Muscular Development in Urechis unicinctus (Echiura, Annelida).

Echiura is one of the most intriguing major subgroups of phylum Annelida because, unlike most other annelids, echiuran adults lack metameric body segmentation. Urechis unicinctus lives in U-shape burrows of soft sediments. Little is known about the molecular mechanisms underlying the development of U. unicinctus. Herein, we overviewed the developmental process from zygote to juvenile U. unicinctus using immunohistochemistry and F-actin staining for the nervous and muscular systems, respectively. Through F-actin staining, we found that muscle fibers began to form in the trochophore phase and that muscles for feeding were produced first. Subsequently, in the segmentation larval stage, the transversal muscle was formed in the shape of a ring in an anterior-to-posterior direction with segment formation, as well as a ventromedian muscle for the formation of a ventral nerve cord. After that, many muscle fibers were produced along the entire body and formed the worm-shaped larva. Finally, we investigated the spatiotemporal expression of Uun_st-mhc, Uun_troponin I, Uun_calponin, and Uun_twist genes found in U. unicinctus. During embryonic development, the striated and smooth muscle genes were co-expressed in the same region. However, the adult body wall muscles showed differential gene expression of each muscle layer. The results of this study will provide the basis for the understanding of muscle differentiation in Echiura.

Cross-Sectional Study on Patient Safety Culture, Patient Safety Competency, and Adverse Events.

This study aims to examine the associations between nurses' perceptions of patient safety culture, patient safety competency, and adverse events. Using convenience sampling, we conducted a cross-sectional study from February to May 2018 in two university hospitals. Furthermore, we performed multiple logistic regression to examine associations between patient safety culture, patient safety competency, and adverse events. Higher mean scores for "communication openness" in patient safety culture were significantly correlated with lower rates for pressure ulcers and falls; furthermore, higher mean scores for "working in teams with other health professionals" in patient safety competency were significantly correlated with reductions in ventilator-associated pneumonia. We recommend that a well-structured hospital culture emphasizing patient safety and continuation of in-service education programs for nurses to provide high-quality, clinically safe care is required. Moreover, further research is required to identify interventions to improve patient safety culture and competency and reduce the occurrence of adverse events.

Impact of emotional labour and workplace violence on professional quality of life among clinical nurses.

AIM: We examined Korean nurses professional quality of life, emotional labour and workplace violence to guide development of interventions to improve nurses professional quality of life. BACKGROUND: Nurses face heavy exposure to emotional labour and workplace violence. Stress experienced by nurses reduces compassion satisfaction and increases compassion fatigue. METHODS: Participants comprised 399 clinical nurses chosen by convenience sampling. Questionnaires measured demographic characteristics, emotional labour, workplace violence and professional quality of life. RESULTS: Nurses professional quality of life was affected by emotional labour and workplace violence. Graduate educational level, emotional exposure and emotional supervision were associated with compassion satisfaction. Burnout was commonly associated with emotional exposure, experience and supervision of workplace violence. Secondary traumatic stress was associated with emotional exposure and experience of workplace violence. CONCLUSIONS: We elucidated the relationship between professional quality of life, emotional labour and workplace violence. Raising professional quality of life among nurses requires regular analysis of emotional labour and provision of organizational-level interventions. Counselling programmes that address violence prevention education and comprehensive response strategies among nurses and policies that foster an organizational culture of respect and cooperation in hospitals are needed.

Comparison of displacement of polyvinyl chloride and silicone leftsided double-lumen tubes during lateral positioning.

BACKGROUND: Compared to an equivalent sized polyvinyl chloride (PVC) double-lumen tube (DLT), a silicone DLT has a shorter endobronchial segment. The aim of this study was to compare the incidence of clinically significant displacement of left-sided PVC and silicone DLTs after a positional change to a lateral position from a supine position and determine its effect on the need for DLT repositioning for successful lung separation in patients undergoing thoracic surgery. METHODS: One hundred eight adult patients requiring one-lung ventilation were randomly divided into group P (PVC DLT, n = 54) and group S (Silicone DLT, n = 54). The position of the DLT was observed before and after lateral positioning to assess the effect of the position change. The incidence of clinically significant displacement (> 10 mm) of DLT was compared between the groups. RESULTS: DLTs were clinically significantly displaced in group P (17/48, 35.4%) and group S (18/52, 34.6%) after lateral positioning (P = 0.933). A proximal displacement (31.3% [group P] and 25.0% [group S]) was more common than distal displacement (4.2% [group P] and 9.6% [group S]), with no significant intergroup difference (P = 0.494). After lateral positioning, critical malposition of DLT with bronchial herniation to the right main bronchus was 8.3% (group P) and 7.9% (group S, P = 0.906). CONCLUSIONS: Left-sided PVC and silicone DLTs produced comparable incidences of clinically significant displacement and, consequently, required similar rates of repositioning for successful lung separation after lateral positioning.

The genome of common long-arm octopus Octopus minor.

Background: The common long-arm octopus (Octopus minor) is found in mudflats of subtidal zones and faces numerous environmental challenges. The ability to adapt its morphology and behavioral repertoire to diverse environmental conditions makes the species a promising model for understanding genomic adaptation and evolution in cephalopods. Findings: The final genome assembly of O. minor is 5.09 Gb, with a contig N50 size of 197 kb and longest size of 3.027 Mb, from a total of 419 Gb raw reads generated using the Pacific Biosciences RS II platform. We identified 30,010 genes; 44.43% of the genome is composed of repeat elements. The genome-wide phylogenetic tree indicated the divergence time between O. minor and Octopus bimaculoides was estimated to be 43 million years ago based on single-copy orthologous genes. In total, 178 gene families are expanded in O. minor in the 14 bilaterian species. Conclusions: We found that the O. minor genome was larger than that of closely related O. bimaculoides, and this difference could be explained by enlarged introns and recently diversified transposable elements. The high-quality O. minor genome assembly provides a valuable resource for understanding octopus genome evolution and the molecular basis of adaptations to mudflats.

Accuracy of the femoral tunnel position in robot-assisted anterior cruciate ligament reconstruction using a magnetic resonance imaging-based navigation system: A preliminary report.

BACKGROUND: Tunnel misplacement is a common cause of failed anterior cruciate ligament (ACL) reconstruction. In this study, the accuracy of the femoral tunnel position was evaluated in robot-assisted ACL reconstruction using a magnetic resonance imaging (MRI)-based navigation system. We hypothesized that a difference of less than 2 mm between the planned femoral tunnel position and the created one was achievable. METHODS: Four cadaveric knees underwent robot-assisted ACL reconstruction. A 3-dimensional model using pre-operative MRI images was used for preoperative planning, and a computed tomography (CT) scan was performed postoperatively. The planned and the created femoral tunnels were compared to assess the accuracy of the femoral tunnel position. RESULTS: The distance between the intra-articular points of the planned and the created tunnels was 7.78 mm in the first experiment and 1.47 mm in the last one. The difference in tunnel length was 4.62 mm in the first experiment and 0.99 mm in the last one. CONCLUSIONS: Accuracy of the femoral tunnel position improved with each robot-assisted ACL reconstruction using an MRI-based navigation system. In the last experiment, the accuracy of the femoral tunnel position was satisfactory.

The Effect of Work Addiction on Korean Nurses' Professional Quality of Life: A Cross-Sectional Study.

This study sought to delineate the relations between work addiction and professional quality of life among nurses in university hospitals. The differences between compassion satisfaction, burnout, and secondary traumatic stress by work addiction tendency were investigated among 278 Korean nurses. Results revealed that 46.5% of participating nurses had mild or high work addiction, and nurses with high work addiction tended to have higher burnout and secondary traumatic stress. Factors influencing burnout were work addiction and daily work hours. Only work addiction influenced secondary traumatic stress. Therefore, concern, understanding, and prevention of nurses' work addiction are needed, as work addiction could affect nurses' professional quality of life.

The developmental transcriptome atlas of the spoon worm Urechis unicinctus (Echiurida: Annelida).

Background: Echiurida is one of the most intriguing major subgroups of annelida because, unlike most other annelids, echiurids lack metameric body segmentation as adults. For this reason, transcriptome analyses from various developmental stages of echiurid species can be of substantial value for understanding precise expression levels and the complex regulatory networks during early and larval development. Results: A total of 914 million raw RNA-Seq reads were produced from 14 developmental stages of Urechis unicinctus and were de novo assembled into contigs spanning 63,928,225 bp with an N50 length of 2700 bp. The resulting comprehensive transcriptome database of the early developmental stages of U. unicinctus consists of 20,305 representative functional protein-coding transcripts. Approximately 66% of unigenes were assigned to superphylum-level taxa, including Lophotrochozoa (40%). The completeness of the transcriptome assembly was assessed using benchmarking universal single-copy orthologs; 75.7% of the single-copy orthologs were presented in our transcriptome database. We observed 3 distinct patterns of global transcriptome profiles from 14 developmental stages and identified 12,705 genes that showed dynamic regulation patterns during the differentiation and maturation of U. unicinctus cells. Conclusions: We present the first large-scale developmental transcriptome dataset of U. unicinctus and provide a general overview of the dynamics of global gene expression changes during its early developmental stages. The analysis of time-course gene expression data is a first step toward understanding the complex developmental gene regulatory networks in U. unicinctus and will furnish a valuable resource for analyzing the functions of gene repertoires in various developmental phases.

Nurses' and patients' perceptions of privacy protection behaviours and information provision.

BACKGROUND: With increased attention to patient privacy and autonomy, privacy protection and information provision for patients are becoming increasingly important. OBJECTIVES: The aim of this study was to identify and analyse nurses' and patients' perceptions of the importance and performance of protecting patients' privacy and providing them with relevant information. RESEARCH DESIGN: This study is a descriptive cross-sectional investigation. Participants and research context: Participants were 168 patients hospitalised in medical and surgical wards and 176 nurses who cared for them. Ethical consideration: This study was approved by the Chung-Ang University Bioethics Committee, and informed written consent was collected from all participants. FINDINGS: Nurses' recognition of the importance of protecting patients' privacy and providing adequate information was higher compared to their actual performance, and the nurses' level of performance was higher in comparison with the patients' recognition of its importance. DISCUSSION: Although a holistic approach to patient privacy protection and information provision is needed, the medical field has not embraced this model of care. CONCLUSIONS: These findings provide empirical data to create an ethical environment for the future, as considerable attention has been devoted to patients' rights and medical institutions' liability for providing explanations to patients.

Professional Quality of Life and Clinical Competencies among Korean Nurses.

PURPOSE: Clinical competence among nurses is an essential requirement for the provision of safe and effective patient care. This study aims to classify types of professional quality of life experienced by Korean nurses, and examine the relationship between demographic and professional characteristics and clinical competence among nurses experiencing each type. METHODS: A total of 335 nurses completed questionnaires assessing professional quality of life, clinical competence, and demographic and professional characteristics. Following identification of the underlying factors of professional quality of life, we classified participants into three clusters. RESULTS: There were significant differences in age, marital status, religion, educational status, and position between clusters. Results also revealed that nurses with high compassion satisfaction and low compassion fatigue (burnout, secondary traumatic stress) tended to have higher clinical competence. CONCLUSIONS: This study demonstrated that it is possible to directly examine the relationship between professional quality of life level and clinical competence among nurses. Thus, interventions to increase nurses' compassion satisfaction and relieve compassion fatigue are needed, as professional quality of life may affect clinical competence.

Progression of subcortical atrophy and iron deposition in multiple system atrophy: a comparison between clinical subtypes.

Magnetic resonance imaging (MRI) can be useful not only for the diagnosis of multiple system atrophy (MSA) itself, but also to distinguish between different clinical subtypes. This study aimed to investigate whether there are differences in the progression of subcortical atrophy and iron deposition between two variants of MSA. Two serial MRIs at baseline and follow-up were analyzed in eight patients with the parkinsonian variant MSA (MSA-P), nine patients with cerebellar variant MSA (MSA-C), and fifteen patients with Parkinson's disease (PD). The R2* values and volumes were calculated for the selected subcortical structures (caudate nucleus, putamen, globus pallidus, and thalamus) using an automated region-based analysis. In both volume and R2*, a higher rate of progression was identified in MSA-P patients. Volumetric analysis showed significantly more rapid progression of putamen and caudate nucleus in MSA-P than in MSA-C. With regard to R2* changes, a significant increase at follow-up and a higher rate of progression were identified in the putamen of MSA-P group compared to MSA-C and PD groups. This longitudinal study revealed different progression rates of MRI markers between MSA-P and MSA-C. Iron-related degeneration in the putamen may be more specific for MSA-P.

Korean nurses' ethical dilemmas, professional values and professional quality of life.

BACKGROUND: In the changing medical environment, professional stress continuously increases as the individual's quality of life suffers. Of all the healthcare professions, nursing is especially prone to burnout, compassion fatigue and reduced compassion satisfaction, due to the tensions resulting from the physical and psychological stress of caring for extremely ill patients. OBJECTIVES: This study examined the professional quality of life of clinical nurses in Korea and the relationship between their experiences in ethical dilemmas and professional values. METHODS: This was a cross-sectional study of a convenience sample consisting of 488 clinical nurses. We used four questionnaires to measure the participants' demographic characteristics, experiences in ethical dilemmas, professional nursing values and professional quality of life (ProQOL assessment, Version 5). Ethical considerations: This study received approval from the Institutional Review Board of Bronco Memorial Hospital. Written informed consent was given by all participants. RESULTS: The nurses' professional quality of life was affected by ethical dilemmas and professional nursing values. The factors influencing compassion satisfaction were age, client domain of ethical dilemmas, social awareness, professionalism of nursing and the roles of nursing services in professional values. The factors influencing burnout were marital status (married), religion (yes), human life domain, professional work domain of ethical dilemmas, social awareness and the role of nursing services in nursing professional values. The factors influencing secondary traumatic stress were human life domain, client domain and the professional work domain of ethical dilemmas. CONCLUSION: Intervention to help nurses increase their professional quality of life will have a greater chance of success if they are based on the nurses' values and beliefs about the ethical dilemmas they face and foster the establishment of positive professional values.

Evaluation of brain iron content in idiopathic REM sleep behavior disorder using quantitative magnetic resonance imaging.

BACKGROUND: Neuroimaging studies in patients with idiopathic rapid eye movement sleep behavior disorder (iRBD) show similar structural and functional changes to alpha-synucleinopathies, including PD. Until now, there have been few attempts to characterize brain iron deposition in iRBD. The aim of this study was to investigate brain iron content in patients with iRBD using quantitative magnetic resonance imaging (MRI). METHODS: 3-T MRI was performed in 15 patients with iRBD and 20 age-matched healthy control subjects. In order to evaluate the iron-related neurodegenerative changes, we assessed volume and transverse relaxation rate (R2*) simultaneously. We used both region-based and voxel-based analysis. RESULTS: No significant differences in R2* values were found between iRBD groups and healthy control subjects. There were no areas of significantly reduced or increased gray matter and white matter volume in the iRBD group. Instead, lateral ventricle volumes measured automatically by FreeSurfer were significantly larger in patients with iRBD than in healthy controls (P < 0.05). CONCLUSION: The present study suggests that iron-related R2* values may not be an imaging biomarker for neurodegeneration in iRBD.

Quantitative assessment of subcortical atrophy and iron content in progressive supranuclear palsy and parkinsonian variant of multiple system atrophy.

It is a matter of debate whether increased brain iron levels are the cause or only the consequence of neurodegenerative process in degenerative parkinsonism. The aim of this study is to characterize disease-related changes in volumes and iron-related R2 values of basal ganglia and thalamus. 13 patients with progressive supranuclear palsy (PSP), 15 with a parkinsonian variant of multiple system atrophy (MSA-p), 29 with Parkinson's disease (PD), and 21 age-matched controls underwent 3-Tesla MRI. The R2 values and volumes were calculated for the selected subcortical structures (caudate nucleus, putamen, globus pallidus, and thalamus) using an automated region-based analysis. Voxel-based analysis was also performed to visualize a topographical correlation of R2 value and volume. The PSP group had significantly higher R2 values in globus pallidus and caudate nucleus (p < 0.05), whereas the MSA-p group had higher R2 values in putamen (p < 0.001) than PD and controls. The globus pallidus in PSP and the putamen in MSA-p were the most significant areas of atrophy to differentiate PSP, MSA-p and PD (AUC = 0.856, 0.832, respectively, p < 0.001). The R2 values in both structures increased in parallel with the extent of atrophy. They were negatively correlated with volumes in putamen (r = -0.777, p < 0.001) and globus pallidus (r = -0.409, p = 0.025) of MSA-p, and globus pallidus (r = -0.4, p = 0.043) of PSP. Voxel-based analysis identified higher R2 values in more severely atrophic sub-regions in these structures. We observed topographical differences of iron deposition as well as atrophy between MSA-p and PSP. Increased iron levels were related to the structural atrophy in basal ganglia. Our results imply that iron accumulation is likely an epiphenomenon of the degenerative process.

Topographical differences of brain iron deposition between progressive supranuclear palsy and parkinsonian variant multiple system atrophy.

OBJECTIVE: There have been various studies showing increased iron levels in parkinsonian disorders. The purpose of this study was to demonstrate topographical differences of brain iron deposition between progressive supranuclear palsy (PSP) and the parkinsonian variant of multiple system atrophy (MSA-p) with SWI images. METHODS: A total of 11 patients with PSP, 12 with MSA-p, 15 with Parkinson's disease (PD), and 20 age-matched healthy controls underwent SWI of the brain. Mean phase shift values of the red nucleus (RN), substantia nigra (SN), head of the caudate nucleus (CN), globus pallidus (GP), putamen (PUT), and thalamus (TH) were calculated and compared between groups. A voxel-based analysis of the processed SWI was performed to determine topographical differences of iron-related hypointense signals in PUT, GP, and TH. RESULTS: Patients with PSP and MSA-p had significantly higher levels of iron deposition than control and PD groups. Comparing patients with PSP and MSA-p, differences were found in iron concentrations of the RN, SN, GP, and TH, which were higher in the PSP group. However, iron levels in the PUT were higher in the MSA group (p<0.05). The area under curve (AUC) indicated that the PUT was the most valuable nucleus in differentiating MSA-p from PSP and PD according to phase shift values (AUC=0.836). Meanwhile the GP (AUC=0.869) and TH (AUC=0.884) were the two most valuable nuclei in differentiating PSP from MSA-p and PD. Voxel-based analysis showed subregional differences in iron-related hypointense signals in the PUT, GP, and TH between MSA-p and PSP groups. Patients with MSA-p had significant increases of iron-related hypointense signals in the posterolateral PUT and adjacent lateral aspect of the GP, whereas the PSP group had increased hypodense signals in the anterior and medial aspects of the GP and TH. CONCLUSION: Our data demonstrate that pathological iron accumulations are more prevalent and severe in PSP compared to MSA-p. The distribution of high-iron-content regions in this study reflects pathoanatomically relevant sites. This finding allows for the use of MRI-based brain iron mapping as a technique to indirectly identify pathological changes.

Evaluation of the brain activation induced by functional electrical stimulation and voluntary contraction using functional magnetic resonance imaging.

BACKGROUND: To observe brain activation induced by functional electrical stimulation, voluntary contraction, and the combination of both using functional magnetic resonance imaging (fMRI). METHODS: Nineteen healthy young men were enrolled in the study. We employed a typical block design that consisted of three sessions: voluntary contraction only, functional electrical stimulation (FES)-induced wrist extension, and finally simultaneous voluntary and FES-induced movement. MRI acquisition was performed on a 3.0 T MR system. To investigate activation in each session, one-sample t-tests were performed after correcting for false discovery rate (FDR; p < 0.05). To compare FES-induced movement and combined contraction, a two-sample t-test was performed using a contrast map (p < 0.01). RESULTS: In the voluntary contraction alone condition, brain activation was observed in the contralateral primary motor cortex (MI), thalamus, bilateral supplementary motor area (SMA), primary sensory cortex (SI), secondary somatosensory motor cortex (SII), caudate, and cerebellum (mainly ipsilateral). During FES-induced wrist movement, brain activation was observed in the contralateral MI, SI, SMA, thalamus, ipsilateral SII, and cerebellum. During FES-induced movement combined with voluntary contraction, brain activation was found in the contralateral MI, anterior cingulate cortex (ACC), SMA, ipsilateral cerebellum, bilateral SII, and SI.The activated brain regions (number of voxels) of the MI, SI, cerebellum, and SMA were largest during voluntary contraction alone and smallest during FES alone. SII-activated brain regions were largest during voluntary contraction combined with FES and smallest during FES contraction alone. The brain activation extent (maximum t score) of the MI, SI, and SII was largest during voluntary contraction alone and smallest during FES alone. The brain activation extent of the cerebellum and SMA during voluntary contraction alone was similar during FES combined with voluntary contraction; however, cerebellum and SMA activation during FES movement alone was smaller than that of voluntary contraction alone or voluntary contraction combined with FES. Between FES movement alone and combined contraction, activated regions and extent due to combined contraction was significantly higher than that of FES movement alone in the ipsilateral cerebellum and the contralateral MI and SI. CONCLUSIONS: Voluntary contraction combined with FES may be more effective for brain activation than FES-only movements for rehabilitation therapy. In addition, voluntary effort is the most important factor in the therapeutic process.

Widespread cerebral cortical mineralization in Wilson's disease detected by susceptibility-weighted imaging.

Signal abnormalities of cortical gray matter, compared with the deep nuclear structures, have received less attention in Wilson's disease (WD). They nearly always accompanied white matter signal change, and commonly are associated with epilepsy and psychiatric features. We report herein two cases diagnosed as WD who, in addition to characteristic deep nuclear lesions on MR imaging, had widespread cerebral cortical paramagnetic signals dramatically detected by susceptibility-weighted imaging. T2-weighted MR images did not show any cortico-subcortical hyperintense lesions. To our knowledge, these findings have not been described before and may help to further characterize the disease.

Evaluation of the keyhole technique applied to the proton resonance frequency method for magnetic resonance temperature imaging.

PURPOSE: To evaluate the temporal and spatial resolution of magnetic resonance (MR) temperature imaging when using the proton resonance frequency (PRF) method combined with the keyhole technique. MATERIALS AND METHODS: Tissue-mimicking phantom and swine muscle tissue were microwave-heated by a coaxial slot antenna. For the sake of MR hardware safety, MR images were sequentially acquired after heating the subjects using a spoiled gradient (SPGR) pulse sequence. Reference raw (k-space) data were collected before heating the subjects. Keyhole temperature images were reconstructed from full k-space data synthesized by combining the peripheral phase-encoding part of the reference raw data and the center phase-encoding keyhole part of the time sequential raw data. Each keyhole image was analyzed with thermal error, and the signal-to-noise ratio (SNR) was compared with the self-reference (nonkeyhole) images according to the number of keyhole phase-encoding (keyhole-data size) portions. RESULTS: In applied keyhole temperature images, smaller keyhole-data sizes led to more temperature error increases, but the SNR did not decreased comparably. Additionally, keyhole images with a keyhole-data size of <16 had significantly different temperatures compared with fully phase-encoded self-reference images (P < 0.05). CONCLUSION: The keyhole technique combined with the PRF method improves temporal resolution and SNR in the measurement of the temperature in the deeper parts of body in real time.

Fabrication and characterization of a three-dimensional feed-horn infrared antenna for an infrared detector.

A three-dimensional feed-horn antenna for the 10-microm-wavelength infrared region has been suggested, characterized, and fabricated. It is applied to an infrared detector for efficient collection of infrared radiation and to reduce background noise. The optimum size of the horn antenna was designed for maximum antenna directivity. The three-dimensional feed-horn antenna mold was fabricated by rotating and tilting illumination, whereas the antenna plate was acquired through electroplating. Antenna characteristics were measured by coupling of the antenna with a microbolometer. Measurement results show that the directivity of the antenna is 16.1 dB and the background noise is reduced by a factor of approximately 2 compared with an open-structure infrared detector.