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Cervical cancer screening during pregnancy presents unique challenges for cytologic interpretation. This review focuses on pregnancy-associated cytomorphological changes and their impact on diagnosis of cervical intraepithelial neoplasia (CIN) and cervical cancer. Pregnancy-induced alterations include navicular cells, hyperplastic endocervical cells, immature metaplastic cells, and occasional decidual cells or trophoblasts. These changes can mimic abnormalities such as koilocytosis, adenocarcinoma in situ, and high-grade squamous intraepithelial lesions, potentially leading to misdiagnosis. Careful attention to nuclear features and awareness of pregnancy-related changes are crucial for correct interpretation. The natural history of CIN during pregnancy shows higher regression rates, particularly for CIN 2, with minimal risk of progression. Management of abnormal cytology follows modified risk-based guidelines to avoid invasive procedures, with treatment typically deferred until postpartum. The findings reported in this review emphasize the importance of considering pregnancy status in cytological interpretation, highlight potential problems, and provide guidance on differentiating benign pregnancy-related changes from true abnormalities. Understanding these nuances is essential for accurate diagnosis and proper management of cervical abnormalities in pregnant women.

Objectives This study was conducted to develop a mobile application for digital health coaching to support self-management in older adults with multiple chronic conditions. Additionally, the usability of this application was evaluated. Methods The HAHA2022 mobile application was developed through a multidisciplinary team approach, incorporating digital health coaching strategies targeting community-dwelling older adults with multiple chronic conditions. Usability was assessed with the Korean version of the Mobile Application Rating Scale. The usability tests involved eight expert panel members and 10 older adults (mean age, 74 ± 3 years; 90% women) from one senior welfare center. Results HAHA2022 is an Android-based mobile application that is also integrated into wearable devices to track physical activity. It features an age-friendly design and includes five main menus: Home, Action Plan, Education, Health Log, and Community. The average overall usability test scores—covering engagement, functionality, aesthetics, and information—were 4.27 of 5 for the expert panel and 4.53 of 5 for the older adults. Conclusions The HAHA2022 application was developed to improve self-management among community-dwelling older adults with multiple chronic conditions. Usability tests indicate that the application is highly acceptable and feasible for use by this population. Consequently, HAHA2022 is anticipated to be widely implemented. Nonetheless, further research is required to confirm its effectiveness through digital health intervention.

BackgroundKidney diseases encompass a variety of conditions, including chronic kidney disease, acute kidney injury, glomerulonephritis, and polycystic kidney disease. These diseases significantly impact patients’ quality of life and health care costs, often necessitating substantial lifestyle changes, especially regarding dietary management. However, patients frequently receive ambiguous or conflicting dietary advice from health care providers, leading them to seek information and support from online health communities. ObjectiveThis study aimed to analyze social media data to better understand the experiences, challenges, and concerns of patients with kidney disease and their caregivers in South Korea. Specifically, it explored how online communities assist in disease management and examined the sentiment surrounding dietary management. MethodsData were collected from KidneyCafe, a prominent South Korean online community for patients with kidney disease hosted on the Naver platform. A total of 124,211 posts from 10 disease-specific boards were analyzed using latent Dirichlet allocation for topic modeling and Bidirectional Encoder Representations From Transformers–based sentiment analysis. In addition, Efficiently Learning an Encoder That Classifies Token Replacements Accurately–based classification was used to further analyze posts related to disease management. ResultsThe analysis identified 6 main topics within the community: family health and support, medication and side effects, examination and diagnosis, disease management, surgery for dialysis, and costs and insurance. Sentiment analysis revealed that posts related to the medication and side effects and surgery for dialysis topics predominantly expressed negative sentiments. Both significant negative sentiments concerning worries about kidney transplantation among family members and positive sentiments regarding physical improvements after transplantation were expressed in posts about family health and support. For disease management, 7 key subtopics were identified, with inquiries about dietary management being the leading subtopic. ConclusionsThe findings highlight the critical role of online communities in providing support and information for patients with kidney disease and their caregivers. The insights gained from this study can inform health care providers, policy makers, and support organizations to better address the needs of patients with kidney disease, particularly in areas related to dietary management and emotional support.

Background and Aims: Helicobacter pylori (H. pylori) is a major cause of peptic ulcer disease (PUD) and upper gastrointestinal bleeding. Testing for and eradication of H. pylori reduces the risk of future PUD-related complications including readmission for gastrointestinal bleeding. Our aim was to determine the most cost-effective testing strategy for H. pylori in patients hospitalized with bleeding peptic ulcers. Methods: We developed a Markov cohort model to compare the following 6 H. pylori testing strategies: no testing, histology, rapid urease test, stool antigen test, urea breath test (UBT), and serology. Histology and rapid urease test require biopsies, while stool antigen test, UBT, and serology do not. We assumed a 17% H. pylori prevalence in patients admitted with bleeding ulcers. Model outcomes included hospitalizations for rebleeds, number needed to treat to avoid another hospitalization, life expectancy, total cost, quality-adjusted life years, and incremental cost-effectiveness ratios. Results: Compared to no testing, UBT resulted in a gain of 0.02 quality-adjusted life years, total cost savings of $2140 per patient, and 1675 hospitalizations avoided per 10,000 patients per year. Additionally, the number needed to treat to avoid an additional hospitalization over 35 years was 167. UBT was the preferred strategy as it was both less costly and more effective than no testing. Conclusion: Our findings suggest that UBT is the cost-effective strategy to identify H. pylori in patients admitted with PUD. Noninvasive H. pylori testing at the point of care or during inpatient admission should be considered, as it presents limited risk to patients and offers potential clinical benefits.

In this study, we provide the synthesis of pristine TiO2 nanosheets (NSs) via a simple flux method and their decoration with Ag nanoparticles (NPs) using a hydrothermal method for room-temperature H2S gas sensing. Gas sensing experiments were conducted at 25 °C, evaluating the response of the Ag NPs-decorated TiO2 NSs to various gases. Results demonstrated the gas sensor exhibited a superior response to H2S gas compared to other gases, outperforming the pristine TiO2 NSs gas sensor. Additionally, its response to H2S gas surpassed that of the TiO2 NSs gas sensor, highlighting the promising role of Ag decoration for H2S gas detection. Sensing behavior in humid atmosphere was also investigated. The improved H2S gas sensing performance can be attributed to the catalytic effect of Ag, the formation of Ag/TiO2 heterojunctions, and the large surface area of the TiO2 NSs. This study introduces a straightforward approach to enhance the gas sensing capabilities of metal oxide NSs.

Exhausting carbon-based gases from building construction or comfortable household supplies have caused the main pollution gas species for the indoor air environment. Given the variety of indoor activities, many reports have been challenged to find room-temperature operational and harmless materials. Here, we report that the activating MoO vibration mode in Na,Sb doped-NiMoO4 micro-sized powder reveals the high response of CO and VOC, occupying multiple bonds at room temperature. We performed Na and Sb doping in the α-NiMoO4 crystal structure, such as introducing the Sb in Ni and interstitial doping of Na in around 4 Å of free space in the NiMoO4 crystal structure that manipulates the partial β-NiMoO4 phase. The Na,Sb-codoped NiMoO4 generates the higher MoO vibration mode from FT-IR measurement and enables carbon-based gas detection with 38 responses to CO and nearly 20 responses to VOC under 20 ppm of each analyte gases environment. Furthermore, the n-type gas sensing behavior of Na,Sb doped-NiMoO4 chemiresistor exhibits an immediate sensing response instead of a none-of response than intrinsic or single element doped NiMoO4. These results suggest that Na,Sb codoped-NiMoO4 is the applicable material for emergent warning against carbon-based gas exposure in the indoor environment. In addition, activating the electrochemical reaction site of MoO4–2 in NiMoO4 is tailorable by a simple doping process.

In this study, non-oriented Au-decorated SnO2 nanospheres (NSs) were synthesized using hydrothermal and microwave methods. The SnO2 spheres ranged from hundreds of nanometers to a microscale. The oxygen vacancy on the surface increased after Au adsorption on the surface of the SnO2 NSs, ultimately showing a synergistic effect with the spillover effect of the existing Au catalyst. Specifically, at 100 °C and 200 °C, the response to 10 ppm H2S gas improved to 16.14 and 46.81, respectively. These gas sensing effects were approached individually by being divided into two disadvantages (oxygen adsorption and homojunction) and five advantages (oxygen vacancies, spill-over, surface area, H2S + SnO2 reaction, and H2S + O2 reaction). Based on this reference, we investigated SnO2 NSs of various sizes and functions by adjusting the process variables.

In this study, we demonstrate the emergence of NO2 gas sensing capabilities in the typically non-active NiWO4, a strongly correlated electron system (SCES), by introducing substitutional Fe at the Ni site. NiWO4 typically exhibits strong Coulombic repulsion between Ni atoms, resulting in a large band gap of over 3.0 eV and insulating behavior. This correlated behavior is clearly reflected in the significant increase of band gap when considering the Hubbard U correction for the cations, bringing the theoretical value closer to the observed value. The single-phase Fe0.5Ni0.5WO4 displays a notable shift in the [NiO6] symmetric vibration mode and an increase in magnetization. Additionally, theoretical calculations confirm the preservation of the wide band gap, with the Fe and O levels generated within the band gap. These findings indicate that Fe located in the Ni sites modulate Coulombic repulsion in NiWO4 SCES insulators. Unlike the poor gas-sensing performance of intrinsic NiWO4, Fe0.5Ni0.5WO4 exhibits a significant NO2 response (Rg/Ra) of 11 at 200°C than other gases and a limit of detection (LOD) of 46.4 ppb. This study provides a pathway for realizing gas-sensing performance in strongly correlated electron insulators with large band gaps through the introduction of dopant levels at the cation sites.

Abstract Background We aimed to identify the impact of muscle mass on locally advanced oesophageal cancer (LAEC) in elderly patients receiving neoadjuvant chemoradiation therapy (NACRT). Methods We reviewed the medical records of 345 patients diagnosed with LAEC who underwent NACRT and surgery. Physical variables, including height, weight, skeletal muscle mass, and laboratory values, were obtained before and after NACRT. Body mass index (BMI, kg/m2), neutrophil‐to‐lymphocyte ratio (NLR), platelet‐to‐lymphocyte ratio (PLR), and prognostic nutritional index (PNI) were calculated as height/(weight)2, ANC/ALC, platelet count/ALC, and (10 × albumin + 0.05 × ALC), respectively. The cutoff for low muscle mass was 43.0 cm2/m2 for BMI below 25 kg/m2 and 53.0 cm2/m2 for BMI 25 kg/m2 or higher. The skeletal muscle index (SMI) was defined as skeletal muscle area/(height)2 (cm2/m2). The ΔSMI (%/50 days) was defined as (SMI after NACRT − SMI before NACRT)/interval (days) × 50 (days) to compare changes over the same period. The excessive muscle loss (EML) group was defined as patients with ΔSMI ≤−10% following NACRT. An elderly patient was defined as aged ≥65 years. The primary outcome measure was overall survival (OS). Results During a median follow‐up of 32.8 months (range, 2.0–176.2), 192 patients died, with a median OS of 50.2 months. Elderly patients did not show inferior OS (young vs. elderly, 57.7% vs. 54.0% at 3 years, P = 0.247). 71.0% and 87.2% of all patients had low muscle mass before and after NACRT, respectively, which was not associated with OS (P = 0.270 and P = 0.509, respectively). Inflammatory (NLR and PLR) and nutritional index (PNI) values or their changes did not correlate with OS. However, the EML group had worse OS (41.6% vs. 63.2% at 3 years, P

Abstract Background Gender sensitivity, which is the capacity to recognize and address issues of gender discrimination and inequality, is initiated with an awareness of gender differences. This is particularly crucial in nursing, where care is tailored to the holistic needs of individuals. Given the sensitive nature of nursing to gender variances, it is essential that the influences of nurses’ own experiences and perceptions on their gender sensitivity are explored. This study is aimed at assessing the effects of childhood experiences of domestic violence and perceptions of sexism among healthcare providers on their gender sensitivity. Additionally, it seeks to provide empirical data to support the enhancement of gender-sensitive practices within nursing environments, thereby fostering a culture of gender equality, and helping to promote the practical application of gender equality within nursing organizations. Methods A cross-sectional survey was employed to gather data from 146 nurses aged 24 and above residing in Daegu. The general characteristics of these nurses, their childhood experiences of domestic violence, their perceptions of sexism, and their level of gender sensitivity were measured. The data were then subjected to a series of statistical analyses, including t-tests, one-way analysis of variance, Pearson’s correlation coefficients, and hierarchical regression analysis, to identify the factors influencing gender sensitivity. Results It was revealed by the analysis that nurses’ gender sensitivity was not significantly associated with their childhood experiences of domestic violence. However, a negative correlation was found between gender sensitivity and their perceptions of sexism (r = -0.46, p

O. humifusa (Korean Cheonnyencho), a prickly pear cactus species, has garnered increased attention owing to its rich phytochemical composition and potential health benefits. In this study, the antioxidant and anti-cancer activities of a microwave-assisted aqueous extract derived from O. humifusa were investigated, and its phytochemical content was characterized. High-performance liquid chromatography (HPLC) was used to identify various bioactive compounds, including polyphenols, flavonoids, and other antioxidants known for their potential health-promoting properties. Furthermore, the individual compounds in the flavonoids were separated using the HPLC fractionation technique. The antioxidant potential of the aqueous extract was evaluated using 2,2-diphenyl-1-picrylhydrazyl radical scavenging activity. The results demonstrated the significant antioxidant activity of the extract, as evidenced by its ability to scavenge free radicals and effectively reduce oxidized molecules. The experiments involved treating colon cancer cells with varying concentrations of the extract (25 to 125 mg/mL) over a 24-h period, resulting in a remarkable dose-dependent inhibition of cell growth. Notably, this inhibitory effect was absent in HDFa cells, highlighting the potential selectivity of O. humifusa in targeting colon cancer cells.

Background and Aims: Gastrointestinal cancer incidence varies by race and ethnicity. In the United States (US), there are screening guidelines for esophageal cancer (EC) and colorectal cancer (CRC), but not gastric cancer (GC). We compared GC, CRC, and EC incidence among the most populous racial and ethnic groups to inform US interception strategies. Methods: We used SEER∗Stat to compare GC, CRC, and EC incidence rates across non-Hispanic White (NHW), non-Hispanic Black, Hispanic, and the 8 largest Asian American populations using the Surveillance, Epidemiology, and End Results 9 registries (2010–2014). Results: Noncardia GC incidence was highest among Korean (18.7 cases per 100,000) and lowest among NHW (1.4 cases per 100,000) Americans. CRC incidence was highest among non-Hispanic Black, Southeast Asian, and Japanese (35.9, 34.2, and 33.8 per 100,000, respectively) Americans and lowest among South Asian Americans (18.9 per 100,000). EC incidence was greatest in NHW (4.7 per 100,000) and lowest in Filipino (1.2 per 100,000) Americans. The incidence of noncardia GC slightly exceeded colon cancer in Korean American men (25.5 vs 22.4 per 100,000). GC surpassed EC incidence in all non-White racial and ethnic groups. Conclusion: The burden of GC, CRC, and EC differs based on race and ethnicity. Non-White racial and ethnic groups experience a disproportionate burden of GC for which systematic programs for cancer interception, similar to CRC and EC, are needed.

Abstract In electrides, interstitial anionic electrons (IAEs) in the quantized energy levels at cavities of positively charged lattice framework possess their own magnetic moment and interact with each or surrounding cations, behaving as quasi-atoms and inducing diverse magnetism. Here, we report the reversible structural and magnetic transitions by the substitution of the quasi-atomic IAEs in the ferromagnetic two-dimensional [Gd2C]2+·2e− electride with hydrogens and subsequent dehydrogenation of the canted antiferromagnetic Gd2CHy (y > 2.0). It is demonstrated that structural and magnetic transitions are strongly coupled by the presence or absence of the magnetic quasi-atomic IAEs and non-magnetic hydrogen anions in the interlayer space, which dominate exchange interactions between out-of-plane Gd−Gd atoms. Furthermore, the magnetic quasi-atomic IAEs are inherently conserved by the hydrogen desorption from the P $$\bar{3}$$ 3 ¯ 1m structured Gd2CHy, restoring the original ferromagnetic state of the R $$\bar{3}$$ 3 ¯ m structured [Gd2C]2+·2e− electride. This variable density of magnetic quasi-atomic IAEs enables the quantum manipulation of floating electron phases on the electride surface.

During the past decade, there has been extensive research toward the possibility of exploring magnesium and its alloys as biocompatible and biodegradable materials for implantable applications. Its practical medical application, however, has been limited to specific areas owing to rapid corrosion in the initial stage and the consequent complications. Surface coatings can significantly reduce the initial corrosion of Mg alloys, and several studies have been carried out to improve the adhesion strength of the coating to the surfaces of the alloys. The composition of hydroxyapatite (HAp) is very similar to that of bone tissue; it is one of the most commonly used coating materials for bone-related implants owing to favorable osseointegration post-implantation. In this study, HAp was coated on Mg using nanosecond laser coating, combining the advantages of chemical and physical treatments. Photothermal heat generated in the liquid precursor by the laser improved the adhesion of the coating through the precipitation and growth of HAp at the localized nanosecond laser focal area and increased the corrosion resistance and cell adhesion of Mg. The physical, crystallographic, and chemical bondings were analyzed to explore the mechanism through which the surface adhesion between Mg and the HAp coating layer increased. The applicability of the coating to Mg screws used for clinical devices and improvement in its corrosion property were confirmed. The liquid environment-based laser surface coating technique offers a simple and quick process that does not require any chemical ligands, and therefore, overcomes a potential obstacle in its clinical use.

Background. Intensive multimodal treatment can improve survival in patients with high-risk neuroblastoma, and consolidative radiation therapy has contributed to local control. We examined the clinical outcomes of patients who underwent consolidative radiation therapy at our institution. Methods. We retrospectively reviewed the records of patients with high-risk neuroblastoma who underwent consolidative radiation therapy from March 2001 to March 2021 at Asan Medical Center. Patients underwent multimodal treatment including high-dose chemotherapy, surgery, stem cell transplantation, and maintenance therapy. Radiation (median, 21.0 Gy; range, 14–36) was administered to the primary site and surrounding lymph nodes. Results. This study included 37 patients, and the median age at diagnosis was 2.8 years (range, 1.3–10.0). Four patients exhibited local failure, and 5-year free-from locoregional failure rate was 88.7%, with a median follow-up period of 5.7 years. The 5-year disease-free survival (DFS) and overall survival (OS) rates were 59.1% and 83.6%, respectively. Univariate analysis revealed that patients with neuron-specific enolase levels >100 ng/mL had significantly worse DFS and OS (P = 0.036, 0.048), and patients with no residual disease before radiation therapy showed superior OS (P = 0.029). Furthermore, patients with 11q deletion or 17q gain exhibited poor DFS and OS, respectively (P = 0.021, 0.011). Six patients experienced grade 1 acute toxicity. Late toxicity was confirmed in children with long-term survival, predominantly hypothyroidism and hypogonadism, typically < grade 3, possibly attributed to combination treatment. Four patients experienced late toxicity ≥ grade 3 with chronic kidney disease, growth hormone abnormality, ileus, premature epiphyseal closure, and secondary tumor, and recovered by hospitalization or surgical treatment. Conclusions. In patients with high-risk neuroblastoma, consolidative radiotherapy to the primary tumor site resulted in excellent local control and a tolerable safety profile.

Abstract Background This study aimed to compare the outcomes of proton beam therapy (PBT) and carbon ion radiotherapy (CIRT) by a systematic review and meta‐analysis of the existing clinical evidence. Methods A systematic literature search was performed to identify studies comparing the clinical outcomes of PBT and CIRT. The included studies were required to report oncological outcomes (local control [LC], progression‐free survival [PFS], or overall survival [OS]) or adverse events. Results Eighteen articles comprising 1857 patients (947 treated with PBT and 910 treated with CIRT) were included in the analysis. The pooled analysis conducted for the overall population yielded average hazard ratios of 0.690 (95% confidence interval (CI), 0.493–0.967, p = 0.031) for LC, 0.952 (95% CI, 0.604–1.500, p = 0.590) for PFS, and 1.183 (0.872–1.607, p = 0.281) for OS with reference to CIRT. The subgroup analyses included patients treated in the head and neck, areas other than the head and neck, and patients with chordomas and chondrosarcomas. These analyses revealed no significant differences in most outcomes, except for LC in the subgroup of patients treated in areas other than the head and neck. Adverse event rates were comparable in both groups, with an odds ratio (OR) of 1.097 (95% CI, 0.744–1.616, p = 0.641). Meta‐regression analysis for possible heterogeneity did not demonstrate a significant association between treatment outcomes and the ratio of biologically effective doses between modalities. Conclusion This study highlighted the comparability of PBT and CIRT in terms of oncological outcomes and adverse events.