Automated eyeball volume measurement based on CT images using neural network-based segmentation and simple estimation.

With the increase in the dependency on digital devices, the incidence of myopia, a precursor of various ocular diseases, has risen significantly. Because myopia and eyeball volume are related, myopia progression can be monitored through eyeball volume estimation. However, existing methods are limited because the eyeball shape is disregarded during estimation. We propose an automated eyeball volume estimation method from computed tomography images that incorporates prior knowledge of the actual eyeball shape. This study involves data preprocessing, image segmentation, and volume estimation steps, which include the truncated cone formula and integral equation. We obtained eyeball image masks using U-Net, HFCN, DeepLab v3 +, SegNet, and HardNet-MSEG. Data from 200 subjects were used for volume estimation, and manually extracted eyeball volumes were used for validation. U-Net outperformed among the segmentation models, and the proposed volume estimation method outperformed comparative methods on all evaluation metrics, with a correlation coefficient of 0.819, mean absolute error of 0.640, and mean squared error of 0.554. The proposed method surpasses existing methods, provides an accurate eyeball volume estimation for monitoring the progression of myopia, and could potentially aid in the diagnosis of ocular diseases. It could be extended to volume estimation of other ocular structures.

Effects of the COVID-19 Pandemic on the Medical Use of Elderly Patients with Hypertension: A Nationwide Cohort Study in Korea.

Background: The coronavirus disease 2019 (COVID-19) pandemic has disrupted healthcare services, including chronic disease management, for vulnerable groups, such as older individuals with hypertension. This study aimed to evaluate hypertension management in South Korea's elderly population during the pandemic using treatment consistency indices such as the continuity of care (COC), modified, modified continuity index (MMCI), and most frequent provider continuity (MFPC). Methods: This study used the Korea Disease Control and Prevention Agency-COVID-19-National Health Insurance Service cohort (K-COV-N cohort) from the National Health Insurance Service between 2017 and 2021. The research included a total of 4,097,299 hypertensive patients aged 65 years or older. We defined 2018 and 2019 as the baseline period before the COVID-19 pandemic and 2020 and 2021 as the COVID-19 period and calculated the indices of medical continuity (number of visits, COC, MMCI, and MFPC) on a yearly basis. Results: The number of visits decreased during the COVID-19 period compared to the baseline period (59.64±52.75 vs. 50.49±50.33, P<0.001). However, COC, MMCI, and MFPC were not decreased in the baseline period compared to the COVID-19 period (0.71±0.21 vs. 0.71±0.22, P<0.001; 0.97±0.05 vs. 0.96±0.05, P<0.001; 0.8±0.17 vs. 0.8±0.17, P<0.001, respectively). Conclusion: COVID-19 had no significant impact on the continuity of care but affected the frequency of outpatient visits for older patients with hypertension. However, this study highlights the importance of addressing healthcare inequalities, especially in older patients with hypertension, during pandemics and advocates for policy changes to ensure continued care for vulnerable populations.

Nurses' job crafting, work engagement, and well-being: a path analysis.

BACKGROUND: Nurses' well-being is a topic of interest at both individual and organizational levels. Studies that explore the relationship between nurses' job crafting, work engagement, and well-being are scarce. Therefore, the purpose of this study was to confirm the effect of job crafting and work engagement on nurses' well-being. METHODS: This cross-sectional survey study involved 207 nurses within a week in July 2022 across two centers, among whom the response rate was 99%. Three following instruments were used in the survey: the 14-item well-being scale, the 12-item job crafting scale, and the 9-item Utrecht Work Engagement Scores (UWES). Path analysis was performed and goodness of fit was evaluated. RESULTS: Job crafting and work engagement were strongly correlated with well-being, and nurses' well-being was affected by job crafting and work engagement. Path model fit indices were adequate. The mediating effect of work engagement on the relationship between job crafting and well-being revealed that task job crafting influenced psychological well-being through work engagement (Effect: 0.15, 95% confidence interval [CI]: 0.08-0.22, p = 0.001). Furthermore, relational job crafting influenced social well-being through work engagement (Effect: 0.22, 95% CI: 0.11-0.38, p = 0.001). CONCLUSION: The study's findings can help strategize human resource management programs to enhance relational job crafting to improve nurses' social well-being and enhance task job crafting to improve their psychological well-being. Furthermore, through job crafting, improved human resource policies can enhance work engagement and improve nurses' well-being.

Risk Factors for Various Cognitive Function Decline Trajectories in Adults Over 40 Years of Age: A Retrospective Cohort Study.

OBJECTIVE: The aims of our study were to identify distinct trajectories of cognitive function using the group-based trajectory model. We also investigate which demographic factors act as risk factors for cognitive decline in each group. METHODS: The data from the Seoul National University Hospital Healthcare System Gangnam Center, from 2005 to 2019. The number of study subjects was 637. We used a group-based model to identify cognitive function trajectories. Multinomial logistic regression was employed to define risk factors for cognitive function decline. RESULTS: The cognitive function trajectories among adults over 40 years of age were heterogeneous. We identified four trajectories: high (27.3%), medium (41.0%), low (22.7%), and rapid decline (9.1%). Older age, male, low educational level, bad dietary habits, diabetes mellitus, technical worker, and lower income increased the likelihood of a cognitive function decline. CONCLUSION: A younger age, a higher educational level, professional worker, good dietary habits, no diabetes mellitus, and no obesity improved cognitive function. A combination of these factors can improve "cognitive reserve" and delay cognitive decline. Interventions to prevent cognitive decline are needed after identification of high-risk groups for cognitive decline.

The effect of sleep disturbance on the association between work-family conflict and burnout in nurses: a cross-sectional study from South Korea.

BACKGROUND: Sleep disturbances can lead to work-family conflicts and affect the mental health of nurses. This study aimed to investigate the mediating effect of sleep disturbance on the association between work-family conflict (WFC) and burnout in nurses. METHODS: Responses to a questionnaire from 156 nurses working in a hospital in South Korea were analyzed. Multiple linear regression analysis and PROCESS Macro Model 4 were used to analyze the mediating effect of sleep disturbance on the relationship between WFC and burnout. A bootstrapping approach was used to test the statistical significance of the indirect parameter effects. RESULTS: The WFC of nurses had a positive correlation with sleep disturbance and burnout. Moreover, sleep disturbance completely mediated the association between WFC and burnout. CONCLUSIONS: Nursing administrators should pay careful attention to WFCs that interfere with nurses' sleep and reduce their sleep quality, and design suitable working schedules that minimize the effects of WFC. In addition, hospital administrators should improve shift scheduling to ensure good sleep quality and reduce the health effects of WFC among nurses.

Development of a Tool for Measuring Ventilator-Associated Pneumonia Prevention Behaviors of Intensive Care Unit Nurses.

Introduction: Ventilator-associated pneumonia (VAP) lengthens intensive care unit (ICU) stays and increases medical expenses and mortality risk. Aim: We aimed to develop and validate a tool for measuring VAP prevention behaviors among ICU nurses. Method: This is a methodological study that included a tool development step, based on the procedure suggested by DeVellis, and a tool verification step. Results: Through a literature review and focus interviews, 35 preliminary items were selected. After a content validity examination by experts and a pre-test, 30 items were chosen for this study. In the testing phase of the main survey, the final version tool was used on 452 ICU nurses to assess validity and reliability. From factor analysis, 7 factors and 17 items were selected. The factors included aspiration prevention, ventilator management, oral care, suction system management, subglottic suction, spontaneous awakening trials and spontaneous breathing trials, and standard precautions. The total determination coefficient was 71.6%. These factors were verified using convergent, discriminant, and concurrent validity tests. Internal consistency reliability was acceptable (Cronbach's α = 0.80); thus, the VAP prevention behavior measurement tool was proven valid and reliable. Conclusions: This tool can be used with ICU nurses to measure behaviors associated with VAP prevention and, in turn, VAP prevention measures can be improved.

Dose-Intensity of Bisphosphonates and the Risk of Osteonecrosis of the Jaw in Osteoporosis Patients.

OBJECTIVE: To examine the incidence rates and association between dose-intensity, stratified by exposure duration, of bisphosphonates and the risk of osteonecrosis of the jaw among Korean osteoporotic patients older than 50 years. STUDY DESIGN AND SETTING: Using the population-based National Health Insurance Claims Data of Korea from January 1, 2006, through December 3, 2012, 13,730 new bisphosphonate users as of 2006 were identified. Truncated age-standardized incidence rate estimation and multivariate logistic regression analyses were conducted. RESULTS: In this retrospective cohort study, increasing age-standardized incidence rates of ONJ attributed to bisphosphonate exposure were observed for individuals with less than 1 year, 1-2 years, over 2 years of defined daily dose (DDD) of bisphosphonate exposure (13.85, 16.19, and 38.20, respectively), using a truncated 2000 United States Standard Population. Also, over 2 years of bisphosphonate DDDs was associated with an increased risk of developing of ONJ with an adjusted odds ratio of 1.51 (95% confidence interval: 1.31-1.75), compared to individuals with less than 1 year of bisphosphonate exposure. CONCLUSION: Our data provided the evidence to support the association between risk of ONJ and duration of bisphosphonate exposure used in the treatment or prevention of osteoporosis.

Explicit role of ionic strength in retention behavior of polystyrene latex particles in sedimentation field-flow fractionation: Slip boundary model.

We investigate an explicit role of the ionic strength in the retention behaviors of polystyrene (PS) latex particles in sedimentation field-flow fractionation (SdFFF) by hinging upon the retention theory recently developed [1] asR=(Ro+vb*)/(1+vb*). Here R is an experimental retention ratio, and Ro is the analytical expression of the standard retention theory based on the parabolic flow velocity. The reduced boundary velocityvb* is expressed in terms of the ionic strength I of the carrier liquid as vb*=vb,o*/(1+εI), where vb,o*=0.070and ε=60 mM-1 for all the PS latex systems under investigation. We then apply this to study the explicit ionic strength effect on the retention behaviors of PS beads of 200, 300, 400, and 500nm, respectively. As a primary result, the strong dependence of the retention ratio on the ionic strength can be quantitatively accounted for in an excellent accuracy: The slip effect at the channel surface is significant, particularly when I≲0.5mM, without showing any distinguishable dependence on the specific additives to control I, such as FL-70, SDS, NaNO3, and NaN3. Based on the present study, we put forward an experimental means to estimate the ionic strength of an aqueous solution using an FFF technique.