Purpose: This conceptual analysis aimed to reveal the “role conflict of physician assistants with nursing licenses in Korea” by defining and organizing its concept. Methods: This study used the conceptual analysis process of Walker and Avant. Results: The role conflict of Korean physician assistant nurses can be defined by the following attributes:“Confusion of identity,” “Psychological burden of work,” “Anxiety and fear of legal responsibility,” “Anxiety about an uncertain future,” “Relative deprivation,” “Sense of neglect,” and a “Lack of sense of belonging.” The antecedents identified were: “unclear work boundaries,” “absence of work guidelines,” “excessive work and poor environment,” “Absence of regulations and administrative regulation,” “Exclusion from unfair treatment and promotion,” “Difficulty measuring job performance,” “Absence of job autonomy,” and “Physician group interest pursuit.” The consequences were: “Decreased job satisfaction,” “Decreased sense of achievement,” “Decreased self-esteem,” “Limited growth,” “Increased turnover intentions,” “Exhaustion of mind and body,” “Career identity crisis,” and “Frustrations.” Conclusion This study provides basic data for constructing a theory concerning role conflict among Korean dedicated nurses and promotes the development of measurement tools. Furthermore, it meaningfully presents both theoretical grounds for reducing the role conflict of dedicated nurses and evidence for legalization.

Purpose: This conceptual analysis aimed to reveal the “role conflict of physician assistants with nursing licenses in Korea” by defining and organizing its concept. Methods: This study used the conceptual analysis process of Walker and Avant. Results: The role conflict of Korean physician assistant nurses can be defined by the following attributes:“Confusion of identity,” “Psychological burden of work,” “Anxiety and fear of legal responsibility,” “Anxiety about an uncertain future,” “Relative deprivation,” “Sense of neglect,” and a “Lack of sense of belonging.” The antecedents identified were: “unclear work boundaries,” “absence of work guidelines,” “excessive work and poor environment,” “Absence of regulations and administrative regulation,” “Exclusion from unfair treatment and promotion,” “Difficulty measuring job performance,” “Absence of job autonomy,” and “Physician group interest pursuit.” The consequences were: “Decreased job satisfaction,” “Decreased sense of achievement,” “Decreased self-esteem,” “Limited growth,” “Increased turnover intentions,” “Exhaustion of mind and body,” “Career identity crisis,” and “Frustrations.” Conclusion This study provides basic data for constructing a theory concerning role conflict among Korean dedicated nurses and promotes the development of measurement tools. Furthermore, it meaningfully presents both theoretical grounds for reducing the role conflict of dedicated nurses and evidence for legalization.

Purpose: This conceptual analysis aimed to reveal the “role conflict of physician assistants with nursing licenses in Korea” by defining and organizing its concept. Methods: This study used the conceptual analysis process of Walker and Avant. Results: The role conflict of Korean physician assistant nurses can be defined by the following attributes:“Confusion of identity,” “Psychological burden of work,” “Anxiety and fear of legal responsibility,” “Anxiety about an uncertain future,” “Relative deprivation,” “Sense of neglect,” and a “Lack of sense of belonging.” The antecedents identified were: “unclear work boundaries,” “absence of work guidelines,” “excessive work and poor environment,” “Absence of regulations and administrative regulation,” “Exclusion from unfair treatment and promotion,” “Difficulty measuring job performance,” “Absence of job autonomy,” and “Physician group interest pursuit.” The consequences were: “Decreased job satisfaction,” “Decreased sense of achievement,” “Decreased self-esteem,” “Limited growth,” “Increased turnover intentions,” “Exhaustion of mind and body,” “Career identity crisis,” and “Frustrations.” Conclusion This study provides basic data for constructing a theory concerning role conflict among Korean dedicated nurses and promotes the development of measurement tools. Furthermore, it meaningfully presents both theoretical grounds for reducing the role conflict of dedicated nurses and evidence for legalization.

Purpose: This conceptual analysis aimed to reveal the “role conflict of physician assistants with nursing licenses in Korea” by defining and organizing its concept. Methods: This study used the conceptual analysis process of Walker and Avant. Results: The role conflict of Korean physician assistant nurses can be defined by the following attributes:“Confusion of identity,” “Psychological burden of work,” “Anxiety and fear of legal responsibility,” “Anxiety about an uncertain future,” “Relative deprivation,” “Sense of neglect,” and a “Lack of sense of belonging.” The antecedents identified were: “unclear work boundaries,” “absence of work guidelines,” “excessive work and poor environment,” “Absence of regulations and administrative regulation,” “Exclusion from unfair treatment and promotion,” “Difficulty measuring job performance,” “Absence of job autonomy,” and “Physician group interest pursuit.” The consequences were: “Decreased job satisfaction,” “Decreased sense of achievement,” “Decreased self-esteem,” “Limited growth,” “Increased turnover intentions,” “Exhaustion of mind and body,” “Career identity crisis,” and “Frustrations.” Conclusion This study provides basic data for constructing a theory concerning role conflict among Korean dedicated nurses and promotes the development of measurement tools. Furthermore, it meaningfully presents both theoretical grounds for reducing the role conflict of dedicated nurses and evidence for legalization.

Background/Aims: Patients with liver cirrhosis (LC) have low levels of branchedchain amino acids (BCAAs). There is accumulating evidence that BCAAs have anti- fibrotic effects in cirrhosis. This study is aimed to evaluate the effect of BCAAs on the function and phenotype of activated hepatic stellate cells (HSCs). Methods: LX-2, an immortalized human stellate cell line, was used in in vitro experiments. LX-2 cells were exposed to transforming growth factor β1 (TGF-β1) and BCAAs or to valine, leucine, and isoleucine, which are components of BCAAs. Activation of the TGF-β signaling pathway in LX-2 cells was observed using real- time quantitative polymerase chain reaction and Western blotting. Results: The increased expression of snail family transcriptional repressor 1 (SNAI1) was observed in LX-2 cells activated by TGF-β1. After BCAA treatment, its expression was significantly decreased at the mRNA level. The increased expression of Col1α1 and TIMP2 at the mRNA level and alpha smooth muscle actin at the protein level in activated LX-2 cells decreased after BCAA treatment. Among the BCAA components, leucine and valine significantly abrogated TGF-β-induced activation of LX-2 cells. BCAA treatment led to the decreased phosphorylation of Smad2 and p38 proteins, which are markers for Smad and Smad-independent p38 mitogen-activated protein kinase signaling pathways, respectively. Conclusions BCAA treatment can improve hepatic fibrosis by directly affecting the activated state of hepatic stellate cells through inhibition of the TGF-β signaling pathway. Among BCAA components, leucine and valine mainly abrogated TGF-β-induced activation of HSCs. Our results suggest that BCAA may be used to attenuate the progression of liver fibrosis.

We examined the precision, accuracy, and capability of detecting changes of Dual-Energy X-ray Absorptiometry (DXA) for the measurements of total-body weight (TBW), total-body fat weight (TBFW), and total-body lean weight (TBLW) in an 8-week follow-up study of rats. Twenty male rats (4-week) were divided into 2 diet groups. For 8 weeks, we measured body composition (TBW, TBFW, TBLW) by DXA and TBW by an electronic scale once a week. In week 8, we measured body composition 5 times by DXA and TBFW by dissecting experiment (EXP) of euthanized rats (12-week). Total-body fat ratio (TBFR) was defined as TBFW/(TBFW+TBLW). The precision of DXA was evaluated by measuring the coefficient of variation (CV) and accuracy was evaluated by comparing DXA-derived data with EXP data. The capability of detecting changes of DXA in follow-up study was verified by analyzing the trend of DXA-derived values over the 8 weeks. For TBW, TBFW, TBLW of DXA, CVs were 0.02 ± 0.01, 0.10 ± 0.05, 0.03 ± 0.02 and errors were − 6.996 ± 3.429 (r = 0.999), + 14.729 ± 3.663 (r = 0.982), − 21.725 ± 4.223 (r = 0.991), respectively. Prediction models were [EXP TBW = − 31.767 + 1.085 (DXA TBW), R2 = 0.998, root mean square error (RMSE) = 1.842] and [EXP TBFR = − 0.056 + 1.177 (DXA TBFR), R2 = 0.948, RMSE = 0.007]. Over 8 weeks, DXA TBW and DXA TBLW steadily increased, DXA TBFW steadily increased followed by saturation or declination, difference of DXA TBFW between 2 diet groups steadily increased. In conclusion, our study verified that DXA (iNSiGHT VET DXA, OsteoSys, Korea) is accurate and precise enough to measure body composition of rats. Additionally, we confirmed the possibility that DXA could be used for the long-term follow-up studies.
Absorptiometry, Photon ; Animals ; Body Composition ; Diet ; Diet, High-Fat ; Follow-Up Studies ; Humans ; Male ; Obesity ; Rats

PURPOSE: This study aimed to evaluate the thermal protective function of firefighter clothes and gloves through real scale fire simulations. METHODS: Firstly, the fire simulation by real scale flame was performed for firefighter clothes. A manikin equipped with firefighter clothes was directly exposed to flames which energy average is 84 Kw/m2. for 22 seconds. Heat flux gauges attached on the body measured surface temperature elevation. Secondly, we also performed the other fire simulation by hot plate exposure to firefighter gloves. Firefighter gloves with heat flux gauges exposed hot plate which temperature is 300℃ in both dry and moist conditions. Primary outcome was surface temperature change of manikin body (first simulation) and hand (second simulation) over times. RESULTS: In the first flame simulation, the surface temperature of face and shoulders elevated more rapidly comparing with the other body surface area when initial period of flame shutter open. After 18sec of shutter open, the surface temperature of upper trunk elevated rapildy. After shutter closure, high surface temperature kept continuously on right side of face and left shoulder. In the second hot plate simulation, fingers and palms showed higher surface temperature than the other areas of hands in the both dry and wet conditions. CONCLUSION: This study suggests that the real scale flame enables firefighter clothes to lose their heat protective function suddenly after 18 seconds. Additionally, the protective function of firefighter gloves were relatively weaker in the palmar side of fingers than the other parts of hand. There should be additional study for evaluate thermal protection performance of firefighter clothes. And, further effort for reinforce palmar side of fingers of firefighter gloves should be done.
Body Surface Area ; Clothing* ; Fingers ; Firefighters* ; Fires ; Hand ; Hot Temperature ; Humans ; Manikins ; Patient Simulation ; Shoulder

BACKGROUND/AIMS: The role of Elk-3 in the epithelial-mesenchymal transition (EMT) during liver fibrogenesis remains unclear. Here, we determined the expression of Elk-3 in in vitro and in vivo models and in human liver fibrotic tissues. We also investigated the molecular relationships among Elk-3, early growth response-1 (Egr-1), and the mitogen activated protein kinases (MAPK) pathway during EMT in hepatocytes. METHODS: We established anin vitro EMT model in which normal mouse hepatocyte cell lines were treated with transforming growth factor (TGF)-β1 and a CCl4-induced liver fibrosis model. Characteristics of EMT were determined by evaluating the expression levels of related markers. The expression of Elk-3 and its target Egr-1 were analyzed using Western blotting. Gene silencing of Elk-3 was performed using an siRNA knockdown system. RESULTS: The expression levels of mesenchymal markers were increased during TGF-β1-induced EMT of hepatocytes. The expression levels of Elk-3 and Egr-1 were significantly (p<0.05) increased during the EMT of hepatocytes, in CCl₄-induced mouse liver fibrotic tissues, and in human liver cirrhotic tissues. Silencing of Elk-3 and inhibition of the Ras-Elk-3 pathway with an inhibitor suppressed the expression of EMT-related markers. Moreover, Elk-3 expression was regulated by p38 MAPK phosphorylation during EMT. CONCLUSIONS: Elk-3 contributes to the progression of liver fibrosis by modulating the EMT via the regulation of Egr-1 under MAPK signaling.
Animals ; Blotting, Western ; Cell Line ; Epithelial-Mesenchymal Transition* ; Gene Silencing ; Hepatocytes ; Humans ; In Vitro Techniques ; Liver Cirrhosis* ; Liver* ; Mice ; Mitogen-Activated Protein Kinases ; p38 Mitogen-Activated Protein Kinases ; Phosphorylation ; RNA, Small Interfering ; Transforming Growth Factors

PURPOSE: This study analyzed the prognostic factors affecting admission in acute alcohol-intoxicated traumatic brain injury (TBI) patients visiting the emergency room. METHODS: A multicenter, retrospective observational study was conducted on 821 acute alcohol-intoxicated adult trauma patients, who visited 10 university hospital emergency centers from April to November 2016. The primary outcome was hospital admission. The secondary outcome was in-hospital mortality. RESULTS: One hundred sixty-eight patients diagnosed with acute alcohol-intoxicated TBI were analyzed. The increase in blood alcohol concentration was associated significantly with a mild decrease in admission (adjusted odds ratio, 0.993; 95% confidence interval, 0.989 to 0.998; p=0.01). Moderate to severe TBI patients showed a significant increase in admission compared to mild TBI patients (adjusted odds ratio, 12.449; 95% confidence interval, 3.316 to 46.743; p < 0.001). CONCLUSION: This study showed that the admission was inversely correlated with the blood alcohol concentration and is correlated directly with the increase in the severity in TBI. Therefore, emergency physicians may be required to identify the severity of TBI rapidly and accurately in acute alcohol-intoxicated trauma patients visiting the emergency room.
Adult ; Alcohol Drinking ; Blood Alcohol Content ; Brain Injuries* ; Emergencies* ; Emergency Service, Hospital* ; Hospital Mortality ; Humans ; Observational Study ; Odds Ratio ; Patient Admission ; Prognosis ; Retrospective Studies

PURPOSE: The purpose of this study was to examine the effect of post-operative exercise on body composition, psychological factors, time to flatus and length of hospital stay in stage 1~3 colorectal cancer patients. METHODS: A total of 35 post surgery patients were recruited and randomly assigned to the exercise or controlled group. Participants in the exercise group exercised twice a day while participants in the control group followed the clinical pathways (CP). RESULTS: A total of 25 participants completed the trial. Post-operative exercise resulted in a clinically meaningful, but statistically insignificant reduction in body weight (Exercise: -1.10±1.63 kg vs. CP: -0.63±1.16 kg; p=.111), fat mass (Exercise: -1.43±0.95 kg vs. CP: 0.64±4.29 kg; p=.100). When participants' body composition were compared to their baseline values at the baseline, only the exercise group experienced a significant reduction in body weight, body mass index (BMI) and fat mass. In addition, post-operative exercise significantly improved health related quality of life (Exercise: 2.27±2.08 vs CP: -12.82±22.47; p=.008). However, there was no difference in time to flatus and the length of hospital stay between groups. CONCLUSION: The current pilot study suggests that the post-operative exercise program was safe and produced for health related quality of life improvements in colorectal cancer patients.
Body Composition ; Body Mass Index ; Body Weight ; Colorectal Neoplasms* ; Critical Pathways ; Flatulence ; Humans ; Length of Stay ; Pilot Projects ; Psychology ; Quality of Life