Objectives: To increase the efficiency of hemodialysis, an appropriate vascular pathway must be created, and its function must be maintained. This study aimed to identify the effects of an ...arteriovenous fistula (AVF) stenosis prevention program on upper muscular strength, blood flow, physiological indexes, and self-efficacy among patients receiving hemodialysis.Methods: The participants were patients receiving hemodialysis at Keimyung University Dongsan Medical Center in Daegu, Republic of Korea. They were divided into experimental and control groups based on the day of the week they received hemodialysis at the outpatient department and included 25 participants each. The study was conducted for 8 weeks.Results: The AVF stenosis prevention program was effective in improving upper extremity muscle strength (F=15.23, p<0.001) and blood flow rate (F=36.00, p<0.001). As a result of the program, the phosphorus index level, which is a physiological indicator in hemodialysis patients, decreased (F=8.64, p<0.001). Encouragement and support through text messages and practice lists also resulted in an increase in self-efficacy (F=18.62, p<0.001).Conclusion: The AVF stenosis prevention program in this study resulted in an increase in upper extremity muscle strength through grip strength exercises and was effective in preventing AVF stenosis by increasing the blood flow rate.
Abstract Latent growth curve modeling was used to study the co-development of internalizing and externalizing problems in a sample of 2844 Korean fourth graders followed over four years. The project ...integrated two major theoretical viewpoints positing developmental mechanism: directional model and common vulnerability model. Findings suggest that (a) boys and girls follow different developmental trajectories in both domains in early adolescence; (b) bidirectional progression from initial levels of each domain to the developmental pattern of the other domain emerged among boys, while only unidirectional progression from externalizing to internalizing problem emerged among girls; and (c) all risk factors are not equally risky across domain and gender; parental violence was a common cross-domain risk factor for boys, whereas affiliation with delinquent friends was a common cross-domain risk factor for girls. Implications for future research and intervention were discussed.
Bacteria-released components can modulate host innate immune response in the absence of direct host cell-bacteria interaction. In particular, bacteria-derived outer membrane vesicles (OMVs) were ...recently shown to activate host caspase-11-mediated non-canonical inflammasome pathway
deliverance of OMV-bound lipopolysaccharide. However, further precise understanding of innate immune-modulation by bacterial OMVs remains elusive. Here, we present evidence that flagellated bacteria-released OMVs can trigger NLRC4 canonical inflammasome activation
flagellin delivery to the cytoplasm of host cells.
-derived OMVs caused a robust NLRC4-mediated caspase-1 activation and interleukin-1β secretion in macrophages in an endocytosis-dependent, but guanylate-binding protein-independent manner. Notably, OMV-associated flagellin is crucial for
OMV-induced inflammasome response. Flagellated
-released OMVs consistently promoted robust NLRC4 inflammasome activation, while non-flagellated
-released OMVs induced NLRC4-independent non-canonical inflammasome activation leading to NLRP3-mediated interleukin-1β secretion. Flagellin-deficient
OMVs caused a weak interleukin-1β production in a NLRP3-dependent manner. These findings indicate that
OMV triggers NLRC4 inflammasome activation
OMV-associated flagellin in addition to a mild induction of non-canonical inflammasome signaling
OMV-bound lipopolysaccharide. Intriguingly, flagellated
-derived OMVs induced more rapid inflammasome response than flagellin-deficient
OMV and non-flagellated
-derived OMVs. Supporting these
results,
-deficient mice showed significantly reduced interleukin-1β production after intraperitoneal challenge with
-released OMVs. Taken together, our results here propose that NLRC4 inflammasome machinery is a rapid sensor of bacterial OMV-bound flagellin as a host defense mechanism against bacterial pathogen infection.
Recently, social learning has been recognized as a means to foster adaptation to changing conditions, and more broadly, social-ecological systems resilience. However, the discussion of social ...learning and social-ecological resilience in different cultural contexts is limited. In this study we introduce the Korean Village Groves Restoration Project (VGRP) through the lens of social learning, and discuss implications of the VGRP for resilience in villages impacted by industrialization and decline of traditional forest resources. We conducted open-ended interviews with VGRP leaders, government and NGO officials, and residents in four villages in South Korea, and found that villages responded to ecosystem change in ways that could be explained by the characteristics of social learning including interaction, integration, systems orientation, and reflection. However, the processes of learning varied among the four villages, and were associated with different levels of learning and different learning outcomes related to changes in village grove management and governance. The cultural and historical context can be used to help understand social learning processes and their outcomes in the Korean cases.
Return to work is known to have a positive effect on the quality of work life of cancer survivors, including the nurse cancer survivors, along with other factors, such as workplace spirituality. The ...aim of this study was to identify the effect of workplace spirituality and its constituent concepts on the quality of work life of nurse cancer survivors.
A cross-sectional survey comprising the nursing workplace spirituality (NWS) and quality of nursing work life (QNWL) scales was completed by 130 cancer survivor nurses between October 15, 2018, and May 15, 2019, in two general hospitals in metropolitan areas, and snowball sampling was used in parallel. The data were analyzed using SPSS 22 software, determining descriptive statistics, and conducting an independent t-test, one-way ANOVA, Pearson's correlation coefficient, and hierarchical multiple regression.
The average scores for all NWS and QNWL subdomains were medium. Age, nursing tenure, and the factors of NWS were positively correlated with QNWL, especially the harmony between the workplace and the individual (r = 0.65, P < 0. 001). In the second hierarchical regression, controlling general characteristics, harmony between the workplace and the individual (β = 0.38, P ≤ 0.001), and relationship with colleagues (β = 0.19, P = 0.031) were significant predictors of QNWL explaining 59.0% of the variance. This model was found to be suitable (F = 16.29, P ≤ 0.001).
Effective and practical organizational systems and intervention programs based on organizational support, including colleagues' support for increasing the quality of work life for nurse cancer survivors, are required.
While a large body of research consistently finds that internalizing and externalizing problems are closely related and commonly co-occur, the literature is mixed regarding the unique and shared risk ...processes in the development of both domains of problems. The present study examined the nature and timing of relationships between internalizing and externalizing problems as well as the mediating effects of negative self-concept on both. Using a developmental cascade model as a guiding framework, we conducted a cross-lagged panel modeling on a sample of 2,844 Korean fourth graders (54% boys and 46% girls) followed over 4 years. Findings suggest that internalizing and externalizing problems were reciprocally reinforcing, each leading to increases in the other indirectly through the mediating influence of negative self-concept. Negative self-concept exacerbates the development of both internalizing and externalizing problems, which in turn further undermines one’s self-concept. Although there were significant gender differences in the stability of internalizing and externalizing problems, the developmental pathways between negative self-concept and both internalizing and externalizing problems held for both boys and girls. Implications for future research and intervention are discussed.
The intraoperative estimated blood loss (EBL), an essential parameter for perioperative management, has been evaluated by manually weighing blood in gauze and suction bottles, a process both ...time-consuming and labor-intensive. As the novel EBL prediction platform, we developed an automated deep learning EBL prediction model, utilizing the patch-wise crumpled state (P-W CS) of gauze images with texture analysis. The proposed algorithm was developed using animal data obtained from a porcine experiment and validated on human intraoperative data prospectively collected from 102 laparoscopic gastric cancer surgeries. The EBL prediction model involves gauze area detection and subsequent EBL regression based on the detected areas, with each stage optimized through comparative model performance evaluations. The selected gauze detection model demonstrated a sensitivity of 96.5% and a specificity of 98.0%. Based on this detection model, the performance of EBL regression stage models was compared. Comparative evaluations revealed that our P-W CS-based model outperforms others, including one reliant on convolutional neural networks and another analyzing the gauze's overall crumpled state. The P-W CS-based model achieved a mean absolute error (MAE) of 0.25 g and a mean absolute percentage error (MAPE) of 7.26% in EBL regression. Additionally, per-patient assessment yielded an MAE of 0.58 g, indicating errors < 1 g/patient. In conclusion, our algorithm provides an objective standard and streamlined approach for EBL estimation during surgery without the need for perioperative approximation and additional tasks by humans. The robust performance of the model across varied surgical conditions emphasizes its clinical potential for real-world application.
Abstract Metastatic gastric cancer (GC) presents significant clinical challenges due to its poor prognosis and limited treatment options. To address this, we conducted a targeted protein biomarker ...discovery study to identify markers predictive of metastasis in advanced GC (AGC). Serum samples from 176 AGC patients (T stage 3 or higher) were analyzed using the Olink Proteomics Target panels. Patients were retrospectively categorized into nonmetastatic, metastatic, and recurrence groups, and differential protein expression was assessed. Machine learning and gene set enrichment analysis (GSEA) methods were applied to discover biomarkers and predict prognosis. Four proteins (MUC16, CAIX, 5’-NT, and CD8A) were significantly elevated in metastatic GC patients compared to the control group. Additionally, GSEA indicated that the response to interleukin-4 and hypoxia-related pathways were enriched in metastatic patients. Random forest classification and decision-tree modeling showed that MUC16 could be a predictive marker for metastasis in GC patients. Additionally, ELISA validation confirmed elevated MUC16 levels in metastatic patients. Notably, high MUC16 levels were independently associated with metastatic progression in T3 or higher GC. These findings suggest the potential of MUC16 as a clinically relevant biomarker for identifying GC patients at high risk of metastasis.
Advancements in minimally invasive surgery has led to the development of several surgical instruments, including the ArtiSential®. This new instrument provides a greater range of motion and improved ...dexterity to laparoscopic procedures, making it an alternative option to traditional straight instruments, and the Da Vinci robot system. The purpose of this study is to compare the postoperative outcomes of a prospective cohort of patients who underwent laparoscopic gastrectomy using articulating instruments with those of a historical cohort of patients who underwent the same procedure using straight instruments. The study was designed as a prospective observational cohort study matched to a retrospective historical cohort using propensity score matching. The primary outcome was the rate of early complications within 90 days of surgery. Other outcomes included the operation time, estimated blood loss, time to first flatus, time to first soft fluid diet, hospital stay, and mortality. After propensity score matching, 41 patients were enrolled in both groups. The mean age was 62.4 ± 12.3 years in the conventional group and 63.5 ± 9.6 years in the artisential group (p = 0.647). Mean operative time was significantly shorter in the artisential group compared to the conventional group (136.1 min vs. 163.9 min, p = 0.032). The time to first soft fluid diet was also significantly shorter in the artisential group (2.2 days vs. 2.8 days, p = 0.030), but there was no significant difference in the time to first flatus and overall hospital stay. The incidence of early complications was lower in the artisential group, but the difference was not significant (24.4% vs 7.3%, p = 0.070). There was no mortality in either group. The use of articulating instruments for laparoscopic gastrectomy did not increase postoperative morbidity compared to straight laparoscopic instruments. The use of articulating instruments may be associated with faster bowel recovery and less early complications.
Computer vision has emerged as a promising tool for improving safety at construction sites through automatic scene recognition. However, traditional approaches require significant labor-intensive and ...time-consuming efforts for annotations. Although weakly supervised learning has the advantage of localizing objects without location information, the conventional class activation map (CAM) technique struggles with small and linear object localization and background noise at construction sites. For effective scene recognition related to construction safety, the spatial relationships between precisely localized objects are crucial. Due to the limitations of traditional CAM techniques in localizing small and linear objects, using CAM for construction safety monitoring remains inaccurate. Therefore, this study proposes a weakly supervised learning approach with an improved CAM for enhancing object detection in construction sites. The improved CAM localizes objects of various scales and is robust against background interference. Spatial relationships between localized objects are employed to determine the status of scenes for construction safety monitoring. Experiment using datasets associated with falls from ladders (FFL) demonstrates that the improved CAM surpasses the traditional CAM in mIoU (mean intersection over union) for the object localization performance as well as in the accuracy and F1-Score for recognizing unsafe scenes. This demonstrates the robust potential of employing CAM as a weakly supervised learning strategy, underlining its substantial feasibility for preventing hazards in construction sites. The proposed framework can minimize annotation efforts, demonstrating the potential of CAM as a viable computer vision technique for efficiently detecting hazards at construction sites.
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