Effects of sitting time and smoking on perceived stress in adults under 65 years of age

Purpose@#Sitting time, smoking, and perceived stress strongly influence physical health independent of physical activity. However, the associations among perceived stress, sedentary behavior, and smoking are poorly understood. Therefore, we examined the relationships between sitting time, smoking, and perceived stress in Korean adults aged < 65 years. @*Methods@#We analyzed data from the seventh National Health and Nutrition Survey. In this cross-sectional study, data from 6,890 Korean adults aged < 65 years were analyzed. Complex-sample logistic regression was used to examine the relationships between sitting time, smoking, and perceived stress. @*Results@#The group with a high sitting time (≥ 8 h/day) and those who smoked had significantly higher odds of experiencing stress than the low sitting time (< 8 h/day) and non-smoking groups (odds ratio: 1.88, 95% confidence interval: 1.42-2.50). @*Conclusion@#Perceived stress was positively correlated with current smoking status and increased sitting time. High sitting time (≥ 8 h/day) and current smoking were associated with a higher risk of perceived stress in Korean adults aged < 65 years.

Effect of flipped learning-based smoking cessation intervention education program for nursing students in South Korea / 한국간호교육학회지

Purpose@#The goal of this study was to see how flipped learning affected nursing students in South Korea who were enrolled in a quit smoking intervention education program. The flipped learning-based quit smoking intervention education program was developed to help nursing students implement the intervention. @*Methods@#This quasi-experimental study was conducted using a pretest-posttest design. A total of 52 nursing students, divided into experimental and control groups of 26 each, participated between November and December 2021. The experimental group was instructed in the flipped learning-based quit smoking intervention education program over six sessions. In accordance with flipped learning, each session was composed of pre-class, in-class, and post-class sections. @*Results@#Compared to the control group, the experimental group showed improved beliefs about the health benefits of quitting smoking, as well as positive attitudes and self-efficacy from the quit smoking intervention. The experimental group experienced the greatest increase in student-centered activities and student participation through flipped learning. @*Conclusion@#These results indicate that the flipped learning method was effective in quit smoking intervention education for nursing students. Therefore, it is worthwhile to consider that a quit smoking intervention education program based on flipped learning be included in the regular nursing curriculum.

Influencing Factors on COVID-19 Preventive Behaviors among College Students

Purpose@#The purpose of this study is to identify health belief, subjective norms, social stigma, and sense of community affecting COVID-19 preventive behaviors among college students, and provide basic data for the development of preventive programs to improve COVID-19 preventive behaviors. @*Methods@#This study used a cross-sectional study design. The study recruited a total of 170 college students, through an online survey from three online communities which are mostly used by college students. Data were collected from July 24 to August 9, 2021. The SPSS 21.0 program was used to analyze the data using simple multiple regression. @*Results@#In simple multiple regression, the perceived susceptibility, perceived benefits and subjective norms were found to have a significant association with COVID-19 preventive behaviors of college students. These variables explained the 55.1% variance in COVID-19 preventive behaviors of college students (p<.001). @*Conclusion@#The results of this study showed that the perceived susceptibility, perceived benefits, and subjective norms were significant factors affecting COVID-19 preventive behaviors of college students. Based on the results of this study, it is expected to develop COVID-19 preventive programs and strategies that increase perceived susceptibility, perceived benefits, and subjective norms to improve the COVID-19 preventive behaviors of college students.

An Atypical Choroid Plexus Papilloma Initially Manifestating as Radicular Symptoms

A 29-year-old woman had 1-month history of back pain radiating into lower extremities, motor weakness, and sensory abnormalities in both lower extremities. Contrast-enhanced spinal magnetic resonance imaging (MRI) revealed a homogeneously enhancing mass at the T12∼L1 and several intradural enhancing nodular lesions at L2∼S1. Tumor resection surgery was performed and following histological examination showed that the tumor satisfied the diagnostic criteria for atypical choroid plexus papilloma (CPP). To find primary tumor sites, contrast-enhanced brain MRI, whole spine MRI, and PET-CT were carried out and additional lesions were detected at the fourth ventricle, right cerebellum, and upper thoracic spinal cord. This is a very rare case of metastatic atypical CPP that involves brain, upper thoracic spinal cord, and cauda equina with initial manifestation of radicular symptoms without clinical signs of primary brain lesion.

An Atypical Choroid Plexus Papilloma Initially Manifestating as Radicular Symptoms

A 29-year-old woman had 1-month history of back pain radiating into lower extremities, motor weakness, and sensory abnormalities in both lower extremities. Contrast-enhanced spinal magnetic resonance imaging (MRI) revealed a homogeneously enhancing mass at the T12∼L1 and several intradural enhancing nodular lesions at L2∼S1. Tumor resection surgery was performed and following histological examination showed that the tumor satisfied the diagnostic criteria for atypical choroid plexus papilloma (CPP). To find primary tumor sites, contrast-enhanced brain MRI, whole spine MRI, and PET-CT were carried out and additional lesions were detected at the fourth ventricle, right cerebellum, and upper thoracic spinal cord. This is a very rare case of metastatic atypical CPP that involves brain, upper thoracic spinal cord, and cauda equina with initial manifestation of radicular symptoms without clinical signs of primary brain lesion.

Analysis of Characteristics of Thoracic Injury Patients and Nursing Interventions Using Nursing Intervention Classification by Emergency Room Type

Purpose@#The purpose of this study was to analyze the content of nursing interventions applied to patients with thoracic injury who visited a trauma emergency room (TER) or an emergency room (ER). @*Methods@#Of 3,938 trauma patients admitted to this hospital between January 1, 2019 and December 31, 2020, 320 adult patients with thoracic injury (94 to TER, 226 to ER) who met the inclusion criteria were enrolled. Patients’ data were acquired from their electronic medical records. General and clinical characteristics of these subjects along with nursing interventions were analyzed. @*Results@#There were statistically significant differences in the length of stay, treatment outcome, and level of consciousness between thoracic injury patients who visited TER and ER. Average thoracic Abbreviated Injury Scale score and average Injury Severity Score of thoracic injury patients who visited TER were 3.13 and 13.54, respectively, which were significantly higher than those of patients who visited ER. The numbers of nursing actions applied was 4,819 for TER and 3,944 for ER, which were classified into five domains, 18 classes, and 56 interventions. The most domain of interventions carried out in both TER and ER was physiological: complex. Classes including Crisis management and Thermoregulation were not carried out in ER. On average, 16 more types of interventions were carried out in TER than in ER. @*Conclusion@#This study demonstrated characteristics of thoracic injury patients and nursing interventions by emergency room type. Based on results of this study, standardized nursing interventions need be applied to thoracic injury patients visiting TER and ER.

A Pilot Study Evaluating the Effectiveness of System-Wide Positive Behavior Support for Institutionalized Orphans in South Korea

Objective@#In South Korea, the placement of orphans in institutions is still common, despite evidence of its adverse influence on children’s psychological, emotional, physical, and cognitive development. In this preliminary study, we evaluate whether system-wide positive behavior support (SWPBS) is effective for decreasing externalizing problems in institutionalized children. @*Methods@#SWPBS was provided for one month to 36 school-aged boys who had lived in an orphanage for an average of 8.72 years (SD=2.52), along with their 10 caregivers. Direct observation of the frequency of target behaviors in the participating children, caregivers’ ratings of the severity of children’s problematic behaviors, self-reported caregiving stress (i.e., Parenting Stress Scale), and intervention fidelity were dependent variables. @*Results@#After receiving SWPBS, the frequency of problematic behaviors in the participating children showed a mean decrease of 73.6%. The caregivers also reported seeing a decrease in the severity of their children’s problematic behaviors after SWPBS compared to before. @*Conclusion@#SWPBS may be a promising intervention to decrease externalizing behaviors in school-aged children who have been living in institutions for a long time and have shown mental health issues.

A Pilot Study Evaluating the Effectiveness of System-Wide Positive Behavior Support for Institutionalized Orphans in South Korea

Objective@#In South Korea, the placement of orphans in institutions is still common, despite evidence of its adverse influence on children’s psychological, emotional, physical, and cognitive development. In this preliminary study, we evaluate whether system-wide positive behavior support (SWPBS) is effective for decreasing externalizing problems in institutionalized children. @*Methods@#SWPBS was provided for one month to 36 school-aged boys who had lived in an orphanage for an average of 8.72 years (SD=2.52), along with their 10 caregivers. Direct observation of the frequency of target behaviors in the participating children, caregivers’ ratings of the severity of children’s problematic behaviors, self-reported caregiving stress (i.e., Parenting Stress Scale), and intervention fidelity were dependent variables. @*Results@#After receiving SWPBS, the frequency of problematic behaviors in the participating children showed a mean decrease of 73.6%. The caregivers also reported seeing a decrease in the severity of their children’s problematic behaviors after SWPBS compared to before. @*Conclusion@#SWPBS may be a promising intervention to decrease externalizing behaviors in school-aged children who have been living in institutions for a long time and have shown mental health issues.

Factors Influencing Intentional Rounding Performance of Tertiary General Hospital Nurses / 간호행정학회지

PURPOSE: The purpose of this study was to examine the effects of perceptions of patient rounding, self-leadership and nursing organization culture on intentional rounding performance.METHODS: The participants for this study were 210 nurses who had the experience of patient rounding care in general hospitals in B and Y cities. Data were collected from February 5th to 22nd, 2018. Collected data were analyzed using descriptive statistics, χ² test, and independent t-test. Logistic regression analysis was performed to identify factors influencing intentional rounding performance.RESULTS: It was found that intentional rounding performance was carried out by 20.0% of the day shift nurses, 18.1% of the evening shift nurses, and 19.5% of the night shift nurses. The significant factors influencing intentional rounding performance were the recommended rounding time interval in wards and the use of rounding protocol in the wards (p < .050).CONCLUSION: It is expected that nurses will be able to provide more advanced and efficient patient rounding by promising a systematic patient rounding time for intentional rounding and developing appropriate protocols for each ward.

Aucubin Promotes Differentiation of Neural Precursor Cells into GABAergic Neurons

Aucubin is a small compound naturally found in traditional medicinal herbs with primarily anti-inflammatory and protective effects. In the nervous system, aucubin is reported to be neuroprotective by enhancing neuronal survival and inhibiting apoptotic cell death in cultures and disease models. Our previous data, however, suggest that aucubin facilitates neurite elongation in cultured hippocampal neurons and axonal regrowth in regenerating sciatic nerves. Here, we investigated whether aucubin facilitates the differentiation of neural precursor cells (NPCs) into specific types of neurons. In NPCs cultured primarily from the rat embryonic hippocampus, aucubin significantly elevated the number of GAD65/67 immunoreactive cells and the expression of GAD65/67 proteins was upregulated dramatically by more than three-fold at relatively low concentrations of aucubin (0.01 µM to 10 µM). The expression of both NeuN and vGluT1 of NPCs, the markers for neurons and glutamatergic cells, respectively, and the number of vGluT1 immunoreactive cells also increased with higher concentrations of aucubin (1 µM and 10 µM), but the ratio of the increases was largely lower than GAD expression and GAD immunoreactive cells. The GABAergic differentiation of pax6-expressing late NPCs into GABA-producing cells was further supported in cortical NPCs primarily cultured from transgenic mouse brains, which express recombinant GFP under the control of pax6 promoter. The results suggest that aucubin can be developed as a therapeutic candidate for neurodegenerative disorders caused by the loss of inhibitory GABAergic neurons.

Aucubin Promotes Neurite Outgrowth in Neural Stem Cells and Axonal Regeneration in Sciatic Nerves

Aucubin is an iridoid glycoside with a wide range of biological activities, including anti-inflammatory, anti-microbial, anti-algesic as well as anti-tumor activities. Recently, it has been shown that aucubin prevents neuronal death in the hippocampal CA1 region in rats with diabetic encephalopathy. In addition, it has protective effects on H2O2-induced apoptosis in PC12 cells. We have shown here that aucubin promotes neuronal differentiation and neurite outgrowth in neural stem cells cultured primarily from the rat embryonic hippocampus. We also investigated whether aucubin facilitates axonal elongation in the injured peripheral nervous system. Aucubin promoted lengthening and thickness of axons and re-myelination at 3 weeks after sciatic nerve injury. These results indicate that administration of aucubin improved nerve regeneration in the rat model of sciatic nerve injury, suggesting that aucubin may be a useful therapeutic compound for the human peripheral nervous system after various nerve injuries.

Effect of Berberine on Cell Survival in the Developing Rat Brain Damaged by MK-801

Berberine is an isoquinoline alkaloid isolated from goldenthread, Coptidis Rhizoma and shown to have many biological and pharmacological effects. We previously reported that berberine promotes cell survival and differentiation of neural stem cells. To examine whether berberine has survival promoting effect on damaged neuronal cells, we generated a cellular model under oxidative stress and an neonatal animal model of degenerating brain disease by injecting MK-801. MK801, a noncompetitive antagonist of N-methyl-d-aspartate (NMDA) receptors, acts as a neurotoxin in developing rats by inhibiting NMDA receptors and induce neuronal cell death. We found that the survival rate of the SH-SY5Y cells under oxidative stress was increased by 287% and 344%, when treated with 1.5 and 3.0microg/ml berberine, respectively. In the developing rats injected by MK801, we observed that TUNEL positive apoptotic cells were outspread in entire brain. The cell death was decreased more than 3 fold in the brains of the MK-801-induced neurodegenerative animal model when berberine was treated to the model animals. This suggests that berberine promotes activity dependent cell survival mediated by NMDA receptor because berberine is known to activate neurons by blocking K+ current or lowering the threshold of the action potential. Taken together, berberine has neuroprotective effect on damaged neurons and neurodegenerating brains of neonatal animal model induced by MK-801 administration.

The Association between Intraocular Pressure and Predictors of Coronary Heart Disease Risk in Koreans

Elevated intraocular pressure (IOP) is one of the major risk factors for glaucomatous visual field defects. Each individual systemic risk factor of coronary heart disease (CHD) is associated with elevated IOP, although no reports have argued for a correlation between the risk factors for CHD and IOP after a comprehensive or collective analysis. The National Cholesterol Education Program Adult Treatment Panel III presented the Framingham projection, which can predict the risk of CHD quantitatively. We investigated the association between IOP and the Framingham projection in 16,383 Korean subjects. The Framingham projection was applied using the indicated risk factors. The associations between the Framingham projection and IOP and the influences of the risk factors on the IOP were examined. The Framingham projection was correlated with the mean IOP in women (p<0.05). The relationship between IOP and systemic variables other than smoking was significant (p<0.05). The mean IOP was significantly higher in the high-risk CHD group than in the low-risk group based on the Framingham projection (p<0.05). Because an elevated IOP was associated with cardiovascular risk factors, subjects with a high CHD risk based on the Framingham projection need continuous monitoring for IOP to prevent glaucomatous visual field defects.

Labeling Efficacy of Superparamagnetic Iron Oxide Nanoparticles to Human Neural Stem Cells: Comparison of Ferumoxides, Monocrystalline Iron Oxide, Cross-linked Iron Oxide (CLIO)-NH2 and tat-CLIO

OBJECTIVE: We wanted to compare the human neural stem cell (hNSC) labeling efficacy of different superparamagnetic iron oxide nanoparticles (SPIONs), namely, ferumoxides, monocrystalline iron oxide (MION), cross-linked iron oxide (CLIO)-NH2 and tat-CLIO. MATERIALS AND METHODS: The hNSCs (5x105 HB1F3 cells/ml) were incubated for 24 hr in cell culture media that contained 25 microgram/ml of ferumoxides, MION or CLIO-NH2, and with or without poly-L-lysine (PLL) and tat-CLIO. The cellular iron uptake was analyzed qualitatively with using a light microscope and this was quantified via atomic absorption spectrophotometry. The visibility of the labeled cells was assessed with MR imaging. RESULTS: The incorporation of SPIONs into the hNSCs did not affect the cellular proliferations and viabilities. The hNSCs labeled with tat-CLIO showed the longest retention, up to 72 hr, and they contained 2.15+/-0.3 pg iron/cell, which are 59 fold, 430 fold and six fold more incorporated iron than that of the hNSCs labeled with ferumoxides, MION or CLIO-NH2, respectively. However, when PLL was added, the incorporation of ferumoxides, MION or CLIO-NH2 into the hNSCs was comparable to that of tat-CLIO. CONCLUSION: For MR imaging, hNSCs can be efficiently labeled with tat-CLIO alone or with a combination of ferumoxides, MION, CLIO-NH2 and the transfection agent PLL.

Assessment of the Accuracy and Precision of Cystatin C-based GFR Estimates and Cr-based GFR Estimates in Comparison with Cr51-EDTA GFR / 대한진단검사의학회지

BACKGROUND: Cystatin C (cysC) is said to be an ideal marker for glomerular filtration rate (GFR), independent of external factors such as age, nutrition and inflammation. The authors compared the accuracy and precision of cysC-based and creatinine (Cr)-based GFR estimates using Cr51-EDTA GFR method as a reference. METHODS: Serum concentrations of cysC and Cr were measured in adults over 17 yr (n=170) and children below 17 yr (n=79) who had had GFR estimated by Cr51-EDTA method. CysC-based GFR was estimated by the formula of Thierry [CysC-based GFR estimates (mL/min/1.73 m2)=78 x (1/cysC, in mg/L)+4] and Cr-based GFR by the formula of modified Modification of Diet in Renal Disease [MDRD II, Cr-based GFR estimates (mL/min/1.73 m2)=186 x (Scr)(-1.154) x (Age)(-0.203) x 0.742 (for a female patient) x 1.212 (for a black patient). RESULTS: In comparison with Cr51-EDTA GFR, in children below 17 yr, the bias +/- standard deviation (SD) of cysC-based and Cr-based GFR estimates were 7.5 +/- 6.1 and 106.5 +/- 98.2, respectively, in the range of below 90 of Cr51-EDTA GFR (mL/min/1.73 m2), and 33.7 +/- 33.0 and 174.4 +/- 18.8 in the range of over 90. In adults over 17 yr, the respective figures were 13.1 +/- 11.0 and 17.4 +/- 29.8 in below 90, and 21.2 +/- 20.1 and 83.6 +/- 108.8 in over 90 of Cr51-EDTA GFR. CONCLUSIONS: CysC-based GFR estimates show acceptable ranges of biases over the whole age and GFR ranges. CysC-based GFR estimates is considered to be the marker for GFR, which could be used without limitation of age and GFR ranges.

Experience of a Break-Even Point Analysis for Make-or-Buy Decision / 대한진단검사의학회지

BACKGROUND: Cost containment through continuous quality improvement of medical service is required in an age of a keen competition of the medical market. Laboratory managers should examine the matters on make-or-buy decision periodically. On this occasion, a break-even point analysis can be useful as an analyzing tool. In this study, cost accounting and break-even point (BEP) analysis were performed in case that the immunoassay items showing a recent increase in order volume were to be in-house made. METHODS: Fixed and variable costs were calculated in case that alpha fetoprotein (AFP), carcinoembryonic antigen (CEA), prostate-specific antigen (PSA), ferritin, free thyroxine (fT4), triiodothyronine (T3), thyroid-stimulating hormone (TSH), CA 125, CA 19-9, and hepatitis B envelope antibody (HBeAb) were to be tested with Abbott AxSYM instrument. Break-even volume was calculated as fixed cost per year divided by purchasing cost per test minus variable cost per test and BEP ratio as total purchasing costs at break-even volume divided by total purchasing costs at actual annual volume. RESULTS: The average fixed cost per year of AFP, CEA, PSA, ferritin, fT4, T3, TSH, CA 125, CA 19- 9, and HBeAb was won 8,279,187 and average variable cost per test, won 3,786. Average break-even volume was 1,599 and average BEP ratio was 852%. Average BEP ratio without including quality costs such as calibration and quality control was 74%. CONCLUSIONS: Because the quality assurance of clinical tests cannot be waived, outsourcing all of 10 items was more adequate than in-house make at the present volume in financial aspect. BEP analysis was useful as a financial tool for make-or-buy decision, the common matter which laboratory managers meet with.

Evaluation of Fixed Quality Control Range of Bayer Rapidpoint 400 Blood Gas and Electrolyte Analyzer with Six Sigma Metrics / 대한진단검사의학회지

BACKGROUND: Bayer Rapidpoint 400 analyzer for point of care testing (POCT) uses fixed quality control (QC) range even when the lot number of a cartridge for quality control changes. To evaluate the fixed QC range recommended by the manufacturer, we analyzed internal QC data of 9 analyzers with Six Sigma metrics. MATERIALS AND METHODS: We investigated QC data of 9 analyzers over 5 months from May to September, 2004 for 8 parameters (pH, pCO2, pO2, Na+, K+, iCa++, Cl-, and glucose). One hundred eighty six groups of QC data were analyzed with capability index (C(p)=total allowable error (TEa)/3 standard deviation (SD)) and capability index considering bias (C(pk),=(TEa-bias)/3 SD). Acceptability was evaluated with criteria of 1.33 C(pk), 4 sigma level or quality criteria of the Clinical Laboratory Improvement Amendments of 1988 (CLIA'88). RESULTS: In 80.7% (150 of 186 groups), both C(p) and C(pk) were at or above 1.33, which indicated that the use of fixed QC range was adequate. In 19.3% (36 of 186 groups), C(pk) was below 1.33, which indicated the inadequacy of fixed QC range. Among them 14.5% (27 of 186 groups) showed C(p) below 1.33, indicating that the errors had a random factor and 4.8% (9 of 186 groups) had C(p) at or above 1.33, indicating that the errors had a systematic factor. CONCLUSIONS: The quality criteria mandated by CLIA '88 was satisfied in about 80% of study groups using fixed QC ranges, but in about 20%, more strict instrument maintenance and specimen handling by operators, and quality improvement of QC materials by manufacturer was required.

Nonspecific association of 2',3'-cyclic nucleotide 3'-phosphodiesterase with the rat forebrain postsynaptic density fraction

The 2',3'-cyclic nucleotide 3'-phosphodiesterase (CNP), a protein of unknown function in vivo, is abundantly expressed in myelinating glia in two isoforms, CNP1 and CNP2. In this study, immunoblot analysis showed that CNP1 is the major isoform in adult forebrain, and that both isoforms are included in the postsynaptic density (PSD) fraction and tyrosine-phosphorylated at the basal level. However, subcellular distribution and detergent extraction data showed that CNP is nonspecifically associated with the PSD fraction. Immunocytochemistry revealed that CNP is detected, in a weak but punctate pattern, in dissociated rat hippocampal neurons of 3 days to 2 weeks in vitro. The CNP-positive punctae were distributed throughout soma and dendrites, and distinct from PSD95-positive ones. Immunoblot analysis indicated that CNP is also expressed in neuronal stem cell lines, HiB5 and F11. Interestingly, in addition to the known two isoforms, a new CNP isoform of MW 45 kDa was expressed in these cell lines and was the major type of isoform in F11 cells. Taken together, our data suggest that CNP is expressed in the early stage of in vitro development and nonspecifically included in the adult rat PSD fraction.