Radionuclide cardiac angiography has distinct advantages in safety, patient comfort, cost and ease of performance. This method offers diagnostic accuracy equivalent to that of cardiac catheterization. By this method the qualitative and quantitative diagnosis of the cardiac shunts are available. Also for it is repeatable with ease and more physiologic, it has application in following pre- and post-operative shunt patients. We performed the radionuclide cardiac angiographies in 147 cases of heart diseases and 26 cases of normal group. 1. The detection of left-to-right shunt was possible in 22 of 24 patients, and 2 patients were not diagnosed due to small shunt amount. (Qp/Qs<1.3) In 21 patients of right-to-left shunt, all were diagnosed by radionuclide cardiac angiography. 2. With the pulmonary time-activity curve, $C_2/C_1$ ratio was calculated. In normal control group, a range of $C_2/C_1$ ratios of $21{\sim}38%$ was established with a mean value of $28.6{\pm}4.6%$. In patients with left-to-right shunts determined by catheterization data, the range of $C_2/C_1$ ratio was $33{\sim}90%$, with a mean value of $67.8{\pm}12.2%$. 3. In 8 cases of left-to-right shunt, $Q_p/Q_s$ ratios determined by radionuclide cardiac angiography were compaired with those of cardiac catheterization. The correlation coefficient was 0.907. (P<0.001) 4. Postoperative radionuclide cardiac angiographies were done in 21 cases. 3 of 13 patients with left-to-right shunts were found to have residual shunts. 8 patients with right-to-left shunts were confirmed to have no residual shunt.
The Journal of Korean Academic Society of Nursing Education
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v.28
no.4
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pp.368-377
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2022
Purpose: This study was conducted to develop and test the effects of a coronavirus disease 2019 (COVID-19) education program for nursing students. Methods: This study used a non-equivalent control group pretest-posttest design. A total of 71 undergraduate nursing students who had completed a fundamental nursing course and were in their third or fourth year of university participated in this study (experimental group n=38, control group n=33). The COVID-19 education program was developed according to the stages of analysis, design, development, implementation, and evaluation. The program consisted of three weekly sessions that each lasted about two hours. The data were collected from February 26 to March 26, 2022 and were analyzed using the chi-squared, Fisher's exact, and independent t-tests. Results: Knowledge about COVID-19, knowledge about personal protective equipment and attitudes toward COVID-19 were not significantly different between the experimental and control groups. However, significant differences were found between the experimental and control groups regarding their confidence in COVID-19 patient nursing care (t=3.02, p=.004). Conclusion: It was confirmed that the developed program was effective in enhancing the confidence of nursing students in performing nursing for COVID-19. Therefore, it is proposed that the education program developed in this study be used as part of an infection control education program to improve nursing students' abilities to respond to emerging infectious diseases, including COVID-19.
Journal of the Korean Association of Oral and Maxillofacial Surgeons
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v.48
no.6
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pp.348-355
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2022
Objectives: To compare the vital sign stability and cost of two commonly used sedatives, midazolam (MDZ) and dexmedetomidine (DEX). Patients and Methods: This retrospective study targeted patients who underwent mandibular third molar extractions under intravenous sedation using MDZ or DEX. The predictor variable was the type of sedative used. The primary outcome variables were vital signs (heart rate and blood pressure), vital sign outliers, and cost of the sedatives. A vital sign outlier was defined as a 30% or more change in vital signs during sedation; the fewer changes, the higher the vital sign stability. The secondary outcome variables included the observer's assessment of alertness/sedation scale, level of amnesia, patient satisfaction, and bispectral index score. Covariates were sex, age, body mass index, sleeping time, dental anxiety score, and Pederson scale. Descriptive statistics were computed including propensity score matching (PSM). The P-value was set at 0.05. Results: The study enrolled 185 patients, 103 in the MDZ group and 82 in the DEX group. Based on the data after PSM, the two samples had similar baseline covariates. The sedative effect of both agents was satisfactory. Heart rate outliers were more common with MDZ than with DEX (49.3% vs 22.7%, P=0.001). Heart rate was higher with MDZ (P=0.000). The cost was higher for DEX than for MDZ (29.27±0.00 USD vs 0.37±0.04 USD, P=0.000). Conclusion: DEX showed more vital sign stability, while MDZ was more economical. These results could be used as a reference to guide clinicians during sedative selection.
This study is a descriptive survey study for nurses in general hospitals to understand the effects of self-leadership, self-efficacy, and organizational commitment on safety management activities. The subjects of the study were nurses at three general hospitals located in G City. An online survey was conducted in consideration of the COVID-19 pandemic situation. Data collection was from August 20 to August 30, 2021. As a result of the study, self-leadership (r=.618, p<.001), self-efficacy (r=306, p<.001), organizational immersion (r=0518, p<.001) showed a positive correlation with safety management activities. In addition, self-leadership, self-efficacy, and organizational commitment explained 38.2% of safety management activities (F=20.478, p<.001). Therefore, it would be helpful to provide regular leadership education and self-efficacy education to increase patient management activities of general hospital nurses. In addition, if a positive work environment, legal standards for nurse work, and an appropriate compensation system are established to improve organizational commitment, it will have a positive effect on environmental safety management activities.
Andrea Y. Lo;Roy P. Yu;Anjali C. Raghuram;Michael N. Cooper;Holly J. Thompson;Charles Y. Liu;Alex K. Wong
Archives of Plastic Surgery
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v.49
no.6
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pp.729-739
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2022
Cranioplasties are common procedures in plastic surgery. The use of tissue expansion (TE) in staged cranioplasties is less common. We present two cases of cranioplasties with TE and systematically review literature describing the use of TE in staged cranioplasties and postoperative outcomes. A systematic review was performed by querying multiple databases. Eligible articles include published case series, retrospective reviews, and systematic reviews that described use of TE for staged bony cranioplasty. Data regarding study size, patient demographics, preoperative characteristics, staged procedure characteristics, and postoperative outcomes were collected. Of 755 identified publications, 26 met inclusion criteria. 85 patients underwent a staged cranioplasty with TE. Average defect size was 122 cm2, and 30.9% of patients received a previous reconstruction. Average expansion period was 14.2 weeks. The most common soft tissue closures were performed with skin expansion only (75.3%), free/pedicled flap (20.1%), and skin graft (4.7%). The mean postoperative follow-up time was 23.9 months. Overall infection and local complication rates were 3.53 and 9.41%, respectively. The most common complications were cerebrospinal fluid leak (7.1%), hematoma (7.1%), implant exposure (3.5%), and infection (3.5%). Factors associated with higher complication rates include the following: use of alloplastic calvarial implants and defects of congenital etiology (p = 0.023 and 0.035, respectively). This is the first comprehensive review to describe current practices and outcomes in staged cranioplasty with TE. Adequate soft tissue coverage contributes to successful cranioplasties and TE can play a safe and effective role in selected cases.
High-dose I-131 used for the treatment of thyroid cancer causes localized exposure among radiology technologists handling it. There is a delay between the calibration date and when the dose of I-131 is administered to a patient. Therefore, it is necessary to directly measure the radioactivity of the administered dose using a dose calibrator. In this study, we attempted to apply machine learning modeling to measured external dose rates from shielded I-131 in order to predict their radioactivity. External dose rates were measured at 1 m, 0.3 m, and 0.1 m distances from a shielded container with the I-131, with a total of 868 sets of measurements taken. For the modeling process, we utilized the hold-out method to partition the data with a 7:3 ratio (609 for the training set:259 for the test set). For the machine learning algorithms, we chose linear regression, decision tree, random forest and XGBoost. To evaluate the models, we calculated root mean square error (RMSE), mean square error (MSE), and mean absolute error (MAE) to evaluate accuracy and R2 to evaluate explanatory power. Evaluation results are as follows. Linear regression (RMSE 268.15, MSE 71901.87, MAE 231.68, R2 0.92), decision tree (RMSE 108.89, MSE 11856.92, MAE 19.24, R2 0.99), random forest (RMSE 8.89, MSE 79.10, MAE 6.55, R2 0.99), XGBoost (RMSE 10.21, MSE 104.22, MAE 7.68, R2 0.99). The random forest model achieved the highest predictive ability. Improving the model's performance in the future is expected to contribute to lowering exposure among radiology technologists.
The purpose of this study was to develop an assist device that could correct and support patient position during biopsy on computed tomography (CT) using 3D printing technology. The development method was conducted in the order of 3D design, 3D output, intermediate evaluation for product, final assist device evaluation. The 3D design method was conducted in the order of prior research data survey, measurement, primary modeling, 3D printing, output evaluation, and supplementary modeling. The 3D output was the 3D printer (3DWOX 2X, Sindoh, Korea) with additive manufacturing technology and the polylactic acid (PLA) materials. At this time, the optimal strength was evaluated to infill degree of product as the 3D printing factors into 20%, 40%, 60%, and 80%. The intermediate evaluation and supplementation was measured noise in the region of interest (ROI) around the beam hardening artifact on the CT images. We used 128-channel MDCT (Discovery 75 HD, GE, USA) to scan with a slice thickness of 100 kVp, 150 mA, and 2.5 mm on the 3D printing product. We compared the surrounding noise of the final 3D printing product with the beginning of it. and then the strength of it according to the degree of infill was evaluated. As a result, the surrounding noise of the final and the early devices were measured at an average of 3.3 ± 0.5 HU and 7.1 ± 0.1 HU, respectively, which significantly reduced the noise of the final 3D printing product (p<0.001). We found that the percentage of infill according to the optimal strength was found to be 60%. Finally, development of assist devices for CT biopsy will be able to minimize artifacts and provide convenience to medical staff and patients.
Journal of The Korean Society of Integrative Medicine
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v.11
no.2
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pp.77-86
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2023
Purpose : This study systematically assessed 9 emotion-function programs for schizophrenic individuals that have been implemented over the past 10 years in Korea and abroad, with the objective of providing clinical grounds and data for further programs. Methods : This study identified 2,558 studies from among those registered in the RISS, KISS, EMbase, PubMed and Scopus databases from 2013 to September 2023, using 'schizophrenia' AND 'emotion' AND ('program' OR 'therapy') as keywords. Of the 2,558 studies retrieved from electronic databases, 602 duplicate papers were excluded. After this process, 1,915 papers that did not meet the study's inclusion and exclusion criteria were excluded based on their titles and abstracts. Following a review of the texts of the remaining 41 papers, nine papers were finally selected, excluding 32 papers according to the selection and exclusion criteria. Results : Programs for the emotional function of patients with schizophrenia have continued to be researched. The results of an evaluation on the quality of the selected literature confirmed that a majority of the reviewed items were "uncertain", confirming that there was a risk of bias. The interventions for emotions included art, cognitive-behavioral, and physical programs, of which art programs were frequently applied. Most of the interventions were implemented in hospitals. The dependent variables for evaluating emotions included emotional expression, depression, anxiety, and positive emotions, and among them, emotional expression was used most frequently. Accordingly, the Berkeley expressivity questionnaire was commonly used as an evaluation tool. Conclusion : This study is significant for intending to analyze domestic and overseas programs for the emotions of patients with schizophrenia, thereby proposing the direction for planning and applying interventions in clinical settings. In follow-up studies, it will be necessary to develop a protocol that confirms interventions according to the settings and patient characteristics of programs and expands the scope of literature reviews.
Background: This study aimed to identify the present level and needs of clinical dental hygienists and to present the Borich needs assessment and the locus for focus model as integrated priorities. Methods: The participants of this study were dental hygienists working in dental clinics (hospitals). The final data of the 194 participants were analyzed using frequency analysis and a paired sample t-test. To analyze the need for clinical dental hygienists to perform work, the Borich priority determination formula was used. The x-y plane consisting of four quadrants was used to analyze the need using the locus for focus model, which helps to determine the priority while showing visual effects. Results: "Scaling" was the highest required level for clinical dental hygienists, and "panorama taking" was the highest present level. The priorities of educational needs were systematically and visually derived from dental hygienists who were currently working through the Borich needs assessment and the locus for focus model for each task performed in the clinical field. Through the priorities of these two models, a total of 13 items appeared in the common high-level area; "oral health care (disability)," "oral health care (systemic disease)," "applying a rubber dam," "professional mechanical tooth cleaning," "root planing," "taking vital signs," "medication counseling," "wire cutting," "removing cement after removing band/bracket," "delivering bracket," "preparing mini-screw implantation," "dental insurance claim," and "patient reception." Conclusion: Based on the results, the department of dental hygiene should maintain and improve the standardized clinical practice curriculum and clinical dental hygienists' practical skills and contribute to the realization of the legal scope of dental hygienists, reflecting the requirements of clinical fields.
The purpose of this study is to identify trends in the application of artificial intelligence by analyzing upper extremity movement assessment and artificial intelligence convergence research using a systematic literature review method. The research was conducted using the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines. Among the 380 articles searched in three databases, 8 articles were finally selected according to the selection and exclusion criteria. For the evaluation of upper extremity movement, motion performance evaluation, FMA, and ARAT were used. For quantification, data were extracted using various tools, and upper extremity movement classification, recovery prognosis prediction, and evaluation tool score were predicted using artificial intelligence. This study is meaningful in that it systematically reviewed studies that objectively evaluated upper extremity movement using artificial intelligence and identified the direction in which artificial intelligence is being applied. Based on this, the introduction of artificial intelligence technology in the assessment of upper extremity movements is expected to help objectively identify the intervention effect and the patient's recovery.
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