Background and Objectives: Cardiac resynchronization therapy (CRT) is a treatment option for patients with heart failure and left ventricular (LV) dyssynchrony. However, one-third of CRT patients are non-responders. The objective of this study is to evaluate the feasibility of an in silico electromechanical heart model to predict CRT outcomes. Methods: The three-dimensional heart geometries of 11 patients (age, 64.0 ± 10.7 years, 4 men) with CRT were constructed from cardiac computed tomography images. The finite element method was used to simulate the electrical wave propagation and mechanics in the heart. We coupled cardiac electrical excitation and mechanical contraction with vascular hemodynamics using a lumped parameter model. We predicted the LV end-diastolic and end-systolic volumes and LV ejection fraction (LVEF) after CRT implantation using the in silico CRT simulation model. A CRT responder was defined as a patient with an absolute LVEF increase ≥ 5%. We compared the in silico CRT outcomes with the real CRT outcomes. Results: Two patients were in silico CRT responders, and those 2 patients were also real CRT responders. Nine patients were in silico CRT non-responders, 8 who were real CRT non-responders, and 1 who was a real CRT responder. The in silico CRT outcomes agreed with the real CRT outcomes in 10 of 11 patients. The positive and negative predictive values, accuracy, sensitivity, and specificity of the in silico CRT model were 100%, 88.9%, 90.9%, 66.7%, and 100%, respectively. Conclusion The in silico CRT simulation model is feasible for predicting real CRT outcomes.

Purpose: The psychiatric survivors movement, which represents people with mental disorders (PWMD), recognizes the autonomy of PWMD activists and emphasizes peer support and advocacy. However, in South Korea, where this movement is still in its early stages, the activities associated with it are not clearly defined. This paper aims to explore the role identities of PWMD activists and examine their significance. Methods: We conducted one or two in-depth interviews with 12 PWMD activists to gather data. The interviews were designed to uncover the participants’ perspectives on their roles as PWMD activists and their understanding of these roles. Thematic analysis was used to identify common themes. Results: The overall theme that emerged from the role identities of PWMD activists was “one who publicly advocates for the rights of the group while leading colleagues towards personal growth and societal change.” Within this overarching theme, three sub-themes were identified: intrapersonal, interpersonal, and socio-political aspects. In total, we identified 10 sub-themes. Conclusion Our findings can inform the development of various activities that support the recovery of PWMD, enabling them to assist their peers and advocate for their future interests, while also ensuring that their roles are reflected in policies.

Purpose: This study was conducted to identify factors influencing grit among nursing students. Methods: A cross-sectional survey was conducted in September 2023 involving 135 nursing students from a college in J City, South Korea. The survey included measures of positive psychological capital, mindset, and grit. At the same time, stress, as part of the general characteristics, was evaluated through the power values of high beta waves in brain waves. Statistical analyses included t-tests, analysis of variance, Pearson’s correlation coefficient, and multiple regression analysis. Results: Positive correlations were found between positive psychological capital, mindset, and grit in nursing students. Volunteer experience and positive psychological capital were identified as significant factors influencing grit. Conclusion To enhance grit among nursing students, it is essential to encourage participation in volunteer activities at the societal, educational, and familial levels, in conjunction with interventions to strengthen positive psychological capital.

Background and Objectives: Atrial fibrillation (AF) is associated with decreased cardiac resynchronization therapy (CRT) benefits compared to sinus rhythm (SR). Effective biventricular (BiV) pacing is a determinant of CRT success, but AF can interfere with adequate BiV pacing and affect clinical outcomes. We investigated the effect of device-detected AF on clinical outcomes and optimal BiV pacing in patients with heart failure (HF) treated with CRT. Methods: We retrospectively analyzed 174 patients who underwent CRT implantation between 2012 and 2019 at a tertiary center. The optimal BiV pacing percentage was defined as ≥98%. Device-detected AF was defined as an atrial high-rate episode ≥180 beats per minute lasting more than 6 minutes during the follow-up period. We stratified the patients without preexisting AF at pre-implantation into device-detected AF and no-AF groups. Results: A total of 120 patients did not show preexisting AF at pre-implantation, and 54 had AF. Among these 120 patients, 19 (15.8%) showed device-detected AF during a median follow-up of 25.1 months. The proportion of optimal BiV pacing was significantly lower in the device-detected AF group than in the no-AF group (42.1% vs. 75.2%, p=0.009). The devicedetected AF group had a higher incidence of HF hospitalization, cardiovascular death, and all-cause death than the no-AF group. The device-detected AF and previous AF groups showed no significant differences regarding the percentage of BiV pacing and clinical outcomes. Conclusions For HF patients implanted with CRT, device-detected AF was associated with lower optimal BiV pacing and worse clinical outcomes than no-AF.

Purpose: This study aimed to explore the experience of clinical nurses regarding training programs for critically ill patients with coronavirus disease 2019 (COVID-19) and their educational needs. Methods: Qualitative data were analyzed using content analysis, and quantitative data were analyzed according to Borich's formula. Data for the study were collected in March 2021 from 16 nurses who had completed a nursing program for critically ill patients with COVID-19 and were working at three hospitals designated for COVID-19. Results: Participants' experiences were classified into three major categories, namely “Participation experiences and perceptions of the training program,” “Recommendations for improving the training program,” and “Perceptions of working in an infectious environment,” and 10 subcategories. According to Borich's formula, the most pressing educational needs in respiratory and non-respiratory nursing, respectively, were for “nursing care for patients on extracorporeal membrane oxygenation” and “application of continuous renal replacement therapy and caring for patients.” Conclusion To prepare for the periodic emergence of communicable infectious diseases throughout the world and cultivate nursing staff to care for critically ill patients, it is necessary to develop nursing education programs with content corresponding to nurses' needs. This study can be used as base data for cultivating nursing staff for critically ill patients with communicable infectious diseases in keeping with clinical nurses’ educational needs and basic educational materials for nursing students.

Purpose: The purpose of this study was to explore family members’ caring experiences of schizophrenia patients during COVID-19 pandemic. Methods: Seventeen family caregivers participated in this study. Focus group and individual interviews were conducted from February to March 2022. Content analysis was applied for the data analysis. Results: Three categories were derived. First, healthcare aspects with three subcategories: increased difficulties in hospitalization process, complete separation of mental health inpatient, and difficulties in implementing quarantine guidelines. Second, rehabilitation aspects with three subcategories: broken daily lives, pity for lost recovery chance, a ruled out life, and nothing different from the pre-pandemic period. Finally, familial aspects with three subcategories: necessity of reorganizing medical system, necessity of national-led care system, and necessity of face-to-face programs. Conclusion Family members’ of schizophrenia patients had various challenges during the COVID-19 pandemic. This study provides evidence for mental health professionals to expand their perspectives of families of schizophrenia during possible infectious disease disasters in the future.

Background: Cardiac resynchronization therapy (CRT) is an effective treatment option for patients with heart failure (HF) and left ventricular (LV) dyssynchrony. However, the problem of some patients not responding to CRT remains unresolved. This study aimed to propose a novel in silico method for CRT simulation. Methods: Three-dimensional heart geometry was constructed from computed tomography images. The finite ele‑ ment method was used to elucidate the electric wave propagation in the heart. The electric excitation and mechani‑ cal contraction were coupled with vascular hemodynamics by the lumped parameter model. The model parameters for three-dimensional (3D) heart and vascular mechanics were estimated by matching computed variables with measured physiological parameters. CRT effects were simulated in a patient with HF and left bundle branch block (LBBB). LV end-diastolic (LVEDV) and end-systolic volumes (LVESV), LV ejection fraction (LVEF), and CRT responsiveness measured from the in silico simulation model were compared with those from clinical observation. A CRT responder was defined as absolute increase in LVEF ≥ 5% or relative increase in LVEF ≥ 15%. Results: A 68-year-old female with nonischemic HF and LBBB was retrospectively included. The in silico CRT simu‑ lation modeling revealed that changes in LVEDV, LVESV, and LVEF by CRT were from 174 to 173 mL, 116 to 104 mL, and 33 to 40%, respectively. Absolute and relative ΔLVEF were 7% and 18%, respectively, signifying a CRT responder.In clinical observation, echocardiography showed that changes in LVEDV, LVESV, and LVEF by CRT were from 162 to 119 mL, 114 to 69 mL, and 29 to 42%, respectively. Absolute and relative ΔLVESV were 13% and 31%, respectively, also signifying a CRT responder. CRT responsiveness from the in silico CRT simulation model was concordant with that in the clinical observation. Conclusion This in silico CRT simulation method is a feasible technique to screen for CRT non-responders in patients with HF and LBBB.

Purpose: This integrative review aims to identify changes in people with schizophrenia during the COVID-19 pandemic. Methods: An integrative literature review method of Whittemore and Knafl was applied to integrate the studies. The literature search was conducted in six electronic databases using English and Korean search terms. Three researchers independently reviewed the extracted papers and rated their quality based on predetermined inclusion and exclusion criteria. A total of fifteen relevant studies were included. Results: The selected articles were all international papers, and most of them were quantitative studies. The changes observed in people with schizophrenia were summarized as follows: (1) changes in health outcomes: psychosocial (increased levels of depression, stress, anxiety, sleep disturbance, and psychotic-like experience) and physical (reduction in food intake, weight loss, changes in immunerelated clinical values, etc.); (2) changes in treatment and health management: increased hospitalization, decreased ICU hospitalization, and a decrease in outpatient visits and prescription rate. Conclusion This study confirmed the impacts of the COVID-19 pandemic on people with schizophrenia. It is necessary to develop mental health policies and appropriate nursing interventions to help people in preparing for possible future crises.

Background/Aims: The current study aimed to elucidate a time-course change in left atrial volume after cardiac resynchronization therapy (CRT) and to verify factors associated with left atrial volume reduction (LAVR) and its prognostic implications. Methods: The records of 97 patients were retrospectively reviewed after CRT.Echocardiographic data were analyzed at baseline before CRT, at early follow-up FU) (≤ 1 year, median 6 months), and at late FU (median 30 months). Left ventricular volume response (LVVR) was defined as 15% reduction in left ventricular (LV) end-systolic volume (ESV). LAVR was classified into two groups by the median value at early FU: LAVR (≥ 7.5%) and no LAVR (< 7.5%). Results: LV ESV index continuously decreased from baseline to early FU and from early FU to late FU (106.1 ± 47.4 mL/m2 vs. 87.6 ± 51.6 mL/m2 vs. 72.5 ± 57.1 mL/m2).LA volume index decreased from baseline to early FU, but there were no reductions thereafter (51.8 ± 21.9 mL/m2 vs. 45.1 ± 19.6 mL/m2 vs. 44.9 ± 23.0 mL/m2).The only echocardiographic factor associated with LAVR was change in E velocity(odds ratio [OR], 1.04;p = 0.002). Early LAVR (OR, 10.05;p = 0.002) was an independent predictor for late LVVR. Conclusions LAVR was related to reduction in E velocity, suggesting its relation with optimization of LV filling pressure. Early LAVR was a predictor for LVVR to CRT in long-term FU.