Exploring the provision of care to hospitalised patients by family members and private carers across Bangladesh, Indonesia, and South Korea: Does this constitute an infection risk?

This thesis investigates the overlooked role of family and/or private carers in infection prevention and control (IPC) practices and examines the underlying factors and implications associated with their involvement in patient care across Bangladesh, Indonesia, and South Korea. Despite their involvement in patient care, family carers have not received sufficient attention in the IPC guidance and practices. Whilst family carers’ presence with patients and their involvement in care activities are considered cultural and social norms, to date, there has been limited exploration of the types of patient care activities and the potential risk of healthcare-associated infections (HAIs) associated with their in-depth involvement. Current efforts to reduce the risk and burden of HAIs have primarily focused on healthcare workers, who are the main care providers in Western hospital settings, thereby neglecting the potential contribution of family carers to infection transmission and prevention efforts, as suggested by evidence from outbreaks like MERS and COVID-19. Therefore, this thesis aims to advance knowledge by investigating patient care arrangements, the role of family carers in care provision, and their significance in IPC practices and guidance. Using a multi-methods approach, this thesis conducted three studies across the selected countries, namely Bangladesh, Indonesia, and South Korea. These countries were chosen because they can highlight cultural elements in care provision that transcend socioeconomic status and due to the availability of local researchers who can immerse themselves in the natural environment for in-depth insights. The first study involved a review of current IPC policies and guidelines in these countries to assess whether the roles of family members in care provision were adequately addressed to ensure safe patient care. The second study utilised a patient self-reported diary over a 5-day period to assess the patient care environment, including family and private carers, IPC communication during patients’ admission, and the details of family/private carers’ involvement and IPC practice. The final study employed a qualitative approach to explore the experiences and perspectives of patients, family carers and healthcare workers regarding family carers’ involvement in care provision, care activities, caregiver guidance and training, and IPC practices. This study also examined factors influencing patients and their family carers’ adherence to recommended IPC measures and comprehensively explored IPC employment in the context. This study highlighted how deeply ingrained cultural values influenced healthcare arrangements and the delivery of care practices. The study identified substantial gaps between actual practice and IPC policies/guidelines, revealing a lack of alignment with the care provided by family carers and the cultural influences shaping the healthcare arrangements. This study also identified key barriers affecting the adherence of patients and their family members with IPC recommendations and highlighted diverse perspectives on IPC empowerment. Furthermore, it uncovered the challenges faced by patients, family members, and healthcare workers in achieving IPC empowerment. Based on the findings, this thesis suggests that policies and guidelines should acknowledge the cultural influences on patient care arrangements. It recommends the development of culturally acceptable and responsive IPC strategies tailored to specific contexts. These strategies should embrace the involvement of family members and private carers to ensure the safety of both patients and their family members throughout the caregiving journey

Optimal set of grid size and angular increment for practical dose calculation using the dynamic conformal arc technique: a systematic evaluation of the dosimetric effects in lung stereotactic body radiation therapy

Purpose To recommend the optimal plan parameter set of grid size and angular increment for dose calculations in treatment planning for lung stereotactic body radiation therapy (SBRT) using dynamic conformal arc therapy (DCAT) considering both accuracy and computational efficiency. Materials and methods Dose variations with varying grid sizes (2, 3, and 4 mm) and angular increments (2°, 4°, 6°, and 10°) were analyzed in a thorax phantom for 3 spherical target volumes and in 9 patient cases. A 2-mm grid size and 2° angular increment are assumed sufficient to serve as reference values. The dosimetric effect was evaluated using dose–volume histograms, monitor units (MUs), and dose to organs at risk (OARs) for a definite volume corresponding to the dose–volume constraint in lung SBRT. The times required for dose calculations using each parameter set were compared for clinical practicality. Results Larger grid sizes caused a dose increase to the structures and required higher MUs to achieve the target coverage. The discrete beam arrangements at each angular increment led to over- and under-estimated OARs doses due to the undulating dose distribution. When a 2° angular increment was used in both studies, a 4-mm grid size changed the dose variation by up to 3–4% (50 cGy) for the heart and the spinal cord, while a 3-mm grid size produced a dose difference of \u3c1% (12 cGy) in all tested OARs. When a 3-mm grid size was employed, angular increments of 6° and 10° caused maximum dose variations of 3% (23 cGy) and 10% (61 cGy) in the spinal cord, respectively, while a 4° increment resulted in a dose difference of \u3c1% (8 cGy) in all cases except for that of one patient. The 3-mm grid size and 4° angular increment enabled a 78% savings in computation time without making any critical sacrifices to dose accuracy. Conclusions A parameter set with a 3-mm grid size and a 4° angular increment is found to be appropriate for predicting patient dose distributions with a dose difference below 1% while reducing the computation time by more than half for lung SBRT using DCAT

Dietary taurine intake, nutrients intake, dietary habits and life stress by depression in Korean female college students: a case-control study

<p>Abstract</p> <p>Background</p> <p>The purpose of this study was to investigate the dietary taurine intake, nutrients intake, dietary habits and life stress by depression in Korean female college students.</p> <p>Methods</p> <p>In this study, research data were collected in March 2009 and 65 patients with depression and 65 controls without depression participated. The CES-D (Center for Epidemiologic Studies Depression) scale was used for depression measure and controls were matched for age. A 3-day recall method was used for dietary assessment (2 weekdays and 1 weekend day).</p> <p>Results</p> <p>Average height, weight and body mass index (BMI) were 161.3±0.5cm, 55.3±1.0kg and 21.2±0.4kg/m² for depression patients and those of control group were 161.4±0.7cm, 53.1±0.8kg and 20.3±0.2kg/m², respectively. Average dietary taurine intakes of depression patients and control group were 89.1 and 88.0 mg/day, respectively. There was no significant difference in dietary taurine intake between depression patients and control group. The average intakes of vitamin A (p<0.05), β-carotene (p<0.01), vitamin C (p<0.05), folic acid (p<0.05) and fiber (p<0.05) of depression patients were significantly lower compared to control group. The average total dietary habit score of depression patients (47.2) was significantly lower than that of control group (51.3) (p<0.01). The average dietary habit scores of “eating meals at regular times” (p<0.05), “eating adequate amount of meals” (p<0.05), “having meals with diverse foods” (p<0.05), “avoiding eating spicy foods” (p<0.01) and “eating protein foods such as meat, fish, eggs, beans more than 2 times a day” (p<0.05) were significantly lower in depression patients compare to control group. The average scores of total life stress (p<0.001) and all stress categories of depression patients were significantly higher than those of control group except faculty problem score.</p> <p>Conclusions</p> <p>These results show that depression patients have poor dietary habits and unbalanced nutrition status. Also depression patients have higher life stress score.</p> <p>Therefore, continuous nutrition education and counselling for good dietary habits and balanced nutrition status are needed to prevent depression in Korean college students.</p

Non-thermal atmospheric pressure plasma-conditioned root dentin promotes attraction and attachment of primary human dental pulp stem cells in real-time Ex Vivo

This study investigated if non-thermal atmospheric pressure plasma (NTAPP) treatment of root dentin surfaces promotes human dental pulp stem cell (hDPSCs) adhesion. Freshly extracted human single-rooted teeth (n = 36) were decoronated and cut (first vertically, then horizontally) into root dentin slices (3 mm thick). Primary hDPSCs cultures were seeded onto slices randomly assigned to pretreatment groups (n = 9/group): NaOCl (1.5%), EDTA (17%) then NTAPP (Group I); NaOCl then NTAPP (Group II); NaOCl then EDTA (Group III); and NaOCl alone (Group IV). Cell viability and proliferation were measured using MTT assay with log-linear statistical analysis. Cell attachment and spreading morphologies on dentin slices (n = 3/group) were examined through scanning electron microscopy. Early cell adhesion events and subcellular activities were observed in real time by live-cell imaging through holotomographic microscopy. Cell viability and proliferation were significantly higher on NTAPP-treated dentin (p \u3c 0.05), without interactions with EDTA (p \u3e 0.05). The attachment, spreading, extensions and multiple layers of hDPSCs were heightened on NTAPP-treated dentin. Cell adhesion, spreading, and dentinal tubule penetration were hastened on NTAPP-treated dentin surfaces in real-time, with elevated subcellular activities and intracellular lipid droplet formation. NTAPP-treated root dentin surfaces support enhanced cellular responses, potentially promoting pulp-dentin regeneration

The Utilization of Traditional Herbal Medicine for Treatment in Traditional Korean Medicine Clinics

A cross-sectional study has been conducted to detect the facts about the use of traditional herbal medicines (THMs) in South Korea. The questionnaire has been adopted from the 2017 National Survey for the usage of traditional Korean medicine (TKM) and consumption of THMs. A total number of 1346 participants have been involved in this study. Results showed that the non-decoction types of herbal medicines, which are mostly used for therapeutic purposes (89.0%), and the decoction types of herbal medicines were not only used for the purpose of treatment of diseases (62.5%) but also health improvement purposes (21.9%). Results presented that decoction types of THMs are used for musculoskeletal diseases (56.0%), digestive diseases (21.3%), and respiratory diseases (6.3%), whereas the non-decoction types of THMs are commonly used in musculoskeletal diseases (55.6%), respiratory diseases (20.5%), and digestive diseases (18.1%). Future studies are highly recommended to detect more details about the medical use of THMs in South Korea

Unleashing the full potential of Hsp90 inhibitors as cancer therapeutics through simultaneous inactivation of Hsp90, Grp94, and TRAP1

Cancer therapeutics: Extending a drug&apos;s reach A new drug that blocks heat shock proteins (HSPs), helper proteins that are co-opted by cancer cells to promote tumor growth, shows promise for cancer treatment. Several drugs have targeted HSPs, since cancer cells are known to hijack these helper proteins to shield themselves from destruction by the body. However, the drugs have had limited success. Hye-Kyung Park and Byoung Heon Kang at Ulsan National Institutes of Science and Technology in South Korea and coworkers noticed that the drugs were not absorbed into mitochondria, a key cellular compartment, and HSPs in this compartment were therefore not being blocked. They identified a new HSP inhibitor that can reach every cellular compartment and inhibit all HSPs. Testing in mice showed that this inhibitor effectively triggered death of tumor cells, and therefore shows promise for anti-cancer therapy. The Hsp90 family proteins Hsp90, Grp94, and TRAP1 are present in the cell cytoplasm, endoplasmic reticulum, and mitochondria, respectively; all play important roles in tumorigenesis by regulating protein homeostasis in response to stress. Thus, simultaneous inhibition of all Hsp90 paralogs is a reasonable strategy for cancer therapy. However, since the existing pan-Hsp90 inhibitor does not accumulate in mitochondria, the potential anticancer activity of pan-Hsp90 inhibition has not yet been fully examined in vivo. Analysis of The Cancer Genome Atlas database revealed that all Hsp90 paralogs were upregulated in prostate cancer. Inactivation of all Hsp90 paralogs induced mitochondrial dysfunction, increased cytosolic calcium, and activated calcineurin. Active calcineurin blocked prosurvival heat shock responses upon Hsp90 inhibition by preventing nuclear translocation of HSF1. The purine scaffold derivative DN401 inhibited all Hsp90 paralogs simultaneously and showed stronger anticancer activity than other Hsp90 inhibitors. Pan-Hsp90 inhibition increased cytotoxicity and suppressed mechanisms that protect cancer cells, suggesting that it is a feasible strategy for the development of potent anticancer drugs. The mitochondria-permeable drug DN401 is a newly identified in vivo pan-Hsp90 inhibitor with potent anticancer activity