Korean Version of the Longer-Term Unmet Needs After Stroke Questionnaire.

OBJECTIVE: : To translate the 22-item Longer-term Unmet Needs after Stroke (LUNS) questionnaire, validate it in the Korean stroke population, and assess the reliability of face-to-face and telephone surveys. METHODS: : Sixty-six adult patients with stroke from Seoul National University Bundang Hospital and Kangwon National University Hospital were involved in the validation. Participants were interviewed twice using the LUNS Korean version: first, a face-to-face survey for validation, and second, a telephone survey for test-retest reliability. Participants completed the Frenchay Activities Index (FAI) and Short Form 12 (SF-12) Mental and Physical Component Summary (MCS and PCS) scores at the first interview. For concurrent validity, the differences in health status (FAI, SF-12 MCS and PCS) between the groups that reported unmet needs and those that did not were analyzed for each item. Cohen's kappa and percentage of agreement between the first and second administrations were calculated for each item to determine the test-retest reliability. RESULTS: : The average age of the participants was 61.2±12.8 years and 74.2% were male. Fifty-seven patients were involved in the second interview. Depending on the unmet needs, SF-12 MCS, PCS, and FAI were significantly different in 12 of 22 items. In the test-retest reliability test, 12 items had a kappa of 0.6 or higher, and two had a kappa of <0.4. CONCLUSION: : The LUNS instrument into Korean (LUNS-K) is a reliable and valid instrument for assessing unmet health needs in patients with stroke. In addition, telephone surveys can be considered reliable.

Bisphenol A release from commercially available 3-dimensionally printed resins and human cell apoptosis to bisphenol A: an in-vitro study.

Bisphenol A (BPA) from dental materials may be linked to children's health issues. This study aimed to assess the release of BPA from commercially available 3-dimensional (3D)-printed resin materials and evaluate BPA-related apoptotic effects on human periodontal ligament cells and gingival fibroblasts. Commercially available 3D-printed resin materials for prosthodontic use were selected as follows: NextDent C&B MFH (3D Systems, Rock Hill, SC, USA), DIOnavi-P. MAX (Dio Co., Busan, Korea), and DIOnavi-Denture02 (Dio Co., Busan, Korea). Identical cuboidal samples (1 cm × 1 cm × 0.5 cm) were printed from the materials and cured. BPA release was assessed using liquid chromatography/mass spectrometry (LC/MS). In addition, human gingival fibroblasts and periodontal ligament cells were exposed to various BPA solutions based on the LC/MS results. Cell Counting kit-8 (CCK-8) and real-time polymerase chain reaction analyses were performed to evaluate BPA-related apoptotic effects. The LC/MS analysis confirmed that none of the 3D-printed resin materials released BPA after curing. Both human gingival fibroblasts and periodontal ligament cells showed lower viability after BPA exposure. Regarding apoptosis-related gene expression, Caspase10 (CASP10) expression in periodontal ligament cells was significantly different in the BPA solutions (p < 0.05). The expression of BAX and Capspase8 (CASP8) in gingival fibroblasts was significantly increased by BPA in a dose-dependent manner (p < 0.05). Within the limitations of this study, the 3D-printed resin materials were not found to release BPA. This finding implies that 3D-printed resin materials are not associated with potential BPA-related risks in children.

Stress distribution in pediatric zirconia crowns depending on different tooth preparation and cement type: a finite element analysis.

BACKGROUND: In clinical settings, tooth preparation for prefabricated zirconia crowns (PZCs) in the primary dentition varies widely. However, knowledge about the biomechanical behavior of PZCs in various clinical settings is limited. This study was conducted to evaluate the biomechanical behavior of PZCs in different clinical settings using 3-dimensional finite element analysis. METHODS: 3-dimensional models of the PZC, cement, and tooth with six different conditions were simulated in primary molar teeth, incorporating cement thickness (100, 500, and 1000 µm) and cement type (resin-modified glass ionomer cement and resin cement). A total of 200 N of occlusal force was applied to the models, both vertically and obliquely as representative cases. A general linear model univariate analysis with partial eta-squared (ηp2) was performed to evaluate the relative effects of the variables. RESULTS: The overall stress of tooth was increased as the cement space increases under oblique loading. The von Mises stress values of the resin cements were significantly higher than those of the resin-modified glass ionomer cements for all cement thicknesses (p < .05). The effect size of the cement type (ηp2 = .519) was more dominant than the cement thickness (ηp2 = .132) in the cement layer. CONCLUSIONS: Within the limits of this study, cement type has a greater influence on the biomechanical behavior of PZCs than cement thickness.

The effect of a telephone-based intervention on physical activity after stroke.

Despite the effectiveness of telephone-based interventions for medical adherence and improved blood pressure, studies on the effect of such interventions on physical activity (PA) are needed. Therefore, we investigated the impact of a telephone-based intervention on PA in patients with subacute stroke. This pre-post study included patients who participated in an education program for stroke rehabilitation before being discharged to home, with a modified Rankin scale (mRS) score of ≤ 3. Patients hospitalized in 2020 (intervention group) received a nurse-led telephone-based intervention with a PA measurement once monthly during the 3 months after discharge. Those hospitalized in 2019 (historical controls) only received a PA measurement 3 months after discharge. Physical activity was assessed via a questionnaire by phone. In addition, demographics, medical history, smoking, mRS scores, and Patient Health Questionnaire-9 data were collected. The study included 139 participants (73 in intervention, 66 in control). The intervention group had a higher proportion of patients with mRS of 0-1 and a shorter length of hospital stay than the historical controls. Three months post-discharge, a significantly higher proportion of participants were physically active in the intervention group (48 [71.6%] vs. control group, 25 [34.7%]). In addition, the intervention group had a significantly higher median energy expenditure (924 vs. 297 MET-min/week) than the control group. The OR of the intervention for achieving 'physically active' individuals was 4.749 (95% CI, 2.313-9.752) before and 5.222 (95% CI, 1.892-14.419) after adjusting for possible confounders. A telephone-based intervention improved PA three months after stroke. Further studies with larger sample size and long-term follow-up are needed.

Unmet Needs for Rehabilitative Management in Common Health-Related Problems Negatively Impact the Quality of Life of Community-Dwelling Stroke Survivors.

Purpose: Community-dwelling stroke survivors have various unmet needs for rehabilitative management, but there is a lack of in-depth investigations on common health problems after stroke. Moreover, the association between unmet needs and health-related quality of life (HRQoL) has not been thoroughly investigated. This study aimed to investigate the unmet needs for rehabilitative management in common problems after stroke and their associations with HRQoL among community-dwelling stroke survivors. Methods: A face-to-face cross-sectional survey was conducted among community-dwelling stroke survivors visiting outpatient clinics of rehabilitation departments between June and October 2020 in three university-affiliated hospitals. Unmet needs for common problems after stroke were assessed across eight domains based on the post-stroke checklist: spasticity, dysphagia, communication, cognition, ambulation, pain/discomfort, anxiety/depression, and self-care. HRQoL was measured using the EuroQoL-5D three level (EQ-5D). The prevalence of unmet needs for rehabilitative management and their associations with the EQ-5D index were analyzed. Results: Among the 239 participants who responded to the survey, 63% (n = 150) were men. The mean age was 63 ± 13 years, and the mean duration of stroke onset was 55.6 months. Overall, 49% reported at least one unmet need, and the most frequently reported unmet needs were anxiety/depression (20.9%), self-care (20.9%), and pain/discomfort (18.0%). The highest proportion of unmet needs was in the anxiety/depression, communication, and cognition domains. Patients with unmet needs for cognition and pain/discomfort showed a significantly lower EQ-5D index, even after adjusting for age, sex, and modified Rankin scale scores. The total number of unmet needs was significantly correlated with a lower EQ-5D index (Pearson's r = -0.329, p < 0.001) in the multivariate linear regression model. Conclusions: Unmet rehabilitative needs are prevalent among community-dwelling stroke survivors, and the proportion of unmet needs was high among non-physical domains such as anxiety/depression. The number of unmet needs is an independent negative predictor of HRQoL. Systematic approaches to identify unmet needs and provide appropriate rehabilitative management are required in long-term stroke survivors.

Exposure assessment for methyl and total mercury from seafood consumption in Korea, 2005 to 2008.

Reports on the occurrence and intake assessment of mercury for Korean seafood are currently not available. This is the first report to estimate the intake of methyl (Me-Hg) and total mercury (T-Hg) from seafood consumption in Korea. The concentrations of Me-Hg and T-Hg in seafood ranged from 1.02 to 780 (mean: 55.6) ng g(-1) wet weight and 4.89 to 1008 (mean: 100) ng g(-1) wet weight, respectively. The residue levels of Me-Hg and T-Hg in Korean seafood were moderate compared with those found in other countries. The methylation ratios of fish, cephalopods and crustaceans were similar, but shellfish had lower values compared with other species. The intakes of Me-Hg and T-Hg from seafood consumption for the general population were estimated to be 38.8 and 73.8 ng kg(-1) body weight per day, respectively. Mackerel, tuna and squid made the highest contributions to the total intake of these contaminants. Among eight age groups, 30-49 year and 3-6 year age groups had the highest exposure to Me-Hg and T-Hg. The concentrations and intakes of Me-Hg and T-Hg from Korean seafood were less than the allowable residue levels and threshold intake levels suggested by Korean and international authorities. The present study may be useful for risk management of mercury in Korean seafood.