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This document, published in the Journal of Neurology, discusses a case study of a 54-year-old man who presented with dizziness and oscillopsia. The patient had previously experienced a right dorsal pontine infarction and subsequent right internuclear ophthalmoplegia (INO). The examination revealed conjugate torsional ocular oscillation and palatal tremor. The patient was diagnosed with oculopalatal tremor (OPT), which is a delayed complication of damage to the dentatorubro-olivary pathway. The study suggests that torsional pendular nystagmus may occur as a delayed complication of a focal lesion affecting the central tegmental tract adjacent to the medial longitudinal fasciculus (MLF). [Extracted from the article]

Objectives: We examined whether an array of scleroderma autoantibodies associates with risk of cancer and could be useful tools for risk stratification. Methods: Scleroderma cancer cases and scleroderma controls without cancer from the Johns Hopkins Scleroderma Center and the University of Pittsburgh Scleroderma Center were studied. Sera were assayed by Lineblot and enzyme‐linked immunosorbent assay (ELISA) for autoantibodies against centromere, topoisomerase 1, RNA polymerase (POLR) 3, PM/Scl, Th/To, NOR90, U3 RNP, Ku, Ro52, U1RNP, and RNPC3. Logistic regression models were constructed to examine whether distinct autoantibodies associated with overall cancer at any time and cancer‐associated scleroderma (cancer occurring three years before and after scleroderma onset). The effects of having more than one autoantibody on cancer were further examined using random forest analysis. Results: A total of 676 cases and 687 controls were studied. After adjusting for relevant covariates, anti‐POLR3 (odds ratio [OR] 1.47, 95% confidence interval [CI] 1.03–2.11) and monospecific anti‐Ro52 (OR 2.19, 95% CI 1.29–3.74) were associated with an increased overall cancer risk, whereas anticentromere (OR 0.69, 95% CI 0.51–0.93) and anti‐U1RNP (OR 0.63, 95% CI 0.43–0.93) were associated with lower risk. When examining risk of cancer‐associated scleroderma, these immune responses remained associated with increased or decreased risk: anti‐POLR3 (OR 2.28, 95% CI 1.33–3.91), monospecific anti‐Ro52 (OR 2.58, 95% CI 1.05–6.30), anticentromere (OR 0.39, 95% CI 0.20–0.74), and anti‐U1RNP (OR 0.32, 95% CI 0.11–0.93). Anti‐Ro52 plus anti‐U1RNP or anti‐Th/To was associated with decreased cancer risk compared with anti‐Ro52 alone. Conclusions: These data suggest that five distinct scleroderma immune responses, alone or in combination, may be useful tools to stratify the risk of cancer for scleroderma patients. Further study examining cancer risk in autoantibody subgroups relative to the general population is warranted. [ABSTRACT FROM AUTHOR]

Background: Thread lifting is a common minimally invasive plastic surgery procedure. Parotid gland injury caused by thread lifting is a known complication; however, visual evidence of this complication is lacking. Objectives: This study aimed to present cases of parotid gland injury by thread lifting shown using ultrasound and to discuss the importance of ultrasound detection of the location of the parotid gland before thread insertion. Methods: This study included eight patients diagnosed with parotid gland perforation and one with parotid duct injury due to threads from November 2020 to October 2022. Results: Six patients showed tenderness and swelling, three were asymptomatic, and one with duct injury showed severe swelling and pain. Although the severity and duration of symptoms have differed, we confirmed the progress of improvement with conservative treatment and confirmed ultrasound findings progressed. Conclusions: Using ultrasound to detect the parotid gland's location before thread lifting might reduce the chance of parotid duct injury. Identifying immediate parotid duct or gland injury with ultrasound can help to act quickly for delayed pain or swelling and reduce the likelihood of additional complications. [ABSTRACT FROM AUTHOR]

Aim: The aim of this study is to examine nursing students' experiences of alternative and nonstandard practicum methods used during the Coronavirus Disease 19 (COVID‐19) pandemic and the associations between these experiences and nursing students' anxiety with clinical decision‐making. Background: Nursing students experiencing alternative clinical practice methods during the COVID19 pandemic have expressed regrets about being unable to experience direct nursing care and doubts about their clinical decision‐making in actual clinical settings as a nurse in the future. Methods: Online surveys were distributed to 239 third‐year nursing students through a link in an email. Data were collected from December 2020 to January 2021. Results: Approximately 80% of participants in the Fall 2020 semester experienced an alternative clinical practice method. The extent of time spent experiencing alternative clinical practice methods and satisfaction with the clinical practicum were associated with anxiety about clinical decision‐making. Conclusions: Although the pandemic continues, nursing students' clinical practice is needed in a clinical setting as much as possible to reduce the anxiety about clinical decision‐making. During the pandemic, clinical nurse educators and clinical managers should work and communicate more closely to facilitate the students' clinical practice. Summary statement: What is already known about this topic? Nursing education has experienced challenges by effectively conducting nursing programmes while responding to the pandemic.In situations where the COVID‐19 pandemic was prolonged, many nursing clinical practicums were replaced with alternative and nonstandard methods.Empirical evidence of the relationship between alternative clinical practice methods and clinical decision‐making in nursing students is lacking. What this paper adds? Satisfaction with clinical practicums was associated with students' anxiety regarding clinical decision‐making during the COVID‐19 pandemic.The extent of time experiencing alternative clinical practice methods during the pandemic was positively associated with nursing students' anxiety with clinical decision‐making. The implications of this paper: Nurse educators should be aware of the extent to which nursing students' experiences of alternative clinical practice methods experience might be associated with anxiety about clinical decision‐making.Clinical nurse educators need to work in close cooperation with clinical managers to ensure that nursing students' clinical practice is as normal as possible during a pandemic to reduce their anxiety about clinical decision‐making. [ABSTRACT FROM AUTHOR]

Organ shortage for transplantation is a global problem for both adult and pediatric recipients and this is particularly apparent in certain areas of the world and within specific communities. Cultural and religious beliefs can influence both a decision by a potential donor and/or their family to donate as well as a potential recipient's or their family's decision to accept the need for transplantation, agree to be listed and accept an organ. Globally, there are cultural and religious diversities that can present significant challenges for the transplant professional, particularly those whose practice is based in multicultural communities. In the pediatric population, in particular, barriers to organ transplantation related to culture and religion have not been well‐described, with resulting implications for how they should or could be effectively addressed. Therefore, this review was undertaken to elucidate cultural and religious barriers to pediatric organ transplantation and, where feasible, to identify facilitators and strategies for overcoming these barriers. [ABSTRACT FROM AUTHOR]

Differentiation of spinocerebellar ataxia type 17 (SCA17) from Huntington's disease (HD) is often challenging since they share the clinical features of chorea, parkinsonism, and dystonia. The ocular motor findings remain to be elucidated in SCA17, and may help differentiating SCA17 from HD. We retrospectively compared the ocular motor findings of 11 patients with SCA17 with those of 10 patients with HD. In SCA17, abnormal ocular motor findings included impaired smooth pursuit (9/11, 82%), dysmetric saccades (9/11, 82%), central positional nystagmus (CPN, 7/11, 64%), abnormal head-impulse tests (4/11, 36%), and horizontal gaze-evoked nystagmus (GEN, 3/11, 27%). Among these, CPN was more frequently observed in SCA17 than in HD (7/11 (64%) vs. 0/10 (0%), p = 0.004) while saccadic slowing was more frequently observed in HD than in SCA17 (8/10 (80%) vs. 2/11 (18%), p = 0.009). Of six patients with follow-up evaluation, five later developed bilateral saccadic hypermetria (n = 4), GEN (n = 1), CPN (n = 1), bilaterally abnormal smooth pursuit (n = 1), and hyperactive head-impulse responses (n = 1) along with a clinical decline. Ocular motor abnormalities can be utilized as a diagnostic marker for differentiation of SCA17 from HD as well as a surrogate marker for clinical decline in SCA17. [ABSTRACT FROM AUTHOR]

Chemotherapy is used for childhood cancer but may lead to infertility in patients. Spermatogonia stem cells are present in the testes of prepubertal boys, although they do not produce sperm at this age. Herein, we evaluated the toxicity of cisplatin, a known medicine for cancer treatment, in neonatal mouse testes using in vitro organ culture. Mouse testicular fragments (MTFs) derived from 5.5-d postpartum mouse testes were exposed to 1–10 μg/mL cisplatin. The results showed that cisplatin significantly downregulated the expression of germ cell marker genes, including differentiated and undifferentiated, in a dose-dependent manner. In particular, a high dose of cisplatin (10 μg/mL) led to germ cell depletion. In addition, the expression levels of the Sertoli cell marker gene, the number of SOX9+ Sertoli cells, and the levels of SOX9 protein were markedly decreased in cisplatin-treated MTFs compared to controls. The mRNA expression of steroidogenic enzyme-related genes significantly increased in cisplatin-treated MTFs, except for estrogen receptor 1 (Esr1). Consistently, 3β-hydroxysteroid dehydrogenase protein was also observed in the interstitial regions of cisplatin-treated MTFs. Altogether, our findings showed a significant impairment in germ cell development, Sertoli cell survival, and steroidogenesis in the MTFs of cisplatin-treated mice. [ABSTRACT FROM AUTHOR]

Aims: This study investigated emergency nurses' attitudes and perceptions about personal protective equipment and their association with the willingness to care for COVID‐19 patients. Background: Emergency nurses are at increased risk for COVID‐19 infection as frontline workers and must wear personal protective equipment while attending suspected and confirmed COVID‐19 patients. Methods: In September 2021, 188 nurses in four emergency departments completed online questionnaires. Results: Multivariable logistic regression demonstrated that as perceptions of COVID‐19 infection risk increased by 1 point, 26% of nurses were willing to care of COVID‐19 patients. The willingness to care for COVID‐19 patients increased in their attitudes by 1.16 point and perceptions by 1.08 points about PPE. Conclusions: Perceptions of the risk of infection exposure and confidence in safety of personal protective equipment are associated with nurses' willingness to care for COVID‐19 patients. Implications for Nursing Management: Nurse managers need to assess nurses' needs for safety and provide a supportive climate to mitigate their concerns regarding infection risk and encourage nurses' willingness to care for patients. Nurse managers should provide precise guidelines on correct personal protective equipment use. Repetitive training on personal protective equipment should be provided to encourage nurses' adaptation to its use. [ABSTRACT FROM AUTHOR]

JIB-04, a pan-histone lysine demethylase (KDM) inhibitor, targets drug-resistant cells, along with colorectal cancer stem cells (CSCs), which are crucial for cancer recurrence and metastasis. Despite the advances in CSC biology, the effect of JIB-04 on liver CSCs (LCSCs) and the malignancy of hepatocellular carcinoma (HCC) has not been elucidated yet. Here, we showed that JIB-04 targeted KDMs, leading to the growth inhibition and cell cycle arrest of HCC, and abolished the viability of LCSCs. JIB-04 significantly attenuated CSC tumorsphere formation, growth, relapse, migration, and invasion in vitro. Among KDMs, the deficiency of KDM4B, KDM4D, and KDM6B reduced the viability of the tumorspheres, suggesting their roles in the function of LCSCs. RNA sequencing revealed that JIB-04 affected various cancer-related pathways, especially the PI3K/AKT pathway, which is crucial for HCC malignancy and the maintenance of LCSCs. Our results revealed KDM6B-dependent AKT2 expression and the downregulation of E2F-regulated genes via JIB-04-induced inhibition of the AKT2/FOXO3a/p21/RB axis. A ChIP assay demonstrated JIB-04-induced reduction in H3K27me3 at the AKT2 promoter and the enrichment of KDM6B within this promoter. Overall, our results strongly suggest that the inhibitory effect of JIB-04 on HCC malignancy and the maintenance of LCSCs is mediated via targeting the KDM6B-AKT2 pathway, indicating the therapeutic potential of JIB-04. [ABSTRACT FROM AUTHOR]

This paper presents diagnostic criteria for vascular vertigo and dizziness as formulated by the Committee for the Classification of Vestibular Disorders of the Bárány Society. The classification includes vertigo/dizziness due to stroke or transient ischemic attack as well as isolated labyrinthine infarction/hemorrhage, and vertebral artery compression syndrome. Vertigo and dizziness are among the most common symptoms of posterior circulation strokes. Vascular vertigo/dizziness may be acute and prolonged (≥24 hours) or transient (minutes to < 24 hours). Vascular vertigo/dizziness should be considered in patients who present with acute vestibular symptoms and additional central neurological symptoms and signs, including central HINTS signs (normal head-impulse test, direction-changing gaze-evoked nystagmus, or pronounced skew deviation), particularly in the presence of vascular risk factors. Isolated labyrinthine infarction does not have a confirmatory test, but should be considered in individuals at increased risk of stroke and can be presumed in cases of acute unilateral vestibular loss if accompanied or followed within 30 days by an ischemic stroke in the anterior inferior cerebellar artery territory. For diagnosis of vertebral artery compression syndrome, typical symptoms and signs in combination with imaging or sonographic documentation of vascular compromise are required. [ABSTRACT FROM AUTHOR]

Background: Transcatheter arterial chemoembolization (TACE) via the inferior phrenic artery has been recognized to have its own therapeutic role without causing serious procedural complications. We report a case of diaphragmatic perforation after repeated TACE sessions conducted via the right inferior phrenic artery.Case Presentation: A 43-year-old man diagnosed with hepatocellular carcinoma was admitted to the hospital with a chief complaint of cough. The patient underwent TACE via the right inferior phrenic artery 3 months prior and was discharged without specific complications. Physical examination revealed decreased breathing sounds in the right lower lung zone. Chest radiograph demonstrated a small right pleural effusion. Chest CT scan revealed a small diaphragmatic perforation. The patient was unable to undergo surgical exploration, and a follow-up CT scan after 2 months revealed progression of the right diaphragmatic perforation with massive herniation of omental fat into the thoracic cavity.Conclusions: Although TACE via the inferior phrenic artery is a relatively safe procedure, it can be associated with rare but serious complications after repeated procedures. This is a rare case report of diaphragmatic perforation after TACE via the right inferior phrenic artery. Early recognition and prompt surgical management are essential to prevent catastrophic outcomes. [ABSTRACT FROM AUTHOR]

The present study was conducted to investigate recent trends of refractive surgery rates and analyze subjects undergoing refractive surgery using large-scale population studies over the past 8 years. We used the dataset of the Korean National Health and Nutrition Examination Surveys, a nationwide population-based cross-sectional study which were performed from 2008 to 2015. Of the 21,415 participants aged 20 to 49 years, 1,621 had refractive surgeries. Seventy three percent of them were females and 81% of them were aged under 40 years old. Over the past 8 years, cumulative prevalence of refractive surgery rate increased more than 10%. Although young (< 40 years, odds ratio (OR) 0.31, P<0.001) women (OR 1.86, P<0.001) living in urban areas (OR 0.51, P<0.001) with high educational attainment (OR 2.67, P<0.001) and income levels (OR 3.16, P<0.001) accounted for a high proportion in refractive surgery group through all survey years, subgroup analyses revealed that gaps between genders (ORs 3.8 in 2008–2009, 2.1 in 2010–2012, and 1.5 in 2013–2015), educational level (ORs 3.0, 2.5, and 2.1, respectively), and highest/lowest quartiles of household income (ORs 5.2, 2.6, and 2.4, respectively) were decreasing over time. Overall, our study suggests that refractive surgery has reached an age where the majority accepts it, and indeed more and diverse people are undergoing refractive surgeries. [ABSTRACT FROM AUTHOR]

Background: Scleroderma is a serious chronic autoimmune disease in which a patient's disease state manifests in several irregularly spaced longitudinal measures of lung, heart, skin, and other organ systems. Threshold crossings of pulmonary and cardiac measures indicate potentially life-threatening key clinical events including interstitial lung disease (ILD), cardiomyopathy, and pulmonary hypertension (PH). The statistical challenge is to accurately and precisely predict these events by using all of the clinical history for the patient at hand and for a reference population of patients.Methods: We use a Bayesian mixed model approach to simultaneously characterize each individual's future trajectories for several biomarkers. We estimate this model using a large population of patients from the Johns Hopkins Scleroderma Center Research Registry. The joint probabilities of critical lung and heart events are then calculated as a byproduct of the mixed model.Results: The performance of this approach is substantially better than standard, more common alternatives. In order to predict an individual's risks in a clinical setting, we also develop a cross-validated, sequential prediction (CVSP) algorithm. As additional data are observed during a patient's visit, the algorithm sequentially produces updated predictions for the future longitudinal trajectories and for ILD, cardiomyopathy, and PH. The updated prediction distributions with little additional computing, for example within an electronic health record (EHR).Conclusions: This method that generates real-time personalized risk estimates has been implemented within the electronic health record system for clinical testing. To our knowledge, this work represents the first approach to compute personalized risk estimates for multiple scleroderma complications. [ABSTRACT FROM AUTHOR]

To investigate the visual/anatomical outcome of diabetic macular edema (DME) patients lost to follow-up (LTFU) for more than 1 year during intravitreal anti-VEGF treatment. A retrospective review of 182 treatment-naïve DME patients was performed. Among them, we identified patients LTFU for more than 1 year during anti-VEGF treatment. Visual acuity and anatomic outcomes at the first visit, last visit before being LTFU, return visit, and after re-treatment were analyzed and compared with those of DME patients with regular follow-up. Patients who had continuous follow-up visits were assigned to the control group. Sixty patients (33%) with DME were LTFU for more than 1 year during anti-VEGF treatment. Multivariate analysis revealed that the ratio of male (p = 0.004), diabetes mellitus (DM) duration less than 5 years (p = 0.015), and poor early anatomic response (p = 0.012) were higher compared to the control group. Eighteen patients returned to the clinic and received re-treatment. After re-treatment with anti-VEGF, central subfield thickness (CST) was significantly improved to the CST of before LTFU. However, visual acuity did not recover to the level before LTFU (0.63 ± 0.26 vs. 0.45 ± 0.28, p = 0.003). About thirty percent of DME patients were LTFU for more than 1 year. Permanent visual loss was observed in these LTFU patients. Patients with a high risk of LTFU such as male, early DM, and poor response after initial injections should be treated more aggressively to improve the visual outcomes. [ABSTRACT FROM AUTHOR]

Introduction: The association between hemoglobin (Hb) level including anemia and fracture has not been studied thoroughly. Materials and methods: 197, 187 adults ≥ 50 years from the National Health Insurance Service of Korea were studied. Hb was determined during health screening examinations in 2004 or 2005. From 1 January 2006, participants were followed up for fracture until 31 December 2013. Hb levels (g/dL) were categorized into five groups, with normal hemoglobin levels subdivided into three groups (low normal, normal, and high normal Hb): < 13, ≥ 13 to < 14, ≥ 14 to < 16, ≥ 16 to < 17, 17 for men and < 12, ≥ 12 to < 13, ≥ 13 to < 14, ≥ 14 to < 16, ≥ 16 for women. Anemia was defined as Hb < 13 g/dL and < 12 g/dL for men and women, respectively. Cox proportional hazards regression was used to determine the adjusted hazard ratios (aHRs) and 95% confidence intervals (CIs) for fracture according to Hb. Results: Compared to individuals with normal Hb, those with anemia and low normal Hb were associated with significantly increased risk of fracture. In women, those with anemia had a higher risk for any (aHR 1.11, 95% CI 1.05–1.17), hip (aHR 1.27, 95% CI 1.01–1.59), and radius fracture (aHR 1.15, 95% CI 1.05–1.25). In men, those with anemia had a higher risk for any (aHR 1.37, 95% CI 1.23–1.51), vertebral (aHR 1.33, 95% CI 1.15–1.53), and hip fracture (aHR 1.64, 95% CI 1.30–2.08). This risk-enhancing association was preserved among various subgroups. Conclusion: Among adults ≥ 50 years, anemia and low normal Hb are risk factors for fracture. [ABSTRACT FROM AUTHOR]

The study aimed to identify the predictors of response to selective serotonin reuptake inhibitors (SSRIs) for 12 weeks in patients with persistent postural–perceptual dizziness (PPPD). Short-term treatment responses were studied in 197 outpatients [127 (64.5%) women, mean age ± SD = 51.7 ± 15.9] diagnosed with PPPD. Clinical and self-rated assessments were analyzed at the baseline and at the end of pharmacotherapy for 12 weeks. Multivariable logistic regression analysis was used to determine the following variables as the potential predictors of treatment response as measured by scoring in clinical global impression-improvement scale (CGI-I) scores: age, sex, comorbidity, baseline CGI-S score, Beck Depression Inventory–II score, State-Trait Anxiety Inventory score, Dizziness Handicap Inventory score at the baseline, and prescribed doses of antidepressants or benzodiazepines. The overall response rate to pharmacotherapy was 65.0% (128/197). Female sex and greater disease severity at the baseline (higher CGI-S score) were associated with a better response to the pharmacotherapy. Subgroup analyses by sex identified younger age and lower anxiety as the indicators for better outcomes in men, and absence of comorbidities in women. During the initial assessment, the severity of PPPD was associated with depressive symptoms and subjective functional handicap due to dizziness. The response to pharmacotherapy is favorable in PPPD. Sex, age and initial disease severity are the predictors of the response to SSRIs in patients with PPPD. [ABSTRACT FROM AUTHOR]

Aims and objectives: To examine transition shock in newly licensed nurses and the association of work environment and resilience with nurses' transition shock. Background: Although work environment is related to transition shock in newly licensed nurses, little is known about the factors of nursing work environment associated with transition shock. Furthermore, resilience is known to help nurses positively face workplace challenges; however, there is little evidence on the associations between resilience and transition shock in new nurses. Design: A cross‐sectional, descriptive study. Methods: Data from 163 new nurses with <12 months of work experience in the current hospital since graduation were analysed. Participants' characteristics, work environment, nurse resilience and transition shock were self‐reported. Multivariable linear regressions were performed in three steps (following the STROBE checklist). Results: The highest mean score of transition shock was obtained for the item 'I perceive the limitations of my professional knowledge in nursing care'. In the regression analysis adjusted for all variables, two factors of work environment—'nurse staffing and resource adequacy' and 'collegial nurse‐physician relationships'—were associated with transition shock. Meanwhile, resilience was not related to transition shock. Conclusions: The gap between newly licensed nurses' theoretical and practical knowledge continues to exist. Adequate nurse staffing and a positive relationship with physicians, rather than nurse resilience, were more likely to associate with new nurses' transition shock. Relevance to clinical practice: Hospitals need to provide ward‐based simulations and case‐based learning methods to enhance nurses' transition to professional practice. For nurses' transition, hospitals should make efforts to provide adequate nurse staffing and resources. Furthermore, hospitals should provide communication opportunities to build a positive collaborative culture between nurses and physicians. Unit nurse managers need to assess newly licensed nurses' perception of nurse–physician professional relationship and create an atmosphere of respect and understanding for each other. [ABSTRACT FROM AUTHOR]

Aims: This study aimed to identify the nursing stress factors, which affect turnover intention in hospital nurses. Background: Nursing stress is known to be an important predictor of turnover intention in nurses. Although nurses experience various sources of stress across work environments, cultures, and generations, little is known about the stress factors affecting turnover intention in nurses. Design A descriptive cross‐sectional design was employed. Methods: A total of 329 nurses were recruited through convenience sampling from 27 hospitals in South Korea. Data were collected from May to November 2018 using a questionnaire. Results: Among the stress factors, stress from patients and their families, workload stress, stress from conflicts with supervisors, and stress from conflicts with peers were associated with turnover intention in hospital nurses. These variables explained 40.0% of the variance in turnover intention among hospital nurses. Conclusions: Stress from interpersonal relationships with patients and their families, supervisors, and peers may have a considerable impact on turnover intention. To reduce nursing turnover intention, coping strategies to reduce stress from patients and their families should be established. It is necessary to provide programmes that foster interpersonal relationship skills in the workplace. Nurse managers may encourage communication among nurses to establish positive relationships. SUMMARY STATEMENT: What is already known about the topic? Nurses' turnover continues to remain a challenging issue across work environments, cultures, and generations.Nursing stress has a great impact on turnover intention in hospital nurses. However, little is known about the stress factors that affect turnover intention in nurses. What this paper adds? Among the nursing stress factors, stress from patients and families had a strong effect on turnover intention in hospital nurses, followed by stress from workload, conflicts with supervisors, and conflicts with peers. The implications of this paper: Our findings suggest that stress from interpersonal relationships might have a considerable impact on turnover intention.Coping strategies to reduce stress from patients and family need to be first established to reduce the turnover intention in hospital nurses.Nurse managers should be aware of the effects of interpersonal relationships on turnover intention and encourage communication among nurses to establish positive relationships. [ABSTRACT FROM AUTHOR]

This study examined the relationships among family socioeconomic status, parental attention, and health behaviors in children during middle childhood. For this descriptive cross‐sectional study, six elementary schools in a metropolitan city in South Korea were selected for recruitment. We surveyed 857 elementary school students aged 8 to 10 years by using self‐report questionnaires. A hierarchical multilinear regression analysis found that family socioeconomic status positively related to children's health behaviors and that parental attention had a moderating effect on this relationship. These results suggest that family socioeconomic status influences health behaviors from the child's perspective. The influence of family socioeconomic status on children's health behaviors might be weakened by parental attention. Healthcare providers should be aware of children's health behaviors and focus interventions on families with low socioeconomic status. Nurses should emphasize to parents that parental supervision and monitoring might benefit their children and improve their health behaviors. [ABSTRACT FROM AUTHOR]

Evolution of vestibular function requires further elucidation in spinocerebellar ataxia (SCA). This study aimed to determine temporal evolution in the findings of head impulse tests (HITs) in SCA type 6 (SCA6). We serially evaluated HITs in 12 patients with SCA6 using video-oculography for 3 months to 5 years [median = 12 months, interquartile range (IQR) = 9–50] at two university hospitals in South Korea. Patients (8/12, 67%) usually showed abnormal responses at least for one semicircular canal during video-HITs. The gains of the vestibulo-ocular reflex (VOR) for the anterior canals (ACs) were larger than those for the posterior canals (PCs, p = 0.005) at initial presentation. During the follow-up, the VOR gains decreased for the horizontal canals (HCs, p = 0.008) and ACs (p = 0.021), but those for the PCs remained unchanged (p = 0.212). Perverted HITs were observed in seven patients (7/12, 58%). The differences in the head impulse VOR gains were larger between the ACs and PCs (ΔACs − PCs) in those with perverted HITs than in those without (p = 0.003). The gains for each semicircular canal showed a negative correlation with the Scale for the Assessment and Rating of Ataxia (HCs, Spearman's coefficient = − 0.675, p = 0.003; ACs, − 0.637, p = 0.006; PCs, − 0.605, p = 0.010). The head impulse gain of the VOR may serve a marker for clinical decline in SCA6. The dissociation in the temporal evolution of the VOR gain indicates dissimilar cerebellar modulation of the vestibular signals from each semicircular canal. [ABSTRACT FROM AUTHOR]

The present work investigates the notch radius effect on fracture resistance using the finite element (FE) damage analysis based on the multiaxial fracture strain model. The damage model was determined from experimental data of notched bar tensile and fracture toughness test data using a sharp‐cracked compact tension specimen. Then, the FE damage analysis was applied to simulate fracture resistance tests of SM490A carbon steel specimens with different notch radii. Comparison of simulated results with experimental data showed good agreement. Further simulation was then performed to see effects of the specimen size, thickness, and side groove on J‐R curves for different notch radii. It was found that effects of the specimen size and thickness became more pronounced for the larger notch radius. Furthermore, it was found that without side groove, tearing modulus for notched specimens was similar to that for cracked specimens, regardless of the notch radius. [ABSTRACT FROM AUTHOR]

Purpose: This study aimed to examine the associations among emotional labor strategies, stress from emotional labor, and burnout in nurses. Design: We employed a descriptive cross‐sectional design. Data were collected from May to November 2018 in South Korea using structured questionnaires. Participants were 303 nurses from 27 hospitals, who were recruited by convenience sampling. Methods: Emotional labor strategies (surface acting, deep acting, and expression of naturally felt emotions), stress, and burnout were self‐reported. A path analysis using structural equation modeling was performed to examine the associations among the study variables. Findings: Bivariate analyses revealed that surface acting was positively correlated with stress and burnout, deep acting was negatively correlated with burnout, and naturally felt emotions were negatively correlated with stress and burnout. The path analysis revealed that surface acting was positively associated with stress, naturally felt emotions were negatively associated with burnout, and the stress from emotional labor was positively associated with burnout. Although surface acting was not directly associated with burnout, it was indirectly associated through stress. Conclusions: Surface acting involves regulation and suppression of one's felt emotions. The findings of this study suggest that hospitals need to reduce expectations for surface acting to reduce nurses' stress and burnout. Organizational efforts to provide interventions that improve nurses' ability to manage their emotions in interactions with patients might effectively foster nurses' well‐being. Clinical Relevance: Surface acting might contribute to nurses' burnout, and naturally felt emotions might reduce nurses' burnout. Nurse managers should thus provide opportunities to discuss the utilized emotional labor strategies and encourage appropriate responses depending on the patient context. Programs that promote emotional competence may reduce the adverse effects associated with nurses' emotional labor and foster effective coping strategies. [ABSTRACT FROM AUTHOR]

Purpose: To investigate the changes in the near reading speed after panretinal photocoagulation (PRP) in diabetic retinopathy patients. Methods: This non-randomized, prospective, clinical study enrolled diabetic retinopathy patients who underwent PRP from January 2016 to June 2017. The near reading speed was measured before and 1 week, 1 month, and 4 months after PRP by using an iPad application for the assessment of reading speed; near best-corrected visual acuity (BCVA) and subfoveal choroidal thickness (SFCT) were also analyzed. The reading speed of age-matched healthy individuals was compared with that of diabetic retinopathy patients. Results: Forty-seven patients were enrolled in this study. The baseline near reading speed of diabetic retinopathy patients was significantly slower than that of age-matched healthy controls. The near reading speed was reduced at 1 week after PRP, but recovered at 1 and 4 months after PRP. Near BCVA showed a similar pattern after PRP. SFCT increased at 1 week after PRP and significantly decreased at both 1 and 4 months after PRP. Conclusion: The near reading speed of diabetic patients was significantly slower than that of age-matched healthy controls. The speed was temporarily reduced at 1 week after PRP, potentially due to short-term impairment of parasympathetic nerve innervation. [ABSTRACT FROM AUTHOR]

Background: Soft tissue filler injection is a common procedure for augmentation rhinoplasty. Various techniques for augmenting the nasal dorsum using a soft tissue filler have been attempted considering the size of the needle, the anatomical layer where the filler is injected, and the vascular distribution. The purpose of this paper was to evaluate the course of the dorsal nasal artery in patients scheduled for nasal augmentation using a soft tissue filler and to propose a method of nasal augmentation that minimizes vessel damage during soft tissue filler injection by confirming the distribution pattern of blood vessels through ultrasound. Methods: Patients underwent augmentation rhinoplasty using a soft tissue filler. All patients underwent ultrasound examination before the filler injections. Results: From July to September 2018, ultrasound studies were conducted before augmentation rhinoplasty in 50 consecutive patients. Forty patients (80%) had a well‐known lateral arterial pathway, while in 10 patients (20%), the dorsal nasal artery was found at the midline of the nose. In four cases (8%), the artery travelled just beneath the preperiosteal layer, which is under the nasalis muscle. Additionally, in seven cases (14%), the dorsal nasal artery coursed superficially, just beneath the subdermal layer. Conclusion: Injecting the filler into the preperiosteal layer either via a needle or cannula is considered relatively safe but there remains the possibility of vascular compromise. Using a large diameter cannula and injecting the filler into the preperiosteal layer using a gentle approach may be the safest approach. [ABSTRACT FROM AUTHOR]

Discriminating strokes in patients with acute dizziness/vertigo is challenging especially when other symptoms and signs of central nervous involvements are not evident. Despite the developments in imaging technology over the decades, a significant proportion of acute strokes may escape detection on imaging especially during the acute phase or when the lesions are small. Thus, small strokes causing isolated dizziness/vertigo would have a higher chance of misdiagnosis in the emergency department. Even though several diagnostic algorithms have been advanced for acute vascular vertigo, we still await more comprehensive and sophisticated ones that can also be applied to transient vestibular symptoms due to vascular compromise. In this respect, vascular and perfusion imaging would be informative. Application of artificial intelligence and tele-consultation may be future perspectives for real-time decision in acute dizziness and vertigo. Several new constellations of ocular motor and vestibular findings have been added to the strokes involving the brainstem and cerebellum. Defining these characteristics would help understanding the function of central vestibular structures and allow more accurate localization of the strokes involving these structures. [ABSTRACT FROM AUTHOR]

Opsoclonus–myoclonus syndrome in adults is a rare and heterogeneous disorder with the clinical features of opsoclonus, myoclonus, ataxia, and behavioral and sleep disturbances. The pathophysiology is thought to be immunological on the basis of paraneoplastic or infectious etiologies. Immunomodulatory therapies should be performed although the response may be incomplete. A number of autoantibodies have been identified against a variety of antigens, but no diagnostic immunological marker has yet been identified. This review focuses on underlying mechanisms of opsoclonus–myoclonus syndrome, including findings that have been identified recently, and provides an update on the clinical features and treatments of this condition. [ABSTRACT FROM AUTHOR]

Aim: This study aimed to explore the association between paediatric nursing‐sensitive outcomes and nurse staffing levels. Background: Although previous studies have reported an association between low nursing‐sensitive outcomes and high nurse staffing levels in adult populations, there are few studies on paediatric nursing‐sensitive outcomes. Methods: This study used electronic Health insurance review and assessment data for all children under 18 years old admitted at 46 tertiary hospitals in Korea between 2013 and 2014. Multiple logistic regression was used to examine relationships among nurse staffing levels and 11 paediatric nursing‐sensitive outcomes. Results: Nurse staffing levels had a clear relationship with the occurrence of lower respiratory tract infection and gastrointestinal infection. Five paediatric nursing‐sensitive outcomes (pneumonia, sepsis, arrest / shock / respiratory failure, wound infection and postoperative cardiopulmonary complication) showed weak relationships with nurse staffing levels. Pressure ulcers and failure to rescue had the lowest incidences in hospitals with the lowest nurse staffing levels. Conclusions: We demonstrated evidence for the relationships of nurse staffing levels with seven paediatric nursing‐sensitive outcomes. Implications for Nursing Management: For quality paediatric nursing care, nurse staffing improvement is required. The study results could be useful evidence for appropriateness of nursing staffing in paediatric facilities. [ABSTRACT FROM AUTHOR]

Background: To promote child development, parenting stress, and maternal–child interactions among mothers of various nationalities must be understood. The purpose of this study was to investigate maternal–child interactions according to the mother’s nationality among married immigrant mothers from the Philippines, Vietnam, and Korea. Method: This study employed a descriptive, cross-sectional design. Inclusion criteria were mothers who had children of preschool age. Results: A total of 348 mothers were interviewed: 142 Korean mothers, 84 immigrant mothers from the Philippines, and 122 immigrant mothers from Vietnam. Parenting stress (p < .001) and maternal–child interactions (p = .023) differed according to the mother’s nationality. Conclusions: By delineating the nurturing characteristics of each country, the results of this study can help immigrant mothers develop maternal–child relationships that aid culturally congruent adjustment to their new culture. Implications for practice: The characteristics of maternal–child interactions according to the mother’s nationality may inform parent education in multicultural societies. [ABSTRACT FROM AUTHOR]

To investigate oxidative stress responses to cadmium and lead, the freshwater water flea Daphnia magna was exposed to Cd and Pb for 48 h. Following treatment with sub-lethal concentrations, intracellular reactive oxygen species (ROS) levels, as well as modulation of multiple biomarker, such as superoxide dismutase (SOD) activity, glutathione (GSH) contents, glutathione S -transferase (GST) activity, antioxidant enzyme - coding genes (three GST isoforms, glutaredoxin [ GRx ], glutathione peroxidase [ GPx ], and thioredoxin [ TRx ]), and stress-response proteins (heat shock protein 70 [Hsp70] and Hsp90) were examined. The results showed that intracellular ROS level was not changed at 24 h, but reduced at 48 h. Levels of total GSH content were reduced by Cd, but highly induced by Pb. SOD and GST activities were stimulated 48 h after exposure to Cd and Pb. A significant modulation of oxidative stress marker genes was observed after exposure to each element with different expression patterns depending on the metal and developmental stages. In particular, the expression levels of GST-sigma , HSP70, and HSP90 genes were enhanced in Cd - and Pb - exposed neonates. These findings imply that oxidative stress markers appear to be actively involved in cellular protection against metal-induced oxidative stress in D. magna . This study would facilitate the understanding of the molecular response to Cd and Pb exposure in water fleas. [ABSTRACT FROM AUTHOR]

The superoxide dismutase (SOD) family is a first line antioxidant enzyme group involved in transformation of the superoxide anion (O 2 − ) into hydrogen peroxide (H 2 O 2 ) and O 2 . SOD gene expression patterns and enzyme activities therefore have a role as molecular biomarkers in evaluating the oxidative stress status of aquatic organisms. However, antioxidant enzyme systems are yet to be fully explored in the marine ciliates. In this study, we identified and characterized two types of Cu/Zn SODs (Ec-Cu/ZnSOD1 and Ec-Cu/ZnSOD2) and Ec-Mn SOD in the marine ciliate Euplotes crassus . Subsequently, SOD activity and transcriptional modulation of the relevant genes were investigated after the exposure to Cd and Cu for 8 h. All Ec-SODs showed conserved domains and metal binding sites on their active sites. Total SOD activity was induced at 1 h after exposure to Cd (125 and 1000 μg/L), and showed a marginal increase at 1-h exposure to Cu (10 and 100 μg/L). However, SOD activity was maintained at a steady level under Cd and decreased under Cu exposure conditions at 3 h and 8 h. mRNA expression of both the Ec-Cu/Zn-SOD s and Mn-SOD were remarkably elevated after the exposure to Cd (250–1000 μg/L, maximum 4-fold, p  < 0.05) and, in particular, Cu (25–100 μg/L, maximum > 20-fold, p <  0.05), in a concentration – dependent manner. These findings suggest that Ec-SODs may be actively involved in cellular protection against metal – mediated oxidative stress. This study is therefore helpful in understanding the molecular responses for metal toxicity in the ciliates. [ABSTRACT FROM AUTHOR]

Aims and objectives: To identify the relationship between emergency nurses’ intention to leave the hospital and their coping methods following workplace violence. Background: Emergency departments report a high prevalence of workplace violence, with nurses being at particular risk of violence from patients and patients’ relatives. Violence negatively influences nurses’ personal and professional lives and increases their turnover. Design: This is a cross‐sectional, descriptive survey study. Methods: Participants were nurses (n = 214) with over one year of experience of working in an emergency department. We measured workplace violence, coping after workplace violence experiences and job satisfaction using scales validated through a preliminary survey. Questionnaires were distributed to all nurses who signed informed consent forms. Multiple logistic regression analysis was used to identify the relationships between nurses’ intention to leave the hospital and their coping methods after workplace violence. Results: Verbal abuse was the most frequent violence experience and more often originated from patients’ relatives than from patients. Of the nurses who experienced violence, 61.0% considered leaving the hospital. As for coping, nurses who employed problem‐focused coping most frequently sought to identify the problems that cause violence, while nurses who employed emotion‐focused coping primarily attempted to endure the situation. The multiple logistic regression analysis revealed that female sex, emotion‐focused coping and job satisfaction were significantly related to emergency nurses’ intention to leave. Conclusions: Emotion‐focused coping seems to have a stronger effect on intention to leave after experiencing violence than does job satisfaction. Relevance to clinical practice: Nurse managers should begin providing emergency nurses with useful information to guide their management of violence experiences. Nurse managers should also encourage nurses to report violent experiences to the administrative department rather than resorting to emotion‐focused coping. Nurses should be provided with the opportunity to communicate their feelings to their colleagues. [ABSTRACT FROM AUTHOR]

The article describes the case of a 61-year-old man who developed a cerebellar dysembryoplastic neuroepithelial tumor. The patient suffered from non-whirling dizziness for six months. He also exhibited gaze-evoked and rebound nystagmus. Magnetic resonance images showed an exophytic mass with a bubbly appearance involving the anterior aspect of the left lower cerebellum with perilesional edema in the left pontomedullary junction and middle cerebellar peduncle.

The objectives of this study is to compare the efficacy between repetition of Epley maneuver and switch to alternate Semont maneuver in treating posterior canal benign paroxysmal positional vertigo (PC-BPPV) that does not respond to the initial Epley maneuver. In the nationwide, seven dizziness clinics of Korea, 506 consecutive patients (303 women, age range 22-87, mean age ± SD = 64 ± 12, median = 61) with idiopathic PC-BPPV were initially treated with a single Epley maneuver. Of those, 144 (28.5%) patients, who did not respond to the therapy, were randomized to the repetition of Epley maneuver ( n = 70) or switch to Semont maneuver ( n = 74). The therapeutic efficacy was determined within 1 h by a blinded examiner after the trial of each second maneuver. The efficacy did not differ between the repetition of Epley maneuver and switch to Semont maneuver groups (38.6 vs. 27.0%, p = 0.14, Chi-square test). However, the patients with a long duration ( p < 0.001, linear regression) and latency ( p = 0.01) of the positional nystagmus during Dix-Hallpike maneuver showed a higher rate of the initial and second treatment failures. Either Epley or Semont maneuver may be applied as a second treatment to the patients with PC-BPPV refractory to the initial Epley maneuver. This study provides Class I evidence that repeated Epley and switch to Semont maneuver shows a similar efficacy in treating PC-BPPV that does not respond to the initial Epley maneuver. Clinical trial registration: NCT01822002. [ABSTRACT FROM AUTHOR]

Background Primary nephrogenic diabetes insipidus (NDI) is a rare disorder and little is known about treatment practices and long-term outcome. Methods Paediatric and adult nephrologists contacted through European professional organizations entered data in an online form. Results Data were collected on 315 patients (22 countries, male 84%, adults 35%). Mutation testing had been performed in 270 (86%); pathogenic variants were identified in 258 (96%). The median (range) age at diagnosis was 0.6 (0.0–60) years and at last follow-up 14.0 (0.1–70) years. In adults, height was normal with a mean (standard deviation) score of −0.39 (±1.0), yet there was increased prevalence of obesity (body mass index >30 kg/m2; 41% versus 16% European average; P < 0.001). There was also increased prevalence of chronic kidney disease (CKD) Stage ≥2 in children (32%) and adults (48%). Evidence of flow uropathy was present in 38%. A higher proportion of children than adults (85% versus 54%; P < 0.001) received medications to reduce urine output. Patients ≥25 years were less likely to have a university degree than the European average (21% versus 35%; P = 0.003) but full-time employment was similar. Mental health problems, predominantly attention-deficit hyperactivity disorder (16%), were reported in 36% of patients. Conclusion This large NDI cohort shows an overall favourable outcome with normal adult height and only mild to moderate CKD in most. Yet, while full-time employment was similar to the European average, educational achievement was lower, and more than half had urological and/or mental health problems. [ABSTRACT FROM AUTHOR]

ABSTRACT BACKGROUND We explored the relationship between body mass index-for-age percentile, body image distortion, and unnecessary weight loss efforts in Korean adolescent girls who are underweight and normal weight and examined the mediating effect of body image distortion on weight loss efforts. METHODS This study used data from the 2013 Korea Youth Risk Behavior Web-based Survey conducted by the Korea Centers for Disease Control and Prevention. The study sample comprised 29,633 Korean adolescent girls who are normal weight and underweight. Chi-square tests and correlations were used to assess bivariate relationships between the variables. To assess the mediating effect of body image distortion on the relationship between body mass index-for-age percentile and weight loss efforts, a 3-step regression analysis was used. RESULTS There was a significant correlation between body mass index-for-age percentiles and body image distortion, and both significantly correlated with weight loss efforts. In addition, a distorted perception of being overweight or obese was a significant mediating variable. CONCLUSIONS School-based health education and intervention programs are needed to promote the formation of a positive body image, not only for obese adolescents, but also for normal-weight and underweight adolescent girls. [ABSTRACT FROM AUTHOR]

Inflammation is a pathological process that is known to be involved in numerous diseases. Microbial infection or tissue injury activates inflammatory responses, resulting in the induction of proinflammatory proteins including cyclooxygenase-2 (COX-2) and inducible nitric oxide synthase (iNOS).Aster yomenais used in traditional Korean remedies to treat cough, asthma, and insect bites. Here, we investigated the effects ofA. yomenaextract (EAY) on the expression of COX-2 and iNOS induced by LPS. EAY inhibited NF-κB activation and IκBα degradation induced by LPS. EAY suppressed LPS-induced COX-2 and iNOS expression which are the target genes regulated through NF-κB activation in macrophages. EAY also suppressed LPS-induced nitrite production. These results suggest that EAY has the potential to be developed as a potent anti-inflammatory drug. [ABSTRACT FROM AUTHOR]

DOI: 10.3233/VES-170619] On page 179, under section 3, "Diagnostic criteria for bilateral vestibulopathy", where it reads: Reduced horizontal angular VOR gain < 0.1 upon sinusoidal stimulation on a rotatory chair (0.1 Hz, Vmax = 50°/sec) and a phase lead > 68 degrees (time constant < 5 sec) Should be: Reduced horizontal angular VOR gain<=0.1 upon sinusoidal stimulation on a rotatory chair (0.1 Hz, Vmax = 50°/sec) and a phase lead>=15 degrees (time constant<=6 sec) Erratum to: Bilateral vestibulopathy: Diagnostic criteria Consensus document of the Classification Committee of the Bárány Society. [Extracted from the article]

Policy and Program evaluation for maternal, newborn and child health is becoming increasingly complex due to changing contexts. Monitoring and evaluation efforts in this area can take advantage of large nationally representative household surveys such as DHS or MICS that are increasing in size and frequency, however, this analysis presents challenges on several fronts. We propose an approach with hierarchical models for cross-sectional survey data to describe evidence relating to program evaluation, and apply this approach to the recent scale up of iCCM in Malawi. We describe careseeking for children sick with diarrhea, pneumonia, or malaria with empirical Bayes estimates for each district of Malawi at two time points, both for careseeking from any source, and for careseeking only from health surveillance assistants (HSA). We do not find evidence that children in areas with more HSA trained in iCCM are more likely to seek care for pneumonia, diarrhea, or malaria, despite evidence that many indeed are seeking care from HSA. Children in areas with more HSA trained in iCCM are more likely to seek care from a HSA, with 100 additional trained health workers in a district corresponding to a 2% average increase in careseeking from HSA. The hierarchical models presented here provide a flexible set of methods that describe the primary evidence for evaluating iCCM in Malawi and which could be extended to formal causal analyses, and to analysis for other similar evaluations with national survey data. [ABSTRACT FROM AUTHOR]

This study reports on the synthesis of bimetallic PtAu nanoparticles (NPs) on the transparent conducting oxide electrode by using dry plasma reduction under atmospheric pressure without using any toxic chemicals and at a low temperature, which are first employed as counter electrodes (CEs) for efficient dye-sensitized solar cells (DSCs). High resolution scanning electron microscopy and x-ray photoelectron spectroscopy are utilized for analyzing the morphology and the chemical composition of bimetallic PtAu NPs. The highest catalytic activity of the bimetallic PtAu NP CE is found through an optimization of the volume ratio of Au and Pt precursors used for synthesis of NPs. As a result, the highest electrocatalytic performance, which corresponds to the lowest charge transfer resistance of 0.43 Ωcm 2 , is obtained at the Au and Pt precursor molar ratio of 1. The DSC employing Pt 0.5 Au 0.5 alloy CE achieved a maximum efficiency of 8.0% among all cells under study. The efficiency is higher than those of 7.4%, and 0.1% for Pt NPs and Au NPs – based DSCs, respectively. The obtained results establish a base for the potential use of PtAu alloy CEs in efficient and robust DSCs. [ABSTRACT FROM AUTHOR]

The purpose of this study was to identify factors predicting clinical nurses' willingness to care for Ebola virus disease (EVD)-infected patients. Data were collected from 179 nurses employed at 10 hospitals in Korea using self-reporting questionnaires. Only 26.8% of the participants were willing to care for EVD-infected patients. Factors predicting their willingness to provide care were their belief in public service, risk perception, and age. Nurses' willingness to provide care was high when their belief in public service was high, low when their risk perception was high, and low as their age increased. In order to strengthen nurses' willingness to care for EVD-infected patients, education that targets the enhancement of belief in public service should be included in nurse training. Efforts should be directed toward lowering EVD risk perception and developing systematic responses through government-led organized support. [ABSTRACT FROM AUTHOR]

Aims and objectives. The aim of this study was to survey nursing students' Middle East respiratory syndrome-related knowledge, preventive behaviours and risk perception to examine the correlations among the variables during a Middle East respiratory syndrome outbreak. Background. Middle East respiratory syndrome is a new viral respiratory illness. Nursing students who engage in clinical practice at hospitals may have been exposed to Middle East respiratory syndrome infection during the Middle East respiratory syndrome outbreak. Design. This study was a descriptive cross-sectional survey. Methods. Participants (n = 249) were nursing students in their third or fourth year of the programme who were engaged in clinical practice for eight hours per day at the tertiary hospitals with Middle East respiratory syndrome patients. Knowledge, preventive behaviours and risk perception related to Middle East respiratory syndrome were measured using scales developed through a preliminary survey and validity testing. Results. The subjects' knowledge level of Middle East respiratory syndrome was 84-4%; their practice of preventive behaviours was rated at 44-5%; and their risk perception rating was 2-4 out of 5. Middle East respiratory syndrome-related risk perception was significantly different according to gender and Middle East respiratory syndrome education. Middle East respiratory syndrome-related knowledge was significantly correlated with preventive behaviours and risk perception. Conclusion. Considering the low scores for items regarding knowledge and preventive behaviours, it is necessary to develop effective and systematic publicity and education programmes for nursing students. Enhancing Middle East respiratory syndrome-related knowledge by considering cooperation between hospitals and universities will sharpen nursing students' risk perception of the disease and effectively increase their preventive behaviours. Relevance to clinical practice. Similar to other emerging infectious diseases, Middle East respiratory syndrome outbreaks may occur in other countries. The results of this study can be used to develop and apply efficient and feasible Middle East respiratory syndrome education programmes for nursing students during Middle East respiratory syndrome outbreaks. [ABSTRACT FROM AUTHOR]

Eye movements are fundamental diagnostic and progression markers of various neurological diseases, including those affecting the cerebellum. Despite the high prevalence of abnormal eye movements in patients with cerebellar disorders, the traditional rating scales do not focus on abnormal eye movements. We formed a consortium of neurologists focusing on cerebellar disorders. The consortium aimed to design and validate a novel Scale for Ocular motor Disorders in Ataxia (SODA). The primary purpose of the scale is to determine the extent of ocular motor deficits due to various phenomenologies. A higher score on the scale would suggest a broader range of eye movement deficits. The scale was designed such that it is easy to implement by non-specialized neurological care providers. The scale was not designed to measure each ocular motor dysfunction's severity objectively. Our validation studies revealed that the scale reliably measured the extent of saccade abnormalities and nystagmus. We found a lack of correlation between the total SODA score and the total International Cooperative Ataxia Rating Scale (ICARS), Scale for Assessment and Rating of Ataxia (SARA), or Brief Ataxia Rating Scale (BARS). One explanation is that conventionally reported scales are not dedicated to eye movement disorders; and when present, the measure of ocular motor function is only one subsection of the ataxia rating scales. It is also possible that the severity of ataxias does not correlate with eye movement abnormalities. Nevertheless, the SODA met the consortium's primary goal: to prepare a simple outcome measure that can identify ocular motor dysfunction in patients with cerebellar ataxia. • Scale for Ocular Motor Disorders in Ataxia is presented. • The scale is an objective measure of eye movement burden in ataxia. • It is operator friendly and is validated with video oculography. [ABSTRACT FROM AUTHOR]

In recent years, great efforts have been made to develop unmanned navigation systems for Autonomous Surface Vehicles (ASVs), while further improvements are still required for ASVs operating around obstacles. In this circumstance, this paper presents an Obstacle Collision Avoidance Guidance (OCAG) using obstacle detection with a two-dimensional (2D) LiDAR sensor. After verifying the algorithm of the OCAG in a numerical manoeuvring simulation, the OCAS was embedded in a physical model of a Catamaran-type ASV with a 2D LiDAR sensor. When the ASV sails along with a predefined global path, the LiDAR sensor detects the obstacles, the collision-avoidance actions are determined based on multiple factors including the motion and orientation information of the vehicle, the measured distance and direction information of the obstacles, as well as the types of the obstacles. The proposed OCAG showed good collision-avoidance performances with different obstacle types along the path. • The obstacle collision avoidance guidance for ASV are proposed that can avoid static floats and line obstacles. • The action of collision avoidance is determined by considering the ship domain of the ASV. • The controller is designed to solve the underacted ASV using thruster output control. • The proposed obstacle collision avoidance system was verified through numerical simulations and experiments. [ABSTRACT FROM AUTHOR]

Toll-like receptors (TLRs) play significant roles in recognizing the pathogen-associated molecular patterns that induce innate immunity, and subsequently, acquired immunity. In general, TLRs have two downstream signaling pathways, the myeloid differential factor 88 (MyD88)-dependent and toll-interleukin-1 receptor domain-containing adapter-inducing interferon-β (TRIF)-dependent pathways, which lead to the activation of nuclear factor-kappa B (NF-κB) and interferon regulatory factor 3 (IRF3). 1-[5-methoxy-2-(2-nitrovinyl)phenyl]pyrrolidine (MNP) has been previously synthesized in our laboratory. To evaluate the therapeutic potential of MNP, its effect on signal transduction via the TLR signaling pathways was examined. MNP was shown to inhibit the activation of NF-κB and IRF3 induced by TLR agonists, as well as to inhibit the expression of cyclooxygenase-2, inducible nitric oxide synthase, and interferon inducible protein-10. MNP also inhibited the activation of NF-κB and IRF3 induced by the overexpression of downstream signaling components of the MyD88- or TRIF-dependent signaling pathways. These results suggest that MNP can modulate MyD88- and TRIF-dependent signaling pathways of TLRs, leading to decreased inflammatory gene expression. [ABSTRACT FROM AUTHOR]

Toll-like receptor 4 (TLR4) recognizes LPS and triggers the activation of the myeloid differential factor 88 (MyD88)- and toll-interleukin-1 receptor domain-containing adapter, inducing interferon-β (TRIF)-dependent major downstream signaling pathways. Previously, we presented biochemical evidence that 1-[4-Fluoro-2-(2-nitrovinyl)phenyl]pyrrolidine (FPP), which was synthesized in our laboratory, inhibits NF-κB activation induced by LPS. Here, we investigated whether FPP modulates the TLR4 downstream signaling pathways and what anti-inflammatory target in TLR4 signaling is regulated by FPP. FPP inhibited LPS-induced NF-κB activation by targeting TLR4 dimerization. These results suggest that FPP can modulate the TLR4 signaling pathway at the receptor level to decrease inflammatory gene expression. [ABSTRACT FROM PUBLISHER]

Non-vestibular sensorimotor signals modulate the vestibular nucleus neuron to achieve current behavioral goals, and may generate or modulate nystagmus. In central lesions affecting the vestibular nuclei, non-vestibular signals such as mastication or swallowing may induce nystagmus. However, the influence of non-vestibular signals on these types of nystagmus has not been investigated in a systematic way and the underlying mechanisms of the modulation are poorly understood. In this study, several non-vestibular sensorimotor stimuli were applied to evaluate the patterns of nystagmus modulation in a patient with suspected rhombencephalitis or imaging negative small infarction, probably involving the left dorsolateral medulla. The nystagmus was induced or significantly modulated by (1) visual inputs, and (2) combined proprioceptive and efference copy signals (during voluntary motion) unrelated to body or head orientation. In contrast, isolated proprioceptive signal, mental set, or non-proprioceptive somatosensory inputs showed a negligible effect on the induction of nystagmus. Based on these modulations, we suggest that (1) the visually mediated nystagmus is due to a lesion-induced pursuit asymmetry, and (2) the nystagmus induced during voluntary motion is due to erroneous contribution of combined proprioceptive and efference copy signals during integration of non-vestibular signals for ocular motor control. Various non-vestibular sensorimotor stimulations may induce nystagmus due to dysfunction of the central vestibular neural circuity. [ABSTRACT FROM AUTHOR]

Toll-like receptors (TLRs) recognize microbial molecules that are widely presented by pathogens and initiate the innate immune system. TLR signaling is divided into two different signaling pathways, the myeloid differential factor 88 (MyD88)- and Toll/interleukin-1 receptor domain-containing adapter inducing interferon-β(TRIF)-dependent pathways.Eupatorium makinoi, a plant species inAsteraceae, is used for medicinal purposes in China, Korea, and Japan. Through our previous research, we found that an ethanol extract ofE. makinoi(EEM) suppresses inducible nitric oxide synthase (iNOS) and cyclooxygenase-2 (COX-2) expression. In this study, we investigated the effect of EEM on TLRs signaling pathways. EEM suppresses NF-κB activation and iNOS and COX-2 expressions induced by TLR2 or TLR4 agonists. Also, EEM suppresses the activation of interferon (IFNs) regulatory factor 3 (IRF3) induced by TLR3 or TLR4 agonists. All results indicate that EEM suppresses myeloid differentiation primary-response protein 88 (MyD88) and TRIF-dependent signaling pathways of TLRs and the expressions of target genes derived from the activation of TLRs [ABSTRACT FROM PUBLISHER]

Highly efficient nonlinear optical quinolinium single crystals are newly designed and synthesized. The quinolinium single crystals consist of a 2-(4-hydroxystyryl)-1-methylquinolinium cation possessing large molecular optical nonlinearity and a 2,4,6-trimethylbenzenesulfonate counter anion. The quinolinium crystals exhibit monoclinic acentric space group P2 1 symmetry, resulting in large macroscopic nonlinear optical response, which is comparable with those of highly nonlinear optical configurationally locked polyene crystals. Plate-shaped bulk quinolinium crystals with an area of up to 56 mm 2 are successfully grown by the solution growth method. Single quinolinium crystals exhibit a large transparency range (550–1600 nm) in the optical region and a relatively low absorption coefficient in the THz region. [ABSTRACT FROM AUTHOR]

In spinocerebellar ataxia type 6 (SCA6), the vestibular dysfunction and its correlation with other clinical parameters require further exploration. We determined vestibular responses over a broad range of stimulus acceleration in 11 patients with SCA6 (six men, age range=33-72 years, mean age±SD=59±12 years) using bithermal caloric irrigations, rotary chair, and head impulse tests. Correlations were also pursued among disability scores, as measured using the International Cooperative Ataxia Rating Scale, disease duration, age at onset, cytosine-adenine-guanine (CAG) repeat length, and the gain of the vestibulo-ocular reflex (VOR). In response to relatively low-acceleration, low-frequency rotational and bithermal caloric stimuli, the VOR gains were normal or increased regardless of the severity of disease. On the other hand, with relatively high-acceleration, high-frequency head impulses, there was a relative increase in gain in the mildly affected patients and a decrease in gain in the more severely affected patients and gains were negatively correlated with the severity of disease (Spearman correlation, R=−0.927, p<0.001). Selective decrease of the vestibular responses during high-acceleration, high-frequency stimuli may be ascribed to degeneration of either the flocculus or vestibular nuclei. The performance of the VOR during high-acceleration, high-frequency head impulses may be a quantitative indicator of clinical decline in SCA6. [ABSTRACT FROM AUTHOR]

A series of π -conjugated styryl quinolinium push–pull chromophores have been designed and synthesized in order to examine the electron-withdrawing strength of various quinolinium electron acceptor groups, and their influence on the photophysical properties and in particular on the second-order nonlinear optical response. The static molecular first hyperpolarizabilities measured by long-wavelength hyper-Rayleigh scattering are found to follow the order of the electron withdrawing strength of their acceptor groups as determined by NMR analysis. The quinolinium chromophores based on the strongest electron acceptor groups (1,2- and 1,4-dimethylquinolinium) exhibit remarkably large first hyperpolarizability values of 233 and 256 × 10 −30 esu respectively, which is higher than that of the well-known and widely-used pyridinium analogue 4-(4-(dimethylamino)styryl)-1-methylpyridinium 4-methylbenzenesulfonate with first hyperpolarizability = 183 × 10 −30 esu. The dimethylquinolinium electron acceptor groups exhibit increased electron-withdrawing strength compared to the dimethylpyridinium group used in 4-(4-(dimethylamino)styryl)-1-methylpyridinium 4-methylbenzenesulfonate, and therefore have a high potential for photonic applications. [ABSTRACT FROM AUTHOR]