Earticle

목적: 당 기반 구조, 즉 XAX(Xylitylglucoside-Anhydroxylitol-Xylitol)가 피부 장벽 기능과 보습에 미치는 영향을 in vitro 및 in vivo 에서 조사하고 글리세린과의 효능을 비교하고자 하였다. 방법: RT-qPCR 분석을 통해 인공피부모델에서의 유전자발현을 측정하 였다. 크로마토그래피를 통해 국소 처리된 인간 피부 외식편에서 세라마이드 신합성을 측정하였다. 기본 세포 배양에서 필수 단 백질의 생산을 모니터링하였다. 즉 크로마토그래피를 사용하여 섬유아세포의 콘드로이틴 설페이트 및 히알루론산을 측정하였고, ELISA를 사용하여 케라티노사이트의 히알루론산을 측정하였다. 피부가 건조한 25명의 여성 지원자를 대상으로 표피 미세부조, 피 부 정전용량 및 경표피 수분 손실(TEWL)을 측정하였다. 그리고 하이드로알코올성 젤과 비교하여 손의 피부 정전용량과 TEWL도 측정하였다. 결과: XAX는 효소, 케라티노사이트 간 접합의 구조적 구성 요소 또는 조절인자, 각질층, 박리 과정, 피부 장벽 기능 및 수분 공급과 같은 주요 보습 관련 유전자의 발현을 증가시켰습니다. 또한 세라마이드, 히알루론산, 황산콘드로이친의 함량을 높였 다. 생체 내에서 3%의 XAX 처리는 TEWL을 감소시켰고 피부 용량, 피부 미세부조 및 박리를 증가시켰다. XAX+글리세린의 조합 (1.5% + 1.5%)은 글리세린 단독에 비해 흥미로운 효과를 보였다. 결론: XAX는 피부 장벽 기능과 관련된 생물학적 경로에 대한 효 과를 촉진했다. 표피 및 진피 수분 저장고 및 표피 물 순환. 생체 내에서 확인된 그 효과는 단독으로 그리고 글리세린과 함께 기본 피부 연화제, 습윤제 및 폐색제에 대한 흥미로운 대안이 된다고 사료된다

Purpose: The study aimed to investigate the effects of a sugar-based structure, i.e. XAX (Xylitylglucoside-Anhydroxylitol-Xylitol) on skin barrier function and moisturization, both in vitro and in vivo , and to compare its efficacy with that of glycerin. Methods: Expression of genes was investigated by RT-qPCR analysis on topically-treated human reconstructed epidermis. Ceramide neosynthesis was measured by chromatography in topically-treated human skin explants. Production of essential proteins was monitored in primary cell cultures: Chondroitin sulfate and hyaluronic acid in fibroblasts, using chromatography; hyaluronic acid in keratinocytes, using ELISA. In vivo , epidermal microrelief, skin capacitance and transepidermal water loss (TEWL) were measured on 25 female volunteers with dry skin. Skin capacitance and TEWL were also measured, on hands, comparing hydroalcoholic gels. Results: XAX increased the expression of key moisturizing-related genes, such as enzymes, structural components or regulators of inter-keratinocytes junctions, cornified layer, desquamation process, as well as skin barrier function and hydration. It also increased the contents of ceramides, hyaluronic acid and chondroitin sulfate. In vivo , XAX treatment at 3% decreased TEWL and increased skin capacitance, skin microrelief and desquamation. The combination of XAX+glycerin (1.5%+1.5%) showed interesting effects compared to glycerin alone. Conclusion: XAX promoted effects on the biological pathways involved in skin barrier function; epidermal and dermal water reserves; and epidermal water circulation. Its effectiveness, confirmed in vivo , alone and in combination with glycerin, makes it an interesting alternative to basic emollients, humectants and occlusives.

目的: 本研究旨在研究基于糖的结构，即 XAX（木糖基葡萄糖苷-脱羟基木糖醇-木糖醇）在体外和体内对皮肤屏 障功能和保湿的影响，并将其功效与甘油进行比较。方法: 通过 RT-qPCR 分析对局部处理的人类重建表皮进行 基因表达研究。在局部处理的人皮肤外植体中通过色谱法测量神经酰胺新合成。在原代细胞培养物中监测必需 蛋白质的产生：使用色谱法测定成纤维细胞中监测硫酸软骨素和透明质酸； 使用ELISA角质形成细胞中的透明 质酸。对25名皮肤干燥的女性志愿者测量了表皮微起伏、皮肤电容和经表皮水分流失 (TEWL)。还测量了手上的 皮肤电容和TEWL，并比较了醇凝胶。结果: XAX增加了关键保湿相关基因的表达，例如角质形成细胞间连接、 角化层、脱屑过程以及皮肤屏障功能和水合作用的酶、结构成分或调节因子。它还增加了神经酰胺、透明质酸 和硫酸软骨素的含量。3%的XAX处理降低了TEWL并增加了皮肤电容、皮肤微观缓解和脱屑。与单独使用甘油相 比，XAX+甘油(1.5%+1.5%)的组合显示出有趣的效果。结论: XAX对涉及皮肤屏障功能的生物学通路即表皮和真 皮水储备、表皮水循环有促进作用。证实，无论是单独使用还是与甘油结合使用，使其成为基本润肤剂、保湿 剂和封闭剂的有趣替代品。

Application of ceramic materials for fabrication of dental restoration materials has been a focus of interest in the field of esthetic dentistry. The ceramic materials of choice are glass ceramics, spinel, alumina, and zirconia. The development of yttrium tetragonal zirconia polycrystal (YTZP)-based systems is a recent addition to all-ceramic systems that have high strength and are used for crowns and fixed partial dentures. Computer-aided design/ computer-aided manufacturing (CAD/CAM)-produced, YTZP-based systems are popular with respect to their esthetic appeal for use in stress-bearing regions. The highly esthetic nature of zirconia and its superior physical properties and biocompatibility have enabled the development of restorative systems that meet the demands of today’s patients. Many in vitro trials have been performed on the use of zirconia; however, relatively fewer long-term clinical studies have been published on this subject. The use of zirconia frameworks for long-span fixed partial dentures is currently being evaluated; in the future, more in vivo research and long-term clinical studies are required to provide scientific evidence for drawing solid guidelines. Further clinical and in vitro studies are required to obtain data regarding the long-term clinical use of zirconia-based restorations.

목적: 본 논문에서는 한국인 여성들을 대상으로 연령별로 나타나는 얼굴 노화 정도에 대한 인식과 임상학적 특성을 밝히고자 하였 다. 방법: 참고문헌 조사를 통해, 얼굴에서 나타나는 노화의 세부 부분 및 정도를 결정하였다. 이를 기반으로, 4지선다 형식의 설문 지를 개발하였으며, 각 부분에서 나타나는 노화의 정도를 4수준(낮음, 중간, 높음, 아주 높음)으로 구분하게 하였다. 40명의 한국인 여성을 대상으로 본인이 가지는 얼굴에 대한 노화 인식 정도를 설문지를 통해 측정하였다. 또한, 얼굴 노화 인식과 실제 연령별 피 부 노화 정도와의 관계성을 알아보기 위해, 임상학적 측정을 통해 관찰하였다. 결과: 참고문헌 조사를 통해 나이가 증가함에 딸 얼 굴에 나타나는 노화는 세부적으로 10부분(눈 밑 주름, 눈꼬리 주름, 미간 주름, 팔자 주름, 볼 부위 기미, 볼 부위 피부톤, 입술 주름, 이중턱 부위의 피부 처짐, 눈 밑 다크서클, 코 옆 부위의 모공 크기) 에서 나타남을 알았다. 설문조사를 통한 얼굴 노화 정도에 대한 인식을 평가한 결과, 10부분 모든 항목 내 노화의 정도와 평가자의 연령대가 비례적인 관계로 나타났다. 이러한 결과를 바탕으로, 얼굴의 노화 정도와 실제 나이와의 연관성을 임상학적으로 증명하고자, 평가자의 얼굴 내 노화 정도를 ANTERA-3D 측정기기를 이용하여 측정하였으며, 연령대가 증가할 수록 얼굴 내 세부 노화 정도도 비례적으로 증가함을 보였다. 결론: 따라서, 본 연구 결과는 노화가 진행되면서 나타나는 얼굴 내 세부적인 10부분에 대한 노화 정도 인식 및 임상학적 특성은 연령에 따라 증가함을 나타낸다.

Purpose: In this study, we tried to reveal the levels of the perception and clinical characteristics of facial skin aging among adult Korean women according to age. Methods: Using literature reviews, we determined the different levels of each facial skin aging sign is related to the chronological age of individuals, and developed the multiple-choice chart based on the four different levels; low, medium, high and very high. Forthy Korean participants were asked to describe their perceived levels of the aged signs using the chart. Also, clinical study was conducted to investigate the changes of the aged signs according to age-group among the participants. Results: We found that age-related structural changes on a human face were shown on the ten different regions, including wrinkles in the outer corner and bottom of eyes, wrinkles between the eyebrows, nasolabial lines, pigmentation and skin texture on cheeks, lip lines, sagging on a double chin, pore sizes on the nose, dark circles under the eyes. The survey results showed that the aged levels of all 10 categories were described to be increased as participant-age increases. To verify the results, we clinically tested whether the facial skin aging signs have a tendency to increase with the chronological age using an ANTERA-3D device, and found that the aged levels of the signs were specifically increased with the chronological age. Conclusion: Therefore, our results suggested that the perceived and clinical levels on the 10 regions of facial skin aging were relate to the chronological age.

目的: 在这项研究中，我们试图根据年龄显示成年韩国女性面部皮肤老化的感知水平和临床特征。方法: 利用文 献综述，确定每个面部皮肤老化征的不同水平与个体的实际年龄有关，并根据四个不同的水平制定多项选择图; 低，中，高和非常高。有意向的韩国参与者被要求使用图表描述他们对老年人体征的感知水平。此外，进行了 临床研究以调查参与者中根据年龄组的老年体征的变化。结果: 我们发现人脸上与年龄相关的结构变化显示在 十个不同的区域，包括眼角外侧和眼底皱纹，眉毛之间的皱纹，鼻唇沟线，色素沉着和脸颊上的皮肤纹理，唇 线，双下巴下垂，鼻子上的毛孔，眼睛下方的黑眼圈。调查结果显示，随着参与者年龄的增加，所有10个类别 的老年人水平都有所增加。为了验证结果，我们临床测试了面部皮肤老化迹象是否有使用ANTERA-3D装置随着 实际年龄增加的趋势，并且发现老化的体征水平随着实际年龄而特别增加。结论: 因此，我们的研究结果表明， 面部皮肤老化的10个区域的感知和临床水平与实际年龄有关。

Overproduction of reactive oxygen species (ROS) induces malfunctioning of the cell, thus leading to a number of pathological conditions such as oxidative-stress related disorders. A well- defined example of cellular damage is lipid peroxidation. Malondialdehyde (MDA) is a stable by-product of lipid peroxidation which easily combines with thiobarbituric acid reactive substances (TBARS) giving a fluorescent red derivative that can assayed spectrophotometrically. On the basis that urinary MDA can be a direct indicator of oxidative stress, we measured urinary MDA using recently developed urinary MDA analyzer and TBARS kit respectively, and studied correlations between two methods on 27 healthy volunteers. As a result highly accurate and reproducible results were obtained from the analyzer with the mean concentration of 451.20 ± 3.35 free radical point (FP) equivalent to 43.95 % normalized data. The detected values was correlated to TBARS kit method with the mean value of 6.632 ± 0.956 (36.60% normalized data) and the correlation value shows positive association with medium strength, r = 0.3126. The Urinary MDA analyzer works on same principle with colorimetric detection of MDA using TBARS, however the analyzer has short analysis time and the possible artifactual formation of MDA during heating with colorimetric TBARS method is abrogated. This is the first analyzer introduced that can detect urinary MDA, clinically implying its effectiveness and specificity in screening and monitoring oxidative stress-related diseases.

Objective To determine the optimal stimulation and recording site for infrapatellar branch of saphenous nerve (IPBSN) conduction studies by a cadaveric study, and to confirm that obtained location is practically applicable to healthy adults. Methods Twelve lower limbs from six cadavers were studied. We defined the optimal stimulation site as the point IPBSN exits the sartorius muscle and the distance or ratio were measured on the X- and Y-axis based on the line connecting the medial and lateral poles of the patella. We defined the optimal recording site as the point where the terminal branch met the line connecting inferior pole of patella and tibial tuberosity, and measured the distance from the inferior pole. Also, nerve conduction studies were performed with obtained location in healthy adults. Results In optimal stimulation site, the mean value of X-coordinate was 55.50±6.10 mm, and the ratio of the Y-coordinate to the thigh length was 25.53%±5.40%. The optimal recording site was located 15.92±1.83 mm below the inferior pole of patella. In our sensory nerve conduction studies through this location, mean peak latency was 4.11±0.30 ms and mean amplitude was 4.16±1.49 mV. Conclusion The optimal stimulation site was located 5.0?6.0 cm medial to medial pole of the patella and 25% of thigh length proximal to the X-axis. The optimal recording site was located 1.5?2.0 cm below inferior pole of patella. We have also confirmed that this location is clinically applicable.

Objective To investigate the question of whether serum leptin levels might be associated with post-stroke depression.Methods We studied 130 patients who experienced a first episode of stroke of more than three months’ duration, without any previous history of depression or speech disorders. Data were collected regarding the patient demographics, depressive mood (Diagnostic and Statistical Manual of Mental Disorders 4th edition [DSM-IV] criteria and Beck Depression Inventory) and serum leptin levels measured by an enzyme-linked immunosorbent assay (ELISA). In addition, the Korean version of Modified Barthel Index (K-MBI) and Korean version of Mini-Mental State Examination (K-MMSE) were used to assess the subjects’ independence, in regard to the activities of daily living and cognition. A statistical analysis was performed to determine differences the serum leptin levels between patients with depression and those without depression, and to determine the difference in the MBI and K-MMSE scores between the groups separated according to the serum leptin levels.Results Higher serum leptin levels were observed in patients with depression, compared with those without depression (38.5 ng/mL [range, 25.1?59.2 ng/mL] vs. 8.2 ng/mL [range, 4.9?17.8 ng/mL]; p<0.01. The serum leptin level showed an association with depression (odds ratio, 1.21; 95% confidence interval, 1.01?1.45; p=0.021). The K-MMSE and K-MBI improvement scores were lower, with statistical significance, in the group with the highest leptin level (>30 mg/dL), compared to the other two groups.Conclusion High serum leptin levels are associated with depression after stroke, and patients with elevated serum leptin levels were disadvantaged in regard to functional and cognitive outcomes.

Objective To predict the probability of lymphedema development in breast cancer patients in the early post-operation stage, we investigated the ability of quantitative lymphoscintigraphic assessment.Methods This retrospective study included 201 patients without lymphedema after unilateral breast cancer surgery. Lymphoscintigraphy was performed between 4 and 8 weeks after surgery to evaluate the lymphatic system in the early postoperative stage. Quantitative lymphoscintigraphy was performed using four methods: ratio of radiopharmaceutical clearance rate of the affected to normal hand; ratio of radioactivity of the affected to normal hand; ratio of radiopharmaceutical uptake rate of the affected to normal axilla (RUA); and ratio of radioactivity of the affected to normal axilla (RRA). During a 1-year follow-up, patients with a circumferential interlimb difference of 2 cm at any measurement location and a 200-mL interlimb volume difference were diagnosed with lymphedema. We investigated the difference in quantitative lymphoscintigraphic assessment between the non-lymphedema and lymphedema groups.Results Quantitative lymphoscintigraphic assessment revealed that the RUA and RRA were significantly lower in the lymphedema group than in the non-lymphedema group. After adjusting the model for all significant variables (body mass index, N-stage, T-stage, type of surgery, and type of lymph node surgery), RRA was associated with lymphedema (odds ratio=0.14; 95% confidence interval, 0.04?0.46; p=0.001).Conclusion In patients in the early postoperative stage after unilateral breast cancer surgery, quantitative lymphoscintigraphic assessment can be used to predict the probability of developing lymphedema.

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Purpose: This study aimed to create a Vietnamese version of both the Maslach Burnout Inventory- General Survey (MBI-GS) and Areas of Worklife Scale (AWS) to assess the burnout state of Vietnamese clinical nurses and to develop a causal model of burnout of clinical nurses. Methods: We conducted a descriptive design using a cross-sectional survey. The questionnaire was hand divided directly by nursing departments to 500 clinical nurses in three hospitals. Vietnamese MBI-GS and AWS were then examined for reliability and validity. We used the revised exhaustion þ1 burnout classification to access burnout state.We performed path analysis to develop a Vietnamese causal model based on the original model by Leiter and Maslach's theory. Results: We found that both scales were reliable and valid for assessing burnout. Among nurse participants, the percentage of severe burnout was 0.7% and burnout was 15.8%, and 17.2% of nurses were exhausted. The best predictor of burnout was “on-duty work schedule” that clinical nurses have to work for 24 hours. In the causal model, we also found similarity and difference pathways in comparison with the original model. Conclusion: Vietnamese MBI-GS and AWS were applicable to research on occupational stress. Nearly one-fifth of Vietnamese clinical nurses were working in burnout state. The causal model suggested a range of factors resulting in burnout, and it is necessary to consider the specific solution to prevent burnout problem.

목적: 안와 협골 복합체 골절 후 안면 통증 및 감각이상이 동반된 환자에서의 안와하 순목 반사 검사와 임상 신경감각 검사 사이의 연관성에 대해 알아보고자 하였다. 대상 및 방법: 20명의 안와 협골 복합체 골절이 있는 환자와 16명의 건강한 정상인을 대상으로 임상 신경감각 검사(clinical neurosensory test) 및 안와하 순목 반사 검사(infraorbital blink reflex study)를 시행하였다. 임상 신경감각 검사로는 주관적인 감각 손상 점수 측정과 두점 식별 검사를 시행하였으며, 감각 손상 점수 측정은 무감각(0점), 감각 이상(1점), 감각 저하(2점), 정상(3점)으로 기록하였다. 안와하 순목 검사를 대상자 모두 양측에서 시행하여 early response(R1) 과 bilateral late response(R2, contralateral R2) 파형의 잠시를 기록하여 비교하였다. 결과: 두점 식별 검사 결과는 환자군과 정상인군에서 각각 평균 20.50± 6.11 mm, 8.15± 3.43mm이었다. 임상 신경감각 검사 의 각 검사 결과에서 주관적 무감각증(0점)을 호소하는 1명을 제외한 19명에서 감각저하(2점)를 보고하였다. 정상인에서의 R1, R2 contralateral R2(cR2) 잠시는 좌측은 각각 9.88± 1.79 milisecond (msec), 27.62± 4.86 msec, 26.70± 5.15 msec 이었고, 우측은 9.80± 1.79 msec, 26.91± 4.88 msec, 25.78± 4.73 msec 이었으며 좌우측 차이는 각각 0.61± 0.51 msec, 1.70± 1.10 msec, 1.85± 1.93 msec 이었다. 환자군에서의 R1, R2 및 cR2 잠시는 정상측에서 10.47 ± 2.54 msec, 28.05 ± 3.66 msec, 28.02 ± 4.77 msec 이었고 환측에서는 11.53± 3.54 msec, 30.73± 6.04 msec, 30.24± 7.99 msec 이었다. 환자군에서의 정상측과 환측간의 R1, R2, cR2 각각에서의 차이는 1.06± 1.00 msec, 2.68± 2.38 msec, 2.22± 3.22msec 이었다. 정상군의 결과를 기초로 하였을 때, R1 잠시의 정상 범위는 8.07􀅭11.61 msec 이었으며, R1 잠시의 양측차는 0􀅭1.13 msec, R2 잠시의 양측차는 0􀅭2.8 msec 으로 관찰되었다. 20명의 환자 중에서 R1의 이상소견을 보인 사람은 14명으로, 4명에선 무반응, 10명에서는 잠시 지연이 보였다. R2의 이상소견을 보인 9명 중 4명에서는 무반응을 5명에서는 잠시 지연이 관찰됨으로서 총17명에서 이상소견을 보였다. Pearson's correlation통계 방법을 이용하여 17명에서 두점 식별 검사 점수와 환측에서의 R1 잠시 지연 사이의 의미있는 상관 관계(correlation coefficient 0.64)가 관찰되었다. 결론: 두점 식별 검사와 R1 잠시 지연 사이의 의미있는 상관관계가 관찰되며 이는 비정상 안와하 순목 반사 검사 소견이 안와 협골 복합체 골절이 있는 환자에서 동반된 안와하 신경 병변을 발견하는데 도움이 되며, 따라서 임상에서 이러한 평가 방법의 활용이 권장된다.

Objective To analyze association between urodynamic study (UDS) parameters and renal function in spinal cord injured (SCI) patients with neurogenic detrusor overactivity.Methods Patients with a suprasacral SCI, who underwent UDS and radioisotope renogram at least twice between January 1, 2006 and January 31, 2013, were included. UDS (cystometric capacity, reflex volume, compliance, and maximal detrusor pressure) and radioisotope renogram (total effective renal plasma flow [ERPF] of both kidneys) data were collected. The following were conducted to reanalyze any association between reflex volume and ERPF: initial and follow-up results of consecutive evaluations were compared; a mixed-model regression analysis to account for clustered data was conducted to evaluate the association between UDS parameters and ERPF; and finally, a mixed-model analysis type 3 test with data pairs, of which the first evaluation showed involuntary detrusor contraction.Results A total of 150 patients underwent 390 evaluations which were arranged into 240 pairs of consecutive evaluations, of which 171 had first evaluations with observed involuntary detrusor contraction. The following results were obtained: cystometric capacity was significantly larger and maximal detrusor pressure was significantly lower on follow-up; on univariate analysis, reflex volume and maximal detrusor pressure were significant, and multivariate analysis using these two parameters showed that maximal detrusor pressure is significantly associated with total ERPF; and no significant differences were observed.Conclusion Maximal detrusor pressure should be closely monitored in the urologic management of neurogenic detrusor overactivity in SCI patients. The results also may serve as a reference for regular UDS follow-up.

Purpose The purpose of the paper is to discover the patterns and processes of decision-making in clinical nursing practice. Methods A set of think-aloud data from five critical care nurses during 40 to 50 minutes of caregiving in intensive care units were obtained and analyzed by applying the procedures recommended by Ericsson and Simon for protocol analysis. Results Four thinking processes before acting were identified to constitute various sorts of thoughts in which the nurses were engaged during patient care: reviewing, validation, consideration, rationalization, and action. In addition, three patterns of sequential streaming of thinking (short, intermediate, long) were identified to reveal various ways the nurses dealt with clinical situations involving nursing tasks and responsibilities. Conclusion This study specifies the initial categories of thoughts for each of the processes and various patterns with which these processes are sequentially combined, providing insights into the ways nurses think about problems and address their concerns. The findings suggest that the thinking in clinical practice involves more than focused decision-making and reasoning, and needs to be examined from a broader perspective.

Purpose: This survey study aimed to investigate the current status, issues, and needs related to Clinical Endoscopy (CE), the official international journal of the Korean Society of Gastrointestinal Endoscopy (KSGE). Methods: A 10-item survey was emailed to domestic KSGE members between May 1 and May 15, 2023. The results were analyzed using descriptive statistics. Results: In total, 216 complete responses were analyzed. Most respondents (46.8%) read CEonce or twice monthly. The proportion of respondents who read the journal once or twice a year or did not read it at all was quite high, at 36.6%. The most informative article type was re-view articles (53%), and the least-read type was editorials (33%). Ninety-nine respondents (45.8%) stated that they did not want to submit their articles to CE because CE is not a Science Citation Index Expanded (SCIE) journal (38.4%). Eighty-nine respondents (41.2%) did not cite CE articles in their manuscripts. Furthermore, 41.2% of the respondents declined review invitations because they were too busy (73.0%). The two most common requests for CE were to increase the number of guidelines and review articles (38.0%) and to improve the journal quality (34.7%). Conclusion: Although CE is a representative journal of KSGE, the level of interest and concern for CE among society members was relatively low. Nonetheless, this survey offers valuable insights into the needs and current status of CE, paving the way for its further development. It is clear that more efforts and investments from the society and the editorial board are necessary.

Purpose: This study examined the relationships among nurses’ readiness for artificial intelligence (AI), attitudes toward AI, and behavioral intention to use AI, focusing on clinical nurses in a tertiary hospital setting.Methods: A cross-sectional descriptive study was conducted using an online self-report survey of 218 clinical nurses recruited through convenience sampling from a tertiary hospital in South Korea. AI readiness was measured using the Medical Artificial Intelligence Readiness Scale, attitudes toward AI were assessed using the Korean version of the General Attitudes toward Artificial Intelligence Scale, and behavioral intention was measured using items adapted from the Unified Theory of Acceptance and Use of Technology. Open-ended responses were summarized descriptively to explore expected AI applications.Results: Clinical nurses demonstrated varying levels of AI readiness, attitudes toward AI, and behavioral intention to use AI, and these variables were positively correlated. Among AI readiness dimensions, ability and ethics tended to show stronger bivariate correlations with behavioral intention than vision. Hierarchical regression analysis indicated that attitudes toward AI were strongly associated with behavioral intention (β=.61, p<.001), whereas AI readiness factors showed weaker associations after attitudes were included. Open-ended responses suggested potential AI applications in both direct and indirect nursing care.Conclusion: Attitudes toward AI were strongly associated with nurses’ behavioral intention to use AI. AI readiness dimensions, particularly ability and ethics, were also associated with behavioral intention in correlation analyses, underscoring the importance of practical competence and ethical awareness. These findings provide empirical evidence to inform AI-related education, clinical integration, and organizational support strategies in nursing.

Lowenfeld developed sandplay therapy as a technique that allows children's multidimensional thoughts and emotions to be expressed more freely, while at the same time combining not only visual but also tactile and sensory factors. Since then, sandplay therapy has been used as a psychotherapy technique in various clinical settings around the world, but there has been no evidence-based research on sandplay therapy and sensory processing ability. This study investigated the clinical effects of school sandplay group counseling on sensory processing abilities in 20 sixth-grade elementary school students with suicide ideation. School sandplay group counseling was conducted for 8 sessions in 12 weeks, from March 2023, to June 2023. The subjects were sixth-grade students with suicide ideation from an elementary school in Chungcheongbuk-do, South Korea, with a single group of 10 males (50%) and 10 females (50%) without a control group. The average age of the participants was 11.74, with a range of 11.25-12.15. The Korean version of the SIQ-JR and the Korean version of the AASP were used as pretest and posttest instruments. The data were analyzed using SPSS 29.0. the paired-sample t-tests indicated statistically significant changes in low registration (p = .025), and suicide ideation (p = 0.017). The results of this study suggest that school sandplay group counseling may have clinical effects on sensory processing abilities and suicide ideation in elementary school children with suicide ideation.

Objective To evaluate the potential feasibility of application of the extended International Classification of Functioning, Disability and Health (ICF) Core Set for stroke.Methods We retrospectively reviewed the medical records of 40 stroke outpatients (>6 months after onset) admitted to the Department of Rehabilitation Medicine for comprehensive rehabilitation. Clinical information of the patients were respectively evaluated to link to the 166 second-level categories of the extended ICF Core Set for stroke. Results Clinical information could be linked to 111 different ICF categories, 58 categories of the body functions component, eight categories of the body structures component, 38 categories of the activities and participation component, and seven categories of the environmental factors component. Conclusion The body functions component might be feasible for application of the extended ICF Core Set for stroke to clinical settings. The activities and participation component and environmental factors component may not be directly applied to clinical settings without additional evaluation tools including interview and questionnaire.

Purpose This study aimed to explore the experience of clinical nurses regarding training programs for critically ill patients with coronavirus disease 2019 (COVID-19) and their educational needs. Methods Qualitative data were analyzed using content analysis, and quantitative data were analyzed according to Borich's formula. Data for the study were collected in March 2021 from 16 nurses who had completed a nursing program for critically ill patients with COVID-19 and were working at three hospitals designated for COVID-19. Results Participants' experiences were classified into three major categories, namely “Participation experiences and perceptions of the training program,” “Recommendations for improving the training program,” and “Perceptions of working in an infectious environment,” and 10 subcategories. According to Borich's formula, the most pressing educational needs in respiratory and non-respiratory nursing, respectively, were for “nursing care for patients on extracorporeal membrane oxygenation” and “application of continuous renal replacement therapy and caring for patients.” Conclusion To prepare for the periodic emergence of communicable infectious diseases throughout the world and cultivate nursing staff to care for critically ill patients, it is necessary to develop nursing education programs with content corresponding to nurses' needs. This study can be used as base data for cultivating nursing staff for critically ill patients with communicable infectious diseases in keeping with clinical nurses’ educational needs and basic educational materials for nursing students. Trial registration CRIS, KCT0006359. Registered 20 July 2021 - Retrospectively registered, https://cris.nih.go.kr/cris/

Purpose: The purpose of this study is to explore problems of clinical nurse performance appraisal system. Methods: This study employed a descriptive qualitative approach. The participants were purposively selected from clinical nurses working across all of the hospital units in a large metropolitan teaching hospital in Tehran, Iran in 2012. Data were collected using five focus group interviews, which were audio taped. The number of participants in each group ranged from 7 to 10. The semi-structured interviews were guided by a set of nondirective questions, and continued until the data reached saturation. Data were analyzed using framework analysis. Results: Four major themes regarding the problems of clinical nurse performance appraisal system emerged from the analysis of textual data. These themes were contextual problems, problems related to performance appraisal structure, problems related to performance appraisal process and those related to performance appraisal results. Conclusion: The findings of this study reveal that the nurse performance appraisal system confronts with various problems. Some of these problems are related to organizational context while the others concerned structure, process and results of the performance appraisal system. In order to achieve high quality of patient care as the final goal of performance appraisal, changing and revision of this system is necessary.

Objective To evaluate the effect of complex decongestive physiotherapy (CDPT) on malignant lymphedema patients. Methods Patients (n=22) with malignant lymphedema of the upper or the lower limb were assigned to this study. CDPT without manual lymphatic drainage (MLD) was used five times per week for two weeks. The main outcome measurements included measurement of the circumference of the limb (proximal, distal, and total) to assess volume changes. We also employed the visual analog scale (VAS) to evaluate pain, and the short form-36 version 2 questionnaire (SF-36) to assess quality of life (QOL). All items were assessed pre and post-treatment for each patient.Results There was a statistically significant difference in the volume change of the upper limbs (3.7%, p=0.001) and the lower limbs (10.9%, p=0.001). A 1.5 point reduction on the ten-point VAS was noted after CDPT. The scores on the physical and the mental components of the SF-36 showed statistical improvement after treatment (p=0.006, p=0.001, respectively).Conclusion These results suggest that all components of the CDPT program except MLD are helpful in treating malignant lymphedema in terms of pain reduction and reduction of the volume of the affected upper or lower limb. This treatment regimen also has positive effects on QOL.