PURPOSE: The aim of this study was to establish a hypothetical model on silence regarding patient safety and to verify the model's goodness of fit and hypotheses. METHODS: The participants in this study were 330 registered nurses working in tertiary hospitals with over 300 beds. Data were collected between July 1, and August 30, 2017, from nurses who agreed to participate. A covariance structure analysis was performed. RESULTS: The model of fit index was χ² =59.54, normed χ² =2.29, GFI=.97, AGFI=.93, SRMR=.05, NFI=.99, CFI=.95 and RMSEA=.05. The organizational culture had an influence on patient safety motivation (β=.26, p=.003) and attitude (β=.43, p < .001). RN-MD collaboration had an influence on patient safety motivation (β=.33, p < .001), attitude (β=.35, p < .001), and patient safety silence (β=−.17, p=.026). Supervisory trust had an influence on patient safety motivation (β=.26, p < .001), attitude (β=.12, p=.036), and patient safety silence (β=−.23, p=.002). Patient safety motivation had an influence on patient safety silence (β=−.33, p=.006). The model of patient safety silence explained 36.0% of the variances. CONCLUSION: This study is meaningful in that it provides basic data for nursing education and program development for rejecting patient safety silence.
Cooperative Behavior ; Education, Nursing ; Humans ; Motivation ; Nurses ; Organizational Culture ; Patient Safety ; Program Development ; Tertiary Care Centers

PURPOSE: The present study is a descriptive cross-sectional study of cause-and-effect relationship, which used the 7th year data of the Panel Study on Korean Children, to investigate the effects of parenting stress, depression, and family interactions of the parents of early school-age children on children's subjective happiness. METHODS: The present study included data of 1419 pairs of parents who participated in the mother and father survey of the Panel Study on Korean Children. The effects of parenting stress, depression, and parental family interactions on children's subjective happiness were analyzed as actor and partner effects using path analysis. RESULTS: Parenting stress had an actor effect on depression; maternal parenting stress (β=−.21, p < .001) and depression (β=−.30, p < .001) had an actor effect on maternal family interaction; and paternal parenting stress (β=−.18, p < .001) and depression (β=−.17, p < .001) had a partner effect on maternal family interaction. Paternal parenting stress was found to have an actor effect on paternal family interaction (β=−.30, p < .001), and parental depression was found to have actor effect (β=−.23, p < .001) and maternal depression had a partner effect on paternal family interactions (β=−.22, p < .001). Children's subjective happiness was found to have a statistically significant relationship with maternal family interaction (β=.40, p < .001). CONCLUSION: The significance of the study is in its provision of basic data for adjusting parents' family interactions that are closely related to the growth and development of children by confirming the effect of parents' parenting stress, depression, and family interaction on children's subjective happiness.
Child ; Cross-Sectional Studies ; Depression ; Fathers ; Growth and Development ; Happiness* ; Humans ; Mothers ; Parenting ; Parents*

Purpose: This study was conducted to evaluate the validity and reliability of the Korean version of Nursing Student Perceptions of Dishonesty Scale (NSPDS). Methods: The English NSPDS was translated into Korean after going through a translation and reverse translation process. Data for this study were collected from 433 student nurses from 8 universities in Korea, who had clinical practice experience. The final data were evaluated using SPSS 20.0 and AMOS 22.0 for exploratory and confirmatory factor analysis. Reliability was tested using Cronbach's ⍺ and test-retest reliability. Results: The exploratory factor analysis showed that 15 items were deleted and 9 subscales were changed into 8 subscales, and the initial 67 items were reduced to 52 items. Confirmatory factor analysis was conducted with 8 subscales and 52 items. The standardized regression coefficients of all the items were statistically significant and between .66 and .93. Convergent validity confirmed that the critical ratio was greater than .85, and the average variance extracted was greater than .53. The criterion-related validity confirmed a negative correlation between student nurses’ ethical value and the Korean version of NSPDS. Reliability was confirmed with a Cronbach's ⍺ of .80~.95. The test-retest confirmed that the correlation coefficient showed significant positive correlations between .68 and .76 in the subscales. Conclusion The findings of this study suggest that the Korean version of NSPDS is an appropriate and reliable tool for identifying dishonesty perceptions among Korean student nurses.

PURPOSE: The purpose of this study was to investigate the casual relationship between nurses' social capital and turnover intention and to verify the goodness of fit between a hypothetical model and actual data in order to suggest the best model. METHODS: This survey was conducted with 315 nurses working in general hospitals in Seoul. Data were collected from December 1 to December 30, 2011, and analyzed using SPSS Windows 18.0 and AMOS 16.0. RESULTS: Nurses' social capital was found to have a direct effect on reducting organization cynicism and increasing organizational commitment. Nurses' organizational cynicism and organizational commitment were found to have a direct effect on turnover intention, but social capital did not have a direct effect on turnover intention. However, social capital had a partial and indirect effect on turnover intention through mediating organizational cynicism and organizational commitment. CONCLUSION: Results of this study indicate that nurse managers should put increased effort in reducing nurses' organizational cynicism and improving their organizational commitment, two contrary parameters. At the same time managers need to develop plans to establish social capital more efficiently so that nurses have lower turnover intention.
Adult ; Female ; Hospitals, General ; Humans ; Intention ; Nursing Staff, Hospital/economics/*psychology ; *Organizational Culture ; *Personnel Turnover ; Questionnaires

PURPOSE: The purpose of this study was to investigate the casual relationship between nurses' mentoring and turnover intention and to verify the goodness of fit between a hypothetical model and actual data in order to suggest an adequate model. METHODS: The survey was conducted with 434 nurses working in general hospitals in Seoul. Data were collected during February 2013, and analyzed with SPSS Windows 18.0 and AMOS 7.0. RESULTS: Mentoring was found to have a direct effect on decrease in role stress. Role stress had a direct effect on increase in burnout and mentoring, with role stress as a mediator, there was an indirect effect on burnout. Burnout had a direct effect on increase in turnover intention, and role stress, with burnout as a mediator, and mentoring, through role stress and burnout, an indirect effect was found on increase in turnover intention. CONCLUSION: The results of this study indicate that nursing managers should put effort into reducing role stress and burnout, while seeking to establish a more efficient mentoring system so that for nurses, there will be a lowering of turnover intention.
Adult ; Attitude of Health Personnel ; *Burnout, Professional ; Female ; Hospitals, General ; Humans ; Job Satisfaction ; Marriage ; Models, Theoretical ; Nursing Staff, Hospital/*psychology ; Personnel Turnover ; *Stress, Psychological

BACKGROUND: Rotaviruses are the primary cause of severe acute gastroenteritis in infants and young children worldwide. We evaluated the performance of the new GENEDIA Rotavirus Ag Rapid test (Greencross Medical Science, Korea) immunochromatographic assay (ICA) for detecting human rotavirus in stool specimens, in comparison with ELISA and PCR assays. METHODS: One hundred rotavirus-positive stool samples and 150 rotavirus-negative stool samples, confirmed by ELISA and PCR tests, were analysed using the GENEDIA Rotavirus Ag rapid test. The positive agreement (sensitivity), negative agreement (specificity), and total agreement rates of the ICA compared to ELISA and PCR were determined. To assess the analytical performance of the ICA, we tested its detection limit, reproducibility, and cross-reactivity. RESULTS: The positive, negative, and total agreement rates of the ICA were 99%, 100%, and 99.6%, respectively, when compared with the results confirmed by ELISA and PCR. The total turnaround time of the ICA was less than 20 minutes. The lower limit of detection of the ICA for rotavirus was 1.33x10(3) TCID50/mL, which was similar to that of ELISA but higher than that of PCR. No cross-reactivity was detected for 11 viruses and 19 bacteria. CONCLUSIONS: The GENEDIA Rotavirus Ag rapid test was easy to perform and provided rapid results, which showed high agreement with those obtained using ELISA and PCR. This test appears to be a useful tool for the diagnosis of rotavirus infection.
Bacteria ; Child ; Diagnosis ; Enzyme-Linked Immunosorbent Assay ; Gastroenteritis ; Humans ; Immunochromatography* ; Infant ; Limit of Detection ; Polymerase Chain Reaction ; Rotavirus Infections ; Rotavirus*

BACKGROUND: Lung cancer is the most common cause of cancer-related mortality worldwide. We previously reported the identification of a new genetic marker, cellular retinoic acid binding protein 2 (CRABP2), in lung cancer tissues. The aim of this study was to assess plasma levels of CRABP2 from patients with non-small cell lung cancer (NSCLC). METHODS: Blood samples that were collected from 122 patients with NSCLC between September 2009 and September 2013 were selected for the analysis, along with samples from age- (± 5 years), sex-, and cigarette smoking history (± 10 pack-years [PY])-matched controls from the Korea Biobank Network. The control specimens were from patients who were without malignancies or pulmonary diseases. We measured plasma levels of CRABP2 using commercially available enzyme-linked immunosorbent assay kits. RESULTS: The mean age of the NSCLC patients was 71.8 ± 8.9 years, and the median cigarette smoking history was 32 PY (range, 0–150 PY). Plasma CRABP2 levels were significantly higher in patients with NSCLC than in the matched controls (37.63 ± 28.71 ng/mL vs. 24.09 ± 21.09 ng/mL, P < 0.001). Higher plasma CRABP2 levels were also correlated with lower survival rates in NSCLC patients (P = 0.014). CONCLUSION: Plasma CRABP2 levels might be a novel diagnostic and prognostic marker in NSCLC.
Biomarkers ; Carcinoma, Non-Small-Cell Lung* ; Carrier Proteins ; Enzyme-Linked Immunosorbent Assay ; Genetic Markers ; Humans ; Korea ; Lung Diseases ; Lung Neoplasms ; Mortality ; Plasma* ; Smoking ; Survival Rate ; Tretinoin

Background: /Aim: Cancer-associated fibroblasts (CAFs) play an immunosuppressive role in the tumor microenvironment (TME) of human cancers; however, their characteristics and role in hepatocellular carcinoma (HCC) remain to be elucidated. Methods: Nine tumor and surrounding liver tissue samples from patients with HCC who underwent surgery were used to isolate patient-derived CAFs. Cell morphology was observed using an optical microscope after culture, and cell phenotypes were evaluated using flow cytometry and immunoblotting. Cytokines secreted by CAFs into culture medium were quantified using a multiplex cytokine assay. Results: CAFs were abundant in the TME of HCC and were adjacent to immune cells. After culture, the CAFs and non-tumor fibroblasts exhibited spindle shapes. We observed a robust expression of alpha-smooth muscle actin and fibroblast activation protein in CAFs, whereas alpha-fetoprotein, epithelial cell adhesion molecule, platelet/endothelial cell adhesion molecule-1, and E-cadherin were not expressed in CAFs. Furthermore, CAFs showed high secretion of various cytokines, namely C-X-C motif chemokine ligand 12, interleukin (IL)-6, IL-8, and C-C motif chemokine ligand 2. Conclusions CAFs are abundant in the TME of HCC and play a crucial role in tumor progression. These fibroblasts secrete cytokines that promote tumor growth and metastasis.

Receptor-interacting serine/threonine-protein kinase (RIPK) 3 is a member of the TNF receptor-I signaling complex and mediates necroptosis, an inflammatory cell death. Ulcerative colitis (UC) is an excessive inflammatory disease caused by uncontrolled T cell activation. The current study is aimed to determine whether RIPK3 inhibitor attenuates UC development inhibiting inflammation and necroptosis using experimental colitis mice model. Dextran sulfate sodium-induced colitis mice were administered RIPK3 inhibitor (3 mg/ml) 3 times and their tissues were analyzed by immunohistochemistry. RIPK3, mixed lineage kinase domain-like (MLKL), phosphorylated MLKL, IL-17, and CD4 in colitis patient colon tissues were detected using confocal microscopy. Protein levels were measured using immunohistochemistry and ELISA. The differentiation of Th17 cells was evaluated using flow cytometry. The expression of proinflammatory cytokines and necroptosis in peripheral blood mononuclear cells from UC patients was decreased markedly by RIPK3 inhibitor treatment. We also observed that the injection of RIPK3 inhibitor improves colitis severity and protects intestinal destruction. RIPK3 inhibitor reduced necroptosis factors and proinflammatory cytokines in the colon and consequently protected colon devastation. The expression of inflammatory mediators in experimental colitis mice splenocytes was decreased significantly by RIPK3 inhibitor treatment. These results suggest that RIPK3 inhibitor ameliorates severity of experimental colitis and reduces inflammation through the inhibition of inflammatory response and necroptosis and support RIPK3-targeting substances for treatment of UC.

Background: Worldwide, sepsis is the leading cause of death in hospitals. If mortality rates in patients with sepsis can be predicted early, medical resources can be allocated efficiently. We constructed machine learning (ML) models to predict the mortality of patients with sepsis in a hospital emergency department. Methods: This study prospectively collected nationwide data from an ongoing multicenter cohort of patients with sepsis identified in the emergency department. Patients were enrolled from 19 hospitals between September 2019 and December 2020. For acquired data from 3,657 survivors and 1,455 deaths, six ML models (logistic regression, support vector machine, random forest, extreme gradient boosting [XGBoost], light gradient boosting machine, and categorical boosting [CatBoost]) were constructed using fivefold cross-validation to predict mortality. Through these models, 44 clinical variables measured on the day of admission were compared with six sequential organ failure assessment (SOFA) components (PaO 2 /FIO 2 [PF], platelets (PLT), bilirubin, cardiovascular, Glasgow Coma Scale score, and creatinine).The confidence interval (CI) was obtained by performing 10,000 repeated measurements via random sampling of the test dataset. All results were explained and interpreted using Shapley’s additive explanations (SHAP). Results: Of the 5,112 participants, CatBoost exhibited the highest area under the curve (AUC) of 0.800 (95% CI, 0.756–0.840) using clinical variables. Using the SOFA components for the same patient, XGBoost exhibited the highest AUC of 0.678 (95% CI, 0.626–0.730). As interpreted by SHAP, albumin, lactate, blood urea nitrogen, and international normalization ratio were determined to significantly affect the results. Additionally, PF and PLTs in the SOFA component significantly influenced the prediction results. Conclusion Newly established ML-based models achieved good prediction of mortality in patients with sepsis. Using several clinical variables acquired at the baseline can provide more accurate results for early predictions than using SOFA components. Additionally, the impact of each variable was identified.