Characterization of PLA/LW-PLA Composite Materials Manufactured by Dual-Nozzle FDM 3D-Printing Processes.

This study investigates the properties of 3D-printed composite structures made from polylactic acid (PLA) and lightweight-polylactic acid (LW-PLA) filaments using dual-nozzle fused-deposition modeling (FDM) 3D printing. Composite structures were modeled by creating three types of cubes: (i) ST4-built with a total of four alternating layers of the two filaments in the z-axis, (ii) ST8-eight alternating layers of the two filaments, and (iii) CH4-a checkered pattern with four alternating divisions along the x, y, and z axes. Each composite structure was analyzed for printing time and weight, morphology, and compressive properties under varying nozzle temperatures and infill densities. Results indicated that higher nozzle temperatures (230 °C and 240 °C) activate foaming, particularly in ST4 and ST8 at 100% infill density. These structures were 103.5% larger on one side than the modeled dimensions and up to 9.25% lighter. The 100% infill density of ST4-Com-PLA/LW-PLA-240 improved toughness by 246.5% due to better pore compression. The ST4 and ST8 cubes exhibited decreased stiffness with increasing temperatures, while CH4 maintained consistent compressive properties across different conditions. This study confirmed that the characteristics of LW-PLA become more pronounced as the material is printed continuously, with ST4 showing the strongest effect, followed by ST8 and CH4. It highlights the importance of adjusting nozzle temperature and infill density to control foaming, density, and mechanical properties. Overall optimal conditions are 230 °C and 50% infill density, which provide a balance of strength and toughness for applications.

Divergent Annulation Modes of (Z)-4-Aryl-4-oxo-2-(pyridin-2-yl)but-2-enenitrile and Methyl Nitroacetate: Selective Access to 2-Acyl-4H-quinolizin-4-one, Isoxazole, and 2-Acylindolizine.

Three different annulation modes of (Z)-4-aryl-4-oxo-2-(pyridin-2-yl)but-2-enenitrile in the reaction with methyl nitroacetate were discovered, allowing selective access to diverse heterocycles such as quinolizin-4-one, isoxazole, and indolizine with unique substitution patterns in good yields. Ease of operation, good chemical yields, and good functional group tolerance of our protocol enabled us to rapidly construct a number of synthetic analogs based on each scaffold under three reaction conditions.

Beyond boundaries: The mechanisms by which host organizations' safety climates impact on-site contractors' safety and retention.

INTRODUCTION: Despite growing concerns over safety risks associated with on-site contractors in high-risk industries, little research has examined how host organizations affect their safety. Drawing from the open systems perspective, this study investigated the influence of host organizations' safety climates on on-site contractor employees' safety and job attitudes. METHOD: The study used multi-level structural equation modeling (MSEM) to test hypothesized relationships among variables with survey data collected from 1,720 employees of 68 on-site contractor organizations and 3,205 employees of six host organizations. RESULTS: At the organization-level, host organizations' safety climates were associated with their on-site contractor employees' safety behaviors, job attitudes, and injuries, and these effects were mediated by the safety climate of the on-site contractor organizations. CONCLUSIONS: This study demonstrates that the safety climates of host organizations can extend to their on-site contractor organizations. Therefore, fostering a positive safety climate not only benefits the host organizations themselves but also creates a crucial environmental cue that shapes the safety climate and outcomes of on-site contractors. PRACTICAL APPLICATIONS: Leading by example and fostering a positive safety climate within the organization are effective ways for a host organization to ensure the safety of its on-site contractors.

The effect of the Smart Health Continuous Feedback For Elderly Exercise (SHe CoFFEE) program on mobility: a randomized controlled pilot study.

Objectives: This study determined the effectiveness of a comprehensive home-based online exercise program called "Smart Health Continuous Feedback for elderly exercise (SHe CoFFEE)" on mobility. Methods: Sixty community-dwelling seniors were randomized in a 1:1 ratio to intervention or control group. Intervention was an 8-week "SHe CoFFEE" program, featuring continuous feedback, self-monitoring, and fall prevention exercises. The primary outcome was mobility, measured at 8 weeks with the Timed Up and Go (TUG) test. Secondary outcomes included TUG at 4 weeks, 10 m walking test, 30-s chair stand test, falls efficacy scale, activity-specific balance confidence, and Euro Quality of Life 5 Dimensions 5 Levels. Results: At 8 weeks, the intervention group showed improved TUG scores compared with the control group (MD = -1.87, 95% CI, -2.60 to -1.14; ηp 2 = 0.326) in the adjusted intention-to-treat analysis. The per-protocol analysis data showed similar results. All secondary outcomes apart from quality of life improved with intervention to a greater degree than in control. Conclusion: Smart healthcare and self-managed exercise programs may be viable for community-based health promotion and fall prevention in older adults unfamiliar with online technology.

Effectiveness of electrocardiogram interpretation education program using mixed learning methods and webpage.

AIM: This study was conducted to develop an electrocardiogram education program that incorporates an HTML webpage and blended learning methods to enhance electrocardiogram interpretation skills. Through continual and efficient education, the program aims to assist nurses in providing appropriate care and treatment to patients. DESIGN: Pre-post design study. METHODS: We developed an electrocardiogram interpretation HTML webpage based on an electrocardiogram interpretation algorithm and implemented an 18-week (2023.5.15 ~ 2023.9.22) electrocardiogram education program, which included daily 5-minute training sessions. Twenty-seven ward nurses were provided with the URL ( https://ecgweb.github.io/ECGwebEN ) to the electrocardiogram interpretation HTML webpage and shared one electrocardiogram case daily for self-interpretation. Electrocardiogram interpretation performance and confidence were evaluated through questionnaires at three phases: before the program, after 6 weeks of basic electrocardiogram and arrhythmia education, and after 12 weeks of application of the electrocardiogram interpretation HTML webpage and case-based lecture education. The statistical tests used were repeated-measures ANOVA or the Wilcoxon signed-rank test. RESULTS: The average score for electrocardiogram interpretation performance before the electrocardiogram education program was 11.89(SD = 3.50), after 6 weeks of basic electrocardiogram and arrhythmia education it was 14.15(SD = 3.68), and after 12 weeks of application of the electrocardiogram interpretation HTML webpage and case-based lecture education, it was 15.56(SD = 3.04). This shows that electrocardiogram interpretation performance significantly improved over time (p < .001). Additionally, post-hoc analysis revealed significant differences in electrocardiogram interpretation performance at each stage, i.e., before, during, and after the application of an electrocardiogram education program. Furthermore, the electrocardiogram interpretation confidence questionnaire score (pre-Median 18, IQR = 5; post-Median 23, IQR = 3) was improved significantly after the completion of the 18-week education program (p < .001). CONCLUSIONS: Based on the results of this study, we believe that an electrocardiogram education program using HTML webpage, and a blended teaching method would be very beneficial for maintaining and improving electrocardiogram interpretation skills of clinical nurses. Such a program can help nurses interpret electrocardiograms more effectively and assist them in making important decisions in patient care.

The Effect of Mindfulness and Emotional Regulation on Self-care Competence Among Cancer Patients Undergoing Chemotherapy.

BACKGROUND: Many cancer patients require long-term self-care, both during and after treatment, and need to have self-care competence. Mindfulness and emotional regulation can enhance self-care competence among cancer patients. OBJECTIVE: To examine the effect of mindfulness and emotional regulation on self-care competence among cancer patients undergoing chemotherapy. METHODS: The data were completed by 106 cancer patients who were hospitalized at 3 long-term nursing hospitals. The instruments were the Mindfulness Scale, Korean Version of the Difficulties in Emotion Regulation Scale, and Self-As-Care Inventory Scale. RESULT: Self-care competence was significantly correlated with mindfulness among cancer patients undergoing chemotherapy. Also, the relationship between mindfulness and emotional regulation was significant. However, emotional regulation did not significantly affect self-care competence. CONCLUSIONS: It is important for cancer patients to focus on the present moment and maintain a balanced approach that keeps a distance from excessive worry. Development and application of interventions aimed at enhancing self-care competence among cancer patients should focus on a high level of mindfulness. IMPLICATIONS FOR PRACTICE: It is necessary to support cancer patients in taking time out for mindfulness practice through meditation programs and to help them seamlessly incorporate this habit into their daily lives. Nurses can effectively assist cancer patients by being well-versed in mindfulness techniques and providing adept guidance. Offering personalized mindfulness guidance based on the patient's condition and needs is also beneficial. By developing programs that incorporate feedback from both patients and healthcare providers, nurses can help patients continuously apply mindfulness practices.

Experiences of Generation Z Nurses Adapting to Work in a Tertiary Hospital: A Grounded Theory Study.

AIM: To investigate the adaptation process of Generation Z nurses at a tertiary hospital in Korea. DESIGN: This qualitative study using grounded theory. METHODS: The participants were 17 Generation Z nurses who were working at tertiary hospitals in Korea. Data were collected through in-depth interviews from September 2022 to July 2023. FINDINGS: Eight categories and 19 concepts were extracted. The core category was 'accepting deficient myself as a nurse in a vertical culture', which consisted of three phases: chaos, endeavouring to adapt and accepting myself. In the adaptation process at the tertiary hospital, most of the participants felt embarrassed by tasks. The most of them tended to stay away from stressors and endeavour to improve their competence. The participants who had familiarity and a sense of belonging and achievement tended to acknowledge themselves. CONCLUSIONS: This study provides help in suggesting the importance of a horizontal organisational culture to Generation Z nurses. Also, the support of senior nurses is needed to encourage Generation Z nurses to accept deficient themselves. IMPLICATIONS FOR THE PROFESSION: Generation Z nurses tended to feel confused by the vertical culture, uncertainty of work and daunting tasks; excessive criticism and rebuke seems to make Generation Z nurses feel a sense of shame. The family-centred culture of nursing organisations could cause conflicts for Generation Z nurses who tend to separate their personal lives from work. IMPACT: Generation Z nurses had no difficulty acquiring knowledge because they had the skills to search for the necessary information, but they experienced difficulty applying this knowledge in practice and becoming familiar with their role as a nurse. REPORT METHODS: We adhered to relevant EQUATOR guidelines of the Consolidated Criteria for Reporting Qualitative Research (COREQ). PATIENT OR PUBLIC INVOLVEMENT AND ENGAGEMENT: No patient or public involvement.

Catabolism of 2-keto-3-deoxy-galactonate and the production of its enantiomers.

2-Keto-3-deoxy-galactonate (KDGal) serves as a pivotal metabolic intermediate within both the fungal D-galacturonate pathway, which is integral to pectin catabolism, and the bacterial DeLey-Doudoroff pathway for D-galactose catabolism. The presence of KDGal enantiomers, L-KDGal and D-KDGal, varies across these pathways. Fungal pathways generate L-KDGal through the reduction and dehydration of D-galacturonate, whereas bacterial pathways produce D-KDGal through the oxidation and dehydration of D-galactose. Two distinct catabolic routes further metabolize KDGal: a nonphosphorolytic pathway that employs aldolase and a phosphorolytic pathway involving kinase and aldolase. Recent findings have revealed that L-KDGal, identified in the bacterial catabolism of 3,6-anhydro-L-galactose, a major component of red seaweeds, is also catabolized by Escherichia coli, which is traditionally known to be catabolized by specific fungal species, such as Trichoderma reesei. Furthermore, the potential industrial applications of KDGal and its derivatives, such as pyruvate and D- and L-glyceraldehyde, are underscored by their significant biological functions. This review comprehensively outlines the catabolism of L-KDGal and D-KDGal across different biological systems, highlights stereospecific methods for discriminating between enantiomers, and explores industrial application prospects for producing KDGal enantiomers. KEY POINTS: • KDGal is a metabolic intermediate in fungal and bacterial pathways • Stereospecific enzymes can be used to identify the enantiomeric nature of KDGal • KDGal can be used to induce pectin catabolism or produce functional materials.

Development and Validation of an Artificial Intelligence Model for Detecting Rib Fractures on Chest Radiographs.

Background: Chest radiography is the standard method for detecting rib fractures. Our study aims to develop an artificial intelligence (AI) model that, with only a relatively small amount of training data, can identify rib fractures on chest radiographs and accurately mark their precise locations, thereby achieving a diagnostic accuracy comparable to that of medical professionals. Methods: For this retrospective study, we developed an AI model using 540 chest radiographs (270 normal and 270 with rib fractures) labeled for use with Detectron2 which incorporates a faster region-based convolutional neural network (R-CNN) enhanced with a feature pyramid network (FPN). The model's ability to classify radiographs and detect rib fractures was assessed. Furthermore, we compared the model's performance to that of 12 physicians, including six board-certified anesthesiologists and six residents, through an observer performance test. Results: Regarding the radiographic classification performance of the AI model, the sensitivity, specificity, and area under the receiver operating characteristic curve (AUROC) were 0.87, 0.83, and 0.89, respectively. In terms of rib fracture detection performance, the sensitivity, false-positive rate, and free-response receiver operating characteristic (JAFROC) figure of merit (FOM) were 0.62, 0.3, and 0.76, respectively. The AI model showed no statistically significant difference in the observer performance test compared to 11 of 12 and 10 of 12 physicians, respectively. Conclusions: We developed an AI model trained on a limited dataset that demonstrated a rib fracture classification and detection performance comparable to that of an experienced physician.

[Analysis of the Adequacy of Nurse Staffing Level through the Estimation of Nursing Activity Hours and Implementation of Focus Group Interviews in a Tertiary Hospital: Using a Mixed-Method Design].

PURPOSE: This study aimed to examine the adequacy of current nurse staffing levels by identifying nursing activities and workload. METHODS: The study used a mixed-method design. A nursing activity survey was conducted using the work sampling method over 2 working days with 119 general ward nurses. A focus group interview was conducted with 12 nurses. Quantitative and qualitative data were analyzed using SPSS 20.0 and content analysis, respectively. RESULTS: The most amount of time was spent on medication (in direct nursing) and electronic medical record documentation (in indirect nursing). The appropriate nurse-to-patient ratio is 1:7.7 for the day shift, 1:9.0 for the evening shift, and 1:11.9 for the night shift. However, the current nurse-to-patient ratio is 1:9.4, 1:11.0, and 1:13.8 for the day, evening, and night shifts, respectively. Therefore, the current nurse staffing level is insufficient for the workload. In the focus group interview, the main reasons cited for being unable to complete tasks within working hours were communication and coordination, and the nursing electronic medical record. The essential nursing activities of basic nursing and emotional support were overlooked owing to a heavy workload. Therefore, an adequate nurse staffing level should be higher than the measured quantitative workload. CONCLUSION: These results suggest the general wards of tertiary hospitals should evaluate the adequacy of their current nurse staffing and allocate sufficient nurses to improve patient safety and nursing care quality.

Functionally distinct pericyte subsets differently regulate amyloid-ß deposition in patients with Alzheimer's disease.

Although the concept that the blood-brain barrier (BBB) plays an important role in the etiology and pathogenesis of Alzheimer's disease (AD) has become increasingly accepted, little is known yet about how it actually contributes. We and others have recently identified a novel functionally distinct subset of BBB pericytes (PCs). In the present study, we sought to determine whether these PC subsets differentially contribute to AD-associated pathologies by immunohistochemistry and amyloid beta (Aß) peptidomics. We demonstrated that a disease-associated PC subset (PC2) expanded in AD patients compared to age-matched, cognitively unimpaired controls. Surprisingly, we found that this increase in the percentage of PC2 (%PC2) was correlated negatively with BBB breakdown in AD patients, unlike in natural aging or other reported disease conditions. The higher %PC2 in AD patients was also correlated with a lower Aß42 plaque load and a lower Aß42:Aß40 ratio in the brain as determined by immunohistochemistry. Colocalization analysis of multicolor confocal immunofluorescence microscopy images suggests that AD patient with low %PC2 have higher BBB breakdown due to internalization of Aß42 by the physiologically normal PC subset (PC1) and their concomitant cell death leading to more vessels without PCs and increased plaque load. On the contrary, it appears that PC2 can secrete cathepsin D to cleave and degrade Aß built up outside of PC2 into more soluble forms, ultimately contributing to less BBB breakdown and reducing Aß plaque load. Collectively our data shows functionally distinct mechanisms for PC1 and PC2 in high Aß conditions, demonstrating the importance of correctly identifying these populations when investigating the contribution of neurovascular dysfunction to AD pathogenesis.

PDCD4 as a marker of mTOR pathway activation and therapeutic target in mycobacterial infections.

Programmed cell death protein 4 (PDCD4) is instrumental in regulating a range of cellular processes such as translation, apoptosis, signal transduction, and inflammatory responses. There is a notable inverse correlation between PDCD4 and the mammalian target of rapamycin (mTOR) pathway, which is integral to cellular growth control. Activation of mTOR is associated with the degradation of PDCD4. Although the role of PDCD4 is well established in oncogenesis and immune response regulation, its function in mycobacterial infections and its interplay with the mTOR pathway necessitate further elucidation. This study investigates the modulation of PDCD4 expression in the context of mycobacterial infections, revealing a consistent pattern of downregulation across diverse mycobacterial species. This observation underscores the potential utility of PDCD4 as a biomarker for assessing mTOR pathway activation during such infections. Building on this finding, we employed a novel approach using PDCD4-based mTOR (Tor)-signal-indicator (TOSI) reporter cells for the high-throughput screening of FDA-approved drugs, focusing on mTOR inhibitors. This methodology facilitated the identification of several agents, inclusive of known mTOR inhibitors, which upregulated PDCD4 expression and concurrently exhibited efficacy in impeding mycobacterial proliferation within macrophages. These results not only reinforce the significance of PDCD4 as a pivotal marker in the understanding of infectious diseases, particularly mycobacterial infections, but also illuminate its potential in the identification of mTOR inhibitors, thereby contributing to the advancement of therapeutic strategies. IMPORTANCE: This study emphasizes the critical role of the mammalian target of rapamycin (mTOR) pathway in macrophage responses to mycobacterial infections, elucidating how mycobacteria activate mTOR, resulting in PDCD4 degradation. The utilization of the (Tor)-signal-indicator (TOSI) vector for real-time monitoring of mTOR activity represents a significant advancement in understanding mTOR regulation during mycobacterial infection. These findings deepen our comprehension of mycobacteria's innate immune mechanisms and introduce PDCD4 as a novel marker for mTOR activity in infectious diseases. Importantly, this research laid the groundwork for high-throughput screening of mTOR inhibitors using FDA-approved drugs, offering the potential for repurposing treatments against mycobacterial infections. The identification of drugs that inhibit mTOR activation opens new avenues for host-directed therapies, marking a significant step forward in combating tuberculosis and other mycobacterial diseases.

Subcutaneous Infliximab (CT-P13 SC) as Maintenance Therapy for Inflammatory Bowel Disease: Two Randomized Phase 3 Trials (LIBERTY).

BACKGROUND & AIMS: CT-P13 subcutaneous (SC), an SC formulation of the intravenous (IV) infliximab biosimilar CT-P13 IV, creates a unique exposure profile. The LIBERTY studies aimed to demonstrate superiority of CT-P13 SC vs placebo as maintenance therapy in patients with Crohn's disease (CD) and ulcerative colitis (UC). METHODS: Two randomized, placebo-controlled, double-blind studies were conducted in patients with moderately to severely active CD or UC and inadequate response or intolerance to corticosteroids and immunomodulators. All patients received open-label CT-P13 IV 5 mg/kg at weeks 0, 2, and 6. At week 10, clinical responders were randomized (2:1) to CT-P13 SC 120 mg or placebo every 2 weeks until week 54 (maintenance phase) using prefilled syringes. (Co-) primary end points were clinical remission and endoscopic response (CD) and clinical remission (UC) at week 54 (all-randomized population). RESULTS: Overall, 396 patients with CD and 548 patients with UC received induction treatment. At week 54 in the CD study, statistically significant higher proportions of CT-P13 SC-treated patients vs placebo-treated patients achieved clinical remission (62.3% vs 32.1%; P < .0001) and endoscopic response (51.1% vs 17.9%; P < .0001). In the UC study, clinical remission rates at week 54 were statistically significantly higher with CT-P13 SC vs placebo (43.2% vs 20.8%; P < .0001). Achievement of key secondary end points was significantly higher with CT-P13 SC vs placebo across both studies. CT-P13 SC was well tolerated, with no new safety signals identified. CONCLUSIONS: CT-P13 SC was more effective than placebo as maintenance therapy and was well tolerated in patients with moderately to severely active CD or UC who responded to CT-P13 IV induction. CLINICALTRIALS: gov, Numbers: NCT03945019 (CD) and NCT04205643 (UC).

Psychological Well-Being of Nurses with One to Five Years of Clinical Experience.

Introduction: Nurses are required to fulfill many roles, including expertise, communication, and leadership and are psychologically vulnerable due to lack of manpower, emotional labor, and shift work. Among them, it is necessary to understand the psychological well-being of new nurses and junior nurses who have a high early resignation rate. Objective: The purpose of this study was to investigate psychological well-being of nurses and compare psychological well-being of nurses from the first to the fifth years of clinical experience. Methods: Cross-sectional comparative design and purposive sampling method were used. Data were collected from 148 nurses with one to five years of experience working in tertiary care general hospitals. On November 11, 2021, an online link for the structured questionnaire was sent to the group social networking service accounts for nurses. Psychological well-being was assessed using a Korean version of the Scales of Psychological Well-being including autonomy, environmental mastery, personal growth, positive relations with others, purpose in life, and self-acceptance. Results: The average psychological well-being of nurses was 194.11, with significant differences depending on years of clinical experience (p = .006, F = 3.82) and satisfaction with nursing (p < .001, F = 13.12). It was lowest at 180.08 in the first year, gradually improving, but falling again from the fourth year. Among five subfactors except positive relations with others (p = .389), psychological well-being was related to clinical experiences years using satisfaction with nursing and religion as covariates. Conclusions: This study that compared psychological well-being from the first to the fifth year according to clinical experience revealed the need for optimized intervention for each year. Nursing managers can improve the psychological well-being of nurses through active and appropriate intervention according to the passage of nursing experience.

Clinical Application of an Augmented Reality Navigation System for Transforaminal Epidural Injection: A Randomized Controlled Trial.

Objectives: Augmented reality (AR) navigation systems are emerging to simplify and enhance the precision of medical procedures. Lumbosacral transforaminal epidural injection is a commonly performed procedure for the treatment and diagnosis of radiculopathy. Accurate needle placement while avoiding critical structures remains a challenge. For this purpose, we conducted a randomized controlled trial for our augmented reality navigation system. Methods: This randomized controlled study involved 28 patients, split between a traditional C-arm guided group (control) and an AR navigation guided group (AR-NAVI), to compare procedure efficiency and radiation exposure. The AR-NAVI group used a real-time tracking system displaying spinal structure and needle position on an AR head-mounted display. The procedural time and C-arm usage (radiation exposure) were measured. Results: All patients underwent successful procedures without complications. The AR-NAVI group demonstrated significantly reduced times and C-arm usage for needle entry to the target point (58.57 ± 33.31 vs. 124.91 ± 41.14, p < 0.001 and 3.79 ± 1.97 vs. 8.86 ± 3.94, p < 0.001). Conclusions: The use of the AR navigation system significantly improved procedure efficiency and safety by reducing time and radiation exposure, suggesting a promising direction for future enhancements and validation.

Characterization of Exterior Parts for 3D-Printed Humanoid Robot Arm with Various Patterns and Thicknesses.

Currently, metal is the most common exterior material used in robot development due to the need to protect the motor. However, as soft, wearable, and humanoid robots are gradually being developed, many robot parts need to be converted into artificial skin using flexible materials. In this study, in order to develop soft exterior parts for robots, we intended to manufacture exterior robot arm parts via fused filament fabrication (FFF) 3D printing according to various structural and thickness conditions and analyze their mechanical properties. The exterior parts of the robot arms were manufactured utilizing Shore 95 A TPU (eTPU, Esun, Shenzhen, China), which is renowned for its softness and exceptional shock absorption characteristics. The exterior robot arm parts were modeled in two parts, the forearm and upper arm, by applying solid (SL) and re-entrant (RE) structures and thicknesses of 1, 2, and 4 mm. The mechanical properties were analyzed through the use of three-point bending, tensile, and compression testing. All of the characterizations were analyzed using a universal testing machine (AGS-X, SHIMADZU, Kyoto, Japan). After testing the samples, it was confirmed that the RE structure was easily bendable towards the bending curve and required less stress. In terms of the tensile tests, the results were similar to the bending tests; to achieve the maximum point, less stress was required, and for the compression tests, the RE structure was able to withstand the load compared to the SL structure. Therefore, after analyzing all three thicknesses, it was confirmed that the RE structure with a 2 mm thickness had excellent characteristics in terms of bending, tensile, and compressive properties. Therefore, the re-entrant pattern with a 2 mm thickness is more suitable for manufacturing a 3D-printed humanoid robot arm.

Support for the Right to Life among Neonatal Intensive Care Nurses in Korea.

The increase of high-risk newborns due to societal changes has presented neonatal intensive care unit nurses with more ethical challenges and heightened their perception of neonatal palliative care. Therefore, this study was a descriptive survey exploring the perceptions of neonatal intensive care unit nurse regarding biomedical ethics and neonatal palliative care in neonatal intensive care units. The research participants were 97 neonatal intensive care unit nurses who had been directly involved with end-of-life care for high-risk babies. Data were collected from November to December 2021 through an online survey. The Korean version of Neonatal Palliative Care Attitude Scale and the tool of biomedical ethics were used. The collected data were analyzed using the T-test, ANOVA, Scheffé test, Pearson correlation coefficient, and multiple regression analysis. The mean score for perception of biomedical ethics in neonatal intensive care unit nurses was 2.89 of 4, and that of neonatal palliative care in neonatal intensive care unit nurses was 3.10 of 5. Existence of a protocol of neonatal palliative care, the experience of patients dying, and the right to life of neonates were factors influencing the perception of neonatal palliative care. The explanatory power was 12.5%. The data support the importance of guidelines regarding systematic neonatal palliative care. Also, developing programs for sharing and supporting experiences of patients dying among colleagues and persistent education about the right to life of neonates for neonatal intensive care unit nurses can improve perception of neonatal palliative care.

Psychological separation, health locus of control, and transition readiness in adolescents and young adults with type I diabetes.

PURPOSE: The purpose of this study was to examine the effects of psychological separation and health locus of control on the health care transition readiness of adolescents and young adults (AYAs) with type 1 diabetes. METHODS: Data were collected between December 2020 and October 2021. One hundred twelve AYAs with type 1 diabetes treated at a tertiary hospital and under follow-up observation as well as AYAs with type 1 diabetes nationwide who were part of the type 1 diabetes internet community were enrolled. The Psychological Separation Inventory, the Multidimensional Health Locus of Control scale from C, and the Self-management and Transition to Adulthood with Therapeutics = Rx Questionnaire were used. RESULTS: Multiple regression analysis indicated that age (ß = 0.302, p = .001), hemoglobin A1c (HbA1c) (ß = -0.174, p = .040), conflictual separation (ß = 0.242, p = .005), functional separation (ß = 0.200, p = .045) and attitudinal separation (ß = -0.240 p = .015) were significantly associated with health management transition readiness; these predictors explained 27.6% of health care transition readiness (F = 8.062, p = .000). CONCLUSIONS: AYAs with type 1 diabetes can enhance readiness for health care transition by fostering psychological separation from parents, effectively managing blood glucose levels, and taking into account age-related factors during the preparation process. At this point, it is essential for healthcare professionals to guide parents in recognizing adolescents' psychological independence and facilitating their supportive role through the process of redefining their roles. PRACTICE IMPLICATIONS: Health care providers should promote psychological separation in AYAs. Additionally, taking into account the developmental characteristics of adolescence can facilitate a successful health care transition.

Anticancer Evaluation of Novel Benzofuran-Indole Hybrids as Epidermal Growth Factor Receptor Inhibitors against Non-Small-Cell Lung Cancer Cells.

The epidermal growth factor receptor (EGFR), also known as ErbB1 and HER1, belongs to the receptor tyrosine kinase family. EGFR serves as the primary driver in non-small-cell lung cancer (NSCLC) and is a promising therapeutic target for NSCLC. In this study, we synthesized a novel chemical library based on a benzofuran-indole hybrid scaffold and identified 8aa as a potent and selective EGFR inhibitor. Interestingly, 8aa not only showed selective anticancer effects against NSCLC cell lines, PC9, and A549, but it also showed significant inhibitory effects against the double mutant L858R/T790M EGFR, which frequently occurs in NSCLC. In addition, in PC9 and A549 cells, 8aa potently blocked the EGFR signaling pathway, cell viability, and cell migration. These findings suggest that 8aa, a benzofuran-indole hybrid derivative, is a novel EGFR inhibitor that may be a potential candidate for the treatment of NSCLC patients with EGFR mutations.