OBJECTIVES: The effectiveness of social distancing during the coronavirus disease 2019 (COVID-19) pandemic has been evaluated using the magnitude of changes in population mobility. This study aimed to investigate a direct indicator—namely, the number of close contacts per patient with confirmed COVID-19. METHODS: From week 7, 2020 to week 43, 2021, population movement changes were calculated from the data of two Korean telecommunication companies and Google in accordance with social distancing stringency levels. Data on confirmed cases and their close contacts among residents of Gyeonggi Province, Korea were combined at each stage. Pearson correlation analysis was conducted to compare the movement data with the change in the number of contacts for each confirmed case calculated by stratification according to age group. The reference value of the population movement data was set using the value before mid-February 2020, considering each data’s characteristics. RESULTS: In the age group of 18 or younger, the number of close contacts per confirmed case decreased or increased when the stringency level was strengthened or relaxed, respectively. In adults, the correlation was relatively low, with no correlation between the change in the number of close contacts per confirmed case and the change in population movement after the commencement of vaccination for adults. CONCLUSIONS The effectiveness of governmental social distancing policies against COVID-19 can be evaluated using the number of close contacts per confirmed case as a direct indicator, especially for each age group. Such an analysis can facilitate policy changes for specific groups.

OBJECTIVES: We compared the viral cycle threshold (Ct) values of infected patients to better understand viral kinetics by vaccination status during different periods of variant predominance in Gyeonggi Province, Korea. METHODS: We obtained case-specific data from the coronavirus disease 2019 (COVID-19) surveillance system, Gyeonggi in-depth epidemiological report system, and Health Insurance Review & Assessment Service from January 2020 to January 2022. We defined periods of variant predominance and explored Ct values by analyzing viral sequencing test results. Using a generalized additive model, we performed a nonlinear regression analysis to determine viral kinetics over time. RESULTS: Cases in the Delta variant’s period of predominance had higher viral shedding patterns than cases in other periods. The temporal change of viral shedding did not vary by vaccination status in the Omicron-predominant period, but viral shedding decreased in patients who had completed their third vaccination in the Delta-predominant period. During the Delta-predominant and Omicron-predominant periods, the time from symptom onset to peak viral shedding based on the E gene was approximately 2.4 days (95% confidence interval [CI], 2.2 to 2.5) and 2.1 days (95% CI, 2.0 to 2.1), respectively. CONCLUSIONS In one-time tests conducted to diagnose COVID-19 in a large population, although no adjustment for individual characteristics was conducted, it was confirmed that viral shedding differed by the predominant strain and vaccination history. These results show the value of utilizing hundreds of thousands of test data produced at COVID-19 screening test centers.

In November 2021, 14 international travel-related severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) B.1.1.529 (omicron) variant of concern (VOC) patients were detected in South Korea. Epidemiologic investigation revealed community transmission of the omicron VOC. A total of 80 SARS-CoV-2 omicron VOC-positive patients were identified until December 10, 2021 and 66 of them reported no relation to the international travel.There may be more transmissions with this VOC in Korea than reported.

An air blow gun is one of the most common pneumatic tools found at industrial sites and entrances of mountain trails in South Korea. It is used for spraying high-pressure air to dust off surfaces and clothes, and to inject air into tubes. There have been many reported cases of injuries and deaths associated with air blow guns. The victim died by placing the nozzle of an air blow gun, installed on an outdoor sports field, into her nose, and pulling the trigger. An autopsy ascribed her death to pneumothorax. Numerous accidents associated with air blow guns have been reported in the media. However, the use of an air blow gun has not been the subject of a suicide case study in forensic literature. To our knowledge, this is the first case report on suicide using an air blow gun. Stronger public safety warnings stressing the potentially fatal outcomes from careless usage of air blow guns are required.

Rivaroxaban, a factor Xa inhibitor, is one of the newly developed direct oral anticoagulants (DOAC). In recent times, it has been increasingly used in the prevention of pulmonary embolism in patients undergoing orthopedic surgery. This report describes a case of epidural hematoma in an elderly patient who underwent combined spinal epidural anesthesia for total knee arthroplasty; the patient received rivaroxaban postoperatively for 7 days to prevent pulmonary embolism. Additionally, the epidural hematomas developed on the 5th postoperative day but the patient recovered well with conservative treatment. Although rivaroxaban has a low need for monitoring and is easily administered, the guidelines should be carefully checked for the postoperative administration schedule in patients undergoing regional anesthesia. In addition, rivaroxaban should be used with caution, especially in elderly patients.
Aged ; Anesthesia, Conduction ; Anesthesia, Epidural ; Anticoagulants ; Appointments and Schedules ; Arthroplasty, Replacement, Knee* ; Factor Xa ; Hematoma* ; Hematoma, Epidural, Spinal ; Humans ; Orthopedics ; Pulmonary Embolism ; Rivaroxaban*

BACKGROUND: Phase-lag entropy (PLE) was recently described as a measurement of temporal pattern diversity in the phase relationship between two electroencephalographic signals from prefrontal and frontal montages. This study was performed to evaluate the performance of PLE for assessing the depth of sedation. METHODS: Thirty adult patients undergoing upper limb surgery with a brachial plexus block were administered propofol by target-controlled infusion. The depth of sedation was assessed using the Observer's Assessment of Alertness/Sedation (OAA/S) scale. The effect-site concentration (Ce) of propofol was initially started at 0.5 μg/ml and was increased in increments of 0.2 μg/ml until an OAA/S score of 1 was reached. Three minutes after the target Ce was reached, the PLE, bispectral index (BIS), and level of sedation were assessed. Correlations between the OAA/S score and PLE or BIS were determined. The prediction probabilities (P(k)) of PLE and BIS were also analyzed. RESULTS: The PLE values were closely correlated with the OAA/S scores (Spearman's Rho = 0.755; P < 0.001) to an extent comparable with the correlation between the BIS and OAA/S score (Spearman's Rho = 0.788; P < 0.001). The P(k) values of PLE and BIS were 0.731 and 0.718, respectively. CONCLUSIONS: PLE is a new and reliable consciousness monitoring system for assessing the depth of sedation induced by propofol, which is comparable with the BIS.
Adult ; Brachial Plexus Block ; Consciousness Monitors ; Electroencephalography ; Entropy ; Humans ; Propofol ; Upper Extremity

BACKGROUND: Phase-lag entropy (PLE) was recently described as a measurement of temporal pattern diversity in the phase relationship between two electroencephalographic signals from prefrontal and frontal montages. This study was performed to evaluate the performance of PLE for assessing the depth of sedation. METHODS: Thirty adult patients undergoing upper limb surgery with a brachial plexus block were administered propofol by target-controlled infusion. The depth of sedation was assessed using the Observer's Assessment of Alertness/Sedation (OAA/S) scale. The effect-site concentration (Ce) of propofol was initially started at 0.5 μg/ml and was increased in increments of 0.2 μg/ml until an OAA/S score of 1 was reached. Three minutes after the target Ce was reached, the PLE, bispectral index (BIS), and level of sedation were assessed. Correlations between the OAA/S score and PLE or BIS were determined. The prediction probabilities (P(k)) of PLE and BIS were also analyzed. RESULTS: The PLE values were closely correlated with the OAA/S scores (Spearman's Rho = 0.755; P < 0.001) to an extent comparable with the correlation between the BIS and OAA/S score (Spearman's Rho = 0.788; P < 0.001). The P(k) values of PLE and BIS were 0.731 and 0.718, respectively. CONCLUSIONS PLE is a new and reliable consciousness monitoring system for assessing the depth of sedation induced by propofol, which is comparable with the BIS.

BACKGROUND: Family values of a married woman may be related to her own depressive mood. Since depressive mood of a married woman is likely to exert a negative influence, in terms of mental health, on her, her family members, and the whole society's, it may be very important to explore the relationship between family values in married women and their depressive mood. METHODS: In this study, we analyzed nationally representative 5,818 married women aged 20 years or older from the 4th panel data of 2012 Korean Longitudinal Survey of Women and Families. As for variables of interest, we constructed three family values variables: family-oriented view of marriage, individualistic view of marriage, and traditional view of marital roles. Then we employed multivariate logistic regression analyses to explore the relationship between family values and depressive mood, adjusting for family and socio-demographic factors. RESULTS: In total, 804 married women (18.4%) had experienced depressive mood. All of the three family values variables were significant in their relationships with depressive mood. The women categorized as ‘very weak’ in family-oriented view of marriage were more likely to experience depressive mood than the women categorized as ‘very strong’ (odds ratio [OR], 1.98; 95% confidence interval [CI], 1.53–2.55). By contrast, the women categorized as ‘very weak’ in individualistic view of marriage (OR, 0.43; 95% CI, 0.33–0.55) and in traditional view of marital roles (OR, 0.68; 95% CI, 0.51–0.92) were less likely to experience depressive mood than their respective counterpart women categorized as ‘very strong.’ CONCLUSION: In Korea, married women's values towards marriage itself and roles between wives and husbands had significant associations with their depressive mood. This suggests that in order to improve mental health in married women, we need to take social and cultural dimensions into consideration along with public health interventions.
Depression ; Female ; Humans ; Korea ; Logistic Models ; Longitudinal Studies ; Marriage ; Mental Health ; Public Health ; Spouses

The intracellular parasite Toxoplasma gondii has unique dense granule antigens (GRAs) that are crucial for host infection. Emerging evidence suggests that GRA8 of T. gondii is a promising serodiagnostic marker in toxoplasmosis. However, little is known about the intracellular regulatory mechanisms involved in GRA8-induced host responses. We found that GRA8 interacts with host proteins involved in mitochondria activation and might be useful as a therapeutic strategy for sepsis. Here, we show that protein kinase-Cα (PKCα)-mediated phosphorylation of T. gondii GRA8 (Thr220) is required for mitochondrial trafficking and regulates the interaction of C terminal of GRA8 with nucleotide binding domain of ATP5A1. Furthermore, GRA8 interacts with SIRT3 in mitochondria, facilitating ATP5A1 deacetylation (K506 and K531), adenosine triphosphate production and subsequent anti-septic activity in vivo. Taken together, these results demonstrate a new anti-sepsis therapeutic strategy using T. gondii GRA8-induced mitochondrial metabolic resuscitation. This strategy represents an urgently needed paradigm shift for therapeutic intervention.