Integrating mixed reality preparation into acute coronary syndrome simulation for nursing students: a single-group pretest-posttest study.

BACKGROUND: Timely and effective intervention within the 'golden hour'-the critical first 90 min after the symptom onset-is crucial for initiating life-saving treatment and reducing mortality in acute coronary syndrome (ACS). This highlights the need for nursing students to be proficient in ACS care, emphasizing the importance of preparatory training. This study enhanced traditional simulation methods by integrating a mixed reality (MR) preparation step, offering a more immersive learning experience. We aimed to evaluate the effectiveness of integrating MR preparation into ACS simulation education, focusing on enhancements in knowledge, self-confidence in learning, and self-efficacy in learning. Additionally, we examined performance, practice immersion, and satisfaction to comprehensively evaluate the MR application. METHODS: One-group pretest-posttest design was implemented in a convenience sample of thirty-nine senior nursing students from a university in South Korea in August 2022. We developed a simulation program integrating MR preparation into ACS simulation (IMRP-ACSS), which was validated through expert review for content validity. The students participated in the simulation program over six hours across two days, including a 40-minute individual session of MR-based simulation preparation using head-mounted displays (the HoloLens 2). Individual changes in knowledge, self-confidence in learning, and self-efficacy in learning evaluated by the survey were analyzed using paired t-tests. Additionally, group performance assessed using the checklist was analyzed. Immersion and satisfaction were measured with a tool and a 10-point Likert scale, respectively. RESULTS: Individually, participants demonstrated significantly increased knowledge (t = 11.87, p < .001), self-confidence in learning (t = 7.17, p < .001), and self-efficacy in learning (t = 4.70, p < .001) post-education. Group performance yielded a mean score of 56.43/70 ± 7.45. Groups scored higher in electrocardiogram interpretation, patient safety, and heparin administration. Participants reported a practice immersion level of 37.82/50 ± 9.13 and expressed satisfaction with the program, achieving an average score of 8.85/10 ± 1.35. CONCLUSION: Integrating MR preparation into ACS simulation enhanced nursing students' knowledge, self-confidence in learning, and self-efficacy in ACS care, providing a replicable and immersive learning experience. This method is an effective addition to nursing education, preparing students through comprehensive, technology-enhanced training.

Enhancing ACLS training effects through video-assisted boosting methods: A comparative analysis of self-simulation and model simulation videos.

AIMS: To assess the impact of learner-participation and instructor-led simulation videos on nurses' CPR skills, focusing on iterative learning to boost proficiency in ACLS. BACKGROUND: Advanced cardiac life support (ACLS) training is crucial for nurses, especially to improve cardiopulmonary resuscitation (CPR) proficiency, for which an effective training strategy is needed. DESIGN: A quasi-experimental, pretest-posttest design was implemented to assess the impact of self-simulation and model simulation videos on sustaining CPR education. METHODS: The research was carried out at a university hospital in Korea from August 2021 to July 2022. A total of 110 nurses were allocated into three groups based on the building of their workplace in the hospital. Each group watched training videos at 4-month intervals after the simulation training. The self-video group viewed simulations featuring their participation, while the model video group watched instructor-led simulations. A comparison group participated in the simulations without subsequent video boosting. RESULTS: Both the self-video and model video groups exhibited significantly superior ACLS performance compatred with the comparison group at both four months (H = 70.33, p <.001) and eight months (H = 81.52, p <.001) following the intervention, with large effect sizes (self-video vs. comparison: d = 4.73 at four months, d = 12.54 at eight months; model video vs. comparison: d = 4.53 at four months, d = 11.01 at eight months). ACLS knowledge scores also significantly increased over time in both intervention groups (self-video: χ² = 22.09, p <.001; model video: χ² = 24.13, p <.001), but not in the comparison group (χ² = 3.75, p =.153). There were no significant differences among the groups in terms of CPR self-efficacy or stress at either time point. CONCLUSION: Supplementary training using simulation videos is an effective method for maintaining and enhancing nurses' ACLS competency, offering a sustainable approach to repetitive CPR training. This study underscores the value of incorporating recorded simulation videos in clinical training, offering insights into efficient methods for continuous learning and CPR proficiency among nursing professionals.

Exploring the impact of the mentoring new nurses for transition and empowerment program led by clinical nurse educators in South Korea: A mixed-methods study.

BACKGROUND: "New nurses" are those with less than a year of work experience at a hospital. To address the challenges of new nurses caused by their limited experience, the Mentoring New Nurses for Transition and Empowerment Program (MNTEP) was designed based on the Stress-Appraisal-Coping Model of Lazarus and Folkman. OBJECTIVES: This study aimed to explore the impact of the MNTEP, in which clinical nurse educators teach stress-coping strategies, on the clinical transition of new nurses in South Korea. DESIGN: This study used a mixed-methods design with a pretest-posttest non-equivalent comparison group and focus group interviews (FGIs). SETTINGS: The research was conducted at a hospital in South Korea. PARTICIPANTS: The intervention and comparison groups comprised 30 and 28 new nurses, respectively. Also, 12 MNTEP participants were subjected to three separate FGIs. METHODS: To comprehensively assess the program's effects, quantitative data were collected through self-report surveys, while qualitative data were obtained from March 2022 to March 2023 using semi-structured interviews that allowed for open-ended responses. RESULTS: There were significant differences in mean self-efficacy scores (t = 2.45, p = 0.017) and perceived social support from clinical nurse educators (F = 4.51, p = 0.038) between the intervention and comparison groups. Additionally, significant changes were observed in the field adaptation pre-test and post-test scores within the intervention group (t = -3.12, p = 0.004). However, there was no statistically significant difference between the groups in terms of active and passive coping strategies. FGIs yielded two main themes: (1) gaining positive energy through empowerment and solidarity; and (2) clinical nurse educators sharing strategies for improved role adaptation and capacity building. CONCLUSIONS: MNTEP led by clinical nurse educators positively influenced new nurses' self-efficacy and facilitated their transition to clinical settings. These findings underscore the importance of mentorship programs and clinical nurse educators.

Development and effectiveness of a metaverse reality-based family-centered handoff education program in nursing students.

PURPOSE: Effective patient handoffs are vital in pediatric populations. This study aimed to develop and identify the impact of a metaverse-based handoff program using ZEPETO on nursing students' handoff competence, handoff self-efficacy, learning realism, and satisfaction. DESIGN AND METHODS: This study used a non-randomized, pre-post nonequivalent group design to develop, implement, and verify a metaverse-based handoff simulation program in a nursing school in South Korea. We assigned 69 senior nursing students from a university to an experimental group or a control group. We developed a metaverse-based, handoff simulation program of family-centered care by building a pediatric intensive care unit (PICU) using ZEPETO. The program included an online lecture, a metaverse rounding discussion, and a metaverse-based handoff simulation of postoperative care for infants with congenital heart disease. We measured handoff competence, handoff self-efficacy, learning realism, and learning satisfaction pre- and post-program. RESULT(S): The experimental group showed significantly higher handoff self-efficacy than the control group (t = 3.17, p = 0.002). No significant differences were found in handoff competency, learning realism, or learning satisfaction between the groups. CONCLUSION(S): This study confirmed that a family-centered care-based handoff metaverse simulation program based on the experiential learning theory enhanced nursing students' handoff self-efficacy. The program equipped students to conduct safe and effective handoffs in real-world clinical settings by providing an immersive learning experience and emphasizing patient-centered communication. PRACTICAL IMPLICATIONS: Based on these results, family-centered, handoff education programs are recommended to be developed that focus on learning realism and learning satisfaction to enhance nursing students' handoff competence.

Enhancing triage accuracy in emergency nurses: The impact of a game-based triage educational app.

INTRODUCTION: Digital technology has enabled gamification methods to enhance triage education, reflecting an evolving healthcare landscape. OBJECTIVE: To evaluate the effectiveness of a Gamification Triage Education App (GTEA) as a learning tool for emergency nurses, with a focus on creating an engaging and educationally effective platform for triage training. METHOD: The GTEA was developed using no-code based software and expanded upon previous iterations, with added features such as points, rankings, instant feedback, and quest-based stories. From December 2021 to March 2022, 27 emergency room nurses from three hospitals in Korea were instructed to use GTEA for 100 min over the course of a week. The effects were measured before and after the intervention. RESULTS: The results demonstrated a significant increase in triage accuracy from 4.3 ± 2.00 to 5.33 ± 1.47 (t = -2.18, p = 0.039), along with a substantial reduction in overtriage (t = 3.11, p = 0.004). Additionally, increases in critical thinking disposition, triage competency, and triage knowledge were observed (t = -3.11, p = 0.004; t = -2.72, p = 0.011; t = -3.14, p = 0.004, respectively). CONCLUSIONS: The findings provide robust evidence for the effectiveness of gamification in triage training within emergency nursing.

Development of a Competency-Based Triage Education Application and Usability Testing for Triage Training Based on the Korean Triage and Acuity Scale.

BACKGROUND: Improving the quality of emergency nursing care requires enhancing triage competency through education programs that integrate the content of the Korean Triage and Acuity Scale, a triage system specifically developed for the Korean context. Thus, this study developed a competency-based triage education application (CTEA), based on the Korean Triage and Acuity Scale, and evaluated its effectiveness through usability testing. METHOD: The CTEA used various teaching methods and game mechanisms, including lectures, case studies, and video-based scenarios, to improve triage competency. RESULTS: In the usability testing phase, the CTEA was refined through expert heuristic evaluation and user interviews conducted with the think-aloud method. Six themes were derived from the interviews, highlighting the need for a well-structured program with realistic scenarios, easy accessibility, gamification, functional improvements, and future triage educational applications. CONCLUSION: These findings suggest that the CTEA is effective and satisfactory for users and can contribute to improving the triage competency of emergency nurses. [J Contin Educ Nurs. 2024;55(1):33-41.].

Effect of a hybrid team-based advanced cardiopulmonary life support simulation program for clinical nurses.

BACKGROUND: During in-hospital cardiac arrest events, clinical nurses are often the first responders; therefore, nurses require sufficient advanced cardiac life support (ACLS) competency. This study aimed to verify the effects of a hybrid team-based ACLS simulation (HTAS) program (developed in this study) on nurses' ACLS performance, specifically ACLS knowledge, cardiopulmonary resuscitation (CPR) self-efficacy, and CPR-related stress. METHODS: The developed HTAS comprised four lecture videos, one team-based skills training video, and a team-based ACLS simulation. A quasi-experimental pretest-posttest design with a comparison group (CG) was used to evaluate the effectiveness of the HTAS. Of the 226 general ward nurses with more than 6 months of clinical experience, 117 were allocated to the intervention group (IG), which attended the HTAS, and 109 to the CG, which attended only basic ACLS training. RESULTS: The IG's ACLS performance significantly improved (t = 50.8, p < 0.001) after the training. Relative to the respective pretest conditions, posttest ACLS knowledge (t = 6.92, p < 0.001) and CPR self-efficacy (t = 6.97, p < 0.001) of the IG also significantly increased. However, when the mean difference values were compared, there was no significant difference between the two groups with respect to ACLS knowledge (t = 1.52, p = 0.130), CPR self-efficacy (t = -0.42, p = 0.673), and CPR stress (t = -0.88, p = 0.378). CONCLUSION: The HTAS for ward nurses was effective at enhancing the nurses' ACLS performance. It is necessary to develop effective training methods for team-based ACLS and verify the sustained effects of such training.

Complete Genome Sequence of a Non-Carbapenemase-Producing Carbapenem-Resistant Providencia rettgeri Strain Isolated from a Clinical Urine Sample in Arkansas.

Here, we report the complete genome sequence of Providencia rettgeri isolate PROV_UAMS_01, which was recovered in 2021 from a urine sample from a hospitalized patient in Arkansas, USA. The genome sequence of P. rettgeri isolate PROV_UAMS_01 comprises a single chromosomal replicon with a G+C content of 40.51% and a total of 3,887 genes.

The Effect of Competency-Based Triage Education Application on Emergency Nurses' Triage Competency and Performance.

The Korean Triage and Acuity Scale (KTAS) is used to determine emergency patient priority. The purpose of this study was to develop the Competency-Based Triage Education Application (CTEA) using KTAS and evaluate its effectiveness on emergency nurses' triage competency and performance. The developed CTEA mobile application comprised 4 lectures, 12 text-based cases, and 8 video-based triage scenarios. A quasi-experimental pre-post design with a comparison group (CG) was used to evaluate the effectiveness of the CTEA. Thirty-one participants were assigned to an intervention group (IG) and used the application for at least 100 min over one week. Thirty-five participants were assigned to a CG and underwent book-based learning, which covered the same content as the CTEA. Triage competency (t = 2.55, p = 0.013) and performance (t = 2.11, p = 0.039) were significantly improved in the IG. The IG's undertriage error was significantly reduced compared to that of the CG (t = 2.08, p = 0.041). These results indicated that the CTEA was effective in improving the emergency nurses' triage competency and performance. This application will be useful as a program for providing repeated and continuous triage education.

Factors Influencing Turnover Intention among Male Nurses in Korea.

The study examined predictors of male nurse turnover intention in Korea using data collected from Korean hospitals. The results were obtained based on a secondary analysis of data previously collected from 306 male nurses in 16 regions of Korea from December 2014 to February 2015. Our findings suggest that male nurse turnover intention is predicted by (1) individual factors: single (B = 0.93, p = 0.008); (2) organizational factors: organizational commitment (B = -0.36, p < 0.001), job satisfaction (B = -0.27, p = 0.001), and job stress (B = 0.24, p < 0.001); and (3) social factors: hospital location in medium-categorized cities (B = 0.70, p = 0.012) and kinship responsibility (B = 0.13, p = 0.026). These factors accounted for 56.9% of the total variance. To lower the rate of turnover intention among male nurses, strategic interventions should be implemented based on the factors identified in this study.

Facilitators and Barriers of the Triage Process based on Emergency Nurses' Experience with the Korean Triage and Acuity Scale: A Qualitative Content Analysis.

PURPOSE: Since 2016, the Korean Triage and Acuity Scale (KTAS) algorithm has been applied to the triage process in the emergency departments (EDs) of Korea. This study aimed to investigate the facilitators of and barriers to a well-run triage function based on how Korean emergency nurses perceived the triage process and their experiences with it. METHODS: Data were collected using focus group interviews from June 2018 to January 2019. Twenty emergency nurses were divided into two junior and four senior groups based on their level of clinical experience. All interviews were recorded as they were spoken and transcribed. Data were analyzed using qualitative content analysis. RESULTS: The participants recognized the need for the KTAS algorithm to efficiently classify emergency patients and were working on it properly. According to the data, we extracted 4 themes and 20 subthemes. Four themes were as follows: (1) awareness about the necessity of triage, (2) facilitators to triage process, (3) barriers to triage process, and (4) suggestions for the establishment and development of triage. CONCLUSION: From the findings of this study, various vulnerabilities of the triage process were identified, and solutions were suggested from the emergency nurses' perspective. Educational, staffing, financial support, and periodic updates of the KTAS are needed to promote the triage process in the future.

Mediating and Moderating Effects of Family Cohesion between Positive Psychological Capital and Health Behavior among Early Childhood Parents in Dual Working Families: A Focus on the COVID-19 Pandemic.

This study examined the mediating and moderating effects of family cohesion on the relationship between positive psychological capital and health promotion behaviors among dual working parents of young children during the COVID-19 pandemic. We collected data from 214 dual working parents and analyzed the results using the IMB SPSS version 26.0 software. We found that positive psychological capital had significant effects on both family cohesion (ß = 0.19, p < 0.001) and health promotion behaviors (ß = 0.26, p < 0.001), while family cohesion showed a significant mediating effect on health promotion behaviors (ß = 0.34, p = 0.002). Positive psychological capital (independent variable) also had significant effects on health promotion behaviors (ß = 0.19, p < 0.001). Finally, a Sobel test showed that family cohesion had a significant partial mediating effect on the relationship between positive psychological capital and health promotion behaviors (Z = 2.70, p = 0.005) but no moderating effect. Thus, it is necessary to enhance health promotion behaviors through programs focused on both family cohesion and positive psychological capital. However, the fact that participants in this study were only from South Korea highlights the requirement for future research that includes participants from different cultural contexts and social systems.

Triage accuracy and causes of mistriage using the Korean Triage and Acuity Scale.

PURPOSE: To identify emergency department triage accuracy using the Korean Triage and Acuity Scale (KTAS) and evaluate the causes of mistriage. METHODS: This cross-sectional retrospective study was based on 1267 systematically selected records of adult patients admitted to two emergency departments between October 2016 and September 2017. Twenty-four variables were assessed, including chief complaints, vital signs according to the initial nursing records, and clinical outcomes. Three triage experts, a certified emergency nurse, a KTAS provider and instructor, and a nurse recommended based on excellent emergency department experience and competence determined the true KTAS. Triage accuracy was evaluated by inter-rater agreement between the expert and emergency nurse KTAS scores. The comments of the experts were analyzed to evaluate the cause of triage error. An independent sample t-test was conducted to compare the number of patient visits per hour in terms of the accuracy and inaccuracy of triage. RESULTS: Inter-rater reliability between the emergency nurse and the true KTAS score was weighted kappa = .83 and Pearson's r = .88 (p < .001). Of 1267 records, 186 (14.7%) showed some disagreement (under triage = 131, over triage = 55). Causes of mistriage included: error applying the numerical rating scale (n = 64) and misjudgment of the physical symptoms associated with the chief complaint (n = 47). There was no statistically significant difference in the number of patient visits per hour for accurate and inaccurate triage (t = -0.77, p = .442). CONCLUSION: There was highly agreement between the KTAS scores determined by emergency nurses and those determined by experts. The main cause of mistriage was misapplication of the pain scale to the KTAS algorithm.

The long-term effects of the health coaching self-management program for nursing-home residents.

BACKGROUND AND AIMS: Little is known about whether a self-management program for nursing-home residents (NHR) with cognitive impairment is likely to have an impact on the care of this growing population. This study aimed to evaluate the effects of the health-coaching self-management program for NHR (HCSMP-NHR) on 1) self-efficacy and goal attainment scaling (GAS), 2) health status and quality of life (QoL) among older people, including those with cognitive impairment, in Korean nursing homes. METHODS: This was a cluster-randomized controlled trial. Participants in the intervention group (n=43, mean age =80.91±7.65 years) received the HCSMP-NHR intervention, composed of group health education and individual coaching, for 8 weeks. Conventional care was provided to the conventional group (n=47, mean age =80.19±7.53 years) during the same period. The effects of the HCSMP-NHR were measured three times: at baseline, week 9, and week 20. RESULTS: The intervention group showed better results for self-efficacy (P=0.007), health distress (P=0.007), depression (P<0.001), and QoL (P=0.04) at week 9. Mean GAS score of the intervention group gradually increased from -0.38 to 0.74. The time × group interaction showed that the intervention group had significant improvements in QoL (P=0.047), and significant reductions in health distress (P=0.016) and depression (P<0.001), while showing no deterioration in shortness of breath (P<0.001). CONCLUSION: Our study findings indicate that the HCSMP-NHR improved self-efficacy and GAS and enhanced the health status and QoL of NHR with chronic conditions who also had mild-to-moderate cognitive impairment. Moreover, these effects were successfully maintained over the 5 months of the trial. Further research is needed to establish the optimum intervention period and to assess the possibility of nationwide implementation of the HCSMP-NHR.

Effect of irradiation on the parameters that influence quality characteristics of uncured and cured cooked turkey meat products.

The objective of this study was to evaluate the effect of irradiation on lipid/protein oxidation, color changes, and off-odor volatiles production in uncured and cured cooked turkey meat products. Uncured cooked turkey breast meat and cured commercial turkey breast rolls and ham were prepared and irradiated at 0, 1.5, 3.0, and 4.5 kGy using a linear accelerator. The results showed that irradiation had little effects on lipid oxidation of cured cooked turkey products, but accelerated lipid oxidation in uncured cooked turkey breast meat (P < 0.05). Protein oxidation was increased both in cured and uncured meats (P < 0.05), but more in cured cooked meat by irradiation. The redness of uncured cooked turkey was increased (P < 0.05), but the redness of cured cooked turkey meat was faded by irradiation (P < 0.05). Irradiated cured cooked turkey meat products produced less off-odor volatile compounds (dimethyl disulfide, 3-methyl/2-methyl-butananl, and hexanal) than irradiated uncured cooked meat products due to various additives in the cured meat products. Our results suggested that irradiation resulted in different chemical reactions to pigments in uncured and cured cooked turkey meat products, but cured cooked turkey meat products have a higher tolerance to odor deterioration than uncured cooked turkey meat products.

Role of Salvia miltiorrhiza for Modulation of Th2-derived Cytokines in the Resolution of Inflammation.

BACKGROUND: Salvia miltiorrhiza (SM) has been used to treat inflammatory diseases including edema and arthritis; however, the anti-inflammatory mechanism of SM action remains unresolved. METHODS: The effects of an ethanol extract of SM (ESM) on pro-inflammatory cytokines such as TNF-α, IL-1ß, IL-6, and NO, on anti-inflammatory cytokines including IL-4, IL-10, TGF-ß, and IL-1Ra have been studied in an attempt to elucidate the anti-inflammatory mechanism in murine macrophages. RESULTS: ESM inhibited the production of pro-inflammatory cytokines via down-regulation of gene and protein expression whereas it increased the anti-inflammatory cytokines. Furthermore, ESM inhibited the expression of the chemokines, RANTES and CX3CL1, as well as of inflammatory mediators such as TLR-4 and 11ß-HSD1. CONCLUSION: These results indicated that the regulatory effects of ESM may be mediated though the suppression of pro-inflammatory cytokines as well as the induction of anti-inflammatory cytokines. Consequently, we speculate that ESM has therapeutic potential for inflammation-associated disorders.

Cordycepin Suppresses Expression of Diabetes Regulating Genes by Inhibition of Lipopolysaccharide-induced Inflammation in Macrophages.

BACKGROUND: It has been recently noticed that type 2 diabetes (T2D), one of the most common metabolic diseases, causes a chronic low-grade inflammation and activation of the innate immune system that are closely involved in the pathogenesis of T2D. Cordyceps militaris, a traditional medicinal mushroom, produces a component compound, cordycepin (3'-deoxyadenosine). Cordycepin has been known to have many pharmacological activities including immunological stimulating, anti-cancer, and anti-infection activities. The molecular mechanisms of cordycepin in T2D are not clear. In the present study, we tested the role of cordycepin on the anti-diabetic effect and anti-inflammatory cascades in LPS-stimulated RAW 264.7 cells. METHODS: We confirmed the levels of diabetes regulating genes mRNA and protein of cytokines through RT-PCR and western blot analysis and followed by FACS analysis for the surface molecules. RESULTS: Cordycepin inhibited the production of NO and pro-inflammatory cytokines such as IL-1beta, IL-6, and TNF-alpha in LPS-activated macrophages via suppressing protein expression of pro-inflammatory mediators. T2D regulating genes such as 11beta-HSD1 and PPARgamma were decreased as well as expression of co-stimulatory molecules such as ICAM-1 and B7-1/-2 were also decreased with the increment of its concentration. In accordance with suppressed pro-inflammatory cytokine production lead to inhibition of diabetic regulating genes in activated macrophages. Cordycepin suppressed NF-kappaB activation in LPS-activated macrophages. CONCLUSION: Based on these observations, cordycepin suppressed T2D regulating genes through the inactivation of NF-kappaB dependent inflammatory responses and suggesting that cordycepin will provide potential use as an immunomodulatory agent for treating immunological diseases.

Role of Cordycepin and Adenosine on the Phenotypic Switch of Macrophages via Induced Anti-inflammatory Cytokines.

BACKGROUND: Chronic low grade inflammation is closely linked to type II diabetes, obesity, and atherosclerosis. Macrophages play a key role in the regulation of pro- or anti-inflammatory actions at the lesion sites of disease. Components of cordyceps militaris, cordycepin and adenosine, have been used for the modulation of inflammatory diseases. The effects of cordycepin in the modulation of macrophages have yet to be elucidated. We investigated the effects of cordycepin and adenosine on the morphological changes of macrophages under the inflammatory condition of LPS and an anti-inflammatory condition involving high concentrations of adenosine. METHODS: We confirmed the mRNA levels of the M1/M2 cytokine genes through RT-PCR and morphological change. RESULTS: LPS-activated macrophages returned to their inactivated original shape, i.e., they looked like naïve macrophages, through the treatment with high concentrations of cordycepin (40 microg/ml). LPS and adenosine activated macrophages also returned to their original inactivated shapes after cordycepin treatment; however, at relatively higher levels of cordycepin than adenosine. This change did not occur with relatively low concentrations of cordycepin. Adenosine down-regulated the gene expression of M1 cytokines (IL-1beta, TNF-alpha) and chemokines (CX3CR1, RANTES), as well as cordycepin. Additionally, M2 cytokines (IL-10, IL-1ra, TGF-beta) were up-regulated by both cordycepin and adenosine. CONCLUSION: Based on these observations, both cordycepin and adenosine regulated the phenotypic switch on macrophages and suggested that cordycepin and adenosine may potentially be used as immunomodulatory agents in the treatment of inflammatory disease.