Gwangju Health University

Human adenoviruses (HAdVs) are important respiratory pathogens that circulate globally and frequently cause outbreaks, particularly among pediatric populations. Despite their clinical relevance, recent data on genome-wide evolution and recombination of circulating HAdVs in Korea remain limited. In this study, we characterized the epidemiological dynamics and genomic evolution of HAdVs detected in Gwangju, South Korea, between 2023 and 2025. Molecular epidemiological surveillance of respiratory samples was conducted, followed by phylogenetic and whole-genome sequencing analyses. Adenovirus positivity increased sharply during an outbreak from August to October 2023, with pediatric cases predominating. Phylogenetic analysis identified eight genotypes from species B and C, with genotype B114 as the principal outbreak strain. Whole-genome sequencing revealed recombination events in both species, involving antigenic, replication, and packaging regions. These findings indicate that circulating HAdVs undergo continuous genome-wide recombination, resulting in genotype-specific outbreaks that are not fully captured by capsid-based classification alone. Our study highlights the importance of whole-genome approaches for understanding adenovirus evolution and provides insights into the genomic diversity underlying recent outbreaks.

Abstract Background During the COVID-19 pandemic, distinguishing bloodstream infections (BSI) from viral illness was challenging, often leading to excessive culture use and increased diagnostic burden in referral hospitals. We aimed to identify clinical predictors of BSI in hospitalized COVID-19 patients to guide targeted diagnostics and optimize resource allocation.Figure 1.Temporal trends in COVID-19 cases, blood culture testing, and BSI during the pandemic in South Korea.(A) Monthly number of confirmed COVID-19 cases in South Korea from January 2020 to August 2023, with major outbreak periods (Delta and Omicron) indicated. The inset shows the early pandemic phase.(B) Monthly number of patients who underwent blood culture within 14 days of COVID-19 diagnosis (green), and those with non-contaminant bloodstream infections (red). Both blood culture utilization and BSI detection increased during outbreak peaks, reflecting the diagnostic burden associated with pandemic surges.Figure 2.Kaplan–Meier survival analysis by blood culture result within 15 days of COVID-19 diagnosisKaplan–Meier curves comparing 15-day survival between patients with non-contaminant bloodstream infection (red) and those with negative or contaminated cultures (blue) following COVID-19 diagnosis. Survival was significantly lower in the BSI group (P<0.001). Methods We conducted a retrospective cohort study across three hospitals in South Korea (Jan 2020 - Dec 2023). Patients with confirmed COVID-19 who underwent blood culture within 15 days were included. BSI was defined as isolation of non-commensal organisms or commensals from ≥2 concurrent culture sets. Data were extracted from electronic records. The primary outcome was 15-day mortality. Independent predictors of BSI were identified via multivariate logistic regression. Results A total of 3,082 hospitalized COVID-19 patients (median age 67 years, 59.1% male) underwent blood culture within 15 days of diagnosis, and 304 (9.9%) had BSI. The number of blood cultures and BSI incidence increased during pandemic surges. BSI was associated with higher 15-day mortality (21.4% vs. 5.0%, p< 0.001). During the study period, a total of 5,095 blood cultures were performed, of which 501 (9.8%) yielded non-contaminant pathogens. Most frequently identified pathogens included Staphylococcus aureus (14.4%), Escherichia coli (14.2%), Klebsiella pneumoniae (12.8%), and Candida species (8.2%). In multivariate logistic regression, independent predictors of BSI included age ≥65 years, diabetes, fever ≥38.1°C, systolic BP ≤90 mmHg, procalcitonin ≥1 ng/mL, CRP ≥6 mg/dL, creatinine ≥1.0 mg/dL, and culture ≥2 days after COVID-19 diagnosis. Conclusion Identifying clinical predictors for BSI in COVID-19 can guide targeted blood culture practices, improving diagnostic stewardship. Risk-based testing strategies may reduce unnecessary cultures and support efficient resource use in future pandemics. Disclosures All Authors: No reported disclosures

Environmental leadership and policy negotiation demand the capacity to process emotions, build consensus and negotiate complex stakeholder dynamics. Building on the framework of the Emotional Intelligence (EI), this study analyzes the influence of EI on leadership effectiveness in environmental governance within the context of stakeholder engagement, conflict resolution and policy success. Utilizing a mixed-methods multi-phased approach, the study combines survey analysis, case studies, regression modeling, and structural equation modeling (SEM) to determine the relationship between EI competencies and leadership outcomes. This is particularly insightful for philanthropy and development practitioners, not only because leaders with high EI perform better, especially in stakeholder trust-building, decision-making and policy adoption, but also because these leaders reach better governance outcomes. For EI dimensions Social Skills was the most significant predictor of leadership effectiveness followed closely by Empathy and Emotional Regulation. The article showed that high EI competencies were linked with fewer delays, higher stakeholder satisfaction and better implementation of policies. This study provides practical insight into the value of EI development in leadership training programs to improve collaboration and resilience within environmental decision-making. Additionally, it suggests the need for more research on the long-term effects of EI training, variability of leadership effectiveness across cultures and EI's intersection with emerging technologies in governance. Through its endorsement of the need for emotionally intelligent leadership, this study extends comprehension of the ways in which interpersonal skills affect sustainable environmental policy outcomes. This is particularly insightful for philanthropy and development practitioners, not only because leaders with high EI perform better, especially in stakeholder trust-building, decision-making and policy adoption, but also because these leaders reach better governance outcomes. For EI dimensions Social Skills was the most significant predictor of leadership effectiveness followed closely by Empathy and Emotional Regulation. The article showed that high EI competencies were linked with fewer delays, higher stakeholder satisfaction and better implementation of policies. This study provides practical insight into the value of EI development in leadership training programs to improve collaboration and resilience within environmental decision-making. Additionally, it suggests the need for more research on the long-term effects of EI training, variability of leadership effectiveness across cultures and EI's intersection with emerging technologies in governance. Through its endorsement of the need for emotionally intelligent leadership, this study extends comprehension of the ways in which interpersonal skills affect sustainable environmental policy outcomes.

Wanjin Shin, Geumcheol Shin, Gyeonghee Ju, Hyunhee Park, Jeonghee Jeong, Juhyeok Hong, Miae Im, Sunyoung Song, Yeonhee Kim, Jongshin Park, Hyunjoong Kim. PTRS 2025;14:389-400. https://doi.org/10.14474/ptrs.2025.14.3.389

This study investigated the effects of gamma-linolenic acid (GLA) on osteogenic differentiation of bone marrow stem cells (BMSCs) in monolayer and 3D spheroid cultures.BMSCs were isolated from the femurs and tibias of 6-week-old male C57BL/6 mice and cultured in 2D monolayer and 3D spheroid conditions.Cells at various concentrations were cultured to form spheroids, and their morphology was analyzed using phase contrast microscopy over time.After 7 days of osteogenic induction, extracellular matrix mineralization was assessed using Alizarin Red staining.Significantly greater mineralization was observed in spheroid cultures than in monolayer cultures, as indicated by strong positive staining and higher absorbance values (P < 0.01).Live/dead assays performed after 48 hours of culture showed no significant difference in cell viability between GLAtreated and control groups.Quantitative real-time PCR analysis demonstrated that the expression levels of key osteogenic markers (alkaline phosphatase, ALP; osteocalcin, OCN; osteopontin, OPN; osterix, OSX; and runt-related transcription factor 2, RUNX2) were significantly higher in 3D spheroid cultures than in monolayer cultures.Additionally, expression of these markers was stimulated by GLA treatment.These findings suggest that 3D spheroid cultures offer a more supportive environment for the osteogenic differentiation of BMSCs compared to monolayer cultures.Furthermore, GLA markedly enhances this differentiation, highlighting its potential as a therapeutic agent in bone tissue engineering and regenerative medicine.

The coronavirus disease pandemic has underscored the importance of surveillance systems for timely response to public health threats. Genomic surveillance of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is essential for tracking the emergence and dissemination of variants of the virus. However, as clinical surveillance is conducted primarily among symptomatic individuals and their contacts, the ability to detect asymptomatic infections and undiagnosed cases is limited. Accordingly, in this study, we evaluated the utility of wastewater-based surveillance as a complementary approach to traditional clinical monitoring methods. From epidemiological weeks 1–21 in 2024, samples were collected from three wastewater treatment plants in the Gwangju region of South Korea. Quantification of SARS-CoV-2 RNA and whole-genome sequencing revealed that temporal changes in the viral concentration closely mirrored the confirmed case counts. Comparative analysis was conducted of the Illumina MiSeq and NextSeq platforms, revealing that the NextSeq platform exhibited relatively higher sensitivity in sequencing depth and genome coverage. Analysis of wastewater-derived sequences further revealed that the sublineage diversity in the samples closely resembled that of contemporaneous clinical isolates. Our findings highlight the utility of wastewater-based surveillance as an effective adjunct to conventional systems, as the method enhances the capacity to monitor SARS-CoV-2 transmission dynamics and variant emergence within the community.

Background/Objectives: Central sensitization (CS) is identified as a cause of pain in various musculoskeletal diseases, and breathing pattern disorders (BPDs) are reported to be correlated with chronic pain. This study aimed to analyze the relationship between CS and BPDs through regression analysis. Methods: A cross-sectional study was designed according to the strengthening the reporting of observational studies in epidemiology (STROBE) guidelines. Forty participants with moderate to extreme CS (central sensitization inventory for Koreans; CSI-K ≥ 40) were enrolled, and their respiratory motion (manual assessment of respiratory motion; MARM), respiratory function (self-evaluation of breathing questionnaire; SEBQ), respiratory muscle strength (maximal inspiratory pressure; MIP, maximal expiratory pressure; MEP), pain intensity (numeric pain rating scale; NPRS), pain cognition (Korean version of pain catastrophizing scale; K-PCS), muscle tone and stiffness were measured. Results: Among participants with moderate to extreme CS, 82.5% showed BPDs and 42.5% reported severe pain intensity. Regression analysis revealed significant relationships between respiratory and pain variables. K-PCS demonstrated significant negative relationships with MARM area (β = −0.437, R2 = 0.191) and positive relationships with SEBQ (β = 0.528, R2 = 0.279). In the subgroup with BPDs, strong regression relationships were found between MARM area and NPRS usual pain (β = −0.486, R2 = 0.237) and K-PCS (β = −0.605, R2 = 0.366). Multiple regression analysis showed that MARM area and SEBQ together explained 41.2% of variance in pain catastrophizing. The comprehensive muscle stiffness prediction model using CSI-K, K-PCS, and muscle tone showed remarkably high explanatory power (R2 = 0.978). Conclusions: In individuals with moderate to extreme CS, respiratory dysfunction was prevalent and significantly predictable through regression models with pain intensity and pain cognition. These quantitative regression relationships between breathing mechanics, pain measures, and muscle properties provide clinical prediction tools and suggest the importance of assessing breathing patterns in CS management.

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Three automobile company workers (one from Factory D and two from Factory E) were diagnosed with amyotrophic lateral sclerosis. The Korean Epidemiologic Investigation and Evaluation Committee determined that there is considerable scientific evidence supporting the association between amyotrophic lateral sclerosis and combined exposure to heavy metals, organic solvents, and diesel exhaust at the manufacturing plant. Patient A, who primarily engaged in engine processing and completed vehicle inspection at Factory D, was exposed to considerable amounts of heavy metals and organic solvents during medium- and large-engine processing, welding, and painting for over 23 years. Additionally, the patient was likely exposed to diesel exhaust for 33 years from forklifts delivering engines in the workshop. Patients B and C, who were responsible for engine assembly, ignition testing, and engine shipment at Factory E since around 1990, were exposed to lead and benzene from gasoline during engine ignition tests in the engine department for 15 and 16 years, respectively. They also encountered welding fumes, heavy metals, and organic solvents during welding and painting tasks. In addition, Patients B and C were continuously exposed to diesel exhaust from logistics vehicles on standby during work hours for 25 and 30 years, respectively. Although the specific level of lead exposure causing amyotrophic lateral sclerosis remains undetermined, numerous studies have consistently reported a relationship between lead exposure and disease development. Limited evidence suggests that exposure to organic solvents and diesel exhaust may increase the risk of amyotrophic lateral sclerosis. Therefore, the Epidemiological Investigation and Evaluation Committee concluded that the three patients' work-related exposure to heavy metals, organic solvents, and diesel exhaust is significantly supported by scientific evidence as a cause of their amyotrophic lateral sclerosis.

Hard ticks are known vectors of various pathogens, including the severe fever with thrombocytopenia syndrome virus, Rickettsia spp., Coxiella burnetii, Borrelia spp., Anaplasma phagocytophilum, and Ehrlichia spp. This study aims to investigate the distribution and prevalence of tick-borne pathogens in southwestern Korea from 2019 to 2022. A total of 13,280 ticks were collected during the study period, with H. longicornis accounting for 86.1% of the collected ticks. H. flava, I. nipponensis and A. testudinarium comprised 9.4%, 3.6%, and 0.8% of the ticks, respectively. Among 983 pools tested, Rickettsia spp. (216 pools, 1.6% MIR) were the most prevalent pathogens across all tick species, with R. japonica and R. monacensis frequently detected in I. nipponensis and Haemaphysalis spp., respectively. Borrelia spp. (28 pools, 0.2% MIR) were predominantly detected in I. nipponensis (27 pools, 13.8% MIR, P < 0.001). Co-infections, mainly involving Rickettsia monacensis and Borrelia afzelii, were detected in I. nipponensis. Notably, this study identified R. monacensis for the first time in A. testudinarium in South Korea. These findings offer valuable insights into the tick population and associated pathogens in the region, underscoring the importance of tick-borne disease surveillance and prevention measures.