The effectiveness of CA125 and HE4 as clinical prognostic markers in epithelial ovarian cancer patients with BRCA mutation.

OBJECTIVE: To investigate the efficacy of cancer antigen 125 (CA125) and human epididymis protein 4 (HE4) in predicting survival outcomes based on breast cancer gene (BRCA) mutational status in epithelial ovarian cancer. METHODS: Medical records of 448 patients diagnosed with epithelial ovarian cancer at a single tertiary institution in Korea were retrospectively analyzed. Area under the curve, sensitivity, specificity, and accuracy were assessed using the CA125 and HE4 values after surgery and 3 cycles of chemotherapy to predict 1-year survival based on the BRCA mutational status. Kaplan-Meier analysis was used to obtain progression-free and overall survival to evaluate CA125 and HE4 effectiveness in predicting survival outcomes. RESULTS: A total of 423 patients were analyzed, including 180 (42.6%) who underwent interval debulking surgery (IDS) and 243 (57.4%) who underwent primary debulking surgery (PDS). BRCA mutations were observed in 37 (15.2%) and 44 (22.4%) patients in the PDS and IDS groups, respectively. CA125 and HE4 normalization demonstrated the highest specificity in patients with or without BRCA mutations, with specificities of 97.1% and 99.1% in the PDS group and 78.6% and 86.2% in the IDS group, respectively. Normalizing HE4 alone may be an effective prognostic marker, with an area under the curve of 0.774 and specificity of 75.0%, in patients with BRCA mutations. CONCLUSION: Normalizing both biomarkers emerged as the most effective predictive marker for the 1-year recurrence rate, regardless of BRCA mutational status. A negative HE4 value can be a useful predictor for 1-year recurrence-free survival in patients with BRCA mutations.

Pectobacterium jejuense sp. nov. Isolated from Cucumber Stem Tissue.

A single Pectobacterium-like strain named 13-115T was isolated from a specimen of diseased cucumber stem tissue collected on Jeju Island, South Korea. The strain presented a rod-like shape and was negative for Gram staining. When grown on R2A medium at 25 °C, strain 13-115T formed round, convex and white colonies. This strain showed growth at temperatures ranging from 10 to 30 °C and tolerated a pH range of 6-9. The strain could also tolerate NaCl concentrations up to 5%. Analysis of the 16S rRNA gene sequence revealed that strain 13-115T exhibited similarity of over 99% with Pectobacterium brasiliense, P. carotovorum, P. polaris, and P. parvum. By conducting multilocus sequence analyses using dnaX, leuS, and recA genes, a separate phylogenetic lineage was discovered between strain 13-115T and other members of the genus Pectobacterium. Moreover, the strain showed relatively low in silico DNA-DNA hybridization (<60.6%) and average nucleotide identity (ANI) (<94.9%) values with recognized Pectobacterium species. The isolate has a genome size of 5,069,478 bp and a genomic G + C content of 52.04 mol%. Major fatty acids identified in the strain included C16:0 (28.99%), summed feature 3 (C16:1 ω7c and/or C16:1 ω6c; 28.85%), and C18:1 ω7c (19.01%). Pathogenicity assay confirmed that the novel strain induced soft rot symptoms in cucumber plants and Koch's postulates were fulfilled. Molecular analysis and phenotypic data indicated that strain 13-115T could be classified as a new species within the Pectobacterium genus, which has been named Pectobacterium jejuense. The type strain is 13-115T (= KCTC 92800T = JCM 35940T).

Educational intervention for family caregivers of older adults with delirium: An integrative review.

AIM: To propose educational strategies to prevent delirium in older adults. DESIGN: Integrative review. METHODS: This review followed the methodology of Whittemore and Knafl (J Adv Nurs 52(5):546-553, 2005. 10.1111/j.1365-2648.2005.03621.x). DATA SOURCES: A literature search was performed of the PubMed, CINAHL, Embase, Cochrane Library CENTRAL, and Scopus databases on 8 July 2022. RESULTS: Three themes of educational interventions were identified: capacity building, resource provision and enhancement of relationships, collectively termed Fa-CARE. Educational interventions improved family caregivers' knowledge about delirium, their anxiety; depression; self-efficacy; and attitudes. Among older adults, these interventions improved the duration, severity and incidence of delirium; functional abilities; and length of hospital stay. CONCLUSION: Providing education to family caregivers benefits both those caregivers and the older adults. When planning educational intervention, diverse and innovative approaches need to be considered. IMPLICATIONS FOR THE PROFESSION AND/OR PATIENT CARE: This study can guide family education regarding the care of older adults with delirium. IMPACT: Educational interventions positively impacted both family caregivers and older adults with delirium. Educational interventions provide family caregivers with resources, improve their capacity for delirium management, and enhance their relationships with older adults. This study suggests future directions in education for family caregivers of older adults with delirium. REPORTING METHOD: This review adhered to the EQUATOR guidelines by using the PRISMA 2020 checklist. PATIENT OR PUBLIC CONTRIBUTION: No patient or public contribution.

Neocucurbitaria chlamydospora sp. nov.: A Novel Species of the Family Cucurbitariaceae Isolated from a Stink Bug in Korea.

The fungal strain KNUF-22-18B, belonging to Cucurbitariaceae, was discovered from a stink bug (Hygia lativentris) during the investigation of insect microbiota in Chungnam Province, South Korea. The colonies of the strain KNUF-22-18B were wooly floccose, white to brown in the center on oatmeal agar (OA), and the colonies were buff, margin even, and colorless, reverse white to yellowish toward the center on malt extract agar (MEA). The strain KNUF-22-18B produced pycnidia after 60 days of culturing on potato dextrose agar, but pycnidia were not observed on OA. On the contrary, N. keratinophila CBS 121759T abundantly formed superficial pycnidia on OA and MEA after a few days. The strain KNUF-22-18B produced chlamydospores subglobose to globose, mainly in the chain, with a small diameter of 4.4-8.8 µm. At the same time, N. keratinophila CBS 121759T displayed a globose terminal with a diameter of 8-10 µm. A multilocus phylogeny using the internal transcribed spacer regions, 28S rDNA large subunit, ß-tubulin, and RNA polymerase II large subunit genes further validated the uniqueness of the strain. The detailed description and illustration of the proposed species as Neocucurbitaria chlamydospora sp. nov. from Korea was strongly supported by molecular phylogeny.

Molecular Phylogeny and Morphology of Tolypocladium globosum sp. nov. Isolated from Soil in Korea.

In this study, fungal strains designated as KNUF-22-14A and KNUF-22-15A were isolated from soil samples in Korea. These two strains were identified based on cultural and morphological characteristics as well as phylogenetic analyses and were found to be morphologically and phylogenetically identical. Upon their morphological comparison with closely related species, such as Tolypocladium album, T. amazonense, T. endophyticum, T. pustulatum, and T. tropicale, a difference in the size of short phialides [0.6-2.4(-9.3) × 0.8-1.4 µm] was observed. Meanwhile, these strains had larger conidia (1.2-3.0 × 1.2-3.0 µm) than T. album, T. amazonense, T. endophyticum, and T. tropicale and smaller conidia than T. pustulatum. Phylogenetic analyses using a multi-locus datasets based on ITS, LSU, and SSU showed that KNUF-22-14A and KNUF-22-15A formed a distinct cluster from previously identified Tolypocladium species. Thus, these fungal strains isolated from soil in Korea are proposed as a novel species according to their characteristics and are named Tolypocladium globosum sp. nov.

Morphological and Phylogenetic Analyses Reveal a New Species of Genus Monochaetia Belonging to the Family Sporocadaceae in Korea.

The fungal strain belonging to the genus Monochaetia of the family Sporocadaceae was isolated from hairy long-horned toad beetle (Moechotypa diphysis) during the screening of microfungi associated with insects from Gangwon Province, Korea. The strain KNUF-6L2F produced white, light brown to dirty black surface, and olivaceous green colonies with the higher growth, while the closest strain M. ilicis KUMCC 15-0520T were light brown to brown, and M. schimae SAUCC 212201T light brown to brown toward center. The strain KNUF-6L2F produced shorter (5.7-14.0 µm) apical appendages than M. ilicis (6.0-24.0 µm), but similar to M. schimae (7.0-12.5 µm). Three median cells of KNUF-6L2F were light brown to olivaceous green, whereas brown and olivaceous cells were observed from M. ilicis and M. schimae, respectively. And the strain KNUF-6L2F produced larger conidiogenous cells than M. ilicis and M. schimae. Additionally, phylogenetic analyses based on molecular datasets of internal transcribed spacer (ITS) regions, translation elongation factor 1-alpha (TEF1α), and ß-tubulin (TUB2) genes corroborated the strain's originality. Thus, the strain is different from other known Monochaetia species, according to molecular phylogeny and morophology, hence we suggested the new species Monochaetia mediana sp. nov. and provided a descriptive illustration.

Taxonomy of Botryotrichum luteum sp. nov. based on Morphology and Phylogeny Isolated from Soil in Korea.

In this study, a fungal strain KNUF-22-025 belonging to the genus Botryotrichum was isolated from the soil in Korea. The cultural and morphological characteristics of this strain differed from those of closely related species. On malt extract agar, strain KNUF-22-025 showed slower growth than most of the related species, except B. domesticum. The conidia size (9.6-21.1 × 9.9-18.4 µm) of strain KNUF-22-025 was larger than those of B. piluliferum, B. domesticum, and B. peruvianum but smaller than those of B. atrogriseum and B. iranicum. Conidiophores in strain KNUF-22-025 (137 µm) were longer than those in other closely related species but shorter than those in B. atrogriseum. Multi-locus analysis of molecular markers, such as ITS, 28S ribosomal DNA, RBP2, and TUB2 revealed that strain KNUF-22-025 was distinct from other Botryotrichum species. Thus, this strain is proposed as a novel species based on morphological characteristics along with molecular phylogeny and named Botryotrichum luteum sp. nov.

The Mediating Effect of Uncertainty in Illness on Cancer Coping in Patients With Primary Malignant Brain Tumors.

BACKGROUND: Patients with primary malignant brain tumors (PMBTs) experience uncertainty in illness (UI) because of the high recurrence rate and symptoms that occur during treatment. OBJECTIVE: To develop and test a model based on the Uncertainty in Illness Theory to predict the UI and cancer coping experienced by PMBT patients. METHODS: This was a cross-sectional study using path analysis. The participants were adults diagnosed with PMBT who completed a questionnaire about demographic and disease-related characteristics, UI, cancer coping, brain tumor symptoms, and social support. Clinical data (eg, the diagnosis, tumor location, and grade) were obtained from electronic health records. Data were analyzed using SPSS 26.0 and the MVN , psych , and lavaan packages in R 4.1.0. RESULTS: This study included 203 PMBT patients. The hypothesized model satisfied all statistical criteria (comparative fit index = 0.998, root mean square error of approximation = 0.044, standardized root mean square residual = 0.016). The indirect and direct associations of UI in the path from social support to cancer coping were all significant with a 95% bootstrapping confidence interval. Although the indirect and direct associations of UI in the path of brain tumor symptoms and cancer coping did not have direct or total effects, the indirect effect was statistically significant. CONCLUSIONS: Uncertainty in illness mediated brain tumor symptoms and social support to predict cancer coping. IMPLICATIONS FOR PRACTICE: A nurse-led intervention for cancer coping among PMBT patients can be developed by considering symptoms and social support and UI as a mediator.

What we need to know about uncertainty in illness among people with primary malignant brain tumours: A mixed-methods systematic review.

AIMS AND OBJECTIVES: To identify the characteristics of uncertainty in illness (UI) among people with primary malignant brain tumours (PMBT). BACKGROUND: High recurrence rates and complex symptoms cause uncertainty in people with PMBT. Given the characteristics of PMBT, reviewing UI among people with PMBT will benefit future research and clinical intervention development. DESIGN: A mixed-methods systematic review. METHODS: We performed a mixed-methods systematic review (PubMed, CINAHL, Embase, PsycINFO, Scopus and Cochrane Library), including studies on UI among people with PMBT, searched from the databases' inception to the search date. The initial search was conducted in July 2021, with an additional search in March 2022. The major search terms were PMBT and UI, and no limitations were placed on the study design. The Cochrane tool was used to evaluate the risk of bias in randomised controlled trials, and JBI checklists were used to evaluate quasi-experimental studies, survey methodology studies and a case study. This review was reported using the PRISMA 2020 checklist. Both quantitative and qualitative research data were extracted, analysed and then integrated in three stages of a mixed-methods systematic review. RESULTS: Eleven studies were included. Due to physical, psychological and social risk factors, the UI progression of people with PMBT was complex and ambiguous, although they adapted to the PMBT diagnosis and treatment process. Subsequently, we proposed a model of UI among people with PMBT. CONCLUSIONS: UI has multidimensional characteristics, and healthcare providers need to consider these aspects for people with PMBT. RELEVANCE TO CLINICAL PRACTICE: The proposed model provides directions for nursing practice and future research. Nurses caring for people with PMBT should comprehend their UI and intervene accordingly. PATIENT OR PUBLIC CONTRIBUTION: This review incorporated data including people with PMBT in hospitals and communities. This analysis contributes to the clinical-to-community nursing transition process for people with PMBT.

Simulation Education Incorporating Academic Electronic Medical Records for Undergraduate Nursing Students: A Pilot Study.

OBJECTIVES: Academic electronic medical records (AEMRs) can be utilized for a variety of educational programs that can enhance nursing students' nursing informatics and clinical reasoning competencies. This study aimed to identify the applicability and effectiveness of simulation education incorporating AEMRs. METHODS: We developed simulation education scenarios incorporating AEMRs and evaluated them with 76 third- and fourth-year nursing students from five nursing schools using a mixed-methods design. We incorporated three simulation case scenarios involving preeclampsia, diabetes mellitus, and myocardial infarction into the AEMRs. After the simulation education, participants' feedback on the usability of the AEMR system and their self-efficacy for AEMR utilization were collected via self-reported surveys. Subsequently, the simulation education incorporating AEMRs was evaluated through a focus group interview. The survey data were examined using descriptive statistics, and thematic analysis was done for the focus group interview data. RESULTS: The average mean scores for the AEMR system's usability and participants' self-efficacy for AEMR utilization were 5.36 of 7 and 3.96 of 5, respectively. According to the focus group interviews, the participants were satisfied with the simulation education incorporating AEMRs and recognized their confidence in AEMR utilization. In addition, participants addressed challenges to simulation education incorporating AEMRs, including the need for pre-education and AEMR utilization difficulties. CONCLUSIONS: Nursing students were satisfied with and recognized the value of simulation education incorporating AEMRs. Although the actual application of simulation education incorporating AEMRs remains challenging, further research can help develop and implement this approach for nursing students.

Evaluation of therapeutic communication education for nursing students based on constructivist learning environments: A systematic review.

OBJECTIVES: Education on therapeutic communication has been emphasized in nursing education. However, few studies have used an educational framework to develop educational interventions, such as the instructional design model for Jonassen's Constructivist Learning Environments. Based on the model of Constructivist Learning Environments, this study aimed to analyze educational interventions on therapeutic communication for nursing students and propose a model for therapeutic communication education for nurse educators. DESIGN: A systematic review. DATA SOURCES: The terms "nursing," "students," "therapeutic," and "communication" were used to search for studies in English conducted between 2000 and 2022 in four databases (PubMed, Embase, Cumulative Index of Nursing and Allied Health Plus with Full Text, and Cochrane Library CENTRAL). REVIEW METHODS: Two researchers independently screened the titles and abstracts of the original studies, followed by the full texts. The Cochrane Risk of Bias Tool 2.0 for randomized controlled trials and Risk of Bias Assessment Tool for Non-Randomized Studies for quasi-experimental studies were used to evaluate the eligible studies. This review adopted the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. RESULTS: Twelve studies were included in this review. Among the six instructional components of the model for Constructivist Learning Environments, the most commonly used were question/case/problem, cognitive tool, and conversational/collaboration tool. Among the three instructional methods of the model, coaching was the most frequently used. Therefore, an instructional design model for effective therapeutic communication education for nursing students was proposed based on Constructivist Learning Environments. CONCLUSIONS: Employing an instructional design, such as Constructivist Learning Environments, can effectively promote the therapeutic communication education of nursing students.

Psychometric evaluation of the Korean version of PROMIS self-efficacy for managing symptoms item bank: Item response theory.

PURPOSE: To evaluate the psychometric properties of the Patient-Reported Outcomes Measurement Information System (PROMIS) self-efficacy for managing symptoms of the version 1.0 item bank in Korean. METHODS: This study consisted of two phases: first, developing the Korean version of the item bank following the translation guidelines; and second, performing a cross-sectional study to evaluate its psychometric properties using the item response theory. This study enrolled 323 patients with type 2 diabetes mellitus between July and August 2020. Cronbach's α was used to assess the reliability of this item bank. Confirmatory factor analysis, using diagonally weighted least squares, was used to identify the assumptions of item response theory. Item parameter estimates including discrimination and thresholds were derived using the graded response model of the item response theory to reflect patient-reported outcomes as individualized responses. RESULTS: The Korean version of the item bank demonstrated good reliability (Cronbach's α =.98) and its discrimination ranged from 1.82 to 4.93. The thresholds resulted in the establishment of a category response curve for each item. However, no overlap was observed among the category curves. Moreover, the differential item functioning was not significant for age, gender, and income variables. CONCLUSION: The graded response model and differential item functioning provided qualitative evidence that demonstrated acceptable psychometric properties of symptom management self-efficacy among patients. This item bank is expected to provide adequate assessments of self-efficacy of symptom management for patients with a chronic disease, which can contribute to nursing research and intervention.

Effects of Serious Games on Depression in Older Adults: Systematic Review and Meta-analysis of Randomized Controlled Trials.

BACKGROUND: Depression is a severe psychological concern that negatively affects health in older adults. Serious games applied in various fields are considered appropriate interventions, especially in mental health care. However, there is a lack of evidence regarding the effects of serious games on depression in older adults. OBJECTIVE: This study aimed to investigate the characteristics and effectiveness of serious games for depression in older adults. METHODS: A systematic review and meta-analysis of randomized controlled trials were conducted. In total, 5 electronic databases (PubMed, CINAHL, Embase, PsycINFO, and Cochrane Library) were searched to identify relevant studies published until July 6, 2021. A total of 2 reviewers independently conducted study selection, data extraction, and quality appraisals. The risk of bias in the included studies was assessed using the JBI Critical Appraisal Checklist. For the meta-analysis, the effect size was calculated as the standardized mean difference (SMD) by using a random effects model. RESULTS: A total of 17 studies with 1280 older adults were included in the systematic review, and 15 studies were included in the meta-analysis. Serious game interventions were classified into 3 types: physical activity (PA), cognitive function, and both PA and cognitive function. The meta-analysis demonstrated that serious games reduced depression in older adults (SMD -0.54, 95% CI -0.79 to -0.29; P<.001). Serious games had a more significant effect size in community or home settings (SMD -0.61, 95% CI -0.95 to -0.26; P<.001) than in hospital settings (SMD -0.46, 95% CI -0.85 to -0.08; P=.02); however, the difference between groups was not significant. Among the types of games, games for PA (SMD -0.60, 95% CI -0.95 to -0.25; P<.001) and games for both (SMD -0.73, 95% CI -1.29 to -0.17; P=.01) had a significant effect on reducing depression in older adults. However, no significant correlations were observed between the duration or number of serious games and depression. CONCLUSIONS: Serious games were beneficial in reducing depression in older adults. Regardless of the study setting, serious games appeared to reduce depression. Particularly, serious games including PA had a significant impact on reducing depression. Furthermore, high-quality randomized controlled trials are needed to establish substantial evidence for the effectiveness of serious games on depression in older adults. TRIAL REGISTRATION: PROSPERO CRD42021242573; https://tinyurl.com/26xf7ym5.

Pedobacter segetis sp. nov., a Novel Bacterium Isolated from Soil.

A Gram-negative, motile by gliding, rod-shaped, aerobic bacterium, designated SD-bT, was isolated from a soil sample collected on Dokdo Island, South Korea. A polyphasic approach based on phenotypic, phylogenetic, and genomic analyses was used to characterize the new isolate. Phylogenetic analysis of 16S rRNA gene sequence showed that strain SD-bT belonged to the family Sphingobacteriaceae and most closely related to Pedobacter psychrophilus P4487AT (95.9% similarity). The isolate contained MK-7 as the predominant respiratory quinone; its main polar lipid was phosphatidylethanolamine; and the major fatty acids were summed feature 3 (C16:1 ω7c/C16:1 ω6c; 32.0%), C15:0 iso (19.1%), C17:0 iso 3-OH (8.3%), and C16:0 (8.2%). The draft genome had a length of 3,842,102 bp with a G+C content of 36.0 mol%, predicting 3282 coding sequences, 3 rRNA genes, 3 ncRNAs, and 36 tRNAs genes. The digital DNA-DNA hybridization and average nucleotide identity values between strain SD-bT and P. psychrophilus LMG 29436T were 22.0% and 78.9%, respectively. The results of phenotypic properties, genotypic distinctiveness, and chemotaxonomic features support the discrimination of SD-bT from its phylogenetic relatives. Pedobacter segetis sp. nov. is therefore proposed with SD-bT (= KCTC 82351T = JCM 34283T) as the type strain.

A Cross-Sectional Study: What Contributes to Nursing Students' Clinical Reasoning Competence?

Clinical reasoning is a vital competence for nursing students, as it is required for solving problems arising in complex clinical situations. Identifying the factors that influence nursing students' clinical reasoning competence in the social context can help their implicit educational needs. Therefore, this study aimed to determine the factors associated with developing clinical reasoning competency among undergraduate nursing students. In total, 206 senior nursing students were included in this study. Self-reported measures were used to obtain data on participants' clinical reasoning competence, problem-solving abilities, academic self-efficacy, and level of clinical practicum stress. Relationships among continuous variables were analyzed using Pearson's correlation coefficients. A multiple linear regression analysis was conducted to identify factors related to clinical reasoning competence. Our findings show that participants with better problem-solving abilities and academic self-efficacy perceived themselves as having higher levels of clinical reasoning competence. Nursing students with lower clinical practicum stress reported higher clinical reasoning competence. Significant factors identified were younger age and subcategories of problem-solving ability such as problem clarification, alternative solution development, planning/implementation, and self-regulated efficacy. Our findings highlight essential factors necessary for developing a nursing curriculum that contributes to professional nurses' clinical reasoning competence.

Mapping three-dimensional surface deformation caused by the 2010 Haiti earthquake using advanced satellite radar interferometry.

Mapping three-dimensional (3D) surface deformation caused by an earthquake is very important for the environmental, cultural, economic and social sustainability of human beings. Synthetic aperture radar (SAR) systems made it possible to measure precise 3D deformations by combining SAR interferometry (InSAR) and multiple aperture interferometry (MAI). In this paper, we retrieve the 3D surface deformation field of the 2010 Haiti earthquake which occurred on January 12, 2010 by a magnitude 7.0 Mw by using the advanced interferometric technique that integrates InSAR and MAI data. The surface deformation has been observed by previous researchers using the InSAR and GPS method, but 3D deformation has not been measured yet due to low interferometric coherence. The combination of InSAR and MAI were applied to the ALOS PALSAR ascending and descending pairs, and were validated with the GPS in-situ measurements. The archived measurement accuracy was as little as 1.85, 5.49 and 3.08 cm in the east, north and up directions, respectively. This result indicates that the InSAR/MAI-derived 3D deformations are well matched with the GPS deformations. The 3D deformations are expected to allow us to improve estimation of the area affected by the 2010 Haiti earthquake.

Usefulness of the Waist Circumference-to-Height Ratio in Screening for Obesity and Metabolic Syndrome among Korean Children and Adolescents: Korea National Health and Nutrition Examination Survey, 2010-2014.

The aims of this study were to assess the diagnostic value of the weight-to-height ratio (WHtR) for the detection of obesity and metabolic syndrome (MS) in Korean children and adolescents, and to determine the advantages of WHtR as a population-based screening tool in comparison with other obesity indicators, such as body mass index (BMI) and waist circumference (WC). We performed a cross-sectional analysis of data from 3057 children and adolescents (1625 boys, 1332 girls) aged 10-19 years who were included in the fifth Korean National Health and Nutrition Examination Survey (KNHANES, 2010-2012) up to the second year of the sixth KNHANES (2013-2014). Receiver operation characteristic (ROC) curves were generated to determine the optimal cutoff value and accuracy of WHtR for predicting individual obesity indicators or more than two non-WC components of MS. The area under the ROC curve (AUC) is a measure of the diagnostic power of a test. A perfect test will have an AUC of 1.0, and an AUC equal to 0.5 means that the test performs no better than chance. The optimal WHtR cutoff for the evaluation of general obesity and central obesity was 0.50 in boys and 0.47-0.48 in girls, and the AUC was 0.9. Regarding the assessment of each MS risk factor, the optimal WHtR cutoff was 0.43-0.50 in boys and 0.43-0.49 in girls, and these cutoffs were statistically significant only for the detection of high triglyceride and low High-density lipoprotein (HDL) cholesterol levels. When a pairwise comparison of the AUCs was conducted between WHtR and BMI/WC percentiles to quantify the differences in power for MS screening, the WHtR AUC values (boys, 0.691; girls, 0.684) were higher than those of other indices; however, these differences were not statistically significant (boys, p = 0.467; girls, p = 0.51). The WHtR cutoff value was 0.44 (sensitivity, 67.7%; specificity, 64.6%) for boys and 0.43 (sensitivity, 66.4%; specificity, 66.9%) for girls. There was no significant difference between the diagnostic power of WHtR and that of BMI/WC when screening for MS. Although the use of WHtR was not superior, WHtR is still useful as a screening tool for metabolic problems related to obesity because of its convenience.

RuvB-Like Protein 2 (Ruvbl2) Has a Role in Directing the Neuroectodermal Differentiation of Mouse Embryonic Stem Cells.

Although many factors have been identified to be involved in the development of the neuroectoderm during embryogenesis, it is still important to identify novel factors that convert undifferentiated embryonic cells into neuroectoderm. RuvB-like protein 2 (Ruvbl2) is known to regulate gene expression via chromatin remodeling by participating in multi-protein complexes, but its role during embryonic development is not well known. In this study, we established Ruvbl2-overexpressing mouse embryonic stem cells and examined their capacity to specifically differentiate into neuroectoderm and confirmed the specific expression of RUVBL2 in early embryonic neuroectoderm. Our results suggest that Ruvbl2 has a role in the differentiation of neuroectoderm during early embryogenesis.

An integrated systems biology approach identifies positive cofactor 4 as a factor that increases reprogramming efficiency.

Spermatogonial stem cells (SSCs) can spontaneously dedifferentiate into embryonic stem cell (ESC)-like cells, which are designated as multipotent SSCs (mSSCs), without ectopic expression of reprogramming factors. Interestingly, SSCs express key pluripotency genes such as Oct4, Sox2, Klf4 and Myc. Therefore, molecular dissection of mSSC reprogramming may provide clues about novel endogenous reprogramming or pluripotency regulatory factors. Our comparative transcriptome analysis of mSSCs and induced pluripotent stem cells (iPSCs) suggests that they have similar pluripotency states but are reprogrammed via different transcriptional pathways. We identified 53 genes as putative pluripotency regulatory factors using an integrated systems biology approach. We demonstrated a selected candidate, Positive cofactor 4 (Pc4), can enhance the efficiency of somatic cell reprogramming by promoting and maintaining transcriptional activity of the key reprograming factors. These results suggest that Pc4 has an important role in inducing spontaneous somatic cell reprogramming via up-regulation of key pluripotency genes.

Cell-penetrating peptide (CPP)-conjugated proteins is an efficient tool for manipulation of human mesenchymal stromal cells.

Delivery of proteins has been regarded as the safest and most useful application in therapeutic application of stem cells, because proteins can regulate gene expression transiently without any genomic alteration. However, it is difficult to accurately measure efficiency or quantity of intracellular protein uptake. Here, we performed a comparison study of cell-penetrating peptide (CPP)-conjugated protein delivery system using seven arginine and Streptolysin O (SLO)-mediated system. To compare CPP- and SLO-mediated protein delivery systems, we used GFP and ESRRB protein, which is known to regulate pluripotency-related genes, for delivery into human bone marrow stromal cells (hBMSCs) and human testicular stromal cells (hTSCs). We found that CPP-conjugated protein delivery was more efficient, lower cytotoxicity, and higher biological activity than SLO-mediated protein delivery system. These results suggest that delivery of CPP-conjugated proteins is an efficient tool for introducing biologically active proteins into cells and may have important implications in clinical cell-based therapy.