Clinical features of COVID-19 among patients with end-stage renal disease on hemodialysis in the context of high vaccination coverage during the omicron surge period: a retrospective cohort study

Background We determined the clinical presentation and outcomes of the Omicron variant of severe acute respiratory syndrome coronavirus 2 infection in hemodialysis patients and identified the risk factors for severe coronavirus disease (COVID-19) and mortality in the context of high vaccination coverage. Methods This was a retrospective cohort study involving hemodialysis patients who were vaccinated against COVID-19 during March–September 2022, when the Omicron variant was predominant, and the COVID-19 vaccination rate was high. The proportion of people with severe COVID-19 or mortality was evaluated using univariate logistic regression. Results Eighty-three (78.3%) patients had asymptomatic/mild symptoms, 10 (9.4%) had moderate symptoms, and 13 (12.3%) had severe symptoms. Six (5.7%) patients required intensive care admission, two (1.9%) required mechanical ventilation, and one (0.9%) was kept on high-flow nasal cannula. Of the five (4.7%) mortality cases, one was directly attributed to COVID-19 and four to pre-existing comorbidities. Risk factors for both severe COVID-19 and mortality were advanced age; number of comorbidities; cardiovascular diseases; increased levels of aspartate transaminase, lactate dehydrogenase, blood urea nitrogen/creatinine ratio, brain natriuretic peptide, and red cell distribution; and decreased levels of hematocrit and albumin. Moreover, the number of COVID-19 vaccinations wasa protective factor against both severe disease and mortality. Conclusions Clinical features of hemodialysis patients during the Omicron surge with high COVID-19 vaccination coverage were significant for low mortality. The risk features for severe COVID-19 or mortality were similar to those in the pre-Omicron period in the context of low vaccination coverage.This work was supported by a research fund of Chung-Ang Jeil Hospital, Chungbuk, South Korea (CAJ-2022-AS 01). Data analysis was supported by the Bio and Medical Technology Development Program of the National Research Foundation, funded by the Korean government (No. 2021M3E5E3081425)

A Cross-Sectional Study: What Contributes to Nursing Students’ Clinical Reasoning Competence?

Clinical reasoning is a vital competence for nursing students, as it is required for solving problems arising in complex clinical situations. Identifying the factors that influence nursing students’ clinical reasoning competence in the social context can help their implicit educational needs. Therefore, this study aimed to determine the factors associated with developing clinical reasoning competency among undergraduate nursing students. In total, 206 senior nursing students were included in this study. Self-reported measures were used to obtain data on participants’ clinical reasoning competence, problem-solving abilities, academic self-efficacy, and level of clinical practicum stress. Relationships among continuous variables were analyzed using Pearson’s correlation coefficients. A multiple linear regression analysis was conducted to identify factors related to clinical reasoning competence. Our findings show that participants with better problem-solving abilities and academic self-efficacy perceived themselves as having higher levels of clinical reasoning competence. Nursing students with lower clinical practicum stress reported higher clinical reasoning competence. Significant factors identified were younger age and subcategories of problem-solving ability such as problem clarification, alternative solution development, planning/implementation, and self-regulated efficacy. Our findings highlight essential factors necessary for developing a nursing curriculum that contributes to professional nurses’ clinical reasoning competence

Psychological Aspects of Child Maltreatment

In this review, we provide information about the etiology, risk factors, and clinical presentations of maltreatment to help clinicians better understand child abuse and neglect. Child maltreatment is a major global health challenge that can result in severe consequences. Abused and neglected children are likely to develop psychiatric disorders, such as major depressive disorder, anxiety disorder, and posttraumatic stress disorder. Understanding child maltreatment is expected to prevent and reduce victimization in children, adolescents, and their families.N

Factors Associated with the Delayed Termination of Viral Shedding in COVID-19 Patients with Mild Severity in South Korea

Background and objectives: We aimed to analyze factors associated with the period of viral shedding in patients with confirmed COVID-19 who experienced only mild symptoms. Materials and methods: We conducted a multicenter retrospective study from three community treatment centers (CTCs) of South Korea. All patients included were admitted to the three centers before 31 March 2020. We collected data about clinical characteristics and the result of real-time reverse transcription polymerase chain reaction (RT-PCR). Results: Viral shedding was terminated within 32 days and 36 days in 75% and 90% of patients, respectively (range: 8–49 days). The mean period of viral shedding was 23.8 ± 8.7 days. In the multivariate Cox proportional hazards regression analysis, the existence of underlying comorbidities lowered the probability of the termination of viral shedding (HR = 0.561, 95% CI 0.388–0.812). Female sex and presence of COVID-19-associated symptoms also lowered the probability, but the significance was marginal. Conclusions: The existence of underlying comorbidities was associated with delayed termination of viral shedding in COVID-19 patients with mild severity

The Implementation of MiRO, a Media-as-Place Computer Game

In this study, we implemented MiRO, a web-based Media-as-Place storytelling game that resembles an existing OS. Media-as-Place storytelling refers to a story where its medium is identical to its place. Observing from escape room games, we propose this concept by contrasting it with interactive storytelling and tangible interaction. To realize the computer version of Media-as-Place storytelling, we focused on imitating visual representation and interactions of existing OSs. MiRO involves OS elements (e.g., a taskbar), in-game applications (e.g., e-mail, a web browser), and interaction techniques for existing OSs (e.g., drag-and-drop). We also conducted a preliminary user evaluation with 17 participants. MiRO was perceived as an OS visually, although its interaction was limited due to the characteristics of the web environment. From the interviews, we found that the role of guidance is important because Media-as-Place storytelling allows a high variety of available interaction at a time.N

Salmonella Risk Assessment in Poultry Meat from Farm to Consumer in Korea

This study predicted Salmonella outbreak risk from eating cooked poultry in various methods. The incidence of Salmonella in poultry meat and the environment from farm to home for consumption was investigated. To develop the predictive models, Salmonella growth data were collected at 4–25 °C during storage and fitted with the Baranyi model. The effects of cooking on cell counts in poultry meat were investigated. Temperature, duration, and consumption patterns were all searched. A simulation in @Risk was run using these data to estimate the probability of foodborne Salmonella disease. In farm, Salmonella was detected from only fecal samples (8.5%; 56/660). In slaughterhouses, Salmonella was detected from feces 16.0% (38/237) for chicken and 19.5% (82/420) for duck) and from carcasses of each step (scalding, defeathering, and chilling) by cross contamination. In chicken (n = 270) and duck (n = 205), Salmonella was detected in 5 chicken (1.9%) and 16 duck meat samples (7.8%). Salmonella contamination levels were initially estimated to be −3.1 Log CFU/g and −2.5 Log CFU/g, respectively. With R2 values between 0.862 and 0.924, the predictive models were suitable for describing the fate of Salmonella in poultry meat with of 0.862 and 0.924. The Salmonella was not detected when poultry meat cooks completely. However, if poultry meat contaminated with Salmonella were cooked incompletely, Salmonella remained on the food surface. The risk of foodborne Salmonella disease from poultry consumption after cooking was 3.0 × 10−10/person/day and 8.8 × 10−11/person/day in South Korea, indicating a low risk

Visible-Light-Induced Organophotocatalytic Difunctionallization: Open-Air Hydroxysulfurization of Aryl Alkenes with Aryl Thiols

© 2022 American Chemical Society. All rights reserved.Herein, we report a regioselective visible-light-induced organophotoredox catalytic difunctionalization method to prepare β-hydroxysulfides using aryl alkenes and aryl thiols as substrates. The reaction provides a wide substrate scope of aryl alkenes (from simple styrene to complex bioactive compounds) and aryl thiols (from diverse heteroaromatic thiols to nonheteroaromatic thiols) (total 45 examples, up to 88% yield). Based on the combined experimental and computational studies, we demonstrate that in situ generated hydroperoxyl radicals from O2 in air react with benzylic radicals, which restrains the reaction between benzylic radicals and the acidic form of thiols in a classical thiol-ene radical reaction. We show that difunctionalization is possible due to the choice of bases, diluted substrate concentrations, increment in catalyst loading, and selection of suitable aryl thiols under aerobic conditions. Considering the biological importance of heteroaromatic thiols and the lack of methods to install them, our approach offers a platform to derive various β-hydroxysulfides that contain aromatic elements.11Nsciescopu

Unique Chemokine Profiles of Lung Tissues Distinguish Post-chemotherapeutic Persistent and Chronic Tuberculosis in a Mouse Model

There is a substantial need for biomarkers to distinguish latent stage from active Mycobacterium tuberculosis infections, for predicting disease progression. To induce the reactivation of tuberculosis, we present a new experimental animal model modified based on the previous model established by our group. In the new model, the reactivation of tuberculosis is induced without administration of immunosuppressive agents, which might disturb immune responses. To identify the immunological status of the persistent and chronic stages, we analyzed immunological genes in lung tissues from mice infected with M. tuberculosis. Gene expression was screened using cDNA microarray analysis and confirmed by quantitative RT-PCR. Based on the cDNA microarray results, 11 candidate cytokines genes, which were obviously up-regulated during the chronic stage compared with those during the persistent stage, were selected and clustered into three groups: (1) chemokine genes, except those of monocyte chemoattractant proteins (MCPs; CXCL9, CXCL10, CXCL11, CCL5, CCL19); (2) MCP genes (CCL2, CCL7, CCL8, CCL12); and (3) TNF and IFN-γ genes. Results from the cDNA microarray and quantitative RT-PCR analyses revealed that the mRNA expression of the selected cytokine genes was significantly higher in lung tissues of the chronic stage than of the persistent stage. Three chemokines (CCL5, CCL19, and CXCL9) and three MCPs (CCL7, CCL2, and CCL12) were noticeably increased in the chronic stage compared with the persistent stage by cDNA microarray (p < 0.01, except CCL12) or RT-PCR (p < 0.01). Therefore, these six significantly increased cytokines in lung tissue from the mouse tuberculosis model might be candidates for biomarkers to distinguish the two disease stages. This information can be combined with already reported potential biomarkers to construct a network of more efficient tuberculosis markers

Neuroendocrine tumor in gastric adenoma: a diagnostic pitfall mimicking invasive adenocarcinoma

Neuroendocrine tumor (NET) in adenoma of the gastrointestinal tract is a rare mixed glandular-endocrine neoplasm and has uncommonly been described mostly in the colon. Histologically, this tumor is composed of a predominant proportion of benign adenomatous component and a small portion of well-differentiated NE component. Only three cases of NET in gastric adenoma have been reported in the literature. We present 4 cases of NET in gastric adenoma mimicking invasive adenocarcinoma. The NETs were 0.62 mm to 4.1 mm in size and located at the basal lamina propria, muscularis mucosa and submucosa. Histologically, NETs consisted of nests, cords, tubules, and clusters of cells that predominantly interposed between the foveolar base without disturbing the overall polyp architecture. The lesions were completely removed by endoscopic submucosal dissection in three cases and in one case, subtotal gastrectomy was performed because endoscopic biopsy was invasive adenocarcinoma. The patients’ clinical course was uneventful without an evidence of recurrence or metastasis. The recognition of NET in gastric adenoma will help avoid potential diagnostic pitfalls masquerading as invasvie adenocarcinomas posed by their infiltrative pattern into submucosa. VIRTUAL SLIDES: The virtual slide(s) for this article can be found here: http://www.diagnosticpathology.diagnomx.eu/vs/168855229376100