Multipurpose advanced split T7 promoter-based transcription amplification for ultrasensitive molecular diagnostics

An accurate, convenient, and rapid diagnostic platform, which can be applied in facility-limited or point-of-care (POC) settings, is essential to help prevent the spread of infectious diseases and enable the most effective treatment to be selected. In this study, we describe the development of a new isothermal molecular diagnostic system named multipurpose advanced split T7 promoter-based transcription amplification (MASTER) for the rapid and ultrasensitive detection of various pathogens containing single-stranded RNA and double-stranded DNA. MASTER produces a large number of RNA amplicons in the presence of target pathogens, which generate fluorescence or colorimetric signals based on light-up RNA aptamers or lateral flow assays. Implementing MASTER at 37 °C for<1 h achieved the detection of a single copy per reaction without cross-reactivity. Moreover, the testing of 40 clinical samples revealed that MASTER exhibited excellent accuracy with 100% sensitivity and specificity for SARS-CoV-2 diagnosis. Furthermore, a one-pot MASTER system capable of accelerating practical applications was demonstrated, indicating that the MASTER system is a promising platform for the effective surveillance of various pathogens. © 2023 Elsevier B.V.

A novel negative pressure isolation device reduces aerosol exposure: A randomized controlled trial

Background and aim: The COVID-19 pandemic has led to a proliferation of intubation barriers designed to protect healthcare workers from infection. We developed the Suction-Assisted Local Aerosol Containment Chamber (SLACC) and tested it in the operating room. The primary objectives were to determine the ease and safety of airway management with SLACC, and to measure its efficacy of aerosol containment to determine if it significantly reduces exposure to health care workers. Method(s): In this randomized clinical trial, adult patients scheduled to undergo elective surgery with general endotracheal anesthesia were screened and informed consent obtained from those willing to participate. Patients were randomized to airway management either with or without the SLACC device. Patients inhaled nebulized saline before and during anesthesia induction to simulate the size and concentration of particles seen with severe symptomatic SARS-CoV-2 infection. Result(s): 79 patients were enrolled and randomized. Particle number concentration (PNC) at the patients' and healthcare workers' locations were measured and compared between the SLACC vs. control groups during airway management. Ease and success of tracheal intubation were recorded for each patient. All intubations were successful and time to intubation was similar between the two groups. Healthcare workers were exposed to significantly lower particle number concentrations (#/cm3) during airway management when SLACC was utilized vs. control. The particle count outside SLACC was reduced by 97% compared to that inside the device. Conclusion(s): The SLACC device does not interfere with airway management and significantly reduces healthcare worker exposure to aerosolized particles during airway management.Copyright © 2023 Elsevier Ltd

REACHING PROGRAM OUTCOMES DURING PANDEMIC: English Language Teacher Professional Development in Uzbekistan

Achieving effective English language teacher professional development (PD) in global contexts calls for a broad understanding of program implementation complexities, including cultural, linguistic, and logistical considerations, particularly with international partners and stakeholders. The organization and administration of a three-year, country-wide in-service teacher PD program in Uzbekistan became more complex when COVID-19 restricted travel by the U.S. partners. Instead of postponing the program, partners and stakeholders found avenues that would still propel them toward achieving intended program outcomes and deliverables. This chapter explores a U.S.-based university's flexible, creative response to the pandemic's restrictions and explains how program administration, from a university partner perspective, could produce innovations in English language teacher and teacher leadership development. Although this chapter includes context specific examples, implications are drawn to guide any administrator of English language teacher education programs with diverse stakeholders. The following key elements were considered central to the success of this international project: 1) commitment to contextual and cultural sensitivity;2) diverse team building;3) asset-based approaches to teacher development;and 4) technological readiness for diverse contexts and communication modes. These elements lay the foundation for effectively reimagining an international program for English language teachers in the face of a pandemic. © 2023 Taylor and Francis.

National trends in suicide-related behaviors among youths between 2005-2020, including COVID-19: a Korean representative survey of one million adolescents.

OBJECTIVE: It is difficult to conclude that COVID-19 is associated with a decrease in the suicide attempts rate by comparing only a short-term period. Therefore, it is necessary to examine attempted suicide rates through a trend analysis over a longer period. This study aimed to investigate an estimated long-term trend regarding the prevalence of suicide-related behaviors among adolescents in South Korea from 2005 to 2020, including COVID-19. SUBJECTS AND METHODS: We sourced data from a national representative survey (Korea Youth Risk Behavior Survey) and analyzed one million Korean adolescents aged 13 to 18 years (n=1,057,885) from 2005 to 2020. The 16-year trends regarding the prevalence of sadness or despair and suicidal ideation and attempt and the trend changes before and during COVID-19. RESULTS: Data of 1,057,885 Korean adolescents was analyzed (weighted mean age, 15.03 years; males, 52.5%; females, 47.5%). Although the 16-year trend in the prevalence of sadness or despair and suicide ideation and attempt consistently decreased (prevalence of sadness or despair between 2005-2008, 38.0% with 95% confidence interval [CI], 37.7 to 38.4 vs. prevalence in 2020, 25.0% [24.5 to 25.6]; suicide ideation between 2005-2008, 21.9% [21.6 to 22.1] vs. prevalence in 2020, 10.7% [10.3 to 11.1]; and suicide attempt between 2005-2008, 5.0% [4.9 to 5.2] vs. prevalence in 2020, 1.9% [1.8 to 2.0]), the downward slope decreased during COVID-19 (ßdiff in sadness, 0.215 with 95% CI 0.206 to 0.224; ßdiff in suicidal ideation, 0.245 [0.234 to 0.256]; and ßdiff in suicide attempt, 0.219 [0.201 to 0.237]) compared with pre-pandemic period. CONCLUSIONS: This study found that the observed risk of suicide-related behaviors during the pandemic was higher than expected through long-term trend analysis of the prevalence of sadness/despair and suicidal ideation and attempts among South Korean adolescents. We need a profound epidemiologic study of the change in mental health due to the pandemic's impact and the establishment of prevention strategies for suicide ideation and attempt.

17-year trends of body mass index, overweight, and obesity among adolescents from 2005 to 2021, including the COVID-19 pandemic: a Korean national representative study.

OBJECTIVE: There is a lack of pediatric studies that have analyzed trends in mean body mass index (BMI) and the prevalence of obesity and overweight over a period that includes the mid-stage of the COVID-19 pandemic. Thus, we aimed to investigate trends in BMI, overweight, and obesity among Korean adolescents from 2005 to 2021, including the COVID-19 pandemic. SUBJECTS AND METHODS: We used data from the Korea Youth Risk Behavior Web-based Survey (KYRBS), which is nationally representative of South Korea. The study included middle- and high-school students between the ages of 12 and 18. We examined trends in mean BMI and prevalence of obesity and/or overweight during the COVID-19 pandemic and compared these to those of pre-pandemic trends in each subgroup by gender, grade, and residential region. RESULTS: Data from 1,111,300 adolescents (mean age: 15.04 years) were analyzed. The estimated weighted mean BMI was 20.48 kg/m2 (95% CI, 20.46-20.51) between 2005 and 2007, and this was 21.61 kg/m2 (95% CI, 21.54-21.68) in 2021. The prevalence of overweight and obesity was 13.1% (95% CI, 12.9-13.3%) between 2005 and 2007 and 23.4% (95% CI, 22.8-24.0%) in 2021. The mean BMI and prevalence of obesity and overweight have gradually increased over the past 17 years; however, the extent of change in mean BMI and in the prevalence of obesity and overweight during the pandemic was distinctly less than before. The 17-year trends in the mean BMI, obesity, and overweight exhibited a considerable rise from 2005 to 2021; however, the slope during the COVID-19 pandemic (2020-2021) was significantly less prominent than in the pre-pandemic (2005-2019). CONCLUSIONS: These findings enable us to comprehend long-term trends in the mean BMI of Korean adolescents and further emphasize the need for practical prevention measures against youth obesity and overweight.

Cerebral venous thrombosis after ChAdOx1 nCoV-19 vaccination: a systematic review

OBJECTIVE: To perform a systematic review of case reports or case series regarding thrombosis with thrombocytopenia syndrome (TTS) and cerebral venous thrombosis (CVT) related to ChAdOx1 nCoV-19 vaccination to address the clinical features, laboratory findings, treatment modalities, and prognosis related with CVT. SUBJECTS AND METHODS: We included 64 TTS patients from 19 articles, 6 case series and 13 case reports, in which thrombosis occurred after the first dose of ChAdOx1 nCoV-19 vaccination published up to 30 June 2021 in Embase, ePubs, Medline/PubMed, Scopus, and Web of Science databases. RESULTS: Of the 64 TTS patients, 38 (59.3%) had CVT. Patients with CVT were younger (median 36.5 vs. 52.5 years, p<0.001), had lower fibrinogen levels (130 vs. 245 mg/dL, p=0.008), had more frequent history of intracerebral hemorrhage (ICH), and had higher mortality rate (48.6% vs. 19.2%, p=0.020) than that of patients without CVT. In multivariable analysis, the possibility of presence of CVT was higher in younger age groups [odd ratio (OR): 0.91, 95% confidence interval (CI): (0.86-0.97, p<0.001)] and those with accompanying intracerebral hemorrhage (ICH) (OR: 13.60, 95% CI (1.28-144.12, p=0.045). CONCLUSIONS: Our study demonstrated that CVT related to ChAdOx1 nCoV-19 vaccination was associated with younger age, low levels of fibrinogen, presence of ICH and more frequent mortality compared to those of non-CVT. If TTS occurs after ChAdOx1 nCoV-19 vaccination, the presence of CVT in patients with young age or ICH should be considered.

Effects of Bed Soils and Plant Growth Regulators on Root Growth of Hibiscus syriacus L

Background and objective: As the COVID-19 pandemic gripped the entire world and people found themselves spending more time at home, many households began gardening, and purchased various ornamental plants. Many cultivars of Hibiscus syriacus are grown for their showy flowers, or used as landscape shrubs. H. syriacus is generally known for its high rate of asexual reproduction. However, it is known that the effectiveness of propagation by cuttings can have big differences depending on internal and external factors. This study was conducted to determine the effects of optimal rooting bed soil composition and auxin on the rooting of H. syriacus cuttings. Methods: Cuttings used in this study were from 17 cultivars. As types of bed soil for propagation by cutting, gardening bed soil, sand, mixed soil 1, and mixed soil 2 were used, and the plant growth regulators of IBA and NAA were applied at 500, 1000, and 1500 mg⋅L-1 concentrations. Results: The rooting rate and number of roots were highest with the combination of perlite and vermiculite. On the other hand, the gardening bed soil showed an extremely low rooting percentage. The root growth was improved in most cultivars when treated by plant growth regulator. The highest rooting rate was verified at IBA 500 mg⋅L-1 treatment while the number of roots and root length showed good result in IBA 1500 mg⋅L-1 treatment. Conclusion: In many cultivars, it was observed that the rooting rate and number of roots differed depending on the bed soil. The most suitable bed soil for the cuttings was a mixture of peat moss and vermiculite, and it was possible to increase the efficiency through treatment with a growth regulator, and the efficiency of IBA was better than that of NAA. However, it is necessary to identify which detailed growth regulator treatment is suitable for the root development of each cultivar, because plant growth regulator was less effective and even problematic in some cultivars. © 2022 by the Society for People, Plants, and Environment.

Standardized Measurement of SARS-CoV-2 Viral Load Over Time in Respiratory Compartments and in Response to Remdesivir Treatment

Background. Two years into the pandemic, clinicians do not have access to a standardized measurement of SARS-CoV-2 viral load (VL) that allows for VL comparison across clinical specimens and different assays. Reliable VL measurement in diverse respiratory specimens, over time, and in response to treatments such as remdesivir (RDV), could better inform treatment and prevention. Methods. To investigate the use of a standardized VL assay in respiratory specimens, we enrolled patients hospitalized with COVID-19 in Providence, RI, with/ without RDV exposure;collected serial samples from 4 compartments (nasopharyngeal-NP, nasal-NA, oropharyngeal-OP, saliva-SA) in 3 visits during the 1st week of hospitalization;and characterized SARS-CoV-2 VL using a ChromaCode HDPCRTM quantitative research use only assay, calibrated to the first World Health Organization (WHO) International Standard (IS). Linear mixed effects models and associated regression coefficients were used to analyze intercompartmental VL differences at enrollment, over time, and with/without RDV. Results. Of 35 participants (60% male;70% White, 14% Hispanic/Latino, 49% RDV exposure), all had visit 1 samples (median hospital day 1, IQR 0-2;pre-RDV for those exposed);80% visit 2 samples (median hospital day 2, IQR 1-8);and 37% visit 3 samples (median hospital day 4, IQR 3-7). Overall, 38 NP, 67 NA, 57 OP, and 67 SA samples were collected. Mean log VLs (Log10IU/mL) differed by compartment at visit 1 (NP 6.3, NA 4.9, OP 4.1, SA 5.6, p=0.0001) and significantly decreased over time in all compartments (p< 0.04 for all comparisons). Log VL change over time was not significantly different between compartments or between people treated/not treated with RDV. Conclusion. We successfully measured respiratory intercompartmental SARS-CoV-2 VL differences among hospitalized patients using a standardized assay calibrated to the WHO IS. Dissemination of standardized VL measurement methods will allow accurate VL comparisons across assay types quantified in IU/mL and improve assessment of the impact of COVID-19 treatments. Inter-compartmental VL differences at baseline may indicate sampling variability or different viral burden. RDV did not appear to accelerate viral decay.

CURRENT APPLICATIONS OF PATIENT COMMUNICATION TECHNOLOGIES IN GERIATRIC CRITICAL CARE

The availability and utility of patient-centered communication technologies in acute-critical care settings have evolved slowly over the past 30 years with wide variability, little standardization, and few randomized controlled clinical trials (RCT). The COVID-19 pandemic forced rapid expansion and use of communication technologies, particularly between patients and remote family caregivers. To capture changes responsive to the pandemic, this paper reviews current literature (< 5 years) on communication technologies in acute-critical care settings focusing on the user experience among older adult patients. We supplement these findings with case-based evidence from a pilot RCT of an electronic tablet communication application provisioned to mechanically ventilated ICU patients, and efforts toward hospital-wide implementation. Recent literature on patient communication technology consists primarily of qualitative, descriptive accounts of video communication (i.e., ICU visits) or provision of augmentative and alternative communication. Recommendations for required skills, standardization, and research regarding patient communication technology are provided.

Cerebral venous thrombosis after ChAdOx1 nCoV-19 vaccination: a systematic review.

OBJECTIVE: To perform a systematic review of case reports or case series regarding thrombosis with thrombocytopenia syndrome (TTS) and cerebral venous thrombosis (CVT) related to ChAdOx1 nCoV-19 vaccination to address the clinical features, laboratory findings, treatment modalities, and prognosis related with CVT. SUBJECTS AND METHODS: We included 64 TTS patients from 19 articles, 6 case series and 13 case reports, in which thrombosis occurred after the first dose of ChAdOx1 nCoV-19 vaccination published up to 30 June 2021 in Embase, ePubs, Medline/PubMed, Scopus, and Web of Science databases. RESULTS: Of the 64 TTS patients, 38 (59.3%) had CVT. Patients with CVT were younger (median 36.5 vs. 52.5 years, p<0.001), had lower fibrinogen levels (130 vs. 245 mg/dL, p=0.008), had more frequent history of intracerebral hemorrhage (ICH), and had higher mortality rate (48.6% vs. 19.2%, p=0.020) than that of patients without CVT. In multivariable analysis, the possibility of presence of CVT was higher in younger age groups [odd ratio (OR): 0.91, 95% confidence interval (CI): (0.86-0.97, p<0.001)] and those with accompanying intracerebral hemorrhage (ICH) (OR: 13.60, 95% CI (1.28-144.12, p=0.045). CONCLUSIONS: Our study demonstrated that CVT related to ChAdOx1 nCoV-19 vaccination was associated with younger age, low levels of fibrinogen, presence of ICH and more frequent mortality compared to those of non-CVT. If TTS occurs after ChAdOx1 nCoV-19 vaccination, the presence of CVT in patients with young age or ICH should be considered.

Generation of human tonsil epithelial organoids as an ex vivo model for SARS-CoV-2 infection

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.

Effect of virtual education of abdominal ultrasonography for internal medicine resident in COVID-19 era;Multi-center analysis

Objectives: The aim of this study was to compare the effect of online education of abdominal ultrasonography(USG) with off-line education and evaluate the effectiveness of one-time abdominal USG education for internal medicine resident and gastroenterology fellow. Materials and Methods: A 25-min lecture on the upper abdomen was carried out online or off-line, and a test with 38 short-answer question was conducted before and after the lecture. Then, theses scores were analyzed for each education method and participant group. Results: A total of 48 physicians were included in this study. The study population included 25 physicians (13 internal medicine residents and 12 gastroenterology fellow) with online-education and 23 physicians (20 internal medicine residents and 3 gastroenterology fellow) with off-line education. The mean of pretest score in on-line and off-line education group was 16.7 ± 8.6 and 7.3 ± 6.1, respectively (P = 0.003). The rate of USG experience in on-line and off-line education was 52% and 8.7%, respectively (P<0.001). However, there was a significant increase of test score after one-time USG education regardless in all internal resident group and gastroenterology fellow with on-line education (P<0.0001,<0.0001, and 0.0035, respectively). In addition, there was no significance difference in delta-score after education between two groups (7.8 ± 3.7 vs 8.8 ± 4.3, respectively;P = 0.406). In addition, on comparison of the score in internal medicine resident and gastroenterology fellow in online and off-line education group, there was no significant difference in delta-score after education, respectively (8.3 ± 3.6 vs 7.3 ± 3.8, P = 0.485;9.0 ± 4.5 vs 7.3 ± 3.0, P = 0.537). Conclusion: The effectiveness of online USG education may not be inferior to off-line education. Additionally, the short-term effect of basic ultrasound education seems to be significantly observed in both the internal medicine resident and gastroenterology fellow group. Besides, there was no significant difference between the two groups.

COVID-19 pandemic and clinicopathologic characteristics of colorectal cancer in Korea: A multicenter, retrospective study

Background: The coronavirus disease 2019 (COVID-19) pandemic has affected not only the control and management of infectious diseases, but also those of other diseases by deteriorating the general healthcare systems worldwide. In accordance with the suggestion by the WHO for postponement of non-urgent procedures, diagnosis and treatment strategies for the patients with malignancy have been changed. The aim of this study was to investigate the impact of COVID-19 pandemic on primary colorectal cancer (CRC) from multi-institutions in Korea. Methods: Medical records of consecutive patients with CRC between March 2019 and February 2021 in six university hospitals were reviewed. Recurrent diseases, admission for management of complications or enterostomy repair, and other pathologies than adenocarcinoma were excluded. Baseline characteristics and perioperative outcomes were compared after a cohort was divided into the two groups: before and after around March 2020, when the COVID-19 test has been mandatory for all admitted patients in most institutions. Treatment characteristics and pathologic outcomes were also compared between the two groups. Results: A total of 3895 patients with CRC admitted during the study period. After 454 patients were excluded, 1820 and 1621 patients were assigned to the pre-pandemic and pandemic groups. The proportion of patients who could not receive curative or palliative surgery for stage IV diseases was not different (88 vs. 91, P>0.999), and 3262 patients underwent surgery for primary CRC. Among them, the pandemic group showed more previous abdominal surgery (21.2% vs. 15.4%, P<0.001), higher preoperative CEA level (46.7 vs. 16.0 ng/mL, P=0.021), and less stent insertion for obstructive lesion (33% vs. 46.4%, P=0.043). There was no difference in sex, age, the ASA grade, and tumor location between the groups. Perioperative outcomes including operation time, operation method, operation type, and postoperative complication rates were not different, whereas more stoma formation was performed in the pandemic group (15.3% vs. 12.4%, P=0.024). Pathologic outcomes including TNM stage, tumor diameter, harvested lymph nodes, and lymphovascular invasion were not different. However, the pandemic group showed higher tendency of lymph node metastasis (44% vs. 40.6%, P=0.070) and more adjuvant chemotherapy (26.4% vs. 20.1%, P<0.001). Conclusions: Although a few factors indicated more advanced CRC, clinical features and perioperative outcomes of the patients in COVID-19 pandemic seemed not to be aggravated in Korea. The national healthcare system which was not shut down in the pandemic, and relatively small number of COVID-19 prevalence might influence these results, although patients' access and medical checkup seemed to decrease slightly. The cause and effect of decreased medical access would be clarified by long-term follow up data.

One Earth, One Humanity Versus the Virus: Examining the Global COVID-19 Social Partnership Communication Networks on Social Media

The COVID-19 pandemic has posed severe challenges that require collaborative efforts from multi-sector organizations. Guided by an institutional theory framework that considers how both organizational fields and national level contexts affect organizations' social partnership communication, the current study examines the COVID-19-related social partnership communication network on social media. The cross-national study using semantic network analysis and exponential random graph models (ERGMs) first maps the meaning of COVID-19 social partnership network, and then investigates the role of organizational fields and a country's political system, economic system, educational system, and cultural system on the formation of interorganizational communication ties surrounding the relief efforts of COVID-19. Results reveal the importance of the political system-such as the presence of populist government, economic disparity, and uncertainty avoidance cultural orientation in shaping the social media-based social partnership communication network. In addition, NGOs from multiple issue areas are actively engaged in the network, whereas corporations from manufacturing and financial industries are active players.

Family Engagement Using Technology in Adult Intensive Care Units: An Integrative Review

Rationale: Patient- and family-centered care is recognized as a key component of safe and effective care in the Intensive Care Unit (ICU). The COVID-19 pandemic has accelerated the adoption of technologies in health care settings. It is timely to review the current state of science in technology use for family engagement in the ICU. Methods: Following Whittemore and Knafl's methodology, PubMed, CINAHL, Web of Science, and SCOPUS were searched to describe studies that used technology-based strategies to promote family engagement in adult ICUs. We included studies that (1) were conducted in the adult ICU setting, (2) involved family engagement during ICU stay, and (3) involved technology use as a way to engage family members. We excluded studies that were not peer-reviewed journal publications or non-English papers. Study findings were further synthesized based on conceptual elements of patient and family engagement: Collaboration, Respect and Dignity, Activation and Participation, Information Sharing, and Decision Making (Brown et al., 2015, AJRCCM, 191, 358-360). Results: Out of 2702 possible citations, fifteen studies (four observational, five qualitative/mixed methods, and six experimental) were included. The majority of studies (n=14) were conducted between 2015 and 2021. Most studies were at the early stage of development and implementation to investigate participants' perceptions or user experiences with various technologies: web-, tablet-, SMS-, television-based technologies or video-conferencing and robotic telepresence. Those technologies were used to 1) provide information about ICU environment and patient care, 2) augment the decision-making process for caregivers, 3) virtual access to the family decisionmaking conference, or 4) increase family knowledge of interdisciplinary rounds. There was a wide variation in the inclusion of family engagement components among the technologies. At the simplest level, technology was used only for information sharing without tailoring or two-way communication (e.g., tablet-based family education package). In studies addressing most components of family engagement comprehensively, interactive devices enabled tailored information with two-way communication and active family involvement in decision making (e.g., interactive web-based decision aid). Figure 1 displays the conceptual elements of patient and family engagement included by types of technology. Conclusion: The findings of this review may be helpful for future considerations in developing and implementing technology-based strategies to improve family engagement in the ICU. Future research should use more robust methods and develop interventions with close family input. We recommend future studies address conceptual components of family engagement when designing technology-based interventions.

Trends in body mass index changes among Korean adolescents between 2005-2020, including the COVID-19 pandemic period: a national representative survey of one million adolescents.

OBJECTIVE: The impact of the coronavirus disease 2019 (COVID-19) pandemic on weight gain in children and adolescents remains unknown. We aimed to identify an estimated 15-year trend in mean body mass index (BMI) changes and prevalence of obesity and overweight among Korean adolescents from 2005 to 2020, including the period of the COVID-19 pandemic. PATIENTS AND METHODS: We analyzed data taken from a nationwide survey (Korea Youth Risk Behavior Survey), between 2005 and 2020. Representative samples of one million Korean adolescents aged 13-18 years (n=1,057,885) were examined. The 15-year trends in mean BMI and proportion of obesity or overweight, and the changes due to the COVID-19 pandemic were analyzed. RESULTS: The data of 1,057,885 Korean adolescents were analyzed (mean age: 14.98 years; females, 48.4%). The estimated weighted mean BMI was 20.5 kg/m2 [95% confidence interval (CI), 20.4-20.5] from 2005 to 2008 and 21.5 kg/m2 (95% CI, 21.4-21.6) in 2020 (during the COVID-19 pandemic). Although the 15-year trend of mean BMI gradually increased, the change in mean BMI before and during the pandemic significantly lessened (ßdiff, -0.027; 95% CI, -0.028 to -0.026). The 15-year (2005-2020) trend changes in the prevalence of obesity and overweight were similar (obesity prevalence from 2005-2008, 3.2%; 95% CI, 3.1-3.3 vs. obesity prevalence in 2020, 8.6%; 95% CI, 8.2-9.0; ßdiff, -0.309; 95% CI, -0.330 to -0.288). CONCLUSIONS: The 15-year trend of overall mean BMI and obesity and overweight prevalence demonstrated a significant increase; however, its slope decreased during the pandemic. These landmark results suggest the need for the development of precise strategies to prevent pediatric obesity and overweight during the COVID-19 pandemic.

Multilabel Emotion Recognition Technique considering the Characteristics of Unstructured Conversation Data

Due to the recent increase in non-face-To-face services due to COVID-19, the number of users communicating through messengers or SNS (social networking service) is increasing. As a large amount of data is generated by users, research on recognizing emotions by analyzing user information or opinions is being actively conducted. Conversation data such as SNS is freely created by users, so there is no set format. Due to these characteristics, it is difficult to analyze using AI (artificial intelligence), which leads to a decrease in the performance of the emotion recognition technique. Therefore, a processing method suitable for the characteristics of unstructured data is required. Among the unstructured data, most emotion recognition in Korean conversation recognizes a single emotion by analyzing emotion keywords or vocabulary. However, since multiple emotions exist complexly in a single sentence, research on multilabel emotion recognition is needed. Therefore, in this paper, the characteristics of unstructured conversation data are considered and processed for more accurate emotion recognition. In addition, we propose a multilabel emotion recognition technique that understands the meaning of dialogue and recognizes inherent and complex emotions. A deep learning model was compared and tested as a method to verify the usefulness of the proposed technique. As a result, performance was improved when it was processed in consideration of the characteristics of unstructured conversation data. Also, when the attention model was used, accuracy showed the best performance with 65.9%. The proposed technique can contribute to improving the accuracy and performance of conversational emotion recognition. © 2022 Myungjin Lim et al.