Background: The aim of this study is to investigate the specific pathway involved in human leukocyte antigen (HLA) sensitization using single-cell RNA-sequencing analysis and an allo-sensitized mouse model developed with an HLA.A2 transgenic mouse. Methods: For sensitization, wild-type C57BL/6 mouse received two skin grafts from C57BL/6-Tg(HLA-A2.1)1Enge/J mouse (allogeneic mouse, ALLO). For syngeneic control (SYN), skin grafts were transferred from C57BL/6 to C57BL/6. We performed single-cell RNA-sequencing analysis on splenocytes isolated from ALLO and SYN and compared the gene expression between them. Results: We generated 9,190 and 8,890 single-cell transcriptomes from ALLO and SYN, respectively. Five major cell types (B cells, T cells, natural killer cells, macrophages, and neutrophils) and their transcriptome data were annotated according to the representative differentially expressed genes of each cell cluster. The percentage of B cells was higher in ALLO than it was in SYN. Kyoto Encyclopedia of Genes and Genomes enrichment analyses indicated that the highly expressed genes in the B cells from ALLO were mainly associated with antigen processing and presentation pathways, allograft rejection, and the Th17 cell differentiation pathway. Upregulated genes in the T cells of ALLO were involved in the interleukin (IL)-17 signaling pathway. The ratio of Th17 cluster and Treg cluster was increased in the ALLO. On flow cytometry, the percentage of Th17 (IL-17+/CD4+ T) cells was higher and regulatory T cells (FOXP3+/CD4+ T) was lower in the ALLO compared to those in the SYN. Conclusion Our results indicate that not only the B cell lineage but also the Th17 cells and their cytokine (IL-17) are involved in the sensitization to HLA.

Objectives: Presenteeism is known to be a much more economically damaging social cost than disease rest while going to work despite physical pain. Since COVID-19, social discussions on the sickness benefit have been taking place as a countermeasure against presenteeism, and in particular, farmers and fishermen do not have an institutional mechanism for livelihood support when a disease other than work occurs. This study attempted to examine the relationship between agricultural, fishing, and forestry workers and presenteeism using the 6th Korean Work Conditions Survey. Methods: From October 2020 to January 2021, data from the 6th working conditions survey conducted on 17 cities and provinces in Korea were used, and a total of 34,981 people were studied. Control variables were gender, age, self-health assessment, education level, night work, shift work, monthly income, occupation, working hours per week, and employment status. Results: As a result of the analysis, farmers and fishermen showed the characteristics of the self-employed and the elderly, and as a result of the regression analysis, when farmers and fishermen analyzed the relationship with presenteeism tendency compared to other industry workers, farmers and fishermen increased by 23% compared to other industry groups. Conclusion This study is significant in that it has representation by utilizing the 6th working conditions survey and objectively suggests the need for a sickness benefit for farmers and fishermen who may be overlooked in the sickness benefit.

Objectives: Presenteeism is known to be a much more economically damaging social cost than disease rest while going to work despite physical pain. Since COVID-19, social discussions on the sickness benefit have been taking place as a countermeasure against presenteeism, and in particular, farmers and fishermen do not have an institutional mechanism for livelihood support when a disease other than work occurs. This study attempted to examine the relationship between agricultural, fishing, and forestry workers and presenteeism using the 6th Korean Work Conditions Survey. Methods: From October 2020 to January 2021, data from the 6th working conditions survey conducted on 17 cities and provinces in Korea were used, and a total of 34,981 people were studied. Control variables were gender, age, self-health assessment, education level, night work, shift work, monthly income, occupation, working hours per week, and employment status. Results: As a result of the analysis, farmers and fishermen showed the characteristics of the self-employed and the elderly, and as a result of the regression analysis, when farmers and fishermen analyzed the relationship with presenteeism tendency compared to other industry workers, farmers and fishermen increased by 23% compared to other industry groups. Conclusion This study is significant in that it has representation by utilizing the 6th working conditions survey and objectively suggests the need for a sickness benefit for farmers and fishermen who may be overlooked in the sickness benefit.

Purpose: This study aims to explore and deeply understand the essence of the nursing experiences of ward nurses who have cared for foreign inpatients. Methods: In this study, in-depth interviews were conducted with 10 nurses at a tertiary hospital in Seoul from May 1 to June 30, 2023. The collected data were analyzed using Colaizzi’s phenomenological method. Results: The nursing experiences of ward nurses caring for foreign inpatients yielded five theme clusters-"A welcome yet challenging encounter," "A journey to navigate language barriers," "New competencies needed to face unfamiliar cultures," "Exerting every possible effort," and "Discovering and embracing the value of coexistence"-along with 11 themes. Ward nurses found caring for foreign inpatients challenging due to cultural differences and language barriers, which often felt burdensome.Nonetheless, they accepted it as a necessary duty, handling additional tasks beyond basic care to support patient recovery. Despite communication challenges, they strived to provide the best care, demonstrating self-efficacy in respecting cultural differences, which fostered a sense of accomplishment and pride in their roles. Conclusion This study identified the complex emotions and challenges experienced by ward nurses caring for foreign inpatients and the process of overcoming these obstacles and building a sense of pride. These findings can serve as an important reference for understanding how ward nurses adapt to their roles in caring for foreign patients and provide foundational data for improving nursing environments to enhance the quality of care for foreign inpatients.

Objectives: Presenteeism is known to be a much more economically damaging social cost than disease rest while going to work despite physical pain. Since COVID-19, social discussions on the sickness benefit have been taking place as a countermeasure against presenteeism, and in particular, farmers and fishermen do not have an institutional mechanism for livelihood support when a disease other than work occurs. This study attempted to examine the relationship between agricultural, fishing, and forestry workers and presenteeism using the 6th Korean Work Conditions Survey. Methods: From October 2020 to January 2021, data from the 6th working conditions survey conducted on 17 cities and provinces in Korea were used, and a total of 34,981 people were studied. Control variables were gender, age, self-health assessment, education level, night work, shift work, monthly income, occupation, working hours per week, and employment status. Results: As a result of the analysis, farmers and fishermen showed the characteristics of the self-employed and the elderly, and as a result of the regression analysis, when farmers and fishermen analyzed the relationship with presenteeism tendency compared to other industry workers, farmers and fishermen increased by 23% compared to other industry groups. Conclusion This study is significant in that it has representation by utilizing the 6th working conditions survey and objectively suggests the need for a sickness benefit for farmers and fishermen who may be overlooked in the sickness benefit.

Purpose: This study aims to explore and deeply understand the essence of the nursing experiences of ward nurses who have cared for foreign inpatients. Methods: In this study, in-depth interviews were conducted with 10 nurses at a tertiary hospital in Seoul from May 1 to June 30, 2023. The collected data were analyzed using Colaizzi’s phenomenological method. Results: The nursing experiences of ward nurses caring for foreign inpatients yielded five theme clusters-"A welcome yet challenging encounter," "A journey to navigate language barriers," "New competencies needed to face unfamiliar cultures," "Exerting every possible effort," and "Discovering and embracing the value of coexistence"-along with 11 themes. Ward nurses found caring for foreign inpatients challenging due to cultural differences and language barriers, which often felt burdensome.Nonetheless, they accepted it as a necessary duty, handling additional tasks beyond basic care to support patient recovery. Despite communication challenges, they strived to provide the best care, demonstrating self-efficacy in respecting cultural differences, which fostered a sense of accomplishment and pride in their roles. Conclusion This study identified the complex emotions and challenges experienced by ward nurses caring for foreign inpatients and the process of overcoming these obstacles and building a sense of pride. These findings can serve as an important reference for understanding how ward nurses adapt to their roles in caring for foreign patients and provide foundational data for improving nursing environments to enhance the quality of care for foreign inpatients.

Whether advanced age is associated with poor outcomes of elderly patients with acute kidney injury (AKI) requiring continuous renal replacement therapy (CRRT) is controversial. This study aimed to evaluate age effect and predictors for mortality in elderly AKI patients undergoing CRRT. Methods: Data of 480 elderly AKI patients who underwent CRRT were retrospectively analyzed. Subjects were stratified into two groups according to age: younger-old (age, 65–74 years; n = 205) and older-old (age, ≥75 years; n = 275). Predictors for 28-day and 90-day mortality and age effects were analyzed using multivariable Cox regression analysis and propensity score matching. Results: Urine output at the start of CRRT (adjusted hazard ratio [aHR], 0.99; 95% confidence interval [CI], 0.99–1.00; p = 0.04), operation (aHR, 0.53; 95% CI, 0.30–0.93; p = 0.03), and use of an intra-aortic balloon pump (aHR, 3.60; 95% CI, 1.18–10.96; p = 0.02) were predictors for 28-day mortality. Ischemic heart disease (aHR, 1.74; 95% CI, 1.02–2.98; p = 0.04) and use of a ventilator (aHR, 0.56; 95% CI, 0.36–0.89; p = 0.01) were predictors for 90-day mortality. The older-old group did not exhibit a higher risk for 28- day or 90-day mortality than the younger-old group in multivariable or propensity score-matched models. Conclusion: Advanced age was not a risk factor for mortality among elderly AKI patients undergoing CRRT, suggesting that advanced age should not be considered for therapeutic decisions in critically ill elderly patients with AKI requiring CRRT.

Purpose: This study aims to explore and deeply understand the essence of the nursing experiences of ward nurses who have cared for foreign inpatients. Methods: In this study, in-depth interviews were conducted with 10 nurses at a tertiary hospital in Seoul from May 1 to June 30, 2023. The collected data were analyzed using Colaizzi’s phenomenological method. Results: The nursing experiences of ward nurses caring for foreign inpatients yielded five theme clusters-"A welcome yet challenging encounter," "A journey to navigate language barriers," "New competencies needed to face unfamiliar cultures," "Exerting every possible effort," and "Discovering and embracing the value of coexistence"-along with 11 themes. Ward nurses found caring for foreign inpatients challenging due to cultural differences and language barriers, which often felt burdensome.Nonetheless, they accepted it as a necessary duty, handling additional tasks beyond basic care to support patient recovery. Despite communication challenges, they strived to provide the best care, demonstrating self-efficacy in respecting cultural differences, which fostered a sense of accomplishment and pride in their roles. Conclusion This study identified the complex emotions and challenges experienced by ward nurses caring for foreign inpatients and the process of overcoming these obstacles and building a sense of pride. These findings can serve as an important reference for understanding how ward nurses adapt to their roles in caring for foreign patients and provide foundational data for improving nursing environments to enhance the quality of care for foreign inpatients.

Purpose: This study aims to explore and deeply understand the essence of the nursing experiences of ward nurses who have cared for foreign inpatients. Methods: In this study, in-depth interviews were conducted with 10 nurses at a tertiary hospital in Seoul from May 1 to June 30, 2023. The collected data were analyzed using Colaizzi’s phenomenological method. Results: The nursing experiences of ward nurses caring for foreign inpatients yielded five theme clusters-"A welcome yet challenging encounter," "A journey to navigate language barriers," "New competencies needed to face unfamiliar cultures," "Exerting every possible effort," and "Discovering and embracing the value of coexistence"-along with 11 themes. Ward nurses found caring for foreign inpatients challenging due to cultural differences and language barriers, which often felt burdensome.Nonetheless, they accepted it as a necessary duty, handling additional tasks beyond basic care to support patient recovery. Despite communication challenges, they strived to provide the best care, demonstrating self-efficacy in respecting cultural differences, which fostered a sense of accomplishment and pride in their roles. Conclusion This study identified the complex emotions and challenges experienced by ward nurses caring for foreign inpatients and the process of overcoming these obstacles and building a sense of pride. These findings can serve as an important reference for understanding how ward nurses adapt to their roles in caring for foreign patients and provide foundational data for improving nursing environments to enhance the quality of care for foreign inpatients.

Background: The clinical significance of low-level donor-specific anti-HLA antibody (low-DSA) remains controversial. We investigated the impact of low-DSA on posttransplant clinical outcomes in kidney transplant (KT) recipients. Methods: We retrospectively reviewed 1,027 KT recipients, namely, 629 living donor KT (LDKT) recipients and 398 deceased donor KT (DDKT) recipients, in Seoul St. Mary’s Hospital (Seoul, Korea) between 2010 and 2018. Low-DSA was defined as a positive anti-HLA-DSA result in the Luminex single antigen assay (LABScreen single antigen HLA class I - combi and class II - group 1 kits; One Lambda, Canoga Park, CA, USA) but a negative result in a crossmatch test. We compared the incidence of biopsy-proven allograft rejection (BPAR), changes in allograft function, allograft survival, patient survival, and posttransplant infections between subgroups according to pretransplant low-DSA. Results: The incidence of overall BPAR and T cell-mediated rejection did not differ between the subgroups. However, antibody-mediated rejection (ABMR) developed more frequently in patients with low-DSA than in those without low-DSA in the total cohort and the LDKT and DDKT subgroups. In multivariate analysis, low-DSA was identified as a risk factor for ABMR development. Its impact was more pronounced in DDKT (odds ratio [OR]: 9.60, 95% confidence interval [CI]: 1.79–51.56) than in LDKT (OR: 3.76, 95% CI: 0.99–14.26) recipients. There were no significant differences in other outcomes according to pretransplant low-DSA. Conclusions Pretransplant low-DSA has a significant impact on the development of ABMR, and more so in DDKT recipients than in LDKT recipients, but not on long-term outcomes.