of old age, including sepsis. The decrease in deaths due to pneumonia may have been due to protective measures against SARS-CoV-2. With the concomitant decrease in fertility, 2020 became the first year in which Korea's natural total population decreased.
ABSTRACT
The purpose of this study was to understand the phenomenon of marital conflict during the coronavirus disease (COVID-19) emergency in South Korea by adapting the vulnerability-stress-adaptation model (VSA;Karney and Bradbury 1995). The public emergency of COVID-19 and social distancing policies caused emotional distress, social isolation, lack of support, and economic crisis in families, increasing the risk of marital conflict. Eleven women who reported experiencing severe marital conflict during the COVID-19 pandemic were interviewed by telephone. The interview data were analyzed through directed content analysis. The women experienced 1) malad-aptation to sudden life changes, 2) family role confusion, 3) economic crisis, and 4) invasion of personal space. These adverse experiences, along with the influence of their spouses' personality traits, led to reduced physical and psychological interaction between the partners and severance of their relationship. Attention must be paid to the mental health and well-being of families to prevent their dissolution. There is an urgent need for community-based psychological intervention and support for families who are house-bound for long periods. Additionally, government policies are necessary to lighten or share the childcare burden on families during the crisis, so women are not compelled to take career breaks. © 2023, Universitaet Bielefeld. All rights reserved.
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The global pandemic of the novel coronavirus (COVID-19) declared in March 2020 has created unprecedented challenges for healthcare professionals and organizations. A significant impact has been physical and psychological stress on nurses working in acute care environments. Stress-related growth may occur concurrently with the experience of negative psychological responses as another facet of coping and adjustment to the stressful event. The primary aim of this study was to describe the degree to which nurses reported stress, anxiety, and stress-related growth during the COVID-19 pandemic. This article discusses the study methods, which included a cross-sectional design with an online survey sent to nurses in a hospital system. Results demonstrated that, of the 1,009 participants in the final analysis, almost 70% reported anxiety symptoms, with 38% having scores at the moderate or severe level. Growth scores were low. Our discussion considers cultural implications of the findings and implications for practice that underscore the need for proactive interventions to mitigate the psychological burden of the pandemic on nurses and the need to implement routine screening of nurses for anxiety. © 2023.
ABSTRACT
As the number of people infected with COVID-19 in Korea is increasing, several measures have been implemented to gradually restrict outdoor activities and indoor gatherings while promoting a non-face-to-face social culture. In this study, we performed a gender-based multi-group analysis using a technology acceptance model (TAM) as an external variable for COVID-19 risk perception to verify the model's predictive ability to increase participation behavior toward digital fitness services. We analyzed the data of 433 Koreans using an online survey consisting of 23 items. A structural equation model was used to verify the perceived ease of use (PEOU), perceived usefulness (PU), intention to use and exercise participation behavior of the TAM with COVID-19 risk perception as an external variable. First, our results showed that COVID-19 risk perception had a statistically higher significant and positive effect on PEOU (beta = 0.170, t = 3.296, p < 0.001) than on PU (beta = 0.130, t = 2.848, p = 0.004) of digital fitness services. Second, the PEOU of the digital fitness service was found to have a statistically higher significant positive effect on PU (beta = 0.512, t = 9.728, p < 0.001) than on intention to use (beta = 0.130, t = -2.774, p = 0.006). Third, the PU of digital fitness services was found to have a statistically significant positive effect on the intention to use (beta = 0.684, t = 12.909, p < 0.001). Fourth, the intention to use the digital fitness service was found to have a statistically significant positive effect on exercise participation behavior (beta = 0.796, t = 16.248, p < 0.001). Lastly, we observed a significant difference between men and women in COVID-19 risk perception and PEOU among the six paths established. Digital environments that encourage participation in exercises could promote health during a pandemic. This study highlighted the need to consider digital environments that encourage exercise participation in creating physical exercise contents as there was no significant difference in the intention to use digital fitness services between men and women.Copyright © 2023 The Author(s).