Journal of Yeungnam Medical Science

Original article

Cortical thickness of the rostral anterior cingulate gyrus is associated with frailty in patients with end-stage renal disease undergoing hemodialysis in Korea: a cross-sectional study: Sang Hyun Jung, Jong Soo Oh, So-Young Lee, Hye Yun Jeong; J Yeungnam Med Sci. 2023;40(4):381-387. Published online March 24, 2023; DOI: https://doi.org/10.12701/jyms.2022.00941; Funded: Korea Health Industry Development Institute, Ministry of Health and Welfare

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Abstract PDF: Background
Frailty is defined as a condition of being weak and delicate, and it represents a state of high vulnerability to adverse health outcomes. Recent studies have suggested that the cingulate gyrus is associated with frailty in the elderly population. However, few imaging studies have explored the relationship between frailty and the cingulate gyrus in patients with end-stage renal disease (ESRD) undergoing hemodialysis.
Methods
Eighteen right-handed patients with ESRD undergoing hemodialysis were enrolled in the study. We used the FreeSurfer software package to estimate the cortical thickness of the regions of interest, including the rostral anterior, caudal anterior, isthmus, and posterior cingulate gyri. The Beck Depression Inventory, Beck Anxiety Inventory, and laboratory tests were also conducted.
Results
The cortical thickness of the right rostral anterior cingulate gyrus (ACG) was significantly correlated with the Fried frailty index, age, and creatinine level. Multiple regression analysis indicated that the cortical thickness of the right rostral ACG was associated with frailty after controlling for age and creatinine level.
Conclusion
Our results indicate that the cortical thickness of the rostral ACG may be associated with frailty in patients with ESRD on hemodialysis and that the rostral ACG may play a role in the frailty mechanism of this population.

Review article

Multidisciplinary approach to sarcopenia: a narrative review: Wook Tae Park, Oog-Jin Shon, Gi Beom Kim; J Yeungnam Med Sci. 2023;40(4):352-363. Published online September 7, 2023; DOI: https://doi.org/10.12701/jyms.2023.00724; Funded: National Research Foundation of Korea, Ministry of Education

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Abstract PDF: Sarcopenia is a condition in which muscle mass and strength are decreased and muscle function is impaired. It is an indicator of frailty and loss of independence in older adults. It is also associated with increased physical disability, which increases the risk of falls. As a multifactorial disease, sarcopenia is caused by a combination of factors including aging, hormonal changes, nutritional deficiencies, and physical inactivity. Understanding the underlying pathophysiology of sarcopenia and identifying its different causes is critical to developing effective prevention and treatment strategies. This review summarizes the pathophysiology, consequences, diagnostic methods, and multidisciplinary approaches to sarcopenia.

Focused Review articles

Management and rehabilitation of moderate-to-severe diabetic foot infection: a narrative review: Chi Young An, Seung Lim Baek, Dong-Il Chun; J Yeungnam Med Sci. 2023;40(4):343-351. Published online September 19, 2023; DOI: https://doi.org/10.12701/jyms.2023.00717; Funded: Soonchunhyang Seoul Hospital

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Abstract PDF

Diabetic foot is one of the most devastating consequences of diabetes, resulting in amputation and possibly death. Therefore, early detection and vigorous treatment of infections in patients with diabetic foot are critical. This review seeks to provide guidelines for the therapy and rehabilitation of patients with moderate-to-severe diabetic foot. If a diabetic foot infection is suspected, bacterial cultures should be initially obtained. Numerous imaging studies can be used to identify diabetic foot, and recent research has shown that white blood cell single-photon emission computed tomography/computed tomography has comparable diagnostic specificity and sensitivity to magnetic resonance imaging. Surgery is performed when a diabetic foot ulcer is deep and is accompanied by bone and soft tissue infections. Patients should be taught preoperative rehabilitation before undergoing stressful surgery. During surgical procedures, it is critical to remove all necrotic tissue and drain the inflammatory area. It is critical to treat wounds with suitable dressings after surgery. Wet dressings promote the formation of granulation tissues and new blood vessels. Walking should begin as soon as the patient’s general condition allows it, regardless of the wound status or prior walking capacity. Adequate treatment of comorbidities, including hypertension and dyslipidemia, and smoking cessation are necessary. Additionally, broad-spectrum antibiotics are required to treat diabetic foot infections.

Citations

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Unveiling the challenges of diabetic foot infections: diagnosis, pathogenesis, treatment, and rehabilitation
Chul Hyun Park
Journal of Yeungnam Medical Science.2023; 40(4): 319. CrossRef

Management of diabetic foot ulcers: a narrative review: Jahyung Kim, Otgonsaikhan Nomkhondorj, Chi Young An, Ye Chan Choi, Jaeho Cho; J Yeungnam Med Sci. 2023;40(4):335-342. Published online September 22, 2023; DOI: https://doi.org/10.12701/jyms.2023.00682; Funded: Hallym University Research Fund

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Abstract PDF

Diabetic foot ulcers (DFUs) are among the most serious complications of diabetes and are a source of reduced quality of life and financial burden for the people involved. For effective DFU management, an evidence-based treatment strategy that considers the patient's clinical context and wound condition is required. This treatment strategy should include conventional practices (surgical debridement, antibiotics, vascular assessment, offloading, and amputation) coordinated by interdisciplinary DFU experts. In addition, several adjuvant therapies can be considered for nonhealing wounds. In this narrative review, we aim to highlight the current trends in DFU management and review the up-to-date guidelines.

Citations

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Kick-Starting Wound Healing: A Review of Pro-Healing Drugs
Bethany L. Patenall, Kristyn A. Carter, Matthew R. Ramsey
International Journal of Molecular Sciences.2024; 25(2): 1304. CrossRef
Unveiling the challenges of diabetic foot infections: diagnosis, pathogenesis, treatment, and rehabilitation
Chul Hyun Park
Journal of Yeungnam Medical Science.2023; 40(4): 319. CrossRef

State-of-the-art update for diagnosing diabetic foot osteomyelitis: a narrative review: Inha Woo, Seung Jae Cho, Chul Hyun Park; J Yeungnam Med Sci. 2023;40(4):321-327. Published online October 12, 2023; DOI: https://doi.org/10.12701/jyms.2023.00976; Funded: Korea Health Industry Development Institute, Ministry of Health and Welfare

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Abstract PDF

Recently, the International Working Group on the Diabetic Foot and the Infectious Diseases Society of America divided diabetic foot disease into diabetic foot infection (DFI) and diabetic foot osteomyelitis (DFO). DFI is usually diagnosed clinically, while numerous methods exist to diagnose DFO. In this narrative review, the authors aim to summarize the updated data on the diagnosis of DFO. An extensive literature search using “diabetic foot [MeSH]” and “osteomyelitis [MeSH]” or “diagnosis” was performed using PubMed and Google Scholar in July 2023. The possibility of DFO is based on inflammatory clinical signs, including the probe-to-bone (PTB) test. Elevated inflammatory biochemical markers, especially erythrocyte sedimentation rate, are beneficial. Distinguishing abnormal findings of plain radiographs is also a first-line approach. Moreover, sophisticated modalities, including magnetic resonance imaging and nuclear medicine imaging, are helpful if doubt remains after a first-line diagnosis. Transcutaneous bone biopsy, which does not pass through the wound, is necessary to avoid contaminating the sample. This review focuses on the current diagnostic techniques for DFOs with an emphasis on the updates. To obtain the correct therapeutic results, selecting a proper option is necessary. Based on these numerous diagnosis modalities and indications, the proper choice of diagnostic tool can have favorable treatment outcomes.

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Unveiling the challenges of diabetic foot infections: diagnosis, pathogenesis, treatment, and rehabilitation
Chul Hyun Park
Journal of Yeungnam Medical Science.2023; 40(4): 319. CrossRef

Original articles

Effect of prehydration solution on hearing threshold after chemotherapy in patients with head and neck cancers: a retrospective study: Dongbin Ahn, Kyu-Yup Lee, Eunjung Oh, Minji Oh, Boseung Jung, Da Jung Jung; J Yeungnam Med Sci. 2023;40(2):164-171. Published online August 24, 2022; DOI: https://doi.org/10.12701/jyms.2022.00276; Funded: Kyungpook National University Hospital

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Abstract PDF: Background
The study aimed to evaluate the effect of prehydration solution on hearing thresholds after cisplatin chemotherapy.
Methods
In this retrospective cohort study, we reviewed the data of patients who underwent ≥3 courses of cisplatin-based chemotherapy for locally advanced head and neck cancers at a tertiary referral center (n=64). The dextrose solution (DW) group (n=26) received 2 L of normal saline and 1 L of 5% dextrose. The Hartmann solution (HS) group (n=38) received 2 L of normal saline and 1 L of HS. Hearing data were measured 1 day before starting the first course of chemotherapy, and again 20 days after the first, second, and third courses of chemotherapy. The severity of hearing loss was evaluated using the Common Terminology Criteria for Adverse Events (CTCAE).
Results
Thresholds at all frequencies after chemotherapy were greater in the DW group than in the HS group. The increase in thresholds in 1 to 4 kHz after the third course of chemotherapy was greater in the DW group than in the HS group. CTCAE grades after the second and third courses of chemotherapy were greater in the DW group than in the HS group. Logistic regression showed that the odds ratio for CTCAE grade 3 or 4 after the third course of chemotherapy in the DW group was 4.84 on univariate analysis.
Conclusion
Prehydration using a solution with salt was associated with a decrease in change in hearing thresholds after cisplatin chemotherapy in patients with head and neck cancers.

Pediatricians’ perception of factors concerning the clinical application of blockchain technology to pediatric health care: a questionnaire survey: Yong Sauk Hau, Min Cheol Chang, Jae Chan Park, Young Joo Lee, Seong Su Kim, Jae Min Lee; J Yeungnam Med Sci. 2023;40(2):156-163. Published online July 18, 2022; DOI: https://doi.org/10.12701/jyms.2022.00241; Funded: Yeungnam University

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Abstract PDF Supplementary Material: Background
Interest in digital medical information has increased because it allows doctors to easily access a patient’s medical records and provide appropriate medical care. Blockchain technology ensures data safety, reliability, integrity, and transparency by distributing medical data to all users over a peer-to-peer network. This study attempted to assess pediatricians’ thoughts and attitudes toward introducing blockchain technology into the medical field.
Methods
This study used a questionnaire survey to examine the thoughts and attitudes of 30- to 60-year-old pediatricians regarding the introduction of blockchain technology into the medical field. Responses to each item were recorded on a scale ranging from 1 (never agree) to 7 (completely agree).
Results
The scores for the intentions and expectations of using blockchain technology were 4.0 to 4.6. Pediatricians from tertiary hospitals responded more positively (4.5–4.9) to the idea of using blockchain technology for hospital work relative to the general population (4.3–4.7). However, pediatricians working in primary and secondary hospitals had a slightly negative view of the application of blockchain technology to hospital work (p=0.018).
Conclusion
When introducing the medical records of related pediatric and adolescent patients using blockchain technology in the future, it would be better to conduct a pilot project that prioritizes pediatricians in tertiary hospitals. The cost, policy, and market participants’ perceptions are essential factors to consider when introducing technology in the medical field.

Resident fellow section: Teaching images

Right arm pain after strength training: ultrasound imaging for pectoralis major tendon strain: Ting-Yu Lin, Ke-Vin Chang, Wei-Ting Wu, Levent Özçakar; J Yeungnam Med Sci. 2023;40(1):109-111. Published online October 25, 2022; DOI: https://doi.org/10.12701/jyms.2022.00626; Funded: National Taiwan University Hospital, Ministry of Science and Technology, Taiwan, Taiwan Society of Ultrasound in Medicine

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MSK Ultrasound: A Powerful Tool for Evaluating and Diagnosing Pectoralis Major Injuries in Healthcare Practice
Robert C. Manske, Chris Wolfe, Phil Page, Michael Voight
International Journal of Sports Physical Therapy.2024;[Epub] CrossRef

Image vignette

Tarsal tunnel syndrome due to talocalcaneal coalition: Chul Hyun Park, Mathieu Boudier-Revéret, Min Cheol Chang; J Yeungnam Med Sci. 2023;40(1):106-108. Published online October 5, 2021; DOI: https://doi.org/10.12701/yujm.2021.01473; Funded: National Research Foundation of Korea

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Citations

Citations to this article as recorded by

Deep-Learning Algorithms for Prescribing Insoles to Patients with Foot Pain
Jeoung Kun Kim, Yoo Jin Choo, In Sik Park, Jin-Woo Choi, Donghwi Park, Min Cheol Chang
Applied Sciences.2023; 13(4): 2208. CrossRef

Case reports

Diagnosis and successful visual biofeedback therapy using fiberoptic endoscopic evaluation of swallowing in a young adult patient with psychogenic dysphagia: a case report: Youngmo Kim, Sang Hun Han, Yong Beom Shin, Jin A Yoon, Sang Hun Kim; J Yeungnam Med Sci. 2023;40(1):91-95. Published online January 13, 2022; DOI: https://doi.org/10.12701/yujm.2021.01543; Funded: Pusan National University Hospital

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Abstract PDF

Psychogenic dysphagia is a deglutition disorder characterized by a fear of swallowing, with no structural or functional causes. This report presents the case of a young male patient who had severe malnutrition due to psychogenic dysphagia and was provided visual biofeedback using fiberoptic endoscopic evaluation of swallowing (FEES). A healthy 25-year-old man presented to our clinic with a complaint of throat discomfort when swallowing that had started 6 months prior. As the symptoms worsened, he became fearful of food spreading to his lungs after swallowing and the development of respiratory difficulties. His food intake gradually decreased, resulting in a weight loss of 20 kg within 2 months. Evaluation of organic and other functional causes of dysphagia was performed, but no abnormalities were detected. The sensation of a lump in his throat, fear of swallowing, and anxiety were transformed into somatic symptoms. The patient was diagnosed with psychogenic dysphagia. After visual biofeedback by a physician who performed FEES, the patient resumed eating normally and increased his food intake. If routine tests do not reveal structural or functional causes of dysphagia, assessment of a psychogenic swallowing disorder should be considered. FEES can help in the diagnosis and management of psychogenic dysphagia.

Citations

Citations to this article as recorded by

Endoscopic Biofeedback Training for Cough and Swallowing: The What, Why, and How
James A. Curtis
Perspectives of the ASHA Special Interest Groups.2024; : 1. CrossRef

Scrotal pyocele secondary to gastrointestinal perforation in infants: a case series: Soo-Hong Kim, Yong-Hoon Cho, Hae-Young Kim, Narae Lee, Young Mi Han, Shin Yun Byun; J Yeungnam Med Sci. 2023;40(1):86-90. Published online December 15, 2021; DOI: https://doi.org/10.12701/yujm.2021.01508; Funded: Pusan National University Yangsan Hospital

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Abstract PDF

Pyocele in infants is rarely described in the literature, but it is an emergent condition that requires rapid recognition and treatment to prevent testicular loss. If peritonitis due to gastrointestinal perforation occurs, abdominal contamination may spread through a patent processus vaginalis in an infant, which may lead to pyocele. We report the cases of three infants with scrotal pyocele due to the spread of infection or inflammatory material from the intraperitoneal cavity through a patent processus vaginalis. Two infants were surgically treated, while the other was treated with percutaneous aspiration and intravenous antibiotic administration. Although rare, pyocele should be considered in the differential diagnosis of acute scrotum in infants, especially in infants who previously had peritonitis due to gastrointestinal perforation.

Citations

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Neonatal pyocele originating from a urinary tract infection: a case report
Zahra Jamali, Mohammad Shafie’ei, Najmeh Soltani Nejad
Journal of Medical Case Reports.2024;[Epub] CrossRef

Original articles

Satisfaction of industrial health care managers regarding the work of industrial hygiene engineers: a cross-sectional study: Byung Sik Choi, Min Keun Kim, Joon Sakong; J Yeungnam Med Sci. 2023;40(1):58-64. Published online May 24, 2022; DOI: https://doi.org/10.12701/jyms.2022.00073; Funded: Chunma Medical Research Foundation

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Abstract PDF: Background
A group health service is a system that delegates workplace health management to an entrusted institution. There have been various studies on group health services to date, but recent changes, such as an increase in foreign workers, are rapidly changing industry characteristics.
Methods
Satisfaction was assessed using a 27-question survey distributed among 203 workplaces employing health professionals. The survey items consisted of general characteristics, comprehensive satisfaction, requirements for health professionals’ work, and satisfaction with work environment management, ergonomic management, and healthcare management. Multiple regression and frequency analyses were performed.
Results
The comprehensive satisfaction was 4.08 points on average, out of 5. The comprehensive satisfaction of health professionals in the industry was positively correlated with each factor. Hazardous materials and chemical management (material safety data sheets, MSDSs) were the most common requirements.
Conclusion
A low level of satisfaction with work environment management indicates high demand for healthcare management. The working environment should be improved by identifying characteristics of the workplace, examining harmful substances, inspecting equipment, and enhancing worker methods. The shorter the work experience of health professionals, the more dependent they are on group health services. The variables affecting comprehensive satisfaction were the period of work, healthcare management satisfaction, and work environment management satisfaction. Most of the requirements of health professionals in the workplace were practical improvement case presentations, MSDSs, and legal document management.

Incidence of congenital hypothyroidism by gestational age: a retrospective observational study: Ha Young Jo, Eun Hye Yang, Young Mi Kim, Soo-Han Choi, Kyung Hee Park, Hye Won Yoo, Su Jeong Park, Min Jung Kwak; J Yeungnam Med Sci. 2023;40(1):30-36. Published online April 12, 2022; DOI: https://doi.org/10.12701/jyms.2022.00059; Funded: Pusan National University Hospital

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Abstract PDF

Background
Congenital hypothyroidism (CH) is the leading cause of preventable physical and intellectual disabilities. This study aimed to assess the incidence and clinical characteristics of CH in newborns.
Methods
We retrospectively reviewed the medical records of all newborns delivered at the Pusan National University Hospital between January 2011 and March 2021. The incidence of CH was compared according to gestational age, birth weight, and small for gestational age (SGA). The patients aged ≥3 years who could not maintain normal thyroid function and required levothyroxine treatment were diagnosed with permanent CH. Logistic regression analysis was performed to compare CH risks.
Results
Of 3,722 newborns, 40 were diagnosed with CH (1.07%). Gestational age and birth weight were significantly associated with CH incidence. The odds ratios (ORs) of CH in infants delivered at 32–37, 28–31, and <28 weeks were 2.568 (95% confidence interval [CI], 1.141–5.778), 5.917 (95% CI, 2.264–15.464), and 7.441 (95% CI, 2.617–21.159) times higher, respectively, than those delivered at term. The ORs of CH in infants weighing 1,500–2,499 g, 1,000–1,499 g, and <1,000 g were 4.664 (95% CI, 1.928–11.279), 11.076 (95% CI, 4.089–29.999), and 12.544 (95% CI, 4.350–36.176) times greater, respectively, than those in infants weighing ≥2,500 g. The OR of CH was 6.795 (95% CI, 3.553–13.692) times greater in SGA than in non-SGA infants.
Conclusion
The CH incidence in South Korea has increased significantly compared with that in the past. Gestational age, birth weight, and SGA were significantly associated with CH incidence.

Citations

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History of Neonatal Screening of Congenital Hypothyroidism in Portugal
Maria José Costeira, Patrício Costa, Susana Roque, Ivone Carvalho, Laura Vilarinho, Joana Almeida Palha
International Journal of Neonatal Screening.2024; 10(1): 16. CrossRef
The prevalence of hypothyroxinemia in premature newborns
Renata Stawerska, Marzena Nowak-Bednarek, Tomasz Talar, Marzena Kolasa-Kicińska, Anna Łupińska, Maciej Hilczer, Ewa Gulczyńska, Andrzej Lewiński
Frontiers in Endocrinology.2022;[Epub] CrossRef

Review article

The use of animal models in rheumatoid arthritis research: Jin-Sun Kong, Gi Heon Jeong, Seung-Ah Yoo; J Yeungnam Med Sci. 2023;40(1):23-29. Published online November 22, 2022; DOI: https://doi.org/10.12701/jyms.2022.00773; Funded: National Research Foundation of Korea, Ministry of Education, Science and Technology

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Abstract PDF

The pathological hallmark of rheumatoid arthritis (RA) is a synovial pannus that comprises proliferating and invasive fibroblast-like synoviocytes, infiltrating inflammatory cells, and an associated neoangiogenic response. Animal models have been established to study these pathological features of human RA. Spontaneous and induced animal models of RA primarily reflect inflammatory aspects of the disease. Among various induced animal models, collagen-induced arthritis (CIA) and collagen antibody-induced arthritis (CAIA) models are widely used to study the pathogenesis of RA. Improved transplantation techniques for severe combined immunodeficiency (SCID) mouse models of RA can be used to evaluate the effectiveness of potential therapeutics in human tissues and cells. This review provides basic information on various animal models of RA, including CIA and CAIA. In addition, we describe a SCID mouse coimplantation model that can measure the long-distance migration of human RA synoviocytes and cartilage destruction induced by these cells.

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CRISPRa engineered Elite macrophages enable adoptive cell therapy for rheumatoid arthritis
Yuhong Huang, Zhuqian Wang, Chuanxin Zhong, Hongzhen Chen, Xinxin Chen, Chunhao Cao, Fang Qiu, Duoli Xie, Jin Li, Jie Li, Xu Yang, Aiping Lu, Xuekun Fu, Chao Liang
The Innovation Medicine.2024; 2(1): 100050. CrossRef
Microenvironmental Enzyme-Responsive Methotrexate Modified Quercetin Micelles for the Treatment of Rheumatoid Arthritis
Xiuying Li, Xin Wang, Xiuwu Qu, Ningning Shi, Qinqing Li, Zhifang Yan, Yandong Li, Yingli Wang
International Journal of Nanomedicine.2024; Volume 19: 3259. CrossRef

Communication

The pros and cons of entry restrictions: are entry restrictions really effective in preventing the spread of SARS-CoV-2?: Donghwi Park, Mathieu Boudier-Revéret, Min Cheol Chang; J Yeungnam Med Sci. 2022;39(4):344-346. Published online January 14, 2022; DOI: https://doi.org/10.12701/yujm.2021.01599; Funded: National Research Foundation of Korea

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Abstract PDF

Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has rapidly spread worldwide, leading the World Health Organization to declare coronavirus disease 2019 (COVID-19) a pandemic. To curb the unchecked spread of SARS-CoV-2 infection, most countries have enforced travel restrictions. However, it is debatable whether such restrictions are effective in containing infections and preventing pandemics. Rather, they may negatively impact economies and diplomatic relationships. Each government should conduct an extensive and appropriate analysis of its national economy, diplomatic status, and COVID-19 preparedness to decide whether it is best to restrict entering travelers. Even if travelers from other countries are allowed entry, extensive contact tracing is required to prevent the spread of COVID-19. In addition, governments can implement “travel bubbles,” which allow the quarantine-free flow of people among countries with relatively low levels of community transmission. An accurate evaluation of the benefits and losses due to entry restrictions during the COVID-19 pandemic would be helpful in determining whether entry restrictions are an effective measure to reduce the spread of infection in future pandemics.

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“Exceptionally challenging time for all of us”: Qualitative study of the COVID-19 experiences of partners of diplomatic personnel
Samantha K. Brooks, Dipti Patel, Neil Greenberg, Joseph Adu
PLOS ONE.2023; 18(11): e0293557. CrossRef

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