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BackgroundThe National Comprehensive Cancer Network Breast Cancer Guidelines Committee suggests that the omission of adjuvant radiation therapy (RT) after breast-conserving surgery can be a reasonable option among older women with low-risk breast cancer (early-stage, estrogen receptor-positive, and node-negative) if they are treated with endocrine therapy. However, RT usage in this group of women still exceeds 50%. Conversely, older women tend to forego RT (even when necessary) due to cost, inconvenience, and potential adverse responses associated with RT. Understanding health-related quality of life (HRQOL) change with receipt of RT among older women in the modern era is limited due to the under-representation of this population in clinical trials. ObjectiveThe proposed study aims to examine the associations of RT with HRQOL trajectories as well as survival outcomes among older women with 5-10 years of follow-up. We will also assess whether prediagnosis comorbidity burden influences receipt of RT and whether the associations between RT and HRQOL trajectory and survival outcomes are modified by the comorbidity burden. MethodsWe will use a retrospective cohort study design with the population-based Surveillance, Epidemiology, and End-Results database linked to the Medicare Health Outcomes Survey (SEER-MHOS). Older women (≥65 years) who were diagnosed with low-risk breast cancer in 1998-2014, received breast-conserving surgery, and participated in MHOS 1998-2016 are eligible for this analysis. The latent class analysis clustering method will be used to identify each patient’s prediagnosis comorbidity burden, and HRQOL will be evaluated using the Short Form 36/Veterans RAND 12-Item Health Survey scales. The inverse-weighted estimates of the probability of treatment will be included to control for treatment selection bias and confounding effects in subsequent analysis. The association of RT with HRQOL trajectory will be evaluated using inverse-weighted multilevel growth mixture models. The inverse-weighted Cox regression model will be used to obtain hazard ratios with 95% CIs for the association of RT with survival outcomes. Differential effects of RT on both outcomes according to comorbidity burden class will also be evaluated. ResultsAs of October 2020, the study was approved by the institutional review board, and SEER-MHOS data were obtained from the National Cancer Institute. Women with low-risk breast cancer who met inclusion and exclusion criteria have been identified, and prediagnosis comorbidity burden class has been characterized using latent class analysis. Further data analysis will begin in November 2020, and the first manuscript will be submitted in a peer-reviewed journal in February 2021. ConclusionsThis research can potentially improve clinical outcomes of older women with low-risk breast cancer by providing them additional information on the HRQOL trajectories when they make RT treatment decisions. It will facilitate informed, shared treatment decision making and cancer care planning to ultimately improve the HRQOL of older women with breast cancer. International Registered Report Identifier (IRRID)DERR1-10.2196/18056

This study aimed to translate the Academic Nurse Self-Efficacy scale (ANSE), assess its appropriateness for use in Korean nursing students, and evaluate the Korean Version of the Academic Nurse Self-Efficacy scale’s (K-ANSE) validity and reliability.

To examine the feasibility and acceptability of a remote-based nutrition education program during COVID-19 for adolescents with autism spectrum disorder (ASD). Ten adolescents with ASD participated in a 4-week nutrition education program utilizing Zoom software during COVID-19. Topics included shopping for healthy food, and food preparation safety measures. Attendance was collected for each session. Participants, parents, and the classroom teacher completed post-program surveys and interviews. The course attendance rate was 97%. Every adolescent reported they would participate in similar future programs, and the teacher/parents felt the program was a positive experience for the participants. The remote-based nutrition education program appeared to be feasible and acceptable to participants. Future research should focus on program efficacy.

BACKGROUND: Adjuvant radiotherapy (RT) can increase the risk of developing pain; however, the molecular mechanisms of RT-related pain remain unclear. The current study aimed to identify susceptibility loci and enriched pathways for clinically relevant acute post-RT pain, defined as having moderate to severe pain (pain score ≥ 4) at the completion of RT. METHODS: We conducted a genome-wide association study (GWAS) with 1,344,832 single-nucleotide polymorphisms (SNPs), a gene-based analysis using PLINK set-based tests of 19,621 genes, and a functional enrichment analysis of a gene list of 875 genes with p

We aimed to examine the association between the use of specific types of dietary supplements and frailty using cross-sectional, nationally representative survey data. Adults aged ≥50 years in the Korea National Health and Nutrition Examination Survey 2018–2020 were included. We calculated a 46-item frailty index to assess frailty. In total, 27,384 older adults were included (mean age: 62.47 years; median frailty index: 0.12). Among them, 72% used at least one dietary supplement. The prevalence of dietary supplement use was higher among women than among men and in participants with higher socioeconomic status. Compared to non-users, users of dietary supplements had a healthier diet and nutrient intake, and lower levels of frailty. After adjusting for socioeconomic and dietary factors, users of vitamin C, red ginseng or calcium were found to be significantly less frail. Our findings indicate promising results concerning dietary supplement intake in managing frailty among older Korean adults. [ABSTRACT FROM AUTHOR]

This study comparatively analyzed the wear characteristics and adhesion properties of 86WC–10Co–4Cr (WC) coatings deposited using the high velocity oxygen fuel process and 75Cr3C2–25NiCr (CrC) and Al2O3–3TiO2 (Al2O3) coatings deposited using the atmospheric plasma spray process on an A390 aluminum alloy substrate. The adhesion strength and wear test results demonstrated that the WC coating exhibited superior wear resistance. In contrast, the CrC and Al2O3 coatings showed lower adhesion properties and unstable frictional variations due to a higher number of defects compared to the WC coating. The WC coating layer, protected by WC particles, exhibited minimal damage and a low wear rate, followed by CrC and Al2O3. Ultimately, WC coating is highlighted as the optimal choice to enhance the wear resistance of A390 aluminum alloy. [ABSTRACT FROM AUTHOR]

Background: Early adverse skin reactions (EASRs) are common side effects of radiotherapy (RT) that impact the quality of life of breast cancer patients. This study used global metabolomics profiles of breast cancer populations to identify metabolic pathways and biomarkers significantly associated with RT-induced EASRs to identify potential targets for precision interventions. Methods: We used a frequency-matched study design to identify pre-RT urine samples from 60 female breast cancer patients (30 with high and 30 with low EASRs) for metabolomic analysis by Metabolon Inc. using UPLC-MS/MS and GC-MS. Using MetaboAnalyst, we performed metabolomic data analysis and visualization on 84 candidate metabolites from 478 total compounds. We used the Oncology Nursing Society (ONS) Skin Toxicity Criteria (0– 6) for EASRs assessment. Results: Seven metabolic pathways were significantly associated with RT-induced EASRs, including alanine, aspartate, and glutamate metabolism (p = 0.0028), caffeine metabolism (p = 0.0360), pentose and glucuronate interconversions (p = 0.0028), glycine, serine, and threonine metabolism (p = 0.0360), beta-alanine metabolism (p = 0.0210), pantothenate and CoA biosynthesis (p = 0.0028), and glutathione metabolism (p = 0.0490). The alanine, aspartate, and glutamate metabolic pathway had the lowest false discovery rate (FDR)-adjusted p-value and the highest impact value of 0.60. Thirteen metabolite biomarkers were significantly associated with RT-induced EASRs. Conclusion: Our data show that the alanine, aspartate, and glutamate metabolism pathways had the highest impact value on RT-induced EASRs. Future larger studies are warranted to validate our findings and facilitate targeted interventions for preventing or mitigating RT-induced EASRs, offering a promising direction for further research and clinical applications. [ABSTRACT FROM AUTHOR]

Thus, we aimed to investigate how real-time documentation of in-hospital medication changes prevents undocumented medication changes at discharge and improves physician-pharmacist communication. Methods: We conducted a retrospective cohort study in a tertiary hospital. Two pharmacists reviewed medical records of patients admitted to the acute medical unit from April to June 2020. In-hospital medication discrepancies were determined by comparing preadmission and hospitalization medication lists and it was verified whether the physician's intent of medication changes was clarified by documentation. By a documentation rate of medication changes of 100% and < 100%, respectively, fully documented (FD) and partially documented (PD) groups were defined. Any undocumented medication changes at discharge were considered a "documentation error at discharge". Pharmacists' survey was conducted to assess the impact of appropriate documentation on the pharmacists. Results: After reviewing 400 medication records, patients were categorized into FD (61.3%) and PD (38.8%) groups. Documentation errors at discharge were significantly higher in the PD than in the FD group. Factors associated with documentation errors at discharge included belonging to the PD group, discharge from a non-hospitalist-managed ward, and having three or more intentional discrepancies. Pharmacists showed favorable attitudes towards physician's documentation. Conclusion: Appropriate documentation of in-hospital medication changes, facilitated by free-text communication, significantly decreased documentation errors at discharge. This analysis underlines the importance of communication between pharmacists and hospitalists in improving patient safety during transitions of care. Plain Language Summary: During transitions of care, communication failures among healthcare professionals can lead to medication errors. Therefore, effective sharing of information is essential, especially when intentional changes in prescription orders are made. Documenting medication changes facilitates real-time communication, potentially improving medication reconciliation and reducing discrepancies. However, inadequate documentation of medication changes is common in clinical practice. This retrospective cohort study underlines the importance of real-time documentation of in-hospital medication changes. There was a significant reduction in documentation errors at discharge in fully documented group, where real-time documentation of medication changes was more prevalent. Pharmacists showed favorable attitudes toward the physician's real-time documenting of medication changes because it provided valuable information on understanding the physician's intent and improving communication and also saved time for pharmacists. This study concludes that physicians' documentation on medication changes may reduce documentation errors at discharge, meaning that proper documentation of medication changes could enhance patient safety through effective communication. [ABSTRACT FROM AUTHOR]

Background: Multicultural families and foreign residents are rapidly increasing in Korea. Thus, the proportion of children and adolescents from minority racial/ethnic groups are also increasing, and there are concerns about adolescents who fail to adapt to school and show low academic achievement and poor health status. Objective: This study aimed to investigate influencing factors related to academic achievement among Korean multicultural adolescents. Methods: Cross-sectional data from 2234 Korean multicultural adolescent participants from the 2010-2014 Korea Youth Risk Behavior Web-based Survey were analyzed using multiple regression. Results: Perceived economic status and breakfast frequency affected academic achievement, regardless of gender. Family affluence, satisfaction with sleep time, and lifetime smoking were additional factors in males. For females, depression and frequency of physical school activities were additional factors. Conclusion: The present study suggests that diverse individual factors should be considered, including economic status, health status, and health-related behaviors, to improve multicultural adolescents' academic achievement.

Artificial intelligence (AI) is an essential strategic element for many industries. Practitioners are exploring ways to incorporate AI into their products, services, and processes, as it transforms everyday life. Recent studies have increasingly examined how consumers respond to various forms of AI robots. This study adds to the existing literature by investigating the factors that drive consumers to adopt AI robots and the underlying psychological processes. Through three studies, we show that consumers' perceived congruence in an AI robot plays an important role in determining their adoption intention for the AI robot. We further demonstrate that such a perception of congruence is jointly determined by the AI robot's benefit type and appearance familiarity. The findings suggest that consumers are more inclined to adopt an AI robot when they are designed to provide hedonic benefits and resembles real‐life objects. By contrast, an AI robot designed for utilitarian benefits are more likely to be adopted when it has the appearance of a machine. In addition, we show that perception of fit mediates this joint effect. Furthermore, we show that the effect of congruence perception on adoption intention is attenuated when consumers have a higher level of dialectical thinking. This study discusses both the theoretical and practical implications. [ABSTRACT FROM AUTHOR]