Efficacy of a new refractive multifocal contact lens for presbyopia.

This prospective single-arm study aimed to evaluate the clinical efficacy and safety of a refractive multifocal contact lens for the correction of presbyopia in 22 patients. The participants underwent clinical examinations before and 1 week after wearing a refractive multifocal contact lens (OptaCon ZOOM). The primary endpoints were the corrected distance visual acuity (CDVA) and distance-corrected near visual acuity (DCNVA). Defocus curve, contrast sensitivity, and ocular surface disease index (OSDI) were analyzed. A slit-lamp examination was performed for safety analysis. Contact lens comfort and patient satisfaction were assessed using a questionnaire. No significant difference in CDVA was observed before and 1 week after refractive multifocal contact lens use (p = 0.127), whereas DCNVA was significantly improved after 1 week (p < 0.001). The contrast sensitivity was not significantly affected at any spatial frequency under mesopic or photopic conditions. OSDI was significantly increased (p = 0.023). The patient-reported satisfaction scores were 96.2, 91.9, and 85.0 out of 100 at far, intermediate, and near distances, respectively. No significant adverse events were observed. Refractive multifocal contact lenses improved near vision while maintaining distance vision in presbyopic patients, without compromising contrast sensitivity. The study results suggest that OptaCon ZOOM can be considered safe and effective for the correction of presbyopia.

Immobilization of Silver(I) Ions on Amino-Functionalized Chromium(III) Terephthalate with Organophosphine and its C-H Carboxylation of a Heteroaromatic Compound.

A newly designed heterogenized catalyst that incorporates silver(I) ions with 2-(dicyclohexylphosphaneyl)acetaldehyde (PCy2 aldehyde) into amino-functionalized chromium(III) terephthalate is developed. Silver(I) ions were robustly immobilized on the amino-functionalized chromium(III) terephthalate, which contains an imine bond formed by the reaction with PCy2 aldehyde. The Ag(I) ion is coordinated with the phosphine in the imine group to create MIL-101-AP(Ag). Characterizations were carefully carried out according to the synthetic steps. The catalytic performance of MIL-101-AP(Ag) was evaluated through the C-H carboxylation of thiophene-2-carbonitrile, achieving a 10 % yield with a turnover number of 1.0. The recyclability of the MIL-101-AP(Ag) catalyst was successfully demonstrated with five cycle, with no loss in activity and selectivity observed. This approach, which involves the formation of an imine bond to facilitate silver loading with phosphine on amino-functionalized MIL-101(Cr), exhibits significant potential for both CO2 fixation and C-H carboxylation, thereby highlighting the modified material's promise as a sustainable catalyst.

Separation of High-Purity C2H2 from Binary C2H2/CO2 Using Robust Al-Based MOFs Comprising Nitrogen-Containing Heterocyclic Dicarboxylate.

In this study, three nitrogen-containing aluminum-based metal-organic frameworks (Al-MOFs), namely, CAU-10pydc, MOF-303, and KMF-1, were investigated for the efficient separation of a C2H2/CO2 gas mixture. Among these three Al-MOFs, KMF-1 demonstrated the highest selectivity for C2H2/CO2 separation (6.31), primarily owing to its superior C2H2 uptake (7.90 mmol g-1) and lower CO2 uptake (2.82 mmol g-1) compared to that of the other two Al-MOFs. Dynamic breakthrough experiments, using an equimolar binary C2H2/CO2 gas mixture, demonstrated that KMF-1 achieved the highest separation performance. It yielded 3.42 mmol g-1 of high-purity C2H2 (>99.95%) through a straightforward desorption process under He purging at 298 K and 1 bar. To gain insights into the distinctive characteristics of the pore surfaces of structurally similar CAU-10pydc and KMF-1, we conducted computational simulations using canonical Monte Carlo and dispersion-corrected density functional theory methods. These simulations revealed that the secondary amine (C2N-H) groups in KMF-1 played a more significant role in differentiating between C2H2 and CO2 compared to that of the N atoms in CAU-10pydc and MOF-303. Consequently, KMF-1 emerged as a promising adsorbent for the separation of high-purity C2H2 from binary C2H2/CO2 gas mixtures.

Pseudo-Gitelman Syndrome Presenting with Hypokalemic Metabolic Alkalosis and Hypocalciuria.

Pseudo-Bartter syndrome is a well-known differential diagnosis that needs to be excluded in cases of normotensive hypokalemic metabolic alkalosis. Pseudo-Bartter syndrome and pseudo-Gitelman syndrome are often collectively referred to as pseudo-Bartter/Gitelman syndrome; however, pseudo-Gitelman syndrome should be considered as a separate entity because Gitelman syndrome is characterized by hypocalciuria and hypomagnesemia, while Bartter syndrome is usually associated with hypercalciuria. Herein, we report the cases of two young adult female patients who presented with severe hypokalemic metabolic alkalosis, hypocalciuria, and hypomagnesemia. Diuretic or laxative abuse and self-induced vomiting were absent, and a chloride deficit and remarkable bicarbonaturia were observed. Initial sequencing studies for SLC12A3, CLCKNB, and KCNJ10 revealed no mutations, and whole-exome sequencing revealed no pathogenic variants. The metabolic alkalosis was saline-responsive in one case, and steroid therapy was necessary in the other to relieve chronic tubulointerstitial nephritis, which was diagnosed with kidney biopsy. A new category of pseudo-Gitelman syndrome should be defined, and various etiologies should be investigated.

Design of Pore Properties of an Al-Based Metal-Organic Framework for the Separation of an Ethane/Ethylene Gas Mixture via Ethane-Selective Adsorption.

A series of Al-based isomorphs (CAU-10H, MIL-160, KMF-1, and CAU-10pydc) were synthesized using isophthalic acid (ipa), 2,5-furandicarboxylic acid (fdc), 2,5-pyrrole dicarboxylic acid (pyrdc), and 3,5-pyridinedicarboxylic acid (pydc), respectively. These isomorphs were systematically investigated to identify the best adsorbent for effectively separating C2H6/C2H4. All CAU-10 isomorphs exhibited preferential adsorption of C2H6 over that of C2H4 in mixture. CAU-10pydc exhibited the best C2H6/C2H4 selectivity (1.68) and the highest C2H6 uptake (3.97 mmol g-1) at 298 K and 1 bar. In the breakthrough experiment using CAU-10pydc, 1/1 (v/v) and 1/15 (v/v) C2H6/C2H4 gas mixtures were successfully separated into high-purity C2H4 (>99.95%), with remarkable productivities of 14.0 LSTP kg-1 and 32.0 LSTP kg-1, respectively, at 298 K. Molecular simulations revealed that the exceptional separation performance of CAU-10pydc originated from the increased porosity and reduced electron density of the pyridine ring of pydc, leading to a relatively larger decrease in π-π interactions with C2H4 than in the C-H···π interactions with C2H6. This study demonstrates that the pore size and geometry of the CAU-10 platform are modulated by the inclusion of heteroatom-containing benzene dicarboxylate or heterocyclic rings of dicarboxylate-based organic linkers, thereby fine-tuning the C2H6/C2H4 separation ability. CAU-10pydc was determined to be an optimum adsorbent for this challenging separation.

An Amine-Functionalized Ultramicroporous Metal-Organic Framework for Postcombustion CO2 Capture.

Among the most promising methods by which to capture CO2 from flue gas, the emission of which has accelerated global warming, is energy-efficient physisorption using metal-organic framework (MOF) adsorbents. Here, we present a novel cuprous-based ultramicroporous MOF, Cu(adci)-2 (adci- = 2-amino-4,5-dicyanoimidazolate), which was rationally synthesized by combining two strategies to design MOF physisorbents for enhanced CO2 capturing, i.e., aromatic amine functionalization and the introduction of ultramicroporosity (pore size <7 Å). Synchrotron powder X-ray diffraction and a Rietveld analysis reveal that the Cu(adci)-2 structure has one-dimensional square-shaped channels, in each of which all affiliated ligands, specifically NH2 groups at the 2-position of the imidazolate ring, have the same orientation, with a pair of NH2 groups therefore facing each other on opposite sides of the channel walls. While Cu(adci)-2 exhibits a high CO2 adsorption capacity (2.01 mmol g-1 at 298 K and 15 kPa) but a low zero-coverage isosteric heat of adsorption (27.5 kJ mol-1), breakthrough experiments under dry and 60% relative humidity conditions show that its CO2 capture ability is retained even in the presence of high amounts of moisture. In a Monte Carlo simulation and a radial distribution analysis, the preferential CO2 binding site of Cu(adci)-2 was predicted to be between two ligands, forming a sandwich-like structure and implying that its CO2 adsorption properties originate from the enhancement of Lewis base-acid and London dispersion interactions due to the amino groups and ultramicroporosity, respectively.

High-Performance Adsorbent for Ethane/Ethylene Separation Selected through the Computational Screening of Aluminum-Based Metal-Organic Frameworks.

The development of a high-performance ethane (C2H6)-selective adsorbent for the separation of ethane/ethylene (C2H6/C2H4) gas mixtures has been investigated for high-efficiency adsorption-based gas separation. Herein, we investigated Al-based metal-organic frameworks (MOFs) to identify an efficient C2H6-selective adsorbent (CAU-11), supported by a computational simulation study. CAU-11 exhibited numerous advantageous properties (such as low material cost, structural robustness, high reaction yield, and high C2H6/C2H4 selectivity) compared to other Al-based MOFs, indicating immense potential as a C2H6-selective adsorbent. CAU-11 exhibited preferential C2H6 adsorption in single-component gas adsorption experiments, and its predicted ideal adsorption solution theory selectivity of C2H6/C2H4 was over 2.1, consistent with the simulation analysis. Dynamic breakthrough experiments using representative compositions of the C2H6/C2H4 gas mixture confirmed the excellent separation ability of CAU-11; it produced high-purity C2H4 (>99.95%) with productivity values of 0.79 and 2.02 mol L-1 while repeating the cyclic experiment with 1:1 and 1:15 v/v C2H6/C2H4 gas mixtures, respectively, at 298 K and 1 bar. The high C2H6/C2H4 separation ability of CAU-11 could be attributed to its non-polar pore environment and optimum pore dimensions which strengthen the interaction of its pores (via C-H···π interactions) with C2H6 to a greater extent than with C2H4.

Performance Comparison of Five SARS-CoV-2 Antibody Assays for Seroprevalence Studies.

BACKGROUND: Seroprevalence studies of coronavirus disease 2019 (COVID-19) cases, including asymptomatic and past infections, are important to estimate the scale of the disease outbreak and to establish quarantine measures. We evaluated the clinical performance of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) antibody assays available in Korea for use in seroprevalence studies. METHODS: The sensitivity, specificity, cross-reactivity, and interference of five SARS-CoV-2 antibody assays were evaluated using the following: 398 serum samples from confirmed COVID-19 patients, 510 negative control samples from before 2018 (pre-pandemic), 163 serum samples from patients with SARS, Middle East respiratory syndrome (MERS), and other viral infections, and five samples for the interference study. RESULTS: The sensitivities of the five assays ranged from 92.2% to 98%, and their specificities, including cross-reactivity and interference, ranged from 97.5% to 100%. The agreement rates were excellent (kappa >0.9). Adjustment of the cutoff values could be considered through ROC curve analysis. The positive predictive values of the individual assays varied from 3.5% to 100% at a 0.1% prevalence but were as high as ≥95% when two assays were combined. CONCLUSIONS: The prevalence of COVID-19 in Korea is considered to be exceptionally low at present; thus, we recommend using a combination of two or more SARS-CoV-2 antibody assays rather than a single assay. These results could help select SARS-CoV-2 antibody assays for COVID-19 seroprevalence studies in Korea.

Post-Synthesis Functionalization Enables Fine-Tuning the Molecular-Sieving Properties of Zeolites for Light Olefin/Paraffin Separations.

Zeolite molecular sieves are widely used in gas separation and shape-selective catalysis, but these applications often require discriminating differences as little as 0.1 Å. Molecular sieving with such size selectivity demands zeolites with highly tunable pore diameters and adsorption properties, which are technically challenging to prepare. Nevertheless, it is shown that a wide range of organic functional groups can be covalently functionalized onto the interior pore walls of the zeolites, MOR, LTL, FAU, and MFI, to systematically "tune" their effective pore diameters with respect to the size of organic groups. For organic functionalization, small and aggressive organic electrophiles are used (e.g., organo-halide and -diazonium) as grafting agents, which are accessible to the intracrystalline void space, forming a C-Ozeolite bond in a reaction with a bridging oxygen as proved by multiple analysis data. It is demonstrated that the post-functionalization can be used to tailor the molecular sieving action of a parent zeolite to give size-selective adsorbents for light olefin/paraffin separations. 4-Methoxybenzene-functionalized MOR separates ethylene from ethane with an ideal-adsorbed-solution-theory selectivity of ≈5873, whereas toluene-grafted MOR completely separates propylene/propane mixtures. Therefore, tailoring the molecular-sieving properties of zeolites by organic functionalization broadens their applications to challenging separations.

Low-Valent Metal Ions as MOF Pillars: A New Route Toward Stable and Multifunctional MOFs.

PCM-102 is a new organophosphine metal-organic framework (MOF) featuring diphosphine pockets that consist of pairs of offset trans-oriented P(III) donors. Postsynthetic addition of M(I) salts (M = Cu, Ag, Au) to PCM-102 induces single-crystal to single-crystal transformations and the formation of trans-[P2M]+ solid-state complexes (where P = framework-based triarylphosphines). While the unmetalated PCM-102 has low porosity, the addition of secondary Lewis acids to install rigid P-M-P pillars is shown to dramatically increase both stability and selective gas uptake properties, with N2 Brunauer-Emmett-Teller surface areas >1500 m2 g-1. The Ag(I) analogue can also be obtained via a simple, one-pot peri-synthetic route and is an ideal sacrificial precursor for materials with mixed bimetallic MA/MB pillars via postsynthetic, solvent-assisted metal exchange. Notably, the M-PCM-102 family of MOFs contain periodic trans-[P2M]+ sites that are free of counter anions, unlike traditional analogous molecular complexes, since the precursor PCM-102 MOF is monoanionic, enabling access to charge-neutral metal-pillared materials. Four M-PCM-102 materials were evaluated for the separation of C2 hydrocarbons. The separation performance was found to be tunable based on the metal(s) incorporated, and density functional theory was employed to elucidate the nature of the unusual observed sorption preference, C2H2 > C2H6 > C2H4.

Seven-Month Analysis of Five SARS-CoV-2 Antibody Assay Results after ChAdOx1 nCoV-19 Vaccination: Significant Decrease in SARS-CoV-2 Antibody Titer.

We investigated the longevity rates of antibodies to severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) after a complete ChAdOx1 nCoV-19 vaccination, which are rare and important to estimate their efficacy and establish a vaccination strategy. We assessed the positivity rates and changes of titers before (T0) and at one month (T1), four months (T2), and seven months (T3) after a ChAdOx1 nCoV-19 vaccination using five SARS-CoV-2 antibody assays. A total of 874 serum samples were obtained from 228 (T0 and T1), 218 (T2), and 200 (T3) healthcare workers. The positive rates for all five assays were 0.0-0.9% at T0, 66.2-92.5% at T1, 98.2-100.0% at T2, and 66.0-100.0% at T3. The positive rates at T3 were decreased compared to those at T2. The median antibody titers of all the assays at T3 were significantly decreased compared to those at T2 (860.5 to 232.0 U/mL for Roche total, 1041.5 to 325.5 AU/mL for Abbott IgG, 10.9 to 2.3 index for Siemens IgG, 99.5% to 94.7% for SD Biosensor V1, and 88.5% to 38.2% for GenScript). A third-dose scheme can be considered based on our data generated from five representative assays. Our findings contribute insights into SARS-CoV-2 antibody assays and appropriate vaccination strategies.

Relationship Between Rotavirus P[6] Infection in Korean Neonates and Histo-Blood Group Antigen: a Single-Center Study.

BACKGROUND: Rotaviruses are a major cause of pediatric gastroenteritis. The rotavirus P[6] genotype is the most prevalent genotype isolated from Korean neonates but has rarely been reported in other countries. Histo-blood group antigen (HBGA) is known to play an important role in rotavirus infection. We investigated the relationship between rotavirus genotype and HBGA-Lewis blood type in Korean children and explored the reasons for the predominance of rotavirus P[6] strain in Korean neonates. METHODS: Blood and stool samples were collected from 16 rotavirus-infected patients. Rotavirus G (VP7) and P (VP4) genotyping was performed using reverse transcription-PCR and sequencing. Lewis antigen phenotypes (Lea/Leb) were tested, and HBGA-Lewis genotype was determined by sequencing the secretor (FUT2) and Lewis (FUT3) genes. Deduced amino acid sequences and three-dimensional structures of the VP8* portion of the rotavirus VP4 protein were analyzed. RESULTS: All P[6] rotaviruses were isolated from neonates under one month of age, who were negative or weakly positive for the Leb antigen. However, 10 of the 11 non-P[6] rotaviruses were isolated from older children who were Leb antigen-positive. The VP8* amino acid sequences differed among P[6], P[4], and P[8] genotypes. Korean P[6] strains showed a unique VP8* sequence with amino acid substitutions, including Y169>L169, which differed from the sequences of P[6] strains from other countries. CONCLUSIONS: The predominance of the rotavirus P[6] genotype in Korean neonates may be related to the interaction between HBGA-Lewis antigen and the VP8* portion of the VP4 protein, and this information will be helpful in future neonatal vaccine development.

Effectiveness of simulation-based interprofessional education for medical and nursing students in South Korea: a pre-post survey.

BACKGROUND: Effective collaboration and communication among health care team members are critical for providing safe medical care. Interprofessional education aims to instruct healthcare students how to learn with, from, and about healthcare professionals from different occupations to encourage effective collaboration to provide safe and high-quality patient care. The purpose of this study is to confirm the effectiveness of Interprofessional education by comparing students' attitudes toward interprofessional learning before and after simulation-based interprofessional education, the perception of teamwork and collaboration between physicians and nurses, and the self-reported competency differences among students in interprofessional practice. METHODS: The survey responses from 37 5th-year medical students and 38 4th-year nursing students who participated in an interprofessional education program were analyzed. The Attitude Towards Teamwork in Training Undergoing Designed Educational Simulation scale, the Jefferson Scale of Attitudes Toward Physician-Nurse Collaboration, and the Interprofessional Education Collaborative competency scale were used for this study. The demographic distribution of the study participants was obtained, and the perception differences before and after participation in interprofessional education between medical and nursing students were analyzed. RESULTS: After interprofessional education, student awareness of interprofessional learning and self-competency in interprofessional practice improved. Total scores for the Jefferson Scale of Attitudes Toward Physician-Nurse Collaboration did not change significantly among medical students but increased significantly among nursing students. Additionally, there was no significant change in the perception of the role of other professions among either medical or nursing students. CONCLUSIONS: We observed an effect of interprofessional education on cultivating self-confidence and recognizing the importance of interprofessional collaboration between medical professions. It can be inferred that exposure to collaboration situations through Interprofessional education leads to a positive perception of interprofessional learning. However, even after their interprofessional education experience, existing perceptions of the role of other professional groups in the collaboration situation did not change, which shows the limitations of a one-time short-term program. This suggests that efforts should be made to ensure continuous exposure to social interaction experiences with other professions.

Comparison of students' performance of objective structured clinical examination during clinical practice.

PURPOSE: Clinical practice for medical students aims to improve their clinical competency. Since students gain experience in clinical practice, it is assumed that their capacity for care is strengthened. This study aimed to verify whether there is a change in the competency of medical students after clinical practice. METHODS: We assessed the clinical performance of 120 medical students who were enrolled in the fifth year over the academic years 2016-2018. Objective structured clinical examination (OSCE) was used to measure the clinical competency. RESULTS: The OSCE scores for November fifth grade improved significantly compared to May fifth grade. The scores in September of sixth grade were slightly lower than those of November of fifth grade, but there was no statistically significant difference. CONCLUSION: It was confirmed that the clinical practice of fifth-year students improved their clinical competency, but it did not show any significant shift in the clinical competency of sixth-year students. The results of this study suggest that it is very important to organize the curriculum so that students can continue to experience patient-facing care throughout the entire clinical practice course to produce highly qualified physicians.

Microporous 3D Graphene-like Zeolite-Templated Carbons for Preferential Adsorption of Ethane.

Microporous 3D graphene-like carbons were synthesized in Faujasite (FAU)-, EMT-, and beta-zeolite templates using the recently developed Ca2+ ion-catalyzed synthesis method. The microporous carbons liberated from these large-pore zeolites (0.7-0.9 nm) retain the structural regularity of zeolite. FAU-, EMT-, and beta zeolite-templated carbons (ZTCs) with faithfully constructed pore diameters of 1.2, 1.1, and 0.9 nm, respectively, and very large Brunauer-Emmet-Teller areas (2700-3200 m2 g-1) were obtained. We have discovered that these schwarzite-like carbons exhibit preferential adsorption of ethane over ethylene at pressures in the range of 1-10 bar. The curved graphene structure, consisting of a diverse range of carbon polygons with a narrow pore size of ∼1 nm, provides abundant adsorption sites in micropores and retains its ethane selectivity at pressures up to 10 bar. After varying the oxygen content in the beta ZTC, the ethane and ethylene adsorption isotherms show that the separation ability is not significantly affected by surface oxygen groups. Based on these adsorption results, a breakthrough separation procedure using a C2H4/C2H6 gas mixture (9:1 molar ratio) is demonstrated to produce ethylene with a purity of 99.9%.

Mycophenolic Acid Trough Concentration and Dose Are Associated with Hematologic Abnormalities but Not Rejection in Kidney Transplant Recipients.

BACKGROUND: Little is known regarding the safe fixed dose of mycophenolic acid (MPA) for preventing biopsy-proven acute rejection (BPAR) in kidney transplant recipients (KTRs). We investigated the correlation of MPA trough concentration (MPA C0) and dose with renal transplant outcomes and adverse events. METHODS: This study included 79 consecutive KTRs who received MPA with tacrolimus (TAC) and corticosteroids. The MPA C0 of all the enrolled KTRs was measured, which was determined monthly by using particle-enhanced turbidimetric inhibition immunoassay for 12 months, and clinical data were collected at each time point. The clinical endpoints included BPAR, any cytopenia, and BK or cytomegalovirus infections. RESULTS: No differences in MPA C0 and dose were observed between KTRs with or without BPAR or viral infections under statistically comparable TAC concentrations. MPA C0 was significantly higher in patients with leukopenia (P = 0.021) and anemia (P = 0.002) compared with those without cytopenia. The MPA dose was significantly higher in patients with thrombocytopenia (P = 0.002) compared with those without thrombocytopenia. MPA C0 ≥ 3.5 µg/mL was an independent risk factor for leukopenia (adjusted odds ratio [AOR], 3.80; 95% confidence interval [CI], 1.24-11.64; P = 0.019) and anemia (AOR, 5.90; 95% CI, 1.27-27.51; P = 0.024). An MPA dose greater than the mean value of 1,188.8 mg/day was an independent risk factor for thrombocytopenia (AOR, 3.83; 95% CI, 1.15-12.78; P = 0.029). However, an MPA dose less than the mean value of 1,137.3 mg/day did not increase the risk of BPAR. CONCLUSION: Either a higher MPA C0 or dose is associated with an increased risk of cytopenia, but neither a lower MPA C0 nor dose is associated with BPAR within the first year of transplantation. Hence, a reduced MPA dose with TAC and corticosteroids might be safe in terms of reducing hematologic abnormalities without causing rejection.

Relationships Between Perspective-Taking, Empathic Concern, and Self-rating of Empathy as a Physician Among Medical Students.

OBJECTIVE: The aim of this study was to ascertain the relationships between perspective-taking, empathic concern, and self-rating of empathy as a physician among medical students. METHODS: This study analyzed the questionnaire responses of 152 medical students enrolled in Ajou University School of Medicine, Suwon, Republic of Korea, in 2018. As measurement instruments, the authors applied the Interpersonal Reactivity Index (IRI) and Korean Student Version of the Jefferson Scale of Physician Empathy (Korean JSPE-S), and then examined participant characteristic variables based on the obtained data and conducted subsequent correlation analyses of subscales, one-way ANOVA, and regression analyses. RESULTS: Medical students with clinical clerkship experience demonstrated higher levels of perspective-taking and empathy as physicians than did students without experience. Moreover, perspective-taking and empathic concern were significant predictors of medical students' empathy as physicians in the regression model. CONCLUSIONS: Medical students with higher scores in perspective-taking and empathic concern demonstrated higher levels of perception regarding the necessity and importance of empathy as a physician in patient-physician relationships. Therefore, in actual medical situations with patient-centered therapy, to enhance the levels of physician empathy, medical education should focus on the understanding of other persons' opinions and interpersonal interactions accompanied by empathic concern.

Changes in Medical Students' Self-Assessments of Clinical Communication Skills after Clinical Practice and Standardized Patient Feedback.

OBJECTIVE: In this study, the authors aimed to analyze the effects of clinical practice and Standardized Patient (SP) feedback on medical students' self-assessments of their clinical communication skills (CCS). METHODS: The authors analyzed questionnaire responses from 43 fifth-year medical students enrolled in the Ajou University School of Medicine, Suwon, Republic of Korea, in 2019, and used the Communication Assessment Tool (CAT) scale to measure the study's variables. A descriptive statistical analysis and paired t test focused on the distribution of and changes in CCS before and after clinical practice and after receiving SP feedback. RESULTS: After clinical practice, the students' perceptions of their own CCS were positively increased, but after the receipt of SP feedback, they significantly decreased. Scores for the item on interpersonal relationships with the patient from the perspective of the patient were significantly lower after the SP feedback was obtained. CONCLUSIONS: SP feedback emerged as an important educational method, allowing students to assess their CCS more objectively and view their CCS as physicians from the patient's perspective. SP feedback is necessary, as is providing students with the experience of receiving direct SP feedback, on clinical performance to increase patient-centered care competencies.

The Effect of Fibrinogen/Thrombin-Coated Collagen Patch (TachoSil®) Application in Pancreaticojejunostomy for Prevention of Pancreatic Fistula After Pancreaticoduodenectomy: A Randomized Clinical Trial.

BACKGROUND: Fibrin sealants and topical glue have been studied to reduce the incidence of postoperative pancreatic fistulas (POPF) after pancreatico-enteric anastomosis, but a definitive innovation is still needed. We aim to evaluate the effectiveness of fibrin sealant patch applied to pancreatico-enteric anastomosis to reduce postoperative complications, including POPF. METHODS: This study was a single-center, prospective, randomized, phase IV trial involving three pancreaticobiliary surgeons. The primary outcome was POPF; secondary outcomes included complications, drain removal days, hospital stay, readmission rate, and cost. Risk factors for POPF were identified by logistic regression analysis. RESULTS: A total of 124 patients were enrolled. Biochemical leakage (BL) or POPF occurred in 16 patients (25.8%) in the intervention group and 23 patients (37.1%) in the control group (no statistical significance). Clinically relevant POPF occurred in 4 patients (6.5%) in both the intervention and control groups (p = 1.000). Hospital stay (11.6 days vs. 12.1 days, p = 0.585) and drain removal days (5.7 days vs. 5.3 days, p = 0.281) were not statistically different between two groups. Complication rates were not different between the two groups (p = 0.506); nor were readmission rates (12.9% vs. 11.3%, p = 1.000) or cost ($13,549 vs. $15,038, p = 0.103). In multivariable analysis, age and soft pancreas texture were independent risk factors for BL or POPF in this study. Applying fibrin sealant patch is not a negative risk factor, but the p value may indicate a likelihood of reducing the incidence of BL (p = 0.084). CONCLUSIONS: Fibrin sealant patches after pancreaticojejunostomy did not reduce the incidence of POPF or other postoperative complications. This study was registered at clinicaltrials.gov (NCT03269955).

Professional self-concept and burnout among medical school faculty in South Korea: a cross-sectional study.

BACKGROUND: Medical school faculty members have been reported to be highly likely to suffer burnout. Research is being conducted on professional self-concepts as a factor that relieves burnout in many professions. However, there is a paucity of data on the relationship between professional self-concept and burnout among medical school faculty. Professional self-concept means a perception of oneself as a member of the profession. It influences an individual's thoughts, actions, and emotions. The more positive the professional self-concept, the higher is the self-esteem in the profession, which can contribute to reducing burnout. This study aimed to investigate the professional self-concept and incidence of burnout among medical school clinical faculty members, and to ascertain the factors that affect professional self-concept with respect to burnout. METHODS: A total of 68 clinical faculty members at the Ajou University School of Medicine completed a modified form of the professional self-concept scale and the Maslach Burnout Inventory. We undertook the following statistical analyses: a descriptive analysis to understand the distribution of participants, correlation analysis to indicate associations between variables and a multiple regression analysis to examine the influence of gender, position, and specialty on professional self-concept and burnout, and the effect of each subscale of professional self-concept on burnout. RESULTS: As professional self-concept increases, burnout decreases. There was no significant difference between professional self-concept and burnout with respect to gender or field of medical specialty, while a significant difference was observed across faculty position levels. Additionally, the professional self-concept subscale, which included satisfaction and communication skill, was found to significantly affect burnout. CONCLUSIONS: This study shows that professional self-concept affects burnout. Through these results, we can infer that professional self-concept functioned to protect medical school faculty from burnout. This may be a strategy that fortifies the professional identity of medical school faculty, and it is suggested that educational programs that are directed toward this goal be established.