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Background: The purpose of the study was to evaluate the relationship and route of dental Social Media marketing by age group and support effective dental marketingy by age group. Methods: A study was conducted on 265 people, aged 20 to 64 years, who lived in Seoul, Gyeonggi area and regularly used one or more of the social media platforms, Naver Band, Facebook, Instagram, KakaoStory, Twitter, or YouTube more than once a day. A 27-question questionnaire survey of approximately 10 minutes was conducted, and the collected data was statistically analyzed using the PASW program, with the significane level set to 0.05. Results: “Introduction of acquaintances” was the most common route to visit the dentist. Regarding the use of social media platforms based on age group, ‘Instagram’ had the highest frequency among people belonging to the age groups of 20 to 29 years and 30 to 39 years; ‘YouTube’ had the highest frequency among those aged 40 to 49 years; and ‘Naver Band’ had the highest frequency among those aged 50 to 65 years. Conclusion: The most frequently used social media by consumers according to age included Facebook, YouTube, and Instagram. However, social media was found to have no significant impact on the choice of dental institutions, as the number of people who visited the dentist through “Introduction of acquaintances” was the highest, and “Introduction of acquaintances” did not have experience accessing the dentist site after dental marketing. If this study could provide customized marketing information for each age group through social media, it is expected that the marketing effect of dental institutions through social media would be maximized in the future.

Purpose: This study aims to determine the optimal mixing ratio of mulberry and peppermint leaves and evaluates their biological activities to identify whether the estimated ratio is suitable for use in inner beauty and cosmetic ingredients.Methods: Total polyphenol and flavonoid contents, 1,1-diphenyl-2-picrylhydrazyl (DPPH) and 2,2′-azino-bis-3-ethylbenzothiazoline-6-sulfonic acid (ABTS) radical scavenging activities, and tyrosinase and elastase inhibition activities were measured to optimize the mixing ratio of mulberry and peppermint leaves.Results: The mixture of mulberry and peppermint leaves showed a total polyphenol content of up to 46.58 mg TAE/g, a total flavonoid content of up to 45.54 mg QE/g, and DPPH and ABTS radical scavenging activities of up to 74.18% and 40.60%, respectively. Tyrosinase and elastase inhibition activities were up to 67.46% and 35.01%, respectively. In the interest section, the maximum antioxidant and tyrosinase inhibitory activities were obtained at a mulberry:pepperint mixing ratio of 1.49:0.75 (g:g). In the experimental section, the maximum antioxidant and tyrosinase inhibitory activities were obtained at a mulberry:pepperint mixing ratio of 1.79:0.80 (g:g). Further, the maximum antioxidant and elastase inhibitory activities were obtained at a mulberry:pepperint mixing ratio of 1.11:0.75 (g:g).Conclusion: This study determined the superiority of the antioxidant activity, tyrosinase and elastase activity inhibition efficacies, and optimal mixing ratios of mulberry and peppermint leaves. Based on our findings, we believe that mulberry and peppermint leaves at an optimal mixing ratio will have considerable use as inner beauty and cosmetic ingredients.

Visual display terminal syndrome is a health problem that occurs when an individual looks at a visual display terminal for a long time. This study aimed to evaluate the quality of YouTube videos on visual display terminal syndrome. YouTube was searched using the keywords "visual display terminal syndrome" and "a prolonged user of a computer or smartphone" on October 16, 2019. A total of 45 videos were evaluated using DISCERN and the Journal of the American Medical Association scoring systems. The variables extracted from the videos were the uploading agency; content; presentation format; days since upload; the number of views, likes, dislikes, and comments; and the video power index. The mean DISCERN and Journal of the American Medical Association scores were 35.64 and 3.08 points, respectively, indicating that the information on visual display terminal syndrome in YouTube videos was inaccurate and unreliable. The major reason for the low quality of the videos was that the sources of information presented in the videos were not provided. The DISCERN and Journal of the American Medical Association scores showed significant differences in the uploading agency and presentation format variables. Nurses must be familiar with evaluating the quality of videos presenting health information. Guidelines informing patients that YouTube might provide misinformation about health need to be developed.

Human papillomavirus (HPV) is the most common sexually transmitted disease in the U.S. Data on knowledge, attitudes, and beliefs related to HPV vaccination among college students are limited. The purpose of this study was to provide a comprehensive description of the variables influencing HPV vaccination uptake and intention among college students. This study employed a cross sectional descriptive quantitative design. Survey data were collected online from the 181 college students, aged 18-25 years. The data were analyzed to identify the students' attitudes toward HPV vaccine (perceived potential harm, effectiveness, barriers, and uncertainty), knowledge of HPV and HPV vaccine, and their intention of receiving the vaccine in the next 6 months. Descriptive statistics, Chi-square tests, ANOVA, and logistic regressions were conducted to examine the correlates of vaccination intention and uptake. Among 181 participants, 101 (55.8%) were had received at least one dose of HPV vaccine, 52 (28.7%) intended to receive HPV vaccine, and 28 (15.5%) did not intend to receive HPV vaccine. On average, participants responded correctly to less than half of the questions on the HPV knowledge and HPV vaccine knowledge scales, and those who were vaccinated were significantly more knowledgeable than their counterparts. Multivariate logistic regression showed HPV vaccine knowledge and uncertainty were significant factors associated with HPV vaccine uptake. Providing education designed to improve HPV and HPV vaccination knowledge and decrease feelings of uncertainty could improve college students' HPV vaccination uptake.

PURPOSE The current research addresses the need for developing a Health Care System Distrust scale for cancer screening among Koreans living in the Republic of Korea. This study developed and validated a scale to measure health care system distrust and to examine the psychometric properties of the scale. METHODS Interviews, expert reviews, a pilot test, and a cross-sectional survey with 884 Koreans were conducted for instrument development and validation. Content validity, construct validity using exploratory and confirmatory factor analyses, convergent and discriminant validity, and reliability of the scale were examined. RESULTS Factor analyses demonstrated a three-factor structure (competency of tests and health care providers, quality of health care organizations, and honesty of health care organizations) of the Health Care System Distrust scale with 12 items accounting for a total of 71.47% of the variance (competency = 33.35%, quality = 21.14%, and honesty = 16.97%). Cronbach's α coefficients of the subscales were 0.72-0.92. CONCLUSION The newly developed Health Care System Distrust scale will aid in understanding Koreans' distrust of the health care system and their cancer screening behaviors, and will improve cancer screening utilization by transforming distrust into trust.

Objective The aim of this study is to evaluate the feasibility of posterior cervical foraminotomy (PCF) for adjacent segmental disease (ASD) after anterior cervical fusion (ACF). As ACF is accepted as the standard treatment for cervical spondylosis, many studies have been conducted to evaluate the efficacy of various surgical techniques to overcome symptomatic ASD after the previous surgery. Herein, PCF was performed for the treatment of symptomatic ASD and the feasibility of the surgery was evaluated. Methods Forty nine patients who underwent PCF due to symptomatic ASD from August 2008 to November 2017 were identified. For demographic and perioperative data, the sex, age, types of previous surgery, ASD levels, operation times, and bleeding amount were recorded. The clinical outcome was assessed using the visual analogue scale for the neck and arm, the modified Odom’s criteria as well as neck disability index. Radiologic evaluations were performed by measuring disc softness, disc height, the cervical 2–7 sagittal vertical axis, cervical cobb angle, and facet violation. Results Thirty-seven patients were enrolled in this study. The patients were divided into two groups based on the location of the pathology; paracentral (group P) or foramina (group F). Both groups showed significant clinical improvement (p0.05). Conclusion PCF showed satisfactory clinical and radiologic outcomes for both paracentral and foraminal pathologies of ASD after ACF. Complications related to anterior revision were also avoided. PCF can be considered a feasible and safe surgical option for ASD after ACF.

Purpose The purpose of this study was to describe the experiences of Korean family caregivers of patients with cancer by reviewing recent literature. Methods Five electronic databases were searched- MEDLINE, the Cumulative Index to Nursing and Allied Health Literature (CINAHL), and PubMed for English literature, and Korean Information Service System (KISS), and Research Information Sharing Service (RISS) for Korean literature for articles published from January 2010 to March 2020 using the key words cancer, caregiver, and Korean. Twenty-six articles met the inclusion criteria and remained in the final review. Results No intervention study was found and most of studies were quantitative without theoretical/conceptual framework. All the studies were conducted with Koreans living in Korea. No previous study has been conducted with Koreans living in the U.S. or other countries. Most studies focused on caregivers' quality of life, burden, unmet needs, and resilience/adaptation/post-traumatic growth. Conclusions Comprehensive intervention studies focused on improving quality of life, burden, and adaptation to their complex roles as caregivers in the context of Korean culture would be helpful. Further research is needed in examining the caregiver-patient dyad interactions longitudinally to understand the dynamic complicated processes of caregiving. This article is protected by copyright. All rights reserved.

Background Lung cancer is one of the common cancers and the leading cause of death. Tremendous caregiving burden of informal caregivers of lung cancer causes psychological disorders, such as anxiety and depression. Interventions for informal caregivers of patients with lung cancer to improve their psychological health, which ultimately leads to patients’ positive health outcomes, are crucial. A systematic review and meta-analysis was conducted to: 1) evaluate the effect of non-pharmacological interventions on the outcomes of depression and anxiety for lung cancer patients’ informal caregivers; and 2) compare the effects of interventions with differing characteristics (i.e. intervention types, mode of contact, and group versus individual delivery). Methods Four databases were searched to identify relevant studies. Inclusion criteria for the articles were peer-reviewed non-pharmacological intervention studies on depression and anxiety in lung cancer patients’ informal caregivers published between January 2010 and April 2022. Systematic review procedures were followed. Data analysis of related studies was conducted using the Review Manager Version 5.4 software. Intervention effect sizes and studies’ heterogeneity were calculated. Results Eight studies from our search were eligible for inclusion. Regarding total effect for the caregivers’ levels of anxiety and depression, results revealed evidence for significant moderate effects of intervention on anxiety (SMD -0.44; 95% CI, -0.67, -0.21; p = 0.0002) and depression (SMD -0.46; 95% CI, -0.74, -0.18; p = 0.001). Subgroup analyses for both anxiety and depression of informal caregivers revealed moderate to high significant effects for specific intervention types (cognitive behavioral and mindfulness combined with psycho-education interventions), mode of contact (telephone-based interventions), and group versus individual delivery. Conclusion This review provides evidence that cognitive behavioral and mindfulness-based, telephone-based, individual or group-based interventions were effective for informal caregivers of lung cancer patients. Further research is needed to develop the most effective intervention contents and delivery methods across informal caregivers with larger sample size in randomized controlled trials.

With an increased consumption of seafood products, food fraud with fish resources has been continuously reported. In particular, codfish has been exploited worldwide as a processed product in fresh, frozen, smoked, canned, or ready-to-eat dish forms. However, it is challenging to identify processed fish products after processing because of their similar morphological characteristics. Substitution and mislabeling of codfish among different species are also happening deliberately or unintentionally. Thus, it is necessary to distinguish cod species to prevent fish adulteration and food fraud. In this study, we developed a multiplex PCR for simultaneously identifying five cod species within Gadidae using capillary electrophoresis. Then, their species-specific primer sets were designed by targeting the mitochondrial cytochrome b gene. Subsequently, the amplicon sizes obtained were 237 bp, 204 bp, 164 bp, 138 bp, and 98 bp for Atlantic cod, Pacific cod, blue whiting, haddock, and Alaska pollock, respectively. The specificity of each primer was further tested using 19 fish species, and no cross-reactivity was observed. The limit of detection of this multiplex PCR assay was 1 pg. The developed multiplex PCR assay can be applied to 40 commercial food products successfully. This detection method will be efficient for managing seafood authentication by simultaneously analyzing multiple cod species.

본 연구에서는 숲유치원 자유놀이의 의미를 프뢰벨의 교육사상의 관점에서 고찰해보고 이에 기초하여 국내 숲유치원 교육의 발전방향을 모색해 보고자 한다. 프뢰벨의 교육사상의 관점에서 볼 때 숲유치원의 자유놀이는 프뢰벨의 자유를 진정으로 실천하는 놀이이며, 상징과 예감에 기초한 유아의 창조적인 자기표현인 동시에 자유의지를 통한 진정한 자기활동으로서 신성(神性)·개성(個性)을 발현시키는 활동으로 볼 수 있다. 또한 자신의 본성 또는 개성에 따라 끊임없이 자기발전을 이루는 자기교육활동인 노작교육이며 풍부한 모험과 도전을 통해 유아에게 새로운 세계를 열어주는 교육이라 할 수 있다. 숲유치원의 자유놀이가 충분히 이루어질 때 유아들은 자신과 자연과 신의 관계성을 깨달으며 프뢰벨이 주장한 생의 합일의 이루어가게 될 것이다. 앞으로 이 같은 프뢰벨의 교육사상이 숲유치원 자유놀이의 이론적 토대를 이룰 때 유아가 주체가 된 진정한 자유놀이의 실현에 도움이 될 것이며 이를 통해 유아들이 몸과 마음과 영혼이 행복하며 자기를 포함한 모든 생명을 사랑하는 자연인 즉, 홍익인간으로 성장하게 될 것이다. 앞으로 숲유치원 자유놀이의 확실한 실현을 통해 국내 숲유치원이 질적으로 더욱 발전되길 기대한다.

Background: Concerning of progression of deformity, it is reluctant to utilize a posterior approach if preoperative sagittal alignment is kyphotic or straight. The purpose of this study was to determine interval changes in cervical segmental angles after posterior cervical foraminotomy (PCF) and analyzing factors affecting cervical sagittal re-alignment in the postoperative period. Methods: Within 2 days and 6 months after PCF, postoperative plain radiograph was obtained to compare the cervical sagittal alignment with preoperative alignment in 286 consecutive patients. Sagittal angle between C2 and C7 formed by lines drawn at the base of axis and the superior endplate of the C7 vertebral body on lateral radiograph. To evaluate clinical outcomes, patients were routinely asked to gauge levels of pain they feeling at that point in time by visual analogue scale (VAS) on admission, prior to postoperative radiographs and 6 months after operation follow-up in outpatient. Results: More than two-third of the patients presenting with kyphotic or straight curvature improved short-term following operation. On follow-up plain radiographs after 6 months, the improvement of sagittal alignment was well maintained, but rather more prominent (P

Health information on the Internet can have a direct effect on healthcare decision-making. However, the quality of information online has seldom been evaluated. This study aimed to assess the quality of online information on high-risk pregnancies provided by English and Korean Web sites. Through a Google search, 30 English and 30 Korean Web sites were selected on January 2 and 3, 2020, respectively, and assessed using DISCERN, a Journal of the American Medical Association, and Health On the Net Foundation code questionnaires. The data assessed were analyzed using descriptive and nonparametric statistical tests. Overall, the information provided by the English Web sites presented higher-quality information than the Korean Web sites. Most Web sites did not provide the sources of the information presented on their Web sites, meet the Journal of the American Medical Association criteria, or provide information on complementarity. Based on our results, nurses need to be competent in assessing the quality of Web sites and the health information presented there, and nursing students need to be prepared to do so as well. Nurses are responsible for educating their patients about the possibility of incorrect information provided by Internet Web sites and informing their patients about reliable Web sites, thus assisting them to make informed decisions regarding their health.

The explosive outbreak of COVID-19 led to a shortage of medical resources, including isolation rooms in hospitals, healthcare workers (HCWs) and personal protective equipment. Here, we constructed a new model, non-contact community treatment centres to monitor and quarantine asymptomatic and mildly symptomatic COVID-19 patients who recorded their own vital signs using a smartphone application. This new model in Korea is useful to overcome shortages of medical resources and to minimise the risk of infection transmission to HCWs.

South Korea has a high incidence of thyroid cancer. This study aimed to describe and understand the nature of the experience of Korean patients with thyroid cancer undergoing radioactive iodine treatment after total thyroidectomy through an in-depth investigation of their experience.Individual interviews using open questions were conducted with 22 participants living in South Korea. All were audio-recorded and transcribed verbatim. This study used the phenomenological analysis method proposed by Colaizzi to determine the essential subjects verified according to the four reliability criteria proposed by Guba and Lincoln.Three categories, 6 theme clusters, and 13 themes emerged from the study. The three categories identified were "broken life," "solitude in a crowd," and "positive changes in values." The six theme clusters were "anxiety about death," "an imperfect being," "feeling social isolation," "struggling alone," "an active attitude toward life," and "life support." The themes that emerged the most were related to physical and psychological difficulties. Of the 13 themes, four themes were related to family-oriented values and culture.This study suggests that nursing interventions are required to reduce the physical and psychological symptoms of Korean patients with thyroid cancer. It is necessary to build a support system with the patient's family members to consider family-oriented values and culture.

Various endoscopic surgical techniques were introduced recently. Among them, transforaminal endoscopic thoracic discectomy (TETD) becomes more popular. Outstanding advances of endoscopic camera system is achieved recently, more shallow working cannula and flexible catching graspers enable surgeons to overcome complex thoracic disc herniation. Highly migrated discs were treated with “epiduroscopic or out-to-in” endoscopic technique. This procedure guide the endoscope into the epidural space. TETD technique approaching disc space through the pedicle of caudal vertebral body by resecting the inferior transverse process and lateral facet. A TETD approach that avoids an open posterior approach, reduces the need to remove stabilizing facet. Retraction of the spinal cord, general anesthesia is not required in TETD, so it could be added as a potent surgical option for minimally invasive spine surgeons.

Bifidobacterium species are used as probiotics to provide beneficial effects to humans. These effects are specific to some species or subspecies of Bifidobacterium. However, some Bifidobacterium species or subspecies are not distinguished because similarity of 16S rRNA and housekeeping gene sequences within Bifidobacterium species is very high. In this study, we developed a real-time polymerase chain reaction (PCR) assay to rapidly and accurately detect 22 Bifidobacterium species by selecting genetic markers using comparative genomic analysis. A total of 210 Bifidobacterium genome sequences were compared to select species- or subspecies-specific genetic markers. A phylogenetic tree based on pan-genomes generated clusters according to Bifidobacterium species or subspecies except that two strains were not grouped with their subspecies. Based on pan-genomes constructed, species- or subspecies-specific genetic markers were selected. The specificity of these markers was confirmed by aligning these genes against 210 genome sequences. Real-time PCR could detect 22 Bifidobacterium specifically. We constructed the criterion for quantification by standard curves. To further test the developed assay for commercial food products, we monitored 26 probiotic products and 7 dairy products. Real-time PCR results and labeling data were then compared. Most of these products (21/33, 63.6%) were consistent with their label claims. Some products labeled at species level only can be detected up to subspecies level through our developed assay.

Objective: Although the purposes and outcomes of screening and diagnostic tests are different, they are often confused. Therefore, it is important to delineate the clinical concept of cancer screening tests to be clear in our communication not only among healthcare professionals but also with client populations. The aim of this study is to both describe and analyze the concept of cancer screening and explain their practical meaning in global contexts. Methods: Comparative case studies of cervical and liver cancer screening tests were used as the basis for developing an understanding of a specific concept (phenomenon) of cancer screening and for delineating the relationships between factors that cause screening to occur. Results: A cancer screening is defined as an action taken by both the patient and health-care provider to detect a possible pre-cancerous condition among healthy and asymptomatic individuals who are at sufficient risk of a specific disorder to warrant further investigation or treatment. The case study-based concept analysis has been shown to be useful for improving our understanding of the multi-dimensional nature of the concept in global contexts. Conclusions: New paradigms maximizing participation in cancer screening to detect diseases before symptoms are manifested rather than focusing on diagnosis and treatment of symptomatic infectious diseases need to be developed and implemented.

This study examined factors related to colorectal cancer (CRC) screening uptake among Thais in the United States. A total of 121 Thais between 50 and 75 years of age, who were married and living in southern California participated in the survey (mean age = 61 years). Out of all the participants, only 21% of the participants had fecal occult blood tests, 21% had sigmoidoscopy, and 45% had colonoscopy that were within the recommended period. Overall, 55% of participants met CRC screening adherence criteria. Participants who had had regular checkups in the previous 2 years without having any symptoms were 16 times more likely to have obtained CRC screening than their counterparts (OR 16.01, CI 3.75-68.75) in the multivariable logistic regression model. Other significant predictors of screening adherence included older age (OR 1.08, 95% CI 1.00-1.17), having lived in the U.S. 15 years or longer (OR 6.65, 95% CI 1.55-28.59), having had at least some college education (OR 3.74, 95% CI 1.23-11.37), and higher levels of perceived self-efficacy (OR 1.88, 95% CI 1.01-3.50) to obtain CRC screening. Targeted interventions for Thais who are less likely receive CRC screening could be effective in improving CRC screening. Interventions to improve the populations' awareness of the importance of preventive measures when they are not sick could be also effective.

We report a case of acute type I aortic dissection in which an emergency graft replacement of the ascending aorta and innominate artery was performed. We performed false lumen thrombosis through hybrid thoracic endovascular aortic repair to seal the primary entry tear, followed by false lumen obliteration at the level of the descending thoracic aorta, abdominal aorta, and right common iliac artery. Over a period of 4.5 years, we used Amplatzer vascular plugs and coils based on our computed tomography angiography follow-up protocol.

Insulin resistance, a pathophysiology of type 2 diabetes, is associated with obesity. Lipotoxicity in obesity leads to the dysfunction and death of pancreatic β-cells and inadequate insulin production, thereby aggravating type 2 diabetes. The present study was conducted to determine the effect of Aloe vera polysaccharides (APs) as an anti-hyperglycemic agent and their mechanisms of action. Gel polysaccharides from Aloe extracts were separated using ultrafiltration devices with molecular weight-cutoff membranes, and the protective effect of APs on pancreatic β-cells in response to free fatty acids (FFAs) was determined. Hamster pancreatic β-cell line HIT-T15 was treated with palmitate and APs to analyze cellular responses. We observed a large number of apoptotic β-cell death after treatment with high levels of palmitate, but this was efficiently prevented by the addition of APs in a dose-dependent manner. It was found that the anti-apoptotic properties of APs were largely due to the relief of endoplasmic reticulum (ER) stress signaling. APs were effective in interfering with the FFA-induced activation of the PERK and IRE1 pathways as well as ROS generation, thereby protecting pancreatic β-cells from lipotoxicity. Although variation in the chain length of APs can influence the activity of FFA-mediated ER stress signaling in different ways, polysaccharide mixtures with molecular weights higher than 50 kDa showed greater antiapoptotic and antioxidant activity in β-cells. After oral administration of APs, markedly lowering fasting blood glucose levels were observed in db/db mice, providing evidence of the potential of APs as an alternative insulin sensitizer. Therefore, it was concluded that APs have a protective effect against type 2 diabetes by modulating obesity-induced ER stress in pancreatic β-cells.