Alleviation of neurotoxicity induced by polystyrene nanoplastics by increased exocytosis from neurons.

Nanoplastics (NPs) are potentially toxic and pose a health risk as they can induce an inflammatory response and oxidative stress at cellular and organismal levels. Humans can be exposed to NPs through various routes, including ingestion, inhalation, and skin contact. Notably, uptake into the body via inhalation could result in brain accumulation, which may occur directly across the blood-brain barrier or via other routes. NPs that accumulate in the brain may be endocytosed into neurons, inducing neurotoxicity. Recently, we demonstrated that exposure to polystyrene (PS)-NPs reduces the viability of neurons. We have also reported that inhibiting the retrograde transport of PS-NPs by histone deacetylase 6 (HDAC6) prevents their intracellular accumulation and promotes their export in mouse embryonic fibroblasts. However, whether HDAC6 inhibition can improve neuronal viability by increasing exocytosis of PS-NPs from neurons remains unknown. In this study, mice were intranasally administered fluorescent PS-NPs (PS-YG), which accumulated in the brain and showed potential neurotoxic effects. In cultured neurons, the HDAC6 inhibitor ACY-1215 reduced the fluorescence signal detected from PS-YG, suggesting that the removal of PS-YG from neurons was promoted. Therefore, these results suggest that blocking the retrograde transport of PS-NPs using an HDAC6 inhibitor can alleviate the neurotoxic effects of PS-NPs that enter the brain.

A novel apoptosis probe, cyclic ApoPep-1, for in vivo imaging with multimodal applications in chronic inflammatory arthritis.

Apoptosis plays an essential role in the pathophysiologic processes of rheumatoid arthritis. A molecular probe that allows spatiotemporal observation of apoptosis in vitro, in vivo, and ex vivo concomitantly would be useful to monitoring or predicting pathophysiologic stages. In this study we investigated whether cyclic apoptosis-targeting peptide-1 (CApoPep-1) can be used as an apoptosis imaging probe in inflammatory arthritis. We tested the utility of CApoPep-1 for detecting apoptotic immune cells in vitro and ex vivo using flow cytometry and immunofluorescence. The feasibility of visualizing and quantifying apoptosis using this probe was evaluated in a murine collagen-induced arthritis (CIA) model, especially after treatment. CApoPep-1 peptide may successfully replace Annexin V for in vitro and terminal deoxynucleotidyl transferase dUTP nick end labeling (TUNEL) assay for ex vivo in the measurement of apoptotic cells, thus function as a sensitive probe enough to be used clinically. In vivo imaging in CIA mice revealed that CApoPep-1 had 42.9 times higher fluorescence intensity than Annexin V for apoptosis quantification. Furthermore, it may be used as an imaging probe for early detection of apoptotic response in situ after treatment. The CApoPep-1 signal was mostly co-localized with the TUNEL signal (69.6% of TUNEL+ cells) in defined cell populations in joint tissues of CIA mice. These results demonstrate that CApoPep-1 is sufficiently sensitive to be used as an apoptosis imaging probe for multipurpose applications which could detect the same target across in vitro, in vivo, to ex vivo in inflammatory arthritis.

Stress Response of Mouse Embryonic Fibroblasts Exposed to Polystyrene Nanoplastics.

Polystyrene (PS) nanoplastic exposure has been shown to affect the viability of neuronal cells isolated from mouse embryonic brains. However, the viability of mouse embryonic fibroblasts (MEFs) was not affected although PS nanoplastics accumulated in the cytoplasm. It is currently unknown whether MEFs do not respond to PS nanoplastics or their cellular functions are altered without compromising viability. Here, we found that PS nanoplastics entered the cells via endocytosis and were then released into the cytoplasm, probably by endosomal escape, or otherwise remained in the endosome. Oxidative and inflammatory stress caused by intracellular PS nanoplastics induced the antioxidant response pathway and activated the autophagic pathway. However, colocalization of the autophagic marker LC3B and PS nanoplastics suggested that PS nanoplastics in the cytoplasm might interfere with normal autophagic function. Furthermore, autophagic flux could be impaired, probably due to accumulation of PS nanoplastic-containing lysosomes or autolysosomes. Intriguingly, the level of accumulated PS nanoplastics decreased during prolonged culture when MEFs were no longer exposed to PS nanoplastics. These results indicate that accumulated PS nanoplastics are removed or exported out of the cells. Therefore, PS nanoplastics in the cytoplasm affect cellular functions, but it is temporal and MEFs can overcome the stress caused by PS nanoplastic exposure.

Reversible Regulation of Polyubiquitin Gene UBC via Modified Inducible CRISPR/Cas9 System.

Ubiquitin is required under both normal and stress conditions. Under stress conditions, upregulation of the polyubiquitin gene UBC is essential to meet the requirement of increased ubiquitin levels to confer stress resistance. However, UBC upregulation is usually observed only under stress conditions and not under normal conditions. Therefore, it has not been possible to upregulate UBC under normal conditions to study the effect of excess ubiquitin on cellular machinery. Recently, the CRISPR/Cas9 system has been widely used in biological research as a useful tool to study gene disruption effects. In this study, using an inducible CRISPR/Cas9 variant, a dCas9-VP64 fusion protein, combined with a single guide RNA (sgRNA) containing MS2 aptamer loops and MS2-p65-HSF1, we developed a system to increase the ubiquitin pool via upregulation of UBC. Although it is challenging to upregulate the expression of a gene that is already expressed at high levels, the significance of our system is that UBC upregulation can be induced in an efficient, reversible manner that is compatible with cellular processes, even under normal conditions. This system can be used to study ubiquitin pool dynamics and it will be a useful tool in identifying the role of ubiquitin under normal and stress conditions.

Total ankle arthroplasty versus ankle arthrodesis for the treatment of end-stage ankle arthritis: a meta-analysis of comparative studies.

PURPOSE: Total ankle arthroplasty (TAA) and ankle arthrodesis (AA) are the main surgical treatment options for end-stage ankle arthritis. Although the superiority of each modality remains debated, there remains a lack of high-quality evidence-based studies, such as randomized controlled clinical trials, and meta-analyses of comparative studies. We performed a meta-analysis of comparative studies to determine whether there is a significant difference between these two procedures in terms of (i) clinical scores and patient satisfaction, (ii) re-operations, and (iii) complications. METHODS: We conducted a comprehensive search in the MEDLINE, EMBASE, and Cochrane library databases. Only retrospective or prospective comparative studies were included in this meta-analysis. The literature search, data extraction, and quality assessment were conducted by two independent reviewers. The primary outcomes were clinical scores and patient satisfaction. We also investigated the prevalence of complications and the re-operation rate. RESULTS: Ten comparative studies were included (four prospective and six retrospective studies). There were no significant differences between the two procedures in the American Orthopaedic Foot and Ankle Society ankle-hindfoot score, Short Form-36 physical component summary and mental component summary scores, visual analogue scale for pain, and patient satisfaction rate. The risk of re-operation and major surgical complications were significantly increased in the TAA group. CONCLUSIONS: The meta-analysis revealed that TAA and AA could achieve similar clinical outcomes, whereas the incidence of re-operation and major surgical complication was significantly increased in TAA. Further studies of high methodological quality with long-term follow-up are required to confirm our conclusions.

Role of interleukin-10 in endochondral bone formation in mice: anabolic effect via the bone morphogenetic protein/Smad pathway.

OBJECTIVE: Interleukin-10 (IL-10) is a pleiotropic immunoregulatory cytokine with a chondroprotective effect that is elevated in cartilage and synovium in patients with osteoarthritis. However, the role of IL-10 during endochondral bone formation and its mechanism of action have not been elucidated. METHODS: IL-10(-/-) mice and IL-10-treated tibial organ cultures were used to study loss and gain of IL-10 functions, respectively, during endochondral bone formation. Primary chondrocytes from the long bones of mouse embryos were cultured with and without IL-10. To assess the role of IL-10 in chondrogenic differentiation, we conducted mesenchymal cell micromass cultures. RESULTS: The lengths of whole skeletons from IL-10(-/-) mice were similar to those of their wild-type littermates, although their skull diameters were smaller. The tibial growth plates of IL-10(-/-) mice showed shortening of the proliferating zone. Treatment with IL-10 significantly increased tibial lengths in organ culture. IL-10 also induced chondrocyte proliferation and hypertrophic differentiation in primary chondrocytes in vitro. Mechanistically, IL-10 activated STAT-3 and the Smad1/5/8 and ERK-1/2 MAP kinase pathways and induced the expression of bone morphogenetic protein 2 (BMP-2) and BMP-6 in primary chondrocytes. Furthermore, the blocking of BMP signaling attenuated the IL-10-mediated induction of cyclin D1 and RUNX-2 in primary chondrocytes and suppressed Alcian blue and alkaline phosphatase staining in mesenchymal cell micromass cultures. CONCLUSION: These results indicate that IL-10 acts as a stimulator of chondrocyte proliferation and chondrogenic or hypertrophic differentiation via activation of the BMP signaling pathway.

A matrix metalloproteinase 1-cleavable composite peptide derived from transforming growth factor ß-inducible gene h3 potently inhibits collagen-induced arthritis.

OBJECTIVE: Transforming growth factor ß-inducible gene h3 (ßIG-H3), which is abundantly expressed in rheumatoid synovium, and matrix metalloproteinases (MMP) play important roles in the pathogenesis of rheumatoid arthritis (RA). The aim of this study was to determine the therapeutic efficacy of ßIG-H3-derived peptides using MMP-1-dependent target tissue delivery in chronic inflammatory arthritis. METHODS: Peptides developed from ßIG-H3 derivatives, including the second and fourth YH peptides, the fourth fas-1 domain, the fourth fas-1 domain truncated for H1 and H2 sequences (dhfas-1), and an MMP-1- cleavable composite peptide (MFK24), were cloned. We confirmed the specificity of MFK24 cleavage by immunoblot analysis after treatment with different proteases. RESULTS: The YH18 peptide in the fourth fas-1 domain of ßIG-H3 was weakly effective in suppressing arthritis severity in mice with collagen-induced arthritis (CIA). Treatment with higher-dose dhfas-1 (30 mg/kg) showed remarkable efficacy, whereas treatment with a lower dose (10 mg/kg) resulted in only partial improvement. MFK24, a composite peptide consisting of dhfas-1 and RGD peptide linked by MMP-1 substrate, was cleaved specifically by MMP-1. The adhesion and migration of NIH3T3 cells mediated by ßIG-H3 were inhibited by MFK24 at a low concentration. MFK24 suppressed the adhesion of NIH3T3 cells more efficiently compared with murine dhfas-1 (MFK00) or RGD, either alone or in combination. The therapeutic efficacy of MFK24 in mice with CIA was remarkably enhanced, with consistently reduced expression of inflammatory mediators within joint tissue. CONCLUSION: This proof-of-concept study showed that an MMP-cleavable composite peptide, based on ßIG-H3 derivatives, had markedly improved therapeutic efficacy in chronic inflammatory arthritis, implicating a new expandable strategy for enhancement of the efficacy of 2 different active molecules in RA.

Granulomatosis with polyangiitis (Wegener granulomatosis) as a differential diagnosis of sternal osteomyelitis: the challenges in diagnosis.

Although granulomatosis with polyangiitis (GPA) can affect a large number of organ systems and produce a broad spectrum of clinical symptoms, skeletal involvement is very rare, with the exception of facial bone involvement associated with destructive nasal and sinus inflammation. We describe here a 54-year-old man with sternal osteomyelitis and destructive arthritis around the sternoclavicular joint. Despite antibiotics and conventional immunosuppressive treatment, his symptoms deteriorated, and a new mass-like lung lesion was developed. A histopathologic analysis of the lung mass revealed chronic granulomatous inflammation with fibrinoid necrosis, and he was diagnosed with GPA. When a patient with a destructive inflammatory lesion has negative culture results and no response to conventional therapy, we propose that an aggressive approach is necessary for a pathologic diagnosis to exclude the possibility of GPA.

Effect of COVID-19 Risk Perception and COVID-19 Self-Care of Korean Correctional Nurses on Occupational Burnout: Mediating Effect of Stress and Anxiety About Viral Epidemics.

ABSTRACT: The purpose of this study was to investigate whether stress and anxiety about viral epidemics have effects as parameters in the relationship among COVID-19 risk perception, COVID-19 self-care, and occupational burnout for Korean correctional nurses. The subjects of this study were 107 correctional nurses working at 52 correctional facilities in Korea that are conducting COVID-19 management and prevention activities. Data were collected from March 12 to 30, 2022. Results suggest that correctional nurses during the COVID-19 pandemic may experience occupational burnout because of increased stress and anxiety about viral epidemics as their COVID-19 risk perception increased. In addition, stress and anxiety about being infected with the COVID-19 virus itself will cause burnout. This study contributes to promotion of the mental health of Korean correctional nurses and provides basic data for developing an intervention program to prevent occupational burnout.

Factors Influencing Infection Anxiety in Korean Male Firefighters Due to COVID-19 Infection Status.

This paper describes descriptive research to identify the effects of job stress, COVID-19 self-care behavior, and COVID-19 vaccination status according to the infection and non-infection of COVID-19 on anxiety about the COVID-19 infection among firefighters in South Korea. Data from 205 firefighters working at 10 fire stations were collected from 26 January to 16 February 2023. The variables used were job stress, COVID-19 self-care behavior, COVID-19 vaccination status, and COVID-19 infection anxiety. The collected data were analyzed using descriptive statistics, t-test, one-way ANOVA, Pearson's correlation coefficient, and multiple linear regression. In subjects who were infected with COVID-19, the factors that significantly affected infection anxiety were job stress (ß = 0.247, p = 0.011) and self-care behavior (ß = 0.343, p = 0.011). In subjects who were not infected with COVID-19, the factors that significantly affected infection anxiety were marriage status (unmarried) (ß = -0.260, p = 0.005) and self-care behavior (ß = 0.374, p = 0.001). These results demonstrate that the infection anxiety of firefighters should be prevented, and their physical and mental health should be promoted by considering job stress, self-care behavior, and personal environment.

Reduced secretion of LCN2 (lipocalin 2) from reactive astrocytes through autophagic and proteasomal regulation alleviates inflammatory stress and neuronal damage.

LCN2/neutrophil gelatinase-associated lipocalin/24p3 (lipocalin 2) is a secretory protein that acts as a mammalian bacteriostatic molecule. Under neuroinflammatory stress conditions, LCN2 is produced and secreted by activated microglia and reactive astrocytes, resulting in neuronal apoptosis. However, it remains largely unknown whether inflammatory stress and neuronal loss can be minimized by modulating LCN2 production and secretion. Here, we first demonstrated that LCN2 was secreted from reactive astrocytes, which were stimulated by treatment with lipopolysaccharide (LPS) as an inflammatory stressor. Notably, we found two effective conditions that led to the reduction of induced LCN2 levels in reactive astrocytes: proteasome inhibition and macroautophagic/autophagic flux activation. Mechanistically, proteasome inhibition suppresses NFKB/NF-κB activation through NFKBIA/IκBα stabilization in primary astrocytes, even under inflammatory stress conditions, resulting in the downregulation of Lcn2 expression. In contrast, autophagic flux activation via MTOR inhibition reduced the intracellular levels of LCN2 through its pre-secretory degradation. In addition, we demonstrated that the N-terminal signal peptide of LCN2 is critical for its secretion and degradation, suggesting that these two pathways may be mechanistically coupled. Finally, we observed that LPS-induced and secreted LCN2 levels were reduced in the astrocyte-cultured medium under the above-mentioned conditions, resulting in increased neuronal viability, even under inflammatory stress.Abbreviations: ACM, astrocyte-conditioned medium; ALP, autophagy-lysosome pathway; BAF, bafilomycin A1; BTZ, bortezomib; CHX, cycloheximide; CNS, central nervous system; ER, endoplasmic reticulum; GFAP, glial fibrillary acidic protein; GFP, green fluorescent protein; JAK, Janus kinase; KD, knockdown; LCN2, lipocalin 2; LPS, lipopolysaccharide; MACS, magnetic-activated cell sorting; MAP1LC3/LC3, microtubule-associated protein 1 light chain 3; MTOR, mechanistic target of rapamycin kinase; NFKB/NF-κB, nuclear factor of kappa light polypeptide gene enhancer in B cells 1, p105; NFKBIA/IκBα, nuclear factor of kappa light polypeptide gene enhancer in B cells inhibitor, alpha; OVEX, overexpression; SLC22A17, solute carrier family 22 member 17; SP, signal peptide; SQSTM1, sequestosome 1; STAT3, signal transducer and activator of transcription 3; TNF/TNF-α, tumor necrosis factor; TUBA, tubulin, alpha; TUBB3/ß3-TUB, tubulin, beta 3 class III; UB, ubiquitin; UPS, ubiquitin-proteasome system.

Effects of tomato ketchup and tomato paste extract on hepatic lipid accumulation and adipogenesis.

Tomatoes include high levels of lycopene, which is a potent antioxidative, hypolipidemic, and antidiabetic phytochemical. The intake of lycopene is associated with a reduced risk of insulin resistance and metabolic syndrome. The aim of this study was to investigate whether tomato ketchup and tomato paste, major dietary sources for tomato and lycopene, could regulate hepatic lipid metabolism and adipogenesis. To investigate the regulatory effects of tomato ketchup and tomato paste, we prepared a tomato ketchup extract (TKE) and a tomato paste extract (TPE) in 80% (v/v) ethyl acetate for the experiment. TKE and TPE reduced lipid accumulation and key markers for gluconeogenesis and induced a higher rate of fatty acid oxidation in HepG2 hepatocytes. In 3T3-L1 adipocytes, TKE and TPE increased adipogenesis and intracellular triglyceride accumulation, and stimulated glucose uptake. Peroxisome proliferator-activated receptor alpha and gamma expression levels were increased by TKE and TPE treatment. A single oral dose of tomato ketchup and tomato paste (9.28 g/kg) significantly improved glucose and insulin tolerance in mice. These findings suggest that lycopene-containing tomato ketchup and tomato paste may have beneficial regulatory effects in terms of energy metabolism in hepatocytes and adipocytes, and thus may improve blood glucose metabolism.

Spatial versus verbal memory impairments in patients with fibromyalgia.

Mounting evidence suggests that individuals with fibromyalgia (FM) have impairments in general cognitive functions. However, few studies have explored the possibility of dissociation between verbal and visuospatial memory impairments in FM. Therefore, the purpose of this study was to investigate the asymmetrical impairment of cognitive functions between verbal and visuospatial memory and between short-term and long-term memory. Neuropsychological assessments were carried out on 23 female patients with FM and 24 healthy female controls. Verbal memory abilities were assessed using the Korean version of the Rey auditory verbal learning test (KAVLT) and digit span task, and visuospatial memory abilities were assessed using the Korean version of the Rey complex figure test (KCFT) and spatial span task. The analysis of covariance was used to assess group differences in performance on cognitive tests after controlling for depression. The two groups did not significantly differ in terms of age, years of education, or in their estimated verbal and performance IQ, but FM patients reported more severe depressive symptoms than did controls on the Beck depression inventory. Significant group differences were found in immediate and delayed recall on the KCFT (F (1,44) = 6.49, p = 0.014 and F (1,44) = 6.96, p = 0.011, respectively), whereas no difference was found in immediate and delayed recall on the KAVLT. In terms of short-term memory, neither the digit span task nor spatial span task showed any difference between groups, regardless of whether repetition was forward or backward. These findings suggest that spatial memory abilities may be more impaired than verbal memory abilities in patients with FM.

Post-traumatic growth of people who have experienced earthquakes: Qualitative research systematic literature review.

Introduction: Earthquakes can have a variety of physical, emotional, and social effects on the people who experience them. Post-traumatic Growth (PTG) results from people attempting to reconstruct their lives after experiencing a traumatic event. We intend to inform the local community of the importance of disaster psychology by identifying and analyzing the literature on post-traumatic growth experiences of subjects who experienced earthquakes. Methods: This study applied a systematic review of qualitative research published from January 1, 2012 to January 31, 2021 to understand PTG in people who have experienced earthquakes. The search expressions "Post-traumatic Growth", "Earthquake", "Qualitative" were applied to CINAHL, EMBASE, PubMed, PsycInfo, KISS, RISS, and NDSL databases. Initially, 720 papers were found; after removal of duplicates, 318 remained. After a review of titles and abstracts, 186 papers that did not meet the selection criteria of this study were removed. After a further examination of the remaining 132 papers, the researchers removed 65 papers that did not match the research topic. Lastly, of the remaining 67 papers, detailed review eliminated quantitative papers that did not match this study (25), articles that were not original (19), articles in which results were not PTG (8), articles that were not related to this study (3), articles that were not written in English (2), or articles that had mixed topics (2). Eight papers remained. Results: The results of this study show that the PTG in people who have experienced earthquakes can be classified into three categories: "Change in self-perception", "Change of interpersonal relationships", and "Spiritual change". They can be further classified into eight subcategories: "Reviewing one's existence", "Acceptance", "Discovering strengths by working through adversity", "Gratitude for life", "Changes in personal relations", "Changes in social relations", "Accepting the existence of God", and "A breakthrough to overcome difficulties". Discussion: These results can be used as basic data for a positive psychological understanding for those who have experienced earthquake trauma.

Increased clearance of non-biodegradable polystyrene nanoplastics by exocytosis through inhibition of retrograde intracellular transport.

Nanoplastics (NPs) are derived from microplastics and may cause health problems. We previously showed that 100 nm polystyrene (PS)-NPs enter cells, including mouse embryonic fibroblasts (MEFs), and their intracellular accumulation induces inflammatory and oxidative stress. Moreover, PS-NP uptake was found to occur via endocytosis, and they accumulated mostly at the juxtanuclear position, but never within the nucleus. We speculated that PS-NPs were cleared from cells when they were no longer exposed to PS-NPs. However, the effects of PS-NPs on the cellular machinery remain unknown. The accumulation of PS-NPs at the juxtanuclear position may be due to retrograde transport along microtubules. To confirm this, we treated PS-NP-exposed MEFs with inhibitors of histone deacetylase 6 (HDAC6), dynein, or microtubule polymerization and found greatly diminished intracellular and juxtanuclear accumulation. Moreover, rapid clearance of PS-NPs was observed when MEFs were treated with an HDAC6 inhibitor. PS-NPs were removed by exocytosis, as confirmed by treatment with an exocytosis inhibitor. Furthermore, inhibiting the retrograde transport of PS-NPs alleviated the activation of the antioxidant response pathway, inflammatory and oxidative stress, and reactive oxygen species generation. In summary, inhibition of the retrograde transport of non-biodegradable PS-NPs leads to their rapid export by exocytosis, which may reduce their cytotoxicity.

Factors Associated with Return of Spontaneous Circulation following Pre-Hospital Cardiac Arrest in Daegu Metropolitan City, South Korea; a Cross-Sectional Study.

Introduction: The probability of Return of Spontaneous Circulation (ROSC) in cardiac arrest cases in pre-hospital setting is still low. This study aimed to identify the factors that may improve the rate of ROSC in patients with pre-hospital cardiac arrest. Methods: This retrospective cross-sectional study is a secondary data analysis of cardiac arrest patients, who were managed by paramedics in the pre-hospital setting, from January 1, 2019, to December 31, 2019, in Daegu, South Korea. The association of ROSC with place of arrest occurrence, cardiac arrest being witnessed, performing cardiopulmonary resuscitation (CPR), using compression device and defibrillator, administration of epinephrine, and intubation was analyzed and independent predictive factors of ROSC were reported. Results: 2750 out-of-hospital cardiac arrest cases, which were managed by paramedics in the pre-hospital setting were studied. 2034 (86.9%) cases of arrest had occurred at home, 2028 (73.7%) were not witnessed, and CPR was not performed for 1721 (64.1%) cases. ROSC before arriving to emergency department (ED) was more probable if the cardiac arrest was witnessed (p < 0.001), if CPR was performed (p = 0.044), if a mechanical compression device was used (p < 0.001), if a first-aid defibrillator was used (p < 0.001), and if intravenous access was secured (p < 0.001). Multivariate regression analysis revealed that using mechanical compression device (OR: 0.18; 95% CI = 0.08 - 0.40; p = 0.001), using first-aid defibrillator (OR: 3.13; 95% CI = 1.40 - 6.99; p = 0.005), administration of epinephrine (OR: 6.57; 95% CI = 2.16 - 19.53; p = 0.001), and intubation (OR: 1.82; 95% CI = 1.04-3.19; p = 0.001) were independent predictive factors of ROSC before arrival to ED. Conclusion: It seems that chest compression by hand instead of using chest compression device, using defibrillator, epinephrine administration, and intubation my increase the probability of ROSC in pre-hospital arrest cases.

Development and Validation of Earthquake Fire Response Simulation Protocol for Korean College Students in Health Programs.

The purpose of this study is to evaluate the adequacy of the developed protocol by verifying the validity of the expert group for the earthquake and fire response simulation protocol. A protocol development team consisting of one emergency rescue professor, one counseling psychology professor, three paramedics, and one firefighter developed the study's protocols to promote the core response and capabilities required at an earthquake fire site. We checked the content validity for the appropriateness of the contextual connection for each stage for the protocol. We also created an evaluation checklist to measure the items for each stage. The protocol developed in this study consists of earthquake response, fire response, evacuation, and fire suppression. We set the situation for each stage and composed learner activities and learning performance goals. The earthquake response stage included (1) shout "it's an earthquake," (2) protect yourself, (3) turn off electricity and gas, and (4) evacuate to a safe place. In the fire response stage, (1) shout "fire," (2) press the emergency bell and call 119, (3) close the door of a dangerous place where fire can spread, and (4) evacuate to a safe place. In the evacuation stage, (1) open the emergency exit, (2) cover your nose and mouth, (3) lower your posture, and (4) evacuate quickly in one direction. Lastly, in the firefighting stage, (1) pull out the safety pin, (2) hold the nozzle and face the fire, (3) grab the handle, and (4) spray the powder evenly. The protocol contributes to the development of systematic and elaborate simulation education materials in the future. Furthermore, it provides basic data for future disaster simulation operation and protocol development through continuous training and practical exercises.

Development of Psychological First Aid Guidelines for People Who Have Experienced Disasters.

This study developed guidelines for psychological first aid. This guideline promotes core response and disaster capabilities for disaster mental-health professionals, such as mental-health nurses and counseling psychologists at disaster sites. A research team composed of a first-aid professor and counseling psychology professor developed this psychological first-aid guideline to promote the psychological response required at disaster sites. The team verified each question's content adequacy at each guideline-development stage to determine the appropriateness of response to a disaster. The PFA performance stage and achievement objectives were moved to the next stage only when the research team fully agreed upon them. This guideline revised and supplemented the six steps suggested in the handbook to five steps through expert meetings. The modified part was made into one step, without separating the first rapport formation and safety check. The checklist for evaluation was developed after verification by a total of four people, including one emergency-rescue-department professor, one counseling psychology professor, one paramedic, and one health educator. Based on previous studies, the cutting point is 24 points. The final completed psychological first aid consists of five stages: rapport formation and safety verification, psychological stabilization, information collection, problem resolution, and recovery, with details to be carried out at each step. These guidelines contribute to the promotion of disaster-response capabilities of disaster psychologists. Continuous training and practical exercises based on the five stages will provide fundamental data for a disaster-simulation psychological-first-aid educational development.

Implementing psychological first aid ontology.

BACKGROUND: This study develops an ontology of Psychological First Aid (PFA) by extracting relevant knowledge from a review of PFA literature. MATERIALS AND METHODS: This study was conducted using the PFA ontology development 101 method. This review processes previously-developed PFA studies by consulting Google Scholar, CINHL, PUBMED, and MEDLINE. Protege 5.0 program was used to integrate with ontology development. The developed PFA ontology consisted of eight super classes: Action agenda, Assessment, Concrete method, Disaster type, Disaster disposition, Purpose, Qualification and Skill, Reaction. In total, 166 terms were collected. RESULTS: The eight super classes were divided into 72 classes and 64 subclasses. The composition yielded in a total of 166 axioms (85 logical axioms; 81 declaration axioms). CONCLUSIONS: This study provides basic data to guide development and composition of PFA arbitration programs.

The Effect of Knowledge, Attitudes, and Practices of Korean Correctional Officers about COVID-19 on Job Stress.

The purpose of this study was conducted to investigate the effects of corrective officers' knowledge, attitudes, and practices on job stress. The subjects of this study were 375 randomly selected male correctional officials working at five South Korean correctional facilities that had been affected by COVID-19. This study considered data collected with approval from 17 May 2021 to 14 June 2021. Knowledge, attitudes, practices, and job stress in relation to COVID-19 were assessed using a personal questionnaire. The data were analyzed using mean, standard deviation, t-test, one-way ANOVA, and post-test using Pearson's correlation coefficient. The job stress of participants was negatively correlated with knowledge, attitudes, and practices. Significant factors influencing job stress included knowledge and practices. These factors explained 38% of the variance. In this study, knowledge and practices were identified as influencing the job stress of correctional officers. These results are intended to contribute to the development of programs that can enhance the COVID-19-related knowledge and practices of correctional officers and reduce job stress.