Search

In Ju Yoon,1 Su Jung Lee2 1Graduate School of Nursing Science, Hallym University, Hallym University Sacred Heart Hospital, Anyang, South Korea; 2School of Nursing, Research Institute of Nursing Science, Hallym University, Chuncheon, South KoreaCorrespondence: Su Jung Lee, Tel +82-33-248-2722, Fax +82-33-248-2734, Email sujunglee.95@gmail.comBackground and Purpose: The COVID-19 pandemic can cause psychological distress, and hemodialysis patients with chronic kidney disease may be particularly vulnerable. The aim of this study is to investigate anxiety levels among patients undergoing hemodialysis during the COVID-19 pandemic and to explore the relationship between health literacy and anxiety.Methods: This study recruited 149 hemodialysis patients from two hospitals between July 16th and July 31st, 2021. Patient data were collected using questionnaires on general characteristics, health literacy, generalized anxiety, and coronavirus disease-related anxiety. We used the Coronavirus Anxiety Scale (CAS) and the Korean version of the Generalized Anxiety Disorder (GAD) scale to evaluate the anxiety symptoms of the patients. Statistical analyses were performed using descriptive statistics, t-test, Mann–Whitney U-test, one-way ANOVA, Kruskal-Walli’s test and Spearman’s rank correlation.Results: The results showed that health literacy increased with decreasing age and increasing educational level among patients who source health information from the internet and among patients without comorbidities. Patients with comorbidities showed high levels of general anxiety. Patients who search for health information for ≥ 1 hour had high levels of coronavirus disease-related anxiety. Both CAS and GAD showed a significant negative correlation with the sub-domains of health literacy, except for critical health literacy.Conclusion: The results of this study highlight the need for a follow-up study on whether health literacy programs will reduce the anxiety levels of patients undergoing hemodialysis during infectious disease outbreaks. In addition, provision of social support for patients with comorbidity is essential for reducing their anxiety levels during disease outbreaks.Keywords: end-stage kidney disease, anxiety, health literacy, coronavirus disease-19, pandemics

Purpose: This study aimed to evaluate the role of Doppler ultrasound (US) and elastography to identify residual breast cancer for patients showing near complete response following chemotherapy on magnetic resonance imaging (MRI).Methods: Between September 2016 and January 2018, 40 breast cancer patients who showed near complete response (either tumor size ≤0.5 cm or lesion-to-background parenchymal signal enhancement ratio ≤1.6) on MRI following neoadjuvant chemotherapy were prospectively enrolled. After excluding seven women who did not undergo Doppler US and elastography, 33 women (median age, 49 years; range, 32 to 67 years) were analyzed. On the day of surgery, women underwent Doppler US and elastography for tumor bed prior to US-guided core needle biopsy. Histopathologic results of biopsy and surgery were evaluated. Negative predictive value (NPV) and false negative rate (FNR) of biopsy and the combined Doppler US and elastography were analyzed, respectively.Results: After surgery, nine women had residual cancers and 24 women had pathologic complete response. The NPV and FNR of biopsy were 92% (24 of 26) and 22% (2 of 9), respectively. The NPV and FNR of combined Doppler US and elastography were 100% (14 of 14) and 0% (0 of 9), respectively. All of nine women with residual cancers had positive vascularity or elasticity. Two women with false-negative biopsy results, having 0.3 cm or 2.5 cm ductal carcinoma in situ at surgery, showed positive vascularity or elasticity.Conclusion: Tumor bed showing positive vascularity or elasticity indicates residual breast cancer for patients showing near complete response on MRI following chemotherapy.

The purpose of this case report was to present a rare clinical case of successful new dental implant installation in the site of previously healed medication-related osteonecrosis of the jaw (MRONJ). An 80-year-old female patient with history of oral bisphosphonate (BP) therapy presented with pain and swelling of gingiva in the right posterior mandible. One of the 3 implants placed 15 years ago in the right mandibular posterior area was removed 6 months before the visit to our hospital, which led to worsening of the symptoms. After clinical and radiographic examination, the patient was diagnosed with stage 2 MRONJ. Along with antibiotic therapy, the patient underwent surgical intervention via sequestrectomy and removal of the remaining 2 implants. Adequate soft and hard tissue healing without any complications and signs of recurrence was confirmed, and implant installation with simultaneous bone grafting and prosthesis fabrication were done in the explantation sites of MRONJ. By the 7-year follow-up, no implant failure has been observed, and installation of implants was successful in the previously healed MRONJ site. Dental implant installation is possible in a patient with history of failed implant due to MRONJ. However, a careful treatment planning is needed before implantation in a previously healed site of MRONJ to reduce the potential risks of MRONJ recurrence and implant failure.

Taking the slanted satellite viewing geometry into account is important in the simulation of satellite radiances, which vary with the atmospheric conditions along the line of sight. As a first step to take the slanted satellite viewing geometry into account in the numerical weather prediction system operated in the Korean Meteorological Administration, the slant-path modeling is applied for the simulation of clear-sky thermal radiances of a geostationary satellite imager, the Advanced Meteorological Imager (AMI) on board the Geo-KOMPSAT-2A (GK2A). The observations minus simulations (O − B) and the Jacobians before and after the slant-path calculation are compared. Since most infrared channels of AMI are not sensitive to the atmosphere above the tropopause, the size of slant-path effect for AMI is overall smaller than the effect shown in the microwave sounders. Still, the slant-path modeling is found to have a noticeable effect on the three water vapor absorption channels of AMI peaking between 300 and 600 hPa, particularly at large satellite zenith angles and on the regions with high water vapor variabilities in the model field along the line of sight. On average, the slant-path interpolation reduces the standard deviation of O − B of the water vapor channels by around 2.0% on land and 1.4% over the ocean for zenith angles 40°–60°, and it also influences not only the shape and magnitude but also the height of the peak of the Jacobians. In addition, the retrieval experiment based on the optimal estimation also demonstrates the impact of this new approach in the retrieved moisture field, though the improvement is not as significant as shown in the simulation experiment.

Roses (Rosa hybrida) are a highly merchandised flower but lack blue varieties. Overexpression of the flavonoid 3′,5′-hydroxylase (F3′5′H) gene can increase the accumulation of blue pigment (delphinidin anthocyanin). However, sometimes the effect of F3′5′H gene alone is inadequate for producing blue flowers. Furthermore, the internal environment of the cell, such as an increase in pH, can also help the conversion of anthocyanins to blue pigments. Nonetheless, genetic engineering methods can simultaneously introduce multiple genes at the same time to regulate the development of blue pigments to achieve the ultimate breeding goal of producing blue color in roses. In the present study, to simultaneously adjust the accumulation of delphinidin and vacuolar pH, we introduced the Viola tricolor flavonoid 3′,5′-hydroxylase (VtF3′5′H) and Rosa hybrida Na+/H+ exchanger (RhNHX) genes into the white rose line “KR056002” using Agrobacterium-mediated transformation. The quantitative real time polymerase chain reaction (qRT-PCR) results showed that the heterologous genes in the transgenic lines were highly expressed in petals and leaves, and simultaneously promoted the expression of related anthocyanin synthesis structural genes. Obvious color changes were observed in both petals and young leaves, especially when petals changed from white to red-purple. The formation of delphinidin was not detected in the petals of control plants, whereas the petals of transgenic lines had higher delphinidin content (135–214 μg/l) and increased pH value (0.45–0.53) compared with those of control plants.

Purpose: To report a case of bilateral optic neuropathy after COVID-19 infection.Case summary: Thirty-four-year-old woman presented with bilateral ocular pain, visual disturbance, and decreased visual acuity after contracting COVID-19 infection 16 days ago. At the initial visit, best-corrected visual acuity was 0.8 in the right eye, and 0.7 in the left eye. Left eye had relative afferent papillary defect and visual field tests revealed enlarged blind spot in both eyes. Fundus exam showed bilateral optic disc swelling and peripapillary retinal hemorrhage along with vitreous hemorrhage in the left eye. Fluorescein angiography revealed bilateral leakage of dye from the optic disc with area of hypofluorescence corresponding to retinal hemorrhage around the optic disc in both eyes. Brain magnetic resonance imaging (MRI) showed ill-defined left optic nerve enhancement. A diagnosis of bilateral optic neuropathy was made, and the patient was treated with high dose IV steroid 1 g per day for 3 days and oral steroid tapering for 2 weeks. Disc swelling and retinal hemorrhage were improved 1 month after treatment along with enhanced visual acuity to 1.0.Conclusions: Bilateral optic neuropathy following COVID-19 infection showed improvement after steroid treatment.

Background: Providing correct information about dementia and people living with dementia and improving the attitude toward the disease have important implications in overcoming prejudice and negative perceptions and strengthening the social support system. However, studies are limited about which aspects of dementia knowledge affect attitudes toward it and the influence of such knowledge on particular aspects of such attitudes. Objective: This study examined which part of dementia knowledge affects attitudes toward dementia and, furthermore, the influence of such knowledge on two aspects of attitudes in the general population. Methods: A population-based cross-sectional survey of 1,200 participants aged 20 years or older was adopted. A landline and wireless telephone survey was conducted from October 12 to October 22, 2021. The survey data included self-report questions about dementia knowledge, dementia attitudes, demographics, and family information. Multiple linear regression analysis was performed. Results: Dementia knowledge was positively associated with global dementia attitudes. In terms of the relationship between the two dimensions of dementia attitudes and knowledge, the latter displayed a significant positive association with accepting attitudes (β= 0.121, p

Purpose of Review Extracorporeal shock wave lithotripsy success rates depend on several stone and patient-related factors, one of which is stone density which is calculated on computed tomography scan in Hounsfield Units. Studies have shown inverse correlation between SWL success and HU; however, there remains considerable variation between studies. We performed a systematic review regarding the use of HU in SWL for renal calculi to consolidate the current evidence and address current knowledge gaps. Recent Findings Database including MEDLINE, EMBASE, and Scopus were searched from inception through August 2022. Studies in English language analysing stone density/attenuation in adult patients undergoing SWL for renal calculi were included for assessment of Shockwave lithotripsy outcomes, use of stone attenuation to predict success, use of mean and peak stone density and Hounsfield unit density, determination of optimum cut-off values, nomograms/scoring systems, and assessment of stone heterogeneity. 28 studies with a total of 4,206 patients were included in this systematic review with sample size ranging from 30 to 385 patients. Male to female ratio was 1.8, with an average age of 46.3 years. Mean overall ESWL success was 66.5%. Stone size ranged from 4 to 30 mm in diameter. Mean stone density was used by two-third of the studies to predict the appropriate cut-off for SWL success, ranging from 750 to 1000 HU. Additional factors such as peak HU and stone heterogeneity index were also evaluated with variable results. Stone heterogeneity index was considered a better indicator for success in larger stones (cut-off value of 213) and predicting SWL stone clearance in one session. Prediction scores had been attempted, with researchers looking into combining stone density with other factors such as skin to stone distance, stone volume, and differing heterogeneity indices with variable results. Summary Numerous studies demonstrate a link between shockwave lithotripsy outcomes and stone density. Hounsfield unit Trial Registration International Prospective Register of Systematic Reviews (PROSPERO) database: CRD42020224647

Atherosclerosis, the leading cause of death, is a vascular disease of chronic inflammation. We recently showed that angiopoietin-like 4 (ANGPTL4) promotes cardiac repair by suppressing pathological inflammation. Given the fundamental contribution of inflammation to atherosclerosis, we assessed the role of ANGPTL4 in the development of atherosclerosis and determined whether ANGPTL4 regulates atherosclerotic plaque stability. We injected ANGPTL4 protein twice a week into atherosclerotic Apoe−/− mice and analyzed the atherosclerotic lesion size, inflammation, and plaque stability. In atherosclerotic mice, ANGPTL4 reduced atherosclerotic plaque size and vascular inflammation. In the atherosclerotic lesions and fibrous caps, the number of α-SMA(+), SM22α(+), and SM-MHC(+) cells was higher, while the number of CD68(+) and Mac2(+) cells was lower in the ANGPTL4 group. Most importantly, the fibrous cap was significantly thicker in the ANGPTL4 group than in the control group. Smooth muscle cells (SMCs) isolated from atherosclerotic aortas showed significantly increased expression of CD68 and Krüppel-like factor 4 (KLF4), a modulator of the vascular SMC phenotype, along with downregulation of α-SMA, and these changes were attenuated by ANGPTL4 treatment. Furthermore, ANGPTL4 reduced TNFα-induced NADPH oxidase 1 (NOX1), a major source of reactive oxygen species, resulting in the attenuation of KLF4-mediated SMC phenotypic changes. We showed that acute myocardial infarction (AMI) patients with higher levels of ANGPTL4 had fewer vascular events than AMI patients with lower levels of ANGPTL4 (p

Phosphorus (P) is a macro mineral needed for bone mineralization and cell membrane structure and P is also involved in several fundamental pathways of metabolism in the body. Because of the low concentration and digestibility of P in plant ingredients that are the main components of diets for poultry and pigs, feed phosphates are usually included in diets in addition to the P contributed by plant ingredients. The most widely used feed phosphates in poultry and swine diets are dicalcium phosphate (DCP) and monocalcium phosphate (MCP), but tricalcium phosphate (TCP), monosodium phosphate (MSP), and magnesium phosphate (MgP) may be used as well. Because feed phosphates are mostly produced from rock phosphate, feed phosphates have impurities that contain minerals other than P. Concentrations of P in feed phosphates range from 14.8% (MgP) to 25.7% (MSP). The standardized total tract digestibility (STTD) of P in pigs ranges from 71% (TCP) to 95% (MSP). The STTD of Ca and the standardized ileal digestibility (SID) of P and Ca in feed phosphates fed to pigs and poultry have been determined only in a few experiments. Available data indicate that the STTD of Ca and SID of P in MCP are greater than in DCP in both poultry and pigs, but the SID of Ca is similar between DCP and MCP fed to broilers. Information on mineral concentrations and digestibility values in feed phosphates is needed in diet formulation for pigs and poultry, but if diets are formulated to contain equal concentrations of digestible P and Ca, it is unlikely that animal performance will be impacted by the source of feed phosphates used in the diet.

Although three-dimensional (3D) bioprinting is a promising technology for reconstructing artificial tissues and organs using bioink, there is a lack of a bioink that satisfies all requirements, including printability, gelation, mechanical properties, and cytocompatibility, Herein, a novel self-crosslinkable bioink derived from chitosan (CS) and gallic acid (GA) is presented. 3D printed scaffolds with excellent shape fidelity are realized by systematically analyzing the self-crosslinking mechanism of hydrogel formation from CS-GA conjugates and by optimizing various parameters of the printing process. The CS-GA hydrogel forms rapidly in a physiological pH without any chemical crosslinking agent. In addition, the CS-GA hydrogel exhibited various physical and chemical intermolecular interactions, fast gelation rates, and excellent mechanical properties (337 kPa). Moreover, the CS-GA hydrogel singificantly improves the cell viability (92 %) and proliferation of the bioink. Therefore, the self-crosslinkable CS-GA bioink has great potential to overcome the limitations of conventional bioinks.