Factors influencing nurses' compliance related to the use of personal protective equipment during the COVID-19 pandemic: A descriptive cross-sectional study.

AIM: To determine how nurses' experiences with the coronavirus disease (COVID-19) pandemic affected their knowledge, awareness, and compliance related to the use of personal protective equipment (PPE) during the COVID-19 pandemic in South Korea. DESIGN: A descriptive cross-sectional study. METHODS: A total of 247 nurses in South Korea participated in this study between May 10 and 19, 2023. An online self-report questionnaire was used to collect data on demographic and occupational characteristics, COVID-19 experience, knowledge, awareness, and compliance related to the use of PPE. Factors affecting compliance were analysed using hierarchical multiple linear regression. RESULTS: Mean age of the nurses was 31.92, and 94.3% were women. Most had a bachelor's degree or higher and the mean clinical experience as a nurse was 6.45 years. Knowledge of the use of PPE was 8.45 out of 10, awareness was 3.52 out of 5, and compliance was 4.28 out of 5. Knowledge and awareness were correlated with compliance related to PPE use. Awareness (ß = 0.234, p < 0.001), knowledge (ß = 0.218, p < 0.001), experience caring for COVID-19 patients (ß = 0.234, p = 0.004), optional fourth dose vaccine (ß = 0.150, p = 0.017), clinical experience (ß = 0.140, p = 0.022), and COVID-19 infection control education (ß = 0.115, p = 0.037) were found to have a significant impact on compliance. CONCLUSION: During the COVID-19 pandemic, nurses' knowledge and awareness of PPE use was a crucial factor in compliance. factors such as clinical experience, experience in caring for COVID-19 patients, optional vaccination, and completion of COVID-19 education also influenced compliance. We hope that these factors can provide a basis for developing training programs for nurses to respond to future emerging infectious diseases.

Automatic detection of teeth and dental treatment patterns on dental panoramic radiographs using deep neural networks.

Disaster victim identification issues are especially critical and urgent after a large-scale disaster. The aim of this study was to suggest an automatic detection of natural teeth and dental treatment patterns based on dental panoramic radiographs (DPRs) using deep learning to promote its applicability as human identifiers. A total of 1 638 DPRs, of which the chronological age ranged from 20 to 49 years old, were collected from January 2000 to November 2020. This dataset consisted of natural teeth, prostheses, teeth with root canal treatment, and implants. The detection of natural teeth and dental treatment patterns including the identification of teeth number was done with a pre-trained object detection network which was a convolutional neural network modified by EfficientDet-D3. The objective metrics for the average precision were 99.1% for natural teeth, 80.6% for prostheses, 81.2% for treated root canals, and 96.8% for implants, respectively. The values for the average recall were 99.6%, 84.3%, 89.2%, and 98.1%, in the same order, respectively. This study showed outstanding performance of convolutional neural network using dental panoramic radiographs in automatically identifying teeth number and detecting natural teeth, prostheses, treated root canals, and implants.

Factors associated with alexithymia in adults with epilepsy.

PURPOSE: The relationship between epilepsy and alexithymia, characterized by the inability to feel or express emotion, remains incompletely understood. We investigated alexithymia and its association with epilepsy-related factors in patients with epilepsy (PWE). METHODS: In this cross-sectional study, PWE and healthy control subjects were recruited. Alexithymia was assessed using the Toronto Alexithymia Scale-20 (TAS-20). The Patient Health Questionnaire-9 (PHQ-9) and the Generalized Anxiety Disorder-7 (GAD-7) were also administered to assess depression and anxiety, respectively. Mediation analysis was conducted using a two-stage regression method. RESULTS: Ninety adult PWE and 161 healthy control subjects were included in the study. PWE had significantly higher TAS-20 scores (B = 2.445, p = 0.014) than controls, but the prevalence of alexithymia, defined as TAS-20≥61, did not differ between PWE and control subjects after controlling for confounders (15.6% vs. 6.2%, respectively; p = 0.873). Uncontrolled seizures significantly increased alexithymia through depression (B = 3.536, p = 0.006), and this effect was responsible for 61.2% of the total effect on alexithymia. The direct effects of uncontrolled seizures on alexithymia were not significant. In contrast, AED polytherapy had significant direct effects on alexithymia (B = 4.489, p = 0.037) independent of depression. The indirect effects of AED polytherapy via depression did not reach statistical significance (B = 2.371, p = 0.066). CONCLUSIONS: Alexithymia was more severe, but not more prevalent, in PWE than in healthy controls. AED polytherapy was directly associated with alexithymia, while uncontrolled seizures were indirectly related to alexithymia through depressive symptoms.

Establishment and operation of a cooperative program to identify work-related acute myeloid leukemia in a general hospital.

BACKGROUND: The purpose of this report is to introduce the occupational cancer surveillance system, implemented in June 2018, and to share the results of our cooperative program. METHODS: The cooperative program begins when the patient is diagnosed with acute myeloid leukemia (AML). Newly diagnosed AML patients are admitted to the internal medicine hematology department, then attending hematology physician requests a consultation from the occupational and environmental medicine (OEM) department. The OEM doctor next visits the hospitalized patient and interviews them to take their occupational history, and preliminarily evaluates the likelihood that the condition is associated with occupation. If the patient wants to apply for compensation through the Korea Workers' Compensation & Welfare Service, the patient was informed to visits the outpatient clinic of the OEM department and requests a 'work-relatedness evaluation report' for use in applying for compensation. RESULTS: Among the 103 patients, who received an OEM departmental work history evaluation, 18 patients were considered to have a work-related incidence and 12 patients were registered in the Industrial Accident Compensation Insurance system. CONCLUSIONS: The present report provides data on a sustainable model for identifying occupational disease in a general hospital setting, while also informing patients about their occupational rights.

Multifaceted Effect of Rubus Occidentalis on Hyperglycemia and Hypercholesterolemia in Mice with Diet-Induced Metabolic Diseases.

Metabolic syndrome is characterized by a combination of several metabolic disorders, including obesity, hyperglycemia, and hyperlipidemia. A simultaneous occurrence is one of the most crucial features of metabolic syndrome; therefore, we selected an animal model in which this would be reflected. We fed C57BL/6N mice a high-fat diet for 23 weeks to develop metabolic syndrome and examined the efficacy of Rubus occidentalis (RO) for hyperglycemia and hypercholesterolemia. Oral administration of RO for 16 weeks improved hyperglycemia as indicated by significantly decreased fasting glucose levels and a glucose tolerance test. Improvements were also observed in hypercholesterolemia, in which significant decreases in serum total cholesterol, non-high-density lipoprotein (non-HDL) cholesterol, apolipoprotein A-1, and apolipoprotein B levels were observed. The time comparison of major biomarkers, observed at the initiation and termination of the experimental period, consistently supported the beneficial effects of RO on each metabolic phenotype. In addition, RO treatment attenuated the excessive fat accumulation in hepatic and adipose tissue by decreasing the size and number of lipid droplets. These results suggested that RO simultaneously exerted antihyperglycemic and antihyperlipidemic effects in mice with diet-induced metabolic syndrome.

Characterization of Lactobacillus plantarum strains isolated from black raspberry and their effect on BALB/c mice gut microbiota.

The objective of this study was to evaluate probiotic effects of two Lactobacillus plantarum strains (GBL16 and 17) isolated from black raspberry. Results revealed that the number of GBL16 was gradually decreased as bile salt concentration was increased from 0.3 to 1%. However, GBL17 did not show any difference when GBL17 was applied to 1% bile salt, and it indicates that GBL17 is more tolerant to bile salt than GBL16. GBL17 exhibited higher heat resistance and adhesion ability to Caco-2 cells than GBL16. Regarding gut microbiome, no significant change in the number of total bacteria in intestines of mice after treatment with GBLs was determined. However, the combination of GBL16 and GBL17 significantly increased the number of total bacteria in intestines of mice after they were orally administered. Therefore, the results suggest that both GBL16 and 17 strains could be one of major probiotics that can improve human gut health.

Effects of a simulated emergency airway management education program on the self-efficacy and clinical performance of intensive care unit nurses.

AIM: To examine the effects of a simulated emergency airway management education program on the self-efficacy and clinical performance among nurses in intensive care units. METHODS: A one-group, pre- and post-test design was used. Thirty-five nurses who were working in adult intensive care units participated in this study. The simulation education program included lectures, skill demonstration, skill training, team-based practice, and debriefing. Self-efficacy and clinical performance questionnaires were completed before the program and 1 week after its completion. The data were analyzed by using descriptive statistics and the paired t-test to compare the mean differences between the pre-test and post-test. The scores before and after education were compared. RESULTS: After education, there was a significant improvement in the nurses' self-efficacy and clinical performance in emergency airway management situations. CONCLUSION: Simulation education effectively improved the self-efficacy and clinical performance of the nurses who were working in intensive care units. Based on the program for clinical nurses within a hospital, it will provide information that might advance clinical nursing education.

Laboratory-based surveillance of hospital-acquired respiratory virus infection in a tertiary care hospital.

Of 7,772 laboratory-confirmed cases of respiratory viral infection among hospitalized patients, 22.8% were categorized as having hospital-acquired infection. The overall incidence of hospital-acquired respiratory viral infection was 3.9 (95% confidence interval, 3.7-4.1) cases per 1,000 admitted patients. Rhinovirus was the most common virus (30.3%), followed by influenza virus (17.6%) and parainfluenza virus (15.6%).

Restoration of Declined Immune Responses and Hyperlipidemia by Rubus occidenalis in Diet-Induced Obese Mice.

Hyperlipidemia, which is closely associated with a fatty diet and aging, is commonly observed in the western and aged society. Therefore, a novel therapeutic approach for this disease is critical, and an immunological view has been suggested as a novel strategy, because hyperlipidemia is closely associated with inflammation and immune dysfunction. In this study, the effects of an aqueous extract of Rubus occidentalis (RO) in obese mice were investigated using immunological indexes. The mice were fed a high-fat diet (HFD) to induce hyperlipidemia, which was confirmed by biochemical analysis and examination of the mouse physiology. Two different doses of RO and rosuvastatin, a cholesterol synthesis inhibitor used as a control, were orally administered. Disturbances in immune cellularity as well as lymphocyte proliferation and cytokine production were significantly normalized by oral administration of RO, which also decreased the elevated serum tumor necrosis factor (TNF)-α level and total cholesterol. The specific immune-related actions of RO comprised considerable improvement in cytotoxic T cell killing functions and regulation of antibody production to within the normal range. The immunological evidence confirms the significant cholesterol-lowering effect of RO, suggesting its potential as a novel therapeutic agent for hyperlipidemia and associated immune decline.

Clearance Rate of Carbapenemase-Producing Enterobacteriaceae Carriage Among Hospitalized Patients.

During the past decade, carbapenemase-producing Enterobacteriaceae (CPE) has emerged and spread across the world. 1 The major carbapenemase enzymes currently being reported are KPC, NDM-1, VIM, IMP, and OXA. 2 Because carbapenemase can be effectively transmitted via mobile genetic elements, and current therapeutic options for CPE infections are extremely limited, CPE may be one of the most serious contemporary threats to public health. However, very little is known about the characteristics of CPE carriage during hospitalization. The aims of this study were to investigate the clearance rate of CPE carriage and determine the number of consecutive negative cultures required to confirm CPE clearance. We also examined CPE transmission among hospitalized patients.

Inhibitory effects of Rubi Fructus extracts on hepatic steatosis development in high-fat diet-induced obese mice.

The present study was performed to investigate the potential effects of the unripened dried fruit of Rubus coreanus Miq., Rubi Fructus (RF), on hepatic steatosis and lipid metabolism in mice fed with a high-fat diet (HFD) known to induce obesity and hyperlipidaemia. Rubi Fructus extract (RFex) fed mice demonstrated a reduced body weight and adipose tissue weight. RFex fed mice also demonstrated decreased aminotransferase levels, lipid contents [triglyceride (TG), total cholesterol (TC) and low-density lipoprotein-cholesterol (LDL-C)], leptin content and increased high­density lipoprotein-cholesterol (HDL­C) contents in the plasma. These effects were accompanied by a decreased expression of lipogenic genes, including sterol regulatory element binding protein-1c, liver X receptor, fatty acid synthase (FAS), acetyl­CoA carboxylase, cluster of differentiation 36, lipoprotein lipase and decreased lipogenic enzyme FAS and 3-hydroxy-3 methylglutamyl coenzyme reductase enzyme activities, while elevating carnitine palmitoyltrasferase-1 activity. Based on these results, the present study hypothesized that the inhibitory effect on hepatic steatosis of RFex is the result of the suppression of lipid synthesis in mice fed with HFD, suggesting that RFex may be beneficial in preventing hepatic steatosis and liver lipotoxicity.

[Validation of a modified early warning score to predict ICU transfer for patients with severe sepsis or septic shock on general wards].

PURPOSE: To assess whether the Modified Early Warning Score (MEWS) predicts the need for intensive care unit (ICU) transfer for patients with severe sepsis or septic shock admitted to general wards. METHODS: A retrospective chart review of 100 general ward patients with severe sepsis or septic shock was implemented. Clinical information and MEWS according to point of time between ICU group and general ward group were reviewed. Data were analyzed using multivariate logistic regression and the area under the receiver operating characteristic curves with SPSS/WIN 18.0 program. RESULTS: Thirty-eight ICU patients and sixty-two general ward patients were included. In multivariate logistic regression, MEWS (odds ratio [OR] 2.02, 95% confidence interval [CI] 1.43-2.85), lactic acid (OR 1.83, 95% CI 1.22-2.73) and diastolic blood pressure (OR 0.89, 95% CI 0.80-1.00) were predictive of ICU transfer. The sensitivity and the specificity of MEWS used with cut-off value of six were 89.5% and 67.7% for ICU transfer. CONCLUSION: MEWS is an effective predictor of ICU transfer. A clinical algorithm could be created to respond to high MEWS and intervene with appropriate changes in clinical management.

Assessment of the appropriateness of hand surface coverage for health care workers according to World Health Organization hand hygiene guidelines.

We monitored hand surface coverage technique in health care workers in a tertiary care hospital using a 5-item hand hygiene assessment tool based on World Health Organization guidelines. Overall hand hygiene compliance was 86.7% (4,300/4,960). Appropriate hand surface coverage was observed in only 7.9% (182/2,297) of hand hygiene procedures.

Accentuation of ursolic acid on muscarinic receptor-induced ANP secretion in beating rabbit atria.

AIMS: Ursolic acid has recently been reported to increase both atrial natriuretic peptide (ANP) secretion and mechanical dynamics in rabbit atria. MAIN METHODS: The present study was designed to clarify the regulatory effects of ursolic acid on the ß-adrenergic or muscarinic receptor-mediated changes in ANP secretory and contractile function allowing measurement of atrial dynamics such as pulse pressure, stroke volume, and cAMP efflux in isolated perfused beating rabbit atria. KEY FINDINGS: Pretreatment with ursolic acid significantly attenuated the isoproterenol (ß-adrenergic agonist)-induced decrease in ANP secretion and increases in cAMP levels and atrial dynamics. Interestingly, ursolic acid concentration-dependently accentuated the acetylcholine-induced increase in ANP secretion and decrease in pulse pressure in the presence of isoproterenol (p<0.001). These findings indicate that acetylcholine-induced increase in ANP secretion is potentiated by ursolic acid; furthermore, acetylcholine-induced decrease in atrial dynamics is also potentiated by ursolic acid, suggesting that ursolic acid regulates muscarinic receptor-mediated secretory and contractile responses in perfused beating rabbit atria. SIGNIFICANCE: This implicates for the beneficial effects of ursolic acid in the regulation of cardiovascular and body fluid homeostasis.

Ursolic acid increases the secretion of atrial natriuretic peptide in isolated perfused beating rabbit atria.

Ursolic acid is reported to have beneficial effects on the regulation of cardiovascular homeostasis. However, the effects of ursolic acid on cardiac hormone secretion are yet to be defined. The present study was designed to test the effects of ursolic acid on the secretory and contractile functions of the atria. Experiments were conducted in isolated perfused beating rabbit atria. We measured the changes in atrial dynamics, pulse pressure, stroke volume, cAMP efflux, as well as the secretion of atrial natriuretic peptide (ANP). Ursolic acid increased ANP secretion and mechanical dynamics in a concentration-dependent manner. The inhibition of L-type Ca(2+) channels with nifedipine attenuated the ursolic acid-induced increase in ANP secretion but not mechanical dynamics. The inhibition of K(+)(ATP) channels with glibenclamide attenuated the ursolic acid-induced increase in ANP secretion-but not atrial dynamics-in a concentration-dependent manner. The selective Na(+)-K(+)-ATPase inhibitor ouabain blocked the ursolic acid-induced increase in atrial dynamics but not ANP secretion. These findings show that ursolic acid increases ANP secretion via its activation of K(+)(ATP) channels and subsequent inhibition of Ca(2+) entry through L-type Ca(2+) channels in rabbit atria. These data also suggest that ursolic acid increases atrial dynamics via its inhibition of Na(+)-K(+)-ATPase activity.

Annual incidence of latent tuberculosis infection among newly employed nurses at a tertiary care university hospital.

OBJECTIVE: To investigate the annual rate of tuberculosis (TB) infection among newly employed nurses using both tuberculin skin test (TST) and QuantiFERON-TB Gold (QFT-G; Cellestis Limited) assay. DESIGN: A prospective cohort study involving newly employed nurses. SETTING: A tertiary care university hospital in South Korea. METHODS: All participants (n = 196) were tested with the TST and QFT-G assay at baseline. After 1 year, the TST and QFT-G assay were reperformed for subjects who had negative TST results at baseline and for all subjects, respectively. RESULTS: The baseline TST and QFT-G assays were positive for 101 subjects (51.5%) and 28 subjects (14.3%), respectively; 22 subjects (11.2%) had positive results of both tests. Although the overall between-test agreement was 54.9% (k = 0.151) [95% confidence interval, 0.047-0.245]), agreement improved to 78.5% (k = 0.462 [95% confidence interval, 0.007-0.917]) for subjects who had not received bacille Calmette-Guérin vaccination. After 1 year, the TST yielded positive results for 16 (21.3%) of 75 nurses with negative baseline results, and the QFT-G assay yielded positive results for 21 (14.4%) of 146 subjects with negative baseline results. Collectively, 5 subjects (3.0%) experienced conversion to positive results with both tests, and 32 subjects (18.9%) experienced conversion to positive results with one of the tests. Neither the employing hospital department nor exposure to patients with TB affected test conversion status. CONCLUSIONS: The poor overall agreement between TST and QFT-G results may have been caused by the confounding effect of bacille Calmette-Guérin vaccination. The annual risk of TB infection among newly employed nurses was at least 3% on the basis of results of both the TST and QFT-G test. Stricter preventive strategies against TB spread should be implemented in our hospital.

Aqueous extract of Zanthoxylum schinifolium elicits contractile and secretory responses via beta1-adrenoceptor activation in beating rabbit atria.

AIM OF STUDY: Although Zanthoxylum schinifolium has long been used in the traditional oriental medicine, cardiac effects have not well been documented. The aim of the present study was to investigate the effects of aqueous extract of leaves and stems from Zanthoxylum schinifolium (AZS) on inotropic effect and atrial natriuretic peptide (ANP) secretion. MATERIALS AND METHODS: The AZS-induced changes in atrial dynamics, cAMP efflux and atrial ANP secretion were determined in isolated perfused beating rabbit atria. RESULTS: AZS increased atrial pulse pressure, stroke volume, and cAMP efflux concomitantly with inhibition of ANP secretion in a concentration-dependent manner. The AZS-induced increases in atrial dynamics and cAMP efflux, and decrease in ANP secretion were attenuated by pretreatment with propranolol and CGP 20712 but not ICI 118,551. Also, the AZS-induced changes in atrial dynamics and ANP secretion were attenuated by diltiazem and KT 5720. Diltiazem and KT 5720 had not significant effect on the AZS-induced increase in cAMP efflux. CONCLUSION: These results suggest that AZS elicits a positive inotropic effect and decrease in ANP secretion via beta(1)-adrenoceptor-cAMP-Ca(2+) signaling in beating rabbit atria.

Anti-angiogenic effect of the seed extract of Benincasa hispida Cogniaux.

Benincasa hispida in Korea was used mainly diabetes and diuresis diseases. This study was carried out to evaluate anti-angiogenic effect of the seed extract of Benincasa hispida Cogniaux. Basic fibroblast growth factor (bFGF) is a potent angiogenic factor found in various tumors. In this study, we found that the seed extract of Benincasa hispida Cogniaux decreased bFGF-induced endothelial cell proliferation and tube formation in a dose-dependent manner. Besides, Benincasa hispida seed extract showed no cytotoxicity on HUVECs and normal fibroblast cells. Furthermore, the seed extract of Benincasa hispida showed a potent inhibitory effect on bFGF-induced angiogenesis in vivo. These results suggest that the seed extract of Benincasa hispida inhibits the proliferation of endothelial cells induced by bFGF, which may explain its anti-angiogenic properties.