ABSTRACT
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.
ABSTRACT
Background: Low total CO2 (tCO2) levels are significantly associated with allcause mortality. Lots of factors are related to the poor prognosis of COVID-19, it was a lack of data to evaluate the impact of tCO2. We evaluated the impact of metabolic acidosis on all-cause mortality in patients with COVID-19. Method(s): We retrospectively reviewed the data from two independent hospitals that care for admitted patients with COVID-19 between February 2020 and September 2021. We excluded subjects with underlying end-stage kidney disease, no data of tCO2 value, and age under 18 years old. The primary outcome was in-hospital mortality. We evaluate the impact of tCO2 as a continuous variable on mortality using the Cox-proportional hazard model. In addition, we tried to find the relative value of tCO2 to increase the risk of mortality using a generalized additive model. We also evaluated the impact of such a value of tCO2 and 22mEq/L of tCO2 on mortality. Result(s): A total of 4,423 patients were included, and the mean age was 54.7+/-18.3 years old. Mean tCO2 was 26.2+/-3.6 mEq/L, and there were 792 (17.9%) with tCO2 <22 mEq/L. Increased in 1 mEq/L of tCO2 significantly decreased risk for all-cause mortality after adjustment with age, sex, history of hypertension, diabetes, and laboratory results such as serum white blood count, hemoglobin, platelet, calcium, phosphate, albumin, and eGFR (adjusted HR 0.95, 95% CI 0.91, 0.99). We found that the level of 24 mEq/L of tCO2 as a cut-off value to increase risk of mortality. In the Cox-proportional hazard model, the risk of all-cause mortality was significantly increased by around 1.6 times in subjects with lower tCO2 irrespective of the cut-off value of 22 or 24 mEq/L. Conclusion(s): Decreased tCO2 significantly increased the risk of all-cause mortality in patients with COVID-19. Monitoring of tCO2 could be a good indicator to predict prognosis, and it needs to be considered to encourage in patients with a specific condition.
ABSTRACT
Email is an essential communication tool for modern people and offers a variety of functions. After the outbreak of COVID-19, the importance of emails enhanced further as non-face-to-face work increased. However, with the spread and dissemination of emails, cybercrime that abused emails has also increased. The number of cases of stealing or damaging email users by impersonating public institutions such as the National Police Agency, the Prosecutor’s Office, or the WHO. This study proposes an advanced algorithm of email classification using an SMTP response code to strengthen the level of email security. The proposed system is located on the side of the recipient’s email server and operates upon receipt of the email. When an email is received, it automatically verifies whether the domain of the email sender is normally registered in DNS. Thereafter, MX, SPF, and PTR records are extracted and combined to determine the state of the sending server. When additional verification is required, a proposed algorithm automatically connects the communication session to the sender to request the SMTP response code. The proposed algorithm was applied to two organizations and succeeded in classifying received emails into various categories. This study contributes to the literature on email classification by presenting new ideas in the process of sender verification. © 2022, The Author(s), under exclusive license to Springer Nature Switzerland AG.
ABSTRACT
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.