A Comprehensive Assessment of the Harms of Fine-Needle Aspiration Biopsy for Thyroid Nodules: A Systematic Review.

BACKGRUOUND: There have concerns related with the potential harms of fine-needle aspiration biopsy (FNAB). We aimed to summarize the clinical complications and evaluate the safety of FNAB. METHODS: Studies related with the harms of FNAB were searched on MEDLINE, Embase, Cochrane library, and KoreaMed from 2012 to 2022. Also, studies reviewed in the previous systematic reviews were evaluated. Included clinical complications were postprocedural pain, bleeding events, neurological symptoms, tracheal puncture, infections, post-FNAB thyrotoxicosis, and needle tract implantation of thyroid cancers. RESULTS: Twenty-three cohort studies were included in this review. Nine studies which were related with FNAB-related pain showed that most of the subjects had no or mild discomfort. The 0% to 6.4% of the patients had hematoma or hemorrhage after FNAB, according to 15 studies. Vasovagal reaction, vocal cord palsy, and tracheal puncture have rarely described in the included studies. Needle tract implantation of thyroid malignancies was described in three studies reporting 0.02% to 0.19% of the incidence rate. CONCLUSION: FNAB is considered to be a safe diagnostic procedure with rare complications, which are mainly minor events. Thorough assessement of the patients' medical condition when deciding to perform FNABs would be advisable to lower potential complications.

Assessment of Various Density Functional Theory Methods for Finding Accurate Structures of Actinide Complexes.

Density functional theory (DFT) is a widely used computational method for predicting the physical and chemical properties of metals and organometals. As the number of electrons and orbitals in an atom increases, DFT calculations for actinide complexes become more demanding due to increased complexity. Moreover, reasonable levels of theory for calculating the structures of actinide complexes are not extensively studied. In this study, 38 calculations, based on various combinations, were performed on molecules containing two representative actinides to determine the optimal combination for predicting the geometries of actinide complexes. Among the 38 calculations, four optimal combinations were identified and compared with experimental data. The optimal combinations were applied to a more complicated and practical actinide compound, the uranyl complex (UO2(2,2'-(1E,1'E)-(2,2-dimethylpropane-1,3-dyl)bis(azanylylidene)(CH3OH)), for further confirmation. The corresponding optimal calculation combination provides a reasonable level of theory for accurately optimizing the structure of actinide complexes using DFT.

Relationships among Healthcare Digitalization, Social Capital, and Supply Chain Performance in the Healthcare Manufacturing Industry.

Due to the impact of coronavirus disease 2019 (COVID-19), automation and artificial intelligence (AI) have attracted renewed interest in multiple industrial fields. Global manufacturing bases were affected strongly by workforce shortages associated with the spread of COVID-19, and are working to increase productivity by embracing digital manufacturing technologies that take advantage of artificial intelligence and the Internet of Things (IoT) that offer the promise of improved connectivity among supply chains. This trend can increase and smooth the flow of social capital, which is a potential resource in supply chains and can affect supply chain performance in healthcare industry. However, such an issue has not been properly recognized as the best practice in healthcare industry. Thus, this study investigates empirically the relationship between digitalization and supply chain performance in healthcare manufacturing companies based on previous research that proposed a role for social capital. We surveyed the staff of domestic small and medium-sized healthcare manufacturing companies in South Korea currently operating or planning to deploy digital manufacturing technologies. Online and email surveys were utilized to collect the data. Invalid responses were excluded and the remaining 130 responses were analyzed using a structural equation model in SPSS with the AMOS module. We found that digitalization has a positive effect on the formation of social capital, which in turn has a positive effect on supply chain performance. The direct effect of digitalization on supply chain performance is small, and relatively large portions are mediated and influenced by social capital. The establishment of strategic relationships in the healthcare manufacturing industry is significant, as supply chain networks and production processes can influence the intended use of factory output. Companies should, therefore, secure timely and accurate information to manage the flow of products and services. The formation of social capital in the supply chain can help visualize entire supply chains and has a positive effect on real-time information-sharing among key elements of those chains.

"Worrying About Getting Sick in the Future": Lived Experience of Health Seeking and Healthcare Utilization Among Korean Immigrant Nail Salon Workers.

To understand the health and safety concerns of Korean immigrant women nail salon workers in the Greater New York City area and their experiences of health seeking and health service utilization, 20 semi-structured interviews were conducted and analyzed using interpretive hermeneutic phenomenology. Most worried about working in nail salons and experienced work-related health symptoms. However, they were disinclined toward personal protective device use because of discomfort and inconvenience. Major barriers to healthcare utilization limited their healthcare use to times when they had intolerable symptoms, preventing opportunities for regular screening tests. To overcome these limitations, workers actively sought available resources and health-related information online and through personal networks, the latter facilitated by living in a Korean community. Despite efforts to maintain their health and manage their symptoms, Korean nail salon workers worried about getting sick as they got older due to prolonged occupational chemical exposure and limited healthcare access. Appropriate education and intervention should aim to resolve current barriers to personal protective device use and healthcare use and provide a source of care for uninsured workers.

A triple approach for diagnostic assessment of endoscopic ultrasound-guided fine needle aspiration in pancreatic solid masses and lymph nodes.

BACKGROUND AND AIMS: Endoscopic ultrasound (EUS)-guided fine needle aspiration (FNA) has been becoming the standard tool for acquiring pancreatic lesion tissue. However, a single cytologic or histologic evaluation is not satisfactory for diagnosis. In this study, we evaluated the diagnostic yield of EUS-FNA for pancreatic solid masses and intra-abdominal lymph nodes using a triple approach. METHODS: This study included patients undergoing evaluation for a solid pancreatic mass (n = 59) or intra-abdominal lymph nodes (n = 16) using EUS-FNA with a 22- or 25-gauge (G) needle, respectively. The specimens from each pass were analyzed by on-site cytology using Diff-Quick stain, cytology using Papanicolaou stain, and histology with immunohistochemical (IHC) staining. RESULTS: A total of 75 patients (49 males; mean age; 63.7 years) were included. The median number of needle pass for diagnosis of malignancy was 2.0, and there was no technical failure. The diagnostic accuracies with on-site cytology, cytology using Papanicolaou staining, and histology were 70.7, 80.0, and 80.0 %, respectively. The diagnostic accuracy using a triple approach was significantly greater than cytology using Papanicolaou staining alone (94.7 vs. 80.0 %; p = 0.007). In patients with malignant lesions, cytology identified 12 of 71 (16.9 %) malignant lesions that were not diagnosed by histology using IHC, and histology identified six (8.5 %) malignant lesions that were not diagnosed by cytology. CONCLUSION: On-site cytopathologic evaluation combined with cytologic and histologic analysis with IHC stain for one-pass specimen is considered to be able to increase the overall accuracy of EUS-FNA in pancreatic solid masses and lymph nodes.

Psychological features of North Korean female refugees on the MMPI-2: latent profile analysis.

This study examined the heterogeneity in the Minnesota Multiphasic Personality Inventory-2nd Edition (MMPI-2; Butcher, Dahlstrom, Graham, Tellegen, & Kaemmer, 1989) profiles of North Korean female refugee population (N = 2,163) using latent profile analysis (LPA). The North Korean female refugee sample arrived at Hanawon, South Korea's resettlement center for North Korean refugees in 2008 and 2009 and took the MMPI-2 as part of an initial psychological screen. The analysis, which included the T scores of the 6 validity scales and the 10 standard clinical scales, identified 4 classes with distinctive psychological features: Class 1 (nonclinical), Class 2 (demoralized), Class 3 (somatized), and Class 4 (detached). The 4 covariates entered into the model (age, education, affiliation with a religion, and the number of forced repatriations) impacted the likelihood of belonging to certain classes. As hypothesized, older age, fewer years of education, and more incidents of forced repatriation predicted higher proneness to psychopathology. However, contrary to our expectation, having a religious faith did not emerge as a salient protective factor. The current LPA results revealed distinct heterogeneous subgroups that previous research on the MMPI and MMPI-2 profiles of refugee populations overlooked with the assumption of a homogeneous sample. Clinical implications for the treatment of North Korean female refugees and the limitations of the study are discussed.

Factors associated with screen time among school-age children in Korea.

The purpose of this study was to investigate the association of sociodemographic, psychosocial, and behavioral characteristics with screen time among school-age children in Korea. This study employed a nonexperimental, cross-sectional study design. A total of 370 children attending four elementary schools participated in the study. Self-report method was used, and instruments included screen time (time spent on TV/video/computer/video games), sleep duration, eating behavior, pros and cons of exercise, and exercise self-efficacy. According to the results, 45.7% of the children had screen time of 1-2.9 hr/day and 8.9% had 3 or more hr/day. Increased screen time showed an association with gender (boy), higher body mass index, fast food consumption, higher cons of exercise, having a working mother, and attendance at a school in an inner city area (p < .05). Understanding the factors associated with screen time may provide useful information in the development of health promotion programs aimed at decreasing sedentary behaviors.

Quantitative assessment of the T2 relaxation time of the gluteus muscles in children with Duchenne muscular dystrophy: a comparative study before and after steroid treatment.

OBJECTIVE: To determine the feasibility of using T2 mapping as a quantitative method to longitudinally follow the disease activity in children with Duchenne muscular dystrophy (DMD) who are treated with steroids. MATERIALS AND METHODS: ELEVEN BOYS WITH DMD (AGE RANGE: 5-14 years) underwent evaluation with the clinical functional score (CFS), and conventional pelvic MRI and T2 mapping before and during steroid therapy. The gluteus muscle inflammation and fatty infiltration were evaluated on conventional MRI. The histograms and mean T2 relaxation times were obtained from the T2 maps. The CFS, the conventional MRI findings and the T2 values were compared before and during steroid therapy. RESULTS: None of the patients showed interval change of their CFSs. On conventional MRI, none of the images showed muscle inflammation. During steroid treatment, two boys showed increased fatty infiltration on conventional MRI, and both had an increase of the mean T2 relaxation time (p < 0.05). The remaining nine boys had no increase in fatty infiltration. Of these, three showed an increased mean T2 relaxation time (p < 0.05), two showed no change and four showed a decreased mean T2 relaxation time (p < 0.05). CONCLUSION: T2 mapping is a feasible technique to evaluate the longitudinal muscle changes in those children who receive steroid therapy for DMD. The differences of the mean T2 relaxation time may reflect alterations in disease activity, and even when the conventional MRI and CFS remain stable.

MR imaging assessment of the lateral head of the gastrocnemius muscle: prevalence of segmental anomalous origins in children and young adults.

BACKGROUND: Variations in the lower extremity musculature have been identified, including an anomalous origin of the medial head of the gastrocnemius muscle. Anomalies of the lateral head of the gastrocnemius muscle (LGN) have been less frequently described, especially in children. OBJECTIVE: To describe the MR imaging appearance, frequency and clinical symptoms associated with anatomic variations of the LGN in children and young adults. MATERIALS AND METHODS: A retrospective review of 465 knee MR imaging examinations was performed. The site of origin of the LGN was identified as either normal, lateral segmental anomalous origin (LSAO), or medial accessory anomalous origin (MAAO). The clinical indication for imaging was recorded. RESULTS: An anatomic variation of the LGN was identified in 16 patients (3.4%). Nine patients had LSAO, and five of these had symptoms referable to or abnormalities of the patella. Seven patients had MAAO, and three of these had chronic nontraumatic knee pain. CONCLUSION: Anatomic variations of the LGN are not rare in young patients, occurring with a frequency of 3.4% in our series. It is unknown whether these anomalies play a role in the etiology of patellofemoral pain or unexplained joint pain in children.

Midlife women's attitudes toward physical activity.

OBJECTIVE: To explore attitudes toward physical activity among a multiethnic group of midlife women. DESIGN: A qualitative cross-sectional study using an online forum. RECRUITMENT SETTINGS: Internet communities/groups for midlife women and for ethnic minorities. PARTICIPANTS: A multiethnic group of 15 midlife women. INSTRUMENTS: Ten online forum topics on attitudes toward physical activity and seven on ethnic-specific contexts. DATA ANALYSIS: Thematic analysis, involving line-by-line coding, categorization, and theme extraction. RESULTS: Six themes across all ethnic groups emerged from the data analysis process, although there were some ethnic differences in details related to each theme. The themes were (a) gendered experience, (b) physical activity as all body movements, (c) no time for physical activity, (d) environment matters, (e) health concerns made me do it, and (f) need a companion. CONCLUSIONS: Nurses need to consider and further investigate the influence of women's multiple roles, cultural factors, and environmental factors on physical activity in order to promote physical activity of midlife women.