Effect of Virtual Game-Based Integrated Clinical Practice Simulation Program on Undergraduate Nursing Students' Attitude Toward Learning.

Game-based virtual reality simulation programs can capitalize on the advantages of non-face-to-face education while effectively stimulating the interest of trainees and improving training efficiency. This study aimed to develop a game-based virtual reality simulation program for nervous system assessment and to evaluate the effects of the program on the learning attitudes of nursing students. Using a one-group pretest-posttest design, 41 senior nursing students were enrolled, and their learning attitudes (self-directed learning attitude, academic self-efficacy, flow-learning experience, and learning presence) were evaluated. The effect of the program was statistically significant in self-directed learning attitude ( t = -2.27, P = .027) and learning presence ( t = -3.07, P = .003), but the difference was not statistically significant in academic self-efficacy ( t = -1.97, P = .054) and learning flow ( t = -0.74, P = .459). The virtual gaming simulation program can be used to effectively replace field training in situations wherein field training is limited, such as during the COVID-19 pandemic.

Evaluation of Probiotic Properties of Pediococcus acidilactici M76 Producing Functional Exopolysaccharides and Its Lactic Acid Fermentation of Black Raspberry Extract.

This study aimed to determine the probiotic potential of Pediococcus acidilactici M76 (PA-M76) for lactic acid fermentation of black raspberry extract (BRE). PA-M76 showed outstanding probiotic properties with high tolerance in acidic GIT environments, broad antimicrobial activity, and high adhesion capability in the intestinal tract of Caenorhabditis elegans. PA-M76 treatment resulted in significant increases of pro-inflammatory cytokine mRNA expression in macrophages, indicating that PA-M76 elicits an effective immune response. When PA-M76 was used for lactic acid fermentation of BRE, an EPS yield of 1.62 g/L was obtained under optimal conditions. Lactic acid fermentation of BRE by PA-M76 did not significantly affect the total anthocyanin and flavonoid content, except for a significant increase in total polyphenol content compared to non-fermented BRE (NfBRE). However, fBRE exhibited increased DPPH radical scavenging activity, linoleic acid peroxidation inhibition rate, and ABTS scavenging activity of fBRE compared to NfBRE. Among the 28 compounds identified in the GC-MS analysis, esters were present as the major groups. The total concentration of volatile compounds was higher in fBRE than that in NfBRE. However, the undesirable flavor of terpenes decreased. PA-M76 might be useful for preparing functionally enhanced fermented beverages with a higher antioxidant activity of EPS and enhanced flavors.

University students' perceptions of airborne infection control: exploratory study using Q methodology.

BACKGROUND: International cooperation for infection control is important to prevent global pandemics. University students were difficult groups to manage of infection control measures. They often had overconfidence to their health, ineffective personal hygiene, and active social activities. Their misperceptions and inappropriate preventive behaviors increase the infection risks to university and community. Understanding university students' perceptions of airborne infection management will contribute to the establishment of relevant policies and health education programs. METHOD: This study explored subjective perceptions of airborne infection among university students in South Korea using Q-methodology. Forty university students representing different majors ranked a set of 33 statements reflecting their perceptions of airborne infection. They sorted the statements into a distribution on seven scales ranging from "strongly disagree" to "strongly agree." Collected data were analyzed by the PC-QUANL program. The subjective perception types were extracted by using the principal component analysis. RESULTS: Four type are derived regardingperception of airborne infection: Type I (Government responsibility), Type II (Personal responsibility in self-management), Type III (Strict external management) and Type IV (Comprehensive countermeasures management). Thesefour types accounted for 45.6% of the total variance, and the individual contributions of Types I, II, III, and IV were 27.7, 7.6, 6.2, and 4.1%, respectively. CONCLUSION: The major contribution of this study is to clarify university students' perceptions of airborne infection. These findings can be used in formulating effective strategies for health education, media reporting, and public health policy to improve airborne infection management.

Metabolic tracking of isoflavones in soybean products and biosamples from healthy adults after fermented soybean consumption.

Fermentation may enhance the nutritional properties of foods by increasing metabolite bioactivity or bioavailability. This study explored the effect of fermentation on isoflavone bioavailability and metabolism. Isoflavone metabolites were tracked in foods and biospecimens of healthy adults after fermented soybean (FS) or non-fermented soybean (NFS) consumption in a randomized, controlled, crossover intervention study. The change in soybean isoflavones caused by fermentation resulted in faster absorption and higher bioavailability after consumption of FS. Although the urinary level of total isoflavone metabolites was similar after the consumption of the two diets, urinary genistein 7-O-sulfate was derived as a discriminant metabolite for the FS diet by partial least squares discriminant analysis. This study suggests that an isoflavone conjugate profile might be a more appropriate marker than total isoflavone levels for discriminating between the consumption of FS and NFS diets.

Comprehensive characterization of hydroxycinnamoyl derivatives in green and roasted coffee beans: A new group of methyl hydroxycinnamoyl quinate.

The aim of this study was to quantitatively characterize 19 green and roasted coffee beans by ultra-performance liquid chromatography coupled with diode array detector and quadrupole time-of-flight mass spectrometry. A total of 57 phenolic acids including nine methyl ester of mono-, di-caffeoylquinic acid, and feruloylquinic acid were identified. The methyl hydroxycinnamoyl quinates are reported for the first time from Coffea arabica and Coffea robusta. The total phenolic content ranged from 5628 ±â€¯227 to 8581 ±â€¯109 mg/100 g dry weight (DW) in green, and from 791 ±â€¯63 to 1891 ±â€¯37 mg/100 g DW roasted beans. The methyl caffeoylquinates accounted for 2.1% of the total phenolic acids. The result suggested that the phenolic composition was affected by the type of species, cultivars, and roasting process. Hence, to retain the balance between health beneficial phenolics and sensory attributes, optimization of roasting condition specific to the cultivar type substantially required.

A systematic review and meta-analysis on the effect of reminiscence therapy for people with dementia.

BACKGROUND: The main objective of this study was to conduct a meta-analysis to identify the effects of reminiscence therapy in people with dementia (PWD). METHODS: A systematic search of randomized controlled trials (RCTs) was conducted using bibliographic databases. A total of 157 original published studies were identified in the search, and 24 complete articles were included in the final review to check for the level of evidence. Two of the study authors independently assessed the quality of the included studies using the "Risk of Bias" (ROB) tool developed by the Cochrane Collaboration. Depression, quality of life, and behavioral and psychological symptoms of dementia (BPSD) were selected to measure the effect of reminiscence therapy. To determine the effects of reminiscence therapy on these variables, each individual study was analyzed using Comprehensive Meta-Analysis Software® (Biostat, Englewood, NJ, USA). RESULTS: The overall effect size was presented using standardized mean differences (SMDs) and 95% confidence intervals. Cohen's d effect size for depression was -0.541 (95% CI: -0.847 to -0.234, Z = -3.730, p<0.001), indicating that depression was significantly reduced in the reminiscence group compared to the control group. Increased quality of life and decreased BPSD were also found in the reminiscence group compared to the control group. CONCLUSION: Reminiscence therapy has a moderate effect on depression and can be broadly used to decrease depression as an alternative to antipsychotics, which can have harmful side effects and high cost.

Tumor Identification in Colorectal Histology Images Using a Convolutional Neural Network.

Colorectal cancer (CRC) is a major global health concern. Its early diagnosis is extremely important, as it determines treatment options and strongly influences the length of survival. Histologic diagnosis can be made by pathologists based on images of tissues obtained from a colonoscopic biopsy. Convolutional neural networks (CNNs)-i.e., deep neural networks (DNNs) specifically adapted to image data-have been employed to effectively classify or locate tumors in many types of cancer. Colorectal histology images of 28 normal and 29 tumor samples were obtained from the National Cancer Center, South Korea, and cropped into 6806 normal and 3474 tumor images. We developed five modifications of the system from the Visual Geometry Group (VGG), the winning entry in the classification task in the 2014 ImageNet Large Scale Visual Recognition Competition (ILSVRC) and examined them in two experiments. In the first experiment, we determined the best modified VGG configuration for our partial dataset, resulting in accuracies of 82.50%, 87.50%, 87.50%, 91.40%, and 94.30%, respectively. In the second experiment, the best modified VGG configuration was applied to evaluate the performance of the CNN model. Subsequently, using the entire dataset on the modified VGG-E configuration, the highest results for accuracy, loss, sensitivity, and specificity, respectively, were 93.48%, 0.4385, 95.10%, and 92.76%, which equates to correctly classifying 294 normal images out of 309 and 667 tumor images out of 719.

Factors influencing on health-related quality of life in South Korean with chronic liver disease.

BACKGROUND: The objective of this study was to determine health-related quality of life (HRQoL) among chronic liver disease (CLD) subjects in South Korea using EuroQol five-dimension questionnaire (EQ-5D). METHOD: The sample consisted of 139 subjects with CLD from the sixth Korean National Health and Nutrition Examination Survey (KNHNES VI). Data were analyzed using SPSS program for descriptive statistics, t-test, ANOVA, Scheffe's test and hierarchical multiple regression. RESULTS: Results indicated that marital status (P < 0.01), occupation (P < 0.01), basic livelihood security recipient status (P < 0.05), hepatocellular carcinoma (P < 0.05), subjective health status (P < 0.01), and depression (P < 0.001) were significant predictors of HRQoL. Health behaviors (alcohol intake, sleep duration) variables were insignificant. CONCLUSION: In conclusion, marital status, occupation, basic livelihood security recipient status (BLSRS), hepatocellular carcinoma (HCC), subjective health status (SHS), and depression were confirmed to be factors affecting the HRQoL. We should be provide to continuous monitoring and education of adequate alcohol intake for patients with CLD. Findings of this study might be used to develop community based health programs and policies for CLD.

Comparison of Factors Associated with Fear of Falling between Older Adults with and without a Fall History.

Background: Although fear of falling (FOF) has been studied since FOF has negative consequences for the elderly, there is limited information about the risk factors of FOF, including the environment. The purpose of this study was to describe individual and environmental factors of FOF between those with and without a fall history from an ecological aspect and to examine whether individual and environmental factors differently affect the FOF according to the state of fall history in community-dwelling older adults in Korea. Methods: Data from the 2014 Survey of Living Conditions and Welfare Needs of Korean Older Adults were used. Participants were 7730 older adults. Hierarchical logistic regression analysis was conducted to examine the predictors of FOF. Results: According to the ecological model, female and discomfort with the neighborhood environment were significantly associated with greater odds of reporting FOF in both older adults with fall history and those without. A significant interaction was not observed between any variable of FOF in participants with and without a fall history. Conclusions: An ecological model including individual and environmental factors should be considered when conducting research and designing programs and decision policies related to FOF for older adults with and without a history of falling.

Case Study of Airborne Pathogen Dispersion Patterns in Emergency Departments with Different Ventilation and Partition Conditions.

The prevention of airborne infections in emergency departments is a very important issue. This study investigated the effects of architectural features on airborne pathogen dispersion in emergency departments by using a CFD (computational fluid dynamics) simulation tool. The study included three architectural features as the major variables: increased ventilation rate, inlet and outlet diffuser positions, and partitions between beds. The most effective method for preventing pathogen dispersion and reducing the pathogen concentration was found to be increasing the ventilation rate. Installing partitions between the beds and changing the ventilation system's inlet and outlet diffuser positions contributed only minimally to reducing the concentration of airborne pathogens.

Effect of the Physical Environment on the Health-related Quality of Life of the Low-income Korean Elderly Population.

BACKGROUND: The increasing number of elderly citizens due to changes in the social structure is of national interest. This study aimed to provide basic data for devising policies to promote the quality of life of elderly National Basic Livelihood Security System (NBLSS) beneficiaries in South Korea by identifying the effects of their general characteristics and physical environment on their health-related quality of life (HRQoL). METHODS: Using the 2013 Korean Community Health Survey (KCHS) raw data, we analyzed 3537 NBLSS beneficiaries aged 65 yr and older. HRQoL was measured using the Euro QoL five-dimension questionnaire (EQ-5D). Hierarchical multiple regression analyses were used to predict the EQ-5D scores. RESULTS: The explanatory power for HRQoL increased to 21.4% when the general characteristics and physical environment were included. HRQoL showed statistically significant differences in the environmental variable, level of safety (P=0.001), natural environment (P=0.001), living environment (P=0.001), traffic condition (P<0.001), and access to health services (P<0.001). Physical environment positively correlated with HRQoL(r=.119, P<0.001), thus confirming its influence (ß=.092, P<0.001). CONCLUSION: We should strive to manage the physical environment to improve the quality of life of elderly NBLSS beneficiaries.

The impact of implementation of an enteral feeding protocol on the improvement of enteral nutrition in critically ill adults.

BACKGROUND AND OBJECTIVES: The optimal delivery of enteral nutrition (EN) may improve clinical outcomes in critically ill patients; thus, optimal EN protocols should be developed. The purpose of this study was to evaluate the impact of implementing an EN protocol on the improvement of EN practices and on the clinical outcomes of critically ill patients. METHODS AND STUDY DESIGN: This was a retrospective study with prospectively collected data. Multidisciplinary working group developed an evidence-based EN protocol based on an extensive review of literature and existing guidelines. Subjects included patients consecutively admitted to the ICU who received EN for more than 24 hours. EN practices and clinical outcomes were compared before and after implementation of the protocol. RESULTS: A total of 270 patients were included, 134 patients before implementation and 136 after implementation of the protocol. EN was initiated earlier (35.8 vs 87.1 hours, p=0.001) and more patients received EN within 24 hours (59.6% vs 41.0%, p=0.002) after implementation of the protocol. The interval between starting EN and reaching the caloric goal was not different, but more patients reached the caloric goal after implementation (52.2% vs 38.3%, p=0.037). The post-implementation group was given more prokinetics and less parenteral nutrition. The incidences of diarrhea and gastrointestinal bleeding significantly decreased following implementation of the protocol. There was no difference in clinical outcomes including in-hospital mortality and length of hospital and ICU stay. CONCLUSION: The implementation of the EN protocol significantly improved the practices of EN and decreased complications in critically ill patients. Clinical outcomes were not different before and after implementation.

Fear of falling and its predictors among community-living older adults in Korea.

OBJECTIVES: To explore the prevalence and predicting factors of fear of falling (FOF) among community-living older adults in Korea. METHODS: Secondary data analysis of the 2011 Korean National Elderly Living Conditions and Welfare Desire Survey was used. Logistic regression analysis was conducted to examine the predictors of FOF. RESULTS: In total, 75.6% of older adults with normal cognition have FOF. Factors associated with an increased risk of FOF in older adults are previous experience with falling (OR = 3.734, 95% CI = 2.996-4.655), limitations in the performance of exercise involving lower extremities (OR = 2.428, 95% CI = 2.063-2.858), being female (OR = 2.335, 95% CI = 2.023-2.694), having more than three chronic diseases (OR = 1.994, 95% CI = 1.625-2.446), limitations in instrumental activities of daily living (IADLs) (OR = 1.745, 95% CI = 1.230-2.477), limitations in the performance of exercise involving upper extremities (OR = 1.646, 95% CI = 1.357-1.997), living without a spouse (OR = 1.626, 95% CI = 1.357-1.948), having poor self-rated health (OR = 1.571, 95% CI = 1.356-1.821), limitations in muscle strength (OR = 1.455, 95% CI = 1.150-1.841), age (≥75 years) (OR = 1.320, 95% CI = 1.150-1.516), lower levels of education (0-6 years) (OR = 1.231, 95% CI = 1.075-1.409), and life satisfaction (OR = 1.104, 95% CI = 1.065-1.114). CONCLUSION: A multidimensional construct of general characteristics, physical, and psychosocial variables act as risk factors for FOF. Preventive intervention should be developed to decrease the FOF among Korean older adults.