The effect of kaempferol on the dentin bonding stability through matrix metalloproteinases inhibition and collagen crosslink in dentin biomodification.

Background/purpose: Naturally derived collagen crosslinkers with matrix metalloproteinases (MMPs) inhibitory activity for dentin bonding have been previously studied. One of these crosslinkers is flavonoids. The purpose of this study was to investigate whether dentin pretreatment with kaempferol (KEM), one of the flavonoids, enhances dentin bond stability and nanoleakage at the dentin-resin interface through MMPs inhibition and collagen crosslinking. Materials and methods: The experimental KEM-containing solution was used to pretreat demineralized dentin prior to the application of a universal adhesive. KEM is a natural flavonoid and those which did not take the experimental solution served as the control group (CON). Microtensile bond strength (µTBS) and nanoleakage tests were conducted before and after the thermocycling to evaluate the influence of KEM on dentin bond strength. The MMPs inhibition activity of KEM was analyzed via MMPs zymography using a confocal microscopy. Fourier-transform infrared (FTIR) spectroscopy was used to demonstrate that KEM inhibits MMPs and enhances collagen crosslinking. Results: The µTBS values of KEM group exhibited a higher bond strength after thermocycling. At the resin-dentin interface, the KEM group did not exhibit any signs of nanoleakage after thermocycling. Furthermore, MMPs zymography confirmed that there was a relatively low activity of MMPs in the presence of KEM. In FTIR analysis, the PO4 peak representing the cross-link between dentin and collagen was significantly higher in the KEM group. Conclusion: Our findings suggest that pretreatment with KEM enhances the dentin bonding stability at the resin-dentin interface by acting as a collagen crosslinker and MMPs inhibitor.

Effects of developing scenario learning in a fundamental nursing course: a pilot study.

BACKGROUND: This pilot study aimed to investigate the effects of developing scenario learning (DSL) on team efficacy, systems thinking, and proactivity in problem-solving in a fundamental nursing course. METHODS: A total of 53 second-year nursing students were enrolled in the study; the DSL nursing education program was implemented for 15 weeks from March 4 to June 17, 2021. Data on team efficacy, systems thinking, and proactivity in problem-solving were measured before and after the DSL-based nursing education program. The collected data were analyzed using the IBM SPSS Statistics version 22.0. RESULTS: The results demonstrated that nursing students' team efficacy (t = - 8.228, p < .001, Cohen's d = 1.079), systems thinking (t = - 9.757, p < .001, Cohen's d = .731), and proactivity in problem-solving (t = - 8.635, p < .001, Cohen's d = .992) significantly increased after the program. CONCLUSIONS: The findings of this study can contribute to the development of nursing competency in nursing students without experience in nursing practicum. The authors recommend incorporating DSL in the nursing curriculum to promote early adaptation in clinical settings.

The prevalence of insulin refusal and psychological insulin resistance among Korean patients with type 2 diabetes mellitus.

BACKGROUND: This study investigated the prevalence of insulin refusal and compared the level of psychological insulin resistance (PIR) with the intention to accept insulin therapy among Korean patients with type 2 diabetes. METHODS: Type 2 diabetes patients (n=1,209) were recruited from inner city outpatient diabetes clinics in 2016. Patient demographic, insulin recommendation, diabetes treatment type, intention to receive insulin therapy, and PIR information was collected using self-reports. The patients were divided into three groups: those who refused insulin therapy (n=184), those who accepted insulin therapy (n=331), and those not recommended for insulin therapy (n=694). Descriptive statistics were used to calculate the prevalence of insulin refusal; t-tests and analyses of variance were used to compare demographics with PIR. RESULTS: The insulin refusal rate was 35.7%. The duration of diabetes, numbers of diabetes-related complications, and glycated hemoglobin levels were significantly lower in the group not recommended for insulin therapy than refused and accepted insulin groups. The level of PIR in insulin refusal group was significantly lower among patients agreeing to receive insulin therapy within 3 months than among those refusing insulin therapy. CONCLUSIONS: The prevalence of insulin refusal in Korea is not low, and people who refuse insulin therapy have high levels of PIR. Strategies to reduce PIR levels are needed.

Revision of the Measurement Tool for Patients' Health Information Protection Awareness.

OBJECTIVES: Despite the importance of the protection of patients' health information in clinical settings, little is known about the awareness of this concept in nursing students due to the lack of a suitable measurement tool. Hence, this study attempted to redevelop the Patients' Health Information Protection Awareness Scale, and evaluate its construct validity and reliability for nursing students. METHODS: A cross-sectional descriptive study was conducted. Nursing students who were in their 3rd and 4th year were recruited from 10 universities in Korea to assess the construct validity, and 30 experts (27 nurses and 3 faculty members) participated in the content validation process. RESULTS: The content validity assessment indicated that 23 items were ideal. The assessment of construct validity using exploratory factor analysis revealed three factors: communication, management, and referrals. They together accounted for 54.1% of the variance in scale scores. The three-factor scale had good fit in the confirmatory factor analysis. Scale reliability was confirmed, with a Cronbach's alpha of 0.94 for all items. CONCLUSIONS: This study was the first attempt to redevelop the Patients' Health Information Protection Awareness Scale for student nurses. The 23-item scale was shown to be a reliable and valid tool. It facilitates the assessment of nursing students' awareness of patient information protection. Academic nursing programs and health organizations can use its scores to implement adequate education plans to safeguard information in nursing students.

[Development of a Psychological Insulin Resistance Scale for Korean Patients with Diabetes].

PURPOSE: This study was done to develop and validate a measure to evaluate the Korean version of psychological insulin resistance (K-PIR) in patients with diabetes in Korea. METHODS: Items were initially generated from literature reviews and interviews with 19 patients with diabetes. The content validity of the items was evaluated by experts. Participants were 424 patients with diabetes recruited through convenience sampling. A cross-sectional survey was designed for item-analysis, exploratory factor analysis with principal axis factoring, and confirmatory factor analysis. Cronbach's alpha was calculated to measure the internal consistency. RESULTS: For the 24 items of the Korean version of psychological insulin resistance, six items were eliminated because of low correlation with the other items. Exploratory factor analysis with 18-item showed that two factors (psycho-cognitive factor and supportive factor) explained 41.8% of the variance, and the factor structure of K-PIR model had a good fit. Internal consistency of K-PIR with 18 items revealed good reliability. CONCLUSION: The findings show that the K-PIR is reliable for measuring the psychological resistance to insulin therapy for Korean patients with diabetes. However, further study is needed to evaluate the validation because the proportion of variation of K-PIR was low in this study.