A Clinical Data Warehouse Analysis of Risk Factors for Inpatient Falls in a Tertiary Hospital: A Case-Control Study.

OBJECTIVES: The aims of the study are to identify fall risk factors and to establish automatic risk assessments based on clinical data from electronic medical records of hospitalized patients. METHODS: In this retrospective case-control study, we reviewed the electronic medical records of 1454 patients (292 and 1162 patients in the fall and nonfall groups, respectively) who were hospitalized at a 1800-bed tertiary hospital in South Korea between January 1, 2017, and December 31, 2017. Patients' age, sex, and clinical department were matched, and all laboratory reports, clinical flow sheets, and nursing initial assessment records of case from the Clinical Data Warehouse system were analyzed. The collated patient records data were analyzed using SAS (version 9.4) and logistic regression. RESULTS: Overall, 65 risk factors, including low body mass index, low blood pressure, low albumin levels, high fasting blood sugar level, low red blood cell counts, and high potassium levels, that significantly increased the incidence of falls were identified. Falls were also associated with 21 items from the clinical flow sheet and nursing initial assessment, including frequent bowel movements, 24-hour urine tests, imaging tests, biopsy, pain, intravenous tubes, unclear consciousness, and taking medication. CONCLUSIONS: Fall risk factors identified via the Clinical Data Warehouse can be used to build an automated detection system to detect fall risk in electronic medical records, enabling nurses to assess the fall risk in addition to using the fall scale.

Physiochemical properties and resorption progress of porcine skin-derived collagen membranes: In vitro and in vivo analysis.

The aim of the present study was to evaluate the physiochemical properties and resorption progress of two cross-linked, porcine skin-derived collagen membranes and compare their features with those of a membrane without cross-linking (Bio-Gide® [BG], Geistlich Biomaterials, Wolhusen, Switzerland). Three porcine skin-derived collagen membranes, dehydrothermally (DHT) cross-linked (experimental), DHT and 1-ethyl-3(3-dimethylaminopropyl)-carbodiimide (DHT/EDC) cross-linked (experimental) and BG were investigated for their morphology, enzyme resistance, and tensile strength in vitro and biodegradation in vivo. DHT and DHT/EDC membranes exhibited irregular, interconnected macro- and micropores that formed a 3D mesh, whereas BG exhibited individual collagen fibrils interlaced to form coarse collagen strands. In enzyme resistance and tensile strength tests, DHT and DHT/EDC membranes demonstrated good resistance and mechanical properties compared with BG. In vivo, all three membranes were well integrated into the surrounding connective tissue. Thus, the DHT membrane exhibited its potential as a barrier membrane for guided bone and tissue regeneration.

Effect of molecular weight of hyaluronic acid (HA) on viscoelasticity and particle texturing feel of HA dermal biphasic fillers.

BACKGROUND: Hyaluronic acid (HA) dermal biphasic fillers are synthesized for their efficacy in correcting aesthetic defects such as wrinkles, scars and facial contouring defects. The fillers consist of crosslinked HA microspheres suspended in a noncrosslinked HA. To extend the duration of HAs within the dermis and obtain the particle texturing feel, HAs are crosslinked to obtain the suitable mechanical properties. RESULTS: Hyaluronic acid (HA) dermal biphasic fillers are prepared by mixing the crosslinked HA microspheres and the noncrosslinked HAs. The elastic modulus of the fillers increased with raising the volume fraction of the microspheres. The mechanical properties and the particle texturing feel of the fillers made from crosslinked HA (1058 kDa) microspheres suspended in noncrosslinked HA (1368 kDa) are successfully achieved, which are adequate for the fillers. CONCLUSIONS: Dermal biphasic HA fillers made from 1058 kDa exhibit suitable elastic moduli (211 to 420 Pa) and particle texturing feel (scale 7 ~ 9).

Tool Development for Cancer Patients' Sexuality Information Needs.

PURPOSE: This study aimed to develop a scale measuring sexuality information needs of patients with cancer. METHODS: Nine items of sexuality information needs were based on the PLISSIT model and concepts of sexual rights. A factor analysis using principal axis factoring and Cronbach's alpha were performed to test validity and reliability. Data were collected from 211 patients with cancer visiting a cancer center in Seoul, Korea. RESULTS: Factor loadings of the 9 items of sub scales ranged from .43 to .96. Three factors in this study explained 74.4% of the total variance. Cronbach's alpha of the 9 items was .83. CONCLUSION: The scale of information needs about sexuality showed acceptable construct validity and reliability. This scale would be useful to assess the levels of information needs for sexuality for patients with cancer. The possibility of the scales' expansion to other group could be investigated in future studies.

Surface characteristics of a novel hydroxyapatite-coated dental implant.

PURPOSE: This study evaluated the surface characteristics and bond strength produced using a novel technique for coating hydroxyapatite (HA) onto titanium implants. METHODS: HA was coated on the titanium implant surface using a super-high-speed (SHS) blasting method with highly purified HA. The coating was performed at a low temperature, unlike conventional HA coating methods. Coating thickness was measured. The novel HA-coated disc was fabricated. X-ray diffraction analysis was performed directly on the disc to evaluate crystallinity. Four novel HA-coated discs and four resorbable blast medium (RBM) discs were prepared. Their surface roughnesses and areas were measured. Five puretitanium, RBM-treated, and novel HA-coated discs were prepared. Contact angle was measured. Two-way analysis of variance and the post-hoc Scheffe's test were used to analyze differences between the groups, with those with a probability of P<0.05 considered to be statistically significant. To evaluate exfoliation of the coating layer, 7 sites on the mandibles from 7 mongrel dogs were used. Other sites were used for another research project. In total, seven novel HA-coated implants were placed 2 months after extraction of premolars according to the manufacturer's instructions. The dogs were sacrificed 8 weeks after implant surgery. Implants were removed using a ratchet driver. The surface of the retrieved implants was evaluated microscopically. RESULTS: A uniform HA coating layer was formed on the titanium implants with no deformation of the RBM titanium surface microtexture when an SHS blasting method was used. CONCLUSIONS: These HA-coated implants exhibited increased roughness, crystallinity, and wettability when compared with RBM implants.

[Relationship of prenatal stress and depression to maternal-fetal attachment and fetal growth].

PURPOSE: Prenatal depression is associated with potential negative consequences for the mother and infant. The purpose of this study was to examine pregnant women's stress, and depression and their impact on maternal-fetal attachment and fetal growth. METHODS: Data were collected by means of a questionnaire and fetal sonogram from a convenience sample of 166 pregnant women. RESULTS: Women who have a low educational level, poor health and are dissatisfied with their marriage showed low maternal-fetal attachment. Prenatal depression had significant correlations with length of pregnancy and level of stress. Even though correlation between maternal stress and fetal weight (r=-.15, p=.099) and correlation between maternal depression and maternal-fetal attachment (r=-.13, p=.095) were not statistically significant, the impact of the prenatal psychological state of mothers can not be ignored as it relates to fetal health. CONCLUSION: Maternal-fetal attachment and fetal growth can be affected by maternal emotional state, including stress or depression. These findings suggest that primary care nurses in hospitals and public health centers should provide prenatal depression screening and nursing intervention programs for management and prevention of prenatal stress and depression.

Antitumor effect of a transducible fusogenic peptide releasing multiple proapoptotic peptides by caspase-3.

We have designed a novel peptide, TK3, composed of three functional domains, a protein transduction domain, a TAT followed by three tandem repeats of a proapoptotic peptide, and a caspase-3 cleavage site, (KLAKLAK)(2)-DEVD. TK3 was able to transduce into cells and then activate caspase-3, which in turn cleaved TK3 to release additional (KLAKLAK)(2) peptides. (KLAKLAK)(2) was well transduced by TAT into tumor cells and was able to induce apoptosis in vitro and in vivo. TK3 also induced apoptosis and inhibited angiogenesis in endothelial cells. Further, direct injection of TK3 into established B16F10 melanoma tumors in C57BL/6 mice resulted in almost complete inhibition of the tumor growth. These results suggest that TK3 could be beneficial for the treatment of accessible tumors and used as an adjuvant for cancer therapy.

Targeting bladder tumor cells in vivo and in the urine with a peptide identified by phage display.

Bladder cancer is one of the most common tumors of the genitourinary tract. Here, we use phage display to identify a peptide that targets bladder tumor cells. A phage library containing random peptides was screened for binding to cells from human bladder tumor xenografts. Phage clones were further selected for binding to a bladder tumor cell line in culture. Six clones displaying the consensus sequence CXNXDXR(X)/(R)C showed selective binding to cells from primary human bladder cancer tissue. Of these, the CSNRDARRC sequence was selected for further study as a synthetic peptide. Fluorescein-conjugated CSNRDARRC peptide selectively bound to frozen sections of human bladder tumor tissue, whereas only negligible binding to normal bladder tissue was observed. When the fluorescent peptide was introduced into the bladder lumen, in a carcinogen-induced rat tumor model, it selectively bound to tumor epithelium. Moreover, when the peptide was intravenously injected into the tail vein, it homed to the bladder tumor but was not detectable in normal bladder and control organs. Next, we examined whether the peptide can detect tumor cells in urine. The fluorescent peptide bound to cultured bladder tumor cells but not to other types of tumor cell lines. Moreover, it bound to urinary cells of patients with bladder cancer, while showing little binding to urinary cells of patients with inflammation or healthy individuals. The CSNRDARRC peptide may be useful as a targeting moiety for selective delivery of therapeutics and as a diagnostic probe for the detection of bladder cancer.

Development of child and adolescent psychiatric nursing practice in Korea, 1980-2000.

PROBLEM: Although the need for mental health services for children and youth is on the rise in Korea, there are no data available regarding the current status of psychiatric nurses working with children and adolescents. METHODS: Descriptive statistics were used to analyze questionnaires from 324 respondents. FINDINGS: Only 5% of psychiatric nurses in Korea are working at child and adolescent-specific programs. The level of nurses' roles and functions vary from simple to specialized. CONCLUSIONS: More effort should be put into networking among nurses to exchange updated information and to share nursing strategies and strengthen college education for further specialization and expansion of nursing roles in the various settings.