Network visualization to interpret which healthcare services are central to people living with HIV.

AIM: To employ network analysis to identify the central healthcare service needs of people living with HIV (PLWH) for integrated care. DESIGN: Cross-sectional survey. METHODS: A list of healthcare services was identified through literature reviews, expert workshops and validity evaluations by PLWH. A total of 243 PLWH participated at five hospitals and self-reported their need for healthcare services on a four-point Likert scale. Centrality of healthcare service needs was analysed using network analysis. RESULTS: The mean score for 20 healthcare service needs was 3.53 out of 4. The highest scoring need, "Precaution for interaction between antiretroviral therapy and other drugs," received a rating of 3.73 but had a centrality of only 0.31. The most central node in the network of healthcare service needs, "Information and coping with opportunistic infections," had a strength centrality of 1.63 and showed significant relationships with "non-HIV-related medical services (e.g., health check-ups)" and "Regular dental services." The correlation stability coefficient, which quantifies the stability of centrality, was 0.44 with an acceptable value. CONCLUSIONS: The most central need was information on opportunistic infections that had connections with many nodes in network analysis. By interpreting the relationships between needs, healthcare providers can design interventions with an integrative perspective. IMPLICATIONS FOR PATIENT CARE: Network visualization provides dynamic relationships between needs that are unknown from the score scale by presenting them graphically and qualitatively. IMPACT: Using network analysis to interpret need assessment offers an integrated nursing perspective. Coping with opportunistic infection is central to connecting the chain of healthcare. This study highlights the multifaceted understanding of patients' needs that nurses gain when they conduct network analysis. REPORTING METHOD: We adhered to the STROBE checklist. PATIENT OR PUBLIC CONTRIBUTION: No patient or public contribution.

Structural characterization and fatty acid epoxidation of CYP184A1 from Streptomyces avermitilis.

The genome of Streptomyces avermitilis contains 33 cytochrome P450 genes. Among the P450 gene products of S. avermitilis, we characterized the biochemical function and structural aspects of CYP184A1. Ultra-performance liquid chromatography-tandem mass spectrometry analysis showed that CYP184A1 induced an epoxidation reaction to produce 9,10-epoxystearic acid. Steady-state kinetic analysis yielded a kcat value of 0.0067 min-1 and a Km value 10 µM. The analysis of its crystal structures illustrated that the overall CYP184A1 structure adopts the canonical scaffold of cytochrome P450 and possesses a narrow and deep substrate pocket architecture that is required for binding to linear chain fatty acids. In the structure of the CYP184A1 oleic acid complex (CYP184A1-OA), C9-C10 of oleic acid was bound to heme for the productive epoxidation reaction. This study elucidates the roles of P450 enzymes in the oxidative metabolism of fatty acids in Streptomyces species.

Intravenous Lidocaine for the Prevention of Postoperative Catheter-Related Bladder Discomfort in Male Patients Undergoing Transurethral Resection of Bladder Tumors: A Randomized, Double-Blind, Controlled Trial.

BACKGROUND: Male patients undergoing transurethral resection of bladder tumors (TURBT) are prone to suffer from catheter-related bladder discomfort (CRBD). Lidocaine administration has been widely performed to reduce postoperative pain. Here, the effect of intravenous lidocaine administration on moderate-to-severe CRBD was evaluated in male patients undergoing TURBT. METHODS: Patients were randomly allocated to receive intravenous lidocaine (1.5 mg/kg bolus dose followed by a 2 mg/kg/h continuous infusion during the intraoperative period, which was continued for 1 hour postsurgery; group L) or placebo (normal saline; group C). The primary outcome was moderate-to-severe CRBD at 0 hour postsurgery (on admission to the postanesthetic care unit), analyzed using the χ test. The secondary outcome was opioid requirement during the 24-hour postoperative period. None, mild, and moderate-to-severe CRBD at 1, 2, and 6 hours postsurgery, postoperative pain, patient satisfaction, side effects of lidocaine and rescue medications (tramadol and fentanyl), and surgical complications were also assessed. RESULTS: A total of 132 patients were included in the study (66 patients in each group). The incidence of moderate-to-severe CRBD at 0 hour postsurgery was significantly lower in group L than in group C (25.8% vs 66.7%, P < .001, relative risk: 0.386, 95% confidence interval: 0.248-0.602). Opioid requirements during the 24-hour postoperative period were significantly lower in group L than in group C (10.0 mg [interquartile range (IQR), 5.0-15.0 mg] vs 13.8 mg [IQR, 10.0-20.0 mg], P = .005). At 1 and 2 hours postsurgery (but not at 6 hours), the incidence of moderate-to-severe CRBD was significantly lower in group L than in group C (1 hour: 10.6% vs 27.3%, P = .026; 2 hours: 0.0% vs 15.2%, P = .003). Patient satisfaction was significantly greater in group L than in group C (5.0 [IQR, 4.8-6.0] vs 4.0 [IQR, 4.0-5.0], P < .001). No lidocaine-related side effects were reported. Rescue medication-related side effects and surgical complications did not differ significantly between the 2 groups. CONCLUSIONS: Intravenous lidocaine administration resulted in lower incidence of moderate-to-severe CRBD, lower opioid requirement, and higher patient satisfaction in male patients undergoing TURBT without evidence of significant side effects.

Asymmetric Fullerene Nanosurfactant: Interface Engineering for Automatic Molecular Alignments.

Since the molecular self-assembly of nanomaterials is sensitive to their surface properties, the molecular packing structure on the surface is essential to build the desired chemical and physical properties of nanomaterials. Here, a new nanosurfactant is proposed for the automatic construction of macroscopic surface alignment layer for liquid crystal (LC) molecules. An asymmetric nanosurfactant (C60 NS) consisted of mesogenic cyanobiphenyl moieties with flexible alkyl chains and a [60]fullerene nanoatom is newly designed and precisely synthesized. The C60 NS directly introduced in the anisotropic LC medium is self-assembled into the monolayered protrusions on the surface because of its amphiphilic nature originated by asymmetrically programmed structural motif of LC-favoring moieties and LC-repelling groups. The monolayered protrusions constructed by the phase-separation and self-assembly of asymmetric C60 NS nanosurfactant in the anisotropic LC media amplify and transfer the molecular orientational order from surface to bulk, and finally create the automatic vertical molecular alignment on the macroscopic length scale. The asymmetric C60 NS nanosurfactant and its self-assembly described herein can offer the direct guideline of interface engineering for the automatic molecular alignments.

Topochemical polymerization of dumbbell-shaped diacetylene monomers: relationship between chemical structure, molecular packing structure, and gelation property.

Herein, we have synthesized novel photopolymerizable dumbbell-shaped diacetylene liquid crystal (LC) monomers by locating a diacetylene dicarboxylic acid group at the center and chemically connecting swallow-tails, such as hydrophobic alkyl chains (abbreviated as AT3DI) and amphiphilic biphenyl mesogens (abbreviated as BP3DI), with bisamide groups. Major phase transitions of dumbbell-shaped diacetylene monomers were identified using differential scanning calorimetry (DSC), polarized optical microscopy (POM), and Fourier transform infrared spectroscopy (FT IR). Molecular packing structures were studied based on structure-sensitive wide-angle X-ray diffraction (WAXD) and small-angle X-ray scattering (SAXS) analyses. Mainly, due to nanophase separations and strong intermolecular hydrogen bonding, AT3DI formed a low-ordered lamellar LC phase at room temperature. BP3DI self-assembled into highly-ordered crystal phases (K1 and K2) at lower temperatures below a low-ordered lamellar LC phase, in which BP3DI were intercalated with each other to compensate the mutual volume differences. From the photopolymerization of AT3DI and BP3DI, it was realized that the topochemical reactions of dumbbell-shaped diacetylene monomers were closely related to their chemical structures as well as molecular packing structures.

Graphene quantum dots as a highly efficient solution-processed charge trapping medium for organic nano-floating gate memory.

A highly efficient solution-processible charge trapping medium is a prerequisite to developing high-performance organic nano-floating gate memory (NFGM) devices. Although several candidates for the charge trapping layer have been proposed for organic memory, a method for significantly increasing the density of stored charges in nanoscale layers remains a considerable challenge. Here, solution-processible graphene quantum dots (GQDs) were prepared by a modified thermal plasma jet method; the GQDs were mostly composed of carbon without any serious oxidation, which was confirmed by x-ray photoelectron spectroscopy. These GQDs have multiple energy levels because of their size distribution, and they can be effectively utilized as charge trapping media for organic NFGM applications. The NFGM device exhibited excellent reversible switching characteristics, with an on/off current ratio greater than 10(6), a stable retention time of 10(4) s and reliable cycling endurance over 100 cycles. In particular, we estimated that the GQDs layer trapped ∼7.2 × 10(12) cm(-2) charges per unit area, which is a much higher density than those of other solution-processible nanomaterials, suggesting that the GQDs layer holds promise as a highly efficient nanoscale charge trapping material.

Dual photo-functionalized amphiphile for photo-reversible liquid crystal alignments.

Without the conventional polymer-based liquid crystal (LC) alignment process, a newly synthesized dual photo-functionalized amphiphile (abbreviated as ADMA1 ) was successfully applied as a robust photo-reversible LC alignment layer by self-assembly and photo-polymerization. The LC alignment layer constructed by directly adding dual photo-functionalized amphiphiles into LC media significantly cuts the manufacturing cost as well as opens new doors for the fabrication of novel electro-optical devices.

Multi-responsible chameleon molecule with chiral naphthyl and azobenzene moieties.

A photochromic chiral molecule with azobenzene mesogens and a (R)-configuration naphthyl moiety (abbreviated as NCA2M) was specifically designed and synthesized for the demonstration of chameleon-like color changes responding to multitudinous external stimuli, such as temperature, light and electric field. The basic phase transition behaviors of NCA2M were first studied by the combination of differential scanning calorimetry (DSC) and polarized optical microscopy (POM). Based on the structure-sensitive X-ray diffraction results obtained at different temperatures, it was comprehended that the NCA2M molecule exhibited the tilted version of highly ordered smectic crystal phase with 5.45 nm layer thickness. Chiral nematic (N*) liquid crystals (LC) with helical superstructures were formed by doping the NCA2M photochromic chiral molecule in an achiral nematic (N) LC medium. By controlling the helical pitch length of N*-LC with respect to temperature, light and electric field, the wavelength of selectively reflected light from the N* photonic crystal was finely tuned. The light-induced color change of N*-LC film was the most efficient method for covering the whole visible region from blue to green and to red, which allowed us to fabricate remote-controllable photo-responsive devices.

Hierarchical superstructures from a star-shaped molecule consisting of a cyclic oligosiloxane with cyanobiphenyl moieties.

Unconventional star-shaped liquid crystals (abbreviated as SiLCs) were successfully synthesized by chemically connecting four cyanobiphenyl anisotropic mesogens to the periphery of a super-hydrophobic and ultra-flexible cyclic tetramethyltetrasiloxane ring with flexible hexyl chains. Based on the combined experimental techniques of differential scanning calorimetry (DSC), cross-polarized optical microscopy (POM), solid-state carbon-13 ((13)C) nuclear magnetic resonance (NMR) spectroscopy and one-dimensional (1D) wide-angle X-ray diffraction (WAXD), it was found that the SiLC molecule exhibited the monotropic phase transition from a LC phase to a crystalline phase. The crystalline phase was only detected during slow heating processes above its glass transition temperature, while a LC phase was formed both during cooling and during heating processes. The hierarchical superstructures were identified from the structure-sensitive 2D WAXD of the macroscopically oriented SiLC film and confirmed by selected area electron diffraction (SAED) of the SiLC single crystals. The molecular packing symmetry in the monoclinic unit cell was further investigated by computer simulations on the real and reciprocal spaces. Macroscopically oriented SiLC hierarchical superstructures on the different length scales may provide the targeted physical properties, which can allow us to apply SiLC molecules in the fields of electro-optical devices and nonlinear optics.

Thermal- and photo-induced phase-transition behaviors of a tapered dendritic liquid crystal with photochromic azobenzene mesogens and a bicyclic chiral center.

A ribbon-shaped chiral liquid crystalline (LC) dendrimer with photochromic azobenzene mesogens and an isosorbide chiral center (abbreviated as AZ3 DLC) was successfully synthesized and its major phase transitions were studied by using differential scanning calorimetry (DSC) and linear polarized optical microscopy (POM). Its ordered structures at different temperatures were further identified through structure-sensitive diffraction techniques. Based on the experimental results, it was found that the AZ3 DLC molecule exhibited the low-ordered chiral smectic (Sm*) LC phase with 6.31 nm periodicity at a high-temperature phase region. AZ3 DLC showed the reversible photoisomerization in both organic solvents and nematic (N) LC media. As a chiral-inducing agent, it exhibited a good solubility, a high helical-twisting power, and a large change in the helical-twisting power due to its photochemical isomerization in the commercially available N LC hosts. Therefore, we were able to reversibly "remote-control" the colors in the whole visible region by finely tuning the helical pitch of the spontaneously formed helical superstructures.

Spatial Analysis of Health System Factors in Infectious Disease Management: Lessons Learned from the COVID-19 Pandemic in Korea.

Infectious disease outbreaks present ongoing and substantial challenges to health systems at local, national, and global levels, testing their preparedness, response capabilities, and resilience. This study aimed to identify and analyze critical health system-level factors that influence infection outbreaks, focusing on the experience of the COVID-19 pandemic in Korea. Conducted as a secondary data analysis, this study utilized national datasets from Korea. Given the inherent spatial dependencies in the spread of infectious diseases, we employed a spatial lag model to analyze data. While city-specific characteristics did not emerge as significant factors, health system variables, particularly the number of community health centers and health budgets, showed significant influence on the course of the COVID-19 outbreak, along with spatial autocorrelation coefficients. Our findings underscore the importance of enhancing public healthcare infrastructure, considering regional specificities, and promoting collaboration among local governments to bolster preparedness for future outbreaks. These insights are crucial for policymakers and healthcare professionals in formulating effective strategies to prevent, manage, and mitigate the impact of infectious disease outbreaks.

Factors associated with health-related quality of life among people living with HIV in South Korea: Tobit regression analysis.

This study investigated health-related quality of life and identified factors affecting it among people with the HIV in South Korea. A total of 243 people living with HIV participated in this cross-sectional survey. Data were collected from five hospitals between November 2021 and August 2022 using structured online questionnaires. Data were analyzed using descriptive statistics, Mann-Whitney U test, Kruskal-Wallis test, Spearman's rho analysis, and Tobit regression analysis because a significant ceiling effect was observed for the dependent variable. The mean score for the health-related quality of life was 75.74 ± 16.48. The significant factors that positively influence the health-related quality of life were "employment" (B = 4.57, p = .035), "not participating in the self-help group" (B = 6.10, p = .004), "higher self-efficacy for managing symptoms" (B = 1.32, p = .036), "higher self-efficacy for getting support/help" (B = 0.95, p = .035), and "higher self-efficacy for managing fatigue" (B = 2.80, p < .001) in the Tobit regression analysis. The results suggest that interventions to increase self-efficacy should involve developing programs and policies for people living with HIV. There is a need for efforts to provide healthcare services linked to employment support, as well as to establish a social environment in which they can work without stigma. Further, self-help groups could be utilized as intervention channels.

Network science and explainable AI-based life cycle management of sustainability models.

Model-based assessment of the potential impacts of variables on the Sustainable Development Goals (SDGs) can bring great additional information about possible policy intervention points. In the context of sustainability planning, machine learning techniques can provide data-driven solutions throughout the modeling life cycle. In a changing environment, existing models must be continuously reviewed and developed for effective decision support. Thus, we propose to use the Machine Learning Operations (MLOps) life cycle framework. A novel approach for model identification and development is introduced, which involves utilizing the Shapley value to determine the individual direct and indirect contributions of each variable towards the output, as well as network analysis to identify key drivers and support the identification and validation of possible policy intervention points. The applicability of the methods is demonstrated through a case study of the Hungarian water model developed by the Global Green Growth Institute. Based on the model exploration of the case of water efficiency and water stress (in the examined period for the SDG 6.4.1 & 6.4.2) SDG indicators, water reuse and water circularity offer a more effective intervention option than pricing and the use of internal or external renewable water resources.

Three cycles of mobile app design to improve HIV self-management: A development and evaluation study.

Objective: Employing three cycles of Design Science Research (DSR) to develop a mobile app 'ESSC (Excellent Self Supervised HIV Care)' to improve self-management among people living with HIV (PLWH). Methods: This study is based on the DSR framework comprising three iterative cycles. In the Relevance cycle, PLWH participated in a survey of mobile health (mHealth) experiences and needs. In the Rigor cycle, the information-motivation-behavioural skills (IMB) model was applied to foundations of the app, and HIV specialists verified the contents. Experts evaluated the heuristic system and the app quality with the Mobile Application Rating Scale (MARS). In the Design cycle, ESSC was built on the findings of the other two cycles, and end-users tested the usability using uMARS. Results: The contents of the app were developed based on user requirements. The IMB model led ESSC to supplement motivational components for self-management, which built five functions: information contents; health life records including mental and sexual health; interactive counselling with healthcare providers; setting health goals after watching videos; and my page for self-reflection. To reduce social stigma and promote acceptance of the information-driven app, we created animated characters with neutral and bright features. The HIV specialists evaluated content validity as highly appropriate. The MARS score by the overall raters was between 3-acceptable and 4-good: functionality, 4.38; information, 4.12; aesthetics, 3.96; engagement, 3.37; and subjective quality, 3.25. Conclusions: The DSR approach is effective for implementing usable and useful mHealth. The ESSC app would be feasible and contribute PLWH to retention in care.

Natronomonas gomsonensis sp. nov., isolated from a solar saltern.

A halophilic archaeal strain, SA3(T), was isolated from sediment of a solar saltern in Gomso Bay, Republic of Korea. Cells of strain SA3(T) were observed to be coccoid-shaped, to lyse in distilled water, Gram stain-negative and to form red-pigmented colonies. Strain SA3(T) was found to require at least 18 % (w/v) NaCl for growth. Optimal growth was observed at 24 % (w/v) NaCl and 6 % (w/v) MgCl2. The optimum pH and temperature for growth were determined to be pH 7.0 and 40 °C, respectively, while the strain was found to grow within pH and temperature ranges of 5.5-8.0 and 20-45 °C, respectively. The polar lipids were determined to consist of phosphatidylglycerol, phosphatidylglycerol phosphate methyl ester, unidentified phosphoglycolipids and unidentified phospholipids. Phylogenetic analysis based on 16S rRNA gene sequences showed that strain SA3(T) was most closely related to the members of the genus Natronomonas, Natronomonas moolapensis JCM 14361(T) (95.2 %) and Natronomonas pharaonis JCM 8858(T) (95.1 %). The genomic DNA G+C content (61.8 mol%) determined for strain SA3(T) was slightly lower than those of N. moolapensis JCM 14361(T) (63.4 mol%) and N. pharaonis JCM 8858(T) (64.3 mol%). DNA-DNA hybridization values between N. moolapensis JCM 14361(T) and N. pharaonis JCM 8858(T) and strain SA3(T) were <20 %. Based on phenotypic, chemotaxonomic and phylogenetic properties, we describe a new species of the genus Natronomonas, represented by strain SA3(T) (=JCM 17867(T) = KCTC 4088(T)), for which we propose the name Natronomonas gomsonensis sp. nov.

Perspectives of Frontline Nurses Working in South Korea during the COVID-19 Pandemic: A Combined Method of Text Network Analysis and Summative Content Analysis.

PURPOSE: This study aimed to explore the perspectives of frontline nurses working during the novel coronavirus disease 2019 (COVID-19) pandemic. METHODS: An online qualitative study was conducted using a pragmatic approach. The data were collected in August 2021. Registered Korean nurses who provided direct nursing care to patients with confirmed COVID-19 were eligible for this study. An online survey was used to gather free-text data, which were then analyzed using machine-based network analysis and summative content analysis. RESULTS: The analysis examined the responses of 126 participants and led to the identification of six prominent themes. These themes were further classified into three distinct levels: personal, task, and organizational. The identified themes are as follows: "collapse of personal life," "being overwhelmed by the numerous roles required," "personal protective equipment was sufficiently provided, but that is not enough," "changes in interprofessional collaboration," "inappropriate workforce management," and "diverted allocation of healthcare services and resources." CONCLUSION: Our findings highlight areas for improvement in resources, systems, and policies to enhance preparedness for future pandemics.

Personal Factors and Clinical Learning Environment as Predictors of Nursing Students' Readiness for Practice: A Structural Equation Modeling Analysis.

PURPOSE: It is essential to ensure the readiness for practice among undergraduate nursing students since the purpose of such education is to cultivate competent nurses who deliver high-quality and safe nursing. Astin's theory of student involvement suggests that this is affected by their personal factors and learning environment. METHODS: We conducted a cross-sectional study between November 16, 2020 and December 21, 2020 which examined personal factors and aspects of the clinical learning environment among senior nursing students (n = 838) enrolled across 54 nursing schools in Korea. The participants were asked to fill out a self-administered online survey, which assessed demographic characteristics, self-esteem, depression, work-life balance, clinical learning environment, anxiety during clinical practicum, and readiness for practice. Readiness for practice was measured using the Casey-Fink Readiness for practice survey. We used structural equational modeling to test our hypothetical model. RESULTS: The nursing students' readiness for practice was significantly affected by their self-esteem, work-life balance satisfaction, and clinical learning environment. Anxiety during clinical practicum directly influenced their readiness for practice. CONCLUSION: Increasing self-esteem and work-life balance satisfaction, and improving their clinical learning environment by providing sufficient educational and clinical support, could help facilitate the transition from nursing schools to real-world practice for nursing students.

Functional Characterization of Drosophila melanogaster CYP6A8 Fatty Acid Hydroxylase.

Genomic analysis indicated that the genome of Drosophila melanogaster contains more than 80 cytochrome P450 genes. To date, the enzymatic activity of these P450s has not been extensively studied. Here, the biochemical properties of CYP6A8 were characterized. CYP6A8 was cloned into the pCW vector, and its recombinant enzyme was expressed in Escherichia coli and purified using Ni2+-nitrilotriacetate affinity chromatography. Its expression level was approximately 130 nmol per liter of culture. Purified CYP6A8 exhibited a low-spin state in the absolute spectra of the ferric forms. Binding titration analysis indicated that lauric acid and capric acid produced type І spectral changes, with Kd values 28 ± 4 and 144 ± 20 µM, respectively. Ultra-performance liquid chromatography-mass spectrometry analysis showed that the oxidation reaction of lauric acid produced (ω-1)-hydroxylated lauric acid as a major product and ω-hydroxy-lauric acid as a minor product. Steady-state kinetic analysis of lauric acid hydroxylation yielded a kcat value of 0.038 ± 0.002 min-1 and a Km value of 10 ± 2 µM. In addition, capric acid hydroxylation of CYP6A8 yielded kinetic parameters with a kcat value of 0.135 ± 0.007 min-1 and a Km value of 21 ± 4 µM. Because of the importance of various lipids as carbon sources, the metabolic analysis of fatty acids using CYP6A8 in this study can provide an understanding of the biochemical roles of P450 enzymes in many insects, including Drosophila melanogaster.

Examine Race/Ethnicity Disparities in Perception, Intention, and Screening of Dementia in a Community Setting: Scoping Review.

BACKGROUND: Delayed detection and diagnosis of Alzheimer's Disease and related dementia (ADRD) can lead to suboptimal care and socioeconomic burdens on individuals, families, and communities. Our objective is to investigate dementia screening behavior focusing on minority older populations and assess whether there are ethnic differences in ADRD screening behavior. METHODS: The scoping review method was utilized to examine ADRD screening behavior and contributing factors for missed and delayed screening/diagnosis focusing on race/ethnicity. RESULTS: 2288 papers were identified, of which 21 met the inclusion criteria. We identified six dimensions of ADRD screening behavior: Noticing Symptoms, Recognizing a problem, Accepting Screen, Intending Screen, Action, and Integrating with time. Final findings were organized into study race/ethnicity, theoretical background, the methods of quantitative and qualitative studies, description and measures of ADRD screening behavior, and racial/ethnic differences in ADRD screening behavior. CONCLUSIONS: A trend in ethnic disparities in screening for ADRD was observed. Our findings point to the fact that there is a scarcity of studies focusing on describing ethnic-specific ADRD screening behavior as well as a lack of those examining the impact of ethnicity on ADRD screening behavior, especially studies where Asian Americans are almost invisible.