Nurses' needs for care robots in integrated nursing care services.

AIMS: To determine the need for care robots among nurses and to suggest how robotic care should be prioritized in integrated nursing care services. BACKGROUND: Korea is expected to be a super-aged society by 2030. To solve care issues with elderly inpatient caused by informal caregivers, the government introduced "integrated nursing care services"; these are comprehensive care systems staffed by professionally trained nurses. To assist them, a care robot development project has been launched. DESIGN: The study applied a cross-sectional survey. METHODS: In 2016, we conducted a multicentre survey involving 302 Registered Nurses in five hospitals including three tertiary and two secondary hospitals in Korea. The questionnaire consisted of general characteristics of nurses and their views on and extents of agreement about issues associated with robotic care. RESULTS: Trial centre nurses and those with ≥10 years of experience reported positively on the prospects for robotic care. The top-three desired primary roles for care robots were "measuring/monitoring", "mobility/activity" and "safety care". "Reduction in workload", especially in terms of "other nursing services" which were categorized as nonvalue-added nursing activities, was the most valued feature. The nurses approved of the aid by care robots but were concerned about device malfunction and interruption of rapport with patients. CONCLUSION: Care robots are expected to be effective in integrated nursing care services, particularly in "measuring/monitoring". Such robots should decrease nurses' workload and minimize nonvalue-added nursing activities efficiently. No matter how excellent care robots are, they must cooperate with and be controlled by nurses.

The Hand, Foot, and Mouth Disease Sentinel Surveillance System in South Korea: Retrospective Evaluation Study.

Background: South Korea has implemented a hand, foot, and mouth disease (HFMD) surveillance system since 2009 to monitor incidence trends and identify disease burden. This nationwide surveillance involves a network of approximately 100 pediatric clinics that report all probable and confirmed HFMD cases. Following the COVID-19 pandemic, infectious disease surveillance systems must be evaluated to ensure the effective use of limited public health resources. Objective: This study aimed to evaluate the HFMD sentinel surveillance system in South Korea from 2017 to 2022, focusing on the transition period after the COVID-19 pandemic. Methods: We retrospectively reviewed the HFMD sentinel surveillance system from the Korea Disease Control and Prevention Agency using systematic guidelines for public health surveillance system evaluation developed by the US Centers for Disease Control and Prevention. We assessed the system's overall performance in 5 main factors: timeliness, stability, completeness, sensitivity, and representativeness (ie, the age and geographic distribution of sentinels). We rated these factors as weak, moderate, or good. Results: Our study showed that the completeness, sensitivity, and age representativeness of the HFMD surveillance performance were temporarily reduced to moderate levels from 2020 to 2021 and recovered in 2022, while the timeliness and geographic representativeness were maintained at a good level throughout the study period. The stability of the surveillance was moderate from 2017 to 2021 and weak in 2022. Conclusions: This is the first study to evaluate the HFMD surveillance system after the acute phase of the COVID-19 pandemic. We identified a temporarily reduced level of performance (ie, completeness, sensitivity, and age-specific representativeness) during the acute phase of the pandemic and good performance in 2022. Surveillance system evaluation and maintenance during public health emergencies will provide robust and reliable data to support public health policy development. Regular staff training programs and reducing staff turnover will improve HFMD surveillance system stability.

Study of the primo-vascular system and location-dependent oxygen levels for a mouse embryo.

The two major circulatory systems, the lymph system and the blood vessel system, play significant roles in controlling embryonic development. The primo-vascular system (PVS) was recently reported as an additional circulatory system in various animals. In this paper, the PVS in a mouse embryo was investigated. The structural characterization of the PVS in the mouse placenta and umbilical cord, which was visualized with the trypan blue staining technique, was focused on. The PVS was well_developed in the mouse placenta area. Using a nanopore-based amperometric oxygen sensor, the oxygen levels at four different areas of the embryonic brain, placenta, blood vessel, and primo-vessel of the PVS were measured. The relatively higher oxygen levels that were measured at the primo-vessels than at the brain and the placenta, while still lower than the oxygen level that was measured at the blood vessels, may suggest a role of PVS in oxygen transport.

Electrochemical nanosensor for real-time direct imaging of nitric oxide in living brain.

As gaseous nitric oxide (NO), a critical and multifaceted biomarker, diffuses easily once released, identifying the precise sources of NO release is a challenge. This study developed a new technique for real-time in vivo direct NO imaging by coupling an amperometric NO nanosensor with scanning electrochemical microscopy. This technique provides three-dimensional information of the NO releasing sites in an intact living mouse brain with high sensitivity and spatial resolution. Immunohistochemical analysis was carried out to confirm the anatomical reliability of the acquired electrochemical NO image. The real-time NO imaging results were well matched with the corresponding immunohistochemical analysis of neuronal NO synthase immunoreactive (nNOS-IR) cells, i.e., NO releasing sites in a living brain. The imaged NO local concentrations were confirmed to be closely related to the location in depth, the size of the nNOS-IR cell, and the intensity of nNOS immunoreactivity. This paper demonstrates the first direct electrochemical NO imaging of a living brain.

Polydeoxyribonucleotide injection in the patients with partial-thickness tear of supraspinatus tendon: a prospective and pilot study using ultrasound.

OBJECTIVE: Polydeoxyribonucleotide as adenosine receptor (A2A) agonist has been used in plastic surgery and dermatology related to its regenerative property. The aim of this pilot study is to evaluate the safety and efficacy of polydeoxynucleotide injection in patients with rotator cuff tears by a variety of outcomes including pain, disability, physical performance test, and ultrasonography (US). METHODS: Seventeen patients (9 men, 8 women, age: 57.9 ± 9.1) with partial-thickness tear of supraspinatus tendon were evaluated in a prospective, open-label, and pre-and-post study. Seventeen patients underwent 3 times intra-lesional polydeoxynucleotide injection under ultrasound (US) guidance on weeks 0, 2 and 4. The safety and efficacy were assessed on weeks 0, 6 and 12. Main outcome measures included shoulder pain on Visual Analogue Scale (VAS) and DASH (disabilities of arm, hand, shoulder) score, range of motion in shoulder, shoulder strength and tear volume (cm3) by US. Adverse events were monitored. (CRIS: https://www.cris.nih.go.kr , KCT0000767). RESULTS: Active shoulder pain on VAS reduced from 5.53 to 3.53 (P = 0.016), and acting pain, one of DASH questionnaires, reduced from 3.35 to 2.00 (P < 0.001). However, resting shoulder pain on VAS and total DASH scores were not significantly different. Forward flexion and internal rotation in range of motion improved significantly (from 169.41 to 178.13 degrees [P = 0.004] and from 83.53 to 88.75 degrees [P = 0.014], respectively). The volume of torn lesion decreased during the study period, however it was not significant. There were no significant adverse events leading to hospitalization. CONCLUSIONS: Minimally invasive procedure through polydeoxynucleotide injection into torn area of supraspinatus tendon on US could be candidate for the safe and effective treatment on shoulder pain and limited range of motion in patients with rotator cuff tear.

Ultrasonographic Evaluation and Feasibility of Posterosuperior Internal Impingement Syndrome: A Case Series.

Posterosuperior impingement (PSI) is an underdiagnosed cause of posterior shoulder pain and should be differentiated from classic and external impingement. PSI involves the internal impingement of soft tissues, including the undersurface of the rotator cuff against the posterosuperior labrum when the arm is brought into abduction and external rotation (ABER). Ultrasonography (US) can be useful in the assessment of PSI because of its high resolution and ability to perform during dynamic maneuvers in ABER. This series of 3 cases illustrates the feasibility of US in the evaluation of PSI when the history and physical examination implicate this condition. LEVEL OF EVIDENCE: V.

Real-time evaluation of nitric oxide (NO) levels in cortical and hippocampal areas with a nanopore-based electrochemical NO sensor.

Nitric oxide (NO) is an important biomolecule for regulating various brain functions, such as the control of neurovascular tone. NO, however, cannot be stored inside cells where NO is produced and immediately diffuses through the cellular membrane and decays rapidly, which makes the detection of NO extremely hard in an in vivo setting. We constructed an amperometric NO nanosensor and utilized it to directly measure NO release in the living brain. The NO nanosensor uses nanopores (pores with an opening radii <500 nm) in which NO is oxidized at the porous platinum surface. The nanopore-based sensor was inserted vertically into the brains of anesthetized mice up to the end of the hippocampal CA 3 region, or to a depth of about 3mm. The sensor was slowly advanced in the brain in 0.5 µm increments and in 0.05 s temporal steps. Different levels of NO release were monitored by the nanopore NO sensor during the course of the penetration. The hippocampal CA3 region had the highest level of NO release, which was followed by CA2 and CA1 of the hippocampus and the cortex. The levels of NO release were not uniformly distributed within the cortical and hippocampal areas of living brain. In sum, the nanopore-based NO sensor was able to grossly measure NO contents within living brain in real time and with high sensitivity. This study may provide good insights about the relationship between the distributions of NOS-immunoreactive neurons and the directly measured levels of NO release in brain.

Primo vascular system of murine melanoma and heterogeneity of tissue oxygenation of the melanoma.

Murine melanoma requires the complex development of lymphatic, vascular, and non-vascular structures. A possible relationship between the primo vascular system (PVS) and the melanoma metastasis has been proposed. In particular, the PVS may be involved in oxygen transport. Vasculogenic-like networks, similar to the PVS, have been found within melanoma tumors, but their functional relationship with the PVS and meridian structures are unclear. Herein, we report on the use of an electrochemical O(2) sensor to study oxygenation levels of melanoma tumors in mice. We consistently found higher tissue oxygenation in specific sites of tumors (n=5). These sites were strongly associated with vascular structures or the PVS. Furthermore, the PVS on the tumor surface was associated with adipose tissue. Our findings suggest that the PVS is involved in the regulation of metastasis.