Immediate effects of a vibrating foam roller on dorsiflexion rom, balance, and gait in stroke patients: a randomized controlled trial.

The purpose of this study was to investigate the immediate effects of vibration foam rolling on dorsiflexion range of motion (ROM), balance, and gait in stroke patients. Thirty stroke patients volunteered to participate and were randomly assigned to the vibrating foam roller group (n=15) and the foam roller group (n=15). The vibrating foam roller group performed a 30-min foam roller exercise program, with participants subjected to vibration at 28 Hz. The foam roller group performed the same exercise program as the vibrating foam roller group, but without vibration. Dorsiflexion lunge test, limits of stability, and Timed Up and Go were used to evaluate dorsiflexion ROM, balance, and gait before and after each intervention. The results revealed that the vibration foam roller group showed significant differences in dorsiflexion ROM and gait after the intervention, while the foam roller group exhibited a significant difference only in dorsiflexion ROM (P<0.05). In comparisons between the vibration foam roller group and the foam roller group, significant differences were observed in dorsiflexion ROM and gait (P<0.05). However, there were no significant differences in balance, both before and after the intervention, as well as in the comparisons between the two groups (P>0.05). This study confirmed that a single-session vibrating foam roller exercise program improves dorsiflexion ROM and gait in stroke patients. Further studies with extended exercise program durations are needed to address limitations and explore long-term effects.

Longitudinal changes in the PTSD symptom network following trauma-focused treatment in military populations: Identifying central symptoms and the role of military sexual trauma.

Posttraumatic stress disorder (PTSD) is a debilitating condition affecting military populations, with a higher prevalence compared to the general population. Despite the development of first-line trauma-focused treatments such as Cognitive Processing Therapy (CPT) and Prolonged Exposure Therapy (PE), a significant proportion of patients continue to experience persistent PTSD symptoms following treatment. This study utilized network analysis to explore the PTSD symptom network's dynamics pre- and post- trauma-focused treatment and investigated the role of military sexual trauma (MST) history in shaping the network. Network analysis is a novel approach that can guide treatment target areas. The sample was comprised of 1648 service members and veterans who participated in a two-week intensive PTSD treatment program, which included completion of evidenced-based individual therapy as well as skill-building focused group therapy. PTSD severity was assessed using the PTSD Checklist for DSM-5 at baseline and post-treatment. Network analyses revealed strong connections within symptom clusters, with negative emotions emerging as one of the most central symptoms. Interestingly, the symptom network's overall structure remained stable following treatment, whereas global strength significantly increased. MST history did not significantly impact the network's structure or its change relative to treatment. Future research should further examine whether targeting negative emotions optimizes PTSD treatment outcomes for military populations.

Lifestyle Changes Caused by COVID-19 Pandemic Increase Oral Disease Symptoms.

The COVID-19 pandemic has led to severe restrictions on society worldwide, and social restrictions can lead to poor physical and oral health. This study investigated the association between oral disease symptoms and changes in lifestyle due to COVID-19. A multivariate logistic regression analysis was used to analyze data from the 2021 Korea Youth Risk Behavior Survey (N = 54 848). It showed that most households' economic conditions as "did not change at all" (adjusted odds ratio [aOR] = 1.00), "no change" (aOR = 1.10), "slightly worsened" (aOR = 1.21), and "very worsened" (aOR = 1.24). Information in a with "did not change at all" (aOR = 1.00), "no change" (aOR = 1.13), "slightly worsened" (aOR = 1.15), and "very worsened" (aOR = 1.18) economic conditions experienced heightened gingival pain and bleeding. In conclusion, the COVID-19 pandemic has caused a change in lifestyle and worsened socioeconomic status. In addition, as lifestyle changed and socioeconomic status declined, symptoms of deteriorating dental health emerged.

Hemodynamic Effect of Repeated Epinephrine Doses Decreases With Cardiopulmonary Resuscitation Cycle Progression.

BACKGROUND: Epinephrine is administered to increase coronary perfusion pressure during advanced life support and promote short-term survival. Recent cardiopulmonary resuscitation (CPR) guidelines recommend an epinephrine dosing interval of 3 to 5 minutes during resuscitation; however, scientific evidence supporting this recommendation is lacking. Therefore, we aimed to investigate the hemodynamic effects of repeated epinephrine doses during CPR by monitoring augmented blood pressure after its administration in a swine model of cardiac arrest. METHODS AND RESULTS: A secondary analysis of data from a published study was performed using a swine cardiac arrest model. The epinephrine dose was fixed at 1 mg, and the first dose of epinephrine was administered after no-flow and low-flow times of 2 minutes and 8 minutes, respectively, and subsequently administered every 4 minutes. Four cycles of dosing intervals were defined because a previous study was terminated 26 minutes after the induction of ventricular fibrillation. Augmented blood pressures and corresponding timelines were determined. Augmented blood pressure trends following cycles and the epinephrine effect duration were also monitored. Among the 140 CPR cycles, the augmented blood pressure after epinephrine administration was the highest during the first cycle of CPR and decreased gradually with further cycle repetitions. The epinephrine effect duration did not differ between repeated cycles. The maximum blood pressure was achieved 78 to 97 seconds after epinephrine administration. CONCLUSIONS: Hemodynamic augmentation with repeated epinephrine administration during CPR decreased with cycle progression. Further studies are required to develop an epinephrine administration strategy to maintain its hemodynamic effects during prolonged resuscitation.

A Survey on the Use of Outcome Measures during Physical Therapy Interventions by Physical Therapists in Korea.

The purpose of this study was to determine the current status of patient care provided by Korean physical therapists (KPTs) in clinical practice by studying the outcome measures (OMs) used in physical therapy interventions among KPTs with experience in treating patients. A total of 225 KPTs with experience in treating patients in clinical settings participated in the study and completed the online questionnaire. The questionnaire included questions about the use of OMs and the reasons for using them, as well as the types, benefits, and barriers of OMs. The participants' responses were analyzed and reported in terms of frequencies and percentages. A total of 220 questionnaires were analyzed. The results show that the majority of KPTs in clinical practice used OMs during interventions. The main reasons for using OMs were to check the patient's condition and to determine the direction and effectiveness of treatment. In terms of the types of OMs used, the highest percentage of subjects used both patient-reported OMs (PROMs) and performance-based OMs (PBOMs). They chose OMs that were quick and easy to use and used them voluntarily. Barriers to and reasons for not using OMs were similar, including lack of benefits, lack of time, and problems with patient performance and uncooperative behavior. When analyzing the effect of demographic characteristics on the use of OMs, we found that physical therapists specializing in musculoskeletal and neurological systems, physical therapists with longer treatment times, and physical therapists who valued OMs were more likely to use them. Based on the results of this study, it is recommended that improvements in the work environment and healthcare system are needed to enhance the professionalism of KPTs working in the field of physical agent therapy by improving their awareness of Oms and improving the quality of physical therapy interventions.

Number of Teeth According to Hand Strength in Adults: A Cross-Sectional Study of 11,499 South Korean Adults.

Background and Objectives: Grip strength is a measure of general health and is associated with oral health. This study aimed to investigate the relationship between the number of teeth and grip strength in Korean adults. Methods and Materials: We recruited adult participants who underwent oral examinations in the Korean National Health and Nutrition Examination Survey (KNHANES) between 2016-2018. When performing the KNHANES oral examination, an experienced dentist performed it according to the oral examination guidelines and recorded the results. A total of 24,269 participants from the 2016-2018 KNHANES were included in this study. Of these, only 16,489 participants underwent oral screening. A total of 3209 were non-adult children and adolescents, and 1781 did not respond to the grip strength test; those who did not respond to the main independent confounder were excluded. The relationships between grip strength, general characteristics, general health, oral health, and the number of remaining teeth were analyzed. There were 11,499 subjects in total in this study, with 4839 males and 6660 females. The age groups were 19-65 years of age, with 8387 subjects, and 65 years and older, with 3112 subjects, and the number of remaining teeth was 0-9 for 936 subjects, 10-19 for 1015 subjects, and 20-28 for 9548 subjects. Results: The probability that the higher the grip strength, the higher the residual number of gingiva was estimated by multinomial logistic regression analysis using complex sampling. The higher the grip strength, the higher the probability of having 20-28 teeth remaining (adjusted odds ratio, 1.59; 95% confidence interval, 1.19-2.13). Conclusions: Maintaining general health is related to maintaining teeth; the higher the grip strength, the higher the number of remaining teeth.

Association between Secondhand Smoke and Allergic Diseases in Korean Adolescents: Cross-Sectional Analysis of the 2019 KYRBS.

This study aimed to determine whether secondhand smoking (SHS) in adolescents is associated with allergic diseases. Data from the 2019 Korea Youth Risk Behavior Survey were used (N = 37,848 Korean adolescents: 19,114 boys and 18,734 girls). This study assessed SHS exposure using questionnaire data, which included information, such as exposure to SHS and allergic diseases. Multiple logistic regression analysis was used to estimate the association between exposure to SHS and allergic diseases. The results showed that exposure to SHS in schools and public places, exposure for 1-3 days (OR = 1.158, 95% CI, 1.077-1.246), 4-6 days (OR = 1.308, 95% CI, 1.190-1.438), and everyday (OR = 1.306, 95% CI, 1.187-1.437), and exposure in one, two, or three places were significantly associated with allergic diseases (one OR = 1.226, 95% CI, 1.169-1.128, two OR = 1.289, 95% CI, 1.222-1.360 and three OR = 1.282, 95% CI, 1.177-1.395). The present results show that exposure to SHS occurs in various places and at various frequencies, and it is associated with allergic diseases in Korean adolescents.

Characteristics and clinical course of patients referred to the NST.

Background and aims: The nutrition support team (NST) comprises doctors, nutritionists, pharmacists, and nurses who provide intensive nutritional treatment designed for each patient by evaluating their nutritional status of hospitalized patients. This study aimed to identify the clinical characteristics of patients referred to the NST among those admitted to a tertiary hospital and to understand the factors affecting their clinical course and changes in pressure sore grades. Methods: This study included 1,171 adult patients aged 18 years or older referred to the NST at a tertiary hospital in a metropolitan city between 1 January 2019 and 31 December 2020. Patients were divided into five age groups, neuro department and non-neuro department, those treated in the intensive care unit (ICU), and those not treated in the ICU. Patients were also compared based on the presence of pressure sores at the time of NST referral and changes in pressure sore grades at the first time of NST referral and discharge (improved pressure sores, no change in pressure sores, and aggravated pressure sores). In addition, this study examined the factors affecting changes in pressure sore grades. Results: As age increased, the proportion of both low albumin levels and pressure sores significantly increased (p < 0.001), and the neuro department showed a significantly lower proportion of low albumin levels and pressure sores (p < 0.001). The proportion of patients with pressure sores was higher (64.9%), and this patient group showed significantly higher rates of low albumin levels (p < 0.001) and treatment in the ICU (p < 0.001). The group with aggravated pressure sore grades had a significantly higher proportion of patients in the surgery department (p = 0.009) and those treated in the ICU (p < 0.001). Admission to the surgery department was a factor that aggravated the grade of pressure sores [adjusted odds ratio (aOR) = 1.985, 95% confidence interval (CI) = 1.168-3.371]. When patients were not treated in the ICU, the grade of the pressure sores was less likely to worsen (aOR = 0.364, 95% CI = 0.217-0.609). Conclusion: Pressure sores and low albumin levels are closely related, and the risk of developing and aggravating pressure sores is particularly high in patients in the surgery department and those receiving ICU treatment. Therefore, it is necessary to actively implement NST referral to ensure that overall nutrition, including albumin, is well supplied, especially for patients in the surgery department and treated in the ICU, as they are at high risk of pressure sore development and aggravation. Moreover, since low albumin levels frequently occur in elderly patients, it is necessary to consider including the elderly in the indications for referral to the NST.

The growth status of North Korean refugee adolescents in South Korea: comparison with South Korean adolescents.

AIM: To assess the growth status of North Korean refugee adolescents (NKRA) living in South Korea (SK) and compare their growth status with that of SK adolescents (SKA). SUBJECTS AND METHODS: NKRA were interviewed from 2017 to 2020, whereas the data for SKA were from the 2016 to 2018 Korea National Health and Nutrition Examination Surveys. SKA and NKRA were matched by age and gender in a 3:1 ratio and 534 SKA and 185 NKRA were enrolled. RESULTS: After adjusting for the covariates, NKRA had greater prevalences of thinness (odds ratio [OR], 11.5; 95% confidence interval [CI], 2.9-45.6) and obesity (OR, 12.0; 95% CI, 3.1-46.1) than SKA, but were not of short stature. In comparison with SKA in low-income families, NKRA had similarly greater prevalences of thinness and obesity, but not of short stature. As the length of stay of NKRA in SK increased, the prevalence of short stature and thinness did not decrease, while the prevalence of obesity increased significantly. CONCLUSION: Although they had lived in SK for several years, NKRA had greater prevalences of thinness and obesity than SKA and the prevalence of obesity increased significantly with the length of stay in SK.

Prevalence and methodological quality of systematic reviews in Korean medical journals.

This study aimed to assess and evaluate the prevalence and methodological quality of systematic reviews (SRs) published in major Korean medical journals (KMJs). The top 15 journals with the highest Korean Medical Citation Index, published between 2018 to 2021, were selected. We assessed the methodological quality of SRs using A Measurement Tool to Assess Systematic Reviews 2 (AMSTAR 2). In total, 126 SRs were included, with an average of 32 SRs being reported annually. The overall prevalence of SRs in KMJs was 2.8%, with an increase from 2.6% in 2018 to 3.4% in 2021. Overall, the methodological quality of SRs was low (9.5% low, 90.5% critically low). More than 80% of the studies adhered to critical domain items such as a comprehensive literature search and risk of bias assessment, but for items such as protocol registration and listing excluded studies and the justification for exclusion, the adherence rate was less than 15%. While the number of SRs in KMJs steadily increased, the overall confidence in the methodological quality was low to critically low. Therefore, in order to provide the best evidence for decision-making in clinical and public health areas, editors, reviewers, and authors need to pay more attention to improving the quality of SRs.

Factors affecting target caloric achievement and calorie intake improvement: the nutrition support team's role.

Background: The nutrition support team (NST) works to improve malnutrition in hospitalized patients, and its role is expanding as more hospitals adopt NST. This study aimed to identify the clinical characteristics of NST-referred patients admitted to a tertiary hospital. The study focused on two groups: those who achieved the target calories, approximately 75% or more of their caloric needs relative to their body weight regardless of the period after the first NST referral, and those who improved their calorie intake 1 week after NST therapy. This study also analyzed the important factors affecting the achievement of target calorie intake and improvement in calorie intake to discover the focus of future NST therapy. Methods: This study examined 1,171 adult patients (aged ≥18 years) who were referred to the NST from all the departments within a tertiary hospital at least twice, with a minimum one-week interval between referrals, between January 1, 2019, and December 31, 2020. The study participants consisted of patients receiving <75% of their required caloric intake at the time of their first NST referral. Patients were categorized and compared according to whether they achieved their target calorie intake regardless of the period after the first NST referral and whether they improved their calorie intake 1 week after the NST therapy. We then identified factors affecting target caloric achievement and improvement in calorie intake. Results: The group that achieved the target calorie intake had a lower proportion of neuro department patients (31.3%), a higher proportion of patients receiving intensive care unit (ICU) care (31.9%), and a longer ICU stay (p < 0.001) than the group that did not achieve the target calorie intake. Neuro department admission negatively affected target caloric achievement [adjusted odds ratio (aOR) = 0.305, 95% confidence interval (CI) = 0.150-0.617], whereas the length of ICU stay positively affected target caloric achievement (aOR = 1.025, 95% CI = 1.007-1.043). The proportion of neuro department patients was also low (42.5%) in the group with improved calorie intake 1 week after NST therapy. Neuro department admission was a negative factor (aOR = 0.376, 95% CI = 0.264-0.537) affecting the improvement in calorie intake. Conclusions: NST therapy significantly improved clinical outcomes for inpatients at nutritional risk. Because achieving target calories and improving calorie intake in neuro department patients is difficult, it is necessary to actively refer them to NST to achieve the target calories and improve calorie intake. Furthermore, because a longer ICU stay positively affects target calorie achievement, the system for ICU nutrition therapy should be expanded and implemented for general-ward patients, including neurological patients.

Factors Associated with Unmet Dental Care Needs among Korean Adult Cancer Survivors: Cross-Sectional Analysis of the 2016-2018 KNHANES.

This study aimed to identify the factors associated with unmet dental care needs among Korean adult cancer survivors. This cross-sectional study used data from the seventh (2016-2018) Korea National Health and Examination Survey. It included 339 adult cancer survivors. Participants' experience of unmet dental care needs was assessed using a health questionnaire survey. Moreover, the subjective oral health status (i.e., toothache) and behavior (i.e., toothbrushing and oral examination) were assessed through oral health interviews. The data were analyzed using descriptive statistics, chi-squared test, and logistic regression analysis. The rate of experience of unmet dental care needs among cancer survivors was 29.5%. Cancer survivors with limitations in performing daily activities of living were more likely to experience unmet dental care needs than cancer survivors without activity limitations ([aOR] = 2.14, [95%CI] = 1.04-4.40). Moreover, cancer survivors who did undergo oral examination within the past year were more likely to experience unmet dental care needs than cancer survivors who underwent oral examination ([aOR] = 2.49, [95%CI] = 1.22-5.07). Korean cancer survivors experienced unmet dental care needs when they did not receive an oral examination or had activity limitations. This study's findings provide insight into social and behavioral factors associated with unmet dental care needs among Korean cancer survivors.

Trends in maintenance status and usability of public automated external defibrillators during a 5-year on-site inspection.

This study aimed to assess the trend of the maintenance status and usability of public automated external defibrillators (AEDs). Public AEDs installed in Seoul from 2013 to 2017 were included. An inspector checked the maintenance status and usability of the AEDs annually using a checklist. During the study period, 23,619 AEDs were inspected. Access to the AEDs was improved, including the absence of obstacles near the AEDs (from 90.2% in 2013 to 99.1% in 2017, p < 0.0001) and increased AED signs (from 34.3% in 2013 to 91.3% in 2017, p < 0.0001). The rate of AEDs in normal operation (from 94.0% in 2013 to 97.6% in 2017, p < 0.0001), good battery status (from 95.6% in 2013 to 96.8% in 2017, p = 0.0016), and electrode availability increased (from 97.1% in 2013 to 99.0% in 2017, p < 0.0001); the rate of electrode validity decreased (from 90.0% in 2013 to 87.2% in 2017, p < 0.0001). The overall rate of the non-ready-to-use AEDs and AEDs with less than 24-h usability accounted for 15.4% and 44.1% of the total number of AEDs, respectively. Although most AEDs had a relatively good maintenance status, a significant proportion of public AEDs were not available for 24-h use. Invalid electrodes and less than 24-h accessibility were the main reasons that limited the 24-h usability of public AEDs.

A bioisosteric approach to the discovery of novel N-aryl-N'-[4-(aryloxy)cyclohexyl]squaramide-based activators of eukaryotic initiation factor 2 alpha (eIF2α) phosphorylation.

Inhibition of translation initiation has emerging implications for the development of mechanism-based anticancer therapeutics. Phosphorylation of eIF2α is recognized as a key target that regulates the translation initiation cascade. Based on the bioisosteric replacement of urea-derived eIF2α phosphorylation activator 1, a novel series of N-aryl-N'-[4-(aryloxy)cyclohexyl]squaramide derivatives was designed and synthesized; their effects on the activation of eIF2α phosphorylation was assessed systematically. A brief structure-activity relationship analysis was established by stepwise structural optimization of the squaramide series. Subsequently, the antiproliferative activities of the selected analogues were determined in human leukemia K562 cells. We then identified 10 potent eIF2α phosphorylation activators with considerable anticancer activity. The most promising analogues 19 and 40 possessed higher cancer cell selectivity (SI = 6.16 and 4.83, respectively) than parent 1 (SI = 2.20). Finally, protein expression analysis revealed that compounds 19 and 40 induced eIF2α phosphorylation and its downstream effectors ATF4 and CHOP.

Perceived health, adversity, and posttraumatic stress disorder in Syrian and Iraqi refugees.

BACKGROUND: Exposure to armed conflict and fleeing country of origin for refugees has been associated with poorer psychological health. METHODS: Within the first month following their arrival in the United States, 152 Syrian and Iraqi refugees were screened in a primary care setting for posttraumatic stress disorder (PTSD), anxiety, and depression and rated their perceived health, and perceived level of adversity of violence, armed conflict/flight. The moderating effects of psychiatric symptoms on the relation between perceived adversity and perceived health were assessed. RESULTS: Three models based on diagnosis (PTSD, anxiety, and depression) were tested. While significant effects were found on perceived adversity negatively influencing perceived health across diagnoses, slightly different patterns emerged based on diagnosis. DISCUSSION: Findings suggest that refugees' perception regarding adversity of violence, armed conflict, and flight may contribute to perceived health, with a moderating role of clinically significant symptoms of PTSD, anxiety, and depression.

RKIP Induction Promotes Tumor Differentiation via SOX2 Degradation in NF2-Deficient Conditions.

Loss of NF2 (merlin) has been suggested as a genetic cause of neurofibromatosis type 2 and malignant peripheral nerve sheath tumor (MPNST). Previously, we demonstrated that NF2 sustained TGFß receptor 2 (TßR2) expression and reduction or loss of NF2 activated non-canonical TGFß signaling, which reduced Raf kinase inhibitor protein (RKIP) expression via TßR1 kinase activity. Here, we show that a selective RKIP inducer (novel chemical, Nf18001) inhibits tumor growth and promotes schwannoma cell differentiation into mature Schwann cells under NF2-deficient conditions. In addition, Nf18001 is not cytotoxic to cells expressing NF2 and is not disturb canonical TGFß signaling. Moreover, the novel chemical induces expression of SOX10, a marker of differentiated Schwann cells, and promotes nuclear export and degradation of SOX2, a stem cell factor. Treatment with Nf18001 inhibited tumor growth in an allograft model with mouse schwannoma cells. These results strongly suggest that selective RKIP inducers could be useful for the treatment of neurofibromatosis type 2 as well as NF2-deficient MPNST. IMPLICATIONS: This study identifies that a selective RKIP inducer inhibits tumor growth and promotes schwannoma cell differentiation under NF2-deficient conditions by reducing SOX2 and increasing SOX10 expression.

Comparing the nutritional status of children and adolescents from North Korean defector families and South Korean families.

OBJECTIVE: This study aimed to investigate the nutritional status of children and adolescents from North Korean defector (NKD) families who are currently living in South Korea (SK) and compared with the status of those from SK families. DESIGN: A cross-sectional study comparing the prevalence of malnutrition, overweight and obesity between children and adolescents from NKD families and SK families. SETTING: Children and adolescents from NKD families were interviewed face-to-face directly, whereas the data about those from SK families acquired by using 2017 Korea National Health and Nutrition Examination Survey. Their nutritional status were estimated using the 2017 Korean National Growth Charts for children and adolescents. PARTICIPANTS: The total number of children and adolescents was 2136 consisting of 527 subjects from the NKD families and 1609 subjects from the SK families. RESULTS: The overall prevalence of stunting, wasting, underweight, overweight and obesity in NKD group was 8.9%, 10.2%, 10.4%, 11.2% and 12.2% respectively, and 1.9%, 7.1%, 5.9%, 9.2% and 9.3%, respectively, in SK families. The NKD group showed significantly higher prevalence than SK group in stunting (p<0.001), wasting (p=0.014), underweight (p<0.001), obesity (p=0.041) but not in overweight. CONCLUSIONS: The nutritional status of children and adolescents form NKD families was worse than that of those from SK families, and also higher prevalence of obesity.

Comparison of Resuscitation Outcomes Between 2- or 3-Stacked Defibrillation Strategies With Minimally Interrupted Chest Compression and the Single Defibrillation Strategy: A Swine Cardiac Arrest Model.

Background There is controversy over whether the number and mode of electrical shock are optimal for successful defibrillation. Methods and Results Fifty-four pigs were randomly assigned to 3 groups. After inducing ventricular fibrillation and a 2-minute downtime, basic life support was initiated with a 30:2 compression/ventilation ratio for 8 minutes. Subsequently, 20 minutes of advanced life support, including asynchronous ventilation, every 10 chest compressions with 15 L/min of oxygen, was delivered. Animals of the single shock group received a single shock, animals of the 2-stacked shock group received 2 consecutive shocks, and animals of the 3-stacked shock group received 3 consecutive shocks. Animals with the return of spontaneous circulation underwent post-cardiac arrest care for 12 hours. The rates of successful defibrillation, return of spontaneous circulation, 24-hour survival, and 48-hour survival and neurological deficit score were compared between the groups. Hemodynamic parameters, arterial blood gas profiles, troponin I, and cardiac output were not different between the groups. There was a significant difference in chest compression fraction between the single and 3-stacked shock groups (P<0.001), although there was no difference between the single and 2-stacked shock groups (P=0.022) or the 2-stacked and 3-stacked shock groups (P=0.040). The rates of successful defibrillation, return of spontaneous circulation, 24-hour survival, and 48-hour survival were higher in the 2- and 3-stacked shock groups than in the single shock group (P=0.021, P=0.015, and P=0.021, respectively). Neurological deficit score at 48 hours was not different between the groups. Conclusions A stacked shock strategy was superior to a single shock strategy for successful defibrillation and better resuscitation outcomes in treating ventricular fibrillation.

Early neuro-prognostication with the Patient State Index and suppression ratio in post-cardiac arrest patients.

PURPOSE: Cardiopulmonary resuscitation guidelines recommend multimodal neuro-prognostication after cardiac arrest using neurological examination, electroencephalography, biomarkers, and brain imaging. The Patient State Index (PSI) and suppression ratio (SR) represent the depth and degree of sedation, respectively. We evaluated the predictive ability of PSI and SR for neuro-prognostication of post-cardiac arrest patients who underwent targeted temperature management. METHODS: This prospective observational study was conducted between January 2017 and August 2020 and enrolled adult patients in an intensive care unit (ICU) with non-traumatic out-of-hospital cardiac arrest with return of spontaneous circulation (ROSC). PSI and SR were monitored continuously during ICU stay, and their maximum, mean, and minimum cutoff values 24 h after ROSC were analyzed to predict poor neurologic outcome and long-term survival. RESULTS: The final analysis included 103 patients. A mean PSI ≤ 14.53 and mean SR > 36.6 showed high diagnostic accuracy as single prognostic factors. Multimodal prediction using the mean PSI and mean SR showed the highest area-under-the-curve value of 0.965 (95% confidence interval 0.909-0.991). Patients with mean PSI ≤ 14.53 and mean SR > 36.6 had relatively higher long-term mortality rates than those of patients with values >14.53 and ≤ 36.6, respectively. CONCLUSIONS: The PSI and SR are good predictors for early neuro-prognostication in post-cardiac arrest patients.

Childhood trauma and the role of ethnic pride and interpersonal relationships among Latina mothers.

Objective: The current study sought to investigate the link between cumulative childhood trauma and depressive mood in urban Latina mothers (n = 209). Specifically, we tested the role of ethnic pride and its conditional direct and indirect effect on depressive mood with interpersonal functioning as a mediating pathway. Method: The sample (age: M = 36.62, SD = 6.72; 83.3% foreign-born) comprises mothers of children enrolled in a school-based intervention study. Analyses focus on baseline data, including interviews assessing childhood trauma, interpersonal functioning, depression, ethnic pride, and acculturation conducted by bilingual (Spanish and English) clinicians in the preferred language of the participants. Results: Using linear regression analyses, results indicated that the link between childhood trauma and depression functions in part through impairments in interpersonal functioning. Ethnic pride moderated the indirect pathway serving as a buffer for those with low interpersonal functioning. Conclusions: Findings highlighted the saliency of including ethnic pride when working with Latina mothers and provided important implications for assessment and clinical intervention. (PsycInfo Database Record (c) 2020 APA, all rights reserved).