All-Solution-Processed High-Performance MoS2 Thin-Film Transistors with a Quasi-2D Perovskite Oxide Dielectric.

Assembling solution-processed van der Waals (vdW) materials into thin films holds great promise for constructing large-scale, high-performance thin-film electronics, especially at low temperatures. While transition metal dichalcogenide thin films assembled in solution have shown potential as channel materials, fully solution-processed vdW electronics have not been achieved due to the absence of suitable dielectric materials and high-temperature processing. In this work, we report on all-solution-processedvdW thin-film transistors (TFTs) comprising molybdenum disulfides (MoS2) as the channel and Dion-Jacobson-phase perovskite oxides as the high-permittivity dielectric. The constituent layers are prepared as colloidal solutions through electrochemical exfoliation of bulk crystals, followed by sequential assembly into a semiconductor/dielectric heterostructure for TFT construction. Notably, all fabrication processes are carried out at temperatures below 250 °C. The fabricated MoS2 TFTs exhibit excellent device characteristics, including high mobility (>10 cm2 V-1 s-1) and an on/off ratio exceeding 106. Additionally, the use of a high-k dielectric allows for operation at low voltage (∼5 V) and leakage current (∼10-11 A), enabling low power consumption. Our demonstration of the low-temperature fabrication of high-performance TFTs presents a cost-effective and scalable approach for heterointegrated thin-film electronics.

External and internal validation of healthcare-associated infection data collected by the Korean National healthcare-associated Infections Surveillance System (KONIS).

BACKGROUND: This study analyzed the validity of healthcare-associated infection (HAI) data of the Korean National healthcare-associated Infections Surveillance System. METHODS: The validation process consisted of external (EV) and internal (IV) validation phases. Of the 193 hospitals that participated from July 2016 through June 2017, EV was performed for 10 hospitals that were selected based on the HAI rate percentile. The EV team reviewed 295 medical records for 60 HAIs and 235 non-HAI control patients. IV was performed for both the 10 EV hospitals and 11 other participating hospitals that did not report any HAIs. RESULTS: In the EV, the diagnosis of urinary tract infections had a sensitivity of 72.0% and a specificity of 99.3%. The respective sensitivities of bloodstream infection and pneumonia were 63.2% and 70.6%; the respective specificities were 98.8% and 99.6%. The agreement (ĸ) between the EV and IV for 10 hospitals was 0.754 for urinary tract infections and 0.674 for bloodstream infections (P < .001, respectively). Additionally, IV found additional cases among 11 zero-report hospitals. DISCUSSION: This study demonstrates the need for ongoing validation and continuous training to maintain the accuracy of nationwide surveillance data. CONCLUSIONS: IV should be considered a validation method to supplement EV.

Heterosynaptic Plasticity in a Vertical Two-Terminal Synaptic Device.

Vertical two-terminal synaptic devices based on resistive switching have shown great potential for emulating biological signal processing and implementing artificial intelligence learning circuitries. To mimic heterosynaptic behaviors in vertical two-terminal synaptic devices, an additional terminal is required for neuromodulator activity. However, adding an extra terminal, such as a gate of the field-effect transistor, may lead to low scalability. In this study, a vertical two-terminal Pt/bilayer Sr1.8Ag0.2Nb3O10 (SANO) nanosheet/Nb:SrTiO3 (Nb:STO) device emulates heterosynaptic plasticity by controlling the number of trap sites in the SANO nanosheet via modulation of the tunneling current. Similar to biological neuromodulation, we modulated the synaptic plasticity, pulsed pair facilitation, and cutoff frequency of a simple two-terminal device. Therefore, our synaptic device can add high-level learning such as associative learning to a neuromorphic system with a simple cross-bar array structure.

Standardized patient experiences study on clinical performance evaluation of nursing college students' ability: A qualitative study.

BACKGROUND: Nursing students' direct exposure to patients is limited, thus affecting their performance in practical clinical settings in the healthcare field, including hospitals or communities. Therefore, various clinical situation scenarios, using standardized patients trained to act like real patients (i.e., simulation practice), are applied in nursing education. OBJECTIVES: This study examined the experiences of standardized patients, who were acting majors and had experience in acting, as patients for nursing students' education. DESIGN: A qualitative research. SETTINGS: A university in J city, South Korea. PARTICIPANTS: Participants were 29 college students majoring in acting with experience of participating as standardized patients. The snowball technique was used for the recruitment of participants. METHODS: Data were collected using focus group interviews from November 20, 2017, to February 2, 2018. The duration of each interview was 60-90 min, and they were analyzed using content analysis. RESULTS: The final theme was 'becoming a partner of nursing education'. The participants' experiences were identified in four subthemes: 'beginning with worries', 'requiring thorough preparation', 'growing together', and 'becoming immersed in the duties undertaken'. CONCLUSIONS: It is necessary to recognize the role of standardized patients as partners in simulation practice in nursing education. Further, developing a systematic education program is vital to nurture patients by understanding their experiences.

Testing the measurement invariance of the Korean clinical learning environment, supervision and nurse teacher (CLES+t) scale.

BACKGROUND: In 2018, the Korean version of the Clinical Learning Environment, Supervision, and Nurse Teacher scale was evaluated for validity and reliability. OBJECTIVES: This study aimed to test the instrument's measurement invariance and to compare the latent means of groups. DESIGN: This was a cross-sectional study. SETTINGS: Nursing departments in four metropolitan cities and five regions of Korea. The study sample comprised 507 nursing students. PARTICIPANTS: Bachelor's-level nursing students in their third and fourth years who have experienced clinical practicum. METHODS: Data were collected from November 11 to December 24, 2018 using the Korean Clinical Learning Environment, Supervision, and Nurse Teacher scale. Confirmatory factor analysis and multi-group confirmatory factor analysis were conducted. Measurement invariance of the Korean Clinical Learning Environment, Supervision, and Nurse Teacher scale was tested in the following order: configural invariance, factor-loading invariance, intercept invariance, factor variance/covariance invariance, and residual invariance, by student year, hospital grade (tertiary or general hospital) and assignment of a nurse instructor (or not). RESULTS: The measurement invariance of the Korean Clinical Learning Environment, Supervision, and Nurse Teacher scale by student year and hospital grade were confirmed by configural invariance, factor-loading invariance, intercept invariance, factor variance/covariance invariance, and residual invariance. The measurement invariance of the scale by assignment of a nurse instructor (or not) was also confirmed for configural invariance, factor-loading invariance, partial intercept invariance, partial factor variance/covariance invariance, and partial residual invariance. Comparing latent mean values, there was a statistically significant difference in the mean of the sub-dimensions of the Korean Clinical Learning Environment, Supervision, and Nurse Teacher scale by student year, hospital grade, and nurse assignment (or not). CONCLUSIONS: The Korean Clinical Learning Environment, Supervision, and Nurse Teacher scale is an appropriate instrument for measuring the clinical learning environment regardless of student year, hospital grade, or nurse assignment.

Nursing students' extracurricular activity experiences of suicide prevention volunteering: A qualitative study.

BACKGROUND: Extracurricular activities of college students have been perceived as a means of developing competencies related to professional success. OBJECTIVES: This study aimed to explore the extracurricular activity experience of nursing students who participated in suicide prevention volunteering. DESIGN: Qualitative research. SETTING: This study was conducted at an undergraduate university in Gyeongsan-do, Korea. PARTICIPANTS: Participants in the study were 36 nursing college students who participated in suicide prevention volunteer activities for more than 4 months. METHODS: Data were collected by focus group interviewers, which were analyzed using content analysis. RESULTS: The experiences of participants in the study were identified by four sub-themes 'Developing sensitivity to suicide issues', 'Improving confidence in suicide prevention', 'Getting interested in mental health nursing', and 'Learning basic skills of practical nursing' that derived the theme 'Prepared for a competent nurse in mental health nursing'. CONCLUSION: A variety of activities and programs for extra-curriculum will serve as a foundation for nursing students to improve their basic competencies and qualities to become more competent in their future careers.

Validation of the Korean Version of the Nursing Profession Self-Efficacy Scale: A Methodological Study.

BACKGROUND: The Nursing Profession Self-Efficacy (NPSE) scale was developed to reflect the characteristics of nursing tasks. This study was conducted to validate the Korean version of the NPSE (K-NPSE) scale. METHODS: The NPSE scale with nineteen items was translated into Korean after forward and backward translation according to Devellis' guideline. For the exploratory factor analysis (EFA), 298 nurses participated and criterion-related validity and reliability were verified. For the confirmatory factor analysis (CFA), 218 other nurses participated. Content validity, criterion-related validity, and internal consistency reliability were examined. Additionally, construct validity was examined. SPSS and AMOS were used for the data analyses. RESULTS: Nineteen items were selected after evaluating the content and cognitive validity and comprised three factors: "Professional (10 items)", "Advocating (4)", and "Caring (5)". Construct validity was supported by the CFA. Criterion-related validity was supported by comparison with the General Self-Efficacy Test (r = 0.43, p < 0.001). Cronbach's alpha of the K-NPSE was 0.93. CONCLUSIONS: Study findings indicate that the K-NPSE could be useful for assessing nurses' self-efficacy. The K-NPSE may be used as a valuable reference for developing programs or policies that promote nursing professionals. It is expected that continued use of this scale in various clinical settings to further generalize and validate the scale.

Exploring the Influences of Nurses' Partnership with Parents, Attitude to Families' Importance in Nursing Care, and Professional Self-Efficacy on Quality of Pediatric Nursing Care: A Path Model.

This study examined the effects of nurse-parent partnership, nurses' attitude to families' importance in nursing care, and nursing professional self-efficacy on the quality of pediatric nursing care. BACKGROUND: The quality of pediatric nursing care based on family-centered care is defined by the qualitative care behavior of nurses from the perspective of hospitalized children and their families. METHODS: The participants were 218 nurses in pediatric wards in hospitals. Data were collected using self-report questionnaires and analyzed using descriptive statistics, Pearson's correlation coefficient, and path analysis. RESULTS: Among the factors influencing the perceived quality of respect, explanation, and skillfulness, nurse experience showed the greatest total effect. The nurse-parent partnership had the greatest direct effect on the quality of respect and the greatest total effect on kindness. Nursing professional self-efficacy showed the greatest direct effect on explanation and the largest total effect on nurse-parent partnership and nurses' attitude to families' importance in nursing care. CONCLUSIONS: To improve the quality of pediatric nursing care, it is necessary to provide a working environment in which pediatric nurses can work continuously. Hospitals should also develop a program that enables proper collaboration between nurses and parents of hospitalized children and improves nursing professional self-efficacy.

Levels of Partnership between Nurses and Parents of Hospitalized Children and the Quality of Pediatric Nursing Care as Perceived by Nurses.

PURPOSE: This study investigated the relationship of the partnership between nurses and parents of hospitalized children with the quality of pediatric nursing care as perceived by pediatric nurses. METHODS: A cross-sectional descriptive study was conducted among 90 nurses. The data collected were analyzed using the independent t-test and the Pearson correlation coefficient. RESULTS: The level of partnership between nurses and parents showed significant differences by nurses' age (t=2.22, p=.029) and marital status (t=2.54, p=.013). The quality of pediatric nursing care was found to significantly differ by the nurses' age (t=2.62, p=.013), marital status (t=4.17, p<.001), whether nurses had children (t=2.53, p=.020), pediatric ward work experience (t=2.43, p=.020), and total work experience (t=2.51, p=.016). The level of partnership between nurses and parents was positively correlated with the quality of pediatric nursing care (r=.48, p<.001). CONCLUSION: To improve the quality of nursing care for hospitalized children and their parents, it is important to consider the specific characteristics of pediatric nurses, whose clinical skills should be improved.

Trends in the Epidemiology of Candidemia in Intensive Care Units From 2006 to 2017: Results From the Korean National Healthcare-Associated Infections Surveillance System.

Candidemia is an important healthcare-associated infection (HAI) in intensive care units (ICUs). However, limited research has been conducted on candidemia in the Republic of Korea. We aimed to analyze the secular trends in the incidence and distribution of candidemia in ICUs over 12-years using data from the Korean National Healthcare-Associated Infections Surveillance System (KONIS). KONIS was established in 2006 and has performed prospective surveillance of HAIs including bloodstream infections (BSIs) in ICUs. We evaluated the trends in the distribution of causative pathogens and the incidence of candidemia. From 2006 to 2017, 2,248 candidemia cases occurred in 9,184,264 patient-days (PDs). The pooled mean incidence rates of candidemia significantly decreased from 3.05 cases/10,000 PDs in 2006 to 2.5 cases/10,000 PDs in 2017 (P = 0.001). Nevertheless, the proportion of candidemia gradually increased from 15.2% in 2006 to 16.6% in 2017 (P = 0.001). The most frequent causative pathogen of BSIs from 2006 to 2012 was Staphylococcus aureus; however, Candida spp. emerged as the most frequent causative pathogen since 2013. C. albicans (39.9%) was the most common among Candida spp. causing BSIs, followed by Candida tropicalis (20.2%) and Candida parapsilosis (18.2%). The proportion of candidemia caused by C. glabrata significantly increased from 8.9% in 2006 to 17.9% in 2017 (P < 0.001). There was no significant change in the distribution of Candida spp. by year (P = 0.285). The most common source of BSIs was central lines associated BSI (92.5%). There was a significant increase in the proportion of candidemia by year in hospitals with organ transplant wards (from 18.9% in 2006 to 21.1% in 2017, P = 0.003), hospitals with <500 beds (from 2.7% in 2006 to 13.6% in 2017, P < 0.001), and surgical ICUs (from 16.2% in 2006 to 21.7% in 2017, P = 0.003). The proportion of candidemia has increased in Korea, especially in hospitals with <500 beds and surgical ICUs. Thus, appropriate infection control programs are needed.

Relationships Between Smartphone Dependency and Aggression Among Middle School Students: Mediating and Moderating Effects of Ego-Resilience, Parenting Behaviour, and Peer Attachment.

This study examined the moderating and mediating effects of ego-resilience, parenting behaviour, and peer attachment on the relationship between smartphone dependency and aggression. Participants included 1863 middle school youths who used smartphones and had responded to the 7th Korean Children and Youth Panel Survey (KCYPS), which was conducted by Korea's National Youth Policy Institute. Data were analysed using descriptive statistics, correlation, and hierarchical regression analyses. First, ego-resilience showed a partial mediating effect on the relationship between smartphone dependency and aggression (significant moderating effects were revealed). Second, parenting behaviour demonstrated a partial mediating effect on the relationship between smartphone dependency and aggression (no moderating effects observed). Third, peer attachment had a partial mediating effect on the relationship between smartphone dependency and aggression (no moderating effects were observed). These findings suggest that mental health and student growth can be improved as children develop by implementing various nursing and health care programs designed to improve ego-resilience, parenting behaviour, and peer attachment.

[Validity and Reliability of the Korean Version Scale of the Clinical Learning Environment, Supervision and Nurse Teacher Evaluation Scale (CLES+T)].

PURPOSE: This study was conducted to evaluate the validity and reliability of the Korean version of the clinical learning environment, supervision and nurse teacher evaluation scale (CLES+T) that measures the clinical learning environment and the conditions associated with supervision and nurse teachers. METHODS: The English CLES+T was translated into Korean with forward and back translation. Survey data were collected from 434 nursing students who had more than four days of clinical practice in Korean hospitals. Internal consistency reliability and construct validity using confirmatory and exploratory factor analysis were conducted. SPSS 20.0 and AMOS 22.0 programs were used for data analysis. RESULTS: The exploratory factor analysis revealed seven factors for the thirty three-item scale. Confirmatory factor analysis supported good convergent and discriminant validities. The Cronbach's alpha for the overall scale was .94 and for the seven subscales ranged from .78 to .94. CONCLUSION: The findings suggest that the 33-items Korean CLES+T is an appropriate instrument to measure Korean nursing students'clinical learning environment with good validity and reliability.

Correlation of Glypican-4 Level with Basal Active Glucagon-Like Peptide 1 Level in Patients with Type 2 Diabetes Mellitus.

BACKGROUND: Previous studies have reported that glypican-4 (GPC4) regulates insulin signaling by interacting with insulin receptor and through adipocyte differentiation. However, GPC4 has not been studied with regard to its effects on clinical factors in patients with type 2 diabetes mellitus (T2DM). We aimed to identify factors associated with GPC4 level in T2DM. METHODS: Between January 2010 and December 2013, we selected 152 subjects with T2DM and collected serum and plasma into tubes pretreated with aprotinin and dipeptidyl peptidase-4 inhibitor to preserve active gastric inhibitory polypeptide (GIP) and glucagon-like peptide 1 (GLP-1). GPC4, active GLP-1, active GIP, and other factors were measured in these plasma samples. We performed a linear regression analysis to identify factors associated with GPC4 level. RESULTS: The subjects had a mean age of 58.1 years, were mildly obese (mean body mass index [BMI], 26.1 kg/m²), had T2DM of long-duration (mean, 101.3 months), glycated hemoglobin 7.5%, low insulin secretion, and low insulin resistance (mean homeostatic model assessment of insulin resistance [HOMA-IR], 1.2). Their mean GPC4 was 2.0±0.2 ng/mL. In multivariate analysis, GPC4 was independently associated with age (ß=0.224, P=0.009), and levels of active GLP-1 (ß=0.171, P=0.049) and aspartate aminotransferase (AST; ß=-0.176, P=0.043) after being adjusted for other clinical factors. CONCLUSION: GPC4 was independently associated with age, active GLP-1, and AST in T2DM patients, but was not associated with HOMA-IR and BMI, which are well known factors related to GPC4. Further study is needed to identify the mechanisms of the association between GPC4 and basal active GLP-1 levels.

Impact of Psychoeducation on Knowledge of and Attitude Toward Medications in Clients With Schizophrenia and Schizoaffective Disorders.

PURPOSE: To examine a psychoeducational intervention's effects on knowledge and attitudes toward antipsychotic medication in clients with schizophrenia and schizoaffective disorders. DESIGNS AND METHODS: A one-group pretest-posttest design was employed. A convenience sample (61 psychiatric clients aged 20 or above) was recruited from a Korean mental health center. FINDINGS: At baseline, participants had limited knowledge (M = 50.89, range: 27-77, SD = 12.05) of and negative feelings toward antipsychotic medications (M = -.89, range: -8 to 8, SD = 4.27). Both measures significantly improved post-intervention. PRACTICE IMPLICATIONS: A psychoeducational intervention improved clients' knowledge of and attitudes toward antipsychotic medications.

Li Storage of Calcium Niobates for Lithium Ion Batteries.

New types of niobates negative electrode were studied for using in lithium-ion batteries in order to alternate metallic lithium anodes. The potassium intercalated compound KCa2Nb3O10 and proton intercalated compound HCa2Nb3O10 were studied, and the electrochemical results showed a reversible cyclic voltammetry profile with acceptable discharge capacity. The as-prepared KCa2Nb3O10 negative electrode had a low discharge capacity caused by high overpotential, but the reversible intercalation and deintercalation reaction of lithium ions was activated after exchanging H+ ions for intercalated K+ ions. The initial discharge capacity of HCa2Nb3O10 was 54.2 mAh/g with 92.1% of coulombic efficiency, compared with 10.4 mAh/g with 70.2% of coulombic efficiency for KCa2Nb3O10 at 1 C rate. The improved electrochemical performance of the HCa2Nb3O10 was related to the lower bonding energy between proton cation and perovskite layer, which facilitate Li+ ions intercalating into the cation site, unlike potassium cation and perovskite layer. Also, this negative material can be easily exfoliated to Ca2Nb3O10 layer by using cation exchange process. Then, obtained two-dimensional nanosheets layer, which recently expected to be an advanced electrode material because of its flexibility, chemical stable, and thin film fabricable, can allow Li+ ions to diffuse between the each perovskite layer. Therefore, this new type layered perovskite niobates can be used not only bulk-type lithium ion batteries but also thin film batteries as a negative material.

Effects of constructivist teaching methods on bioethics education for nursing students: a quasi-experimental study.

BACKGROUND: In order to help nurses advocate for the patient's human rights and ensure respect for life in clinical situations, it is of utmost importance to improve nursing students' capacity to make ethical decisions. OBJECTIVES: This study compares the effects of two constructivist teaching strategies (action learning and cross-examination debate) on nursing students' recognition of bioethical issues, experience of bioethical issues, and attainment of ethical competence. DESIGN: This study used a quasi-experimental (two-group pretest-posttest) design. SETTING: A nursing college in South Korea. PARTICIPANTS: A total of 93 Korean nursing students participated in the study (46 in the action learning group and 47 in the cross-examination debate group). METHODS: Participants took a bioethics class employing one or the other of the strategies mentioned, 2h a week for 15 weeks. All participants responded twice to a set of questionnaires, at the beginning of the first session and at the end of the last session. RESULTS: After their bioethics education, the students' recognition of bioethical issues improved for both classes; however, the knowledge of students who had participated in action learning improved more than that of the students in the debate-based class. Students in both groups reported more experience of bioethics and exposure to better-quality instruction in bioethics after their classes than previously. Students in both groups also reported improved ethical competency after this education. CONCLUSION: Positive effects of action learning and cross-examination debate implemented as teaching strategies on nursing students' understanding of bioethical issues and their ethical competency were identified; these findings will be important in the essential task of teaching bioethics to nursing students in order to foster more ethical decision-making and other ethical behavior.

Characteristics of subjects with very low serum low-density lipoprotein cholesterol and the risk for intracerebral hemorrhage.

BACKGROUND/AIMS: The clinical implications of hypocholesterolemia have not been well studied, although some studies have revealed an association between hypocholesterolemia and intracerebral hemorrhage (ICH). We evaluated the clinical characteristics of subjects with very low-density lipoprotein cholesterol (LDL-C) and compared the risk for ICH using various clinical parameters. METHODS: Using hospital records, we evaluated the clinical characteristics of subjects with LDL-C levels ≤ 40 mg/dL (very low LDL-C group). We also evaluated the risk for ICH in this very low LDL-C group and in subjects with low LDL-C ≤ 70 mg/dL (low LDL-C group). RESULTS: Among 34,415 subjects who presented at the laboratory for serum LDL-C measurements, 250 subjects had a very low serum LDL-C level (≤ 40 mg/dL). About half of the subjects were statin users; the very low LDL levels in the other subjects were likely attributable to alcohol consumption or a various chronic illness such as liver disease or end-stage renal disease (ESRD). ICH occurred in three subjects with very low LDL-C, all of whom had no history of statin use. ESRD tended to be associated with ICH in subjects with serum LDL-C ≤ 70 mg/dL. CONCLUSIONS: About 1% of the subjects whose LDL-C was measured in the hospital had a LDL-C level ≤ 40 mg/dL, and about half of these subjects had no history of hypolipidemic therapy. ICH incidence was not related to LDL-C level or statin use.

Solitary rectal metastasis from primary small cell lung carcinoma.

Lung cancer may rarely appear with a solitary rectal metastasis and no other metastases. We report the first case of primary small cell lung cancer presenting with a solitary rectal metastasis in a 62-year-old man. Chest computed tomography revealed a soft tissue lesion in the subcarinal area. Following bronchoscopic biopsy, the patient was diagnosed with small cell lung cancer. The rectal mass was incidentally found during an imaging study for staging work-up. Histological examination revealed that the rectal mass was consistent with metastasis from small cell lung cancer. We suggest that clinicians should consider the possibility of rectal metastasis in small cell lung cancer patients with rectal masses.

BROTHER OF FT AND TFL1 (BFT), a member of the FT/TFL1 family, shows distinct pattern of expression during the vegetative growth of Arabidopsis.

Transition to the flowering stage is precisely controlled by a few classes of regulatory molecules. BROTHER OF FT AND TFL1 (BFT) is a member of FLOWERING LOCUS T (FT)/TERMINAL FLOWER 1 (TFL1) family, an important class of flower development regulators with unidentified biochemical function. BFT has a TFL1-like activity and plays a role in axillary inflorescence development. To elucidate the expression pattern of BFT, we analyzed the subcellular localization and conditional expression of BFT in this study. We generated 35S::BFT:GFP plants to investigate the subcellular localization of BFT protein. 35S::BFT:GFP plants showed late flowering, similarly as did 35S::BFT plants. BFT:GFP fusion protein was localized in the nucleus and the plasma membrane, which was different from the localization pattern of FT and TFL1. BFT expression was induced by abiotic stress conditions. ABA, drought, and osmotic stress treatments induced BFT expression, whereas cold, salt, and heat stress conditions did not, suggesting that BFT plays a role in regulating flowering time and inflorescence structure under drought conditions. The induction pattern of BFT was different from those of other FT/TFL1 family genes. Our studies indicated that BFT showed a distinct expression pattern from its homologous genes during the vegetative growth in Arabidopsis.