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This study assessed three commercially available cell-free DNA (cfDNA) extraction kits and the impact of a PEG-based DNA cleanup procedure (DNApure) on cfDNA quality and yield. Six normal donor urine and plasma samples and specimens from four pregnant (PG) women carrying male fetuses underwent extractions with the JBS cfDNA extraction kit (kit J), MagMAX Cell-Free DNA Extraction kit (kit M), and QIAamp Circulating Nucleic Acid Kit (kit Q). Recovery of a PCR product spike-in, endogenous TP53, and Y-chromosome DNA was used to assess kit performance. Nucleosomal-sized DNA profiles varied among the kits, with prominent multi-nucleosomal-sized peaks present in urine and plasma DNA isolated by kits J and M only. Kit J recovered significantly more spike-in DNA than did kits M or Q (p < 0.001) from urine, and similar amounts from plasma (p = 0.12). Applying DNApure to kit M- and Q-isolated DNA significantly improved the amplification efficiency of spike-in DNA from urine (p < 0.001) and plasma (p ≤ 0.013). Furthermore, kit J isolated significantly more Y-chromosome DNA from PG urine compared to kit Q (p = 0.05). We demonstrate that DNApure can provide an efficient means of improving the yield and purity of cfDNA and minimize the effects of pre-analytical biospecimen variability on liquid biopsy assay performance.

Background and Purpose Stereotactic thalamotomy has been an effective surgical procedure in the treatment of medically refractory essential tremor (ET), however, little is known about the bilateral effects of unilateral ventralis intermedius (Vim) thalamotomy and Vim deep brain stimulation (DBS). We studied the lateralized effects of unilateral Vim thalamotomy and Vim DBS in ET patients. Methods Vim thalamotomy was performed in 6 patients and Vim DBS in 6. Patients were evaluated preoperatively and at 3 and 6 months postoperatively using the Clinical Rating Scale for Tremor (CRST). Results The contralateral Part A (tremor localization/severity rating) and Part B (specific motor tasks/function rating) subscores, and axial subscores of CRST significantly improved after unilateral Vim thalamotomy or Vim DBS. On the side ipsilateral to surgery, ET patients demonstrated no significant improvements in the Part A and Part B subscores of CRST. The Part C (functional disabilities resulting from tremor) subscores and total scores of CRST were significantly improved after surgery. Conclusions Vim thalamotomy and DBS may be equally effective for the management of contralateral and axial tremor in ET patients, but both interventions may not improve tremor on the side ipsilateral to surgery.

OBJECTIVE: To investigate the expression of transglutaminases (TGs) in the ocular surface, the eyelid margin and associated glands and to determine effect of muscarinic agents on TGs in scleral fibroblasts (SF). MATERIALS AND METHODS: Primary SFs cultured from mouse and human sclera were treated with atropine and carbachol for 5 days. Lysed cell RNA was used for real-time PCR, protein was used for Western blot analysis and TG-2 transamidase activity was measured by ELISA. Immunohistochemistry was done to determine the expression of TGases. RESULTS: Immunohistochemistry and western blot confirmed the expression of TGs-1, 2, 3 and 5 proteins in cultured SFs and eye tissues. Real time PCR showed TG-1, 2, 5 transcript levels to be down regulated 3 fold (p

Summary: Purpose: To reduce falls in hospitalized patients with mental disorders, the patients should be sensitive to fall risk perception. This study identified the sensitivity to fall risk perceptions and associated factors, including demographic, clinical, and fall-related factors, among inpatients with mental disorders. Methods: We used a descriptive, cross-sectional design, recruiting 170 inpatients with mental disorders from two psychiatric hospitals in South Korea. Sensitivity to fall risk perception was classified using fall occurrence and the Fall Risk Perception Questionnaire. Results: The prevalence of falls was 16.5%. Approximately 47% of falls occurred within 10 days of hospitalization, 67.9% within 1 month, and 85.7% within 2 months. Among the 28 participants who fell, 60.7% had inadequate low sensitivity to fall risk perception. Among the 142 participants who did not fall, 11.3% had inadequate high sensitivity to fall risk perception. A low sensitivity to fall risk perception was related to diagnosis, psychiatric symptoms, and fall history due to the mental disorder. A high sensitivity to fall risk perception was related to age at the onset of the mental disorder, urinary or bowel problems, and fear of falling. The multiple logistic regression analysis found that the diagnosis and fall history due to the mental disorder were associated with inadequate low sensitivity, and age at the onset and fear of falling were associated with inadequate high sensitivity to fall risk perception. Conclusion: Over 60% of patients who fell had low sensitivity to fall risk perception. Inadequate low and high sensitivity to fall risk perception are related to the demographic, clinical, and fall-related characteristics among inpatients with mental disorders. Therefore, nurses should assess fall risk perception, consider these factors together during this assessment, and manage them appropriately in hospitalized patients with mental disorders.

Summary: Purpose: Although the significance of health literacy (HL) in fall-prevention strategies is growing, limited knowledge is available regarding the relationship, impact, and role of HL in falls. This scoping review aimed to explore and synthesize the current evidence regarding the role of HL in enhancing fall prevention in hospital and community settings. Methods: We adhered to the Joanna Briggs Institute manual and the Preferred Reporting Items for Systematic Reviews and Meta-Analysis extension for scoping reviews. PubMed, CINAHL, EMBASE, and the Cochrane Library were searched until November 2023 using Medical Subject Headings and text words. Studies related to HL and falls, regardless of study design, were considered eligible. Results: We screened 99,249 records, of which 27 were included: 12 interventional studies, seven observational studies, four qualitative studies, and four mixed-methods studies. Two-thirds of the studies were conducted in community-based settings. Four observational studies reported that HL was associated with fall-related outcome including fall incidence. Although intervention studies did not encompass all elements of HL based on the Health Literacy Framework, eight out of 12 intervention studies reported the effect of HL-embedded fall-prevention interventions, and HL was effective in fall-related outcomes including fall incidence in six studies. Three of 14 studies reported the measurement properties of fall-related HL. While HL can be increased through tailored information, verbal debriefing, interactive communication, and culturally adapted interventions, low HL impedes the understanding of education, engaging interventions, and using technological devices in implementing fall-prevention interventions in qualitative and mixed-methods studies. Conclusion: This scoping review suggests that nurses need to recognize and assess patients’ HL as a potential risk factor for falls and implement fall-prevention interventions based on the HL level of participants. Further research is required to develop culturally adapted and fall-relevant HL measures applicable to various vulnerable populations and settings.

Childhood obesity is increasingly prevalent in Western and non-Western societies. The authors related multiple dimensions of physical self-concept to body composition for 763 Chinese children aged 8 to 15 and compared the results with Western research. Compared with Western research, gender differences favoring boys were generally much smaller for physical self-concept and body image. Objective and subjective indexes of body fat were negatively related to many components of physical self-concept, but--in contrast to Western research--were unrelated to global self-esteem and slightly positively related to health self-concept. In support of discrepancy theory, actual-ideal discrepancies in body image were related to physical self-concept. However, consistent with the Chinese cultural value of moderation, and in contrast to Western results, being too thin relative to personal ideals was almost as detrimental as being too fat. The results reflect stronger Chinese cultural values of moderation and acceptance of obesity than in Western culture and have implications for social and educational policy in China.

Education is so strongly emphasized in the Chinese culture that academic success is widely regarded as the only indicator of success, while too much physical activity is often discouraged because it drains energy and affects academic concentration. This study investigated the relations among academic achievement, self-esteem, school conduct and physical activity level. The participants were 333 Chinese pre-adolescents (aged 8-12) in Hong Kong. Examination results and conduct grades were obtained from the school records. Global self-esteem was measured with the "Physical self-description questionnaire" (PSDQ), while physical activity patterns of the children were assessed with the "Physical activity questionnaire for children" (PAQ-C). Results showed that high academic achievers consistently attained better school conduct marks. However, physical activity level was quite an independent entity that was related neither to academic achievement nor school conduct. Furthermore, regression analyses showed that only academically high-achieving boys and physically active boys had higher self-esteem. (Contains 3 tables.)

BackgroundPCR and culture tests are used together to confirm the diagnosis of active tuberculosis (TB). Due to the long culture period, if the PCR test is negative, it takes a significant amount of time for the culture result to be available. Interferon-γ release assays (IGRAs), which are widely used to diagnose TB or latent tuberculosis infection (LTBI), cannot effectively discriminate TB from LTBI. The purpose of this study is to analyze the diagnostic performance of various markers for differentiating between TB from LTBI.MethodsPubMed-Medline, EMBASE, Cochrane Library, and Web of Science were searched up to the end of May 2024, without restrictions on publication date and population. Articles describing the diagnostic value of at least one biomarker for differentiating between TB and LTBI were included. The QUADAS-2 tool was used to assess study quality. Two independent researchers assessed the articles using Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. The network meta-analysis (NMA) was performed for diagnostic tools of 11 groups used to differentiate TB from LTBI.ResultsOut of 164 identified articles, 159 reports were included in the systematic review and 58 in the meta-analysis. Seventy results from 58 reports accounting for 9,291 participants were included. When measuring interleukin-2 (IL-2) after stimulation with latency antigen, the most significant odds ratio was shown in terms of sensitivity, specificity, positive predictive value and negative predictive value. The values were 9.46, 18.5, 11.30, and 9.61, respectively.ConclusionThis study shows that the IL-2 level after stimulation with latent antigen is a potential biomarker for differentiating TB from LTBI.Systematic review registrationhttps://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42024542996.

Background Bronchiectasis is a chronic respiratory disease that leads to airway inflammation, destruction, and airflow limitation, which reflects its severity. Impulse oscillometry (IOS) is a non-invasive method that uses sound waves to estimate lung function and airway resistance. The aim of this study was to assess the usefulness of IOS in predicting the severity of bronchiectasis. Methods We retrospectively reviewed the IOS parameters and clinical characteristics in 145 patients diagnosed with bronchiectasis between March 2020 and May 2021. Disease severity was evaluated using the FACED score, and patients were divided into mild and moderate/severe groups. Results Forty-four patients (30.3%) were in the moderate/severe group, and 101 (69.7%) were in the mild group. Patients with moderate/severe bronchiectasis had a higher airway resistance at 5 Hz (R5), a higher difference between the resistance at 5 and 20 Hz (R5−R20), a higher resonant frequency (Fres), and a higher area of reactance (AX) than patients with mild bronchiectasis. R5 ≥0.43, resistance at 20 Hz (R20) ≥0.234, R5−R20 ≥28.3, AX ≥1.02, reactance at 5 Hz (X5) ≤−0.238, and Fres ≥20.88 revealed significant univariable relationships with bronchiectasis severity (p

Background It is well known that a large number of patients with diabetes also have dyslipidemia, which significantly increases the risk of cardiovascular disease (CVD). This study aimed to evaluate the efficacy and safety of combination drugs consisting of metformin and atorvastatin, widely used as therapeutic agents for diabetes and dyslipidemia. Methods This randomized, double-blind, placebo-controlled, parallel-group and phase III multicenter study included adults with glycosylated hemoglobin (HbA1c) levels >7.0% and 100 and

BackgroundDiapers are commonly used by older patients with urination disorders. A smart diaper system (SDS) may be able to estimate the weight of urine comparably to conventional measurements made by weighing diapers. ObjectiveThe aim of the current research is to determine the degree of accuracy of an SDS technology specifically designed for the management of urination routines and the use of incontinence pads in older adults. MethodsFrom January to December 2022, 97 older patients with at least 1 chronic disease from 3 nursing homes were included. In this study, the SDS was used for 1 month per patient after obtaining their consent; all patients originally used traditional diapers in the nursing home. The index test measured the change in electrical resistance of the SDS and the reference test measured the change in actual urine weight. When measuring the actual urine weight, the degree of absorption was directly confirmed with the naked eye because the expression value varied according to pressure changes caused by the user’s movement or position. The Pearson correlation was used to determine the correlation between the 2 test methods, the intraclass correlation coefficient (ICC) was used to check the degree of agreement between the evaluators, and the Bland-Altman test was used to confirm whether there was a significant difference between the 2 test methods. ResultsThe average age of the 97 participants was 86.48 (SD 6.26) years, with 10 men and 87 women. There were 73 patients (75%) with hypertension, 86 patients (88%) with dementia, and 86 patients (88%) with 2 or more comorbidities, accounting for the majority. The Pearson correlation coefficient and ICC were 0.971 and 0.985 (P

PurposeThe use of artificial intelligence (AI) for chest X-ray (CXR) analysis is becoming increasingly prevalent in medical environments. This study aimed to determine whether AI in CXR can unexpectedly detect lung nodule detection and influence patient diagnosis and management in non-respiratory outpatient clinics.MethodsIn this retrospective study, patients over 18 years of age, who underwent CXR at Yongin Severance Hospital outpatient clinics between March 2021 and January 2023 and were identified to have lung nodules through AI software, were included. Commercially available AI-based lesion detection software (Lunit INSIGHT CXR) was used to detect lung nodules.ResultsOut Of 56,802 radiographic procedures, 40,191 were from non-respiratory departments, with AI detecting lung nodules in 1,754 cases (4.4%). Excluding 139 patients with known lung lesions, 1,615 patients were included in the final analysis. Out of these, 30.7% (495/1,615) underwent respiratory consultation and 31.7% underwent chest CT scans (512/1,615). As a result of the CT scans, 71.5% (366 cases) were found to have true nodules. Among these, the final diagnoses included 36 lung cancers (7.0%, 36/512), 141 lung nodules requiring follow-up (27.5%, 141/512), 114 active pulmonary infections (22.3%, 114/512), and 75 old inflammatory sequelae (14.6%, 75/512). The mean AI nodule score for lung cancer was significantly higher than that for other nodules (56.72 vs. 33.44, p < 0.001). Additionally, active pulmonary infection had a higher consolidation score, and old inflammatory sequelae had the highest fibrosis score, demonstrating differences in the AI analysis among the final diagnosis groups.ConclusionThis study indicates that AI-detected incidental nodule abnormalities on CXR in non-respiratory outpatient clinics result in a substantial number of clinically significant diagnoses, emphasizing AI’s role in detecting lung nodules and need for further evaluation and specialist consultation for proper diagnosis and management.