The Psychometric Properties of the Difficult Behavior Self-Efficacy Scale

The study was designed to estimate the psychometric properties of Hastings and Brown’s (2002a) Difficult Behavior Self-efficacy Scale. Participants were two samples of physical educators teaching in Korea (n = 229) and the United States (U.S.; n = 139). An initial translation of the questionnaire to Korean and pilot study were conducted along with the larger study using a confirmatory factor analysis procedure. Internal consistency estimates (weighed Omega) for the five-item scale were 0.88 both the Korean and U.S. samples. The average variances extracted for the one factor were 0.59 for the total data set and 0.57 each for the Korean and U.S. samples. Confirmatory factor analysis supported a five-item, unidimensional model for self-efficacy for the total sample: Goodness of Fit Index (GFI) = 0.97, Nonnormed Fit Index (NNFI) = 0.95, Comparative Fit Index (CFI) = 0.98, and Standardized Root Mean Square Residual (SRMR) = 0.03. Only the Root Mean Square Error of Approximation (RMSEA = 0.12) fell below criterion levels of acceptable fit, with similar fit indices occurring in separate analyses of the Korean and U.S. samples. Invariance testing across the two samples supported metric invariance (similarity of factor loadings) but not scalar invariance (U.S. means higher on all five items). The factor structure for the self-efficacy scale provides an initial estimate of validity and internal consistency for use with different teacher groups

The Emotional Reactions to Challenging Behavior Scale-Korean (ERCBS-K): Modification and Validation

The purpose of this study was to explore the original version of Mitchell and Hastings\u27s (1998) Emotional Reaction to Challenging Behavior Scale (ERCBS) and estimate validity and reliability of a revised version containing 29 items. The Emotional Reaction to Challenging Behavior Scale-Korean (ERCBS-K) was studied using 445 in-service physical educators (228 females; 217 males). Data were collected using onsite administration as well as mail survey administration procedures. Confirmatory and exploratory factor analyses results supported a five factor, 28-item scale (ERCBS-K). Acceptable internal consistency coefficients were found for each of the subscales of the ERCBS-K (Cronbach\u27s alpha ranged from 0.71 to 0.87)

A lab-on-a-disc platform enables serial monitoring of individual CTCs associated with tumor progression during EGFR-targeted therapy for patients with NSCLC

Rationale: Unlike traditional biopsy, liquid biopsy, which is a largely non-invasive diagnostic and monitoring tool, can be performed more frequently to better track tumors and mutations over time and to validate the efficiency of a cancer treatment. Circulating tumor cells (CTCs) are considered promising liquid biopsy biomarkers; however, their use in clinical settings is limited by high costs and a low throughput of standard platforms for CTC enumeration and analysis. In this study, we used a label-free, high-throughput method for CTC isolation directly from whole blood of patients using a standalone, clinical setting-friendly platform. Methods: A CTC-based liquid biopsy approach was used to examine the efficacy of therapy and emergent drug resistance via longitudinal monitoring of CTC counts, DNA mutations, and single-cell-level gene expression in a prospective cohort of 40 patients with epidermal growth factor receptor (EGFR)-mutant non-small cell lung cancer. Results: The change ratio of the CTC counts was associated with tumor response, detected by CT scan, while the baseline CTC counts did not show association with progression-free survival or overall survival. We achieved a 100% concordance rate for the detection of EGFR mutation, including emergence of T790M, between tumor tissue and CTCs. More importantly, our data revealed the importance of the analysis of the epithelial/mesenchymal signature of individual pretreatment CTCs to predict drug responsiveness in patients. Conclusion: The fluid-assisted separation technology disc platform enables serial monitoring of CTC counts, DNA mutations, as well as unbiased molecular characterization of individual CTCs associated with tumor progression during targeted therapy

Validation of the Korean criteria for trauma team activation

Objective We conducted a study to validate the effectiveness of the Korean criteria for trauma team activation (TTA) and compared its results with a two-tiered system. Methods This observational study was based on data from the Korean Trauma Data Bank. Within the study period, 1,628 trauma patients visited our emergency department, and 739 satisfied the criteria for TTA. The rates of overtriage and undertriage in the Korean one-tiered system were compared with the two-tiered system recommended by the American College of Surgery-Committee on Trauma. Results Most of the patient’s physiologic factors reflected trauma severity levels, but anatomical factors and mechanism of injury did not show consistent results. In addition, while the rate of overtriage (64.4%) was above the recommended range according to the Korean criteria, the rate of undertriage (4.0%) was within the recommended range. In the simulated two-tiered system, the rate of overtriage was reduced by 5.5%, while undertriage was increased by 1.8% compared to the Korean activation system. Conclusion The Korean criteria for TTA showed higher rates of overtriage and similar undertriage rates compared to the simulated two-tier system. Modification of the current criteria to a two-tier system with special considerations would be more effective for providing optimum patient care and medical resource utilization

The risk of newly diagnosed cancer in patients with rheumatoid arthritis by TNF inhibitor use: a nationwide cohort study

Background : Tumor necrosis factor (TNF) inhibitors use in patients with rheumatoid arthritis (RA) has raised safety concerns about cancer risk, but study results remain controversial. This largest nationwide study to date compared cancer risk in TNF inhibitor users to non-biologic disease-modifying anti-rheumatic drug (nbDMARD) users in Korean patients with RA. Methods : Data on all the eligible patients diagnosed with RA between 2005 and 2016 were retrieved from the Korean National Health Information Database. The one-to-one matched patients consisted of the matched cohort. The risks for developing all-type and site-specific cancers were estimated using incidence and incidence rate (IR) per 1000 person-years. Adjusted hazard ratio (HR) and 95% confidence interval (CI) were estimated using a Cox regression model. Results : Of the 22,851 patients in the before matching cohort, 4592 patients were included in the matched cohort. Treatment with TNF inhibitors was consistently associated with a lower risk of cancer than in the nbDMARD cohort (IR per 1000 person-years, 6.5 vs. 15.6; adjusted HR, 0.379; 95% CI, 0.255–0.563). The adjusted HR (95% CI) was significantly lower in the TNF inhibitor cohort than the nbDMARD cohort for gastrointestinal cancer (0.432; 0.235–0.797), breast cancer (0.146; 0.045–0.474), and genitourinary cancer (0.220; 0.059–0.820). Conclusions : The use of TNF inhibitors was not associated with an increased risk of cancer development, and rather associated with a lower cancer incidence in Korean patients with RA. Cautious interpretation is needed not to oversimplify the study results as cancer-protective effects of TNF inhibitors. A further study linking claims and clinical data is needed to confirm our results.This research was supported by a grant of the Korea Health Technology R&D Project through the Korea Health Industry Development Institute (KHIDI), funded by the Ministry of Health & Welfare, Republic of Korea (grant number: HC17C0069

Necrotizing fasciitis involving the chest and abdominal wall caused by Raoultella planticola

<p>Abstract</p> <p>Background</p> <p><it>Raoultella planticola </it>was originally considered to be a member of environmental <it>Klebsiella</it>. The clinical significance of <it>R. planticola </it>is still not well known.</p> <p>Case presentation</p> <p>We describe the first case of necrotizing fasciitis involving the chest and abdominal wall caused by <it>R. planticola</it>. The identity of the organism was confirmed using 16S rRNA sequencing. The patient was successfully treated with the appropriate antibiotics combined with operative drainage and debridement.</p> <p>Conclusions</p> <p><it>R. planticola </it>had been described as environmental species, but should be suspected in extensive necrotizing fasciitis after minor trauma in mild to moderate immunocompromised patients.</p