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A study on oral discomfort in gynecological cancer patients undergoing chemotherapy (화학요법을 받는 부인암환자의 구강불편감에 관한 연구)

  • 정재원
    • Journal of Korean Academy of Nursing
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    • v.25 no.2
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    • pp.372-389
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    • 1995
  • The frequency with which administration of chemotherapy for gynecological cancer treatment is used has increased along with the use of surgery and radiotherapy Among the various side effects of chemotherapy, stomatitis causes a problem of function and sensation in the oral cavity. This oral discomfort can be categorized into two components ; perceived oral symptoms and observed oral symptoms. If the oral problem continues, it may cause infection, bleeding and nutritional deficiencies. As a result of this condition, compliance with the treatment process can be affected as well as the prognosis for the cancer patients. But as the oral discorrfort usually appears after chemotherapy, it is often not reported to the health care personnel as a patient problem. Without problem identification of the oral discomfort and ability to assess the problem, effective intervention cannot be planned. Therefore, this study was conducted to identify the pattern and the degree of oral discomfort due to cancer chemotherapy and thus to provide data for identification of the patient problem and for nursing assessment. The design of this study was a longitudinal de-scriptive study The subjects were in - patients who received chemotherapy under the diagnosis of gynecological cancer between Mar. 15, 1994 and May 15, 1994 at a general hospital in Seoul, Korea. The number of subjects was 64 and they were divided into two groups, one of 41 (A : 5FU & Neoplatin), the other of 23(B : Neoplatin, Cytoxan, Adriamycin), according to the treatment regimen. The data were collected for 24 days using self-re-port instruments. The instruments were the 「Perceived Oral Symptom Assessment Tool」 and 「Observed Oral Symptom Assessment Tool」 developed by this researcher. Data were analyzed using the SPSS-PC program, ANOVA, t-test, paired t-test and the Pearson Correlation Coefficient were applied. The results of this study are as follows : 1. In A regimen the peak time for perceived oral symptom scores was the fifth day after chemotherapy, and the tenth day for observed oral symptom scores. Both of the problems started on first day of chemotherapy and were not resolved completely until the 24th day after treatment. 2. In B regimen, the peak time for perceived oral symptom scores was on the seventh day after chemotherapy, and the eighth day for observed oral symptom scores. It was noted that perceived oral symptom scores were higher than observed oral symptom scores consistently for 24 days. Both also started on first day of chemotherapy, and were not resolved completely until the 24th day after chemotherapy. 3. There were no differences statistically in perceived oral symptom scores between A and B regimen. The loss of appetite and xerostomia caused the most severe discomfort in both of these two groups. 4. The were no differences statistically in observed oral symptom scores between the A and B regi moil. In the A regimen, the highest observed symptom scores were the lips, gingiva, tongue and buccal membrane in that order. But in the B regimen, the highest observed symptom scores were tongue, lips, buccal membrane and gingiva in that order. 5. In A regimen, the patients who had gingival edema and dentures had significantly higher perceived oral symptom scores. And those who had gingival edema and bleeding, foul odor and aphthous stomatitis had significantly higher observed oral symptom scores. 6. In B regimen, the patients who had the experience of stomatitis in the last course of chemotherapy had significantly higher perceived oral symptom scores. Those who had gingival edema had significantly higher observed oral symptom scores. 7. In the A regimen there was no correlation between lab values for lymphocytes and albumin with perceived oral symptom scores and observed oral symptom scores. In the B regimen, there was a significant negative correlation between lymphocytes and albumin with the observed oral symptom scores, but not between perceived oral symptom scores and lymphocytes and albumin values. In conclusion, the nurse should expect that the patient undergoing chemotherapy will complain severely about subjective discomfort and before objective physical change is observed. Also the patients who have chronic oral problems such as dentures, gingival edema and bleeding, foul odor, aphthous stomatitis will complain of severe oral discomfort due to chemotherapy.

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THE EFFECT OF A MENTAL HEALTH PROMOTION PROGRAM AT A MENTAL HEALTH MODEL MIDDLE SCHOOL (정신건강시범 중학교에서 수행된 정신건강 증진 프로그램의 효과)

  • Kwak, Young-Sook;Ko, Hey-Joung
    • Journal of the Korean Academy of Child and Adolescent Psychiatry
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    • v.16 no.2
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    • pp.251-260
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    • 2005
  • Objectives : This study was performed to evaluate the effects of a mental health program within a mental health model middle school. Methods : Subjects of the study consisted of 748 students from the second grade and third grade students at the middle school chosen for a school mental health program by the Ministry of Education in Jeju. The subjects participated in 12 consecutive sessions of group discussion developed to prevent mental health problems. The authors investigated the effects of the program by evaluating the students with Young's Internet Addiction Scale (IAS), Conners & Wells' Adolescent Self Report Scale(CASS) and Minnesota Multiphasic Personality Inventory (MMPI) before the initial session and after the final session. The data was analyzed by t-test in SPSS PC+ 10.0. The range of significance was p<.05. Results : In MMPI, the percentage of students above clinical range reduced from $12.9\%\;to\;11.0\%$. It reduced in the second grade students, but increased in the third grade students. The scores of paranoia and mania subscales showed a statistically significant reduction. In IAS, the percentage of students above the range of Internee overuse reduced from $16.0\%\;to\;6.8\%$. The percentage of students who showed risk of attention problems in CASS reduced from $22.7\%\;to\;18.3\%$. Also, both IAS and CASS scores showed a statistically significant reduction. The clinical significance of the reduction of IAS scores was within moderate range. Conclusion : The mental health program reduced the percentage of students' risk of mental health problems, internet addiction and attention problems and it was clinically effective on preventing Internet addiction. These results support the effects of a school mental health program to promote students' mental health. The authors suggest to expand this program to other schools, to reconfirm the effect of the program by using proper & specified instruments and to evaluate long-term effect of the program.

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Comparison of Deep Learning Frameworks: About Theano, Tensorflow, and Cognitive Toolkit (딥러닝 프레임워크의 비교: 티아노, 텐서플로, CNTK를 중심으로)

  • Chung, Yeojin;Ahn, SungMahn;Yang, Jiheon;Lee, Jaejoon
    • Journal of Intelligence and Information Systems
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    • v.23 no.2
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    • pp.1-17
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    • 2017
  • The deep learning framework is software designed to help develop deep learning models. Some of its important functions include "automatic differentiation" and "utilization of GPU". The list of popular deep learning framework includes Caffe (BVLC) and Theano (University of Montreal). And recently, Microsoft's deep learning framework, Microsoft Cognitive Toolkit, was released as open-source license, following Google's Tensorflow a year earlier. The early deep learning frameworks have been developed mainly for research at universities. Beginning with the inception of Tensorflow, however, it seems that companies such as Microsoft and Facebook have started to join the competition of framework development. Given the trend, Google and other companies are expected to continue investing in the deep learning framework to bring forward the initiative in the artificial intelligence business. From this point of view, we think it is a good time to compare some of deep learning frameworks. So we compare three deep learning frameworks which can be used as a Python library. Those are Google's Tensorflow, Microsoft's CNTK, and Theano which is sort of a predecessor of the preceding two. The most common and important function of deep learning frameworks is the ability to perform automatic differentiation. Basically all the mathematical expressions of deep learning models can be represented as computational graphs, which consist of nodes and edges. Partial derivatives on each edge of a computational graph can then be obtained. With the partial derivatives, we can let software compute differentiation of any node with respect to any variable by utilizing chain rule of Calculus. First of all, the convenience of coding is in the order of CNTK, Tensorflow, and Theano. The criterion is simply based on the lengths of the codes and the learning curve and the ease of coding are not the main concern. According to the criteria, Theano was the most difficult to implement with, and CNTK and Tensorflow were somewhat easier. With Tensorflow, we need to define weight variables and biases explicitly. The reason that CNTK and Tensorflow are easier to implement with is that those frameworks provide us with more abstraction than Theano. We, however, need to mention that low-level coding is not always bad. It gives us flexibility of coding. With the low-level coding such as in Theano, we can implement and test any new deep learning models or any new search methods that we can think of. The assessment of the execution speed of each framework is that there is not meaningful difference. According to the experiment, execution speeds of Theano and Tensorflow are very similar, although the experiment was limited to a CNN model. In the case of CNTK, the experimental environment was not maintained as the same. The code written in CNTK has to be run in PC environment without GPU where codes execute as much as 50 times slower than with GPU. But we concluded that the difference of execution speed was within the range of variation caused by the different hardware setup. In this study, we compared three types of deep learning framework: Theano, Tensorflow, and CNTK. According to Wikipedia, there are 12 available deep learning frameworks. And 15 different attributes differentiate each framework. Some of the important attributes would include interface language (Python, C ++, Java, etc.) and the availability of libraries on various deep learning models such as CNN, RNN, DBN, and etc. And if a user implements a large scale deep learning model, it will also be important to support multiple GPU or multiple servers. Also, if you are learning the deep learning model, it would also be important if there are enough examples and references.

Biological Activity of Oenothera Biennis Seed Extracts (달맞이꽃 종자 추출물의 생리활성)

  • Cho, Hyun-Dong;Kim, Du-Hyun;Kim, Min-Geun;Lee, Yong-Suk;Seo, Kwon-Il
    • Journal of Life Science
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    • v.28 no.9
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    • pp.1048-1055
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    • 2018
  • In the current study, comparisons of Oenothera Biennis seed extracts with water, ethanol, methanol, and 70% ethanol in their total polyphenolics contents, anti-oxidant, anti-neurotoxicity, anti-cancer, and immune-modulatory activities were investigated. Compared with other extracts, those concentrations of total phenolics and flavonoids were the highest in MeOH extract (31.90 mg GAE/g and 20.66 mg QE/g). The radical scavenging and reducing power activities were dose-dependently increased by treatment of O. Biennis seed water, EtOH, MeOH, and 70% EtOH extracts. Furthermore, pretreatment of water, EtOH, and MeOH extracts significantly reduced glutamate-induced cytotoxicity in HT22 hipocampal neuron cells. In the case of cancer cells, MeOH extracts showed lower $IC_{50}$ values in HepG2 ($74.21{\mu}g/ml$), A549 ($188.24{\mu}g/ml$), MCF-7 ($186.42{\mu}g/ml$), and B16 ($101.80{\mu}g/ml$) than other extracts, where those water ($101.96{\mu}g/ml$) and EtOH ($788.39{\mu}g/ml$) extracts showed the lowest $IC_{50}$ activity in HT-29 and PC-3 cells, respectively. O. Biennis seed extracts did not show any cytotoxicity in RAW 264.7 macrophages at the concentration of $1-10{\mu}g/ml$, whereas 70% EtOH extract dose-dependently enhanced nitric oxide (NO) production in RAW 264.7 cells. Overall, we evaluated that various bioactive potentials of O. Biennis seed extracts which would relate with phenolic compounds abundance, thus these can be useful to future developments as functional food ingredients and natural medicines.

Effects of Hagocho (Prunella vulgaris L.), Gamgook (Chrysanthemum indicum L.) and Galgeun (Pueraria Radix) on Plasma Lipid Compositin and Histological Consideration in Hyperlipidemic Rat (하고초, 감국 및 갈근 증류액이 비만쥐의 지질구성 및 각종 장기의 해부조직학적 소견에 미치는 영향)

  • Park, Chan-Hee;Kim, Nam-Young;Nam, Eun-Jeung;Kim, Sang-Hyeun;Lee, Ji-Hyang;Lee, Eun
    • Korean Journal of Plant Resources
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    • v.20 no.1
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    • pp.22-27
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    • 2007
  • Effects of prunella vulgaris L., chrysanthemum indicum L. and pueraria Radix on plasma lipid composition and histological consideration were investigated in hyperlipidemic rats. Concentration of plasma ${\beta},-lipoprotein$ showed a tendence to decrease in prunella vulgaris L., chrysanthemum indicum L. and pueraria Radix treatment groups. However these values were showed not significantly different from control group. Concentration of plasma FFA in prunella vulgaris L., chrysanthemum indicum L. and pueraria Radix treatment groups showed a lower values compared to control group and concentration of plasma FFA of prunella vulgaris L. and pueraria Radix treatment group showed a lower values than prunella vulgaris L. and chrysanthemum indicum L. treatment group. Concentration of plasma glucose and triglyceride showed a tendence to decrease in prunella vulgaris L., chrysanthemum indicum L. and pueraria Radix treatment groups. However plasma glucose values showed not significantly different from control group. Plasma total cholesterol concentration showed a low and HDL-cholesterol concentration showed a high in prunella vulgaris L. and pueraria Radix treatment group. However LDL-cholesterol concentrations were not significantly different in treatment groups. Histological consideration of heart, liver and kidney in prunella vulgaris L. and pueraria Radix treatment groups showed a good features in fat accumulation condition than those of other treatment groups. However in the condition of high fat accumulation in tissues, heart, liver and kidney were showed a slight congestion and a bashed cell nucleus.

Analyses on the Mean Length of Stay of and the Income Effects due to Early Discharge of Car Accident Patients at General Hospital (3차 병원에 입원한 교통사고환자의 평균 재원기간과 조기퇴원시의 수입증대효과 분석연구)

  • Ryu, Ho-Sihn
    • Research in Community and Public Health Nursing
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    • v.10 no.1
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    • pp.70-79
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    • 1999
  • This study attempts to encourage the development of a rehabilitation delivery system as a substitute service for hospitalization such as a community based intermediate facility or home health care. We need substitute services for hospitalization to curtail the length of stay for inpatients due to car accidents. It focused on developing an estimation for early discharge based on a detailed statement of treatment from medical records of 109 inpatients who were hospitalized at General Hospital in 1997. This study has three specific purposes: First, to find the mean length of stay and mean medical expenditure. Second, to estimate the mean of early discharge from the mean length of stay. Third, to analyize the income effect per bed from early discharge. In order to analyze the length of stay and medical expenditure of inpatients the author conducted a micro and macro-analysis with medical expenditure records. To estimate the early discharge we examined with a group of 4 experts decreases in the amount of treatment after surgery, in treatments, in tests, in drug methods. We also looked their vital signs, the start of ROM exercise, the time removel, a patient's visitations, and possible stable conditions. In addition to identifing the income effect due to an early discharge, the data was analyzed by an SPSS-PC for windows and Excell program with a regression analysis model. The research findings are as follows: First, the mean length of stay was 47.56 days, but the mean length of stay due to early discharge was 32.26 days. The estimation of early discharge days was shown to depend on the length of stay. The longer the length of stay, the longer the length before discharge. For example, if the patient stayed under 14 days the mean length of stay was 7.09 while an early discharge was 6.39, whereas if the mean length of stay was 155.73, the early discharge time was 107.43. The mean medical expenditure per day of car accident patients was found to be 169,085 Won, whereas the mean medical expenditure per day was shown to be in a negative linear form according to the length of stay. That is the mean expenditure for under 14 days of stay was 303,015 Won and the period of the hospitalization of 15 days to 29 days was 170,338 Won and those of 30 days to 59 days was 113,333 Won. The estimation of the income effect due to being discharged 16 days was around 2,350,000 Won with a regression analysis model. However, this does not show the real benefits from an early discharge, but only the income increasing amount without considering prime medical cost at a general hospital. Therefore, we need further analysis on cost containments and benefits incending turn over rates and medical prime costs. From these research findings, the following suggestions have been drawn, we need to develop strategies on a rehabilitation delivery system focused on consumers for the 21st century. Varions intermediate facilities and home health care should be developed in the community as a substitute for shortening the length of stay in hospitals. In home health care cases, patients who want rehabilitation services as a substitute for hospitalization in cooperation with private health insurance companies might be available immediately.

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The Effect of Benevolence and Communication on Commitment and Switching Intentions : The Automobile Parts Buyer's Perspective (자동차 부품 제조업체와 공급업체 간의 선의와 의사소통이 몰입과 교체의도에 미치는 영향: 구매자의 관점을 중심으로)

  • Kim, Hong-Keun;Lee, Phil-Soo;Kim, Min-Seong;Lee, Yong-Ki
    • Asia-Pacific Journal of Business Venturing and Entrepreneurship
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    • v.9 no.6
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    • pp.129-144
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    • 2014
  • This study is to examine the effect of mutualistic benevolence, altruistic benevolence, and communication on affective commitment, calculative commitment, and switching intentions and investigate how two commitment dimensions play mediating roles between two benevolence constructs and communication, and switching intentions. For these purposes the author developed a structural model which consists of several constructs. In this model, benevolence factor that consists of mutualistic benevolence and altruistic benevolence, and communication were proposed to affect two commitment constructs and result in, increase switching intentions. Thus, two commitment constructs(e.g., affective and calculative commitment) were proposed as core mediating variables between mutualistic benevolence, altruistic benevolence, and communication, and switching intentions. The data were collected from 210 automobile parts buyers and were analyzed using frequency, reliability, and confirmatory factor analysis and SEM (structural equation model) with SPSS/WIN 20.0 and AMOS 20.0. The data were analyzed with structural equation modeling with AMOS 20.0 and SPSS Win/PC 20.0. The result of the overall model analysis appeared as follows: ${\chi}2=224.885$, d.f=123(${\chi}2/df=1.828$), p=0.000, GFI=.898, AGFI=.859, IFI=.967, NFI=.930, TLI=.958, RMSEA=.063, CFI=.966. Since the result of the overall model analysis demonstrated a good fit, we could further analyze our data. The findings can be summarized as follows: According to structural equation modeling analysis, firstly, mutualistic benevolence has direct effects on calculate commitment and affective commitment. Secondly, altruistic benevolence has a positively direct effect on calculate commitment. Thirdly, communication has a statistically direct effect on affective commitment. Fourthly, calculative commitment has direct effects on affective commitment and switching intentions. Lastly, affective commitment has a direct effect on switching intentions.

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Effects of Nordic Walking Exercise on muscular strength, Flexibility, Balance and Pain in Older Woman with Knee Osteoarthritis (노르딕 워킹이 퇴행성 무릎 관절염 노인여성의 근력과 유연성, 균형 및 통증에 미치는 영향)

  • Oh, Yoo-Sung;Kim, Ji-sun;Jang, Woo-Seong
    • Journal of the Korean Applied Science and Technology
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    • v.36 no.4
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    • pp.1312-1326
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    • 2019
  • The purpose of this study is to examine whether the 12-week Nordic walking can improve the physical function and arthritis pain of elderly women with osteoarthritis This study were divided into randomly assigned Nordic Walking Exercise Group (n=9) and Control Group (n=7) for 16 Elderly women diagnosed with Osteoarthritis (age: 73±3.79 year, height: 154.3±4.09 cm). The exercise group used Nordic sticks to carry out 30 minutes of Nordic walking exercise three times a week for 12 weeks, and the kinetic intensity was set at 40-60% of HRR. The control group maintained daily life for the same period. Body composition (weight, percentage body fat, skeletal muscle mass), muscular strength, Flexibility (muscular strength of upper and lower limbs, flexibility of upper and lower limbs), balance ability (static balance, dynamic balance) and pain level were measured as subordinate variables. These indicators were measured twice before and after the exercise program. The study shows that percentage body fat and skeletal muscle mass in the body composition function over 12 weeks of Nordic walking exercise have significant effects after the exercise than before (p=004)(p=.003), and it also shows significant interaction effects between the groups and timings(p=.018)(p=.005). In muscular strength, Flexibility factors, there were significant effects between the groups and timings in the upper limb muscular strength and the lower limb flexibility (p=.009)(p=.036), and a significant difference between the exercise group and the control group(p=.006) in the lower limb muscular strength. In addition, in the upper limb flexibility, there was a more significant difference after the exercise than before(p=.020). There were improvement effects after the exercise than before in the balance ability and the static balance(p=.016), but no difference in the dynamic balance(p>.05). In pain, there was a significant improvement after the exercise than before(p=.022), and a significant difference between the exercise group and the control group(p=.013). In conclusion, the 12-week Nordic walking exercise has positive effects on the body composition functions of the elderly women with Osteoarthritis, and has a positive effect on the improvement of upper limb muscular strength and lower limb flexibility in the health fitness factors. These effects are believed to have contributed effectively to the improvement of the level of pain by contributing to the improvement of physical and motor functions of the elderly women with Osteoarthritis. Therefore, it is considered that Nordic walking exercise, which enhances stability and balance of the patients with Osteoarthritis by using poles, is an effective exercise method for the improvement of the body and motor functions by lowering the pain of the joints and reducing the muscular strength and percentage body fat.

The Relationship of Anxiety, Hopelessness, and Family Suppoort of Breast Cancer Patients Undergoing Chemotherapy (암화학요법을 받는 유방암 환자의 불안, 절망감 및 가족지지와의 관계)

  • Park Jum-Hee;Lee Hyoun-Ju;Kim Hyun-Mi;Lyu Eun-Kyung
    • Journal of Korean Academy of Fundamentals of Nursing
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    • v.4 no.1
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    • pp.147-162
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    • 1997
  • This study was attempted to provide the basic data for nursing intervention to improve the psychosociological adaptation of patients receiving chemotherapy for breast cancer by examining relationship between anxiety and hopelessness that they are experiencing and family support, in order to help them successfully cope with various psychological problems. This study was carried out with 93 breast cancer patients who are receiving chemotherapy in the injection treatment room of K University Hospital located in the downtown of Taegu after having underwent mastectomy in the hospital between December 1995 and August 1996. This study used the systematized questionnaires which contain 7 questions about general characteristics, Spielberger's trait anxiety & state anxiety scale, the tool that WON(1987) modified the hopelessness scale which was developed by Beck et al.(1967) and the family support tool made by TAE(1985). By using the SPSS/PC program, this study obtained the real number and percentage for the general characteristics of the subjects, and mean and standard variation for the degrees of trait anxiety, state anxiety, hopelessness and family support. The correlation between each variables was identified on the basis of the Pearson Correlation, and the degrees of trait anxiety, state anxiety, hopelessness and family support in the general characteristics of the subjects were analyzed by using the t-test, ANOVA, and Duncan test. The results of this study were summarized as follows. In the general characteristics of the subjects, most of each group were 51 years old or more and the middle class in income, had educational background under elementary school, no job, Buddhism in religion and spouse, and were receiving chemotherapy using MTX and 5FU. It was shown that the degree of the subjects' trait anxiety is, on an average, 50. 29, state anxiety 49. 68, hopelessness 51. 46 and family support 34. 28. Both trait anxiety and hopelessness showed normal correlation ; the higher the degree of trait anxiety is, the higher the degree of hopelessness is, while trait anxiety and family support showed reverse correlation ; the higher the degree of trait anxiety, the lower the degree of family support that the subjects perceive is. State anxiety and hopelessness also showed normal correlation ; the higher the degree of state anxiety is, the higher the degree of hopelessness is. Family support and hopelessness showed reverse correlation ; the higher the degree of family support is, the lower the degree of hopelessness that the subjects perceive is. And family support and state anxiety showed reverse correlation but there was a statistically significant difference. The degree of trait anxiety in the general characteristics of the subjects showed a significant difference by age, job and religion, the degree of state anxiety a signigicant difference by job and religion, the degree of hopelessness a signigicant difference by age, educational background and existence or not of spouse. In conclusion, the breast cancer patients receiving chemotherapy perceive anxiety and hopelessness due to several causes such as diagnosis itself or side effects of chemotherapy, so that it is required not only to develop specific nursing interventions including family support to alleviate anxiety and hopelessness but also to apply such interventions to clinical practice.

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Phylogenetic Analysis based on Metallothionein Gene Sequence of an Indigenous Species Pisidium (Neopisidium) coreanum in Korea (한국 고유종 Pisidium (Neopisidium) coreanum (산골조개) 의 metallothionein 유전자를 기초로 한 분자계통 분류학적 연구)

  • Baek, Moon-Ki;Lee, Jun-Seo;Kang, Se-Won;Lee, Jae-Bong;Kang, Hyun-Jung;Jo, Yong-Hun;Noh, Mi-Young;Han, Yeon-Soo;Choi, Sang-Haeng;Chae, Sung-Hwa;Park, Hong-Seog;Lee, Jun-Sang;Lee, Yong-Seok
    • The Korean Journal of Malacology
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    • v.25 no.2
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    • pp.153-160
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    • 2009
  • Pisidium (Neopisidium) coreanum is a freshwater snail and lives in spring water near mountain areas. Interestingly, this snail has been traditionally regarded as medicinal food, and thus has been used as folk remedies for healing broken bones. Recently, alpha classification on Pisidium (Neopisidium) coreanum through redescription has been conducted. However, not much attention has been made in beta classification. In this study, we performed the beta classification based on metallothionein (MT) genes found from various organisms. To this end, the complete cDNA sequences were obtained from the Expressed Sequence Tag (EST) sequencing project of Pisidium (Neopisidium) coreanum. The coding region (315 bp) encoded an amino acid sequence of 105 residues. The combined results from BLAST analyses, multiple sequence alignment and molecular phylogenetic study of Pc-MT gene indicate that Pisidium (Neopisidium) coreanum has similarity to freshwater bivalve such as Dreissena polymorpha (zebra mussel), Unio tumidus (swollen river mussel) and Crassostrea ariakensis (suminoe oyster).

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