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Abstract Purpose This study aimed to review the literature on complementary and alternative therapies, utilizing text mining and trend analysis in nursing research. As CAM becomes increasingly prevalent in healthcare settings, a comprehensive understanding of the current research landscape is essential to guide evidence-based practice, inform clinical decision-making, and ultimately enhance patient outcomes. Method This study aimed to identify CAM-related literature published from 2018 to 2023. Using the search terms 'complementary therap*', 'complementary medicine', 'alternative therap*', and 'alternative medicine', we performed a comprehensive search in eight databases, including EMBASE, Cochrane Central, PubMed Central, Korea Education and Research Information Service (RISS), Web of Science, KMbase, KISS, and CINAHL. From the text network and topic modeling analysis of 66,490 documents, 15 topics were identified. These topics were classified into two nursing-related topics through an academic classification process involving three doctors with doctoral degrees, three nurses, and three pharmacists. Based on the classified topics, research trends were comparatively analyzed by re-searching the database for 12 nursing and 22 non-nursing literature. Result This study found that in nursing literature, yoga is used to improve mental symptoms such as stress and anxiety. In non-nursing literature, most of the experimental studies on complementary and alternative therapies were conducted in a randomized manner, confirming that a variety of physiological and objective indicators were used. Additionally, it was discovered that there were differences in the diversity of research subjects and research design methods for the same intervention method. Therefore, future research should focus on broadening the scope of subjects and measurement tools in nursing studies. Additionally, such studies should be conducted with randomization and generalizability in the experimental design in mind. Conclusion This study employed text network analysis and text mining to identify domestic and international CAM research trends. Our novel approach combined big data-derived keywords with a systematic classification method, proposing a new methodological strategy for trend analysis. Future nursing research should focus on broadening the scope of subjects, diversifying measurement tools, and emphasizing randomization and generalizability in experimental designs.

Abstract Background The demand for bioplastics has increased exponentially as they have emerged as alternatives to petrochemical plastics. However, there is a substantial lack of knowledge regarding bioplastic degradation. This study developed a novel pretreatment method to improve the accessibility of a bioplastic substrate for biodegradation. In this study, cellulose acetate, a bioplastic found in the world’s most littered waste, e.g. cigarette filters, was selected as a potential substrate. Before anaerobic digestion, three thermal alkaline pretreatments: TA 30 °C, TA 90 °C, and TA 121 °C, were used to evaluate their effects on the chemical alterations of cellulose acetate. Result The ester groups in cellulose acetate were significantly reduced by the TA 30 °C pretreatment, as seen by a decrease in C = O stretching vibrations and shortening of C − O stretches (1,270 ∼ 1,210 cm− 1), indicating effective removal of acetyl groups. This pretreatment significantly enhanced cellulose acetate biodegradability to a maximum of 91%, surpassing the previously reported cellulose acetate degradation. Methane production increased to 695.0 ± 4 mL/g of volatile solid after TA 30 °C pretreatment, indicating enhanced cellulose acetate accessibility to microorganisms, which resulted in superior biogas production compared to the control (306.0 ± 10 mL/g of volatile solid). Diverse microbes in the anaerobic digestion system included hydrolytic (AB240379_g, Acetomicrobium, FN436103_g, etc.), fermentative, and volatile fatty acids degrading bacteria (JF417922_g, AB274492_g, Coprothermobacter, etc.), with Methanobacterium and Methanothermobacter being the sole hydrogenotrophic methanogens in the anaerobic digestion system. Additionally, an attempt to predict the pathway for the effective degradation of cellulose acetate from the microbial community in different pretreatment conditions. Conclusions To the best of our knowledge, this is the first study to estimate the maximum cellulose acetate degradation rate, with a simple and cost-effective pretreatment procedure. This approach holds promise for mitigating the environmental impact of cellulose acetate of cigarette filters and presents a sustainable and economically viable waste management strategy.

Summary: Purpose: This study developed a resilience scale for kidney transplantation (RS-KTPL) and assessed its reliability and validity. Methods: During the tool development phase, the concept of resilience in 10 patients who had undergone a kidney transplant was analyzed by integrating results from the theoretical and field research stages. Initial tool items were then derived. These items underwent content validity verification, item review, and a preliminary survey. The validation phase involved two main surveys, conducted using the preliminary 59 items derived from the development phase for data gathering. The first survey had 266 participants, and the second had 205 participants. Using the collected data, the structural validity, convergent validity, discriminant validity, criterion validity, and reliability of the tool items were verified, ultimately establishing the final items. Results: The RS-KTPL comprises six factors with 27 items confirmed through exploratory factor analysis (EFA) and confirmatory factor analysis (CFA) on a 4-point Likert scale: positive thought transition through recovery belief, supportive relationships with others, self-awareness of negative psychological reactions, physical health control, homeostasis control, and supportive relationships with medical staff. The cumulative explanation of the tool was 50.71%. The model fit of the RS-KTPL was represented as follows: GFI 0.88, CFI 0.93, TLI 0.91, RMSEA 0.04, and SRMRI 0.06. Convergent, discriminant, and criterion validity were also secured. The reliability of the tool, measured by Cronbach α was 0.87. Conclusions: The RS-KTPL can be used to identify the level of resilience in patients who have undergone a kidney transplant, enabling them to recognize their strengths and areas of improvement for enhanced resilience. This tool can be applied in clinical nursing practices to comprehensively assess the resilience of patients with a kidney transplant, providing direction for nursing intervention plans to enhance patient resilience.

Abstract Background For elderly people with chronic lower back pain who need long-term management, there is a need for a nursing intervention study that is effective, is easy to perform, and applies complementary and alternative therapies to manage pain without repulsion. Hand pressure therapy is a treatment indigenous to Korea used to reduce pain and improve functions of daily life by applying acupuncture, pressure sticks, and moxibustion to parts of the hand as they relate to parts of the body. This research is to identify the effects of pellet pressed on the hand on pain and the daily lives of elders with chronic lower back pain (CLBP). Methods The hand pressed-pellet intervention period was six weeks long. Twenty-seven patients in the intervention group and twenty-four patients in the placebo control group were recruited from elderly over sixty-five who used welfare centers. In the intervention group, hand pressed-pellet therapy was conducted in eleven acupressure response zones related to CLBP, and the placebo control group was provided with similar therapy and zones, but unrelated to CLBP. The research tool measured the intensity of CLBP using the Visual Analogue Scale (VAS), the Korean Owestry Disability Index (K-ODI), which are subjective indicators, and the Compact Digital Algometer, which is an objective indicator. Result The pain intensity (VAS) measured after six weeks of hand pressed-pellet therapy showed significant difference between the two groups compared to their pain before the experiment (F = 60.522, p

Despite the inhibitory effect of phytoncide (Pht) on food-borne pathogenic bacterial growth, the hydrophobic nature and susceptibility to biodegradation under physiological conditions limits its applications. Here, we developed Pht-loaded polyvinylpyrrolidone (PVP) micelles (Pht@PVP MC) via micelle packing. Pht was solubilized using different types of PVP as micellar vehicles. The as-prepared Pht@PVP MCs were characterized using dynamic light scattering and transmission electron microscopy. The sizes of the Pht@PVP MCs were controlled from 301 ± 51 to 80 ± 3 nm by adjusting the PVP content. The polydispersity index of Pht@PVP MC was between 0.21 ± 0.03 and 0.16 ± 0.04, indicating homogeneous size. A colony-counting method was employed to evaluate the improvement in antibacterial activity after Pht encapsulation in PVP micelles. The reactive oxygen species (ROS)-scavenging activity and anti-inflammatory efficacy of Pht@PVP MC were analyzed in a concentration range of 10–100 μg/mL by evaluating in vitro ROS and nitric oxide levels using DCFDA and Griess reagents. PVP with both hydrophobic and hydrophilic moieties improved the aqueous solubility of Pht and stabilized it via steric hindrance. Higher-molecular-weight PVP at higher concentrations resulted in a smaller hydrodynamic diameter of Pht@PVP MC with uniform size distribution. The spherical Pht@PVP MC maintained its size and polydispersity index in a biological buffer for 2 weeks. Pht@PVP MC exhibited enhanced antibacterial activity compared to bare Pht. The growth of Staphylococcus aureus was effectively inhibited by Pht@PVP MC treatment. Furthermore, biocompatible Pht@PVP MC exhibited dose-dependent antioxidant and anti-inflammatory activities in vitro. Overall, Pht@PVP MC is an effective alternative to synthetic antibacterial, antioxidant, and anti-inflammatory chemicals.

Purpose This study investigated the effects of peripheral neuropathy symptoms, self-care ability, and disturbances to daily life on quality of life (QoL) among gynecological cancer patients undergoing chemotherapy. Methods The participants included 144 patients with gynecological cancer undergoing anticancer chemotherapy at a tertiary hospital in Seoul, South Korea, from December 1, 2021 to January 28, 2022. Convenience sampling was used to recruit patients who had received 4 or more cycles of chemotherapy using a paclitaxel-platinum regimen, and a self-reported questionnaire was used to collect data. Descriptive statistics, the t-test, analysis of variance, Scheffé test, Pearson correlation coefficients, and multiple regression analysis were performed. Results Most of the participants had ovarian cancer (70.1%) or endometrial cancer (14.6%), and the most common number of treatment cycles was 6 to 10 (29.2%). The mean QoL (60.83±19.89) was greater than the midpoint. The regression model analyzing the patients’ QoL was statistically significant (F=15.38, p

Diabetic ketoacidosis (DKA) is a medically fatal condition in poorly controlled hyperglycemia or newly diagnosed diabetes mellitus. Severe hypertriglyceridemia (HTG) is an uncommon complication of DKA and can be associated with acute pancreatitis (AP). We present the clinical manifestations, laboratory findings, and management of AP associated with HTG in a 14-year-old girl with DKA. The patient, with a 7-year history of type 2 diabetes presented with epigastric pain, 1 month after stopping insulin injection. DKA, severe HTG, and AP were diagnosed based on the laboratory and imaging tests. She recovered from DKA after conventional treatment for DKA, and her triglyceride (TG) level was reduced from 10,867 mg/dL to the normal range after 7 days of admission without antilipid medication. Given that her C-peptide level was not too low and considering her negative diabetes-related antibodies and high TG level, targeted gene panel sequencing was performed on the genes associated with diabetes and HTG. We identified a heterozygous mutation, c.4607C>T (p. Ala1537Val), in ABCC8 related to maturityonset diabetes of the young (MODY) 12. To our knowledge, this is the first reported case of HTG-induced AP with DKA in a patient with MODY. In addition, we reviewed the literature for pediatric cases of HTG with DKA. In patients with DKA, timely awareness of severe HTG related to insulin deficiency is crucial for improving the consequences of AP. We recommend considering AP in all DKA patients presenting with severe HTG to ensure early and proper management.

Congenital lipoid adrenal hyperplasia (CLAH) is one of the most fatal conditions caused by an abnormality of adrenal and gonadal steroidogenesis. CLAH results from loss-of-function mutations of the steroidogenic acute regulatory (STAR) gene; the disease manifests with electrolyte imbalances and hyperpigmentation in neonates or young infants due to adrenocortical hormone deficiencies, and 46, XY genetic male CLAH patients can be phenotypically female. Meanwhile, some patients with STAR mutations develop hyperpigmentation and mild signs of adrenal insufficiency, such as hypoglycemia, after infancy. These patients are classified as having nonclassic CLAH (NCCLAH) caused by STAR mutations that retain partial activity of STAR. We present the case of a Korean boy with normal genitalia who was diagnosed with NCCLAH. He presented with whole-body hyperpigmentation and electrolyte abnormalities, which were noted at the age of 17 months after an episode of sepsis with peritonitis. The compound heterozygous mutations p.Gly221Ser and c.653C>T in STAR were identified by targeted gene-panel sequencing. Skin hyperpigmentation should be considered an important clue for diagnosing NCCLAH.

Abstract Background Atopic dermatitis (AD) is a chronic and relapsing inflammatory skin disease. Great efforts have been recently made to treat AD using mesenchymal stem cells (MSCs), which have immunomodulatory functions. However, the immunomodulatory effects of MSCs need to be enhanced for clinical application in the treatment of AD. Objectives To evaluate and characterise the therapeutic effects of human Wharton’s jelly-derived MSCs (WJ-MSCs) primed with the Toll-like receptor 3 agonist poly I:C or interferon-γ (IFN-γ) in a murine model of AD. Methods Mice were treated with Aspergillus fumigatus extract to induce AD and then subcutaneously injected with non-primed, poly I:C-primed or IFN-γ-primed WJ-MSCs. Clinical symptom scores, transepidermal water loss (TEWL), histological characteristics and cytokine levels were determined. Transcriptome profiling and pathway analyses of primed WJ-MSCs were conducted. Results The clinical symptom score and TEWL in skin lesions were reduced in mice administered non-primed and primed WJ-MSCs. Epidermal thickness and inflammatory cell infiltration in skin lesions were reduced more in mice administered primed WJ-MSCs than in mice administered non-primed WJ-MSCs. Secretion of interleukin-17 was significantly reduced in skin draining lymph nodes of mice administered primed WJ-MSCs. Genomics and bioinformatics analyses demonstrated the enrichment of certain pathways specifically in WJ-MSCs primed with poly I:C or IFN-γ. Conclusions Priming with poly I:C- or IFN-γ improved the therapeutic effects of WJ-MSCs in a murine model of AD. This study suggests that priming with poly I:C or IFN-γ enhances the immunomodulatory functions of WJ-MSCs and can be used as a novel therapeutic approach for AD.

PurposePheochromocytoma (PCC) and paraganglioma (PGL) (PPGL) are rare neuroendocrine tumors, and data on managing these conditions in children and adolescents are lacking. The objective of this study was to demonstrate the clinical presentation and treatment outcomes in children and adolescents with PPGL in a single tertiary care center in Korea.MethodsThis retrospective study included 23 patients diagnosed with PCC (n = 14) and PGL (n = 9) before the age of 21 at Samsung Medical Center (from June 1994 to June 2019). We describe age, gender, family history, clinical characteristics, laboratory findings, pathologic findings, therapeutic approaches, and treatment outcomes.ResultsOf the 23 patients, 14 had PCC and nine had PGL. The median age at diagnosis was 16.8 years (range, 6.8–20.8 years). The common presenting symptoms were hypertension (n = 10), headache (n = 9), palpitation (n = 4), and sweating (n = 4). The plasma or 24-hour urine catecholamine and/or metabolite concentrations were markedly elevated in 22 patients with PPGL, but were normal in one patient with carotid body PGL. All tumors were visualized on computed tomography. Genetic tests were performed in 15 patients, and seven patients showed mutations in RET (n = 3), SDHB (n = 3), and VHL (n = 1). All patients underwent surgery, and complete excision was performed successfully. Three patients with metastasis underwent postoperative adjuvant therapy.ConclusionThis study suggests that pediatric PPGL tends to be extra-adrenal and bilateral and shows a higher potential for genetic mutations. Considering the hereditary predisposition of pediatric PPGL, genetic screening tests are strongly recommended, and lifelong follow-up is needed to detect recurrence and metastasis. Further research with a larger sample size and routine genetic screening is needed to better understand the genetic conditions and long-term prognosis of PPGL.

Background/Purpose: A prolactinoma is the most common pituitary adenoma, but it is relatively rare in childhood and adolescence. There is only limited research about the clinical spectrum, treatment, and outcomes of prolactinomas in childhood and adolescence. In this single-center cohort study, we assessed the clinical, hormonal, and neuroradiological characteristics and therapeutic outcomes of children and adolescents with prolactinomas.Methods: This retrospective cohort study included 25 patients with prolactinomas diagnosed before 19 years of age, who presented at Samsung Medical Center during a 15-year period (March 2005 to August 2019).Results: The median age at diagnosis was 16.9 (range 10.1–18.5) years, and 80% of the patients were female. The common clinical manifestations at diagnosis were galactorrhea (10/20, 50%) and amenorrhea (9/20, 45%) among females and visual field defects (3/5, 60%) and headaches (2/5, 40%) among males. In our cohort, macroadenomas accounted for 56% of cases, and the rate of overall responsiveness to dopamine agonists (DAs) was 56% (10/18). Male gender, the prolactin (PRL) level at diagnosis, and the presence of panhypopituitarism were positively correlated with maximum tumor diameter (r = 0.443, P = 0.026; r = 0.710, P < 0.001; and r = 0.623, P = 0.001, respectively). After the trans-sphenoidal approach (TSA), 53% (8/15) of patients showed normalization of the PRL level. Three patients, who underwent gamma knife surgery (GKS) owing to either resistance or intolerance to DAs or recurrence after the TSA, achieved a normal PRL level accompanied with marked tumor reduction and symptom remission.Conclusions: A macroprolactinoma is more prevalent than a microprolactinoma in children and adolescents than in adults. Male gender, increased PRL levels, and the presence of panhypopituitarism at diagnosis are closely related to macroprolactinomas in children and adolescents.

Anaerobic digestion using cigarette butts, one of most littered items, was studied not only as a waste treatment, but also as an energy production method. Methane production from cigarette butts was measured through the biochemical methane potential (BMP) test and it was evaluated whether it is possible to produce electrical energy. Intact cigarettes or individual components (filter, paper, and leaf) were supplied as the sole carbon source (substrate) for the BMP test. The tendency of methane production indicated biodegradation in the order of paper, filter, and leaves; however, the filter of cigarettes was the substrate produced the highest amount of methane per total solid. The microbial community was also analyzed in each anaerobic digestion reactor, and substrate-specific microorganisms were identified, such as Proteiniphilum strain (filter) and Methanobacterium formicicum (paper). In intact cigarettes, the related microbial community became dominant over time in the order of paper, filter, and leaf. The conversion of cigarette butts to methane, a renewable energy source, can be proposed as a sustainable route for energy demand, for example, in a smoking room.

PURPOSE: The purpose of this study was to investigate the effect of aroma inhalation therapy on stress, anxiety, depression, and an autonomic nervous system reaction in high-risk hospitalized pregnant women. METHODS: A quasiexperimental study used a non-equivalent control group non-synchronized design. Fifty high-risk hospitalized pregnant women were selected as participants on delivery room and maternity ward at university hospital. Twenty-five were selected for the experimental group while 25 were assigned to a control group. Neroli essential oil was used for aroma therapy and was already identified as not being hazard to pregnant women. It provided emotional stability from previous study. The participants inhaled Neroli 2 minutes, 3 times (9 am to 10 am, 4 pm to 5 pm, just before sleep) a day. A total of 15 sessions were held from the day of the preliminary investigation. Pre and post written survey and measuring an autonomic nervous system reaction were collected from both groups. RESULTS: The data were analyzed by χ2 test, t-test, and paired t-test. There was a statistically significant difference in stress (t=-3.98, p

This case report concerns a young patient with an extremely rare combination of d-transposition of the great arteries (d-TGA) and anomalous origin of the right subclavian artery. In our patient, the right subclavian artery originated from the pulmonary artery, which is why he did not show reversed differential cyanosis. We conclude that the presence of an aortic arch anomaly should be considered in patients with d-TGA who do not present with reversed differential cyanosis. A further imaging work-up, including computed tomography or magnetic resonance imaging, might be helpful.

PURPOSE: The purpose of this study was to examine the effect of preoperative education using multimedia on level of pain, uncertainty, anxiety and depression in hysterectomy patients. METHODS: A non-equivalent control group, with a pretest-posttest design was used in this study. The level of post operation pain, pre and post operation uncertainty, anxiety and depression of both the groups was measured. The experimental group was provided with preoperative education using multimedia on the preoperative day at the hospital. The control group was only given usual care. Data were analyzed using SPSS/WIN version 22.0 program. RESULTS: Experimental group showed lower level of post-operation pain in 1 hour (t=-5.08, p

Purpose: This study investigated the impact of standardized nursing terminology video education on Intensive Care Unit (ICU) nurses' knowledge, perception, attitude, and self-efficacy in evidence-based practice. Methods: ICU nurses with over 1 year of clinical experience participated in the study, with 26 in the experimental group and 27 in the control group. The experimental group received standardized nursing terminology videos, while the control group received pamphlets. Standardized tools were used to measure outcomes before and after the intervention in both groups. The collected data were analyzed using SPSS 28.0. Differences between the experimental and control groups were analyzed using the χ² test, Fisher's exact test, and Independent t-test. Changes within groups for outcome variables were analyzed using paired t-test and Wilcoxon signed-rank test, while group differences were analyzed using Independent t-test and Mann-Whitney U test. Results: Standardized nursing terminology education significantly improved perception, attitude, and self-efficacy in evidence-based practice among ICU nurses. Knowledge scores increased from 22.77±6.59 to 27.58±3.61 (p<.001), perception scores from 24.65±5.78 to 28.54 ±3.84 (p=.001), attitude scores from 63.46± 11.85 to 74.27±9.05 (p< .001), and self-efficacy in evidence-based nursing scores from 53.12± 10.85 to 58.12±9.51 (p=.007). However, there was no significant difference in knowledge improvement between experimental and control groups. Conclusion: This research provides evidence supporting the necessity of systematic education on standardized nursing language and its application in clinical practice to improve nurses' perceptions, attitudes, and self-efficacy in evidence-based nursing related to standardized nursing terminology. [ABSTRACT FROM AUTHOR]

Purpose: This study aimed to examine the influence of attitude toward job rotation, professional self-concept and organizational commitment on patient safety nursing activities. Methods: In this descriptive correlational study, the participants were 120 nurses with over 1 year of experience working at a tertiary general hospital in Seoul. Data were analyzed using descriptive statistics, the independent t-test and one-way analysis of variance, the Scheffe test, Pearson correlation coefficients, and hierarchical multiple regression analysis. Results: The average scores for attitude toward job rotation, professional self-concept, organizational commitment and patient safety nursing activities were 3.07±0.43, 5.80±0.87, 3.11 ±0.55, and 4.57±0.35, respectively. Patient safety nursing activities showed statistically significant differences according to age (F=4.66, p=.011), marital status (t=-2.06, p=.042), and total clinical experience (t=-2.38, p=.019). Attitude toward job rotation (r=.23, p=.011), professional self-concept (r=.36, p<.001), and organizational commitment (r=.30, p<.001) were positively correlated with patient safety nursing activities. The Factors affecting patient safety nursing activities were total clinical experience (β=.24, p=.029) and professional self-concept (β=.22, p=.037), with a total explanatory power of approximately 20%. Conclusion: These results suggest that nurses' activities need to be planned based on their total clinical experience. and professional self-concept predicted higher patient safety nursing activities among nurses. [ABSTRACT FROM AUTHOR]

Purpose: This study aimed to examine the effects of disaster perception, disaster attitude, and communication skills on disaster nursing competence among nurse officers at armed forces hospitals. Methods: In this descriptive study, data were collected from 191 nurse officers at armed forces hospitals in Korea, using convenience sampling. Data were analyzed by conducting descriptive statistics, the independent sample t-test, one-way analysis of variance, the Scheffe test, Pearson correlation coefficients, and multiple regression analysis. Results: The mean scores for disaster perception, disaster attitude, communication skills, and disaster nursing competency were 73.02±7.66, 36.86±3.96, 57.97±6.39, and 52.88±7.66, respectively. Disaster perception was correlated with disaster attitude (r=.32, p=.002), communication skills (r=.46, p<.001) and disaster nursing competence (r=.40, p<.001). Disaster attitude was correlated with communication skills(r=.28, p<.001) and disaster nursing competence (r=.19, p=.008). Communication skills were correlated with disaster nursing competence (r=.50, p<.001). The factors influencing nurse officers' disaster nursing competence were communication skills (β=.34, p<.001), disaster perception (β=.20, p=.003), experience in disaster education (β=-.20, p=.001), experience in disaster nursing work (β=-.14, p=.022) and working experience (β=.14, p=.033). Conclusion: Disaster nursing competence had a positive correlation with recognition of communication skills, disaster perception, experience of disaster education, and experience of disaster nursing work. [ABSTRACT FROM AUTHOR]

Chronic low back pain (CLBP) is a major problem throughout the world and getting worse because of population increase and aging. The cost of treatment increases as the population of people with CLBP increases. This study aimed to examine the effect of auricular acupressure (AA) on pain and disability in elders with chronic low back pain. The randomized, single-blinded, and placebo-controlled study was conducted on 51 elders with CLBP in South Korea from June 2019 to August 2019. The experimental group (n = 26) received AA on low back pain-related points, whereas the placebo control group (n = 25) received AA on points unrelated to low back pain. Participants received 6 weeks of AA in weekly cycles. Collected data were analyzed using IBM SPSS Statistics, version 25. Statistically significant differences between the 2 groups emerged in the visual analog scale (P < .001), pain threshold (P < .001), and Oswestry Disability Index (P < .001). This study showed that 6 weeks of AA improved CLBP and pain-related disability. Therefore, AA can be used as a noninvasive and self-managed alternative intervention for CLBP in older adults. [ABSTRACT FROM AUTHOR]

BACKGROUND: Transcatheter device closure of ventricular septal defect (VSD) has become an attractive alternative to surgery. We report here on our early experiences of transcatheter closure of VSD using Cocoon devices, which are now available in Korea. METHODS: We reviewed the medical records and angiographic images of 13 patients who underwent transcatheter closure of VSD with a Cocoon occluder at Samsung Medical Center. The median patient age was 5.8 years, and the median patient weight was 20.3 kg. RESULTS: The device was successfully implanted in all patients. The follow-up period was 10 ± 6 months, and no mortality was observed. An immediate residual leak on the next day was detected in 7 patients (including 4 with perimembranous VSD). However, 6 months later, a residual leak was observed only in 2 patients with perimembranous VSD and 1 patient with muscular VSD. Early conduction abnormalities were observed in 3 patients, all of whom had perimembranous VSD, but no significant complete atrioventricular block was observed. One patient experienced newly developed significant aortic regurgitation that decreased spontaneously but still existed at the 6 month follow-up. No hemolysis or embolization was noted on the next day or during the follow-up period. CONCLUSIONS: Cocoon devices can be used safely and effectively for VSD closure. However, residual leaks and conduction abnormalities may occur early after implantation, especially in patients with perimembranous VSD. Although normal conduction was recovered, long-term evaluation remains essential. [ABSTRACT FROM AUTHOR]

Purpose: This study was conducted to evaluate clinical outcomes following definitive concurrent chemoradiotherapy (CCRT) for patients with N3-positive stage IIIB (N3-IIIB) non-small cell lung cancer (NSCLC), with a focus on radiation therapy (RT) techniques. Materials and Methods: From May 2010 to November 2012, 77 patients with N3-IIIB NSCLC received definitive CCRT (median, 66 Gy). RT techniques were selected individually based on estimated lung toxicity, with 3-dimensional conformal RT (3D-CRT) and intensity-modulated RT (IMRT) delivered to 48 (62.3%) and 29 (37.7%) patients, respectively. Weekly docetaxel/paclitaxel plus cisplatin (67, 87.0%) was the most common concurrent chemotherapy regimen. Results: The median age and clinical target volume (CTV) were 60 years and 288.0 cm3, respectively. Patients receiving IMRT had greater disease extent in terms of supraclavicular lymph node (SCN) involvement and CTV ⩾ 300 cm3. The median follow-up time was 21.7 months. Fortyfive patients (58.4%) experienced disease progression, most frequently distant metastasis (39, 50.6%). In-field locoregional control, progression-free survival (PFS), and overall survival (OS) rates at 2 years were 87.9%, 38.7%, and 75.2%, respectively. Although locoregional control was similar between RT techniques, patients receiving IMRT had worse PFS and OS, and SCN metastases from the lower lobe primary tumor and CTV ⩾ 300 cm3 were associated with worse OS. The incidence and severity of toxicities did not differ significantly between RT techniques. Conclusion: IMRT could lead to similar locoregional control and toxicity, while encompassing a greater disease extent than 3D-CRT. The decision to apply IMRT should be made carefully after considering oncologic outcomes associated with greater disease extent and cost. [ABSTRACT FROM AUTHOR]

Purpose This study was conducted to evaluate the treatment outcomes following definitive bimodality concurrent chemoradiotherapy (CCRT) in patients with inoperable N2-positive stage IIIA (N2- IIIA) non-small cell lung cancer (NSCLC). Materials and Methods From May 1997 to December 2012, 65 out of 633 patients with N2-IIIA NSCLC received bimodality therapy. The treatment modality was selected during/after neoadjuvant CCRT in 21 patients or primarily at diagnosis in 44 through a multidisciplinary consensus meeting. The median age was 65 years (range, 36 to 76 years). Sixty patients (92.3%) had clinically evident N2 disease, while 22 (33.8%) had multi-station N2 involvement. The median radiation therapy dose was 66 Gy in 33 fractions, while the dose was elevated to 72 Gy in 13 patients who had a treatment break due to delayed decision regarding resectability. The most frequent chemotherapy regimen was weekly paclitaxel or docetaxel plus cisplatin or carboplatin (54, 83.1%). Results During the median follow-up of 18.8 months (range, 1.6 to 173.1 months), 34 patients (52.3%) experienced disease progression, with distant metastasis being the most common first treatment failure pattern (23, 34.8%). The median and 2-year rates of progression-free survival were 18.8 months and 45.9%, respectively. The median and 2-year rates of overall survival were 28.6 months and 50.1%, respectively. Conclusion Definitive bimodality therapy in patients with N2-IIIA NSCLC demonstrated favorable outcomes, while trimodality therapy could be considered for candidates for less than pneumonectomy. [ABSTRACT FROM AUTHOR]

Purpose: This study was conducted to examine the effect of oral care with an aroma solution on oral status and oral cavity microorganism growth in elderly patients with stroke. Methods: A non-equivalent control group, with a pretest-posttest design was used in this study. The participants were assigned to the experimental group (n=30) that received oral care with an aroma solution or the control group (n=31) that received 0.9% saline solution. To identify the effect of the experimental treatments, objective/subjective assessments of oral status and oral cavity microorganism growth were performed using the oral assessment guide, oral perception guide, and oral swab culture. Data were analyzed using Chi-square test, Fisher’s exact test, and t-test with the SPSS version 21.0 program. Results: The objective oral status was significantly lower in the experimental group than in the control group (t= -3.64, p<.001). There was no significant difference between the subjective oral status of the experimental group and control groups (t= -1.24, p=.109). Oral microorganism growth was significantly lower in the experimental group than in the control group (t= -7.39, p<.001). Conclusion: These findings indicate that special mouth care using an aroma solution could be an effective oral health nursing intervention for elderly patients with stroke. [ABSTRACT FROM AUTHOR]

Purpose: The purpose was to examine the self-efficacy, coping, and compliance in patients with kidney transplantation. Methods: Participants consisted of 300 out patients who underwent kidney transplantation and regularly visited hospital for health check-up. A tool developed by Ahn (2000) was used for measuring self-efficacy. A modified version of the Jalowiec Coping Scale (Jalowiec, 1987) by Hwang (2004) was used for measuring coping, and a tool developed by Ryu, Kim, and Kang (2003) was used for compliance. Data were analyzed using SPSS program version 21.0 ANOVA, Pearson’s correlation coefficient, and Scheffé’s test for post-hoc test. Results: Coping shows significant differences according to marital status and education. Coping was used more often among patients with ABO incompatible transplantation than those with ABO compatible. Differences in compliance were significant according to donor type, ABO incompatible, period after transplantation, and admission after the transplantation. The management of life style, stress, nutrition, and exercise in self-efficacy and compliance had lower scores than the others. Conclusion: There are significant correlations between self-efficacy, coping, and compliance in patients with kidney transplant which might be helpful for health care professionals in taking care of these population. [ABSTRACT FROM AUTHOR]

1. Topic/Introduction Patients who undergo ostomy have a reduced quality of life due to ostomy care. In order to quickly and properly adjust to their changed bodies after ostomy, patients must acquire sufficient ostomy self-care skills through dedicated stoma education. While the changes in many healthcare systems compel healthcare professionals to shorten the duration of hospital stay, stoma education cannot be spared for the sake of patients' safety and quality of life. 2. Purpose This study investigated the effects of preoperative stoma education on self-care knowledge, self-care proficiency, anxiety, depression, length of hospital stay, and stoma-related complications. 3. Methodology Patients were randomized into the intervention group (n=21) or the control group (n=20). The control group underwent stoma site marking and three postoperative education sessions, and the intervention group received a single 45-minute session of video-based preoperative stoma education along with stoma site marking and postoperative education. Self-care knowledge, anxiety, and depression were assessed with a questionnaire, and self-care proficiency was assessed via direct observation using a checklist. Stoma-related complications were evaluated by a stoma nurse. Length of hospital stay and disease-related characteristics were analyzed from medical records. 4. Result Compared with the control group, the intervention group showed significantly superior improvements in self-care knowledge (Z = -5.599, P < .001) and self-care proficiency scores (Z = -5.543, P < .001) Furthermore, the intervention group showed decreases in anxiety (Z = -2.247, P < .025) and depression scores (Z = -2.463, P < .014) as well as shorter hospital stay (Z = -2.661, P = .008) and less stoma-related complications (T = -4.980, P < .001). 5. Conclusion In patients undergoing ostomy, a single 45-minute session of preoperative video-based stoma education was effective in significantly improving the self-reported outcomes and reducing stoma-related complications. [ABSTRACT FROM AUTHOR]

The purpose of this study was to understand better how a conversational human voice versus a corporate tone of voice in blogs affects key publics' responses to an organization in the context of a crisis, using a 2 (tone of voice: human/organizational) x 2 (source: public relations executive/private citizen) x 2 (crisis response: defensive/ accommodative) mixed experimental design. Results indicate that first-person voice and personal narratives increased perceptions of social presence and interactivity in online communication. These perceptions subsequently resulted in positive post-crisis outcomes, such as reputation and behavioral intentions. [ABSTRACT FROM AUTHOR]

Purpose: To investigate the frequency and clinical significance of detected incidental lung nodules found on computed tomography (CT) simulation images for hepatocellular carcinoma (HCC) using computer-aided diagnosis (CAD) and a physician review. Materials and Methods: Sixty-seven treatment-naïve HCC patients treated with transcatheter arterial chemoembolization and radiotherapy (RT) were included for the study. Portal phase of simulation CT images was used for CAD analysis and a physician review for lung nodule detection. For automated nodule detection, a commercially available CAD system was used. To assess the performance of lung nodule detection for lung metastasis, the sensitivity, negative predictive value (NPV), and positive predictive value (PPV) were calculated. Results: Forty-six patients had incidental nodules detected by CAD with a total of 109 nodules. Only 20 (18.3%) nodules were considered to be significant nodules by a physician review. The number of significant nodules detected by both of CAD or a physician review was 24 in 9 patients. Lung metastases developed in 11 of 46 patients who had any type of nodule. The sensitivities were 58.3% and 100% based on patient number and on the number of nodules, respectively. The NPVs were 91.4% and 100%, respectively. And the PPVs were 77.8% and 91.7%, respectively. Conclusion: Incidental detection of metastatic nodules was not an uncommon event. From our study, CAD could be applied to CT simulation images allowing for an increase in detection of metastatic nodules. [ABSTRACT FROM AUTHOR]

Purpose: The purpose of this study was to analyze the effect of sexual attitude among the elderly to their sexual life while exploring the moderating effect of general characteristics in the relationship between sexual attitude and sexual life. Methods: A descriptive research design was used. The subjects were 322 married elderly from four silver centers in Seoul and Gangwon-do. Aging Sexuality Attitude Scale developed by White (1982) was used to examine sexual life status and general characteristics of the subjects (gender, age, academic background, religion, economic status, and residential type). For data analysis, x²-test, t-test, and ANOVA were conducted. Since the dependent variable of sexual life is a binary variable, hierarchical logistic regression was implemented. Results: There were 180 people (55.9%) who had a sexual life. Depending on gender (x² =35.03, p<.001), academic background (x² =29.45, p<.001), and economic status (x² =7.36, p=.025), the subjects showed significant difference in terms of sexual life. Regarding sexual attitude, the subjects showed significant difference depending on gender (t=-5.47, p<.001), age (t=-2.31, p=.021), academic background (t=5.16, p<.001), economic status (F=3.17, p=.043), and sexual life status (t=4.99, p<.001). Conclusion: It is important to devise the sex education program in consideration of gender, age, and academic background that showed moderating effects. [ABSTRACT FROM AUTHOR]

Purpose: The purpose of this study was to investigate the effects of sex education for the elderly on sexual knowledge and life satisfaction. Methods: A quasi-experimental study used a non-equivalent control group pre-post test design. A seven week sex education program for the elderly was developed and offered to the treatment group. Subjects were drawn from three welfare centers in Seoul. Twenty six were selected for the treatment l group while 27 were assigned to a comparison group. Sexual knowledge and life satisfaction were measured. Results: The level of life satisfaction reported by the treatment group was greatly increased (t=2.14, p=.037). There were no statistically significant differences in sexual knowledge between both the two groups. Conclusion: A positive influence of sex education was found to increase the level of life satisfaction. Further study on customized sex education for the elderly by individual characteristics is required. [ABSTRACT FROM AUTHOR]

Purpose: The purpose of this study was to examine late-onset hypogonadism, erectile dysfunction, depression, and quality of life among middle-aged male workers. Methods: The subjects included 343 men aged between 40 and 64, responded to self-report questionnaires on general characteristics, late-onset hypogonadism, erectile dysfunction, depression, and quality of life. Data were collected from May 16, 2012 to October 9, 2012 and analyzed using t-test, ANOVA, χ²-test, hierarchical multiple regression. Result: The prevalence rate of late-onset hypogonadism was 63.8% with high points in reduction of libido, energy, physical strength and endurance, and erectile function. There were significant differences in late-onset hypogonadism according to age (χ²=8.98, p=.048) and in erectile dysfunction according to age (F=11.03, p<.001), monthly income (F=2.84, p=.024) and smoking ( t=2.96, p=.018). Significant differences were also found in depression according to educational level (F=8.12, p<.001) and in quality of life according to monthly income (F=7.21, p<.001). The factors which influenced quality of life were late-onset hypogonadism, erectile dysfunction, depression, marital status and religion. Conclusion: Symptoms of erectile dysfunction can be improved by smoking cessation education program. In order to improve the life quality of middle-aged men, nursing intervention programs that would both provide proper knowledge on climacteric syndrome and alleviate symptoms should be designed while, at the same time, other programs to evaluate, prevent and control depression are developed. [ABSTRACT FROM AUTHOR]

Purpose: The purpose of the study was to examine the sexual behavior and awareness of sexually transmitted diseases (STD) among the elderly. Methods: Subjects were 599 elderly living in a metropolitan area who completed a structured questionnaire. Data collection was from September 6, 2011 to January 17, 2012. The data were analyzed by using percentage and χ²-test. Results: Approximately 25% of the subjects reported a sexual life. Age, gender, education, family type, presence and health of spouse, health state of the subject, past occupation, dwelling pattern, and economic state made statistically significant difference in sexual behavior. Fifty five percent of the respondents reported no knowledge of STD. Factors such as age, gender, education, presence of spouse, and past occupation were statistically significant in terms of awareness of STD. Conclusion: Age, education, and presence of spouse should be factored in to understand the sexuality of the elderly as well as to develop sexuality counseling programs that provide adequate information for each individual. [ABSTRACT FROM AUTHOR]

5-Lipoxygenase (5-LO) catalyzes the formation of two major groups of leukotrienes, leukotriene B4 and cysteinyl leukotrienes (CysLTs), and it has been implicated as a promising drug target to treat various inflammatory diseases. However, its role in osteo-clastogenesis has not been investigated. In this study, we used mouse bone marrow-derived macrophages (BMMs) to show that 5-LO inhibitor suppresses RANKL-induced osteoclast formation. Inhibition of 5-LO was associated with impaired activation of multiple signaling events downstream of RANK, including ERK and p38 phosphorylation, and IKB degradation, followed by a decrease in NFATcl expression. Ectopic overexpression of a constitutively active form of NFATcl partly rescued the antiosteoclastogenic effect of 5-LO inhibitor. The knockdown of 5-LO in BMMs also resulted in a significant reduction in RANKL-induced osteoclast formation, accompanied by decreased expression of NFATcl. Similar effects were shown with CysLT receptor (CysLTR)l/2 antagonist and small RNA for CysLTRl in BMMs, indicating the involvement of CysLT and CysLTRl in 5-LO-mediated osteo-clastogenesis. Finally, 5-LO inhibitor suppressed LPS-induced osteoclast formation and bone loss in the in vivo mouse experiments, suggesting a potential therapeutic strategy for treating diseases involving bone destruction. Taken together, the results of this study demonstrate that 5-LO is a key mediator of RANKL-induced osteoclast formation and possibly a novel therapeutic target for bone-resorption diseases. [ABSTRACT FROM AUTHOR]

Purpose: The purpose of this study was to investigate knowledge of cervical cancer and HPV in adult men and their acceptance of vaccination for HPV. Methods: A convenience sample of 229 men between 19 and 39 years of age, responded to self-report questionnaires on knowledge of cervical cancer and HPV, vaccination intention, and general and sexual characteristics. Data were collected during September and October, 2010 and analyzed using t-test, χ2-test, and ANOVA. Results: Mean scores for knowledge of cervical cancer and HPV were 4.88, and 7.87 respectively. Seventy-five percent stated they intended to be vaccinated. There were significant differences in knowledge of cervical cancer depending on education (F=3.04, p=.030), sexual frequency (F=4.62, p=.011), condom use (t=2.19, p=.029), and frequency of condom use (F=3.28, p=.040), and in knowledge of HPV depending on sexually activity (t=2.35, p=.020), condom use (t=0.03, p=.019), and frequency of condom use (F=4.65, p=.011). There were significant differences in vaccination intention depending on education (χ2=10.47, p=.015), but sexual characteristics were not significant for vaccination intentions. Conclusion: The results indicate a need to consider levels of education and knowledge of cervical cancer and HPV in target populations of men, when planning a cervical cancer prevention education program for men. [ABSTRACT FROM AUTHOR]

Purpose: The purpose of this study was to compare the effects of a 45-minute session of video-based preoperative ostomy education on self-care knowledge, self-care proficiency, anxiety, depression, length of hospital stay, and ostomy-related complications to a control group who received 3 postoperative educational sessions., Design: This was a randomized controlled trial., Sample and Setting: The sample comprised 47 patients scheduled to undergo ostomy surgery for colon or rectal cancer surgery at a tertiary referral hospital in Seoul, South Korea, from November 2018 to May 2019. However, 2 participants in the intervention group and 4 in the control group withdrew from the study and data analysis is based on 41 participants who completed study procedures., Methods: Participants were randomly allocated to an intervention group (n = 21) or a control group (n = 20). The intervention group received a single 45-minute session of video-based preoperative ostomy education along with stoma site marking and postoperative education. The control group underwent stoma site marking and 3 postoperative education sessions Self-care knowledge, anxiety, and depression were assessed by validated instruments. Self-care proficiency was assessed via direct observation using a checklist. Ostomy-related complications were evaluated by a WOC nurse. Length of hospital stay and disease-related characteristics were collected from medical records., Results: Compared with the control group, the intervention group showed significant improvements in self-care knowledge (P = .001) and self-care proficiency scores (P = .001). Intervention group participants also had lower anxiety scores (P = .025), depression scores (P = .014), shorter hospital stays (P = .008), and fewer ostomy-related complications (P = .001)., Conclusions: In patients undergoing ostomy surgery, a single 45-minute session of preoperative video-based ostomy education improved self-care knowledge and proficiency. This intervention also reduced depression, anxiety, and ostomy-related complications., Competing Interests: The authors have no conflict of interest to report., (Copyright © 2023 by the Wound, Ostomy and Continence Nurses Society.)

Purpose: The purpose of this study was to evaluate the effects of combined pelvic floor muscle exercises (PFMEs) and a novel electrical stimulation (ES) device versus PFMEs alone on lower urinary tract symptoms, urinary incontinence-related quality of life, and pelvic floor muscle contractions (PFMCs)., Design: Nonrandomized comparison cohort study., Subjects and Setting: The sample comprised 54 community-dwelling middle-aged women with stress urinary incontinence recruited from churches and cultural centers in Gyeonggi Province, South Korea. Comparisons of demographic and pertinent clinical characteristics revealed no significant differences between the experimental and comparison groups., Methods: Participants allocated to the combined intervention group (n = 27) performed self-exercises of the pelvic floor muscles 3 times a day under weekly telephone coaching, and they used the ES device twice daily for 8 weeks. Participants in the comparison group (n = 27) received the PFMEs alone without telephone coaching. The 3 main outcomes including lower urinary tract symptoms, urinary incontinence-related quality of life, and PFMCs were measured using the Bristol Female Lower Urinary Tract Symptom instrument (BFLUTS), King's Health Questionnaire (KHQ), and a perineometer, respectively. Study outcomes were measured at baseline and at the end of the 8-week period., Results: Participants in the experimental group achieved significantly greater reductions in lower urinary tract symptoms (t = -4.07, P < .001) and improvement in urinary incontinence-related quality of life (P = .006), peak PFMC pressure (P = .004), mean pelvic muscle contraction (PMC) pressure (P < .001), and duration of PFMCs (P < .001) when compared to participants undergoing PFMEs alone., Conclusions: Combined ES and pelvic floor exercise was more effective in reducing severity of lower urinary tract symptoms, enhancing health-related quality of life, and increasing PMC pressure in middle-aged women with stress urinary incontinence than PFMEs alone., Competing Interests: The authors declare no conflicts of interest., (Copyright © 2021 by the Wound, Ostomy and Continence Nurses Society.)

The purpose of this study was to examine the effect of auricular acupressure on bowel symptoms, stress, mental health, and heart rate variability in women with irritable bowel syndrome (IBS). A quasi-experimental study design with a nonequivalent control group assessed a total sample of 56 women diagnosed with IBS according to Rome III criteria. There were 29 women in the experimental group who received auricular acupressure; 27 women were in the control group. Semen sinapis albae seeds were used to administer acupressure to four auricular points: endocrine, large intestine, lung, and Shenmen for 5 days/week for 4 weeks; the control group received no treatment. Bowel symptoms, stress, mental health, and heart rate variability were measured twice, once before and once after the intervention. Chi-square tests, t tests, and paired t tests were used for analysis. The experimental group had decreased loose stools, abdominal pain, diarrhea, abdominal discomfort, stress, and heart rate variability compared with the control group (p < .05). Auricular acupressure was effective for symptom improvement in patients with IBS.