Defining the molecular dynamics associated with T cell differentiation enhances our understanding of T cell biology and opens up new possibilities for clinical implications. In this study, we investigated the dynamics of CD5 expression in CD8+ T cell differentiation and explored its potential clinical uses. Using PBMCs from 29 healthy donors, we observed a stepwise decrease in CD5 expression as CD8+ T cells progressed through the differentiation stages. Interestingly, we found that CD5 expression was initially upregulated in response to T cell receptor stimulation, but diminished as the cells underwent proliferation, potentially explaining the differentiation-associated CD5 downregulation. Based on the proliferationdependent downregulation of CD5, we hypothesized that relative CD5 expression could serve as a marker to distinguish the heterogeneous CD8+ T cell population based on their proliferation history. In support of this, we demonstrated that effector memory CD8+ T cells with higher CD5 expression exhibited phenotypic and functional characteristics resembling less differentiated cells compared to those with lower CD5 expression. Furthermore, in the retrospective analysis of PBMCs from 30 non-small cell lung cancer patients, we found that patients with higher CD5 expression in effector memory T cells displayed CD8+ T cells with a phenotype closer to the less differentiated cells, leading to favorable clinical outcomes in response to immune checkpoint inhibitor (ICI) therapy. These findings highlight the dynamics of CD5 expression as an indicator of CD8+ T cell differentiation status, and have implications for the development of predictive biomarker for ICI therapy.

Purpose: This study aims to describe and identify in-depth the breastfeeding experience of primiparas for more than one year using a phenomenological research method and to raise the understanding of the primiparas’ subjective experiences during the breastfeeding process to contribute to the improving and maintaining maternal and child health. Methods: This research was a phenomenological and qualitative study conducted on 5 primiparas who continued breastfeeding for more than 12 months. Data was collected through individual in-depth interviews from November 1, 2021 to March 20, 2022, and it was analyzed through the sixth stage of phenomenological research analysis presented by Colaizzi. Results: The study consisted of 10 theme clusters and 26 themes from meaningful statements about the breastfeeding success experiences of primiparas for more than one year. The 10 theme collections were "Planning breastfeeding during pregnancy," "Commitment to breastfeeding through information and education," "Challenges faced during breastfeeding," "Continuous hard work," "Continued conflict over breastfeeding amid confusion," "Connects with experts who lead the way," "Establishes one's own standards and direction," "Peace after hard work," "Solid and firm confidence," and "Deep-rooted beliefs brestfeeding serve as reminders." Conclusion It is expected that this study will help to understand the individual difficulties and problems experienced by primiparas during breastfeeding, the importance of breastfeeding education, the role of medical personnel in the early stage of childbirth, social and environmental support, and the importance of an active window for information exchange. By identifying these factors, this study can serve as basic data for nursing practice to promote successful breastfeeding.

Purpose: This study aimed to examine the pediatric sedation knowledge and performance of nurses in tertiary hospitals. Methods: Altogether 120 nurses working in the Pediatric Departments of 4 tertiary hospitals in Busan and Kyungnam participated in this descriptive survey. The questionnaire was developed based on domestic and international guidelines and consisted of 40 questions including 18 questions on knowledge and 22 on the performance level of sedation nursing. Results: The mean score regarding the knowledge of pediatric sedation care was 3.14 points and the mean performance level score was 3.44 points. Questions that received low scores in terms of pediatric sedation care knowledge included items regarding the latest policies, level of sedation, and fasting before sedation. Questions that received low scores in the performance level included items regarding psychological preparation before sedation, sedation education considering developmental level and disease, and items related to blood pressure measurement. Pediatric sedation knowledge scores were higher in the groups with higher age, longer clinical experience, higher educational experience, and awareness of sedation guidelines. Performance scores were significantly higher in the groups having educational experience in pediatric sedation and in those exhibiting awareness of sedation guidelines. Conclusion Sedation education was significantly associated with both knowledge and performance of sedation nursing, conducting educational programs on pediatric sedation nursing.

Purpose: This study aimed to compare the attitudes of nurses and physicians toward neonatal palliative care and identify the barriers to and facilitators of neonatal palliative care, with the goal of improving palliative care for infants in neonatal intensive care units (NICUs). Methods: This cross-sectional study analyzed data from the NICUs of seven general hospitals with 112 nurses and 52 physicians participating. Data were collected using the Neonatal Palliative Care Attitude Scale questionnaire. Results: Only 12.5% of nurses and 11.5% of physicians reported that they had sufficient education in neonatal palliative care. In contrast, 89.3% of the nurses and 84.6% of the physicians reported that they needed further education. The common facilitators for both nurses and physicians were: 1) agreement by all members of the department regarding the provision of palliative care and 2) informing parents about palliative care options. The common barriers for both nurses and physicians were: 1) policies or guidelines supporting palliative care were not available, 2) counseling was not available, 3) technological imperatives, and 4) parental demands for continuing life support. Insufficient resources, staff, and time were also identified as barriers for nurses, whereas these were not identified as barriers for physicians. Conclusion It is necessary to develop hospital or national guidelines and educational programs on neonatal palliative care, and it is equally necessary to spread social awareness of the importance of neonatal palliative care.

Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) transmission among non-close contacts is not infrequent. We evaluated the proportion and circumstances of individuals to whom SARS-CoV-2 was transmitted without close contact with the index patient in a nosocomial outbreak in a tertiary care hospital in Korea. From March 2020 to March 2021, there were 36 secondary cases from 14 SARS-CoV-2 infected individuals. Of the 36 secondary cases, 26 (72%) had been classified as close contact and the remaining 10 (28%) were classified as non-close contact. Of the 10 non-close contact, 4 had short conversations with both individuals masked, 4 shared a space without any conversation with both masked, and the remaining 2 entered the space after the index had left. At least one quarter of SARSCoV-2 transmissions occurred among non-close contacts. The definition of close contact for SARS-CoV-2 exposure based on the mode of droplet transmission should be revised to reflect the airborne nature of SARS-CoV-2 transmission.

Background: Most unintentional injuries that occur at home are preventable. However, it may be difficult to sufficiently reduce the number of falls occurring at home by only identifying risk factors focused on specific age groups. Therefore, this study aimed to identify the risk factors (especially age and places where injuries occurred at home) for intracranial injury (ICI) caused by unintentional falls at home. Methods: Using the Emergency Department (ED)-Based Injury In-depth Surveillance, we analyzed the data of patients who visited the ED due to unintentional falls at home. Risk factors were identified using multivariable logistic regression according to age groups and interactions between place of injury occurrence and age groups, and sex and age groups were assessed. Results: In total, 232,124 patients were included in the analysis; older adults had a higher adjusted odds ratio (aOR) 14.05 (95% confidence interval [CI], 12.74–15.49) of ICI than infants. The corridor was associated with ICI in the male pediatric group (aOR, 2.71; 95% CI, 1.08–6.84) and the balcony with the female pediatric group (aOR, 2.04; 95% CI, 1.03–4.04). In the adult group, aOR of kitchen was 1.38 (95% CI, 1.02–1.88) in females and 0.56 (95% CI, 0.48–0.66) in males. Conclusion In this study, we identified the risk factors of ICI caused by falls at home using ED-based injury surveillance data. The risk of ICI was different among places of occurrence in the home depending on the age groups and sex.

Purpose: This study aimed to compare the attitudes of nurses and physicians toward neonatal palliative care and identify the barriers to and facilitators of neonatal palliative care, with the goal of improving palliative care for infants in neonatal intensive care units (NICUs). Methods: This cross-sectional study analyzed data from the NICUs of seven general hospitals with 112 nurses and 52 physicians participating. Data were collected using the Neonatal Palliative Care Attitude Scale questionnaire. Results: Only 12.5% of nurses and 11.5% of physicians reported that they had sufficient education in neonatal palliative care. In contrast, 89.3% of the nurses and 84.6% of the physicians reported that they needed further education. The common facilitators for both nurses and physicians were: 1) agreement by all members of the department regarding the provision of palliative care and 2) informing parents about palliative care options. The common barriers for both nurses and physicians were: 1) policies or guidelines supporting palliative care were not available, 2) counseling was not available, 3) technological imperatives, and 4) parental demands for continuing life support. Insufficient resources, staff, and time were also identified as barriers for nurses, whereas these were not identified as barriers for physicians. Conclusion It is necessary to develop hospital or national guidelines and educational programs on neonatal palliative care, and it is equally necessary to spread social awareness of the importance of neonatal palliative care.

Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) transmission among non-close contacts is not infrequent. We evaluated the proportion and circumstances of individuals to whom SARS-CoV-2 was transmitted without close contact with the index patient in a nosocomial outbreak in a tertiary care hospital in Korea. From March 2020 to March 2021, there were 36 secondary cases from 14 SARS-CoV-2 infected individuals. Of the 36 secondary cases, 26 (72%) had been classified as close contact and the remaining 10 (28%) were classified as non-close contact. Of the 10 non-close contact, 4 had short conversations with both individuals masked, 4 shared a space without any conversation with both masked, and the remaining 2 entered the space after the index had left. At least one quarter of SARSCoV-2 transmissions occurred among non-close contacts. The definition of close contact for SARS-CoV-2 exposure based on the mode of droplet transmission should be revised to reflect the airborne nature of SARS-CoV-2 transmission.

Background: Most unintentional injuries that occur at home are preventable. However, it may be difficult to sufficiently reduce the number of falls occurring at home by only identifying risk factors focused on specific age groups. Therefore, this study aimed to identify the risk factors (especially age and places where injuries occurred at home) for intracranial injury (ICI) caused by unintentional falls at home. Methods: Using the Emergency Department (ED)-Based Injury In-depth Surveillance, we analyzed the data of patients who visited the ED due to unintentional falls at home. Risk factors were identified using multivariable logistic regression according to age groups and interactions between place of injury occurrence and age groups, and sex and age groups were assessed. Results: In total, 232,124 patients were included in the analysis; older adults had a higher adjusted odds ratio (aOR) 14.05 (95% confidence interval [CI], 12.74–15.49) of ICI than infants. The corridor was associated with ICI in the male pediatric group (aOR, 2.71; 95% CI, 1.08–6.84) and the balcony with the female pediatric group (aOR, 2.04; 95% CI, 1.03–4.04). In the adult group, aOR of kitchen was 1.38 (95% CI, 1.02–1.88) in females and 0.56 (95% CI, 0.48–0.66) in males. Conclusion In this study, we identified the risk factors of ICI caused by falls at home using ED-based injury surveillance data. The risk of ICI was different among places of occurrence in the home depending on the age groups and sex.

The infection status with Clonorchis sinensis metacercariae (CsMc) was examined in freshwater fishes from Yongjeon-cheon (a branch of Nakdong-gang) located in Cheongsong-gun, Gyeongsangbuk-do, the Republic of Korea (Korea). A total of 750 fishes in 19 species were examined by the artificial digestion method for 2 years (2019 and 2020). CsMc were detected in 378 (51.4%) out of 735 fishes in 14 species (73.7%), and the infection intensity was 666 per fish infected. In 2019, CsMc were found in 172 (68.0%) out of 253 fishes in 10 species, and the infection intensity was 565 per fish infected. In 2020, CsMc were detected in 206 (62.2%) out of 331 fishes in 10 species, and the infection intensity was 751 per fish infected. The other zoonotic trematode, ie. Metagonimus spp., Centrocestus armatus, Echinostoma spp. and Clinostomum complanatum, metacercariae were also detected in fishes from the survey streams, but their endemicities were relatively low. Conclusively, it was first confirmed that CsMc are highly endemic in fishes from Yongjeon-cheon in Cheongsong-gun, Gyeongsangbuk-do, Korea.