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Purpose: To investigate the clinical significance of ocular torsion in children by analyzing the associated ophthalmic diseases.Methods: Fundus images were used to detect ocular torsion in one or both eyes of 83 children aged 2-12 years at a pediatric ophthalmology clinic. In cases with ocular torsion, associated ophthalmic diseases, including strabismus, amblyopia, and refractive errors, were investigated.Results: Among the 83 patients, 59 (71.2%) and 45 (54.2%) had strabismus and refractive errors, respectively. Six had amblyopia (five patients with refractive amblyopia and one with strabismus), while six patients (7.2%) had no strabismus, refractive errors, or amblyopia. The extorsion group included 80 eyes in 59 patients, while the intorsion group included 26 eyes in 22 patients. Two patients were in the mixed cyclotorsion group with extorsion in one eye and intorsion in the other eye. There were no differences in the frequencies of exotropia and esotropia based on the torsion type (p = 0.209). The torsion angles in the exotropia and esotropia groups were -16.35 ± 5.20 and -12.71 ± 3.16, respectively (p = 0.002).Conclusions: Children with ocular torsion on fundus photography had a high prevalence of strabismus. Extorsion was more frequent than intorsion with a greater extorsion angle in exotropia than in esotropia.

To define school nurse-parent partnerships in school health care for children with type 1 diabetes (T1D) and determine its attributes using a hybrid model.This method involves a three-phase process: theoretical, fieldwork, and analytical. A literature review was conducted during the theoretical phase. A literature search of articles from January 1991 to February 2020 was conducted using relevant electronic databases. Eighty-three articles that met the inclusion criteria were completely read. Fieldwork data were collected through individual interviews from February to July 2019 in South Korea. In the fieldwork phase, interviews were conducted individually with 22 mothers of students with T1D and 20 school nurses recruited by purposeful sampling. Inductive content analysis was conducted. The findings from the theoretical phase were integrated with those from the fieldwork phase, and the final concept was derived.School nurse-parent partnership in school health care for children with T1D has been defined as an interactive process of maintaining a balanced responsibility and providing tailored care to meet needs by establishing trusting relationships and communicating transparently and openly. This analysis yielded four attributes: trusting relationships, transparent and open communication, balanced responsibility, and providing tailored care to meet needs-this entails providing nursing actions by advocating for students and performing a negotiated role together or individually for student and family.The findings of this study add to the importance of an attribute of balancing responsibility for partnership in school health care. The results show that this partnership could contribute to the development of a scale, theory, and nursing intervention in school health care for children with T1D.

Colonoscopic polypectomy is effective in decreasing the incidence and mortality of colorectal cancer (CRC). Premalignant polyps discovered during colonoscopy are associated with the risk of metachronous advanced neoplasia. Postpolypectomy surveillance is the most important method for the management of advanced metachronous neoplasia. A more efficient and evidence-based guideline for postpolypectomy surveillance is required because of limited medical resources and concerns regarding colonoscopy complications. In these consensus guidelines, an analytic approach was used to address all reliable evidence to interpret the predictors of CRC or advanced neoplasia during surveillance colonoscopy. The key recommendations state that the high-risk findings for metachronous CRC following polypectomy are as follows: (1) adenoma ≥10 mm in size; (2) 3 to 5 (or more) adenomas; (3) tubulovillous or villous adenoma; (4) adenoma containing high-grade dysplasia; (5) traditional serrated adenoma; (6) sessile serrated lesion (SSL) containing any grade of dysplasia; (7) serrated polyp of at least 10 mm in size; and (8) 3 to 5 (or more) SSLs. More studies are needed to fully comprehend the patients most likely to benefit from surveillance colonoscopy and the ideal surveillance interval to prevent metachronous CRC.

The purpose of this secondary analysis was to determine the clusters of midlife women by gastrointestinal (GI) symptoms and to explore differences in the clusters by race/ethnicity. This analysis used the data from two internet-based studies among 1,054 midlife women. The analysis was conducted with the data on background characteristics, health and menopausal status, and GI symptoms (collected using the GI Symptom Index for Midlife Women). The data were analyzed using factor analyses, hierarchical cluster analyses, chi-square tests, multinomial logistic regression analyses, and analyses of covariance. Three clusters were adopted: Cluster 1 (with low total numbers and severity scores of symptoms; 46.0%), Cluster 2 (with moderate total numbers and severity scores of symptoms; 44.0%), and Cluster 3 (with high total numbers and severity scores of symptoms; 10.0%). Only in Cluster 2, there were significant racial/ethnic differences in individual GI symptoms. These results provide directions for future GI symptom management among midlife women.

OBJECTIVES: This study aimed to explore the associations of immigration transition to gastrointestinal (GI) symptoms experienced during the menopausal transition among 974 midlife women in the U.S. METHODS: The data among 974 midlife women from two national Internet survey studies were used for this secondary analysis. Only the data related to background characteristics and health/menopausal status, immigration transition, and the Gastrointestinal Symptom Index for Midlife Women were included. The data were analyzed using descriptive and inferential statistics including ANCOVA, logistic regression analyses and hierarchical multiple regression analyses. RESULTS: There were statistical differences in total numbers and total severity scores of total GI symptoms between immigrants and non-immigrant (F = 7.08 and 6.20, respectively; both p < .05); Immigrants had fewer total numbers and lower total severity scores of GI symptoms than non-immigrants. All immigration transition variables including immigration status, the length of stay in the U.S., and the acculturation level accounted for 11.8% of the total numbers (F = 32.79, p < .001) and 12.5% of the total severity scores of GI symptoms (F = 35.10, p < .001). However, only immigration status (being non-immigrant) was a significant factor that was associated with greater total numbers and higher total severity scores of GI symptoms (β = 0.62, p < .001 and β = 0.65, p < .001, respectively). CONCLUSIONS: This study supports that immigration status was a significant factor that influences GI symptoms during the menopausal transition.

Purpose: This study aimed to identify the longitudinal effects of children’s temperament on maternal depression.Methods: Data from a longitudinal cohort of the Panel Study of Korean Children (PSKC) from 2010 to 2012 were analyzed using hierarchical linear modeling. The survey included 1,721 mother-child dyads. The mothers reported on their children’s temperament and on maternal depression. The children’s temperament was measured by the Emotionality, Activity and Sociability-Temperament Survey for Children-Parental Ratings, while maternal depression was measured by the Kessler 6 Psychological Distress Scale.Results: The results showed that both children’s temperament and maternal depression were relatively stable when the children were between the ages of 2 to 4. The mean maternal depression scores were 11.83 in 2010, 11.88 in 2011, and 11.75 in 2012. There were significant negative correlations between the maternal depression scores and children’s ages, and sociability and activity subdomain scores ranged from r=-.05 to -.11 (p

Aim This study aimed to assess the effectiveness of a programme designed to promote global health competency among nursing students. Design It used a randomized pre–post‐test comparison group design to compare the effects of a global health competency programme among nursing students. Methods Data collection for the pre‐test was carried out for 2 days (25–26 October 2018) and that of post‐test was conducted for 2 days (23–24 December 2018). A total of 38 fourth‐year nursing students participated in this study (14 in the international nursing group, 11 in the transcultural nursing group and 13 in the complementary and alternative medicine group). The participants were from the nursing department of a university in Cheongju. Results There were no statistically significant differences between the groups in the pre‐test homogeneity test. The international nursing group showed statistically significant improvements between the pre‐ and post‐tests in global health competency, cultural competency, global health confidence and cultural nursing confidence.

Exudates were prepared using sucrose from the edible parts of sea tangle, aloe, onion, maesil (Prunus mume fruit) and kale. Changes in the amount of sugar and organic acid were investigated during 12-month storage of the exudates in hangari (a traditional Korean jar) and stainless-steel containers. Dominant lactic acid-producing bacteria were isolated and identified. Lactic acid was the major organic acid in the exudates of sea tangle, onion, and aloe, whereas citric acid and acetic acid were the major organic acids in maesil and kale exudates, respectively. In addition, it was confirmed that container type affected the composition of each exudate. Overall, the pH of these exudates decreased without any significant changes in acidity. As the storage time increased, viable bacterial counts decreased, and the number of acid-producing bacteria also decreased or disappeared. A total of 18 dominant species of lactic acid-producing bacteria were screened and classified into Lactobacillus homohiochii, Lactobacillus plantarum, and Bacillus megaterium based on 16S rRNA gene sequencing. Lactobacillus spp. showed high sugar tolerance and multiplied even at sucrose concentrations of 20-50%. Depending on the strain, these dominant bacteria hydrolyze sucrose to glucose and fructose, with lactic acid as the final product. The dominant type of lactic acid-producing bacteria differed depending on the type of sugaring exudate. Further research on the role of these microorganisms in the food industry, such as preparing exudates using bacterium as a starter material, is required.

Purpose: To evaluate the correction of vertical strabismus associated with exotropia by vertical transposition of the horizontal muscle to an extent equal to half the muscle width combined with muscle recession-resection. Methods: We enrolled patients with vertical strabismus of 4-15 prism diopters (PD) associated with exotropia who were not scheduled for vertical rectus or oblique muscle surgery. Regardless of the strabismus angle, the insertion site of the horizontal muscle was vertically transposed by half the muscle width during surgery. Success was defined as a vertical strabismus angle of 2 PD or less. Results: The preoperative mean exodeviation far angle in 41 patients was 27.8 PD and the average vertical strabismus far angle 8.1 PD. The success rate of exotropia surgery was 68.3%. The mean vertical strabismus angle was 2.8 PD on postoperative day 1 and the success rate of vertical strabismus surgery 92.7%. Undercorrection was evident in 4.9% of patients and overcorrection in 2.4%. The preoperative vertical strabismus angle was strongly associated with the residual angle after surgery (r = 0.386, p = 0.013). Receiver operating curve analysis revealed that the preoperative vertical strabismus far angle cutoff was 11 PDs. No patient factor significantly influenced vertical strabismus correction. Conclusions: Vertical transposition of the horizontal muscle by half of the muscle width may correct vertical strabismus of far angle 11 PDs or less.

Breast cancer is the most common female cancer in the world. Despite the active research on metastatic breast cancer, the treatment of breast cancer patients is still difficult because the mechanism is not well known. Therefore, research on new targets and mechanisms for diagnosis and treatment of breast cancer patients is required. On the other hand, microRNA (miRNA) has the advantage of simultaneously regulating the expression of many target genes, so it has been proposed as an effective biomarker for the treatment of various diseases including cancer. This study analyzed the role and mechanism of DBC2 (deleted in breast cancer 2), which is known to inhibit its expression in breast cancer, and proposed microRNA (miR)-5088-5p, which regulates its expression. It was revealed that the biogenesis of miR-5088-5p was upregulated by hypomethylation of its promoter, promoted by Fyn, and was involved in malignancy in breast cancer. With the use of the cellular level, clinical samples, and published data, we verified that the expression patterns of DBC2 and miR-5088-5p were negatively related, suggesting the potential as novel biomarkers for the diagnosis of breast cancer patients., Graphical abstract, The effects of DBC2, which is downregulated in breast cancer, and miR-5088-5p, which regulates its expression, on malignancy of breast cancer were studied. It was confirmed that miR-5088-5p expression was increased by Fyn induced its hypomethylation. Therefore, DBC2 and miR-5088-5p have potential as new biomarkers for diagnosing breast cancer malignancy.

To describe clinical manifestations and short-term prognosis of ocular motility disorders following coronavirus disease-2019 (COVID-19) vaccination.Ocular motility disorders were diagnosed by clinical assessment, high-resolution magnetic resonance imaging, and laboratory testing. Clinical manifestations, short-term prognosis, and rate of complete recovery were analyzed.Sixty-three patients (37 males, 26 females) with a mean age of 61.6 ± 13.3 years (range, 22-81 years) were included in this study. Among 61 applicable patients with sufficient information regarding medical histories, 38 (62.3%) had one or more significant underlying past medical histories including vasculopathic risk factors. The interval between initial symptoms and vaccination was 8.6 ± 8.2 (range, 0-28) days. Forty-two (66.7%), 14 (22.2%), and 7 (11.1%) patients developed symptoms after the first, second, and third vaccinations, respectively. One case of internuclear ophthalmoplegia, 52 cases of cranial nerve palsy, two cases of myasthenia gravis, six cases of orbital diseases (such as myositis, thyroid eye disease, and IgG-related orbital myopathy), and two cases of comitant vertical strabismus with acute onset diplopia were found. Among 42 patients with follow-up data (duration: 62.1 ± 40.3 days), complete improvement, partial improvement, no improvement, and exacerbation were shown in 20, 15, 3, and 4 patients, respectively.This study provided various clinical features of ocular motility disorders following COVID-19 vaccination. The majority of cases had a mild clinical course while some cases showed a progressive nature. Close follow-up and further studies are needed to elucidate the underlying mechanisms and long-term prognosis.

This study aimed to understand school nurses' perceptions regarding barriers to and facilitators for health care services for children with chronic diseases in school settings. Using the PubMed, Cumulative Index to Nursing and Allied Health Literature, Embase, and Web of Science databases, a mixed studies review was conducted for literature published between January 2011 and June 2020. We performed a mixed-methods systematic review using a convergent integrated approach. A quality appraisal of the included studies was conducted using a mixed-methods appraisal tool. Twenty-seven articles (10 qualitative, 10 quantitative, and seven mixed-methods) that met the inclusion criteria were analyzed. Integrated findings that emerged from data synthesis were categorized into four levels (intrapersonal level, interpersonal level, institutional level, and community and public policy level) based on a socio-ecological model framework. This mixed systematic review provides a comprehensive understanding of school nurses' perceived barriers and facilitators when providing school health care for students with chronic diseases and how these barriers and facilitators interact across multiple systems. Further policies and strategies should be developed to provide effective school health services considering this study's findings.

We evaluated the prognostic implications of the circulating tumor cell (CTC) count in non-metastatic, HER2-negative breast cancer patients who failed to achieve pathologic complete response (pCR) after neoadjuvant chemotherapy (NCT). A total of 173, non-metastatic breast cancer patients treated with NCT were prospectively enrolled. CTCs were obtained from blood drawn pre-NCT and post-NCT using a SMART BIOPSY SYSTEM isolation kit (Cytogen Inc., Seoul, Korea) with immunofluorescence staining. Excluding 26 HER2-positive patients, Relapse-free survival (RFS) and overall survival (OS) related to the CTC count and the association of the CTC count with the treatment response to given therapy were analyzed in 147 HER2-negative patients. Among 147 HER2-negative patients, 28 relapses (19.0%) and 13 deaths (8.8%, all breast cancer-specific) were observed during a median follow-up of 37.3 months. One hundred and seven patients (72.8%) were hormone receptor-positive, and 40 patients (27.2%) had triple-negative breast cancer (TNBC). One or more CTCs were identified in 88 of the 147 patients (59.9%) before NCT and 77 of the 134 patients (52.4%) after NCT. In the entire HER2-negative patient cohort, the initial nodal status was the most significant factor influencing RFS and OS. In TNBC, 11 patients (27.5%) achieved pCR and patients that failed to achieve pCR with ≥ 5 CTCs after NCT, showed worse RFS (HR, 10.66; 95% CI, 1.80–63.07; p = 0.009) and OS (HR, 14.00; 95% CI, 1.26–155.53; p = 0.032). The patients with residual tumor and a high number of the CTCs after NCT displayed the worse outcome. These findings could provide justification to launch a future, well designed trial with longer follow-up data to obtain regulatory approval for clinical use of the assay, especially for the ER-positive, HER2-negative breast cancer subset.

This preliminary study analyzed the peripheral retinal vascular pattern in children, using ultra-widefield fluorescein angiography, and its association with perinatal conditions. Retrospective review was conducted examining the fluorescein angiographic findings of children with amblyopia (January 2017 to December 2018). We categorized the peripheral vascular patterns into two groups: loop and branching patterns. We investigated differences in these patterns, according to the perinatal condition. Thirty children (9.27 ± 3.41 years old; 47.67% male) were included. An equal number of children had the loop or branching pattern (15:15). The gestational age (GA) in the loop group was significantly shorter than the branching group (32.92 ± 5.62 vs. 36.67 ± 5.63 weeks, p = 0.04). The birth weight of the loop group was significantly lower than the branching group (2.00 ± 1.03 vs. 2.72 ± 0.93 kg, p = 0.03). Gender, age, delivery-type, and visual acuity, were not different between the groups. Lower birth weight and shorter GA were observed in children with the loop pattern. The difference in peripheral retinal vascular patterns, according to birth weight and GA, might be due to the development of immature retinal vessels at birth.