Investigation of the association between sleep problems and food allergies in preschool children with/ without siblings: a cross-sectional study in Chongqing, China / 한국영양학회지

Purpose@#This study investigated the association between sleep problems and food allergies (FAs) in Chinese preschoolers and assessed whether there is a difference in this association among children with/without siblings. @*Methods@#A cluster-stratified sampling approach was employed to select four districts in Chongqing based on demographic considerations. A total of 16 kindergartens (n = 966 parents) participated in this study. Parents completed the Children’s Sleep Habits Questionnaire (CSHQ) and a standard FAs questionnaire. Analysis of covariance and multiple logistic regression were used to assess the associations between sleep problems and FAs after adjusting for relevant confounders. @*Results@#The study found that 16.3% of children had FAs, with eggs, shellfish, and fruit being the most common allergenic foods. The prevalence of FAs was significantly higher in single children (20.63%) than in children with siblings (13.36%). A total of 70.39% of children had CSHQ scores above the clinical cut-off for sleep disorder. Factor analysis revealed five underlying dimensions from the CSHQ. Factor scores, except for the ‘difficulty morning waking’ factor, were not significantly different between the two groups. Remarkably, the factor scores of ‘parasomnias’ and ‘sleep anxiety’ were significantly higher when children had both siblings and FAs. For all subjects, the odds ratios (ORs) of FAs significantly increased with the presence of sleep disorder (OR, 2.35; 95% confidence interval [CI],1.50–3.68) and ‘difficulty falling asleep’ (OR, 1.34; 95% CI, 1.22–1.48). The subgroup analysis showed that the probability of FAs significantly increased with the ‘difficulty falling asleep’ (OR, 1.32 vs. 1.38) and sleep disorder (OR, 2.48 vs. 2.14) in children with and without siblings, respectively. The ‘parasomnias’ was positively associated only with children with siblings. @*Conclusion@#This study suggests that children with siblings might be more susceptible to FAs when accompanied by certain sleep problems. Further studies are warranted to address the underlying dimensions and possible mediation effects of having siblings with sleep problems.

A Study on the Oral Health Literacy and Related Factors of Mother’s in Some Areas: A 25% Comparison Study of the Upper and Lower Grades / 치위생과학회지

Background@#This study compares and analyzes the degree of oral health information literacy by 25% for upper and lower grades to assess how differences in mothers’ oral health information literacy affect infants’ oral health behavior. @*Methods@#The study surveyed 201 mothers with infants and children using a 36 question survey tool. Cross-analysis was conducted to determine the difference in oral health information literacy between the upper and the lower 25%. @*Results@#Comparing 25% of the upper and lower grades of verbal oral health information literacy scores, the word with the most significant difference in the correct answer was resin. An item asking about the time to eat after fluoride varnish application showed the most significant difference in the correct answer on the functional oral health information literacy scale. Mothers’ oral and functional oral health information literacy scores showed that verbal literacy was statistically significant for brushing guidance after children’s meals, brushing guidance before children’s bedtime, food intake restrictions before bedtime, and restrictions on consumption of cavity-inducing foods (p＜0.05). Functional literacy was statistically significant in the post-brushing test of children and the correct brushing method map items (p＜0.05). @*Conclusion@#As a result of comparing and analyzing the upper and lower 25% of the mother’s oral health information literacy, it was found that the mother’s oral health information literacy affected the infant’s oral health behavior. Therefore, systematic education is needed to raise literacy by grasping the level of oral health information literacy of mothers, and oral health education by level according to oral health information literacy should be developed.

Short-term Comparison of Refractive Errors between Two Different Age Groups after LASEK for Moderate Myopia

Purpose@#To investigate the safety of laser epithelial keratomileusis (LASEK) by drawing a comparison between two groups divided according to age (18-19 vs. 20-21 years old). @*Methods@#The study was conducted as a retrospective analysis including 339 patients (678 eyes) who underwent LASEK between January 2017 and April 2020. Patients were divided by age group, group I (18-19 years old) and group II (20-21 years old). The objectives of the study included determination of visual acuity and refractive errors before and at 1, 3, and 6 months after the procedure. @*Results@#The preoperative mean spherical equivalents (SEs) were -4.73 ± 0.88 diopters (D) in group I and -4.58 ± 0.87 D in group II (p = 0.34). At 1 month postoperatively, mean SEs were 0.32 ± 0.46 D in group I and 0.26 ± 0.59 D in group II (p = 0.18). At 3 months postoperatively, the mean SEs were 0.30 ± 0.47 D in group I and 0.28 ± 0.50 D in group II (p = 0.67). At 6 months postoperatively, the mean SEs were 0.15 ± 0.47 D in group I and 0.14 ± 0.50 D in group II (p = 0.89). There were no significant differences in postoperative best corrected visual acuity between group I and group II at 1, 3, or 6 months (p = 0.20, p = 0.13, and p = 0.11, respectively). @*Conclusions@#There were no significant differences in postoperative mean SE or safety of LASEK between moderate myopia patients 18-19 years old and those 20-21 years old.

Hepatitis B virus X Protein Promotes Liver Cancer Progression through Autophagy Induction in Response to TLR4 Stimulation

Hepatitis B virus X (HBx) protein has been reported as a key protein regulating the pathogenesis of HBV-induced hepatocellular carcinoma (HCC). Recent evidence has shown that HBx is implicated in the activation of autophagy in hepatic cells. Nevertheless, the precise molecular and cellular mechanism by which HBx induces autophagy is still controversial.Herein, we investigated the molecular and cellular mechanism by which HBx is involved in the TRAF6-BECN1-Bcl-2 signaling for the regulation of autophagy in response to TLR4 stimulation, therefore influencing the HCC progression. HBx interacts with BECN1 (Beclin 1) and inhibits the association of the BECN1-Bcl-2 complex, which is known to prevent the assembly of the pre-autophagosomal structure. Furthermore, HBx enhances the interaction between VPS34 and TRAF6-BECN1 complex, increases the ubiquitination of BECN1, and subsequently enhances autophagy induction in response to LPS stimulation. To verify the functional role of HBx in liver cancer progression, we utilized different HCC cell lines, HepG2, SK-Hep-1, and SNU-761. HBx-expressing HepG2 cells exhibited enhanced cell migration, invasion, and cell mobility in response to LPS stimulation compared to those of control HepG2 cells. These results were consistently observed in HBx-expressed SK-Hep-1 and HBx-expressed SNU-761 cells. Taken together, our findings suggest that HBx positively regulates the induction of autophagy through the inhibition of the BECN1-Bcl-2 complex and enhancement of the TRAF6-BECN1-VPS34 complex, leading to enhance liver cancer migration and invasion.

Clinical Significance of Tear Film Osmolarity in Patients with Mild Dry Eye Syndrome

Purpose@#To seek Pearson correlations of tear film osmolarity measured by the I-PEN® (I-MED Pharma Inc., Dollard-des-Ormeaux, Canada) with Schirmer test result, tear break-up time, and Ocular Surface Disease Index score in patients with mild dry eye syndrome. @*Methods@#Patients with mild dry eye syndrome were divided into two groups according to Ocular Staining Score: group 1 (50 patients; 67 eyes) and group 2 (59 patients; 91 eyes), 90 patients and 158 eyes in total. The above mentioned correlations were derived. @*Results@#No significant correlations were observed between tear film osmolarity and Schirmer test result (r < -0.01, p = 0.97), tear break-up time (r = 0.05, p = 0.54), or Ocular Surface Disease Index score (r = 0.03, p = 0.76). When the two groups were compared, the Ocular Surface Disease Index score significantly differed between groups (p < 0.01), whereas the Schirmer test result (p = 0.31), tear break-up time (p = 0.11), and tear film osmolarity (p = 0.12) did not. @*Conclusions@#No significant correlations were found between tear film osmolarity and other dry eye indicators in patients with mild dry eye syndrome. The diagnostic utility of tear film osmolarity in patients with moderate dry eye syndrome is should be evaluated.

Clinical Significance of Tear Film Osmolarity in Patients with Mild Dry Eye Syndrome

Purpose@#To seek Pearson correlations of tear film osmolarity measured by the I-PEN® (I-MED Pharma Inc., Dollard-des-Ormeaux, Canada) with Schirmer test result, tear break-up time, and Ocular Surface Disease Index score in patients with mild dry eye syndrome. @*Methods@#Patients with mild dry eye syndrome were divided into two groups according to Ocular Staining Score: group 1 (50 patients; 67 eyes) and group 2 (59 patients; 91 eyes), 90 patients and 158 eyes in total. The above mentioned correlations were derived. @*Results@#No significant correlations were observed between tear film osmolarity and Schirmer test result (r < -0.01, p = 0.97), tear break-up time (r = 0.05, p = 0.54), or Ocular Surface Disease Index score (r = 0.03, p = 0.76). When the two groups were compared, the Ocular Surface Disease Index score significantly differed between groups (p < 0.01), whereas the Schirmer test result (p = 0.31), tear break-up time (p = 0.11), and tear film osmolarity (p = 0.12) did not. @*Conclusions@#No significant correlations were found between tear film osmolarity and other dry eye indicators in patients with mild dry eye syndrome. The diagnostic utility of tear film osmolarity in patients with moderate dry eye syndrome is should be evaluated.

A Study on the Oral Health Literacy and Related Factors of Mother’s in Some Areas / 치위생과학회지

Background@#This study aims to provide basic data for development of the level-based oral health care program depending on the mother’s oral health literacy by finding out how mother’s oral health literacy can effect on the preschool children’s oral health and behavior. @*Methods@#The survey was conducted on 192 mothers who have preschool children and the data were analyzed by t-test, ANOVA, multiple regression analysis to identify differences in verbal and functional oral health literacy. @*Results@#The study showed statistical significance (p＜0.05) in educational level depending on differences in verbal and functional oral health literacy by sociodemographic factor. In differences in verbal and functional literacy depending on experience of education for oral health behavior and oral health, statistical significance (p＜0.05) was showed highly on verbal and functional literacy in the case that subjects have an experience of education for oral health and their children have not been experienced of oral illness. And when it comes to the case that subjects have experience of education for oral health within one to two years, statistical significance was showed highly on verbal literacy. It showed that verbal and functional oral health literacy effects to oral health care behavior of children judging from results that the higher level of mother’s verbal oral health literacy, the higher score of children’s oral health knowledge, attitude and behavior. @*Conclusion@#It is necessary to develop the systematic program which is appropriate for characteristics of each oral period in childhood depending on level of primary caregiver’s oral health literacy, and systematic education should be preceded to enhance the literacy of the caregiver. It is considered necessary to improve the oral health care of children by developing a manual for oral health care education to enhance primary caregiver’s oral health literacy.

Relevance between Marketing Route of Social Media and Consumer Age Group for Choosing Dental Clinics / 치위생과학회지

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.

Effects of Dental Hygienists Job Stress on Somatization in an Area / 치위생과학회지

Background@#This study aims to analyze the job stress of dental hygienists and the factors affecting somatization and to provide basic data for effectively managing job stress and somatization of dental hygienists. @*Methods@#In this study, the data collected from 208 dental hygienists working in Jeollabuk-do Province were analyzed. Job stress was investigated using a questionnaire with 43 questions. In addition, the degree of somatization was evaluated through a simplified psychotherapy examination (Symptom Check List-90-Revision). @*Results@#Age, employment history, position, average monthly income, night duty execution status, and perceived health status were significantly associated with job stress (p＜0.05). The job stress sub-items scores based on general characteristics showed significance in ‘workload’ for those working a five-day workweek and perceived health status (p＜0.05). Age, average monthly income, and perceived health status were noted in ‘role conflict as a professional’. In ‘lack of expertise and skill’, it was noted that age, employment history, position, income, and night clinic were implemented. In ‘improper treatment and interpersonal issues’, level of education and perceived health status were significant (p＜0.05). The higher the job stress, the higher the somatization symptom score (p＜0.05), and the higher the job stress component, the higher the somatization symptom score (p＜0.01). @*Conclusion@#The job stress of dental hygienists should be reduced, and the symptoms of somatization should be mitigated. To improve the quality of medical services and the work efficiency of dental hygienists, proper treatment and compensation systems should be implemented for them to take pride as professional. Further, programs and regulations on mitigating job stress and somatization symptoms should be developed.

Food consumption frequency of Korean adults based on whether or not having chewing difficulty using 2013–2016 KNHANES by sex-stratified comparative analysis

BACKGROUND/OBJECTIVES@#This study examined the associations between food consumption frequency of Korean adults and self-perceived chewing difficulty, using the food frequency questionnaire (FFQ, 112 items) from 2013–2016 of the Korea National Health and Nutrition Examination Survey (KNHANES). @*SUBJECTS/METHODS@#Subjects were divided into not difficult in chewing (NDC) and difficult in chewing (DC) groups, with 24.17% being classified into DC. Males and females consumed 35 and 37 items less frequently than the other sex, respectively. Due to the remarkable gender difference in food consumption, gender-stratified one-sided survey regression analysis was performed after adjusted for the effect of age, household income, and self-rated health status. @*RESULTS@#Thirty-four items of FFQ were significantly less consumed by the DC group.Females exclusively consumed less beverages and alcohol while males showed the same for fruits and milk·dairy products. Consumption frequency of 8 items such as steamed potatoes·grilled potatoes, stir fried beef, other kimchi·fresh vegetable kimchi, orange, sour pork·pork cutlet, tteokbokki and green tea were significant only in males. In contrast, 17 items including cooked rice with other grains and legumes, boiled egg·steamed egg, Korean cabbage kimchi, banana, and tofu stew·soft tofu stew were significant only for females. Finally, items that showed significance for both were 9 items including loaf bread, readyto-eat cereal, steamed sweet potatoes·grilled sweet potatoes, stir-fried lotus roots·stir-fried burdock, green laver salad·brown seaweed salads, apples, tomato·cherry tomatoes, squid (raw, dried shredded, boiled, stir-fried), and curd type yogurt. @*CONCLUSIONS@#Findings in this study suggest chewing difficulty may be an important nutritional issue that has to be dealt with for healthful food consumption, with distinct interest of gender.

Lodoxamide Attenuates Hepatic Fibrosis in Mice: Involvement of GPR35

A previous pharmacogenomic analysis identified cromolyn, an anti-allergic drug, as an effective anti-fibrotic agent that acts on hepatocytes and stellate cells. Furthermore, cromolyn was shown to be a G protein-coupled receptor 35 (GPR35) agonist. However, it has not been studied whether anti-fibrotic effects are mediated by GPR35. Therefore, in this study, the role of GPR35 in hepatic fibrosis was investigated through the use of lodoxamide, another anti-allergic drug and a potent GPR35 agonist. Longterm treatment with carbon tetrachloride induced hepatic fibrosis, which was inhibited by treatment with lodoxamide. Furthermore, CID2745687, a specific GPR35 antagonist, reversed lodoxamide-mediated anti-fibrotic effects. In addition, lodoxamide treatment showed significant effects on the mRNA expression of collagen Iα1, collagen Iα2, and TGF-β1 in the extracellular matrix. However, a transforming growth factor α (TGF-α) shedding assay revealed lodoxamide not to be a potent agonist of mouse GPR35 in vitro. Therefore, these results showed anti-fibrotic effects of lodoxamide in mice and raise concerns how lodoxamide protects against liver fibrosis in vivo and whether GPR35 is involved in the action.

Effect of Head Nurses' Authentic Leadership on Nurses' Job Satisfaction and Nursing Performance: Focusing on the Mediating Effects of Empowerment / 간호행정학회지

PURPOSE: The purpose of this study was to explore the effects of head nurses' authentic leadership and empowerment on job satisfaction, and nursing performance of nurses and to identify the mediating effect of empowerment in the relationships of head nurses' authentic leadership, with nurses' job satisfaction, and nursing performance. METHODS: The sample for this study was 149 nurses from 2 general hospitals located in Busan. Data were collected using self-administered questionnaires and the SPSS/WIN 23.0 program was used for analysis. Mediation analysis was performed according to the Baron and Kenny method and Sobel test. RESULTS: Head nurses' authentic leadership showed positive correlations with empowerment, job satisfaction, and nursing performance. Empowerment showed partial mediating effects in the relationship between head nurses' authentic leadership and nurses job satisfaction, and a perfect mediating effect in the relationship between head nurses' authentic leadership and the performance of nursing. CONCLUSION: The results indicate that it is necessary to develop strategies and applications to enhance nurses' empowerment for improved job satisfaction and nursing performance.

Clinically Occult Diffuse Large B-Cell Lymphoma of the Middle Turbinate Identified Using ¹⁸F-Fluorodeoxyglucose Positron Emission Tomography/Computed Tomography: A Case Report

We report a case of clinically occult diffuse large B-cell lymphoma (DLBCL) of the middle turbinate (MT) identified by ¹⁸F-fluorodeoxyglucose positron emission tomography/computed tomography (¹⁸F-FDG PET/CT) in a 71-year-old man along with imaging findings. DLBCL was presented with a hypermetabolic right MT [maximum standardized uptake values (SUV(max)) = 8.8 gm/dL] on ¹⁸F-FDG PET/CT, while rhinologic examination was normal. CT showed nothing but slightly more intense enhancement of the right MT compared with the opposite side. The disease progressed during next 7 months until follow-up CT demonstrated solidly enhancing mass occupying entire right nasal cavity which was intensely hypermetabolic (SUV(max) = 12.8 gm/dL). Surgical biopsy confirmed the diagnosis. Follow-up CT and 18F-FDG PET/CT performed after chemotherapy demonstrated complete resolution of DLBCL of the right nasal cavity including the right MT. This is thought to be the first case report in the literature concerning clinically occult DLBCL presenting as a hypermetabolic MT on ¹⁸F-FDG PET/CT.

Bacteremia due to Rahnella aquatilis in a Patient with a Chemoport

Rahnella aquatilis, a saprophytic organism, is a member of the Enterobacteriaceae family. The natural habitat of this organism is fresh water, and it is rarely found in clinical specimens. Clinical conditions ascribed to this organism include bacteremia, respiratory infection, urinary tract infection, wound infection in an immunocompromised host, and infective endocarditis in patients with congenital heart diseases. Here, we report a case of bacteremia due to R. aquatilis in a woman with breast cancer who had received chemotherapy through a chemoport. To our knowledge, this is the second case of bacteremia caused by this organism in a patient with cancer in Korea.

Moderating Effects of Career Commitment in the Relationship between Work Engagement and Organizational Citizenship Behaviors of the Clinical Nurses / 간호행정학회지

PURPOSE: The purpose of the study was to investigate the effect of work engagement (WE) on organizational citizenship behaviors (OCB) and ability to control career commitment (CC) in the relationship between work engagement and OCB. METHODS: Data were collected using structured self-report questionnaires from 205 nurses currently working at three national hospitals. Data were analyzed using descriptive statistics, ANOVA, Scheffé test, Pearson correlation coefficient, and hierarchical multiple regression analysis using the SPSS 21.0 program. RESULTS: Mean scores for each variable were: WE 3.77 (on a 7-point scale), OCB 3.41 (on a 5-point scale), and CC 3.05 (on a 5-point scale). As a result, comparison showed that all research variables were higher with age, OCB was higher with total clinical career, and CC was higher with higher education level. Total clinical career, WE and CC had a significant effect on OCB, and CC had a moderate effect on work engagement and OCB. These variables had a total explanatory power of 38% for OCB. CONCLUSION: The nurses' WE had a positive effect on OCB, and the CC showed a moderating effect on the relationship between WE and OCB. Therefore, we suggest that CC is an important factor in improving nurses' OCB.

Effect of Emotional Labor on Somatization among Dental Hygienists in an Area / 치위생과학회지

BACKGROUND: We investigated somatization symptoms experienced by dental hygienists due to stress from emotional labor. Our aim was to provide basic research data that could be useful in the development of efficient stress management schemes for this occupational group. METHODS: We analyzed data collected from 208 dental hygienists working in Jeollabuk-do Province, Korea. To measure the level and intensity of emotional labor among research participants, we used the Korean Emotional Labor Questionnaire. We used the Somatization Symptom Checklist-90-Revised (SCL-90-R) to measure the level of somatization symptoms among participants. RESULTS: On analyzing the level of emotional labor and somatization symptoms according to general characteristics, participants aged 23~25 years showed high scores for stress due to emotional labor (p<0.05). Working 5 days per week, subjective health status, and organizational support and protection systems were found to correlate with the level of stress due to emotional labor (p<0.05). In the analysis of correlations between emotional labor and somatization symptoms, scoring high across all domains of emotional labor was associated with scoring high for somatization symptoms in the subdomains of emotional labor. When emotional labor and demographical variables were used as independent variables, having higher scores for emotional labor and having poor subjective health status were found to be associated with having higher levels of somatization symptoms (p<0.05). CONCLUSION: Our results showed that working at night and organizational support and protection systems were correlated with emotional labor and somatization symptoms. Measures must be taken at the organizational level to reduce emotional labor and somatization symptoms.

p62 Negatively Regulates TLR4 Signaling via Functional Regulation of the TRAF6-ECSIT Complex

Sequestosome 1 (SQSTM1, p62), a ubiquitin binding protein, plays a role in cell signaling, oxidative stress, and autophagy. However, its functional role in inflammatory signaling is controversial. Recent studies have shown that p62 is negatively implicated in inflammatory responses. But, the precise molecular mechanisms by which p62 regulates inflammatory responses remain unclear. In this study, we report on a new regulatory role for p62 in TLR4-mediated signaling. p62 overexpression led to the suppression of NF-κB activation and the production of pro-inflammatory cytokines, TNF-α, IL-6, and IL-1β in response to TLR4 stimulation. In contrast, p62(−/−) mouse embryonic fibroblast (MEF) cells exhibited marked enhancement of NF-κB activation and production of pro-inflammatory cytokines by TLR4 stimulation, compared to p62(+/+) MEF cells. Additionally, the TLR4-induced activation of signal transduction was significantly augmented in p62(−/−) MEF cells, indicating that p62 was negatively implicated in TLR4-mediated signaling. Biochemical studies revealed that p62 interacted with the internal domain of evolutionarily conserved signaling intermediate in Toll pathways (ECSIT), which is critical for associating with the TNF receptor associated factor 6 (TRAF6)-ECSIT complex to activate NF-κB in TLR4 signaling. Interestingly, p62-ECSIT interaction inhibited the interaction between TRAF6 and ECSIT and attenuated the ubiquitination of ECSIT. Furthermore, upon LPS challenge, the mortality of p62(−/−) (p62-knockout) mice was markedly enhanced compared to p62(+/+) (p62 wild-type) mice. Taken together, our data demonstrate that p62 negatively regulated TLR4 signaling via functional regulation of the TRAF6-ECSIT complex.

Clinical Presentation with High Penetrance in a Korean Family with Pulmonary Arterial Hypertension Associated with a BMPR2 Intron 3 Splice Site Pathogenic Variant

Pathogenic variants of bone morphogenic protein receptor type 2 gene (BMPR2) are related to the majority of cases of heritable pulmonary arterial hypertension (PAH). Over 400 pathogenic variants have been identified. However, clinical characterization of PAH is still incomplete. We present a case of heritable PAH in a Korean family showing serious clinical presentation with high penetrance. Genetic sequencing revealed a known heterozygous BMPR2 pathogenic variant, c.418+5G>A, at a splice site of intron 3. Serious clinical presentation with high penetrance suggested that the interplay of other factors with pathologic variants might be in genotype-phenotype correlation. Further studies are needed to clarify these issues for the development of personalized medicine approaches for PAH.

Development and Effects of a Sex Education Program with Blended Learning for University Students

PURPOSE: This study was describes the development and implementation a sex education program with a blended learning method for university students. METHODS: Sixty-eight university students were recruited either to the experimental group (n=35) or the control group (n=33). This program was developed based on the analysis, design, development, implementation, and evaluation model. The analysis phase consisted of a literature review, focus group interview, expert consultations, and target group survey. In addition, learning objectives and structure were designed, and a printed text-book, presentation slides, cross-word puzzle, and debate topics were developed. In the implementation phase, the program was conducted 3 times over the course of 3 weeks. The evaluation phase involved verification of the effects of the program on sex-related knowledge, sexual autonomy, and justification of violence, as well as an assessment of satisfaction with the program. RESULTS: The experimental group had significantly higher scores on sex-related knowledge (t=5.47, p < .001), sexual autonomy (t=2.40, p=.019), and justification of violence (t=2.52, p=.015) than the control group. CONCLUSION: The results indicate that this sex education program with blended learning was effective in meeting the needs of university students and can be widely used in this context.

Diagnostic Strategy of CT Urography as a Prior Examination in the Detection of Bladder Cancer

PURPOSE@#To prospectively assess the diagnostic potential of computed tomography urography (CTU) as a prior examination in the detection of bladder cancer.@*MATERIALS AND METHODS@#A total of 3280 CTU examinations were assessed in 3050 consecutive patients. Patients who were over 35 years of age, with gross hematuria, persistent microhematuria, or a history of urothelial tumor, were included in our study. Our study investigated the diagnostic capability of CTU over the course of two prior examinations. After the first examination, patients with a definite lesion observed by CTU were referred directly for rigid cystoscopy (RC) and patients with negative or probable lesion were referred for flexible cystoscopy (FC). After the second examination, patients with a definite lesion observed by CTU were referred directly for RC, patients with probable lesion were referred for FC, and patients with negative lesion were referred for clinical follow-up. Performance characteristics for the two prior examinations were determined by using pathologic findings or clinical follow-up as the reference standard.@*RESULTS@#The overall sensitivity, specificity, accuracy, positive predictive value, and negative predictive value for detecting bladder cancer were 95.2%, 95.4%, 95.4%, 69.1%, and 99.2%, respectively, for the first prior examination, and 93.4%, 93.3%, 93.3%, 61.1%, and 98.4%, respectively, for the second prior examination.@*CONCLUSION@#CTU as a prior examination is accurate for the early detection of bladder cancer. Notably, when used as a second prior examination, CTU could help to avoid the unnecessary use of FC in patients with negative lesions.