1.The Impact of Clinical Competence and Perception of Clinical Ladder System on Organizational Commitment among Nurses at a General Tertiary Hospital
Yeon Hee SHIN ; Mi Ra LEE ; Sung Nam KIM ; Min Jung KIM ; Ae Jin KIM ; Hyun Ja KIM ; Ji Yoon KANG
Journal of Korean Academy of Nursing Administration 2025;31(1):120-131
Purpose:
This study aimed to evaluate the performance of a clinical ladder system in a tertiary hospital by examining how nurses' clinical competence and perceptions of the system affect organizational commitment.
Methods:
The study involved 394 nurses working at a tertiary hospital. Data were collected from May 3 to July 10, 2023, using a self-reported questionnaire. Statistical analyses, including descriptive statistics, independent t-tests, one-way ANOVA, Kruskal-Wallis test, Scheffé post-hoc test, Pearson correlation, and hierarchical regression analysis, were performed using SPSS 27.0.
Results:
Nurses who applied for promotion to the CN III level and current CN III nurses reported higher clinical competence, perceptions of the clinical ladder system, and organizational commitment than those who did not and those at lower levels (p<.001). A positive correlation existed among all independent variables.Controlling for general characteristics, the effects of clinical competence and perceptions of the clinical ladder system explained 49% of organizational commitment variance (Adjusted R 2 =.49, F=33.43, p<.001).
Conclusion
Greater clinical competence and positive perceptions of the clinical ladder system are likely to enhance organizational commitment, emphasizing its effectiveness in fostering better organizational outcomes.
2.Neutralizing Activity and T-Cell Responses Against Wild Type SARSCoV-2 Virus and Omicron BA.5 Variant After Ancestral SARS-CoV-2 Vaccine Booster Dose in PLWH Receiving ART Based on CD4 T-Cell Count
Na Young HA ; Ah-Ra KIM ; Hyeongseok JEONG ; Shinhye CHEON ; Cho Rong PARK ; Jin Ho CHOE ; Hyo Jung KIM ; Jae Won YOON ; Miryoung KIM ; Mi Yeong AN ; Sukyoung JUNG ; Hyeon Nam DO ; Junewoo LEE ; Yeon-Sook KIM
Journal of Korean Medical Science 2025;40(9):e28-
Background:
We evaluated severe acute respiratory syndrome-coronavirus-2 (SARS-CoV-2)-specific humoral and cellular responses for up to 6 months after the 3rd dose of ancestral coronavirus disease 2019 (COVID-19) vaccination in people living with HIV (PLWH) and healthy controls (HCs) who were not infected with COVID-19.
Methods:
Anti-spike receptor-binding domain IgG (anti-RBD IgG) concentrations using chemiluminescence immunoassay and neutralizing antibodies using focus reduction neutralization test (FRNT) were assessed at 1 week after each dose of vaccination, and 3 and 6 months after the 3rd dose in 62 PLWH and 25 HCs. T-cell responses using intracellular cytokine stain were evaluated at 1 week before, and 1 week and 6 months after the 3rd dose.
Results:
At 1 week after the 3rd dose, adequate anti-RBD IgG (> 300 binding antibody unit /mL) was elicited in all PLWH except for one patient with 36 CD4 T-cell count/mm3 . The geometric mean titers of 50% FRNT against wild type (WT) and omicron BA.5 strains of SARS-CoV-2 in PLWH with CD4 T-cell count ≥ 500 cells/mm3(high CD4 recovery, HCDR) were comparable to HC, but they were significantly decreased in PLWH with CD4 T-cell count < 500/mm3 (low CD4 recovery, LCDR). After adjusting for age, gender, viral suppression, and number of preexisting comorbidities, CD4 T-cell counts < 500/mm3 significantly predicted a poor magnitude of neutralizing antibodies against WT, omicron BA.5, and XBB 1.5 strains among PLWH. Multivariable linear regression adjusting for age and gender revealed that LCDR was associated with reduced neutralizing activity (P = 0.017) and interferon-γ-producing T-cell responses (P = 0.049 for CD T-cell; P = 0.014 for CD8 T-cell) against WT, and strongly associated with more decreased cross-neutralization against omicron BA.5 strains (P < 0.001).
Conclusion
HCDR demonstrated robust humoral and cell-mediated immune responses after a booster dose of ancestral SARS-CoV-2 vaccine, whereas LCDR showed diminished immune responses against WT virus and more impaired cross-neutralization against omicron BA.5 strain.
3.The Impact of Clinical Competence and Perception of Clinical Ladder System on Organizational Commitment among Nurses at a General Tertiary Hospital
Yeon Hee SHIN ; Mi Ra LEE ; Sung Nam KIM ; Min Jung KIM ; Ae Jin KIM ; Hyun Ja KIM ; Ji Yoon KANG
Journal of Korean Academy of Nursing Administration 2025;31(1):120-131
Purpose:
This study aimed to evaluate the performance of a clinical ladder system in a tertiary hospital by examining how nurses' clinical competence and perceptions of the system affect organizational commitment.
Methods:
The study involved 394 nurses working at a tertiary hospital. Data were collected from May 3 to July 10, 2023, using a self-reported questionnaire. Statistical analyses, including descriptive statistics, independent t-tests, one-way ANOVA, Kruskal-Wallis test, Scheffé post-hoc test, Pearson correlation, and hierarchical regression analysis, were performed using SPSS 27.0.
Results:
Nurses who applied for promotion to the CN III level and current CN III nurses reported higher clinical competence, perceptions of the clinical ladder system, and organizational commitment than those who did not and those at lower levels (p<.001). A positive correlation existed among all independent variables.Controlling for general characteristics, the effects of clinical competence and perceptions of the clinical ladder system explained 49% of organizational commitment variance (Adjusted R 2 =.49, F=33.43, p<.001).
Conclusion
Greater clinical competence and positive perceptions of the clinical ladder system are likely to enhance organizational commitment, emphasizing its effectiveness in fostering better organizational outcomes.
4.Neutralizing Activity and T-Cell Responses Against Wild Type SARSCoV-2 Virus and Omicron BA.5 Variant After Ancestral SARS-CoV-2 Vaccine Booster Dose in PLWH Receiving ART Based on CD4 T-Cell Count
Na Young HA ; Ah-Ra KIM ; Hyeongseok JEONG ; Shinhye CHEON ; Cho Rong PARK ; Jin Ho CHOE ; Hyo Jung KIM ; Jae Won YOON ; Miryoung KIM ; Mi Yeong AN ; Sukyoung JUNG ; Hyeon Nam DO ; Junewoo LEE ; Yeon-Sook KIM
Journal of Korean Medical Science 2025;40(9):e28-
Background:
We evaluated severe acute respiratory syndrome-coronavirus-2 (SARS-CoV-2)-specific humoral and cellular responses for up to 6 months after the 3rd dose of ancestral coronavirus disease 2019 (COVID-19) vaccination in people living with HIV (PLWH) and healthy controls (HCs) who were not infected with COVID-19.
Methods:
Anti-spike receptor-binding domain IgG (anti-RBD IgG) concentrations using chemiluminescence immunoassay and neutralizing antibodies using focus reduction neutralization test (FRNT) were assessed at 1 week after each dose of vaccination, and 3 and 6 months after the 3rd dose in 62 PLWH and 25 HCs. T-cell responses using intracellular cytokine stain were evaluated at 1 week before, and 1 week and 6 months after the 3rd dose.
Results:
At 1 week after the 3rd dose, adequate anti-RBD IgG (> 300 binding antibody unit /mL) was elicited in all PLWH except for one patient with 36 CD4 T-cell count/mm3 . The geometric mean titers of 50% FRNT against wild type (WT) and omicron BA.5 strains of SARS-CoV-2 in PLWH with CD4 T-cell count ≥ 500 cells/mm3(high CD4 recovery, HCDR) were comparable to HC, but they were significantly decreased in PLWH with CD4 T-cell count < 500/mm3 (low CD4 recovery, LCDR). After adjusting for age, gender, viral suppression, and number of preexisting comorbidities, CD4 T-cell counts < 500/mm3 significantly predicted a poor magnitude of neutralizing antibodies against WT, omicron BA.5, and XBB 1.5 strains among PLWH. Multivariable linear regression adjusting for age and gender revealed that LCDR was associated with reduced neutralizing activity (P = 0.017) and interferon-γ-producing T-cell responses (P = 0.049 for CD T-cell; P = 0.014 for CD8 T-cell) against WT, and strongly associated with more decreased cross-neutralization against omicron BA.5 strains (P < 0.001).
Conclusion
HCDR demonstrated robust humoral and cell-mediated immune responses after a booster dose of ancestral SARS-CoV-2 vaccine, whereas LCDR showed diminished immune responses against WT virus and more impaired cross-neutralization against omicron BA.5 strain.
5.The Impact of Clinical Competence and Perception of Clinical Ladder System on Organizational Commitment among Nurses at a General Tertiary Hospital
Yeon Hee SHIN ; Mi Ra LEE ; Sung Nam KIM ; Min Jung KIM ; Ae Jin KIM ; Hyun Ja KIM ; Ji Yoon KANG
Journal of Korean Academy of Nursing Administration 2025;31(1):120-131
Purpose:
This study aimed to evaluate the performance of a clinical ladder system in a tertiary hospital by examining how nurses' clinical competence and perceptions of the system affect organizational commitment.
Methods:
The study involved 394 nurses working at a tertiary hospital. Data were collected from May 3 to July 10, 2023, using a self-reported questionnaire. Statistical analyses, including descriptive statistics, independent t-tests, one-way ANOVA, Kruskal-Wallis test, Scheffé post-hoc test, Pearson correlation, and hierarchical regression analysis, were performed using SPSS 27.0.
Results:
Nurses who applied for promotion to the CN III level and current CN III nurses reported higher clinical competence, perceptions of the clinical ladder system, and organizational commitment than those who did not and those at lower levels (p<.001). A positive correlation existed among all independent variables.Controlling for general characteristics, the effects of clinical competence and perceptions of the clinical ladder system explained 49% of organizational commitment variance (Adjusted R 2 =.49, F=33.43, p<.001).
Conclusion
Greater clinical competence and positive perceptions of the clinical ladder system are likely to enhance organizational commitment, emphasizing its effectiveness in fostering better organizational outcomes.
6.Neutralizing Activity and T-Cell Responses Against Wild Type SARSCoV-2 Virus and Omicron BA.5 Variant After Ancestral SARS-CoV-2 Vaccine Booster Dose in PLWH Receiving ART Based on CD4 T-Cell Count
Na Young HA ; Ah-Ra KIM ; Hyeongseok JEONG ; Shinhye CHEON ; Cho Rong PARK ; Jin Ho CHOE ; Hyo Jung KIM ; Jae Won YOON ; Miryoung KIM ; Mi Yeong AN ; Sukyoung JUNG ; Hyeon Nam DO ; Junewoo LEE ; Yeon-Sook KIM
Journal of Korean Medical Science 2025;40(9):e28-
Background:
We evaluated severe acute respiratory syndrome-coronavirus-2 (SARS-CoV-2)-specific humoral and cellular responses for up to 6 months after the 3rd dose of ancestral coronavirus disease 2019 (COVID-19) vaccination in people living with HIV (PLWH) and healthy controls (HCs) who were not infected with COVID-19.
Methods:
Anti-spike receptor-binding domain IgG (anti-RBD IgG) concentrations using chemiluminescence immunoassay and neutralizing antibodies using focus reduction neutralization test (FRNT) were assessed at 1 week after each dose of vaccination, and 3 and 6 months after the 3rd dose in 62 PLWH and 25 HCs. T-cell responses using intracellular cytokine stain were evaluated at 1 week before, and 1 week and 6 months after the 3rd dose.
Results:
At 1 week after the 3rd dose, adequate anti-RBD IgG (> 300 binding antibody unit /mL) was elicited in all PLWH except for one patient with 36 CD4 T-cell count/mm3 . The geometric mean titers of 50% FRNT against wild type (WT) and omicron BA.5 strains of SARS-CoV-2 in PLWH with CD4 T-cell count ≥ 500 cells/mm3(high CD4 recovery, HCDR) were comparable to HC, but they were significantly decreased in PLWH with CD4 T-cell count < 500/mm3 (low CD4 recovery, LCDR). After adjusting for age, gender, viral suppression, and number of preexisting comorbidities, CD4 T-cell counts < 500/mm3 significantly predicted a poor magnitude of neutralizing antibodies against WT, omicron BA.5, and XBB 1.5 strains among PLWH. Multivariable linear regression adjusting for age and gender revealed that LCDR was associated with reduced neutralizing activity (P = 0.017) and interferon-γ-producing T-cell responses (P = 0.049 for CD T-cell; P = 0.014 for CD8 T-cell) against WT, and strongly associated with more decreased cross-neutralization against omicron BA.5 strains (P < 0.001).
Conclusion
HCDR demonstrated robust humoral and cell-mediated immune responses after a booster dose of ancestral SARS-CoV-2 vaccine, whereas LCDR showed diminished immune responses against WT virus and more impaired cross-neutralization against omicron BA.5 strain.
7.The Impact of Clinical Competence and Perception of Clinical Ladder System on Organizational Commitment among Nurses at a General Tertiary Hospital
Yeon Hee SHIN ; Mi Ra LEE ; Sung Nam KIM ; Min Jung KIM ; Ae Jin KIM ; Hyun Ja KIM ; Ji Yoon KANG
Journal of Korean Academy of Nursing Administration 2025;31(1):120-131
Purpose:
This study aimed to evaluate the performance of a clinical ladder system in a tertiary hospital by examining how nurses' clinical competence and perceptions of the system affect organizational commitment.
Methods:
The study involved 394 nurses working at a tertiary hospital. Data were collected from May 3 to July 10, 2023, using a self-reported questionnaire. Statistical analyses, including descriptive statistics, independent t-tests, one-way ANOVA, Kruskal-Wallis test, Scheffé post-hoc test, Pearson correlation, and hierarchical regression analysis, were performed using SPSS 27.0.
Results:
Nurses who applied for promotion to the CN III level and current CN III nurses reported higher clinical competence, perceptions of the clinical ladder system, and organizational commitment than those who did not and those at lower levels (p<.001). A positive correlation existed among all independent variables.Controlling for general characteristics, the effects of clinical competence and perceptions of the clinical ladder system explained 49% of organizational commitment variance (Adjusted R 2 =.49, F=33.43, p<.001).
Conclusion
Greater clinical competence and positive perceptions of the clinical ladder system are likely to enhance organizational commitment, emphasizing its effectiveness in fostering better organizational outcomes.
8.Neutralizing Activity and T-Cell Responses Against Wild Type SARSCoV-2 Virus and Omicron BA.5 Variant After Ancestral SARS-CoV-2 Vaccine Booster Dose in PLWH Receiving ART Based on CD4 T-Cell Count
Na Young HA ; Ah-Ra KIM ; Hyeongseok JEONG ; Shinhye CHEON ; Cho Rong PARK ; Jin Ho CHOE ; Hyo Jung KIM ; Jae Won YOON ; Miryoung KIM ; Mi Yeong AN ; Sukyoung JUNG ; Hyeon Nam DO ; Junewoo LEE ; Yeon-Sook KIM
Journal of Korean Medical Science 2025;40(9):e28-
Background:
We evaluated severe acute respiratory syndrome-coronavirus-2 (SARS-CoV-2)-specific humoral and cellular responses for up to 6 months after the 3rd dose of ancestral coronavirus disease 2019 (COVID-19) vaccination in people living with HIV (PLWH) and healthy controls (HCs) who were not infected with COVID-19.
Methods:
Anti-spike receptor-binding domain IgG (anti-RBD IgG) concentrations using chemiluminescence immunoassay and neutralizing antibodies using focus reduction neutralization test (FRNT) were assessed at 1 week after each dose of vaccination, and 3 and 6 months after the 3rd dose in 62 PLWH and 25 HCs. T-cell responses using intracellular cytokine stain were evaluated at 1 week before, and 1 week and 6 months after the 3rd dose.
Results:
At 1 week after the 3rd dose, adequate anti-RBD IgG (> 300 binding antibody unit /mL) was elicited in all PLWH except for one patient with 36 CD4 T-cell count/mm3 . The geometric mean titers of 50% FRNT against wild type (WT) and omicron BA.5 strains of SARS-CoV-2 in PLWH with CD4 T-cell count ≥ 500 cells/mm3(high CD4 recovery, HCDR) were comparable to HC, but they were significantly decreased in PLWH with CD4 T-cell count < 500/mm3 (low CD4 recovery, LCDR). After adjusting for age, gender, viral suppression, and number of preexisting comorbidities, CD4 T-cell counts < 500/mm3 significantly predicted a poor magnitude of neutralizing antibodies against WT, omicron BA.5, and XBB 1.5 strains among PLWH. Multivariable linear regression adjusting for age and gender revealed that LCDR was associated with reduced neutralizing activity (P = 0.017) and interferon-γ-producing T-cell responses (P = 0.049 for CD T-cell; P = 0.014 for CD8 T-cell) against WT, and strongly associated with more decreased cross-neutralization against omicron BA.5 strains (P < 0.001).
Conclusion
HCDR demonstrated robust humoral and cell-mediated immune responses after a booster dose of ancestral SARS-CoV-2 vaccine, whereas LCDR showed diminished immune responses against WT virus and more impaired cross-neutralization against omicron BA.5 strain.
9.Research Trends in Artificial Intelligence Applications in Dental Hygiene and Dentistry in Korean Academic Journals: A Scoping Review
Eun-Ha JUNG ; Bo-Ra KIM ; Soon-Jeong JEONG ; Mi-Sook YOON ; Ji-Hyun MIN ; Miyuki KIBAYASHI
Journal of Dental Hygiene Science 2025;25(4):306-324
Background:
This scoping review examined research on artificial intelligence (AI) published in Korean academic journals in thefields of dental hygiene and dentistry. The Context–Concept–Maturity framework was applied to compare research trends and identify future directions.
Methods:
Following the Arksey and O’Malley framework, with extensions by Levac et al., the review adhered to Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews guidelines. Domestic academic journals published between January 1, 2020, and September 30, 2025, were searched in KISS, RISS, ScienceON, and DBpia. Studies were screened, extracted, and coded according to population, concept, and context criteria, yielding 70 eligible articles (26 in dental hygiene and 44 in dentistry).
Results:
In dental hygiene, most research focused on education (38.5%) and community/public oral health (38.5%), while clinicalapplications were limited (7.7%). Major conceptual domains included education/training tools (42.3%), workflow/automation (38.5%), prediction (15.4%), and classification (3.8%). Dentistry studies were predominantly clinically oriented and imagingbased, emphasizing classification, automation, and segmentation. Maturity analysis indicated that dentistry primarily occupied Stage 2 (application; ∼84.1%), whereas dental hygiene showed a dual distribution across Stage 1 (exploration; 46.2%) and Stage 2 (application; 46.2%), with limited Stage 3 (integration; 7.7%) studies.
Conclusion
AI research in Korea exhibits divergent developmental trajectories. Dental hygiene research emphasizes education,prevention, and public oral health, combining exploratory and applied approaches, while dentistry demonstrates greater clinical integration and application-level maturity. Advancing AI maturity in dental hygiene will require expansion of clinical data–driven studies, incorporation of AI and data literacy into curricula, standardized integration of unstructured and clinical data, multicenter long-term validation, and the development of ethical and performance governance frameworks.
10.Risk factors of hypotension during cesarean section with spinal anesthesia in parturients with COVID-19: a retrospective study in comparison with pregnant women without COVID-19
Si Ra BANG ; Gunn Hee KIM ; Sung Jun CHO ; Mi Jung YOON
Anesthesia and Pain Medicine 2024;19(4):326-332
The incidence of hypotension in parturients with coronavirus disease (COVID-19) undergoing regional anesthesia remains controversial. This study aimed to investigate the incidence of hypotension during spinal anesthesia in parturients infected with COVID-19, as well as to identify associated risk factors. Methods: This retrospective study compared COVID-19-positive parturients who underwent cesarean section under spinal anesthesia (COVID-19 group) with a control group between January 2017 and June 2022. We reviewed the medical records and collected the following information: basic patient characteristics, spinal anesthesia, and newborn-related data. Results: Compared with the control group, the COVID-19 group did not show any significant differences in terms of hypotension occurrence and vasopressor usage. A positive correlation was noted in the COVID-19 group between heart rate and duration of hospital stay (P < 0.001, Spearman’s rho = 0.422). In subgroup analysis of the COVID-19 group, group with a baseline heart rate ≥ 100 (group H) had lower Apgar scores at 1 min, longer hospital stays, and more severe COVID-19 symptoms than the with a baseline heart rate < 100 (group L). Moreover, in group H, there was a positive correlation between the heart rate and the lowest systolic blood pressure after spinal anesthesia (P = 0.012, Spearman’s rho = 0.528). Conclusions: Parturients with COVID-19 do not appear to have a higher risk of hypotension during cesarean section under spinal anesthesia than those without COVID-19. Given the close association between preoperative heart rate and extent of hypotension in parturients with COVID-19 undergoing spinal anesthesia, vigilant monitoring of vital signs by anesthesiologists is crucial during the perioperative period.

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