The protocol of DECO-MOM: a clinical trial testing the effectiveness of a mobile application for an environmental health intervention among pregnant women.

BACKGROUND: Environmental toxins are particularly harmful to pregnant women and their fetuses due to the long-term effects of these toxins on children after birth. Environmental health behaviors can prevent and protect mothers and their babies' environmental health. METHODS/DESIGN: This study presents a protocol for a double-blinded randomized controlled trial to examine the effect of a mobile application named "DECO-MOM" (Deep ECOlogy-MOM) for pregnant women. This application contains content related to environmental perceptions and behaviors according to the revised protection motivation theory. The mobile intervention will be implemented for 4 weeks for 40 pregnant women with a gestational age in the first trimester. As the control group, 40 pregnant women will be recruited at public healthcare centers in Chuncheon and Gongju in South Korea. The hypothesis is that the experimental group will have higher scores for environmental perceptions and behaviors than the control group. An online survey administered before and after the intervention will contain outcome parameters including depression, stress, quality of life, e-learning satisfaction, environmental perceptions, and environmental behaviors. DISCUSSION: This study will elaborate a guide for an intervention to enhance the effects of the mobile application on strengthening environmental health perceptions, behaviors, e-learning satisfaction, and quality of life and curtailing depression and stress among pregnant women. TRIAL REGISTRATION: Trial registration Number: KCT0007725, Registered September 22, 2022. Prospectively registered.

Oral Pathogenic Bacteria-Inducing Neurodegenerative Microgliosis in Human Neural Cell Platform.

Porphyromonas gingivalis is a gram-negative bacterium found in the human oral cavity and is responsible for the development of chronic periodontitis as well as neurological diseases, including Alzheimer's disease (AD). Given the significance of the roles of P. gingivalis in AD pathogenesis, it is critical to understand the underlying mechanisms of P. gingivalis-driven neuroinflammation and their contribution to neurodegeneration. Herein, we hypothesize that P. gingivalis produces secondary metabolites that may cause neurodegeneration through direct or indirect pathways mediated by microglia. To test our hypothesis, we treated human neural cells with bacterial conditioned media on our brain platforms and assessed microgliosis, astrogliosis and neurodegeneration. We found that bacteria-mediated microgliosis induced the production of nitric oxide, which causes neurodegeneration assessed with high pTau level. Our study demonstrated the elevation of detrimental protein mediators, CD86 and iNOS and the production of several pro-inflammatory markers from stimulated microglia. Through inhibition of LPS and succinate dehydrogenase in a bacterial conditioned medium, we showed a decrease in neurodegenerative microgliosis. In addition, we demonstrated the bidirectional effect of microgliosis and astrogliosis on each other exacerbating neurodegeneration. Overall, our study suggests that the mouth-brain axis may contribute to the pathogenesis of AD.

Pro-environmental health behaviour and educational needs among pregnant women: A cross-sectional survey.

AIM: To investigate pro-environmental health perceptions, behaviour and educational needs among pregnant women in Korea. BACKGROUND: Based on concerns about the effects of environmental hazards and pollution on their babies and themselves, pregnant women behave in ways that protect their health. The framework of this study was based on Rogers' protection motivation theory. DESIGN: Cross-sectional survey using questionnaires. METHOD: The sample comprised 358 pregnant women recruited from July - August 2018 in South Korea. Participants were recruited from prenatal classes at two healthcare centres and patients receiving prenatal check-ups at two women's hospitals. RESULTS: Perceived educational needs were ranked in the following order: particulate matter (23.7%), electromagnetic waves (11.7%), instant food (food additives) (9.0%) and environmental hormones (8.3%). Age (ß = 0.17, p = .001), perceived severity (ß = 0.19, p = .001) and response efficacy (ß = 0.28, p < .001) affected pro-environmental behaviour, which explained 23.0% of the variance. CONCLUSION: Educational programs are necessary for mitigating environmental risks during pregnancy. Pregnant women engage in pro-environmental behaviour influenced by pro-environmental perceptions, especially perceptions of severity regarding environmental diseases and the efficacy of health behavioural responses. Nursing professionals can use these results to promote pro-environmental health in pregnant women. IMPACT: This study demonstrated that pregnant women need environmental health programs in prenatal education. Pro-environmental perceptions regarding the severity of the environmental diseases and behavioural efficacy preceded the formation of environmental health behaviours. Nurses should support pregnant women's environmental health through educational interventions including air, electromagnetic, food pollution and endocrine disruptors.

Factors Affecting Happiness Among Rural Residents: A Cross Sectional Survey.

This cross-sectional and descriptive study aimed to investigate factors that affected the happiness of rural residents. The study used a convenience sample consisting of 1029 Korean rural residents from the Gyeong-gi Province collected between November and December 2014. The results found that people aged 60 and over were happier than those between 15 and 19 years old. Happiness was correlated with age, income, violence, social support, subjective health, depression, and suicidal ideation. Factors affecting the happiness of rural residents were depression, social support, suicidal ideation, and age, and these factors explained 48.0% of the variance in happiness. The results demonstrate that the happiness of rural residents was affected by various psychological factors and supportive intervention should be developed to enhance the happiness of people living in rural areas.

Anti-Melanogenic Effects of Korean Red Ginseng Oil in an Ultraviolet B-Induced Hairless Mouse Model.

A 'remedy for all' natural product widely known in the Korean Peninsula is called Panax Ginseng Meyer. Globalization represents a persistent risk to the ozone layer, leading to bountiful amounts of Ultra-Violet B beams (UVB). The variety in human skin hues is ascribed to the characteristic color called Melanin. However, Melanin overproduction due to UVB beams promotes skin staining and tumorigenesis, a process called photo aging, which damages skin quality. To assess the effects of Korean Red Ginseng Oil (KGO) on photo aging, the murine melanoma cell lines B16/F10 were used in vitro and HRM-2 hairless mice exposed to UVB were studied in vivo. Our results revealed that KGO reduced tyrosinase activity and melanin production in B16/F10 cells along with the suppression of upstream factors involved in the melanin production pathway, both transcriptionally and transitionally. In the in vivo studies, KGO suppressed the expression of Matrix Metalloproteinase (MMP) and Interleukins along with a reduction of depth in wrinkle formation and reduced collagen degradation. Moreover, the feed intake and feed efficiency ratio that decreased as a result of UVB exposure was also improved by KGO treatment. In light of our results, we conclude that KGO can have considerable benefits due to its various properties of natural skin enhancement.

Transmembrane BAX Inhibitor Motif-6 (TMBIM6) protects against cisplatin-induced testicular toxicity.

STUDY QUESTION: Is the Transmembrane BAX Inhibitor Motif-6 (TMBIM6) involved in the molecular mechanism by which cisplatin causes reproductive toxicity? SUMMARY ANSWER: TMBIM6 protects against cisplatin-induced testicular toxicity through up-regulation of heme oxygenase-1 (HO-1),-which maintains the levels of steroidogenic enzymes by decreaseing oxidative stress in the endoplasmic reticulum (ER). WHAT IS KNOWN ALREADY: Testosterone production is highly suppressed as a main complication of cisplatin (cis-diamminedichloroplatinum) anticancer therapy. STUDY DESIGN, SIZE, DURATION: Groups of seven wild type or Tmbim6 KO C57BL/6J mice were given a single i.p., injection of cisplatin (30 mg/kg body wt) and testis and serum were collected 3 days later. Tmbim6-lentivirus-mediated testicular expression-rescued KO mice were analyzed to confirm function was restored. Tmbim6-over expressing TM3 mouse Leydig cells were exposed to cisplatin in vitro. PARTICIPANTS/MATERIALS, SETTING, METHODS: After collection of the specimens serum testosterone level and testicular weight and structure were compared between the groups. Quantitative PCR, immunoblot, and assays for ROS, HO-1 activity and protein disulfide isomerase (PDI) carbonylation were performed. MAIN RESULTS AND THE ROLE OF CHANCE: Phospho protein kinase B (p-Akt), nuclear factor erythroid 2 (NFE2)-related factor 2 (Nrf2), and its downstream gene product HO-1 and the levels of testosterone synthesis-associated enzymes, including steroidogenic acute regulatory protein (StAR), a rate limiting enzyme for testosterone production, were significantly expressed in the presence of Tmbim6 and maintained after cisplatin treament. Excessive post-translational oxidation of protein disulfide isomerase (PDI), altered folding capacitance and ROS accumulation, and ER stress were also decreased in the presence of Tmbim6. Higher levels of ER stress and protein hypercarbonylation were consistently observed in KO testis, compared with WT testis. In the Tmbim6 KO mice, lentivirus-mediated testicular expression of Tmbim6 rescued the above phenotypes. Furthermore, the protective role of Tmbim6 against testicular toxicity was consistently shown in Tmbim6-overexpressing TM3 Leydig cells (testosterone producing cells). We conclude that TMBIM6 protects against cisplatin-induced testicular toxicity by inducing HO-1 and enhancing ER folding capacitance. LARGE SCALE DATA: N/A. LIMITATIONS, REASONS FOR CAUTION: This study was performed using a short, 3-day cisplatin treatment condition. Therefore, the results need to be cautiously interpreted with regard to cisplatin-associated chronic toxicity. Moreover, to determine the clinical relevance of the role of TMBIM6, further studies in testicular cancer are needed. WIDER IMPLICATIONS OF THE FINDINGS: Cisplatin-associated ER stress and redox imbalance might be implicated as toxicity mechanisms associated with anticancer therapy. STUDY FUNDING/COMPETING INTEREST(S): This study was supported by the National Research Foundation of Korea (2015R1A2A1A13001849). The authors have no competing interests to disclose.

CD3Z hypermethylation is associated with severe clinical manifestations in systemic lupus erythematosus and reduces CD3ζ-chain expression in T cells.

Objective: The importance of hypomethylation in SLE is well recognized; however, the significance of hypermethylation has not been well characterized. We screened hypermethylated marks in SLE and investigated their possible implications. Methods: DNA methylation marks were screened in SLE whole-blood DNA by microarray, and two marks ( CD3Z and VHL hypermethylations) were confirmed by a methylation single-base extension method in two independent ethnic cohorts consisting of 207 SLE patients and 151 controls. The correlation with clinical manifestations and the genetic influence on those epigenetic marks were analysed. Results: Two epigenetic marks, CD3Z and VHL hypermethylation, were significantly correlated with SLE: CD3Z hypermethylation (odds ratio = 7.76; P = 1.71 × 10 -13 ) and VHL hypermethylation (odds ratio = 3.77; P = 3.20 × 10 -8 ), and the increased CD3Z methylation was correlated with downregulation of the CD3ζ-chain in SLE T cells. In addition, less genetic influence on CD3Z methylation relative to VHL methylation was found in analyses of longitudinal and twin samples. Furthermore, a higher CD3Z methylation level was significantly correlated with a higher SLE disease activity index and more severe clinical manifestations, such as proteinuria, haemolytic anaemia and thrombocytopenia, whereas VHL hypermethylation was not. Conclusion: CD3Z hypermethylation is an SLE risk factor that can be modified by environmental factors and is associated with more severe SLE clinical manifestations, which are related to deranged T cell function by downregulating the CD3ζ-chain.

Endoplasmic reticulum stress in the regulation of liver diseases: Involvement of Regulated IRE1α and ß-dependent decay and miRNA.

Compromised protein folding capacity in the endoplasmic reticulum (ER) leads to a protein traffic jam that produces a toxic environment called ER stress. However, the ER smartly handles such a critical situation by activating a cascade of proteins responsible for sensing and responding to the noxious stimuli of accumulated proteins. The ER protein load is higher in secretory cells, such as liver hepatocytes, which are thus prone to stress-mediated toxicity and various diseases, including alcohol-induced liver injury, fatty liver disease, and viral hepatitis. Therefore, we discuss the molecular cues that connect ER stress to hepatic diseases. Moreover, we review the literature on ER stress-regulated miRNA in the pathogenesis of liver diseases to give a comprehensive overview of mechanistic insights connecting ER stress and miRNA in the context of liver diseases. We also discuss currently discovered regulated IRE1 dependent decay in regulation of hepatic diseases.

The Application of REDOR NMR to Understand the Conformation of Epothilone B.

The structural information of small therapeutic compounds complexed in biological matrices is important for drug developments. However, structural studies on ligands bound to such a large and dynamic system as microtubules are still challenging. This article reports an application of the solid-state NMR technique to investigating the bioactive conformation of epothilone B, a microtubule stabilizing agent, whose analog ixabepilone was approved by the U.S. Food and Drug Administration (FDA) as an anticancer drug. First, an analog of epothilone B was designed and successfully synthesized with deuterium and fluorine labels while keeping the high potency of the drug; Second, a lyophilization protocol was developed to enhance the low sensitivity of solid-state NMR; Third, molecular dynamics information of microtubule-bound epothilone B was revealed by high-resolution NMR spectra in comparison to the non-bound epothilone B; Last, information for the macrolide conformation of microtubule-bound epothilone B was obtained from rotational-echo double-resonance (REDOR) NMR data, suggesting the X-ray crystal structure of the ligand in the P450epoK complex as a possible candidate for the conformation. Our results are important as the first demonstration of using REDOR for studying epothilones.

Factors Affecting Suicidal Ideation Among Middle-Aged Korean Women in an Urban-Rural Province.

PURPOSE: This study aimed to investigate the factors that affect suicidal ideation among middle-aged Korean women in an urban-rural province. METHODS: This study used a convenience sample consisting of 196 middle-aged Korean women who live in Gyeonggi Province. Data were collected between November 2013 and January 2014. RESULTS: There were significant correlations among social relationships (r=-.18, p=.013), previous experiences of violence (r=.15, p=.032), subjective happiness (r=-.36, p<.001), depression (r=.44, p<.001), and suicidal ideation. Economic status, subjective happiness, and depression were found to have an effect on suicidal ideation (R(2)=.26). CONCLUSIONS: The study's results demonstrate that there needs to be greater focus on middle-aged women when considering mental health interventions in rural areas of Korea. The results may also contribute to the development of improved interventions for psychological health care.

An Integrative Review on Development of "QUality Of care Through the patients' Eyes" (QUOTE) Instruments.

"QUality Of care Through the patients' Eyes" (QUOTE) instruments for measuring care quality were classified in terms of procedures, structures, and content. The content and structures of each instrument were found to include (a) participation of the client in the tool development process, (b) evaluation of the importance and performance of care based on the client's needs, and

The Effects of Artificial Intelligence Chatbots on Women's Health: A Systematic Review and Meta-Analysis.

PURPOSE: This systematic review and meta-analysis aimed to investigate the effects of artificial intelligence chatbot interventions on health outcomes in women. METHODS: Ten relevant studies published between 2019 and 2023 were extracted from the PubMed, Cochrane Library, EMBASE, CINAHL, and RISS databases in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. This review focused on experimental studies concerning chatbot interventions in women's health. The literature was assessed using the ROB 2 quality appraisal checklist, and the results were visualized with a risk-of-bias visualization program. RESULTS: This review encompassed seven randomized controlled trials and three single-group experimental studies. Chatbots were effective in addressing anxiety, depression, distress, healthy relationships, cancer self-care behavior, preconception intentions, risk perception in eating disorders, and gender attitudes. Chatbot users experienced benefits in terms of internalization, acceptability, feasibility, and interaction. A meta-analysis of three studies revealed significant effects in reducing anxiety (I2 = 0%, Q = 8.10, p < 0.017), with an effect size of -0.30 (95% CI, -0.42 to -0.18). CONCLUSIONS: Artificial intelligence chatbot interventions had positive effects on physical, physiological, and cognitive health outcomes. Using chatbots may represent pivotal nursing interventions for female populations to improve health status and support women socially as a form of digital therapy.

Attraction and achievement as 2 attributes of gamification in healthcare: an evolutionary concept analysis

This study conducted a conceptual analysis of gamification in healthcare utilizing Rogers' evolutionary concept analysis methodology to identify its attributes and provide a method for its applications in the healthcare field. Gamification has recently been used as a health intervention and education method, but the concept is used inconsistently and confusingly. A literature review was conducted to derive definitions, surrogate terms, antecedents, influencing factors, attributes (characteristics with dimensions and features), related concepts, consequences, implications, and hypotheses from various academic fields. A total of 56 journal articles in English and Korean, published between August 2 and August 7, 2023, were extracted from databases such as PubMed Central, the Institute of Electrical and Electronics Engineers, the Association for Computing Machinery Digital Library, the Research Information Sharing Service, and the Korean Studies Information Service System, using the keywords "gamification" and "healthcare." These articles were then analyzed. Gamification in healthcare is defined as the application of game elements in health-related contexts to improve health outcomes. The attributes of this concept were categorized into 2 main areas: attraction and achievement. These categories encompass various strategies for synchronization, enjoyable engagement, visual rewards, and goal-reinforcing frames. Through a multidisciplinary analysis of the concept's attributes and influencing factors, this paper provides practical strategies for implementing gamification in health interventions. When developing a gamification strategy, healthcare providers can reference this analysis to ensure the game elements are used both appropriately and effectively.

Content and quality of YouTube regarding women's health: a scoping review.

PURPOSE: This scoping review investigated the content and quality of YouTube videos on women's health. METHODS: A literature search of the Cochrane Library, PubMed, Embase, CINAHL, ERIC, and RISS databases was performed using the keywords "('youtube'/exp OR youtube OR 'social media'/ exp OR 'social media' OR (('social'/exp OR social) AND ('media'/exp OR media))) AND ('female health care' OR (('female'/exp OR female) AND ('health'/exp OR health) AND ('care'/exp OR care)))" from February 21 to 27, 2023. Peer-reviewed analytic studies in English or Korean that focused on women's health using YouTube were included. RESULTS: The review identified 21 articles that covered various themes related to women's health, such as breast cancer, urinary disease, sexual health, pelvic organ prolapse, the human papillomavirus vaccine, Papanikolaou smears, contraception, women's health information during the coronavirus disease 2019 pandemic, obstetric epidural anesthesia, and placenta accreta. However, the overall quality of the content was low, inaccurate, unreliable, and misleading. CONCLUSION: This scoping review demonstrated that YouTube videos on women's health covered diverse topics, but the quality of the content needed improvement. More reliable and high-quality videos produced by academic institutes and healthcare professionals specializing in women's health are needed for social media to be usable as a reliable source of women's health information. The high number of views and shares received by the videos underscores the importance of providing accurate and reliable information on women's health.

Effects of anxiety, depression, social support, and physical health status on the health-related quality of life of pregnant women in post-pandemic Korea: a cross-sectional study.

PURPOSE: This study aimed to examine the effects of anxiety, depression, social support, and physical health status on the health-related quality of life of Korean pregnant women using Spilker's quality of life model. METHODS: This was a cross-sectional study with a correlational design. The participants included 166 pregnant women who were recruited via convenience sampling at two healthcare centers in South Korea. Questionnaires were collected from April 22 to May 29, 2023, in two cities in South Korea. The EuroQol-5D-3L, General Anxiety Disorder-7, Patient Health Questionnaire-2, Perceived Social Support through Others Scale-8, and EuroQol visual analog scale were used to assess the study variables. The t-test, Pearson correlation coefficients, and multiple regression tests were conducted using IBM SPSS ver. 26.0. RESULTS: Statistically significant correlations were identified between the health-related quality of life of pregnant women and anxiety (r=.29, p<.001), depression (r=.31, p<.001), social support (r=-.34, p<.001), and physical health status (r=-.44, p<. 001). Physical health status (ß=-.31, p<.001) and social support (ß=-.21, p=.003) had the greatest effect on health-related quality of life (F=15.50, p<.001), with an explanatory power of 26.0%. CONCLUSION: The health-related quality of life of pregnant women was affected by social support and physical health status. This study demonstrated that physical health and social support promotion can improve the health-related quality of life of pregnant women. Healthcare providers should consider integrating physical health into social support interventions for pregnant women in the post-pandemic era.

Exacerbation of Chronic Spontaneous Urticaria Following Coronavirus Disease 2019 (COVID-19) Vaccination in Omalizumab-Treated Patients.

BACKGROUND: The rapid development and rollout of vaccines against coronavirus disease 2019 (COVID-19) has led to more than half of the world's population being vaccinated to date. Real-world data have reported various adverse cutaneous reactions, including delayed-onset urticaria, which was highly ranked as a common manifestation across studies. However, the impact of these novel mRNA or viral vector COVID-19 vaccines on preexisting chronic spontaneous urticaria (CSU) remains largely unknown. OBJECTIVE: To investigate the impact of COVID-19 vaccination on the clinical status of patients with relatively stable CSU who are undergoing omalizumab treatment and to identify risk factors for exacerbation. METHODS: We conducted a questionnaire-based cross-sectional study in a tertiary hospital. Adult patients with relatively stable CSU under regular omalizumab treatments who had received at least one COVID-19 vaccination were included. RESULTS: There were 105 study subjects who received 230 COVID-19 vaccinations between March and December 2021. Fifteen patients (14.3%) experienced aggravation of urticaria at least once after COVID-19 vaccination. The demographics and clinical characteristics of the patients were comparable regardless of the exacerbation of CSU. However, case-level analysis revealed that the presence of urticaria (vs none) before vaccination (odds ratio [OR] = 4.99; 95% CI, 1.57-15.82) and the development of systemic reactogenicity (OR = 4.57; 95% CI, 1.62-12.90) were associated with a higher risk for exacerbation. CONCLUSIONS: The novel COVID-19 vaccination induced exacerbation in more than one-tenth of patients with well-controlled CSU. The establishment of a proper management strategy during COVID-19 vaccination is necessary for patients with CSU.

The effects of maternal-child nursing clinical practicum using virtual reality on nursing students' competencies: a systematic review.

PURPOSE: This study aimed to investigate the effects of virtual reality used in maternal-child nursing clinical practicums on nursing students' competencies through a systematic review. METHODS: The inclusion criteria were peer-reviewed papers in English or Korean presenting analytic studies of maternal-child nursing practicums using virtual reality. An electronic literature search of the Cochrane Library, CINAHL, EMBASE, ERIC, PubMed, and Research Information Sharing System databases was performed using combinations of the keywords "nursing student," "virtual reality," "augmented reality," "mixed reality," and "virtual simulation" from February 4 to 15, 2022. Quality appraisal was performed using the RoB 2 and ROBINS-I tools for randomized controlled trials (RCTs) and non-RCTs, respectively. RESULTS: Of the seven articles identified, the RCT study (n=1) was deemed to have a high risk of bias, with some items indeterminable due to a lack of reported details. Most of the non-RCT studies (n=6) had a moderate or serious risk of bias related to selection and measurement issues. Clinical education using virtual reality had positive effects on knowledge, skills, satisfaction, self-efficacy, and needs improvement; however, it did not affect critical thinking or self-directed learning. CONCLUSION: This study demonstrated that using virtual reality for maternal-child nursing clinical practicums had educational effects on a variety of students' competencies. Considering the challenges of providing direct care in clinical practicums, virtual reality can be a viable tool that supplements maternal-child nursing experience. Greater rigor and fuller reporting of study details are required for future research.

Effect of Pro-Environmental Prenatal Education Program on Pregnant Women's Environmental Health Awareness and Behaviors based on the Protection Motivation Theory.

This study aimed to verify whether a pro-environmental prenatal education program has an effect on pregnant women's environmental health awareness and behaviors in Korea. This quasi-experimental study employed a nonequivalent control group and nonsynchronized design based on the protection motivation theory as a theoretical framework. In total, 96 pregnant women had their data collected and analyzed in Korea (40 in the experimental group; and 56 in the control group). Data collection through self-reported questionnaire was conducted between September 2017 and August 2018. The program consisted of lectures and group activities aimed at educating participants on environmental awareness and behaviors. The data were analyzed using t-test, chi square test, and ANCOVA using SPSS 24.0 program. After the intervention, the experimental group showed significantly higher sensitivity (54.78 ± 9.47 and 49.75 ± 5.42; F = 15.13, P < .001), susceptibility (26.30 ± 5.18 and 24.28 ± 4.53; F = 53.94, P < .001), response efficacy (27.40 ± 3.40 and 25.18 ± 4.23; F = 39.42, P < .001), self-efficacy (22.43 ± 4.15 and 21.35 ± 4.25; F = 41.13, P < .001), individual environmental behavior (58.59 ± 12.25 and 51.93 ± 12.64; F = 172.75, P < .001), and communal environmental behavior (18.45 ± 9.68 and 13.13 ± 8.24; F = 126.26, P < .001) than the control group. The developed pro-environmental prenatal education program contained content on the environment and pregnancy, environmental toxin, effects of endocrine disruptors, airborne pollutants, water pollutant, soil pollutant, radio-electronic exposure, and pro-environmental health behaviors during pregnancy. Pregnant women who participated in the pro-environmental prenatal education program had positive changes in environmental health perceptions and behaviors. As environmental hazards continue to increase, pregnant women should receive effective motivational education on eco-environmental protection to increase their sensitivity to environmental risk factors and to encourage active environmental health behaviors.

The effects of environmental prenatal program on environmental health perception and behavior using internet-based intervention in South Korea: A non-randomized controlled study.

PURPOSE: This study aimed to develop and examine the effects of an internet-based intervention program on environmental perception and behavior among Korean pregnant women based on revised protection motivation theory. METHOD: This study was a non-equivalent control group pre-post-test design. The experimental program consisted of prenatal education, reduction of fine dust, birth education, environmental health promotion, and postnatal management education using zoom video conferences. The face-to-face interventions were provided through regular prenatal classes at public health services for the control group. The total participant was 49 pregnant women: 25 in the experimental group and 24 in the control group. The program adaptation was conducted between April 2021 and November 2021 in Korea. The data were analyzed by ANCOVA and t-test to examine the effects using SPSS 26.0 program. RESULTS: After intervention of the program, environmental severity (F = 17.96, p < .001), response efficacy (F = 15.69, p < .001), and total environmental perception (F = 7.80, p = .008) were higher in the experimental group than in the control group. There were no significant differences in feasibility, accessibility, satisfaction, susceptibility, self-efficacy, barrier, personal environmental behavior, and community environmental behavior between the two groups. CONCLUSION: The internet-based educational program can be the alternative for the face-to-face prenatal class to promote environmental health perceptions during pregnancy in the pandemic situations.

Transglutaminase 2 as an independent prognostic marker for survival of patients with non-adenocarcinoma subtype of non-small cell lung cancer.

BACKGROUND: Expression of transglutaminase 2 (TGase 2) is related to invasion and resistance to chemotherapeutic agents in several cancer cells. However, there has been only limited clinical validation of TGase 2 as an independent prognostic marker in cancer. METHODS: The significance of TGase 2 expression as an invasive/migratory factor was addressed by in vitro assays employing down-regulation of TGase 2. TGase 2 expression as a prognostic indicator was assessed in 429 Korean patients with early-stage non-small cell lung cancer (NSCLC) by immunohistochemical staining. RESULTS: TGase 2 expression increased the invasive and migratory properties of NSCLC cells in vitro, which might be related to the induction of MMP-9. In the analysis of the immunohistochemical staining, TGase 2 expression in tumors was significantly correlated with recurrence in NSCLC (p = 0.005) or in the non-adenocarcinoma subtype (p = 0.031). Additionally, a multivariate analysis also showed a significant correlation between strong TGase 2 expression and shorter disease-free survival (DFS) in NSCLC (p = 0.029 and HR = 1.554) and in the non-adenocarcinoma subtype (p = 0.030 and HR = 2.184). However, the correlation in the adenocarcinoma subtype was not significant. CONCLUSIONS: TGase 2 expression was significantly correlated with recurrence and shorter DFS in NSCLC, especially in the non-adenocarcinoma subtype including squamous cell carcinoma.