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Purpose@#This study describes changes in the utilization pattern of emergency departments (EDs) by neonates during the coronavirus disease 2019 pandemic to ensure efficient resource allocation during future infectious disease outbreaks. @*Methods@#We performed a retrospective observational study by reviewing the medical records of neonates (≤ 30 days) who visited the ED. They were divided into pre-pandemic (February 2018-January 2020) and pandemic (February 2020-January 2022) groups. We compared data regarding ED utilization, including length of stay, disposition, and chief complaints. @*Results@#A total of 156 neonates visited the ED during the study period. A 42.4% decrease in the visits was observed during the pandemic group (n = 57), compared with the pre-pandemic group (n = 99). In particular, the proportion of visits by neonates aged 7 days or younger has decreased from 14.1% (14/99) to 3.5% (2/57; P = 0.035). The proportion of plain radiography performed and median ED length of stay increased from 36.4% (36/99) to 63.2% (36/57; P = 0.001), and from 66.0 minutes (interquartile range, 42.0-116.0) to 86.0 minutes (59.0-153.0; P = 0.007), respectively. Among the chief complaints, fever, respiratory symptoms, and minor clinical problems increased during the pandemic (29.3% to 36.8%, 11.1% to 14.0%, and 9.1% to 14.0%, respectively). @*Conclusion@#The pandemic led to a marked reduction in neonatal ED visits, particularly among those aged 7 days or younger. Increases were noted in the rates of plain radiography performed, fever, respiratory, and minor clinical symptoms, as well as median ED length of stay. EDs should prepare for efficient emergency treatments tailored to neonates.
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Endogenous stem cell-based in-situ tissue regeneration has recently gained considerable attention. In this study, we investigated the potential of a chemokine, SDF-1-mimic peptide (SMP), to promote endogenous stem cell-based in-situ wound healing. Our approach involved the development of a click crosslinked hyaluronic acid scaffold loaded with SMP (Cx-HA + SMP) to release SMP in a wound site. The Cx-HA scaffold maintained its structural integrity throughout the wound healing process and also captured endogenous stem cells. Gradual SMP release from the Cx-HA + SMP scaffold established a concentration gradient at the wound site. In animal wound experiments, Cx-HA + SMP exhibited faster wound contraction compared to Cx-HA + SDF-1. Additionally, Cx-HA + SMP resulted in approximately 1.2-1.6 times higher collagen formation compared to Cx-HA + SDF-1. SMP released from the Cx-HA + SMP scaffold promoted endogenous stem cell migration to the wound site 1.5 times more effectively than Cx-HA + SDF-1. Moreover, compared to Cx-HA + SDF-1, Cx-HA + SMP exhibited higher expression of CXCR4 and CD31, as well as the positive markers CD29 and CD44 for endogenous stem cells. The endogenous stem cells that migrated through Cx-HA + SMP regenerated into wound skin with minimal scar granule formation, similar to the normal tissue. In conclusion, SMP peptide offers greater convenience, while efficiently attracting migrating endogenous stem cells compared to the SDF protein. Our findings suggest that Cx-HA + SMP scaffolds hold promise as a strategy to enhance endogenous stem cell-based in-situ wound healing.
Subject(s)
Hyaluronic Acid , Wound Healing , Animals , Cell Movement , Stem Cells/metabolism , Chemokine CXCL12ABSTRACT
Purpose@#Height at 3 years of age, when catch-up growth based on birth history is completed, is considered a major prognostic factor for predicting short stature, underweight, and growth faltering. However, too few large-scale studies have followed and analyzed height, weight, and body mass index (BMI) changes in children whose stature was short at 3 years of age. This study followed and compared the growth parameters (height, weight, and BMI) of children with short stature at 3 years of age and children with nonshort stature at 3 years of age for 6 years after birth using nationwide, population-based data. @*Methods@#We retrospectively analyzed physical measurement data from the National Health Screening Program for Infants and Children for people born in 2011–2014 in Korea and followed to 2020. The data were provided by the National Health Insurance Service’s customized data service. Growth parameters were compared using chi-square tests, Student t-tests, analyses of variance, and linear regressions. @*Results@#Among 210,902 enrolled participants, 759 (0.4%) and 210,143 (99.6%) were in the short stature at 3 years group and the nonshort stature at 3 years group, respectively. In both sexes, height, weight, and BMI for 6 years after birth were significantly higher in the nonshort stature at 3 years group than in the short stature at 3 years group (P<0.0001). The BMI rebound was observed later than the standard period in the short stature at 3 years group. @*Conclusion@#Early intervention and close follow-up are necessary to prevent persistent short stature and growth faltering in children with short stature at 3 years of age.
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Background@#The improvement in the survival rate of preterm infants has paradoxically raised the risk of morbidities in childhood. Our objectives were to assess the medical utilization and costs in preterm infants following discharge from the neonatal intensive care unit in the first 6 years of life. @*Methods@#We conducted a population-based study using the National Health Information Database (2011–2017) provided by the Korean National Health Insurance Service (NHIS).A total of 361,190 children born in Korea between January 1 and December 31, 2011 were divided into four groups according to the gestational age at birth: extremely preterm (less than 28 weeks), very preterm (28–31 weeks), moderate to late preterm (32–36 weeks), and full term (37–41 weeks). The cumulative number of outpatient visits, cumulative length of hospital stay, rate of hospital and intensive care unit admissions, and cumulative medical costs for inpatients and outpatients were compared for each gestational age group. @*Results@#Earlier gestational age was significantly associated with an increased risk of the cumulative number of outpatient visits, cumulative length of hospital stay, and rate of hospital and intensive care unit admissions for the first 6 years of life. The mean cumulative inpatient and outpatient costs per child significantly decreased with increasing gestational age. When assessed based on population size, the total cumulative medical costs were highest for moderate to late preterm children. @*Conclusion@#Earlier gestational age was strongly associated with increased healthcare resource utilization and medical costs. Our findings on the potential long-term socioeconomic impact on public health are expected to aid the development of future health care policies for preterm children.
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It is unclear how severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) affects pregnant women and their fetuses or newborns. We report two infants born to mothers with coronavirus disease 2019 (COVID-19) in Korea. The first case was a healthy female baby born at 39 +3 weeks' gestation from a mother diagnosed with COVID-19. The second case was a female baby born at 38 +0 weeks' gestation. The newborn in the second case had symptoms of respiratory distress immediately after birth, and nasal continuous positive airway pressure support was applied for 8 hours. Real-time polymerase chain reaction test results for SARSCoV-2 using amniotic fluid, neonatal nasopharyngeal and oropharyngeal swabs, blood, urine, stool, and rectal swab were all negative in the 1st and 2nd days of life in both cases. Placental pathology showed acute necrotizing deciduitis and intervillous fibrin deposition with acute intervillositis. Although clinical evidence of vertical transmission was not found in our cases, with the possibility of placental inflammation, close monitoring of SARS-CoV-2 positive mothers and their newborn is required.
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Purpose@#This study aimed to construct and validate a model of the quality of working life (QWL) among cancer survivors returning to work. @*Methods@#A cross-sectional study was developed. Participants included 204 cancer survivors in the extended cancer survivor stage, 6 months after returning to work, who were treated at two tertiary hospital cancer centers. The data were analyzed with SPSS 22.0 and AMOS 20.0 for confirmatory factor analysis to assess the hypothesis fit and verify the hypothesis. @*Results@#Factors affecting cancer survivors’ quality of working liferesulted in cancer stigma and social support (explanatory power was 43.1%) and the model showed acceptable goodness of fit. In the final model, cancer stigma had a significant direct effect on social support and indirect effect on organizational health, employee health, and QWL. Additionally, social support had significant direct effect on organizational health, employee health and QWL. @*Conclusion@#Based on the results of this study, there is a need to develop strategies and effective intervention programs that can increase the support of supervisors and colleagues for improving overall quality of work life. Furthermore, the development of policies and intervention programs to reduce cancer stigma for the purpose of transforming perceptions through education and public relations which are indirect factors that affect the quality of work life, can contribute to improving the quality of work life for cancer survivors.
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Purpose@#This study aimed to construct and validate a model of the quality of working life (QWL) among cancer survivors returning to work. @*Methods@#A cross-sectional study was developed. Participants included 204 cancer survivors in the extended cancer survivor stage, 6 months after returning to work, who were treated at two tertiary hospital cancer centers. The data were analyzed with SPSS 22.0 and AMOS 20.0 for confirmatory factor analysis to assess the hypothesis fit and verify the hypothesis. @*Results@#Factors affecting cancer survivors’ quality of working liferesulted in cancer stigma and social support (explanatory power was 43.1%) and the model showed acceptable goodness of fit. In the final model, cancer stigma had a significant direct effect on social support and indirect effect on organizational health, employee health, and QWL. Additionally, social support had significant direct effect on organizational health, employee health and QWL. @*Conclusion@#Based on the results of this study, there is a need to develop strategies and effective intervention programs that can increase the support of supervisors and colleagues for improving overall quality of work life. Furthermore, the development of policies and intervention programs to reduce cancer stigma for the purpose of transforming perceptions through education and public relations which are indirect factors that affect the quality of work life, can contribute to improving the quality of work life for cancer survivors.
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Chylothorax, the accumulation of chyle in the pleural space, is a rare condition, but can lead to serious complications in neonates. Conservative therapy for chylothorax includes enteral feeding with medium-chain triglyceride-enriched diet or parenteral nutrition and administration of octreotide. Surgical management is considered in cases where there is no response to conservative therapy; however, the standardized approach to refractory neonatal chylothorax is still controversial. Chemical pleurodesis can be used when medical therapies for chylothorax fail, to avoid more invasive surgical procedures. We report an extremely preterm infant born at 26 weeks of gestation with refractory chylothorax after patent ductus arteriosus ligation. The infant was successfully treated with pleurodesis using 4% povidone-iodine, without long-term side effects.
Subject(s)
Humans , Infant , Infant, Newborn , Pregnancy , Chyle , Chylothorax , Diet , Ductus Arteriosus, Patent , Enteral Nutrition , Infant, Extremely Low Birth Weight , Infant, Extremely Premature , Infant, Premature , Ligation , Octreotide , Parenteral Nutrition , Pleurodesis , Povidone-IodineABSTRACT
PURPOSE@#The purpose of this study was to identify factors influencing the quality of working life of cancer survivors (QWL-CS) after return to the workplace.@*METHODS@#Data were collected from 154 cancer survivors from May 16 to June 23, 2018. Participants were selected as candidates from two different hospitals in the metropolitan area and snowball sampling was used in parallel. The data were analyzed by SPSS 21.0 using descriptive statistics, t-test, ANOVA, Pearson's correlation coefficient, and stepwise multiple linear regression.@*RESULTS@#Mean score of QWL-CS was 4.39±0.59. QWL-CS was negatively correlated with fatigue, and job stress: however, it was positively correlated with workplace spirituality. The factor that had the greatest influence on the QWL-CS was job stress (β=−.36, p < .001), followed by fatigue (β=−.35, p < .001), workplace spirituality (β=.35, p < .001), number of currently cancer treatment (β=−.15, p=.009), and number of children (β=.12, p=.031). The explanatory power of models was 54%.@*CONCLUSION@#Effective and practical intervention programs for increasing the quality of working life are required to be provided to cancer survivors after return to the workplace in accordance with job stress, fatigue, workplace spirituality, and general characteristics of cancer survivors such as number of currently cancer treatments and number of children.
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PURPOSE: The purpose of this study was to identify factors influencing the quality of working life of cancer survivors (QWL-CS) after return to the workplace. METHODS: Data were collected from 154 cancer survivors from May 16 to June 23, 2018. Participants were selected as candidates from two different hospitals in the metropolitan area and snowball sampling was used in parallel. The data were analyzed by SPSS 21.0 using descriptive statistics, t-test, ANOVA, Pearson's correlation coefficient, and stepwise multiple linear regression. RESULTS: Mean score of QWL-CS was 4.39±0.59. QWL-CS was negatively correlated with fatigue, and job stress: however, it was positively correlated with workplace spirituality. The factor that had the greatest influence on the QWL-CS was job stress (β=−.36, p < .001), followed by fatigue (β=−.35, p < .001), workplace spirituality (β=.35, p < .001), number of currently cancer treatment (β=−.15, p=.009), and number of children (β=.12, p=.031). The explanatory power of models was 54%. CONCLUSION: Effective and practical intervention programs for increasing the quality of working life are required to be provided to cancer survivors after return to the workplace in accordance with job stress, fatigue, workplace spirituality, and general characteristics of cancer survivors such as number of currently cancer treatments and number of children.
Subject(s)
Child , Humans , Fatigue , Linear Models , Spirituality , SurvivorsABSTRACT
PURPOSE: Nursing workplace spirituality (NWS) has received attention as a new and meaningful subject for nursing to consider, but little is known about the relation of NWS to nursing. The purpose of this study was to identify the effect of NWS on job satisfaction, burnout and turnover intention. METHODS: Participants were 145 clinical nurses, who had worked for over 6 months in one of four general hospitals in B city. Data were collected using self-reported questionnaires and analyzed using descriptive statistics, independent t-test, ANOVA, Pearson coefficient and hierarchical multiple regression. RESULTS: In the second hierarchy controlling general characteristics, significant predictors of job satisfaction were burnout and NWS, which explained 45.0% of the variance. NWS had more influence on job satisfaction than burn out, and the model was suitable. NWS showed no statistically significant effect on burnout and turnover intention, when general characteristics and job related factors were controlled. CONCLUSION: Findings indicate that nursing workplace spirituality has a positive influence on job satisfaction, but no direct influence on burnout or turnover intention, which may indicate an indirect influence. Nurse managers need to develop the NWS enhancement program and provide them to nurse to improve job satisfaction.
Subject(s)
Humans , Burns , Hospitals, General , Intention , Job Satisfaction , Nurse Administrators , Nursing , SpiritualityABSTRACT
An interpoly-stacked dielectric film with a SiO2/Si3N4/SiO2/Si (ONO) structure was prepared via the atomic-layer deposition method. The multilayer structure of the ONO film with triple interfaces was investigated via medium-energy ion scattering (MEIS). A few defects in the interface layer of the ONO structure were detected. From the X-ray photoelectron spectroscopy (XPS) results, it was presumed that the interface layer with defects in the MEIS result is due to the formation of an oxynitride layer on the unstable and rougher Si3N4 layer via. By measuring the I-V characteristics, the leakage current density and breakdown field of the ONO film were determined to be 3.4 x 10(-9) A/cm2 and 10.86 MV/cm, respectively. By estimation the C-V curve, the flat band (V(FB)) of the ONO film shifted to a negative voltage (-1.14 V), the dielectric constant (K(ONO)) of the ONO film was 5.79, and the effective interface-trapped charge density of the ONO film was about 4.96 x 10(11)/cm2.
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OBJECTIVE: This study examined the effects of exogenous nitric oxide (NO) on human pulp cells and the involvement of cyclic 3',5'-monophosphate (cGMP) in pulpal protection induced by heme oxygenase-1 (HO-1) against NO-induced cytotoxicity. STUDY DESIGN: This study investigated cytotoxicity and HO-1 induction in pulp cells induced by the NO donor S-nitroso-N-acetyl-D,L-penicillamine (SNAP), by using Western blotting and a cell viability assay. It also investigated whether HO-1 contributes to the cytoprotective effect against the cytotoxicity caused by NO and the relationship between HO-1 and cGMP in the signaling pathway. RESULTS: S-nitroso-N-acetyl-D,L-penicillamine decreased cell viability, but increased HO-1 expression in a concentration- and time-dependent manner in human pulp cells. NO-induced cytotoxicity was inhibited in the presence of hemin (inducer of HO-1), whereas it was enhanced in the presence of zinc protoporphyrin IX (ZnPP IX, HO-1 inhibitor); therefore, the NO-induced cytotoxicity was correlated with HO-1 expression. Pretreatment with a membrane-permeable cGMP analog, 8-bromo-cGMP, restored cell death and enhanced the HO-1 protein expression induced by SNAP. By contrast, 1 mM SNAP inhibited guanylate cyclase in pulp cells pretreated with 1H-[1,2,4]oxadiazole[4,3-alpha]quinoxalin-1-one (ODQ), resulting in marked cytotoxicity. CONCLUSION: These findings of a link between HO-1, regulated via the cGMP system and NO-induced cytotoxicity in human pulp cells, suggest a protective role for HO-1 in pulpal inflammation.