Background: Severe acute respiratory syndrome coronavirus 2, an RNA virus, exhibits variations in transmission power, severity rate, and vaccine effectiveness due to its mutable nature. We investigated the field epidemiological characteristics of the delta and omicron variants of coronavirus disease 2019 (COVID-19) clusters in a long-term care hospital. Materials and Methods: This study aimed to investigate the incidence, fatality, and vaccination effectiveness of confirmed COVID-19 cases caused by delta and omicron variants. The investigation focused on patients admitted to two long-term care hospitals in a Seoul autonomous district, comparing and analyzing relevant factors. Results: Among the COVID-19 cases, 101 (34.3%) exhibited delta variants, while 193 (65.4%) showcased omicron variants. The incidence rate of omicron variants, compared to delta variants, was 2.24 times higher (95% confidence interval [CI], 1.68–3.00). This elevation was particularly notable in women across all age groups, patients, workers, and individuals with a history of three or more vaccinations. Deaths were reported in 13 cases (52.0%) with the delta variant and 12 cases (48.0%) with the omicron variant. The fatality rate of the omicron variant, in comparison to the delta variant, was 0.09 times (95% CI, 0.44–2.26), indicating no significant difference. No discernible variations in variables were observed. Conclusion The noteworthy surge in outbreaks among female patients, workers engaged in outdoor activities, and the apparent ineffectiveness of vaccination against omicron mutations underscore the need for careful consideration in formulating quarantine measures.

Background: Severe acute respiratory syndrome coronavirus 2, an RNA virus, exhibits variations in transmission power, severity rate, and vaccine effectiveness due to its mutable nature. We investigated the field epidemiological characteristics of the delta and omicron variants of coronavirus disease 2019 (COVID-19) clusters in a long-term care hospital. Materials and Methods: This study aimed to investigate the incidence, fatality, and vaccination effectiveness of confirmed COVID-19 cases caused by delta and omicron variants. The investigation focused on patients admitted to two long-term care hospitals in a Seoul autonomous district, comparing and analyzing relevant factors. Results: Among the COVID-19 cases, 101 (34.3%) exhibited delta variants, while 193 (65.4%) showcased omicron variants. The incidence rate of omicron variants, compared to delta variants, was 2.24 times higher (95% confidence interval [CI], 1.68–3.00). This elevation was particularly notable in women across all age groups, patients, workers, and individuals with a history of three or more vaccinations. Deaths were reported in 13 cases (52.0%) with the delta variant and 12 cases (48.0%) with the omicron variant. The fatality rate of the omicron variant, in comparison to the delta variant, was 0.09 times (95% CI, 0.44–2.26), indicating no significant difference. No discernible variations in variables were observed. Conclusion The noteworthy surge in outbreaks among female patients, workers engaged in outdoor activities, and the apparent ineffectiveness of vaccination against omicron mutations underscore the need for careful consideration in formulating quarantine measures.

Background: Severe acute respiratory syndrome coronavirus 2, an RNA virus, exhibits variations in transmission power, severity rate, and vaccine effectiveness due to its mutable nature. We investigated the field epidemiological characteristics of the delta and omicron variants of coronavirus disease 2019 (COVID-19) clusters in a long-term care hospital. Materials and Methods: This study aimed to investigate the incidence, fatality, and vaccination effectiveness of confirmed COVID-19 cases caused by delta and omicron variants. The investigation focused on patients admitted to two long-term care hospitals in a Seoul autonomous district, comparing and analyzing relevant factors. Results: Among the COVID-19 cases, 101 (34.3%) exhibited delta variants, while 193 (65.4%) showcased omicron variants. The incidence rate of omicron variants, compared to delta variants, was 2.24 times higher (95% confidence interval [CI], 1.68–3.00). This elevation was particularly notable in women across all age groups, patients, workers, and individuals with a history of three or more vaccinations. Deaths were reported in 13 cases (52.0%) with the delta variant and 12 cases (48.0%) with the omicron variant. The fatality rate of the omicron variant, in comparison to the delta variant, was 0.09 times (95% CI, 0.44–2.26), indicating no significant difference. No discernible variations in variables were observed. Conclusion The noteworthy surge in outbreaks among female patients, workers engaged in outdoor activities, and the apparent ineffectiveness of vaccination against omicron mutations underscore the need for careful consideration in formulating quarantine measures.

Purpose: This study investigated the reliability of partial-mouth periodontal examinations (PMPEs) for 1) identifying the presence of periodontitis, 2) staging periodontal disease, and 3) reflecting mean clinical parameters. Methods: All patients were diagnosed using 8 different exam types: (A) full-mouth periodontal examination (FMPE), (B) Community Periodontal Index of Treatment Needs (CPITN) codes, (C) panoramic radiographs only, (D) clinical parameters only, (E) 6 teeth, including the first molar (#11, #16, #26, #31, #36, #46), (F) CPITN index teeth (#11, #16, #17, #26, #27, #31, #36, #37, #46, #47), (G) Ramfjord teeth (#16, #21, #24, #36, #41, #44), and (H) 10 modified Ramfjord teeth, including all first premolars and first molars (#16, #14, #21, #24, #26, #36, #34, #41, #44, #46). Case definitions were established according to the criteria outlined in the 2018 American Academy of Periodontology/European Federation of Periodontology classification of periodontal diseases. The accuracy of diagnosis and diagnostic performance were assessed using the kappa coefficient and area under the curve (AUC)/receiver operating characteristic analyses, respectively. To compare the mean clinical parameters, intraclass correlation coefficients (ICCs) were calculated between 4 types of PMPEs (E, F, G, H) and FMPE. Results: In total, 218 subjects (130 female, 88 male) were included in this study. Exam type F achieved perfect agreement (kappa coefficient: 1.0) in identifying the presence of periodontitis, and it showed almost perfect agreement in staging periodontal disease (0.85≤ kappa ≤0.98) except for the healthy category, with AUCs ≥0.97. Exam type H demonstrated the highest correlations of all mean clinical parameters with FMPE (ICCs ≥0.96). Conclusions PMPEs using the CPITN index teeth can be an excellent alternative for diagnosing periodontitis and staging its severity.

Purpose: Stem cell-based therapies are considered an alternative approach for critical limb ischemia (CLI) patients with limited or exhausted options, yet their clinical use is limited by the lack of sustainability and unclear mechanism of action.In this study, a substance P-conjugated scaffold was injected with mesenchymal stem cells (MSCs) into an animal model of CLI to verify whether angiogenesis could be enhanced. Methods: A self-assembling peptide (SAP) was conjugated with substance P, known to have the ability to recruit host stem cells into the site of action. This SAP was injected with MSCs into ischemic hindlimbs of rats, and the presence of MSCs was verified by immunohistochemical (IHC) staining of MSC-specific markers at days 7, 14, and 28. The degree of angiogenesis, cell apoptosis, and fibrosis was also quantified. Results: Substance P-conjugated SAP was able to recruit intrinsic MSCs into the ischemic site of action. When injected in combination with MSCs, the presence of both injected and recruited MSCs was found in the ischemic tissues by double IHC staining. This in turn led to a higher degree of angiogenesis, less cell apoptosis, and less tissue fibrosis compared to the other groups at all time points. Conclusion The combination of substance P-conjugated SAP and MSCs was able to enhance angiogenesis and tissue repair, which was achieved by the additive effect from exogenously administered and intrinsically recruited MSCs. This scaffold-based intrinsic recruitment approach could be a viable option to enhance the therapeutic effects in patients with CLI.

Objective: This study was performed to evaluate the efficacy and safety of lurasidone (160 mg/day) compared to quetiapine XR (QXR; 600 mg/day) in the treatment of acutely psychotic patients with schizophrenia. Methods: Patients were randomly assigned to 6 weeks of double-blind treatment with lurasidone 160 mg/day (n=105) or QXR 600 mg/day (n=105). Primary efficacy measure was the change from baseline to week 6 in Positive and Negative Syndrome Scale (PANSS) total score and Clinical Global Impressions severity (CGI-S) score. Adverse events, body measurements, and laboratory parameters were assessed. Results: Lurasidone demonstrated non-inferiority to QXR on the PANSS total score. Adjusted mean±standard error change at week 6 on the PANSS total score was -26.42±2.02 and -27.33±2.01 in the lurasidone and QXR group, respectively. The mean difference score was -0.91 (95% confidence interval -6.35–4.53). The lurasidone group showed a greater reduction in PANSS total and negative subscale on week 1 and a greater reduction in end-point CGI-S score compared to the QXR group. Body weight, body mass index, and waist circumference in the lurasidone group were reduced, with significantly lower mean change compared to QXR. Endpoint changes in glucose, cholesterol, triglycerides, and low-density lipoprotein levels were also significantly lower. The most common adverse drug reactions with lurasidone were akathisia and nausea. Conclusion Lurasidone 160 mg/day was found to be non-inferior to QXR 600 mg/day in the treatment of schizophrenia with comparable efficacy and tolerability. Adverse effects of lurasidone were generally tolerable, and beneficial effects on metabolic parameters can be expected.

As a leading cause of chronic kidney disease, clinical demand for noninvasive biomarkers of diabetic kidney disease (DKD) beyond proteinuria is increasing. Metabolomics is a popular method to identify mechanisms and biomarkers. We investigated urinary targeted metabolomics in DKD patients. Methods: We conducted a targeted metabolomics study of 26 urinary metabolites in consecutive patients with DKD stage 1 to 5 (n = 208) and healthy controls (n = 26). The relationships between estimated glomerular filtration rate (eGFR) or urine protein-creatinine ratio (UPCR) and metabolites were evaluated. Multivariate Cox analysis was used to estimate relationships between urinary metabolites and the target outcome, end-stage renal disease (ESRD). C statistics and time-dependent receiver operating characteristics (ROC) were used to assess diagnostic validity. Results: During a median 4.5 years of follow-up, 103 patients (44.0%) progressed to ESRD and 65 (27.8%) died. The median fold changes of nine metabolites belonged to monosaccharide and tricarboxylic acid (TCA) cycle metabolites tended to increase with DKD stage. Myo-inositol, choline, and citrates were correlated with eGFR and choline, while mannose and myo-inositol were correlated with UPCR. Elevated urinary monosaccharide and TCA cycle metabolites showed associations with increased morality and ESRD progression. The predictive power of ESRD progression was high, in the order of choline, myo-inositol, and citrate. Although urinary metabolites alone were less predictive than serum creatinine or UPCR, myo-inositol had additive effect with serum creatinine and UPCR. In time-dependent ROC, myo-inositol was more predictive than UPCR of 1-year ESRD progression prediction. Conclusion: Myo-inositol can be used as an additive biomarker of ESRD progression in DKD.

Objective: The air pollution on pregnancy outcome (APPO) study is a prospective hospital-based cohort study designed to investigate the maternal and fetal effects of a particulate matter with an aerodynamic below 10 μm (PM10) and PM2.5 (below 2.5 μm) exposure. This study aims to analyze a relationship between particulate matter and adverse pregnancy outcomes and to find related biomarkers and develop management guidelines. Methods: About 1,200 pregnant women are recruited for 3 years (from January 2021 to December 2023) from seven university hospitals to investigate the effects of particulate matter on pregnancy complications and adverse pregnancy outcomes. We collect biological samples by 5 mL of maternal venous blood and 15 mL of urine in each trimester of pregnancy, and 5 mL of umbilical cord blood and 2×2×2 cm of placental tissue are collected after delivery. In addition, by applying PM10 and PM2.5 concentration values and time-activity patterns from the time weighted average model, the individual predicted exposure of air pollution for the pregnant women are obtained. Results: The average exposure of PM10 and PM2.5 of the participants in the entire period of pregnancy, was exceeded the World Health Organization air quality guidelines (an annual level, PM10 >15 μg/m3, PM2.5 >5 μg/m3). Moreover, it was revealed that the PM concentration was increasing toward the 3rd trimester of pregnancy. Conclusion The APPO study will be able to identify the degree of exposure to air pollution in pregnant women and use it as basic data for estimating individual exposure to particulate matter. And the results of the APPO study will facilitate in the development of health management for pregnant women against air pollution.

Purpose: This study aimed to develop a discharge nursing service model (DNSM), including one that accounts for the role of discharge nurses and the discharge nursing process for heart failure patients (HFP) with a high readmission rate, and to verify its clinical feasibility. Methods: As a methodological study, DNSM was established through a literature review and benchmarking, and the clinical feasibility of the expert group was confirmed through the Delphi technique. Results: Through a literature review and the benchmarking, the DNSM for HFP was formulated. The nine core competencies are professional nursing practice, education, counseling, advice, ethical decision-making, research, collaboration, evidence-based practice, and leadership. In addition, fifteen criteria and 42 indicators were added as detailed items. The discharge process comprised five stages and 25 processes identified by analyzing and integrating the content of discharge nursing intervention required for HFP by period-from hospitalization to 30 days after discharge.Content validity was verified by the twofold application of the Delphi technique, and the average CVI was over 0.92. Conclusion In terms of quality management, developing an efficient system or service is necessary to prevent readmission, and developed DNSM should be continuously revisioned and reinforced through follow-up studies.

This study evaluated the nutrient adequacy ratio (NAR) and depression based on the sleep duration of adult women using data from the Korea National Health and Nutrition Examination Survey (KNHANES) 2016 and 2018. A total of 4,507 subjects were divided into two groups: sleep hours＜7 (lack of sleep, LS) and 7≤ sleep hours (normal sleep, NS). For a more detailed analysis, the subjects were further divided into normal sleep with no depression (NSND) and lack of sleep with depression (LSWD) groups. When compared with NS group, the nutrient intake of the LS group was observed to be higher in carbohydrates (P＜0.05) and thiamine (P＜0.01), but had a significantly lower mean nutrient adequacy ratio (P＜0.05). Also, the LS group showed a higher frequency of early menopause (P＜0.001) and depression (P＜0.05) than the NS group. In the analysis of anthropometry and blood parameters of the subjects based on their sleep duration, the LS group showed a lower body mass index (BMI, P＜0.05), lower blood creatinine (P＜0.01), glycated hemoglobin (P＜0.05), and high-density lipoprotein (HDL) cholesterol (P＜0.01) levels adjusted by age and menopause than the NS group. When compared to the NSND group, the LSWD group had a lower intake of cholesterol (P＜0.05), vitamin A (P＜0.05), vitamin C (P＜0.05), and folic acid (P＜0.05). There was no variation in the menopausal status, NAR, and mean nutrient adequacy ratio between the NSND and LSWD groups. However, there were differences in total blood cholesterol (P＜0.05) and depression based on sleep duration. Apart from nutritional status, differences in BMI and blood parameters were observed based on sleep duration.