Daewon University College

Continuous blood pressure (BP) measurement is essential for real-time hypertension management and the prevention of related complications. To address this need, a cuffless BP estimation technique utilizing biosignals from wearable devices has gained significant attention. This study proposes a feasibility approach that integrates microneedle array electrodes (MNE) for ECG acquisition with photoplethysmogram (PPG) sensors for cuffless BP estimation. The algorithm employed is a baseline multivariate regression model using PTT and RR intervals, while the novelty lies in the hardware design aimed at improving signal quality and long-term wearability. The algorithm’s performance was validated using the Medical Information Mart for Intensive Care (MIMIC) database, achieving a mean error range of ±5.28 mmHg for the SBP and ±2.81 mmHg for the DBP. Additionally, the comparison with 253 measurements from three volunteers against an automated sphygmomanometer indicated an accuracy within ±25%. Therefore, these findings demonstrate the feasibility of an MNE-based ECG with PPG for BP integration for cuffless monitoring of SBP and DBP in daily life. The MIMIC-based evaluation was performed to verify the feasibility of the regression model under ideal public-database conditions. The volunteer experiment, performed with the developed MNE-ECG hardware, served as a separate preliminary feasibility test to observe hardware behavior in real-world measurements.

ABSTRACTPurposeThis study aimed to develop a virtual reality (VR) intervention for reducing exposure to endocrine disruptors (EDs) and examined the effect of the intervention among Korean adolescent girls.Design and MethodsA methodological design was employed involving five phases for developing the VR tool and its evaluation of validity testing. The five development phases were conducted through (1) a literature review and surveys to select appropriate VR content for adolescents’ snack shopping, (2) a VR scenario composition based on the information‐motivation‐behavioral (IMB) skills model, (3) implementation of the VR tool using Oculus Quest 2, (4) heuristic and usability evaluations of the VR tool, and (5) the confirmation of final maintenance. For the evaluation, a one‐group pre‐ and post‐test design was utilized with a convenience sample of 19 adolescent girls who were recruited from a high school located in W city. Knowledge about EDs and sensitivity to women's reproductive health problems were measured using a self‐administered questionnaire.ResultsThe prototype of a 15‐min VR intervention was developed based on the waterfall model and evaluation criteria yielded acceptable results through content validity, heuristic evaluation, and usability test. The Wilcoxon signed‐rank test showed significant differences in knowledge about EDs (U = 3.57, p < 0.001) and sensitivity to women's reproductive health problems (U = 4.36, p < 0.001) between pre‐ and post‐intervention.Practice ImplicationsThe VR intervention was found to be applicable and effective for reducing exposure to EDs in female adolescents. School and community health centers need to expand the application of VR‐based health education to provide adolescents with a conducive environment for engaging in health behaviors and enhancing learning experiences.

Background: This study aimed to investigate the association between metabolic syndrome and tooth loss among adults aged 19 years and older using data from the nationally representative Korea National Health and Nutrition Examination Survey (KNHANES). Methods: A total of 49,468 adults aged 19 years and older who participated in the 2007∼2018 KNHANES were included in the final analysis. Chi-square tests were conducted to examine tooth loss according to sociodemographic factors and the presence of metabolic syndrome. Logistic regression analysis was performed to evaluate factors influencing tooth loss. Results: Sociodemographic factors and components of metabolic syndrome were identified as potential risk factors for tooth loss. The prevalence of tooth loss was higher among individuals in older age groups, those with lower educational and income levels, those engaged in agricultural or fishery-related occupations, and those residing in rural areas (p＜0.001). Adults with metabolic syndrome exhibited a relatively higher prevalence of tooth loss (p＜0.001), with a 1.19-fold increased likelihood of tooth loss compared to those without metabolic syndrome (p＜0.001). Conclusion: Efforts are needed to develop oral health education programs and integrate systemic health management strategies aimed at improving oral health among adults with metabolic syndrome.

Shifts in the gut microbiota and metabolites are interrelated with liver cirrhosis progression and complications. However, causal relationships have not been evaluated comprehensively. Here, we identified complication-dependent gut microbiota and metabolic signatures in patients with liver cirrhosis. Microbiome taxonomic profiling was performed on 194 stool samples (52 controls and 142 cirrhosis patients) via V3-V4 16S rRNA sequencing. Next, 51 samples (17 controls and 34 cirrhosis patients) were selected for fecal metabolite profiling via gas chromatography mass spectrometry and liquid chromatography coupled to time-of-flight mass spectrometry. Correlation analyses were performed targeting the gut-microbiota, metabolites, clinical parameters, and presence of complications (varices, ascites, peritonitis, encephalopathy, hepatorenal syndrome, hepatocellular carcinoma, and deceased). Veillonella bacteria, Ruminococcus gnavus, and Streptococcus pneumoniae are cirrhosis-related microbiotas compared with control group. Bacteroides ovatus, Clostridium symbiosum, Emergencia timonensis, Fusobacterium varium, and Hungatella_uc were associated with complications in the cirrhosis group. The areas under the receiver operating characteristic curve (AUROCs) for the diagnosis of cirrhosis, encephalopathy, hepatorenal syndrome, and deceased were 0.863, 0.733, 0.71, and 0.69, respectively. The AUROCs of mixed microbial species for the diagnosis of cirrhosis and complication were 0.808 and 0.847, respectively. According to the metabolic profile, 5 increased fecal metabolites in patients with cirrhosis were biomarkers (AUROC >0.880) for the diagnosis of cirrhosis and complications. Clinical markers were significantly correlated with the gut microbiota and metabolites. Cirrhosis-dependent gut microbiota and metabolites present unique signatures that can be used as noninvasive biomarkers for the diagnosis of cirrhosis and its complications.

Colorectal cancer is one of the most common malignancies worldwide. Oxaliplatin, which is used as adjuvant chemotherapy, affects quality of life by causing oxaliplatin-induced peripheral neuropathy in colorectal cancer patients. This study examined the effects of an application (app)-based physical activity program for alleviating peripheral neuropathy symptoms in colorectal cancer patients undergoing chemotherapy. This was a randomized controlled study that included 34 patients undergoing chemotherapy after being diagnosed with colorectal cancer. Outcomes were compared between patients who participated in a 6-week app-based physical activity program (experimental group; n = 17) and who received standard booklet education (control group; n = 17). Data were collected using questionnaires, and exercise time was recorded to evaluate intervention adherence. Significant differences were observed between the groups in peripheral neuropathy symptoms ( F = 8.93, P = . 002), interference with activities ( Z = -2.55, P = .011), and quality of life ( F = 7.65, P = . 003). The experimental group showed significantly higher average exercise times at 1 to 4 weeks ( Z = -2.10, P = . 026), 5 to 6 weeks ( Z = -4.02, P < . 001), and 1 to 6 weeks ( Z = -3.40, P = . 001) than the control group. The app-based physical activity program had a positive effect on participants' exercise adherence and reduced peripheral neuropathy symptoms. Thus, we propose the adoption of a mobile health app that can be used at any time or place as an intervention for preventing or alleviating adverse effects during the treatment of cancer patients. An app-based physical activity program using the mobile health app can be used as a nursing intervention to manage symptoms and increase the health behavior adherence in cancer patients.

Proton resonance frequency shift (PRFS) is an MRI-based simple temperature mapping method that exhibits higher spatial and temporal resolution than temperature mapping methods based on T1 relaxation time and diffusion. PRFS temperature measurements are validated against fiber-optic thermal sensors (FOSs). However, the use of FOSs may introduce temperature errors, leading to both underestimation and overestimation of PRFS measurements, primarily due to material susceptibility changes caused by the thermal sensors. In this study, we demonstrated susceptibility-corrected PRFS (scPRFS) with a high frame rate and accuracy for suitably distributed temperatures. A single-echo-based background removal technique was employed for phase variation correction, primarily owing to magnetic susceptibility, which enabled fast temperature mapping. The scPRFS was used to validate the temperature fidelity by comparing the temperatures of fiber-optic sensors and conventional PRFS through phantom-mimicked human and ex vivo experiments. This study demonstrates that scPRFS measurements in agar-gel are in good agreement with the thermal sensor readings, with a root mean square error (RMSE) of 0.33-0.36 °C in the phantom model and 0.12-0.16 °C in the ex vivo experiment. These results highlight the potential of scPRFS for precise thermal monitoring and ablation in both low- and high-temperature non-invasive therapies.

Constipation is one of the most common gastrointestinal (GI) disorders worldwide. The use of probiotics to improve constipation is well known. In this study, the effect on loperamide-induced constipation by intragastric administration of probiotics Consti-Biome mixed with SynBalance® SmilinGut (Lactobacillus plantarum PBS067, Lactobacillus rhamnosus LRH020, Bifidobacterium animalis subsp. lactis BL050; Roelmi HPC), L. plantarum UALp-05 (Chr. Hansen), Lactobacillus acidophilus DDS-1 (Chr. Hansen), and Streptococcus thermophilus CKDB027 (Chong Kun Dang Bio) to rats was evaluated. To induce constipation, 5 mg/kg loperamide was intraperitoneally administered twice a day for 7 days to all groups except the normal control group. After inducing constipation, Dulcolax-S tablets and multi-strain probiotics Consti-Biome were orally administered once a day for 14 days. The probiotics were administered 0.5 mL at concentrations of 2 × 108 CFU/mL (G1), 2 × 109 CFU/mL (G2), and 2 × 1010 CFU/mL (G3). Compared to the loperamide administration group (LOP), the multi-strain probiotics not only significantly increased the number of fecal pellets but also improved the GI transit rate. The mRNA expression levels of serotonin- and mucin-related genes in the colons that were treated with the probiotics were also significantly increased compared to levels in the LOP group. In addition, an increase in serotonin was observed in the colon. The cecum metabolites showed a different pattern between the probiotics-treated groups and the LOP group, and an increase in short-chain fatty acids was observed in the probiotic-treated groups. The abundances of the phylum Verrucomicrobia, the family Erysipelotrichaceae and the genus Akkermansia were increased in fecal samples of the probiotic-treated groups. Therefore, the multi-strain probiotics used in this experiment were thought to help alleviate LOP-induced constipation by altering the levels of short-chain fatty acids, serotonin, and mucin through improvement in the intestinal microflora.

Rapid and accurate detection and serotyping of foot‐and‐mouth disease (FMD) virus (FMDV) is essential for implementing control policies against emergent FMD outbreaks. Current serotyping assays, such as VP1 reverse transcription‐polymerase chain reaction (RT‐PCR)/sequencing (VP1 RT‐PCR/sequencing) and antigen detection enzyme‐linked immunosorbent assay (ELISA), have problems with increasing serotyping failure of FMDVs from FMD outbreaks. This study was conducted to develop a multiplex real‐time RT‐PCR for specific detection and differential serotyping of FMDV serotype O, A, and Asia 1 directly from field clinical samples. Primers and probes were designed based on 571 VP1 coding region sequences originated from seven pools. Multiplex real‐time RT‐PCR using these primers and probes demonstrated serotype‐specific detection with enhanced sensitivity compared to VP1 RT‐PCR/sequencing for reference FMDV (n = 24). Complete serotyping conformity between the developed multiplex real‐time RT‐PCR and previous VP1 RT‐PCR/sequencing was demonstrated using FMDV field viruses (n = 113) prepared in cell culture. For FMDV field clinical samples (n = 55), the serotyping rates of multiplex real‐time RT‐PCR and VP1 RT‐PCR/sequencing were 92.7% (51/55) and 72.7% (40/55), respectively. Moreover, the developed multiplex real‐time RT‐PCR demonstrated improved FMDV detection (up to 33.3%) and serotyping (up to 67.7%) capabilities for saliva samples when compared with 3D real‐time RT‐PCR and VP1 RT‐PCR/sequencing, during 10 days of challenge infection with FMDV serotype O, A, and Asia 1. Collectively, this study suggests that the newly developed multiplex real‐time RT‐PCR assay may be useful for the detection and differential serotyping of FMDV serotype O, A, and Asia 1 in the field.

This study aims to understand the factors influencing clinical practices and experiences of nursing students in varied clinical learning environments during the COVID-19 pandemic.It uses an exploratory sequential mixed methods design where quantitatively, the subjects' sense of powerlessness, self-efficacy, clinical practice satisfaction, and learning flow according to the clinical learning environment were evaluated, and qualitatively, in-depth interview and analysis of the reflections were conducted.Data analysis was performed by paired t-test and multivariate regression analysis using the SPSS 25.0 program, and qualitative thematic analysis was performed.As a result of the study, in online clinical education, it was found that the lower the sense of helplessness (p=.018) and the higher the clinical practice satisfaction (p=.004), the higher the learning commitment was, and the model composed of these variables explained 39.2% of the learning flow.In addition, the higher the satisfaction with clinical practice, the higher the learning immersion (p<.001), and the explanation power was 54.1%.As a result of qualitative thematic analysis, three central themes and six sub-themes were derived, and it was found that students experienced 'a fearful but useful experience, regret about the limited experience, and pride and high satisfaction in the nursing profession'.In the context of the spread of COVID-19, it is necessary to develop effective practical training methods to improve the quality of nursing education.