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Background We investigated the change of coronary atherosclerosis with long-term exposure to fine particulate matter of aerodynamic diameter Methods Subjects undergoing serial CCTAs between January 2007 and December 2017 (n = 3,127) were analyzed. Each individual's cumulative amount of PM2.5 exposure between the two CCTAs was evaluated by Kriging interpolation and zonal analysis, considering the time interval between the two CCTAs. The main outcome was progression of coronary artery calcium (CAC) with additional semiquantitative analysis on the changes in the severity and composition of atherosclerotic plaques. Results The CAC scores increased by 30.8 Agatston units per-year under a median PM2.5 concentration 24.9μg/m3 and tended to increase with the cumulative amount of PM2.5 exposure (r = 0.321, p Conclusions Cumulative exposure to air pollution is associated with the progression of diffuse coronary calcification, the importance of which may be more significant than other traditional cardiovascular risk factors. Further investigations into the causality between PM2.5 and coronary atherosclerosis are warranted to improve global cardiovascular health.

We describe the epidemiology of a coronavirus disease (COVID-19) outbreak in a call center in South Korea. We obtained information on demographic characteristics by using standardized epidemiologic investigation forms. We performed descriptive analyses and reported the results as frequencies and proportions for categoric variables. Of 1,143 persons who were tested for COVID-19, a total of 97 (8.5%, 95% CI 7.0%–10.3%) had confirmed cases. Of these, 94 were working in an 11th-floor call center with 216 employees, translating to an attack rate of 43.5% (95% CI 36.9%–50.4%). The household secondary attack rate among symptomatic case-patients was 16.2% (95% CI 11.6%– 22.0%). Of the 97 persons with confirmed COVID-19, only 4 (1.9%) remained asymptomatic within 14 days of quarantine, and none of their household contacts acquired secondary infections. Extensive contact tracing, testing all contacts, and early quarantine blocked further transmission and might be effective for containing rapid outbreaks in crowded work settings.

This study examined how exposure to government health advisories on face mask-wearing and trust in government influenced people's compliance with the advisory overtime. We conducted a three-wave panel survey (N = 1,024; T1 in February, T2 in March, T3 in April 2020) in Singapore, where the government initially enforced wearing a face mask conditional on feeling sick, and then later revised its advisory to make mask-wearing mandatory regardless of sickness. Exposure to the initial advisory at T1 had cross-lagged effects on forming positive expectancy, normative, and self-efficacy beliefs on conditional face mask-wearing at T2. Government trust at T1 also had a cross-lagged effect on increasing supportive perceived norm for conditional mask-wearing, while reducing positive expectancy of nonconditional mask-wearing at T2. Exposure to the revised advisory and government trust at T3 were positively associated with outcome expectancy, perceived norm, and self-efficacy regardless of behavior type. Regarding nonconditional mask-wearing, the autoregressive links from T2 to T3 were insignificant for perceived norm and self-efficacy and even negatively significant for intention and behavior. This study offers theoretical and practical insights by documenting the complex and dynamic processes involved in health decision-making during a novel disease pandemic. Ministry of Education (MOE) This research is supported by the Ministry of Education Tier 1 Fund and the Social Science Research Council Grant in Singapore.

Background and Objective This study has evaluated the pharmacokinetic parameters and bioavailabilities of monotropein, kae-mpferol-3-O-glucoside, and quercetin-4’-O-glucoside after administration of MOTILIPERM in rats. Material and Methods Following the administration of MOTILIPERM, the plasma concentrations of each compound in rats were simultaneously determined by using liquid chromatography tandem mass spectrometry (LC-MS/MS). Results The pharmacokinetic parameters of monotropein in rats were AUCinf 20,020.44±3944.67 and 11,915.53±1190.91 min·ng/mL and Cmax 286.99±38.37 and 56.23±9.02 ng/mL for intravenous and oral administration, respectively. The pharmacokinetic parameters of kaempferol-3-O-glucoside in rats were AUCinf 287.86±126.17 min·ng/mL and not estimated; Cmax 5.80±1.87 and 1.24±0.41 ng/mL for intravenous and oral administration, respectively. The pharmacokinetic parameters of querce-tin-4’-O-glucoside in rats were AUCinf 511.38±248.11 and 481.44±65.72 min·ng/mL; Cmax 10.72±2.70 and 2.83±0.34 ng/mL for intravenous and oral administration, respectively. Conclusion The absolute bioavailabilities of monotropein and quercetin-4’-O-glucoside for oral administration were evaluated and calculated as 3.0 and 4.7%, respectively. The absolute bioavailability of kaemp-ferol-3-O-glucoside was not calculated because the elimination rate constant could not be estimated. These results may be applied to the basic data in a further study in order to develop functional foods or herbal medicinal products.

Summary Purpose There is an increasing number of colorectal cancer survivors in South Korea. However, no research has identified supportive care needs of survivors of colorectal cancer in South Korea. Thus, the purpose of this study was to determine the level of supportive care needs and effects of emotional state and quality of life (QoL) on supportive care needs of colorectal cancer survivors. Methods This cross-sectional study was conducted among 115 survivors of colorectal cancer in South Korean who had primary treatment of surgery for colorectal cancer. Data were collected from April to September 2016. Participants responded to self-reported questionnaires assessing supportive care needs, emotional state (Hospital Anxiety and Depression Scale), and QoL (Functional Assessment of Cancer Therapy-Colorectal scale). Results The overall score of supportive care needs for colorectal cancer survivors was 1.22 ± 0.61 (full score: 3 points), with health care staff and social support needs garnering highest scores. Approximately, 20.0% and 21.7% of patients had anxiety and depression, respectively. The mean QoL score was 2.90 ± 0.53, with social and family status having the lowest QoL score. Multiple regression analysis showed that both the period after treatment and anxiety significantly influenced supportive care needs. Conclusion Appropriate interventions should be used immediately after completion of treatment to help reduce anxiety and meet supportive care needs of colorectal cancer survivors.

The study examines differential motivational factors underlying risk information seeking and sharing in the context of transboundary air pollution (“haze”) in Singapore. In particular, it addresses specific conditions under which information insufficiency influences information seeking and sharing. The analysis of an online survey with 1,021 Singaporeans showed that one’s perceived knowledge about haze was a consistent predictor of both information seeking and sharing intention. Information seeking was attitudinally driven, whereas information sharing was primarily driven by the perceived capacity of sharing information. Others’ information insufficiency promoted information sharing only when individuals considered themselves sufficiently efficacious at and had positive attitudes toward information sharing. Addressing perceived others’ knowledge, beyond one’s own, this study provides new theoretical insights into the factors that may promote risk information seeking and sharing. Nanyang Technological University This work was supported by the Nanyang Technological University, HASS Incentive Scheme Award [M4081726.060], Singapore.

A 14-day quarantine is implemented in many countries in response to the coronavirus disease pandemic. Korea implemented a mandatory quarantine for those who had close contact with infected patients and those returning from abroad. The present study explored the implications of mandatory coronavirus disease 2019 testing before releasing individuals from the 14-day quarantine in Incheon, Korea. From February 11 to July 5, 2020, 19,296 people were self-quarantined, and 56 (0.3%) of them were confirmed cases of COVID-19. Twenty (35.7%) were identified through the reporting of symptoms during quarantine, and 32 (57.1%) were identified using mandatory pre-release RT-PCR tests. Among the 32, 14 (25%) individuals reported mild symptoms and 18 (32.1%) were asymptomatic. It is suggested that mandatory diagnostic testing prior to release and the symptom-based surveillance after the 14-day quarantine may help control delayed or asymptomatic COVID-19 cases., Graphical Abstract

Purpose: This study identifies correlations among information needs and knowledge about prenatal genetic screening and diagnosis (I-PGSD & K-PGSD), and attitude toward terminating pregnancy (ATP) among pregnant women in South Korea. Methods: A descriptive survey was conducted from January 2013 to April 2014 in South Korea. 222 pregnant women responded to three questionnaires developed by the authors. The questionnaire for I-PGSD consisted of 19 questions; 18 questions for K-PGSD; and 10 questions for ATP. Results: Mean scores were $80.46{pm}11.73$ for I-PGSD; $14.86{pm}3.74$ for K-PGSD; and $33.71{pm}6.13$ for ATP. The ATP score was positively correlated with the I-PGSD and K-PGSD scores, but statistically significant with only I-PGSD (p=.006). I-PGSD scores were higher than average on three genetic syndromes (Down, Patau, and Edwards syndrome), on management after the diagnosis of positive fetal aneuploidy, and on test result interpretation after the amniocentesis and level II fetal ultrasonogram. Conclusions: In light of current legal and moral controversy regarding terminating pregnancy and rapidly advancing prenatal genetic testing technology, more prenatal genetic education for nurses and nursing students who teach pregnant women is needed. In addition, more professional counseling services provided by trained nurses are also required.

// Jung Nyeo Chun 1, 2, * , Soonbum Park 1, * , Sanghoon Lee 3 , Jae-Kyung Kim 1 , Eun-Jung Park 1 , MinJi Kang 1 , Hye Kyung Kim 4, 5 , Jong Kwan Park 5 , Insuk So 1, 2 and Ju-Hong Jeon 1, 2 1 Department of Physiology and Biomedical Sciences, Seoul National University College of Medicine, Seoul 03080, Korea 2 Institute of Human-Environment Interface Biology, Seoul National University, Seoul 03080, Korea 3 Department of Biochemistry, University of Utah School of Medicine, Salt Lake City, UT 84112-5650, USA 4 College of Pharmacy, Kyungsung University, Busan 48434, Korea 5 Department of Urology, Medical School, and Institute for Medical Sciences, Chonbuk National University, Jeonju 54896, Korea * These authors contributed equally to this work Correspondence to: Ju-Hong Jeon, email: jhjeon2@snu.ac.kr Keywords: schisandra chinensis; schisandrol B; schisandrin B; TGFβ1; NF-κB Received: June 30, 2017 Accepted: November 15, 2017 Published: December 14, 2017 ABSTRACT Aberrant transforming growth factor β1 (TGFβ1) signaling plays a pathogenic role in the development of vascular fibrosis. We have reported that Schisandra chinensis fruit extract (SCE), which has been used as a traditional oriental medicine, suppresses TGFβ1-mediated phenotypes in vascular smooth muscle cells (VSMCs). However, it is still largely unknown about the pharmacologic effects of SCE on various TGFβ1 signaling components. In this study, we found that SCE attenuated TGFβ1-induced NF-κB activation and nuclear translocation in VSMCs. Among the five active ingredients of SCE that were examined, schisandrol B (SolB) and schisandrin B (SchB) most potently suppressed TGFβ1-mediated NF-κB activation. In addition, SolB and SchB effectively inhibited IKKα/β activation and IκBα phosphorylation in TGFβ1-treated VSMCs. The pharmacologic effects of SolB and SchB on NF-κB activation were independent of the Smad-mediated canonical pathway. Therefore, our study demonstrates that SCE and its active constituents SolB and SchB suppress TGFβ1-mediated NF-κB signaling pathway in a Smad-independent mechanism. Our results may help further investigations to develop novel multi-targeted therapeutic strategies that treat or prevent vascular fibrotic diseases.

Introduction The development of novel therapeutic options is imperative in patients with erectile dysfunction, especially those non-responsive to phosphodiesterase type 5 inhibitors. LDD175, a potent BKCa channel opener, has a relaxation effect on the in vitro cavernosal smooth muscle strip. Aim To investigate the effect of LDD175 on erectile function using in vivo animal disease model. Methods Male Sprague-Dawley rats were assigned to a normal control group and seven diabetic groups: diabetic control, sildenafil (1 and 5 mg/kg), LDD175 (5 and 10 mg/kg), LDD175 5 mg/kg plus sildenafil 1 mg/kg, and LDD175 10 mg/kg plus tetraethylammonium. Main Outcome Measures Intracavernosal pressure (ICP), ratio of ICP to mean arterial pressure (MAP), and the area under curve of ICP/MAP of eight groups were compared using in vivo pelvic nerve stimulation. Results The ICP, ICP/MAP ratio, and area under curve of the ICP/MAP ratio of the normal control rats increased with an increase in electrical field stimulation voltage. All parameters in the diabetic control group were significantly lower than those in the normal control rats, with an electrical field stimulation ranging from 1 to 5 V (P < .05). LDD175 improved the erectile response in diabetic rats in a dose-dependent manner. The combination of sildenafil (1 mg/kg) and LDD175 (5 mg/kg) showed a significant additive effect (P < .05) on the improvement of erectile function compared with sildenafil (1 mg/kg) alone. The enhancement of erectile function by LDD175 was completely blocked by tetraethylammonium. Conclusion The results showed that the BKCa channel opener LDD175 improved erectile function in an in vivo diabetic rat model. Furthermore, combination therapy of LDD175 and sildenafil had an additive effect on the improvement of erectile function in diabetic rats. LDD175 could be a new candidate for the treatment of erectile dysfunction.

Purpose The purpose of this study was to identify the purpose, type, and site of medical adhesives (MAs) used for patient care and to measure the incidence of medical adhesive-related skin injury (MARSI) among patients in a pediatric intensive care unit (PICU). Design A prospective observational study. Subjects and setting The sample comprised 60 children hospitalized at a 13-bed PICU in a university-affiliated tertiary care hospital in Yangsan (southeastern Korea) from August 2 to October 25, 2017. The median age was 2.9 months, and the composition of male and female was 34 (56.7%) and 26 (43.3%), respectively. Methods The skin of all participants was examined by first-line staff nurses every shift and occurrences of MARSI were confirmed by a wound care specialist. Characteristics of MA use were analyzed with descriptive statistics, and incidence rates of MARSI were calculated using 3 methods: (1) rate per 100 patients, (2) rate per 100 MAs, and (3) rate per 1000 days of MA use. Chi-squared (χ) tests were conducted to analyze associations between MARSI and sex, age group, and primary service type (medical vs surgical). Results The total number of MAs used was 414 and the total day of use of MAs was 1424.8. Medical adhesives most frequently used were endotracheal tube fixation devices (55/414) and fixation devices for the face (167/414). The number of MARSI occurrences was 35 cases in 23 patients; skin stripping was the most common form of MARSI (26/35). The incidence rate was 58.3 MARSIs per 100 patients, 8.5 MARSIs per 100 MAs, and 24.6 MARSIs per 1000 days of MA use. The MARSI incidence rate was significantly different based on age group (P = .014). Conclusion We observed a frequent occurrence of MARSI among patients in the PICU, especially in patients requiring long-term use of MAs such as central line dressings or in MAs placed in high-moisture areas such as near an endotracheal tube. We highlight the importance of regular skin inspection and frequent but gentle replacement of MAs for prolonged use of MAs in critically ill children.

Endoplasmic reticulum (ER) stress, defined as prolonged disturbances in protein folding and accumulation of unfolded proteins in the ER. Perturbation of the ER, such as distribution of oxidative stress, iron imbalance, Ca2+ leakage, protein overload, and hypoxia, can cause ER stress. The cell reacts to ER stress by activating protective pathways, called the unfolded protein response (UPR), which is comprised of cellular mechanisms aimed for maintaining cellular homeostasis or, in case of excessively severe stress, at the initiation of cellular apoptosis. The three UPR signaling pathways from the ER stress sensors are initiated by activating transcription factor 6, inositol requiring enzyme 1, and protein kinase RNA-activated-like ER kinase. A number of physiological and pathological conditions, environmental toxicants and variety of pharmacological agents showed disruption of proper ER functions and thereby cause ER stress in male reproductive organ in rat model. The present review summarizes the existing data concerning the molecular and biological mechanism of ER stress in male reproduction and male infertility. ER stress initiated cell death pathway has been related to several diseases, including hypoxia, heath disease, diabetes, and Parkinson’s disease. Although there is not enough evidence to prove the relationship between ER stress and male infertility in human, most studies in this review found that ER stress was correlated with male reproduction and infertility in animal models. The ER stress could be novel signaling pathway of regulating male reproductive cellular apoptosis. Infertility might be a result of disturbing the ER stress response during the process of male reproduction.

Introduction: This systematic review protocol describes the methods that will be used to evaluate the efficacy and safety of mindfulness meditation and cognitive behavioral therapy programs as a psychological intervention for insomnia disorders. Methods and analysis: We will search the following 11 electronic databases without language or publication status restrictions: MEDLINE, the Cochrane Central Register of Controlled Trials, EMBASE, Allied and Complementary Medicine Database, Cumulative Index to Nursing and Allied Health Literature, and PsycARTICLES. Furthermore, we will also search 5 Korean-language databases (Oriental Medicine Advanced Searching Integrated System, Korean studies Information Service System, Research Information Service System, Korean Medical Database, and Korea Citation Index). The study selection and data extraction will be performed independently by 2 authors. The study quality assessment and evaluation of the quality of evidence for the main findings will be performed independently by 2 authors using the Cochrane tool for assessing risk of bias and predefined criteria (the Grading of Recommendations Assessment, Development, and Evaluation approach). Data synthesis and analysis will be performed using RevMan Version 5.3. Data will be synthesized by either a fixed effects or random effects model according to a heterogeneity test or the number of studies included in the meta-analysis. If any plan for documenting important protocol amendments changes, the researchers will have a revision agreement and then register the modification in the International Prospective Register of Systematic Reviews (PROSPERO). Ethics and dissemination: Ethical approval will not be required because individual patient data are not included and because this protocol is for a systematic review. The findings of this systematic review will be disseminated through conference presentations. PROSPERO registration number: CRD42018111217.

Polygonum cuspidatum (PC) has been used as traditional Korean medicine to treat various diseases including asthma, hypertension, cancer, and arteriosclerosis. In this study, we assessed the antibacterial and anti-inflammatory effects of PC ethanol extract. Persistent antibacterial activity against Streptococcus mutans for up to 23 days was observed when the extract was used at a concentration of 10 mg/mL. The minimum inhibitory concentration of PC against S. mutans was 0.2 mg/mL and the minimum bactericidal concentration was 10 mg/mL. We compared the antimicrobial activities of S. mutagens cultured with or without PC. Bacterial activity was observed only in the group where RE was not added. The anti-inflammatory effect of PC on RAW264.7 cells was assessed using the MTT assay; changes in nitric oxide (NO) production and inflammatory cytokine levels (tumor necrosis factor [TNF]-α and interleukin [IL]-6) were measured in the presence of PC. In lipopolysaccharide-induced RAW264.7 cells, PC inhibited NO production by 68.6% when used at a concentration of 50 µg/mL. The expression of TNF-α and IL-6 was reduced by PC in a concentration-dependent manner. These results suggest that the ethanol extract of PC could be used as a mouthwash component with antibacterial and anti-inflammatory effects.

Objective To investigate the gastroprotective effects of Acanthopanax senticosus leaves (ASLs) extrusion on acute gastric mucosal lesion in rats induced by compound 48 / 80 (C48 / 80). Methods Rats were divided into six groups: normal; C48/80-induced gastric lesion control; gastric lesion positive control (famotidine 4 mg/kg); gastric lesion administered with two levels of extruded ASLs (ASLE, 40 and 200 mg/kg); and gastric lesion treated with ASLs (ASL 200 mg/kg). Mucus secretion / damage was determined by immunohistological staining. Immunofluorescence and western blotting were performed to determine gastric mucosal Bax and Bcl-2 expression. Gastric mucosal oxidative-stress-related enzymes and malondialdehyde were determined. Results C48/80-induced mucus depletion and inflammation in the gastric mucosa were significantly attenuated by ASLs. The increased serum serotonin and histamine concentrations in C48/80-treated rats were also attenuated by ASLs. Gastric mucosal Bax protein expression was increased and Bcl-2 expression was decreased after C48/80 treatment, and ASLs ameliorated Bax and Bcl-2 expression. The extrusion process significantly augmented the effects of ASLs in a dose-dependent manner. ASLEs at 200 mg/kg normalized mucus damage / secretion, C48 / 80-induced increases of mucosal myeloperoxidase activity (index of inflammation), xanthine oxidase, and malondialdehyde content (index of lipid peroxidation). The effects of ASLs on Bax and Bcl-2 expression were also enhanced by extrusion. Furthermore, these effects of ASLEs at 200 mg/kg were similar to those of famotidine, a histamine H2-receptor antagonist commonly used to treat gastric ulcers. Conclusion ASLEs prevented acute gastric mucosal lesion progression induced by C48/80, possibly by inducing mucus production, and reduced inflammation and oxidative stress in gastric mucosa through an anti-apoptotic mechanism.

Objectives To investigate the effect of 4-chloro-7-trifluoromethyl-10H-benzo[4,5]furo[3,2-b]indole-1-carboxylic acid, a new benzofuroindole derivative, on the intraurethral pressure in a rat model of benign prostatic hyperplasia. Methods Benign prostatic hyperplasia was induced by testosterone and 17β-estradiol, which were administered intramuscularly once a day for 12 weeks. The effects of 4-chloro-7-trifluoromethyl-10H-benzo[4,5]furo[3,2-b]indole-1-carboxylic acid and tamsulosin on the intraurethral pressure induced by the electrostimulation of hypogastric nerves after a single intravenous injection of 4-chloro-7-trifluoromethyl-10H-benzo[4,5]furo[3,2-b]indole-1-carboxylic acid (10 mg/kg) or tamsulosin (10 μg/kg) were evaluated in a benign prostatic hyperplasia model. The electrostimulation-induced intraurethral pressure was measured just before and after the injection of 4-chloro-7-trifluoromethyl-10H-benzo[4,5]furo[3,2-b]indole-1-carboxylic acid. Bodyweight and genitourinary organ weights were recorded, and serums and tissues were subjected to hormone assays and histopathology. In addition, the expression of α1-adrenoceptors in the prostate was measured by western blotting. Results The benign prostatic hyperplasia groups showed increased prostatic index, increased concentrations of testosterone, free testosterone and estradiol in serum, and increased epithelial thickness of the prostate. An injection of 4-chloro-7-trifluoromethyl-10H-benzo[4,5]furo[3,2-b]indole-1-carboxylic acid or tamsulosin significantly inhibited the elevation of electrostimulation-induced intraurethral pressure. In addition, 4-chloro-7-trifluoromethyl-10H-benzo[4,5]furo[3,2-b]indole-1-carboxylic acid did not cause a significant change in the blood pressure compared with tamsulosin. While the benign prostatic hyperplasia group showed increased the expression of α1-adrenoceptors, the 4-chloro-7-trifluoromethyl-10H-benzo[4,5]furo[3,2-b]indole-1-carboxylic acid or tamsulosin injection into a rat model of benign prostatic hyperplasia decreased the expression of α1-adrenoceptors. Conclusions These findings show that 4-chloro-7-trifluoromethyl-10H-benzo[4,5]furo[3,2-b]indole-1-carboxylic acid might be beneficial for lowering the intraurethral pressure associated with benign prostatic hyperplasia, and it could represent a therapeutic option for benign prostatic hyperplasia patients.

Avatars are now used widely across digital content and services, and creating one's own avatar through customization has become a common user activity on digital media. This study focuses on the process involved in avatar customization, which requires engaged self-reflection. We test whether avatar customization enhances persuasive effects through self-affirmation in three lab experiments. Study 1 (N = 126) finds that avatar customization meets the key criteria of the self-affirmation task—self-appraisal and self-awareness—equivalent to a widely-used self-affirmation method based on essay writing. The study also finds that avatar customization significantly enhances how participants feel about themselves. Study 2a (N = 102) and 2b (N = 76) further shows that avatar customization (vs. a matched control) improves persuasion by reducing defensive processing of self-threatening health information. The findings offer important insights for understanding the psychology of avatar customization and its potential utility in communications practice. Nanyang Technological University Accepted version The research was supported by the first author’s Nanyang Technological University, Singapore, Start-up Grant.

Objective To assess the psychometric properties of the Brief PREPARED (B-PREPARED) and the Care Transitions Measure (CTM) in patients discharged from hospitals in Korea, and examine their relationships with health literacy. Design A cross-sectional study with a follow-up telephone survey 4 weeks post-discharge. Setting Six medical and surgical wards in a tertiary hospital in Seoul. Participants 293 patients discharged from general wards. Main outcome measures Psychometric properties of the Korean versions of the B-PREPARED and the 15- and 3-item CTM (CTM-15 and CTM-3), and the 3-item Brief Screening Questionnaire for health literacy. Results All instruments discriminated well between patients who were satisfied with hospital care and the discharge process, and those who were not. One month post-discharge, the CTM-15 score was significantly higher in patients with good health status than the others, and the CTM-3 score was significantly higher in patients who used outpatient care than the others. However, no significant difference was found in the scores for all instruments by emergency department visits, rehospitalization, and medication adherence. Cronbach's alpha values were 0.69 for B-PREPARED, 0.91 for CTM-15 and 0.67 for CTM-3. Intraclass correlation coefficients were 0.64, 0.75 and 0.66, respectively. Approximately 33% of the participants had limited health literacy. After adjusting for other patient variables, those with inadequate health literacy had lower scores on all instruments. Conclusions Although the three instruments had acceptable validity and reliability, they showed limited criterion validity. Patients with limited health literacy should be supported to ensure the quality of transitional care.

Bo Ram Choi,1–3 Hye Kyung Kim,4,* Kiran Kumar Soni,1–3 Keshab Kumar Karna,1–3 Sung Won Lee,5 Insuk So,6 Jong Kwan Park1–3,* 1Department of Urology, Chonbuk National University, Jeonju, Republic of Korea; 2Research Institute of Clinical Medicine of Chonbuk National University-Biomedical Research Institute, Chonbuk National University Hospital, Jeonju, Republic of Korea; 3Clinical Trial Center of Medical Device of Chonbuk National University, Jeonju, Republic of Korea; 4College of Pharmacy, Kyungsung University, Busan, Republic of Korea; 5Department of Urology, Samsung Medical Center, Samsung Biomedical Research Institute, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea; 6Department of Physiology and Biomedical Sciences, Seoul National University College of Medicine, Seoul, Republic of Korea *These authors contributed equally to this work Objective: We investigated the benefits of the BKCa agonist 4-chloro-7-trifluoromethyl-10H-benzo[4,5]furo[3,2-b]indole-1-carboxylic acid (LDD175) combined with tamsulosin and finasteride, in a benign prostatic hyperplasia (BPH) rat model.Materials and methods: Castration was performed by bilateral orchiectomy under ketamine anesthesia. A rat model of BPH was established by daily intramuscular administration of testosterone propionate plus 17β-estradiol for 8 weeks. Model rats were administered combinations of 20 mg/kg LDD175, 0.01 mg/kg tamsulosin and 1 mg/kg finasteride once daily by oral gavage for 4 weeks from week 6 to 9 post-surgery. Intraurethral pressure induced by electrostimulation of the hypogastric nerve was measured at the end of administration. Body and genitourinary organ weights were recorded, serums were assayed for hormone concentrations, and tissues were subjected to histopathology, and analyses of α1-adrenoceptor mRNA and protein expression levels after treatment.Results: Combined LDD175, tamsulosin, and finasteride significantly decreased prostatic index, serum hormone levels, epithelial thickness, and prostate expression of α1-adrenoceptors in BPH model rats. The 3-drug combination was more effective than any other combination or LDD175 alone.Conclusion: These results suggest that LDD175 addition to tamsulosin and finasteride may be beneficial for the treatment of BPH patients who do not respond to tamsulosin plus finasteride. Keywords: α1-adrenoceptors, α1-adrenergic receptor antagonists, benzofuroindole, intraurethral pressure, 5α-reductase inhibitors&nbsp

Container technology has become an integral part of today’s major IT services. Although it offers several benefits, it also introduces new challenges for operating and maintaining secure container environments. One such challenge is to retain the ability to detect and address the containers’ vulnerabilities and compliance violations. However, designing an effective solution to enable this capability must be based on the accurate understanding of characteristics observed from actual container images and instances. To contribute toward this objective, we have built a general data processing framework, applying the principles of the state-of-the-art. It is a system that decouples the data collection process from the analysis so as to allow user to focus more on building new analysis logics rather than on the tools for monitoring agents. We applied it to the analysis of container images from the Docker Hub image repository, to learn about their security posture. In this work we present various interesting findings and new insights from analyzing the public image corpus. We have learned that more than 92% of the images contain compliance violations and/or vulnerable packages.

암환자는 항암제, 약물, 수액, 영양제, 혈액 주입 및 혈액 채취 등을 안전하고 편리하게 시행하기 위해 중심정맥관을 삽입하는 경우가 많다(Bae, 2011; Mitchell, Anderson, Williams, & Umscheid, 2009). 그 중 삽입형 포트는 카테터를 정맥에 삽입하고 이와 연결되는 포트는 피하에 삽입되는 장치로(Bae, 2011), 피하에 삽입된 포트는 외관상 잘 보이지 않고 바늘이 꽂혀 있지 않은 상태에서는 피부 소독을 할 필요가 없으며, 카테터가 당겨지거나 절단될 위험도 없다(Lamont et al., 2003). 또한 다른 중심정맥관에 비해 감염률이나 혈전 등의 부작용이 적으며, 수영, 목욕 등 환자들의 일상활동에 제약을 주지 않아서(Dougherty, 2006; Maki, Kluger, & Crnich, 2006), 주기적인 항암치료에 가장 적합하고, 항생제 치료와 총정맥영양에 사용

The aim of this study is to develop fashion cultural product designs in order to promote the Iksan region by using motifs from the Mireuksaji, Iksan`s most representative archeological site of Baekje culture. The fashion cultural products designs developed by applying cultural resources can be effective at enhancing our cultural identity. Adobe Illustrator CS4 and Adobe Photoshop CS4 were used to reconstruct motifs from the Sumakse tiles and the bronze horse figure in the Mireuksaji Museum. The Iksan brand slogan "Amazing Iksan" was combined with the bronze horse to emphasize the local cultural identity. The motifs from the Mireuksaji were modified and stylized to make different patterns and these patterns were repeated in various ways to be applied to necktie and scarf designs. The motifs for necktie designs were double-row chrysanthemum tiles and phoenix tiles, and the motifs for scarf designs were the double-row lotus tiles and the bronze horse artifacts. Different colorways were chosen and the value of each color was displayed in the CMYK percentages. As a result, eight necktie designs and twelve scarf designs were proposed. The motifs and patterns developed in this study can be used to introduce Iksan`s distinct history as the birthplace of Baekje culture. It is also expected that the result of this study can advance the promotion of Korean traditional culture internationally.

Little is known about the home food safety practices of Mexican-Americans living in the U.S. The current study examined the knowledge, perception of food safety risk and factors associated with home food safety practices among the Mexican-Americans who cook regularly for their families. Ten focus group interviews in New York and Texas identified a number of issues. Most participants did not defrost properly (i.e., placed frozen meat in the sink or countertop) and did not handle leftovers safely (i.e., cooled down more than 2 h at room temperature). Although participants reported good hygienic practices in the use of utensils when cooking, there seemed to be limited awareness of the dangers of cross-contamination when handling raw meats and produce; unsafe thawing of raw meats by leaving the raw meat in the sink or counter, and handling of cooked meats. Many incorrectly believed that the appearance of cooked meats was an indicator of safety, and that a food thermometer was unnecessary. These focus group findings informed a probability–based web panel survey (N = 468) of Mexican-Americans who cook for their families in the United States. The survey study reports two major findings: (1) Mexican-Americans' perception and awareness about food safety risk were closely related to their reported food preparation practices (except for eating raw eggs) and (2) Mexican-Americans born in the U.S. and those of Mexican origin living in the U.S. differed in their level of risk awareness and in their compliance with some associated food safety practices. Practical implications are discussed for designing targeted communication campaigns to increase compliance with safe home food preparation practices.

This study aimed to investigate the metabolic syndrome-related risk factors for the development of benign prostatic hyperplasia (BPH) with lower urinary tract symptoms (LUTS) in healthy men.A total of 4880 healthy men who underwent transrectal ultrasonography at our hospital during routine health examinations were included in this study. Those who had undergone a prior biopsy or surgery for prostate disease, were suspected of having urinary tract infection, or were taking BPH/LUTS or metabolic syndrome medications were excluded. BPH/LUTS was defined as an International Prostate Symptom Score (IPSS) of ≥8 and a prostate volume (PV) of ≥30 cm.The subjects had a mean age of 54.1 years, PV of 29.2 cm, prostate-specific antigen (PSA) level of 1.20 ng/mL, and IPSS of 9.2. The annual PV growth rate was 0.48 cm/year. Age, body mass index (BMI), PSA, basal metabolic rate, apolipoprotein A-1, fasting blood glucose, high-density lipoprotein (HDL) cholesterol levels were significant predictive factors for PV. Age, PSA, apolipoprotein B, fasting blood glucose, cholesterol, HDL, and low-density lipoprotein (LDL) levels were predictors of BPH/LUTS at the initial health examination. A decreased fat mass and LDL level were a significant risk factor for the development of BPH/LUTS within 5 years in men without a BPH/LUTS diagnosis at the initial examination.Metabolic syndrome-related variables were strongly associated with BPH/LUTS and by decreasing fat mass and LDL levels, development of BPH/LUTS could be prevented within 5 years in healthy Korean men.

This study investigates how both positive and negative emotions relate to stakeholders' attributions of crisis responsibility, relational trust, and willingness to engage in crisis-related information seeking from the organization. Structural equation modeling was used to analyze data obtained from a survey of 429 students in a university that experienced a large H1N1 influenza outbreak. Students felt several positive emotions more frequently than negative emotions during a flu pandemic. Crisis responsibility was associated with both negative and positive emotions, and these emotions were significant mediators between crisis responsibility and both relational trust and willingness to seek information from the organization in a crisis. Implications of these findings are discussed.

This paper develops fashion products that express the beauty of Baekje through an investigation of the unique characteristics of Baekje artifacts. This work can promote the Baekje region and provide cultural goods for local festivals to improve the economic competitiveness of the area. Artifacts from the Muryongwangreung in Gongju (the capital city of Baekje during the Woongjin period)were reinterpreted into a more modern form. Among the Muryongwangreung arti- facts, the king and queen's gold coffin as well as chignon ornaments were used as design motifs. These artifacts were styl- ized into motifs and developed into patterns using Adobe Illustrator CS3 and Adobe Photoshop CS3. The patterns were subsequently applied to the designs of scarves and ties. The color was selected using the CMYK colorway from the Gongju city logo subsequently, a total of 12 designs (including 6 ties and 6 scarves) were developed. The design developed from this research can be applied to diverse products to promote the area. Using the research as a foundation, fashion product development based on the local culture can have a significant impact on the establishment of the Baekje cultural identity and the competitiveness of the region.

Although culture is acknowledged as an important factor that influences health, little is known about cultural differences pertaining to cancer-related beliefs and prevention behaviors. This study examines two culturally influenced beliefs-fatalistic beliefs about cancer prevention, and optimistic beliefs about cancer risk-to identify reasons for cultural disparity in the engagement of cancer prevention behaviors. We utilized data from national surveys of European Americans in the United States (Health Information National Trends Survey 4, Cycle3; N = 1,139) and Asians in Singapore (N = 1,200) to make cultural comparisons. The odds of an Asian adhering to prevention recommendations were less than half the odds of a European American, with the exception of smoking avoidance. Compared to European Americans, Asians were more optimistic about their cancer risk both in an absolute and a comparative sense, and held stronger fatalistic beliefs about cancer prevention. Mediation analyses revealed that fatalistic beliefs and absolute risk optimism among Asians partially explain their lower engagement in prevention behaviors, whereas comparative risk optimism increases their likelihood of adhering to prevention behaviors. Our findings underscore the need for developing culturally targeted interventions in communicating cancer causes and prevention. Accepted version

This study was conducted in order to develop an aptitude test for child care teachers (ATCCT) and to analyze it in terms of both validity and reliability. The main participants in this study consisted of 710 pre-service child care teachers. The results of factor analysis identified 7 factors and 56 items which were selected from 121 items in the original scale. The seven factors were as follows; interpersonal relationship management abilities, receptiveness and responsiveness to children, creativity and personal development, the ability to form close relationships with children, the ability to supervise child safety, the sense of duty, and positive emotions. The four factors were related to social relationship. Criterion-related validity was established by using correlations between the ATCCT and the TSES (Teacher Self-efficacy Scale). The internal consistency was found to be relatively high (Cronbach`s

The purpose of the study were to investigate the effect of the neuro-feedback program which improves brain function and stress reduction effect. The research design is one group pretest-posttest survey. 121 nursing students of a college in the Busan region took part in the study. Training involving the neuro-feedback program was conducted twice a week, 30 minutes per session, for a total of 10 weeks. The collected data was encoded and analyzed using SPSS 12.0 Version. The brain function and stress levels of the subjects were analyzed through the before-and-after results of the training were analyzed using a paired t-test. The results of the study showed that the BQ and SQ were enhanced as a result of the neuro-feedback. In particular, there were significant increases in the SRQ, ATQ, ACQ, and EQ of the BQ. SQ is correlated with the prevalence rate and resistance to disease, meaning not only psychological anxiety, uneasiness and excitement, but also physical anxiety and response to disease. Based on the study, by using the neuro-feedback training as a program for stress reduction, it is expected that nursing students will receive less stress from internal and external factors, and their ability to cope with stress will be enhanced.

The purpose of this study is to develop design for daily hanbok with Jacquard textile design developed by using the traditional patterns that suit the needs and lifestyles of the middle and old aged group. This study will also develop Jacquard textile design that has elaborate and luxurious patterns and abundant expression of colors using the traditional patterns that suit the needs and lifestyles of the middle and old aged group. Developing daily hanbok design for woman`s casual and formal occasion will contribute to fashion business significantly by popularization of daily hanbok as one of the important fashion genre. The "Texpro Design CAD V8.21" program was used for the textile design. A total of 2 designs were developed as the Jacquard textile design with traditional patterns using flower motifs. One type of fabric was produced for each of the textile design with a color selected from "Pantone Color Chips". And finally, four woman`s daily hanbok design for either casual or and formal style were developed and these daily hanboks were consisted of one set of jacket and trouser, durumagi, one set of jacket and skirt and one set of vest and trouser. And the actual garments were constructed and the design procedure and the photos of these works were presented. This study showed the possibility of producing highly sensible daily hanbok that suits the fashion trend of middle aged women and the widening of consumer range and the creation of new market by developing Jacquard textile design.

What's known on the subject? and What does the study add? Schisandra chinensis extract (SCE) has been known to have relaxative effects on penile smooth muscle. A recent study showed that SCE could enhance slidenafil citrate-induced relaxation of penile corpus cavernosum. The current study investigated the mechanism of action of SCE and its constituents on corporal smooth muscle cells. And this study shows that SCE induced relaxation of CSM primarily through an endothelium independent pathway and the relaxation effects of SCE on corporal smooth muscle are, in part, due to the activation of K+ channels and inhibition of TRPC6 channels, resulting in decreased [Ca2+]. OBJECTIVE • To evaluate the relaxant effects of Schisandra chinensis extract (SCE) on corporal tissue in the penis and to investigate the mechanism of action of SCE and its constituents on corporal smooth muscle (CSM) cells. MATERIALS AND METHODS • The fruit of SC was collected and extracted with ethanol. Six SC lignans (schisandrol A, schisandrol B, schisandrin A, schisandrin B, gomisin N, and schisandrin C) were isolated and purified, and the chemical structures were confirmed by 1H-nuclear magnetic resonance (NMR) and 13C-NMR data. • Isolated rabbit CSM strips were mounted in an organ-bath system, and the effects of SCE were evaluated. • To estimate the intracellular Ca2+ level ([Ca2+]i), we used a Fura-2 fluorescent technique, and a conventional whole-cell patch-clamp technique was used to measure the calcium-sensitive K+ channels (KCa), inward rectifier K+ channels (KIR), and canonical transient receptor potential cation channel 6 (TRPC6) currents. RESULTS • SCE induced concentration-dependent relaxation in contracted CSM tissue, and the removal of the endothelium did not significantly affect their relaxation potencies. • In CSM cells, extracellular application of SCE significantly increased whole-cell KCa currents (117.4%) and KIR currents (110.0%). These effects were completely abolished by charybdotoxin or BaCl2. • In contrast, carbachol-induced TRPC6 channel activity was significantly inhibited (87.3%) by SCE in green fluorescent protein-TRPC6 pcDNA transfected HEK 293 cells. [Ca2+]i measurements showed that SCE effectively reduced basal [Ca2+]i in both cell lines (CSM cells and A7r5 cells) and the [Arg8]-vasopressin (AVP)-induced [Ca2+]i increase in A7r5 cells. • Among the six SC lignans, schisandrin A and schisandrin B most effectively attenuated the AVP-induced [Ca2+]i increase. CONCLUSIONS • SCE induced relaxation of CSM that occurred primarily via an endothelium-independent pathway. • The relaxation effects of SCE on CSM were, in part, due to the activation of K+ channels and inhibition of TRPC6 channels, resulting in decreased [Ca2+]i.

The effect of the ethanol extract and active components of the fruit of Schisandra chinensis was evaluated on rabbit penile corpus cavernosum (PCC). PCC, pre-contracted with 10(-5) m phenylephrine (Phe), was treated with extracts of S. chinensis at five different compositions of ethanol and water (95%, 70%, 50%, 30% and ethanol/water [v/v]) and three fractions (0.1, 0.5, 1 and 2 mg/mL). The effect of the extracts and active lignans (schisandrol A and schisandrol B) from S. chinensis on sildenafil citrate pre-incubated PCC was also evaluated. The PCC relaxation induced by the 95% ethanol extraction and the n-hexane fraction was concentration-dependent and the ethanol extract enhanced sildenafil citrate-induced PCC relaxation. The active components of S. chinensis (schisandrol A and schisandrol B) significantly enhanced sildenafil citrate-induced relaxation >2-fold; schisandrol A had the highest relaxant effect on sildenafil citrate pre-incubated PCC. The lignans, schisandrol A and schisandrol B, isolated from the fruits of S. chinensis enhanced sildenafil citrate-induced relaxation and may have synergistic action in patients who do not completely respond to sildenafil.

The purpose of this study is to develop design for daily hanbok with Jacquard textile design developed by using the traditional patterns that suit the needs and lifestyles of the middle and old aged group. This study will also develop Jacquard textile design that has elaborate and luxurious patterns and abundant expression of colors using the traditional patterns that suit the needs and lifestyles of the middle and old aged group. Developing daily Hanbok design for woman's casual and formal occasion will contribute to fashion business significantly by popularization of daily hanbok as one of the important fashion genre. The "Texpro Design CAD V8.21" program was used for the textile design. A total of 3 designs were developed as the Jacquard textile design with traditional patterns using lotus flower motifs. One type of fabric was produced for each of the textile design with a color selected from "Pantone Color Chips". And finally, three woman's daily Hanbok design for either casual or and formal style were developed and these daily Hanboks were consisted of Durumagi, one-piece dress, and one set of jacket and trouser. And the actual garments were constructed and the design procedure and the photos of these works were presented. This study showed the possibility of producing highly sensible daily hanbok that suits the fashion trend of middle aged women and the widening of consumer range and the creation of new market by developing Jacquard textile design.

The purpose of this study was to examine university students' clothing and cosmetics purchasing behaviors according to gender and major. For the study, 337 university students living in Chonbuk area participated in this survey research. The data were analyzed utilizing SPSS statistics package. Exploratory factor analysis, reliability test, and t-test were used. Five factors in each clothing and cosmetics purchasing orientation were generated from the factor analysis. According to gender and major, clothing and cosmetics purchasing behavior were significantly different. Female students showed more impulsive, rational, and economical purchasing orientations than male students did. On the contrary, male students showed more independent and convenient purchasing orientations. The students with fashion design major showed higher tendency in impulsive and rational clothing purchasing orientations than non-fashion design major students. Finally, clothing and cosmetics purchasing behaviors were significantly different by gender and major in terms of information usage and expenditure for clothing and cosmetics.