Higher fibular head is a risk for lateral hinge fracture in medial open wedge high tibial osteotomy.

PURPOSE: To examine the association between the hinge position, fibular head position, and type III lateral hinge fracture (LHF) in patients with knee osteoarthritis (OA) who underwent medial open wedge high tibial osteotomy (MOWHTO). METHODS: This retrospective study examined patients who underwent MOWHTO. Radiographically, the Kellgren-Lawrence (K/L) classification, distance between the articular surface and the tip of the fibular head (fibular head position), hinge point (hinge position), type of LHF, and safe zone (within the proximal tibiofibular joint) outlier were evaluated. To determine the cut-off value of the hinge position and fibular head position associated with type III LHF, a receiver operating characteristic (ROC) curve analysis was performed. The odds ratio (OR) was calculated from the obtained cut-off values using logistic regression, which was adjusted by age, gender, body mass index, and opening distance. RESULTS: Among 132 knees in 120 patients, the radiographic severity of knee OA was 19 (14%), 73 (55%), and 40 (30%) of K/L grades 2, 3, and 4, respectively. LHF was observed in 40 knees (30%), including types I, II, and III fractures in 21 (16%), 5 (4%), and 14 (11%) knees, respectively. Hinge and fibular head positions were 16 and 10 mm, respectively, with significant correlation. Safe zone outlier was observed in 38 knees (29%). The hinge and fibular head positions with type III LHF were significantly higher (more cranial) than those with no fracture or other LHF subtypes. The ROC curve revealed that the cut-off value for the hinge and fibular head positions was 13.3 and 8.6 mm, respectively. The OR of the hinge and fibular head positions was 22.42 and 13.86, respectively. CONCLUSIONS: A higher hinge position was a risk factor for type III LHF and was associated with a higher fibular head in patients with knee OA who underwent MOWHTO. The hinge position should be placed at a certain distance from the articular surface to avoid type III LHF, especially in participants with higher fibular head position, even if the hinge position is located in the safe zone. LEVEL OF EVIDENCE: Retrospective cohort study, Level III.

Knowledge, attitudes, and perceptions associated with HPV vaccination among female Korean and Chinese university students.

BACKGROUND: Human papillomavirus (HPV) vaccination is a form of primary prevention for cervical cancer. The HPV vaccination rate of female university students is not high in Korea and China. Therefore, the purpose of this study was to identify and compare the factors associated with intention to receive HPV vaccination between Korean and Chinese female university students. METHODS: The participants were 273 Korean and 317 Chinese female university students who had not been vaccinated for HPV, and data were collected using a self-reported questionnaire about attitudes toward HPV vaccination, HPV knowledge, perceptions of HPV infection, and intention to receive HPV vaccine. RESULTS: There were no significant differences between the Korean and Chinese female university students in HPV knowledge, attitudes, perceptions, and vaccination intention. The factors influencing the intention of HPV vaccination in Korean students were a positive attitude toward the HPV vaccine and a high HPV knowledge score. For Chinese students, sexual experience, awareness of genital warts, a positive attitude toward the HPV vaccine, a high HPV knowledge scores, a perception of the seriousness of HPV infection, and negative emotions regarding HPV infection were significant factors. CONCLUSIONS: It is important to improve attitudes and knowledge about HPV and the HPV vaccine in order to enhance HPV vaccination both in Korea and China. Perceived seriousness and negative emotions regarding HPV infection should be used as a framework to develop subject-tailored interventions in China.

A bone bruise at the lateral and medial tibial plateau with an anterior cruciate ligament injury is associated with a meniscus tear.

PURPOSE: Bone bruises with anterior cruciate ligament (ACL) injury are well studied, but the association between bone bruises and multiple factors is unclear. The main objective of this study was to investigate the association between bone bruising and ACL injury and concomitant injury as well as clinical and functional scores. The second objective was to investigate the presence and distribution patterns of bone bruises. METHOD: A total of 176 patients who underwent ACL reconstruction for primary ACL injury were included. The demographic characteristics and responses to clinical and functional assessments (the Visual Analog Scale for activities of daily living and sports, the Cincinnati Knee Rating System, the Lysholm score, the Knee Osteoarthritis Outcome Score and side-to-side difference in anterior laxity) were recorded at the initial visit. Concomitant injuries were evaluated by intraoperative assessment. RESULTS: Bone bruises were detected in 141 patients (80.1%). The lateral femoral condyle (LFC) was the most common site in 116 patients (65.9%), followed by the lateral tibial plateau (LTP) in 82 patients (46.6%), medial tibial plateau (MTP) in 47 patients (26.7%) and medial femoral condyle (MFC) in 29 patients (16.5%). Regarding the distribution patterns, bone bruising at only the LFC, which was the most common pattern, was detected in 38 patients (27.0%). Bone bruising at the LTP or MTP was significantly associated with lateral (LM) and medial meniscus (MM) tears (odds ratios 4.0, 3.0, 4.3 and 40.5, 95% confidence intervals 1.5-11.6, 1.2-15.1, 1.2-17.3 and 8.6-283.0, respectively). No marked differences in the functional or clinical scores were noted. The severity of bone bruising at the MTP was significantly associated with MM tears and that at the LTP was significantly associated with LM tears. (p < 0.01). CONCLUSION: This study showed association between bone bruising at LTP and LM tears or at MTP and MM tears. Additionally, it provided detailed information on the presence and distribution patterns of bone bruises at each anatomic site. These findings are clinically relevant and will aid in preoperatively diagnosing meniscus tears in cases of ACL injury. LEVEL OF EVIDENCE: Level III.

Identification of a Novel MAN1A1-ROS1 Fusion Gene Through mRNA-based Screening for Tyrosine Kinase Gene Aberrations in a Patient with Leiomyosarcoma.

BACKGROUND: Soft tissue sarcomas are a heterogeneous group of rare malignant tumors. Advanced soft tissue sarcomas have a poor prognosis, and effective systemic therapies have not been established. Tyrosine kinases are increasingly being used as therapeutic targets for a variety of cancers and soft tissue sarcomas. Although complex karyotype sarcomas typically tend to carry more potentially actionable genetic alterations than do translocation-associated sarcomas (fusion gene sarcomas), based on our database review, we found that leiomyosarcoma and malignant peripheral nerve sheath tumors have lower frequencies of potential targets than other nontranslocation soft tissue sarcomas. We theorized that both leiomyosarcoma and malignant peripheral nerve sheath tumors might be included in any unique translocations. Furthermore, if tyrosine kinase imbalances, especially fusion genes, occur in patients with leiomyosarcomas and malignant peripheral nerve sheath tumors, tyrosine kinase inhibitors might be a drug development target for this sarcoma. In this study, we used a tyrosine kinase screening system that could detect an imbalance in mRNA between 5'- and 3'-sides in tyrosine kinase genes to identify potential novel therapeutic tyrosine kinase targets for soft tissue sarcomas. QUESTIONS/PURPOSES: (1) Are there novel therapeutic tyrosine kinase targets in tumors from patients with soft tissue sarcomas that are detectable using mRNA screening focusing on imbalance expressions between the 5' and 3' end of the kinase domain? (2) Can potential targets be verified by RNA sequencing and reverse transcription PCR (RT-PCR)? (3) Will potential fusion gene(s) transform cells in in vitro assays? (4) Will tumors in mice that have an identified fusion gene respond to treatment with a therapeutic drug directed at that target? METHODS: We used mRNA screening to look for novel tyrosine kinase targets that might be of therapeutic potential. Using functional assays, we verified whether the identified fusion genes would be good therapeutic candidates for soft tissue sarcomas. Additionally, using in vivo assays, we assessed whether suppressing the fusion's kinase activity has therapeutic potential. Study eligibility was based on a patient having high-grade spindle cell and nontranslocation sarcomas, including leiomyosarcoma, malignant peripheral nerve sheath tumor, and high-grade myxofibrosarcoma. Between 2015 and 2019, of the 172 patients with soft tissue sarcomas treated with surgical resection at Juntendo University Hospital, 72 patients had high-grade nontranslocation sarcomas. The analysis was primarily for leiomyosarcoma and malignant peripheral nerve sheath tumors, and there was a limitation of analysis size (reagent limitations) totaling 24 samples at the start of the study. We collected additional samples from a sample bank at the Tokyo Medical and Dental University to increase the number of sarcomas to study. Therefore, in this study, a total of 15 leiomyosarcoma samples, five malignant peripheral nerve sheath tumors samples, and four high-grade myxofibrosarcoma samples were collected to achieve the sample size of 24 patients. To identify tyrosine kinase fusion genes, we designed a NanoString-based assay (NanoString Technologies Inc, Seattle, WA, USA) to query the expression balances regarding transcripts of 90 tyrosine kinases at two points: the 5' end of the kinase domain and within the kinase domain or 3' end of the kinase domain. The tumor's RNA was hybridized to the NanoString probes and analyzed for the expression ratios of outliers from the 3' to 5' end of the kinase domain. Presumed novel fusion events in these positive tumors that were defined by NanoString-based assays were confirmed tyrosine kinase fusion genes by RNA sequencing and confirmatory RT-PCR. Functional analyses consisting of in vitro and in vivo assays were also performed to elucidate whether the identified tyrosine kinase gene fusions were associated with oncogenic abilities and drug responses. RESULTS: We identified aberrant expression ratios regarding the 3' to 5' end of the kinase domain ratios in ROS1 transcripts in a leiomyosarcoma in a 90-year-old woman. A novel MAN1A1-ROS1 fusion gene was identified from her thigh tumor through RNA sequencing, which was confirmed with real-time PCR. In functional assays, MAN1A1-ROS1 rearrangement revealed strong transforming potential in 3T3 cells. Moreover, in an in vivo assay, crizotinib, a ROS1 inhibitor, markedly inhibited the growth of MAN1A1-ROS1 rearrangement-induced transformed cells in a dose-dependent manner. CONCLUSION: We conducted tyrosine kinase screening to identify new therapeutic targets in soft tissue sarcomas. We found a novel MAN1A1-ROS1 fusion gene that may be a therapeutic target in patients with leiomyosarcoma. This study demonstrates that the mRNA screening system may aid in the development of useful therapeutic options for soft tissue sarcomas. CLINICAL RELEVANCE: If novel tyrosine fusions such as MAN1A1-ROS1 fusion can be found in sarcomas from other patients, they could offer avenues for new molecular target therapies for sarcomas that currently do not have effective chemotherapeutic options. Therefore, the establishment of a screening system that includes both genomic and transcript analyses in the clinical setting is needed to verify our discoveries and take the developmental process of treatment to the next step.

Individual and organizational factors influencing workplace cyberbullying of nurses: A cross-sectional study.

Workplace cyberbullying has emerged as a new issue. This study aimed to explore individual and organizational factors that affect nurses' workplace cyberbullying in hospital settings. A multicenter, cross-sectional study was conducted using a self-report questionnaire. Three tertiary and 18 general hospitals were selected from one city in Korea. A total of 270 nurses with 6 months to 10 years of experience in the current department were enrolled. Multiple regression analysis was conducted to identify the factors associated with cyberbullying. Workplace cyberbullying was affected by self-labeled victimization due to face-to-face bullying, subjective health level, years of experience as a nurse (ß = 0.148, p = 0.009), and relation-oriented nursing organizational culture. Face-to-face bullying must be addressed to prevent workplace cyberbullying. It is important to assist nurses to maintain good health-considering that, new nurses with less than 1 year of experience are vulnerable to being victimized. Effective prevention strategies should be prepared to control workplace cyberbullying in clinical practice.

Assessment of Predictive Biomarkers of the Response to Pazopanib Based on an Integrative Analysis of High-grade Soft-tissue Sarcomas: Analysis of a Tumor Sample from a Responder and Patients with Other Soft-tissue Sarcomas.

BACKGROUND: Soft-tissue sarcomas are a rare group of malignant tumors that usually are treated with surgical excision and radiation therapy, but recently, pazopanib, an oral tyrosine kinase inhibitor, has been used in patients with metastases who do not respond to standard chemotherapy regimens. Based on patients with advanced soft-tissue sarcomas who had received prior chemotherapy, several clinical studies have reported the survival and sensitivity (approximately 5% to 10% sensitive) of patients with soft-tissue sarcomas treated with pazopanib. Recently, next-generation sequencing (NGS) technologies have been used to provide a wide genetic information and to develop personalized medicine in cancer treatment. However, there are few reports and no genetic analyses of patients with soft-tissue sarcomas who had a complete response (CR) to pazopanib. QUESTIONS/PURPOSES: We described the clinicopathologic features of a patient with a rare, advanced soft-tissue sarcoma who achieved a CR to pazopanib treatment. Furthermore, integrative analyses using NGS and arrays were performed to elucidate characteristic alterations, including gene mutations, copy number changes, and protein expression that were associated with response to pazopanib. Additionally, functional analyses consisting of in vitro and in vivo assays were also performed to elucidate whether the identified alterations were associated with oncogenic abilities and drug responses. METHODS: In a sample from a 70-year-old woman with an advanced soft-tissue sarcoma treated for 1 month with 800 mg of oral pazopanib daily, CT scans demonstrated a CR to treatment. To our knowledge, there have been no patients with soft-tissue sarcomas among several clinical trials of pazopanib that have achieved a CR and therefore, our patient is considered to be extremely rare. We performed an integrative analysis including whole-exome sequencing, transcriptome sequencing, and phosphorylation profiling of receptor tyrosine kinases (RTK) using tumor samples from a patient with a CR matched to normal samples. From here on we will refer to this patient as having a CR, although a short term high-grade partial response may be more accurate. These analyses were performed using NGS and the phosphoreceptor tyrosine kinase (phospho-RTK) array. As a validation study, we also performed target sequencing using three samples from patients with long-term stable disease and two samples from patients with progressive disease who responded to pazopanib treatment. In addition, characteristic gene alterations that were identified according to the response to pazopanib in one patient with a CR, in three patients with long-term stable disease, and in 27 patients with high-grade soft-tissue sarcomas with different histologic subtypes and different responses to pazopanib were verified by quantitative real-time polymerase chain reaction. We conducted a focus formation assay to evaluate the transforming activities of these genomic alterations. RESULTS: In the patient with a CR to pazopanib, we identified several somatic mutations including Fms related receptor tyrosine kinase 1 (FLT1) p.G38S, platelet-derived growth factor receptor alpha (PDGFRA) p.T83S, and platelet-derived growth factor receptor beta (PDGFRB) exon 13 skipping. Amplification at chromosome 12q13-14 encompassing GLI family zinc finger 1 (GLI1) and cyclin-dependent kinase-4 (CDK4) was also detected. Furthermore, an elevated PDGFRB phosphorylation level was observed in the tumor. In target sequencing analyses in five patients, one of three patients with long-term stable disease had 12q13-14 amplification. The mRNA expression of GLI1, CDK4, and pazopanib targets including PDGFRA, PDGFRB, vascular endothelial growth factor receptor (VEGFR)1-3, and stem cell factor receptor (KIT) in samples from the patient with a CR, and 27 patients with high-grade soft-tissue sarcomas was verified. The expression of GLI1 was characteristically increased in the patient with a CR and in those with long-term stable disease relative to other patients with soft-tissue sarcomas. Overexpression of GLI1 showed strong transforming potential in 3T3 cells. Moreover, the overexpression of GLI1 upregulated the expression of the PDGFRB protein and promoted phosphorylation, which was dose-dependently inhibited by pazopanib. However, inhibition of GLI1-induced transformation by pazopanib was limited in the focus formation assay; therefore, mechanisms other than PDGFRB activation may contribute to transformation. CONCLUSIONS: We identified several gene alterations that might be associated with a CR and long-term stable disease in patients who received pazopanib for advanced soft-tissue sarcomas. We therefore believe that this distinct molecular profile warrants further investigation to identify predictive biomarkers of the response to pazopanib. CLINICAL RELEVANCE: Our findings identify molecular mechanisms that possibly explain the high sensitivity of soft-tissue sarcomas to pazopanib and may lead to the development of predictive biomarkers and novel therapies in patients with this and other types of soft-tissue sarcomas.

Influencing factors on preventive health behaviours for Zika virus in pregnant women and their partners.

AIMS AND OBJECTIVES: To identify Zika virus-related knowledge, attitudes to Zika virus and health motivations of pregnant women, women preparing for pregnancy and their partners, and to identify factors that influence preventive health behaviours for Zika virus infection. BACKGROUND: Prevention of Zika virus infection is becoming a major worldwide public health effort. The high-risk group for Zika virus infection comprises women who are pregnant or preparing for pregnancy. Few studies have addressed preventive health behaviours for Zika virus infection by gender. DESIGN: This study was a descriptive cross-sectional survey. METHODS: Participants (112 males and 147 females) were selected by convenience sampling from three obstetric clinics located in South Korea. Women and their partners who visited obstetric clinics during pregnancy or preparing for pregnancy were included as subjects. RESULTS: Factors associated with preventive health behaviours for Zika virus were checking infection status of Zika virus on destinations when planning a trip and attitudes to Zika virus in males and age, educational level, intention to travel to Zika virus endemic countries, attitudes to Zika virus and health motivation in females. CONCLUSIONS: Factors that influence preventive health behaviours for Zika virus were different by gender. However, attitudes to Zika virus were influential to both genders. Gender differences should be considered in development of health policies to improve preventive health behaviours for Zika virus. Younger and less educated women are to be targeted, and health management programmes should be developed to promote health motivation. RELEVANCE TO CLINICAL PRACTICE: Pregnant women, women preparing for pregnancy and their partners need education and public health promotion to improve self-management during travel to places where Zika virus is endemic. Health policies and health management programmes considering age and educational background should be developed to promote health motivation in women of childbearing age.

Men's awareness of cervical cancer: a qualitative study.

BACKGROUNDS: As HPV is a sexually transmitted virus, men are crucial in the prevention of cervical cancer, but research about men's awareness on cervical cancer is limited. Therefore, in this study, we investigated men's awareness toward women's cervical cancer, to thoroughly understand the viewpoints of men, and to emphasize the centrality of the role of men in the prevention of cervical cancer. METHODS: A qualitative descriptive design was chosen to explore men's awareness of women's cervical cancer. Twelve men aged 20-58 were interviewed. Snowball sampling was conducted to recruit participants. RESULTS: Most participants stated that they were not interested in women's health, and that they did not have much knowledge about cause and prevention of cervical cancer. They acknowledged that cervical cancer was different from other cancers, based on cause and prognosis of disease. The recognition of cervical cancer in participants varied widely depending on their relationship with women. Respondents' recognition of cervical cancer was classified into four types based on a Situational Awareness (SA) model including individual factors (knowledge about cervical cancer, interest in women's health) and system/task factors (relationship with women, men's responsibility). CONCLUSION: This study is one of the few studies describing men's awareness on cervical cancer. Korean men's awareness level was low, and their concern and knowledge were not good. Some participants thought that cervical cancer can be treated, can be prevented, and is recognized as a disease of a female with men intervening. Our participants perceived that the role of men is necessary for the prevention of cervical cancer. Therefore, a strategy is needed to develop the awareness and knowledge of men on cervical cancer prevention. When planning cervical cancer education for men, phase and type-specific approaches are required, depending on perception level.

Spread of multidrug-resistant Escherichia coli harboring integron via swine farm waste water treatment plant.

Wastewater treatment plants (WWTPs) that release treated wastewater into the environment have emerged as a major threat to public health. In this study, we investigated Escherichia coli load and antibiotic-resistance profiles across different treatment processes at a swine farm WWTP. The frequency of the detection of class 1 and 2 integrons, and their association with antibiotic resistance, were also analyzed. Samples were obtained at each of five sampling sites that represented each processing step within the WWTP. The largest decrease in E. coli load was observed during the anaerobic digestion step (from 4.86 to 2.89log CFU/mL). Isolates resistant to ß-lactam antibiotics were efficiently removed after a series of treatment steps, whereas the proportions of isolates resistant to non-ß-lactam antibiotics and multidrug-resistant strains were maintained across treatments. The occurrence of integron-positive strains was not significantly different at the various sampling sites (43.4-70%; p>0.05). Of the class 1 integron-positive isolates, 17.9% harbored the integron-associated gene cassettes aadA2, aadA12, aadA22, and dfrA15. To the best of our knowledge, this is the first description of a class 1 integron containing the aadA12 gene cassette from a swine farm and the presence of a class 1 integron containing dfrA15 in E. coli. This suggests that novel antibiotic-resistance gene cassette arrays could be generated in swine farm WWTPs. Moreover, 75% of integron-positive strains were categorized as multidrug resistant, whereas only 15.4% of integron-negative strains were multidrug resistant (p<0.05), indicating that integrons may be responsible for mediating resistance in WWTPs. With regard to the occurrence of multidrug-resistant, integron-positive E. coli recovered from the final effluent, our results highlighted the potential risks associated with wastewater discharge from swine farm WWTPs in terms of the spread of antibiotic-resistant bacteria to the aquatic environment.

Knowledge and health beliefs about gestational diabetes and healthy pregnancy's breastfeeding intention.

AIMS AND OBJECTIVES: If the knowledge and health beliefs relating to gestational diabetes mellitus during pregnancy are associated with behaviours during pregnancy and lactation, this suggests potential educational interventions. BACKGROUNDS: Women with gestational diabetes mellitus are more likely to develop type 2 diabetes mellitus, and babies with gestational diabetes mellitus incur increased risk of neonatal hypoglycaemia and childhood obesity. Breastfeeding is an effective way to improve maternal and lipid metabolism of gestational diabetes mothers, and to lower the risk of type 2 diabetes mellitus after birth, to prevent conception. Nurses have an important role in encouraging mothers to breastfeed for health promotion. The importance of cognitive factors such as knowledge, beliefs and attitudes is emphasised to increase the breastfeeding rate and to improve the quality of breastfeeding for pregnant women. Little research has been undertaken exploring cognitive factors and breastfeeding intention. DESIGN: Cross-sectional descriptive survey in healthy pregnant women. METHODS: A questionnaire about gestational diabetes mellitus-related knowledge and health beliefs of gestational diabetes mellitus management composed of perceived susceptibility, severity, benefits, barriers and self-efficacy was developed by investigators. The association of two predictor variables of interest, gestational diabetes mellitus-related knowledge and health beliefs of gestational diabetes mellitus management, was tested with the outcome variable, breastfeeding intention, using chi-square test, t test, ANOVA and multiple logistic regression. RESULTS: Two hundred and thirty-seven of the 250 participants returned questionnaires for a final response rate of 94.8%. Breastfeeding intention after childbirth was associated with stronger perceived benefit, higher levels of self-efficacy and lower alcohol consumption. CONCLUSION: History of drinking and health beliefs such as perceived benefits and self-efficacy were highly associated with breastfeeding intention relating to gestational diabetes mellitus. Education for breastfeeding in gestational diabetes mellitus mothers should focus upon the benefit of breastfeeding and strengthening self-efficacy.

Prevention of Zika virus infection: Knowledge, attitudes, and practices of pregnant women in Korea.

This study was performed to investigate the association of knowledge, attitudes, and preventive practices for the prevention of Zika virus infection. The study sample consisted of 185 pregnant women in Korea. The Zika virus-related knowledge and attitude of pregnant women significantly affected preventive practices. The younger pregnant women and pregnant women who had not taken the influenza vaccine had lesser preventive practices of the Zika virus, thereby necessitating educating them and emphasizing good preventive practices. Our results suggest that systematic education and effective prevention programs for Zika virus will contribute to the prevention of infection.

A Single-Step Enrichment Medium for Nonchromogenic Isolation of Healthy and Cold-Injured Salmonella spp. from Fresh Vegetables.

Culture-based detection of nontyphoidal Salmonella spp. in foods requires at least four working days; therefore, new detection methods that shorten the test time are needed. In this study, we developed a novel single-step Salmonella enrichment broth, SSE-1, and compared its detection capability with that of commercial single-step ONE broth-Salmonella (OBS) medium and a conventional two-step enrichment method using buffered peptone water and Rappaport-Vassiliadis soy broth (BPW-RVS). Minimally processed lettuce samples were artificially inoculated with low levels of healthy and cold-injured Salmonella Enteritidis (100 or 101 colony-forming unit/25 g), incubated in OBS, BPW-RVS, and SSE-1 broths, and streaked on xylose lysine deoxycholate (XLD) agar. Salmonella recoverability was significantly higher in BPW-RVS (79.2%) and SSE-1 (83.3%) compared to OBS (39.3%) (p < 0.05). Our data suggest that the SSE-1 single-step enrichment broth could completely replace two-step enrichment with reduced enrichment time from 48 to 24 h, performing better than commercial single-step enrichment medium in the conventional nonchromogenic Salmonella detection, thus saving time, labor, and cost.

Evaluation of Tazobactam-Supplemented, Modified Charcoal-Cefoperazone-Deoxycholate Agar for Qualitative Detection of Campylobacter from Chicken Carcass Rinse.

Overgrowth of extended-spectrum ß-lactamase (ESBL)-producing Escherichia coli on modified charcoal-cefoperazone-deoxycholate agar (mCCDA) is the most common confounding factor for the isolation of Campylobacter from poultry samples. mCCDA modified by supplementation with tazobactam, an ESBL inhibitor, was evaluated for Campylobacter isolation from chicken carcass rinse with regard to isolation rate and selectivity. In total, 120 whole chicken carcasses purchased from retail stores were rinsed with buffered peptone water enriched with 2× blood-free Bolton broth at 42°C for 48 h and then inoculated onto mCCDA with and without tazobactam supplementation (mCCDA or T-mCCDA) at 42°C for 48 h under microaerobic conditions. Suspect colonies were subcultured and confirmed by colony PCR. Plates with tazobactam exhibited a higher Campylobacter isolation rate (56.7% vs. 30.8%, p < 0.05) and selectivity (0.8 vs. 83.3% plates contaminated with non-Campylobacter, p < 0.05) than mCCDA. Thus, tazobactam-supplemented mCCDA would be a useful option for qualitative detection of Campylobacter in chicken carcass rinse.

High Occurrence Rate and Contamination Level of Bacillus cereus in Organic Vegetables on Sale in Retail Markets.

Organic foods have risen in popularity recently. However, the increased risk of bacterial contamination of organic foods has not been fully evaluated. In this study, 100 samples each of organic and conventional fresh vegetables (55 lettuce samples and 45 sprout samples) sold in South Korea were analyzed for aerobic bacteria, coliforms, Escherichia coli, and Bacillus cereus. Although the aerobic bacteria and coliform counts were not significantly different between the two farming types (p > 0.05), the occurrence rate of B. cereus was higher in organically cultivated vegetables compared with those grown conventionally (70% vs. 30%, respectively). The mean contamination level of B. cereus-positive organic samples was also significantly higher (1.86 log colony-forming unit [CFU]/g vs. 0.69 log CFU/g, respectively) (p < 0.05). In addition, six samples of organic vegetables were found to be contaminated with B. cereus at over 4 log CFU/g categorized as unsatisfactory according to Health Protection Agency guideline. The relatively higher occurrence rate of B. cereus in organic vegetables emphasizes the importance of implementing control measures in organic vegetable production and postharvest processing to reduce the risk of food poisoning.

High occurrence of extended-spectrum ß-lactamase-producing Salmonella in broiler carcasses from poultry slaughterhouses in South Korea.

The emergence of antibiotic-resistant foodborne Salmonella has become a major public health problem. Consumption of undercooked poultry contaminated with Salmonella can induce food poisoning in humans. In this study, we investigated the occurrence and antibiotic resistance patterns of Salmonella spp. isolated from 120 chicken carcasses produced in 6 poultry slaughterhouses in South Korea. A total of 11 samples (9.2%) were found contaminated with Salmonella: 5 isolates were serotyped as Salmonella Bellevue strain (slaughterhouse C) and 6 isolates were serotyped as Salmonella Enteritidis strain (slaughterhouse E). Salmonella Bellevue isolates were resistant to five antibiotics (ampicillin, chloramphenicol, nalidixic acid, tetracycline, and trimethoprim/sulfamethoxazole), while Salmonella Enteritidis isolates were resistant to nine antibiotics (ampicillin, cefotaxime, ceftazidime, cefazolin, cephalothin, amikacin, nalidixic acid, streptomycin, and tetracycline). All cephalosporin-resistant Salmonella Enteritidis isolates exhibited the extended-spectrum ß-lactamase (ESBL) phenotype and carried the gene encoding CTX-M-15, the most prevalent ESBL enzyme worldwide. Based on molecular subtyping performed using the automated rep-polymerase chain reaction (PCR) system (DiversiLab), the isolates showing ≥ 95 similarity in their rep-PCR banding patterns were classified into 5 pulsotypes. Given that cephalosporins are the drugs of choice for invasive Salmonella infections, the high incidence of ESBL-producing strains in chicken should emphasize the necessity of regular monitoring of the occurrence of antibiotic-resistant ESBL-positive Salmonella strains in poultry meat.

Evaluation of Mobile Applications for Patients with Diabetes Mellitus: A Scoping Review.

There has been increasing interest in mobile healthcare for diabetes management. However, there remains limited evidence regarding the effectiveness of these mobile applications (apps). This scoping review aimed to evaluate the clinical effectiveness of mobile diabetes management apps. We used the following search terms: "mobile app", "mobile application", and "diabetes". We included only articles written in English and published between January 2016 and August 2021. We identified two, six, and four articles focused on type 1 diabetes, type 2 diabetes, and both diabetes types, respectively. Five, four, and three of these studies reported on the apps' functionality, usability, and both, respectively. Our findings indicated that diabetes mobile apps allowed for convenient user experience and improved blood sugar levels in patients with diabetes. Considering these findings, usability must be comprehensively evaluated by using definitions such as the ISO9241-11 usability definition or the mobile application rating scale (MARS) when developing diabetes-related apps. For the feasibility of diabetes mobile apps, we recommend that HbA1C and self-management be included as evaluation variables. Given the increasing importance of continuous management for patients with diabetes, interventions using mobile apps are bound to become effective tools for patient-led self-management.

Potassium fluoride-induced FeOOH formation in NiFe oxalate for improved oxygen evolution performance.

Our study introduces a facile synthetic route for the in situ formation of nickel (Ni)-iron (Fe) oxyhydroxide from NiFe oxalate. By adding potassium fluoride (KF) to the synthetic solution, we achieved a predominant surface distribution of Fe (>80 at%) while limiting its bulk incorporation compared to solutions without KF. Operando Raman spectroscopy analysis confirms that the enriched Fe predominantly exists as FeOOH. Our optimized catalyst demonstrates significant efficiency, achieving a current density of 10 mA cm-2 at a notably low overpotential of 226 mV.

Osterix is required for cranial neural crest-derived craniofacial bone formation.

Osx plays essential roles in regulating osteoblast and chondrocyte differentiation, and bone formation during mouse skeletal development. However, many questions remain regarding the requirement for Osx in different cell lineages. In this study, we asked whether Osx is required for craniofacial bone formation derived from cranial neural crest (CNC) cells. The Osx gene was conditionally inactivated in CNC-derived cells using a Wnt1-Cre recombination system. Neural crest-specific inactivation of Osx resulted in the complete absence of intramembranous skeletal elements derived from the CNC, and CNC-derived endochondral skeletal elements were also affected by Osx inactivation. Interestingly, Osx inactivated CNC-derived cells, which were recapitulated by lacZ expression, occupied the same regions of craniofacial skeletal elements as observed for controls. However, cells lost their osteogenic ability to differentiate into functional osteoblasts by Osx inactivation. These results suggest that Osx is important for craniofacial bone formation by CNC-derived cells. This finding provides novel insights of the regulation of craniofacial development by the gene network and transcription factors, and the understanding of human diseases caused by neural crest developmental abnormalities.

Research Topic Trends on Turnover Intention among Korean Registered Nurses: An Analysis Using Topic Modeling.

This study aimed to explore research topic trends on turnover intention among Korean hospital nurses by analyzing the keywords and topics of related articles. Methods: This text-mining study collected, processed, and analyzed text data from 390 nursing articles published between 1 January 2010 and 30 June 2021 that were collected via search engines. The collected unstructured text data were preprocessed, and the NetMiner program was used to perform keyword analysis and topic modeling. Results: The word with the highest degree centrality was "job satisfaction", the word with the highest betweenness centrality was "job satisfaction", and the word with the highest closeness centrality and frequency was "job stress". The top 10 keywords in both the frequency analysis and the 3 centrality analyses included "job stress", "burnout", "organizational commitment", "emotional labor", "job", and "job embeddedness". The 676 preprocessed key words were categorized into five topics: "job", "burnout", "workplace bullying", "job stress", and "emotional labor". Since many individual-level factors have already been thoroughly investigated, future research should concentrate on enabling successful organizational interventions that extend beyond the microsystem.

Hip abduction angle after open-wedge high tibial osteotomy is associated with the timed up & go test and recurrence of varus alignment.

The aim of this study is to investigate the association between the hip abduction angle (HAA) and lower limb alignment as well as the clinical assessments in open-wedge high tibial osteotomy (OWHTO) patients. A total of 90 patients who underwent OWHTO were included. The demographic characteristics and clinical assessments (the Visual Analogue Scale for activities of daily living, the Japanese knee osteoarthritis measure, the Knee injury and Osteoarthritis Outcome Score, the Knee Society score, the Timed Up & Go (TUG) test, the single standing (SLS) test and muscle strength) were recorded. The patients were divided into two groups according to the HAA at 1 month after operation: the HAA (-) group (HAA < 0°) and the HAA (+) group (HAA ≥ 0°). Clinical scores except for the SLS test and radiographic parameters except for the posterior tibia slope (PTS), lateral distal femoral angle (LDFA) and lateral distal tibial angle (LDTA) were significantly improved at 2 years postoperatively. Regarding the two groups, scores on the TUG test in the HAA (-) group were significantly lower than those in the HAA (+) group (p = 0.011). The hip-knee-ankle angle (HKA), weight bearing line (WBLR) and knee joint line obliquity (KJLO) in the HAA (-) group were significantly higher than those in the HAA (+) group (p < 0.001, 0.001 and p = 0.025). In contrast, the LDFA in the HAA (-) group were significantly lower than those in the HAA (+) group (p < 0.001). The TUG test and the LDFA were weakly positively correlated with the HAA (r = 0.34, 0.42, p < 0.001 and 0.001). In contrast, the HKA, WBLR and KJLO had a weak negative correlation with the HAA (r = - 0.43, - 0.38 and - 0.37, p < 0.001, 0.001 and 0.001). This study showed the postoperative HAA was significantly associated with the TUG test and the HKA, WBLR, LDFA, and KJLO. A higher postoperative HAA might induce varus recurrence and poor outcomes of the gait parameter.