Background: Immunocompromised patients with severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) infection often have prolonged viral shedding, and some are clinically suspected of reinfection with different SARSCoV-2 variants. However, data on this issue are limited. This study investigated the SARS-CoV-2 variants in serially collected respiratory samples from immunocompromised patients with prolonged viral shedding for over 12 weeks or relapsed viral shedding after at least 2 weeks of viral clearance. Materials and Methods: From February 2022 to September 2023, we prospectively enrolled immunocompromised patients with coronavirus disease 2019 who had hematologic malignancies or had undergone transplantation and were admitted to a tertiary hospital. Weekly saliva or nasopharyngeal swabs were collected from enrolled patients for at least 12 weeks after diagnosis. Genomic RNA polymerase chain reaction (PCR) was performed on samples, and those testing positive underwent viral culture to isolate the live virus. Spike gene full sequencing via Sanger sequencing and real-time reverse transcription-PCR for detecting mutation genes were conducted to identify SARSCoV-2 variants. Results: Among 116 enrolled patients, 20 with prolonged or relapsed viral shedding were screened to identify the variants. Of these 20 patients, 7 (35%) exhibited evidence of re-infection; one of 8 patients with prolonged viral shedding and 6 of 12 with relapsed viral shedding were reinfected with SARS-CoV-2. Conclusion Our data suggest that approximately one-third of immunocompromised patients with persistent or relapsed viral shedding had reinfection with different variants of SARS-CoV-2.

Background: Immunocompromised patients with severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) infection often have prolonged viral shedding, and some are clinically suspected of reinfection with different SARSCoV-2 variants. However, data on this issue are limited. This study investigated the SARS-CoV-2 variants in serially collected respiratory samples from immunocompromised patients with prolonged viral shedding for over 12 weeks or relapsed viral shedding after at least 2 weeks of viral clearance. Materials and Methods: From February 2022 to September 2023, we prospectively enrolled immunocompromised patients with coronavirus disease 2019 who had hematologic malignancies or had undergone transplantation and were admitted to a tertiary hospital. Weekly saliva or nasopharyngeal swabs were collected from enrolled patients for at least 12 weeks after diagnosis. Genomic RNA polymerase chain reaction (PCR) was performed on samples, and those testing positive underwent viral culture to isolate the live virus. Spike gene full sequencing via Sanger sequencing and real-time reverse transcription-PCR for detecting mutation genes were conducted to identify SARSCoV-2 variants. Results: Among 116 enrolled patients, 20 with prolonged or relapsed viral shedding were screened to identify the variants. Of these 20 patients, 7 (35%) exhibited evidence of re-infection; one of 8 patients with prolonged viral shedding and 6 of 12 with relapsed viral shedding were reinfected with SARS-CoV-2. Conclusion Our data suggest that approximately one-third of immunocompromised patients with persistent or relapsed viral shedding had reinfection with different variants of SARS-CoV-2.

Background: Immunocompromised patients with severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) infection often have prolonged viral shedding, and some are clinically suspected of reinfection with different SARSCoV-2 variants. However, data on this issue are limited. This study investigated the SARS-CoV-2 variants in serially collected respiratory samples from immunocompromised patients with prolonged viral shedding for over 12 weeks or relapsed viral shedding after at least 2 weeks of viral clearance. Materials and Methods: From February 2022 to September 2023, we prospectively enrolled immunocompromised patients with coronavirus disease 2019 who had hematologic malignancies or had undergone transplantation and were admitted to a tertiary hospital. Weekly saliva or nasopharyngeal swabs were collected from enrolled patients for at least 12 weeks after diagnosis. Genomic RNA polymerase chain reaction (PCR) was performed on samples, and those testing positive underwent viral culture to isolate the live virus. Spike gene full sequencing via Sanger sequencing and real-time reverse transcription-PCR for detecting mutation genes were conducted to identify SARSCoV-2 variants. Results: Among 116 enrolled patients, 20 with prolonged or relapsed viral shedding were screened to identify the variants. Of these 20 patients, 7 (35%) exhibited evidence of re-infection; one of 8 patients with prolonged viral shedding and 6 of 12 with relapsed viral shedding were reinfected with SARS-CoV-2. Conclusion Our data suggest that approximately one-third of immunocompromised patients with persistent or relapsed viral shedding had reinfection with different variants of SARS-CoV-2.

Background: Health information should be accurate and of high quality. While search websites are widely used to obtain health information, search results can vary depending on the availability of information in each language and the algorithms of search websites. We compared the search results and their reliability on popular search websites in Korea and the United States. Methods: Using the most popular search websites in Korea (A) and the US (B), with B divided into KR and US domains, we evaluated the search results for three diseases (hypertension, diabetes, osteoporosis) and two medications (Lipitor, Norvasc). We compared the proportion of paid ads and website categories, as well as quality and accuracy using a validated scoring tool. Results: Search website A had a high proportion of paid ads (40.3%), compared to B KR (4.3%) and B US (0%). B US had the highest proportion of reliable websites (58.1%), followed by B KR (52.9%) and A (14.6%). B US had the highest median quality score (25) while A had the lowest (14).Additionally, B US had the highest accuracy (95%), followed by B KR (87.7%) and A (52.2%). Conclusions Our data suggest that health information provided by popular search website in Korea is inaccurate and of low quality compared with that provided by its counterpart in the US. Users should prioritize credible websites, be cautious of ads, and seek professional advice. In addition, jointefforts from the government, search websites, and healthcare professionals are needed to provide accurate online health information.

Background: Health information should be accurate and of high quality. While search websites are widely used to obtain health information, search results can vary depending on the availability of information in each language and the algorithms of search websites. We compared the search results and their reliability on popular search websites in Korea and the United States. Methods: Using the most popular search websites in Korea (A) and the US (B), with B divided into KR and US domains, we evaluated the search results for three diseases (hypertension, diabetes, osteoporosis) and two medications (Lipitor, Norvasc). We compared the proportion of paid ads and website categories, as well as quality and accuracy using a validated scoring tool. Results: Search website A had a high proportion of paid ads (40.3%), compared to B KR (4.3%) and B US (0%). B US had the highest proportion of reliable websites (58.1%), followed by B KR (52.9%) and A (14.6%). B US had the highest median quality score (25) while A had the lowest (14).Additionally, B US had the highest accuracy (95%), followed by B KR (87.7%) and A (52.2%). Conclusions Our data suggest that health information provided by popular search website in Korea is inaccurate and of low quality compared with that provided by its counterpart in the US. Users should prioritize credible websites, be cautious of ads, and seek professional advice. In addition, jointefforts from the government, search websites, and healthcare professionals are needed to provide accurate online health information.

Background: Health information should be accurate and of high quality. While search websites are widely used to obtain health information, search results can vary depending on the availability of information in each language and the algorithms of search websites. We compared the search results and their reliability on popular search websites in Korea and the United States. Methods: Using the most popular search websites in Korea (A) and the US (B), with B divided into KR and US domains, we evaluated the search results for three diseases (hypertension, diabetes, osteoporosis) and two medications (Lipitor, Norvasc). We compared the proportion of paid ads and website categories, as well as quality and accuracy using a validated scoring tool. Results: Search website A had a high proportion of paid ads (40.3%), compared to B KR (4.3%) and B US (0%). B US had the highest proportion of reliable websites (58.1%), followed by B KR (52.9%) and A (14.6%). B US had the highest median quality score (25) while A had the lowest (14).Additionally, B US had the highest accuracy (95%), followed by B KR (87.7%) and A (52.2%). Conclusions Our data suggest that health information provided by popular search website in Korea is inaccurate and of low quality compared with that provided by its counterpart in the US. Users should prioritize credible websites, be cautious of ads, and seek professional advice. In addition, jointefforts from the government, search websites, and healthcare professionals are needed to provide accurate online health information.

Background: Health information should be accurate and of high quality. While search websites are widely used to obtain health information, search results can vary depending on the availability of information in each language and the algorithms of search websites. We compared the search results and their reliability on popular search websites in Korea and the United States. Methods: Using the most popular search websites in Korea (A) and the US (B), with B divided into KR and US domains, we evaluated the search results for three diseases (hypertension, diabetes, osteoporosis) and two medications (Lipitor, Norvasc). We compared the proportion of paid ads and website categories, as well as quality and accuracy using a validated scoring tool. Results: Search website A had a high proportion of paid ads (40.3%), compared to B KR (4.3%) and B US (0%). B US had the highest proportion of reliable websites (58.1%), followed by B KR (52.9%) and A (14.6%). B US had the highest median quality score (25) while A had the lowest (14).Additionally, B US had the highest accuracy (95%), followed by B KR (87.7%) and A (52.2%). Conclusions Our data suggest that health information provided by popular search website in Korea is inaccurate and of low quality compared with that provided by its counterpart in the US. Users should prioritize credible websites, be cautious of ads, and seek professional advice. In addition, jointefforts from the government, search websites, and healthcare professionals are needed to provide accurate online health information.

Background: Although most studies on the cardiovascular toxicity of proteasome inhibitors have focused on carfil‑ zomib, the risk of cardiotoxicity associated with bortezomib remains controversial. This study aimed to evaluate the incidence and risk factors of cardiovascular adverse events (CVAEs) associated with bortezomib in patients with multiple myeloma in a real-world setting. Methods: This cross-sectional study included patients who were treated with bortezomib at a tertiary hospital in South Korea. CVAEs, defined as hypertension, arrhythmia, heart failure, myocardial infarction, pulmonary arterial hypertension, angina, and venous thromboembolism, were detected using cardiac markers, ECG, echocardiography, medications, or documentation by clinicians. The patients were observed for at least 6 months and up to 2 years after starting bortezomib administration. Results: Among the 395 patients, 20.8% experienced CVAEs of any grade, and 14.7% experienced severe adverse events. The median onset time for any CVAE was 101.5 days (IQR, 42–182 days), and new-onset/worsened hyperten‑ sion was the most prevalent CVAE. The risk of CVAEs increased in patients with a body mass index lower than 18.5 (adjusted HR (aHR) 3.50, 95% confidence interval (CI) 1.05-11.72), light chain (1.80, 1.04-3.13), and IgD (4.63, 1.06-20.20) as the multiple myeloma subtype, baseline stroke (4.52, 1.59-12.80), and hypertension (1.99, 1.23-3.23). However, CVAEs did not significantly affect the 2-year overall survival and progression-free survival. Conclusion Approximately 15% of the Korean patients treated with bortezomib experienced severe CVAEs. Thus, patients, especially those with identified risk factors, should be closely monitored for CVAE symptoms during bort‑ ezomib treatment.

Purpose: To analyze changes in astigmatism and visual acuity in pediatric patients with limbal dermoid before and after surgery. Methods: Twenty-five pediatric patients (7 male, 18 female) diagnosed with limbal dermoid from March 2018 to February 2022 were included. We analyzed best corrected visual acuity and astigmatism using cycloplegic refraction, automated keratometry, and topography before and after surgery. Results: In cycloplegic refraction and automated keratometry, postoperative astigmatism did not decrease significantly (p = 0.53 and p = 0.38, respectively). Topography showed a significant decrease in corneal astigmatism from 3.6 ± 2.8 diopters (D) to 2.7 ± 1.8 D (p < 0.05) and in irregular astigmatism from 3.7 ± 2.2 D to 2.5 ± 1.5 D (p < 0.001). Significant decreases were observed in the corneal irregularity index from 0.14 ± 0.10 mm to 0.08 ± 0.47 mm (p < 0.001) and in the index of surface variance from 60.56 ± 41.02 to 35.00 ± 16.00 (p < 0.001). There was a statistically significant improvement in best corrected visual acuity from logarithm of minimal angle of resolution (logMAR) 0.18 to logMAR 0.07 (p < 0.05). Conclusions Surgery for limbal dermoid significantly reduced irregular astigmatism and improved best-corrected visual acuity. It is suggested that achieving visual development through active amblyopia treatment after surgery is important.

Purpose: To identify the effect of a new leadership type by confirming the effect of clinical nurses' grit and nursing work environment on nursing performance and retention intention with the mediating effect of compassionate rationalism leadership in the process. Methods: A proportional stratified sampling method was used with 45 tertiary general hospitals nationwide as the sampling unit. An online survey targeting nurses who have been working continuously for more than one year was conducted from October 14 to November 9, 2022. The final analysis included 1,256 questionnaires. The correlation between the participants' variables was analyzed using Pearson's correlation coefficients. The mediating effect was confirmed using a regression analysis, and bootstrapping. Results: The compassionate rationalism leadership had a mediating effect on the relationship between grit and nursing performance (F=203.21, p<.001), nursing work environment and nursing performance (F=109.48, p<.001), grit and retention intention (F=149.90, p<.001), and nursing work environment and retention intention (F=25.14, p<.001). Conclusion The compassionate rationalism leadership of nursing managers had a positive effect on nursing performance and retention intention.Therefore, with the development and application of educational programs of compassionate rationalism leadership, it can be used to improve nursing performance and operate an efficient nursing organization.