Privacy-Preserving Federated Model Predicting Bipolar Transition in Patients With Depression:Prediction Model Development Study

BACKGROUND: Mood disorder has emerged as a serious concern for public health; in particular, bipolar disorder has a less favorable prognosis than depression. Although prompt recognition of depression conversion to bipolar disorder is needed, early prediction is challenging due to overlapping symptoms. Recently, there have been attempts to develop a prediction model by using federated learning. Federated learning in medical fields is a method for training multi-institutional machine learning models without patient-level data sharing. OBJECTIVE: This study aims to develop and validate a federated, differentially private multi-institutional bipolar transition prediction model. METHODS: This retrospective study enrolled patients diagnosed with the first depressive episode at 5 tertiary hospitals in South Korea. We developed models for predicting bipolar transition by using data from 17,631 patients in 4 institutions. Further, we used data from 4541 patients for external validation from 1 institution. We created standardized pipelines to extract large-scale clinical features from the 4 institutions without any code modification. Moreover, we performed feature selection in a federated environment for computational efficiency and applied differential privacy to gradient updates. Finally, we compared the federated and the 4 local models developed with each hospital's data on internal and external validation data sets. RESULTS: In the internal data set, 279 out of 17,631 patients showed bipolar disorder transition. In the external data set, 39 out of 4541 patients showed bipolar disorder transition. The average performance of the federated model in the internal test (area under the curve [AUC] 0.726) and external validation (AUC 0.719) data sets was higher than that of the other locally developed models (AUC 0.642-0.707 and AUC 0.642-0.699, respectively). In the federated model, classifications were driven by several predictors such as the Charlson index (low scores were associated with bipolar transition, which may be due to younger age), severe depression, anxiolytics, young age, and visiting months (the bipolar transition was associated with seasonality, especially during the spring and summer months). CONCLUSIONS: We developed and validated a differentially private federated model by using distributed multi-institutional psychiatric data with standardized pipelines in a real-world environment. The federated model performed better than models using local data only.</p

Factors Influencing Nursing Students’ Person-Centered Care

Background and objectives: Numerous theoretical and clinical advances have been made through research on person-centered care (PCC). Nevertheless, care is still focused on the medical aspects of treating patients&rsquo; diseases in Korea, and thus providing individualized PCC to patients tends to be neglected. This study aimed to investigate the relationship between PCC competence, empathic competence, interpersonal competence, and perceived stress to identify the factors that impact PCC competence for developing programs that foster PCC competence in nursing students. Materials and Methods: Data were collected from 149 participants, which comprised third- and fourth-year nursing students from two universities in Korea who have experienced clinical training. PCC competence, empathic competence, interpersonal competence, and perceived stress were measured using structured self-reported questionnaires. Results: PCC competence was positively correlated with empathic competence (p &lt; 0.001) and interpersonal competence (p &lt; 0.001), and negatively correlated with perceived stress (p &lt; 0.001). Empathic competence, perceived stress, interpersonal competence, and satisfaction with the participants&rsquo; nursing major were identified as factors that influenced the PCC competence (adjusted R2 = 0.570). Conclusions: To enhance PCC competence in nursing students, empathic competence, interpersonal competence, and satisfaction with the participants&rsquo; nursing major need to be improved and perceived stress needs to be reduced

The Factors Associated with Person-Centered Care Competence among Nursing Students

To improve person-centered care (PCC) competence among nursing students, various associated factors must be considered. This study aimed to identify the factors influencing PCC competence among South Korean nursing students, using a descriptive, cross-sectional design. Participants were recruited from three nursing colleges in South Korea using convenience sampling. Data were collected from 1 December 2020 to 31 January 2021, using structured self-report questionnaires. Demographic information, positive psychological capital, ego-resiliency, and depression of the participants were assessed. Descriptive statistics, independent t-tests, one-way analyses of variance, and hierarchical multiple regression analysis were used in statistical analysis. Participants with highly positive psychological capital (r = 0.509, p &lt; 0.001) and high ego-resiliency (r = 0.480, p &lt; 0.001) had very good PCC competence. The multiple regression analysis revealed that 30.1% of the variance in PCC competence is attributable to positive psychological capital and ego-resiliency (F = 34.59, p &lt; 0.001, adjusted R2 = 0.301). These results highlighted the need for strategies to enhance psychological factors, such as positive psychological capital and ego-resiliency, that could boost PCC competence in nursing students

Influencing Factors on Person-Centered Care Competence among Nursing Students Experienced Clinical Training

Background and Objectives: Nursing students require appropriate education to improve their person-centered care competence. Therefore, research on the various factors that influence person-centered care competence is necessary. This study aimed to identify factors influencing nursing professional values, satisfaction with major, and perception of the nursing profession on person-centered care competence. Materials and Methods: This study was a descriptive survey, and participants were nursing students from three universities in Korea. Structured self-report questionnaires were used for data collection. Results: Nursing professional values (p &lt; 0.001) were found to be an influencing factor on person-centered care competence (Adjusted R2 = 0.244). However, the perception of the nursing profession, and the satisfaction with the major were not found to be significant influencing factors on person-centered care competence. Conclusions: The findings suggest that fostering nursing professional values in nursing students and developing educational interventions for the same are essential to improve person-centered care competence

Effects of a Web-Based Educational Program Regarding Physical Restraint Reduction in Long-Term Care Settings on Nursing Students: A Cluster Randomized Controlled Trial

Physical restraint is still frequently used in many countries. However, a lack of education hinders physical restraint reduction in long-term care facilities. No study has yet to examine the effects of physical restraint reduction education on nursing students. This study aimed to evaluate the effects of a web-based educational program of physical restraint reduction on nursing students’ knowledge and perceptions. A cluster randomized controlled and single-blind design was used. This study was conducted at four nursing schools in South Korea. A total of 169 undergraduate nursing students completed this study. Using random allocation, two nursing schools (85 students) were allocated as the experimental group and the other two schools (84 students) as the control group. The experimental group received the web-based educational program, and the control group did not receive the educational program. Data were collected immediately before and after the web-based educational program. The experimental group’s knowledge and perceptions significantly improved between pre-test and post-test. The analysis of covariance showed statistically significant differences between groups in knowledge (p &lt; 0.001) and perceptions (p &lt; 0.001) over time, revealing positive effects of the web-based educational program. The web-based educational program regarding physical restraint reduction positively affected nursing students’ knowledge and perceptions. Future studies are required to examine the educational program’s longitudinal effects with more rigorous measurements and research methods

Piezoresistive Behaviour of Additively Manufactured Multi-Walled Carbon Nanotube/Thermoplastic Polyurethane Nanocomposites

To develop highly sensitive flexible pressure sensors, the mechanical and piezoresistive properties of conductive thermoplastic materials produced via additive manufacturing technology were investigated. Multi-walled carbon nanotubes (MWCNTs) dispersed in thermoplastic polyurethane (TPU), which is flexible and pliable, were used to form filaments. Specimens of the MWCNT/TPU composite with various MWCNT concentrations were printed using fused deposition modelling. Uniaxial tensile tests were conducted, while the mechanical and piezoresistive properties of the MWCNT/TPU composites were measured. To predict the piezoresistive behaviour of the composites, a microscale 3D resistance network model was developed. In addition, a continuum piezoresistive model was proposed for large-scale simulations

Piezoresistive behaviour of additively manufactured multi-walled carbon nanotube/thermoplastic polyurethane nanocomposites

To develop highly sensitive flexible pressure sensors, the mechanical and piezoresistive properties of conductive thermoplastic materials produced via additive manufacturing technology were investigated. Multi-walled carbon nanotubes (MWCNTs) dispersed in thermoplastic polyurethane (TPU), which is flexible and pliable, were used to form filaments. Specimens of the MWCNT/TPU composite with various MWCNT concentrations were printed using fused deposition modelling. Uniaxial tensile tests were conducted, while the mechanical and piezoresistive properties of the MWCNT/TPU composites were measured. To predict the piezoresistive behaviour of the composites, a microscale 3D resistance network model was developed. In addition, a continuum piezoresistive model was proposed for large-scale simulations.Y

A Randomized, Double-Blind, Placebo-Controlled Trial to Assess the Acidogenic Potential of Dental Biofilms through a Tablet Containing Weissella cibaria CMU

The possibility of preventing dental caries by taking probiotic bacterium Weissella cibaria (W. cibaria) CMU tablets to alter the pH of the dental plaque in the oral cavity was evaluated. A randomized, double-blind, placebo-controlled trial was performed on adults aged 20 years or older with 20 or more natural teeth. Ninety-two people underwent dental scaling before being randomly assigned to the experimental group (n = 49) or the control group (n = 43). Depending on the group they belonged to, W. cibaria CMU or the placebo was administered to them once daily for 8 weeks before bedtime. Twenty-four subjects were later excluded from the study because the week 8 dosing was not smoothly performed, for a final subject count of 68. The Cariview test was used to evaluate the amount of acid produced by the dental plaque to assess the risk of caries. The results showed that although there was no significant difference between the results of the two groups, the intake of the W. cibaria CMU tablets eliminated the risk of developing dental caries from acid production in the oral flora because the W. cibaria colonizes and lives in the dental plaque and the oral cavity and suppresses acids

Effects of Oral Probiotics on Subjective Halitosis, Oral Health, and Psychosocial Health of College Students: A Randomized, Double-Blind, Placebo-Controlled Study

Altogether, 81% of Korean college students experience halitosis and concomitant psychosocial problems such as depression and lowered self-esteem, as well as poor oral-health-related quality of life. Although halitosis causes many social and psychological problems among college students, there have been no reports of improvement interventions. This study aimed to identify the effects of ingesting tablets of the oral probiotic Weissella cibaria CMU (Chonnam Medical University, Gwangju, Korea) on halitosis and examine its effects on psychosocial indicators. This was a randomized, double-blind, placebo-controlled trial. The participants were randomly assigned to the experimental group or the control group. They ingested W. cibaria CMU or the placebo, depending on which group they belonged to, before going to bed daily for eight weeks. The measured indicators were subjective halitosis, subjective oral-health status, depression, self-esteem, and oral-health-related quality of life. Measurements were at baseline and eight weeks later. The participants showed statistically significant differences in subjective halitosis and oral-health-related quality of life. For college students with halitosis, intake of the oral probiotic for eight weeks could be a useful nursing intervention for reducing halitosis and improving oral-health-related quality of life

Characteristics of kidney transplantation recipients over time in South Korea

Background/Aims: Detailed nationwide information regarding the recent status and time trends of kidney transplantation (KT) in South Korea is limited. Methods: We performed a nationwide, population-based cohort study using the national claims database of Korea. We included KT recipients from 2008 to 2016, and their demographic and clinical characteristics were collected. The prognostic outcome was graft failure consisted of patient death and death-censored graft failure (DCGF). Results: We studied 14,601 KT recipients with median follow-up duration of 3.96 years. The median age at the time of transplantation consistently increased from the past, and proportion of underlying diabetes mellitus prominently increased, reaching 35.6% in 2016. The preemptive KT accounted for approximately 30% of the total transplantation cases. The recipients showed a 10-year cumulative graft survival rate of 71.8%, consisting of 10-year DCGF free survival of 77.6% and patient survival of 92.8%. Age &gt;= 20 and &lt; 30 years, age &gt;= 70 years, underlying history of diabetes, non-preemptive transplantation, and poor compliance on tacrolimus and mycophenolic acid were the significant risk factors associated with worse DCGF outcome. The economic cost of KT showed prominently increasing trends, reaching a total insured fee of &gt; 60,000,000$ in 2016. However, the expansion was mainly burdened by the national insurance service but not by the patients. Conclusions: In South Korea, the number of kidney transplantation in elderly or in patients with comorbidities has been increasing. Complex clinical factors were associated with medication compliance and patient prognosis.Y