Exploring the Relationships Among (COVID)-19 Stress, Leisure Constraints, and Happiness for Adults During the (COVID)-19 Pandemic in Korea.

Objectives: The emergence of COVID-19 and its consequences has led to fears, worries, discomfort, depression, and anxiety for human beings worldwide. In this study, we examined the relationships among COVID-19 stress, leisure constraints, and happiness of Korean adults. Methods: We employed on-line convenience sampling to recruit participants. The sample consisted of Korean adults. A total of 600 surveys were distributed, we retained 293 responses for analysis. Results: COVID-19 stress subcomponents significantly impacted on individual happiness. Our findings align with research focusing on positive correlates between perceived COVID-19 stress and leisure constraints subcomponents. We also found that as COVID-19 stress decreased, perceived happiness increased. Conclusions: Future research is proposed to explore the mechanism of how leisure constraints influence the engagement of physical activities and strategies of leisure constraints negotiation to gain the benefits of happiness in the pandemic crisis. Managerial implications and future research are discussed from the perspectives of constraint negotiation and happiness.

The Korea National Patient Safety Incidents Inquiry Survey: Characteristics of Adverse Events Identified Through Medical Records Review in Regional Public Hospitals.

OBJECTIVES: In 2019, the Korean National Patient Safety Incidents Inquiry was conducted in the Republic of Korea to identify the national-level incidence of adverse events. This study determined the incidence and detailed the characteristics of adverse events at 15 regional public hospitals in the Republic of Korea. METHODS: Medical records data of 500 randomly selected patients (discharged in 2016) were extracted from each of the 15 studied hospitals and reviewed in 3 stages. First, for each hospital, 2 nurses independently reviewed the medical records, using 41 screening criteria. Second, 2 physicians independently reviewed the records of those patients with at least 1 screening criterion from the first stage for adverse events occurrence and their characteristics. Third, a 9-member committee conducted a final review and compiled the final adverse event report. RESULTS: Among 7500 patients, 4159 (55.5%) had at least 1 screening criterion; 745 (9.9%) experienced 901 adverse events (incidence, 12.0%). By type of institution, adverse event incidence varied widely from 1.2% to 45.6%. In 1032 adverse events, the majority (33.5%) were "patient care-related." By severity, the majority (638; 70.8%) were temporary, requiring intervention, whereas 38 (4.2%) resulted in death. The preventability score was high for "patient care-related" and "diagnosis-related" adverse events. Duration of hospitalization was extended for 463 (44.9%) adverse events, with "diagnosis-related" (30.8%) and "surgery/procedural-related" (30.1%) types extended by at least 21 days. CONCLUSIONS: A review of medical records aids in identifying adverse events in medical institutions with varying characteristics, thus helping prioritize interventions to reduce their incidence.

The Korea National Patient Safety Incidents Inquiry Survey: Feasibility of Medical Record Review for Detecting Adverse Events in Regional Public Hospitals.

OBJECTIVES: We aimed to examine the Korea National Patient Safety Incidents Inquiry conducted in the Republic of Korea; specifically, we assessed the validity of screening criteria, interreviewer reliability, quality of medical records, and the time required for reviewing medical records. METHODS: A 3-stage retrospective medical record review was performed. The sensitivity and positive predictive value of the screening criteria for the adverse events were calculated, and interreviewer reliability was verified using the overall agreement rate and κ value. In addition, the results of medical record quality assessment and time required for review were analyzed. RESULTS: There were a total of 4159 patients (55.5%) with at least 1 of the 41 screening criteria. In stage 1, the overall percent of agreement was 81.9% when all negatives from the 2 reviewers were included, and the κ value was 0.64 (95% confidence interval [CI], 0.61-0.66). In stage 2, 84.6% of cases were a perfect match, and 87.4% were a partial match. The κ values were 0.159 (95% CI, 0.12-0.20) and 0.389 (95% CI, 0.35-0.43), respectively. The mean quality assessment scores were 3.18 of 4 points in stage 1 and 3.05 of 4 points in stage 2. In stage 1, it took an average of 13.02 minutes to asses each patient file; in stage 2, it took an average of 5.06 minutes. CONCLUSIONS: To increase the feasibility of medical record review for detecting adverse events, it is important not only to improve the reliability between reviewers but also to monitor the quality of medical records and the time required for review.

[Effects of Hospital Characteristics on Employment Rate, Working Period and Retirement of Ward Nurses in Korea: A Retrospective Cohort Study Based on HIRAS Data].

PURPOSE: The purpose of this study was to investigate the effects of hospital characteristics on employment rate, working period, and retirement of ward nurses in Korea through a retrospective cohort study based on HIRAS data. METHODS: Data were obtained from a report on medical care institutions of Health Insurance Review & Assessment Service (HIRAS). Data from 259,941 nurses who were working for a day or more from January 1, 2012, to December 31, 2016, at 2,942 medical care institutions were analyzed. Life table method analysis, Kaplan-Meier analysis, and Cox proportional hazard regression analysis were conducted. RESULTS: The employment rates of 5 yeas and 10 years for the total sample were 38% and 28%, respectively. The estimated mean value of the working period was 3,642.7 days (SE: 17.4 days). Cox proportional hazard regression analyses revealed that nurses who were working at the general hospital/hospital, clinic, and nursing hospital were more likely to leave the hospital compared to those who were working at the 3rd general hospital. Nurses who were working at the medical institutions which were located in cities and countries, established by the private foundation, rated lower levels of nursing, and owned an insufficient number of beds, nurses and doctors were more likely to leave their workplace compared to those of the counterparts. CONCLUSION: This study indicates that hospital characteristics may play a significant role in retirement and working period of ward nurses in Korea. The improvement of hospital conditions to reduce ward nurses' retirement are needed.

Comparison of cytotoxicity of black phosphorus nanosheets in different types of fibroblasts.

BACKGROUND: Two-dimensional black phosphorus nanosheets (BPNSs) have recently emerged as a successive novel nanomaterial owing to their uniqueness in optical and electrical properties. Although BPNSs have found a wide range of biomedical applications, their biosafety is still a major concern to be addressed. METHODS: In this study, we have prepared layered BPNSs using liquid exfoliation procedure, and evaluated their physicochemical properties using Fourier Transform-infrared (FTIR) spectroscopy, Raman spectroscopy, atomic force microscopy, and Zetasizer analyses. We have investigated potential cytotoxicity of BPNSs against three different types of fibroblast cells, i.e. mouse embryonic fibroblast (NIH3T3), primary cultured normal human dermal fibroblast (nHDF), and fibrosarcoma (HT1080). Cell counting kit-8 (CCK-8) assay was carried out to assess cellular metabolic activity in cells whereas lactate dehydrogenase (LDH) activity assay was helpful to study plasma membrane integrity. RESULTS: Our salient research findings showed that BPNSs were polydispersed in solution due to aggregation. Toxic response of BPNSs against fibroblast cells was in the order, HT1080>nHDF>NIH3T3. The nanosheets reduced the number of cancerous cells with significant difference to normal cells. CONCLUSIONS: We suggest that BPNSs can be considered for cancer treatment as they destroy cancerous cells effectively. However, a comprehensive study is required to elucidate other biological effects of BPNSs.

The Curves Exercise Suppresses Endotoxemia in Korean Women with Obesity.

Obesity and metabolic syndrome is a worldwide pandemic and associated with high cardiovascular risk. Metabolic endotoxemia (ME) is thought to be an underlying molecular mechanism. It triggers toll-like receptor 4-mediated inflammatory adipokines and causes a chronic low grade inflammatory status, which results in cardiovascular risk increase. Exercise is the best nonpharmacological treatment to improve prognosis. In this study, we examined the circulating endotoxin level in Korean obese women and investigated effects of exercise on it. Women over body mass index (BMI) 25 kg/m² participated in a resistance training exercise, Curves. At baseline and after 12 weeks exercise, tests including blood samples were taken. In Korean obese women, the fasting endotoxin was 1.45 ± 0.11 EU/mL. Ingestion of a high calorie meal led to a peak level after 2 hours (postprandial 2 hours [PP2]) and a significant rise over the 4 hours (postprandial 4 hours [PP4]) in it (1.78 ± 0.15 and 1.75 ± 0.14 EU/mL for PP2 and PP4, P < 0.05 vs. fasting). After exercise, BMI and hip circumference were reduced significantly. The total cholesterol (TC) at fasting, PP2 and PP4 were decreased significantly. All levels of circulating endotoxin at fasting, PP2 and PP4 showed reduction. But, the peak change was only significant (baseline vs. 12 weeks for PP2; 1.78 ± 0.15 vs. 1.48 ± 0.06 EU/mL, P < 0.05). We report the circulating endotoxin level in Korean obese women for the first time. Also, we establish that energy intake leads to endotoxemia and exercise suppresses the peak endotoxemia after meal. It suggests an impact for a better prognosis in obese women who follow regular exercise.

Elevation of Serum APE1/Ref-1 in Experimental Murine Myocarditis.

Myocarditis is an inflammatory disease of the myocardium that causes cardiogenic shock and death. However, endomyocardial biopsy that is, the gold standard for a diagnosis is limited. Apurinic/apyrimidinic endonuclease 1/redox effector factor-1 (APE1/Ref-1) is a multifunctional protein, which is involved in DNA-based excision repair pathway, and in redox signaling, its changes are observed in various cardiovascular diseases including hypertension and coronary artery disease. We analyzed serum APE1/Ref-1 in experimental murine myocarditis. To induce myocarditis, coxsackievirus B3 was injected intraperitoneally to BALB/c mice. The serum APE1/Ref-1, N-terminal pro-B-type natriuretic peptide (NT-proBNP) and troponin I were measured. The histology and virus titers measurements were performed. The troponin I and inflammation were significantly elevated at day 3, peaked to day 7 and decreased at day 10. The NT-proBNP and virus titers were significantly peaked at day 3, and dropped at day 7 and 10. The serum APE1/Ref-1 was gradually raised and its elevation is still maintained until a later time, namely day 10. Also, its level was positively correlated with myocardial inflammation, reflecting severity of myocardial injury. We suggest that serum APE1/Ref-1 can be used to assess for myocardial injury in viral myocarditis without endomyocardial biopsy.

Elevation of the Serum Apurinic/Apyrimidinic Endonuclease 1/Redox Factor-1 in Coronary Artery Disease.

BACKGROUND AND OBJECTIVES: Apurinic/apyrimidinic endonuclease 1/redox effector factor-1 (APE1/Ref-1) is a multifunctional protein involved in the DNA base excision repair pathway, inflammation, angiogenesis, and survival pathways. We investigated serum APE1/Ref-1 in patients with coronary artery disease (CAD). SUBJECTS AND METHODS: Serum APE1/Ref-1 was measured with a sandwich enzyme-linked immunosorbent assay from 360 patients who received coronary angiograms. They were divided into two groups; a control (n=57) and a CAD group (n=303), the latter included angina (n=128) and myocardial infarction (MI, n=175). RESULTS: The levels of APE1/Ref-1 were higher in the CAD than the control (0.63±0.07 vs. 0.12±0.07 ng/100 µL, respectively; p<0.01). They were also higher in MI than angina (0.81±0.10 vs. 0.38±0.11 ng/100 µL, respectively; p<0.01) and different according to the thrombolysis in myocardial infarction (TIMI) flow (0.88±0.09 for TIMI flow 0, 1, 2 vs. 0.45±0.13 ng/100 µL for TIMI flow 3, p<0.01) in acute coronary syndrome. In correlation analysis, the levels of APE1/Ref-1 were positively correlated with Troponin I (r=0.222; p<0.0001) and N-terminal pro-B type natriuretic peptide (NT-proBNP, r=0.217; p<0.0001) but not high sensitivity to C-reactive protein. Also, they revealed a negative correlation with ejection fraction (EF, r=-0.221; p=0.002). However, there were no significant differences among the three groups, were divided by their levels of APE1/Ref-1, for major adverse cardiovascular events (death, recurrent MI, stroke, revascularization) (8.2 vs. 14.0 vs. 12.5%, p=ns). CONCLUSION: The levels of serum APE1/Ref-1 are elevated in CAD, and are higher in MI than in angina. They are correlated with Troponin I, NT-proBNP, and EF.

A comparison of the cancer incidence rates between the national cancer registry and insurance claims data in Korea.

Although much health services research has been conducted using national health insurance claims data in Korea, the validity of this method has not been ascertained. The objective of this study was to validate the use of claims data for health services research by comparing incidence rate of cancers found using insurance claims data against rates of the national cancer registry of Korea. An algorithm to estimate incidence rates using claims data was developed and applied. The claims data from 2005-2008 were acquired and the patients admitted to hospitals due to cancer in 2008 without admission to hospital from 2005- 2007 by the same diagnosis code were regarded as incident cases. The acquired results were compared with the values from the National Cancer Registry of Korea. The incidence rate of all cancers found using claims data was 363.1 per 100,000 people, which is very similar to the 361.9 per 100,000 rate of the national cancer registry. Also the age-, gender- and disease-specific rates between the two data sources were similar. Therefore, national health insurance claims data may be a worthwhile resource for health services research if appropriate algorithms are applied, especially considering the cost effectiveness of this method.

Increased Cutaneous Lymphocyte Antigen (CLA) +T Cells in the Peripheral Blood of Children with Severe Atopic Dermatitis / 소아알레르기및호흡기학회지

PURPOSE: Skin-homing T cells expressing cutaneous lymphocyte antigen (CLA) are known to be important in the pathogenesis of atopic dermatitis (AD). So far, there have been few reports on the peripheral lymphocyte subpopulations expressing CLA, especially in children with AD. METHODS: We investigated the peripheral blood lymphocyte subpopulations expressing CLA in children with severe AD andcontrol subjects to identify which proportions of circulating CLA+ T cells were expanded in atopic dermatitis. We assayed the peripheral blood lymphocyte subpopulation with flow cytometry in 15 children with severe chronic lichenified skin lesions and 12 control subjects who had no symptoms of atopic dermatitis. The expressions of peripheral blood CD4+CLA+ T cells and CD3+CLA+ T cells were significantly increased in children with AD compared with those in control subjects, whereas there was no significant difference of CD8+CLA+ T cells between the two groups. RESULTS: The expressions of CD3+ T cells, CD4+ T cells, and CD8+ T cells showed no significant differences between children with AD and control subjects. CONCLUSION: These findings suggest that circulating CD4+CLA+ T cells play an important role in the pathogenesis of chronic severe AD in children.