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Objectives: This study was conducted to assess the efficacy of nirmatrelvir/ritonavir treatment in patients with coronavirus disease 2019 (COVID-19), particularly those aged 60 years and older. Using real-world data, the period during which the BN.1 Omicron variant was dominant was compared to the period dominated by the BA.5 variant. Methods: In this retrospective cohort study, data were collected regarding 2,665,281 patients infected with severe acute respiratory syndrome coronavirus 2 between July 24, 2022, and March 31, 2023. Propensity score matching was utilized to match patients who received nirmatrelvir/ritonavir in a 1:4 ratio between BN.1 and BA.5 variant groups. Multivariable logistic regression analysis was employed to assess the effects of nirmatrelvir/ritonavir within these groups. Results: Compared to the prior period, the efficacy of nirmatrelvir/ritonavir did not significantly differ during the interval of Omicron BN.1 variant dominance in the Republic of Korea. Among patients treated with nirmatrelvir/ritonavir, a significantly lower risk of mortality was observed in the BN.1 group (odds ratio [OR], 0.698; 95% confidence interval [CI], 0.557-0.875) compared to the BA.5 group. However, this treatment did not significantly reduce the risk of severe or critical illness, including death, for those in the BN.1 group (OR, 0.856; 95% CI, 0.728-1.007). Conclusion: Nirmatrelvir/ritonavir has maintained its effectiveness against COVID-19, even with the emergence of the BN.1 Omicron subvariant. Consequently, we strongly recommend the administration of nirmatrelvir/ritonavir to patients exhibiting COVID-19-related symptoms, irrespective of the dominant Omicron variant or their vaccination status, to mitigate disease severity and decrease the risk of mortality. [ABSTRACT FROM AUTHOR]

Objectives: This study aimed to classify coronavirus disease 2019 (COVID-19)-related deaths according to whether COVID-19 was listed as the cause of death, and to investigate the differences in demographic characteristics and risk factors for COVID-19 death classifications. Methods: A total of 5,625 deaths in South Korea among patients with confirmed COVID-19 from January 20, 2020 to December 31, 2021 were selected. Excluding false reports and unnatural deaths, 5,597 deaths were analyzed. Based on death report data, deaths were classified according to whether the cause of death was listed as COVID-19 (CD) or not (NCD). The epidemiological characteristics and causes of deaths were investigated using descriptive, univariate, and multivariate statistical analyses. Odds ratios (ORs) and 95% confidence intervals (CIs) were calculated to analyze the risk factors. Results: The case fatality ratio was 0.89% and increased with age. Additionally, 96.4% of the subjects had an underlying disease, and 53.4% died in winter. The proportion of NCDs was 9.3%, of whom 19.1% died at home and 39.0% were confirmed to have COVID-19 after death. Malignant neoplasms (102/416 vs. 637/4,442; OR, 1.71; 95% CI, 1.36-2.16; p<0.001) were significantly associated with NCD. Conclusion: This is the first study to analyze risk factors by cause of death using COVID-19 death report data in South Korea. These results are expected to be used as evidence for establishing a death monitoring system that can collect timely information in a new infectious disease pandemic. [ABSTRACT FROM AUTHOR]

The purpose of this study was to examine the impacts of AI-integrated MALL on Korean students' TOEIC preparation, by comparing with AI-integrated CALL. A total of 496 freshmen students participated in this study. They were arbitrarily assigned to AI CALL (n = 190), AI MALL (n = 164), and the control (n = 132) groups. During a 2021 academic semester, the two experimental groups studied TOEIC through computers or mobile phones, integrated with AI technology. The control group was taught by a human teacher, in a traditional classroom setting. Before and after the treatment, TOEIC listening and reading tests were administered. Paired samples t-tests and one-way ANOVAs, were used to analyze collected data. Findings show that all groups significantly increased listening and reading test scores. Group comparison results show that the AI CALL group outperformed the control group for both tests. This group also outperformed the AI MALL group for the reading test. Based on this, pedagogical implications are invaluable. [ABSTRACT FROM AUTHOR]

This study explores effects of e-book and audio-book on EFL comprehension. It was conducted at a university in Korea with 75 college students. The whole experiment lasted for five weeks in 2020. To determine effectiveness of multiple modalities, participants were assigned to three different experimental groups: e-book, audio-book, and e-audiobook (a combination of e-book and audio-book) groups. While the e-book group was provided with passages in a text format, the audio group received the same passages in an audio format. The e-audio-book group was given both text and audio formats. At the beginning and end of the treatment, pretest and posttest were administered. As expected, the e-audio-book group benefited more than the other two groups in listening comprehension. However, they showed better performance in reading comprehension than the audio-book group only. Additionally, the e-book group performed better in reading comprehension compared to the audio-book group. Based on these findings, pedagogical implications are made. [ABSTRACT FROM AUTHOR]

This study describes the epidemiological characteristics of coronavirus disease 2019 (COVID-19) based on reported cases from long-term care facilities. As of April 20th, 2020, 3 long-term care facilities in a metropolitan area of South Korea had reported cases of COVID-19. These facilities' employees were presumed to be the sources of infection. There were 2 nursing hospitals that did not report any additional cases. One nursing home had a total of 25 cases, with an attack rate of 51.4% (95% CI 35.6- 67.0), and a fatality rate of 38.9% (95% CI 20.3-61.4) among residents. The results from this study suggest that early detection and maintenance of infection control minimizes the risk of rapid transmission. [ABSTRACT FROM AUTHOR]

Purpose: To assess the effect of extracorporeal shock wave therapy (ESWT) for healthy participants with hamstring tightness. Materials and Methods: This study was performed at a university rehabilitation hospital. Twenty nine healthy adults with hamstring tightness were enrolled and randomly allocated into four groups (ESWT, stretching exercise, ESWT with stretching exercise, and control). The effects of individual treatments were compared by the finger-to-floor test and popliteal angle. Results: The ESWT group, stretching exercise group and ESWT with stretching exercise group had decreased finger-to-floor distances and right popliteal angles immediately after intervention, compared with the control group (p<0.05). At 4 weeks after completion of the interventions, finger-to-floor distances and the right popliteal angle in only the ESWT with stretching exercise group showed a significant improvement, compared with the control group (p=0.008 and 0.023). Conclusion: While ESWT and stretching both reduced hamstring tightness immediately after interventions, only ESWT with stretching exercise maintained the significantly improved relief of hamstring tightness significantly after 4 weeks. [ABSTRACT FROM AUTHOR]

The current study explores the effects of different types of voice-based chat on EFL students' negotiation of meaning according to proficiency levels. Participants included 123 Korean university students of English. They were divided into two voice-based chat groups: student-student voice-based chat and student-chatterbot voice-based chat. The experiment was administered throughout one semester, 16 weeks. Negotiation of meaning evident in the chats was coded for confirmation check, comprehension check, clarification requests, repetition, and reformulation, and was measured by counting the number of meaning negotiation moves. Important findings were as follows: Firstly, there were significant differences between the first chat and the last chat. The mean frequencies of negotiation moves at all proficiency levels positively changed over time as a result of participating in student-chatterbot voice-based chat. Particulalry, student-chatterbot voice-based chat, as compared to student-student voice-based chat, allowed students to use more negotiation strategies, and the strategies used in the chats also appeared to be different according to the students' proficiency levels. Lastly, positive perceptions of voice-based chat were observed at all proficiency levels. This study provides empirical evidence to substantiate the effects of voice-based chatterbots in oral interaction. Based on the findings, pedagogical implications are made on the effective implementation of voice-based chatterbots in EFL contexts. [ABSTRACT FROM AUTHOR]

Purpose: The aim of this study was to evaluate the effects of premedication with oral atenolol or enalapril, in combination with remifentanil under sevoflurane anesthesia, on intraoperative blood loss by achieving adequate deliberate hypotension (DH) during orthognathic surgery. Furthermore, we investigated the impact thereof on the amount of nitroglycerin (NTG) administered as an adjuvant agent. Materials and Methods: Seventy-three patients undergoing orthognathic surgery were randomly allocated into one of three groups: an angiotensin converting enzyme inhibitor group (Group A, n=24) with enalapril 10 mg, a β blocker group (Group B, n=24) with atenolol 25 mg, or a control group (Group C, n=25) with placebo. All patients were premedicated orally 1 h before the induction of anesthesia. NTG was the only adjuvant agent used to achieve DH when mean arterial blood pressure (MAP) was not controlled, despite the administration of the maximum remifentanil dose (0.3 μg kg-1min-1) with sevoflurane. Results: Seventy-two patients completed the study. Blood loss was significantly reduced in Group A, compared to Group C (adjusted p=0.045). Over the target range of MAP percentage during DH was significantly higher in Group C than in Groups A and B (adjusted p-values=0.007 and 0.006, respectively). The total amount of NTG administered was significantly less in Group A than Group C (adjusted p=0.015). Conclusion: Premedication with enalapril (10 mg) combined with remifentanil under sevoflurane anesthesia attenuated blood loss and achieved satisfactory DH during orthognathic surgery. Furthermore, the amount of NTG was reduced during the surgery. [ABSTRACT FROM AUTHOR]

Background: Few studies have investigated the roles of religiosity and spirituality in predicting treatment response among psychiatric patients with depressive disorders. Methods: In total, 232 outpatients with depressive disorders completed measurements of psychological symptoms, religiosity, and spirituality at baseline. A response was defined as Clinical Global Impression--Improvement scale (CGI-I) score of 1 or 2 at the last visit during a 6-month treatment period. Univariate analyses and logistic regression analysis were used to identify predictors of treatment response. Results: In univariate analyses, treatment response was associated with marital status, longer treatment duration, less severe baseline symptoms, higher personal importance of religion, and higher spirituality. In logistic regression analysis, subjective important considerations for religion and spirituality were significantly related with treatment response after controlling for marital status, treatment duration, and baseline symptom severity. Of these variables, spirituality remained a significant predictor in the final model. Conclusions: These findings suggest that higher spirituality may independently contribute to favorable treatment responses among depressed patients in addition to other demographic and clinical factors. [ABSTRACT FROM AUTHOR]

Purpose: We evaluated the validity of robotic surgery (RS) for pediatric choledochal cyst (CC) in comparison to open surgery (OS). Materials and Methods: From January 2009 to April 2013, clinical data from 79 consecutive pediatric patients with CC, who underwent RS (n=36) or OS (n=43) performed by a single pediatric surgeon, were analyzed retrospectively. Results: In the RS group, the age of the patients was significantly older, compared to the OS group. Operation and anesthesia times were significantly longer in the RS group than the OS group. Fluid input rates to maintain the same urine output were significantly smaller in the RS group than the OS group. The American Society of Anesthesiologists (ASA) physical status, length of postoperative hospital stay, and the incidence of surgical complications did not differ significantly between the two groups. Conclusion: Although early complications could not be avoided during the development of robotic surgical techniques, RS for pediatric CC showed results comparable to those for OS. We believe that RS may be a valid and alternative surgery for pediatric CC. After further development of robotic surgical systems and advancement of surgical techniques therewith, future prospective studies may reveal more positive results. [ABSTRACT FROM AUTHOR]

Purpose: This study was to evaluate the characteristics of selective spinal anesthesia using 1 mg of bupivacaine combined with fentanyl or sufentanil in elderly patients undergoing transurethral resection of prostate. Materials and Methods: Fifty- six patients were randomized into two groups. The Fentanyl group received 0.5% hyperbaric bupivacaine 0.2 mL+fentanyl 20 μg+5% dextrose 1.4 mL, and the Sufentanil group received 0.5% hyperbaric bupivacaine 0.2 mL+sufentanil 5 μg+5% dextrose 1.7 mL intrathecally. Intraoperative and postoperative characteristics were evaluated. Patient satisfaction was assessed postoperatively. Results: Twenty-six patients in each group completed the study. The median peak sensory block level was similar between two groups, but sensory regression time was longer in the Sufentanil group than the Fentanyl group (p=0.017). All patients were able to move themselves to the bed without any aid when they arrived at the admission room. Pain scores were lower in the Sufentanil group than the Fentanyl group at postoperative 6, 12, and 18 hours (p=0.001). Compared to the Fentanyl group, the Sufentanil group required less postoperative analgesia (p=0.023) and the time to the first analgesic request was longer (p=0.025). Twenty-four of 26 patients (92.3%) in each group showed "good" satisfaction level. Conclusion: Selective spinal anesthesia using 1 mg of bupivacaine with fentanyl or sufentanil provided appropriate sensory block level with spared motor function for transurethral resection of the prostate in elderly patients. Intrathecal sufentanil was superior to fentanyl in postoperative analgesic quality. [ABSTRACT FROM AUTHOR]

Purpose: Dexmedetomidine, a potent selective α2-adrenergic agonist, produces sedation and analgesia. This study was conducted to assess the effect of dexme-detomidine infusion on sevoflurane requirements, recovery profiles, and emergence agitation in children undergoing ambulatory surgery. Materials and Methods: Forty children undergoing ambulatory hernioplasty or orchiopexy were randomized into two groups. The dexmedetomidine group (Group D, n=20) received dexmedetomidine 1 µg/kg, followed by 0.1 µg/kg/h until the end of surgery, whereas the saline group (Group S, n=20) received volume-matched normal saline. Sevolurane was used for induction and maintenance of anesthesia and caudal block was performed in all children. End-tidal sevolurane concentration (ET-sevo), the incidence of emergence agitation, pain scores, and sedation scores were recorded. Hemodynamic changes and other adverse effects were assessed in the perioperative period. Results: ET-sevo of Group D was significantly reduced in 23.8-67% compared to Group S during surgery. The incidence of emergence agitation was lower in Group D than in Group S (5% vs. 55%, p=0.001). Postoperative pain was comparable, and discharge time was not different between the groups. Mean arterial pressure and heart rate were significantly lower in Group D during surgery. Conclusion: Intraoperative infusion of dexmedetomidine reduced sevoflurane requirements and decreased emergence agitation without delaying discharge in children undergoing ambulatory surgery. However, caution should be taken in regard to bradycardia and hypotension. [ABSTRACT FROM AUTHOR]

Model scratches of the size found in hard disk drives are produced under controlled, conditions at a series of applied loads on both longitudinal magnetic recording (LMR) media and perpendicular magnetic recording (PMR) media using a diamond tip. The scratches are created at low speed, eliminating thermal considerations from the interpretation of the media response. Nanoindentations are produced as well. The scratches and indentations are characterized by atomic force microscope (AFM), magnetic force microscope (MFM), and also by the same magnetic reader and writer used in an integrated hard disk drive (HDD). A comparison of the response of PMR and LMR media shows the PMR media to have larger scratches and greater magnetic signal degradation than LMR media for a given scratch load. The extent of magnetic damage, as measured by MFM, is greater than the extent of surface mechanical damage, as measured by AFM. Analysis of scratches using the HDD reveals that the magnetic damage is irreversible and permanent damage in magnetic layer, which is confirmed by cross section transmission electron microscope image. The experiments reveal the mechanism for magnetic scratch, erasure in the absence of thermal effects. This understanding is expected to lead to improved designs for mechanical scratch robustness of next-generation PMR media. [ABSTRACT FROM AUTHOR]

A patient received combined spinal-epidural anesthesia for a scheduled total knee arthroplasty. After an injection of spinal anesthetic and ephedrine due to a decrease in blood pressure, the patient developed a severe headache. The patient did not respond to verbal command at the completion of the operation. A brain CT scan revealed massive subarachnoid and intraventricular hemorrhages, and a CT angiogram showed a ruptured aneurysm. Severe headaches should not be overlooked in an uncontrolled hypertensive patient during spinal anesthesia because it may imply an intracranial and intraventricular hemorrhage due to the rupture of a hidden aneurysm. [ABSTRACT FROM AUTHOR]