• Pediatric Infection and Vaccine
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• v.29 no.3
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• pp.147-154
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• 2022

The clinical severity of coronavirus disease 2019 (COVID-19) in children is usually mild. Most of the affected patients completely recovered from COVID-19 before being released from approximately 7-day quarantine. However, children with comorbidities are at risk of more severe disease and adverse outcomes. We report three cases of COVID-19-affected adolescents with underlying chronic respiratory difficulty due to neurologic diseases who showed sudden clinical aggravations at the time of discharge, even after full clinical improvement. Patient 1 is a 17-year-old boy with Ullrich congenital muscular dystrophy who had cardiopulmonary arrest 9 days after the initial COVID-19 symptoms. Patient 2 is a 17-year-old girl with intracerebral hemorrhage with infarction in bed-ridden status who had cardiopulmonary arrest 11 days after the initial symptoms. Patient 3 is a 12-year-old boy with intraventricular hemorrhage with hydrocephalus in bed-ridden status who showed multiorgan failure 10 days after the initial symptoms. Remdesivir, dexamethasone, and empirical antibiotics were administered with mechanical ventilation and intensive unit care. Among the three patients, two (patients 1 and 3) were alive, and one (patient 2) expired. Clinicians caring for adolescents with chronic neurologic and/or pulmonary disease should keep in mind that these patients could have sudden deterioration after recovery from the acute phase of COVID-19 around or after the time of discharge.

• Journal of Cardiovascular Imaging
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• v.31 no.3
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• pp.125-132
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• 2023

BACKGROUND: There is limited data on the residual echocardiographic findings including strain analysis among post-coronavirus disease (COVID) patients. The aim of our study is to prospectively phenotype post-COVID patients. METHODS: All patients discharged following acute COVID infection were systematically followed in the post-COVID-19 Recovery Clinic at Vancouver General Hospital and St. Paul's Hospital. At 4-18 weeks post diagnosis, patients underwent comprehensive echocardiographic assessment. Left ventricular ejection fraction (LVEF) was assessed by 3D, 2D Biplane Simpson's, or visual estimate. LV global longitudinal strain (GLS) was measured using a vendor-independent 2D speckle-tracking software (TomTec). RESULTS: A total of 127 patients (53% female, mean age 58 years) were included in our analyses. At baseline, cardiac conditions were present in 58% of the patients (15% coronary artery disease, 4% heart failure, 44% hypertension, 10% atrial fibrillation) while the remainder were free of cardiac conditions. COVID-19 serious complications were present in 79% of the patients (76% pneumonia, 37% intensive care unit admission, 21% intubation, 1% myocarditis). Normal LVEF was seen in 96% of the cohort and 97% had normal right ventricular systolic function. A high proportion (53%) had abnormal LV GLS defined as < 18%. Average LV GLS of septal and inferior segments were lower compared to that of other segments. Among patients without pre-existing cardiac conditions, LVEF was abnormal in only 1.9%, but LV GLS was abnormal in 46% of the patients. CONCLUSIONS: Most post-COVID patients had normal LVEF at 4-18 weeks post diagnosis, but over half had abnormal LV GLS.

• IMMUNE NETWORK
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• v.23 no.4
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• pp.33.1-33.13
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• 2023

Vaccination against severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has been acknowledged as an effective mean of preventing infection and hospitalization. However, the emergence of highly transmissible SARS-CoV-2 variants of concern (VOCs) has led to substantial increase in infections among children and adolescents. Vaccine-induced immunity and longevity have not been well defined in this population. Therefore, we aimed to analyze humoral and cellular immune responses against ancestral and SARS-CoV-2 variants after two shots of the BNT162b2 vaccine in healthy adolescents. Although vaccination induced a robust increase of spike-specific binding Abs and neutralizing Abs against the ancestral and SARS-CoV-2 variants, the neutralizing activity against the Omicron variant was significantly low. On the contrary, vaccine-induced memory CD4⁺ T cells exhibited substantial responses against both ancestral and Omicron spike proteins. Notably, CD4⁺ T cell responses against both ancestral and Omicron strains were preserved at 3 months after two shots of the BNT162b2 vaccine without waning. Polyfunctionality of vaccine-induced memory T cells was also preserved in response to Omicron spike protein. The present findings characterize the protective immunity of vaccination for adolescents in the era of continuous emergence of variants/subvariants.

• Pediatric Infection and Vaccine
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• v.31 no.1
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• pp.83-93
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• 2024

Purpose: Since the start of the coronavirus disease 2019 (COVID-19) pandemic, various variants of concern have emerged. We divided the representative COVID-19 mutation period into four waves and aimed to analyze the clinical and laboratory features of children with COVID-19 from pre-mutation wave to the middle of omicron wave. Methods: We retrospectively reviewed the medical records of hospitalized patients aged ≤19 years with laboratory confirmed COVID-19. Clinical and laboratory findings during pre-mutation (February 1st 2020 to September 30th 2020), alpha/beta (October 1st 2020 to May 31st 2021), delta (June 1st 2021 to October 31st 2021), and omicron (November 1st 2021 to May 31st 2022) waves were compared. Results: Among total 827 patients, 163 (19.7%) were asymptomatic, and the frequency of fever and cough was 320 (38.7%) and 399 (48.2%), respectively. The proportion of fever ≥38.5℃ was observed to be high during the omicron wave in the age group under 12 years. Lymphopenia was observed highly in the omicron wave in the age group under 12 years, and in the delta wave in the age group older than 12 years. Neutropenia was highly observed in the delta wave in the 0-4 years age group. Conclusions: There were distinct characteristics during all epidemic waves of COVID-19. Children with COVID-19 had more frequent persistent fever during delta wave and children during the omicron wave had a higher peak fever.

• Journal of the Korean Society for information Management
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• v.39 no.1
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• pp.331-350
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• 2022

This study aims to understand topics of incivility related to COVID-19 from analyzing Twitter posts including COVID-19-related hate speech. To achieve the goal, a total of 63,802 tweets that were created between December 1st, 2019, and August 31st, 2021, covering three targets of hate speech including region and public facilities, groups of people, and religion were analyzed. Frequency analysis, dynamic topic modeling, and keyword co-occurrence network analysis were used to explore topics and keywords. 1) Results of frequency analysis revealed that hate against regions and public facilities showed a relatively increasing trend while hate against specific groups of people and religion showed a relatively decreasing trend. 2) Results of dynamic topic modeling analysis showed keywords of each of the three targets of hate speech. Keywords of the region and public facilities included "Daegu, Gyeongbuk local hate", "interregional hate", and "public facility hate"; groups of people included "China hate", "virus spreaders", and "outdoor activity sanctions"; and religion included "Shincheonji", "Christianity", "religious infection", "refusal of quarantine", and "places visited by confirmed cases". 3) Similarly, results of keyword co-occurrence network analysis revealed keywords of three targets: region and public facilities (Corona, Daegu, confirmed cases, Shincheonji, Gyeongbuk, region); specific groups of people (Coronavirus, Wuhan pneumonia, Wuhan, China, Chinese, People, Entry, Banned); and religion (Corona, Church, Daegu, confirmed cases, infection). This study attempted to grasp the public's anti-citizenship public opinion related to COVID-19 by identifying domestic COVID-19 hate targets and keywords using social media. In particular, it is meaningful to grasp public opinion on incivility topics and hate emotions expressed on social media using data mining techniques for hate-related to COVID-19, which has not been attempted in previous studies. In addition, the results of this study suggest practical implications in that they can be based on basic data for contributing to the establishment of systems and policies for cultural communication measures in preparation for the post-COVID-19 era.

• Pediatric Infection and Vaccine
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• v.31 no.1
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• pp.102-112
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• 2024

Purpose: To identify the epidemiological characteristics and risk factors of coronavirus disease 19 (COVID-19) outbreaks depending on the type of educational facility by analyzing the COVID-19 cluster associated with educational facilities. Methods: This study is based on epidemiological investigation of COVID-19 cluster in Gangwon-do, Korea from December 10, 2020 to September 23, 2021 reported to the Korea Disease Control and Prevention Agency's Integrated Disease and Health Management System. Four hundred seven patients in 19 facilities, classified as cluster related to educational facilities, were the study population. The result of preliminary epidemiology survey report, in-depth epidemiological survey by phone and the result of risk assessment derived from the field epidemiology investigation were retrospectively analyzed to evaluate infectivity and the characteristics of the risk factors. Results: There were total of 407 confirmed patients related to 19 educational facilities, with 204 students under the age of 19 (50.1%). One hundred fifty-five preceding spreaders were from families (38.1%) and 125 were the teachers (30.7%). The place exposed to confirmed patients was the highest with 139 people (34.2%) at home. Conclusions: It was confirmed that the cause of the occurrence of clusters related to educational facilities was higher due to family transmission than the risk of facilities in schools. Nevertheless, continuous efforts should be made to control infection in educational facilities, and that teachers' implementation of principles for prevention of COVID-19 personal hygiene in their daily lives should be strengthened.

• Pediatric Infection and Vaccine
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• v.31 no.1
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• pp.113-121
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• 2024

Purpose: In response to the surge in coronavirus disease 2019 (COVID-19) omicron variant cases, we have implemented preemptive testing for preschool and school. The purpose is to quickly detect COVID-19 cases using a rapid antigen test (RAT) kit so that normal school activities can continue. Methods: The results entered in The Healthcare Self-Test App were merged with the information on the status of confirmed cases in the COVID-19 Information Management System by Korea Disease Control and Prevention Agency (KDCA) for preschool and school of students and staffs March 2 to May 1, 2022 to analyze the RAT positive rate and positive predictive value of RAT. Results: In preschool and school 19,458,575 people were tested, weekly RAT positive rate ranged from 1.10% to 5.90%, positive predictive value of RAT ranged from 86.42% to 93.18%. By status, RAT positive rate ranged from 1.13% to 6.16% for students, 0.99% to 3.93% for staffs, positive predictive value of RAT ranged from 87.19% to 94.03% for students, 77.55% to 83.10% for staffs. RAT positive rate by symptoms ranged from 76.32% to 88.02% for those with symptoms and 0.34% to 1.11% for those without symptoms. As a result of preschool and school RAT, 943,342 confirmed cases were preemptively detected, before infection spread in preschool and school. Conclusions: RAT was well utilized to detect confirmed cases at an early stage, reducing the risk of transmission to minimize the educational gap in preschool and school. To compensate for the limitations of RAT, further research should continue to reevaluate the performance of RAT as new strains of viruses continue to emerge. We will have to come up with various ways to utilize it, such as performing periodic and repeated RAT and parallel polymerase chain reaction.

• Clinical and Experimental Pediatrics
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• v.53 no.3
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• pp.373-379
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• 2010

Purpose : This study was performed to investigate the epidemiologic and clinical features of 13 respiratory viruses in children with acute lower respiratory tract infections (ALRIs). Methods : Nasopharyngeal aspirates were prospectively obtained from 325 children aged 15 years or less from May 2008 to April 2009 and were tested for the presence of 13 respiratory viruses by multiplex real-time-polymerase chain reaction (RT-PCR). Results : Viruses were identified in 270 children (83.1%). Co-infections with ${\geq}2$ viruses were observed in 71 patients (26.3 %). Respiratory syncytial virus (RSV) was the most common virus detected (33.2%), followed by human rhinovirus (hRV) (19.1%), influenza virus (Flu A) (16.9%), human metapneumovirus (hMPV) (15.4%), parainfluenza viruses (PIVs) (8.3%), human bocavirus (hBoV) (8.0%), adenovirus (ADV) (5.8%), and human coronavirus (hCoV) (2.2%). Clinical diagnoses of viral ALRIs were bronchiolitis (37.5%), pneumonia (34.5%), asthma exacerbation (20.9%), and croup (7.1%). Clinical diagnoses of viral bronchiolitis and pneumonia were frequently demonstrated in patients who tested positive for RSV, hRV, hMPV, or Flu A. Flu A and hRV were most commonly identified in children older than 3 years and were the 2 leading causes of asthma exacerbation. hRV C was detected in 14 (4.3%) children, who were significantly older than those infected with hRV A ($mean{\pm}SD$, $4.1{\pm}3.5$ years vs. $1.7{\pm}2.3$ years; P =0.009). hBoV was usually detected in young children ($2.3{\pm}3.4$ years) with bronchiolitis and pneumonia. Conclusion : This study described the features of ALRI associated with 13 respiratory viruses in Korean children. Additional investigations are required to define the roles of newly identified viruses in children with ALRIs.

• Journal of the Society of Disaster Information
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• v.17 no.3
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• pp.640-654
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• 2021

Purpose: Normal education operation was difficult in the national disaster situation of Coronavirus Infection-19. Non-face-to-face education can be an alternative to face to face education, but it is not easy to provide the same level of education. In this study, the professor of disaster management field will identify problems that can occur in the overall operation and progress of non-face-to-face education and seek ways to improve non-face-to-face education. Method: Non-face-to-face real-time education was largely categorized into pre-class, in-class, post-class, and evaluation, and case studies were conducted through the professor's case studies. Result&Conclusion: The results of the survey are as follows: First, pre-class, it was worth considering providing a non-face-to-face educational place for professors, and the need for prior education on non-face-to-face educational equipment and systems was required. In addition, it seems necessary to make sure that education is operated smoothly by giving enough notice on classes and to make efforts to develop non-face-to-face education programs for practical class. Second, communication between professor and learner, and among learners can be an important factor in non-face-to-face mid classes. To this end, it is necessary to actively utilize debate-type classes to lead learners to participate in education and enhance the educational effect through constant interaction. Third, non-face-to-face post classes, policies on the protection of privacy due to video records should be prepared to protect the privacy of professors in advance, and copyright infringement on educational materials should also be considered. In addition, it is necessary to devise various methods for fair and objective evaluation. According to the results of the interview, in the contents, which are components of non-face-to-face education, non-face-to-face education requires detailed plans on the number of students, contents, and curriculum suitable for non-face-to-face education from the design of the education. In the system, it is necessary to give the professor enough time to fully learn and familiarize with the function of the program through pre-education on the program before the professor gives non-face-to-face classes, and to operate the helpdesk, which can thoroughly check the pre-examination before non-face-to-face education and quickly resolve the problem in case of a problem.

• Journal of the Society of Disaster Information
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• v.17 no.4
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• pp.722-732
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• 2021

Purpose: Due to the coronavirus infection-19 (COVID) pendemics, all educational institutions were required to provide full non-face-to-face real-time education, and fire officials were required to provide fire-fighting education by applying non-face-to-face education. In this difficult situation, the National Fire Service Academy tries to find the direction of the non-face-to-face real-time education and suggest ways to improve it through a survey of the status of non-face-to-face real-time education conducted by the NFSA to fire officials. Method: A survey was conducted on fire officials under the theme of "Consciousness Survey for Improving the Quality and Specialization of Non-face-to-face Real-Time Remote Education" and an in-depth analysis was conducted based on the results. Result & Conclusion: First, professors or educational operators shall actively utilize remote education programs suitable for educational characteristics by utilizing various programs. Second, a dedicated notebook for non-face-to-face training should be provided to provide an educational environment where all learners can participate in the training without difficulty. Third, in the case of education and training that requires the use of equipment due to the nature of fire officials' education and training, it is necessary to consider it as a non-face-to-face training place by arranging educational equipment at each fire station. Fourth, it is hard to expect a satisfactory educational effect to cope with practical education with theoretical education. Therefore, facilities and programs that enable non-face-to-face real-time hands-on training should be developed. It is worth considering the proper combination of face-to-face education while maintaining the social distance as much as possible until such non-face-to-face training is possible. Fifth, non-face-to-face education is considered to have high eye fatigue due to the light and electromagnetic waves of the computer screen, and as time goes by, the concentration level decreases. Therefore, it is necessary to form an education time to reduce the eye fatigue of learners and increase concentration through proper class and rest time. Finally, professors should operate a learner participation-oriented education that allows professors and learners to interact rather than one-sided knowledge transfer education. In addition, technical problems of non-face-to-face remote education should be thoroughly prepared through preliminary system checks to ensure that education is not disrupted.