: This study was to develop and evaluate the validity and inter-rater reliability of airway management tool. Methods : Airway management skills in 20 nursing students were assessed by two investigators using a procedures-specific assessment tool. Overall performance and domain scores between teams were compared using independent samples t-test to assess construct validity. Intraclass correlation coefficients (ICC) were calculated to assess inter-rater reliability. Results : Regarding construct validity, there was no statistical difference in the performance scores for each class of the two evaluators for students in class 1 and class 2. ICCs for overall performance were –0.145-0.835. Conclusion : Overall inter-rater reliability appears to have been achieved at a moderate level and good construct validity. In order to supplement the items, it is judged that it is necessary to simplify the skill evaluation questions and increase the practice time.

: This study was to develop and evaluate the validity and inter-rater reliability of airway management tool. Methods : Airway management skills in 20 nursing students were assessed by two investigators using a procedures-specific assessment tool. Overall performance and domain scores between teams were compared using independent samples t-test to assess construct validity. Intraclass correlation coefficients (ICC) were calculated to assess inter-rater reliability. Results : Regarding construct validity, there was no statistical difference in the performance scores for each class of the two evaluators for students in class 1 and class 2. ICCs for overall performance were –0.145-0.835. Conclusion : Overall inter-rater reliability appears to have been achieved at a moderate level and good construct validity. In order to supplement the items, it is judged that it is necessary to simplify the skill evaluation questions and increase the practice time.

: This study was to develop and evaluate the validity and inter-rater reliability of airway management tool. Methods : Airway management skills in 20 nursing students were assessed by two investigators using a procedures-specific assessment tool. Overall performance and domain scores between teams were compared using independent samples t-test to assess construct validity. Intraclass correlation coefficients (ICC) were calculated to assess inter-rater reliability. Results : Regarding construct validity, there was no statistical difference in the performance scores for each class of the two evaluators for students in class 1 and class 2. ICCs for overall performance were –0.145-0.835. Conclusion : Overall inter-rater reliability appears to have been achieved at a moderate level and good construct validity. In order to supplement the items, it is judged that it is necessary to simplify the skill evaluation questions and increase the practice time.

Background: : Effective communication between doctors and patients is very important not only for diagnosis and treatment but also for building trust. Although teaching communication skills is very important in medical schools, there are limitations such as the number of students and the uncertainty of the patient population. Therefore, this study evaluates the effect of Fishbowl method to teach communication skills to medical students, which involves the medical students communicating with standardized patients in front of a large classroom and being observed by rest of the students. Methods: : This study involves 10 weeks of educating 126 fourth grade medical students and graduates. During this period, total 8 classes were taken by subjects, where each class lasts 2 hours and is conducted by observing treatments of the standardized patients on 14 clinical topics by randomly selected medical students and giving feedback on the communication skills of the selected medical students. The educational effect was evaluated based on the scores of the clinical performance examination before and after the classes. Results: : The scores assessed for medical history taking before and after the training are increased by 2.45 (p<0.001) and the scores for patient-doctor relationship is increased by 7.56 (p<0.001). Conclusions : It is expected to improve the communication skills of medical students by large scale lectures with standardized patients.

Porcine epidemic diarrhea virus (PEDV) is a contagious coronavirus infecting pigs that leads to significant economic losses in the swine industry. Given that PEDV infection occurs in gut epithelial cells mainly via the fecal-oral route, induction of PEDV-specific immune responses in the mucosal compartment is required for protective immunity against viral infection. However, an effective mucosal vaccine against the currently prevalent PEDV strain is not available. In this study, we demonstrated that the N-terminal domain (NTD) of the spike (S) protein of PEDV represents a new vaccine candidate molecule to be applied via the mucosal route. We first established an Escherichia coli expression system producing the partial NTD (NTD231–501) of the PEDV S protein. Orally administered NTD231–501 protein specifically interacted with the apical area of M cells in the follicle-associated epithelium of Peyer's patch. Additionally, the NTD protein induced antigen-specific immune responses in both the systemic and mucosal immune compartments when administered orally. Collectively, we propose the NTD of the PEDV S protein to be a candidate mucosal vaccine molecule.
Coronavirus ; Epithelial Cells ; Epithelium ; Escherichia coli ; Immunity, Mucosal ; Porcine epidemic diarrhea virus* ; Swine

In the intestinal mucosal surface, microfold cells (M cells) are the representative gateway for the uptake of luminal antigens. At the same time, M cells are the primary infection site for pathogens invading mucosal surface for their infection. Although it is well recognized that many mucosal pathogens exploit the M cells for their infection, the mechanism to infect M cells utilized by pathogens is not clearly understood yet. In this study, we found that M cells expressing complement 5a (C5a) receptor (C5aR) also express Toll-like receptor (TLR) 1/2 and TLR4. Infection of Yersinia enterocolitica, an M cell-invading pathogen, synergistically regulated cyclic adenosine monophosphate-dependent protein kinase A (cAMP-PKA) signaling which are involved in signal crosstalk between C5aR and TLRs. In addition, Y. enterocolitica infection into M cells was enhanced by C5a treatment and this enhancement was abrogated by C5a antagonist treatment. Finally, Y. enterocolitica infection into M cells was unsuccessful in C5aR knock-out mice. Collectively, we suggest that exploit the crosstalk between C5aR and TLR signaling is one of infection mechanisms utilized by mucosal pathogens to infect M cells.
Adenosine ; Animals ; Complement C5a* ; Complement System Proteins* ; Cyclic AMP-Dependent Protein Kinases ; Mice ; Mice, Knockout ; Phenobarbital ; Receptor, Anaphylatoxin C5a* ; Toll-Like Receptors* ; Yersinia enterocolitica* ; Yersinia*

Vaccination is the most successful immunological practice that improves the quality of human life and health. Vaccine materials include antigens of pathogens and adjuvants potentiating the effectiveness of vaccination. Vaccines are categorized using various criteria, including the vaccination material used and the method of administration. Traditionally, vaccines have been injected via needles. However, given that most pathogens first infect mucosal surfaces, there is increasing interest in the establishment of protective mucosal immunity, achieved by vaccination via mucosal routes. This review summarizes recent developments in mucosal vaccines and their associated adjuvants.
Humans ; Immunity, Mucosal ; Methods ; Needles ; Vaccination ; Vaccines*

Major histocompatibility complex (MHC) class II molecules, which are recognized for their primary function of presenting an antigen to the T cell receptor, are involved in various signaling pathways in B cell activation. We identified heterogeneous nuclear ribonucleoprotein (hnRNP) A2B1 as an MHC class II molecule-associated protein involved in MHC class II-mediated signal transduction in lipopolysaccharide (LPS)-stimulated 38B9 B cells. Although the function of hnRNP A2B1 in the nucleus is primarily known, the level of hnRNP A2B1 in the cytoplasm was increased in LPS-stimulated 38B9 cells, while it was not detected in the cytoplasm of non-treated 38B9 cells. The silencing of hnRNP A2B1 expression using siRNA disturbed B cell maturation by regulation of mitogen-activated protein kinase signaling, NF-κB activation, and protein kinase B activation. These results suggest that hnRNP A2B1 is associated with MHC class II molecules and is involved in B cell activation signaling pathways in LPS-stimulated 38B9 cells.
B-Lymphocytes ; Cytoplasm ; Heterogeneous-Nuclear Ribonucleoproteins* ; Major Histocompatibility Complex ; Protein Kinases ; Proto-Oncogene Proteins c-akt ; Receptors, Antigen, T-Cell ; RNA, Small Interfering ; Signal Transduction

PURPOSE: Femoral intertrochanteric fractures are common in the elderly. Appropriate surgical fixation of trochanteric fracture fragments can restore normal anatomical structure and ambulation, and can aid in the recovery of biomechanical function of the hip. We evaluated clinical outcomes of bipolar hemiarthroplasty using a wiring technique for trochanteric fracture fragment fixation. MATERIALS AND METHODS: From September 2006 to February 2015, a total of 260 cases underwent simultaneous bipolar hemiarthroplasty and wire fixation. A total of 65 patients (69 hips) with an average age of 78 years and more than one year of follow-up was included in the study. Using pre-, postoperative and follow-up radiograms, we evaluated wire fixation failure and also assessed changes in walking ability. RESULTS: Loosening or osteolysis around the stem was not observed; however, we did observe bone growth around the stem (54 cases), cortical hypertrophy (6 cases), a wide range of sclerotic lines but no stem subsidence (1 case), wire breakage (9 cases), and fracture fragment migration with no significant functional deficiency (2 cases). CONCLUSION: Our study showed that additional wiring for trochanteric fracture fragment fixation following bipolar hemiarthroplasty can help restore normal anatomy. The added stability results in faster rehabilitation, and good clinical and radiographic outcomes. We recommend this procedure in this type of fracture.
Aged ; Bone Development ; Bone Wires ; Clinical Study* ; Femur* ; Follow-Up Studies ; Fracture Fixation ; Hemiarthroplasty* ; Hip ; Hip Fractures ; Humans ; Hypertrophy ; Osteolysis ; Rehabilitation ; Walking

Red ginseng is a well-known alternative medicine with anti-inflammatory activity. It exerts pharmacological effects through the transformation of saponin into metabolites by intestinal microbiota. Given that intestinal microflora vary among individuals, the pharmacological effects of red ginseng likely vary among individuals. In order to produce homogeneously effective red ginseng, we prepared probiotic-fermented red ginseng and evaluated its activity using a dextran sulfate sodium (DSS)-induced colitis model in mice. Initial analysis of intestinal damage indicated that the administration of probiotic-fermented red ginseng significantly decreased the severity of colitis, compared with the control and the activity was higher than that induced by oral administration of ginseng powder or probiotics only. Subsequent analysis of the levels of serum IL-6 and TNF-α, inflammatory biomarkers that are increased at the initiation stage of colitis, were significantly decreased in probiotic-fermented red ginseng-treated groups in comparison to the control group. The levels of inflammatory cytokines and mRNAs for inflammatory factors in colorectal tissues were also significantly decreased in probiotic-fermented red ginseng-treated groups. Collectively, oral administration of probiotic-fermented red ginseng reduced the severity of colitis in a mouse model, suggesting that it can be used as a uniformly effective red ginseng product.
Administration, Oral ; Animals ; Colitis ; chemically induced ; drug therapy ; immunology ; Colon ; drug effects ; immunology ; Dextran Sulfate ; adverse effects ; Disease Models, Animal ; Female ; Fermentation ; Humans ; Interleukin-6 ; immunology ; Lactobacillus plantarum ; metabolism ; Mice ; Mice, Inbred BALB C ; Panax ; chemistry ; metabolism ; microbiology ; Plant Extracts ; administration & dosage ; chemistry ; metabolism ; Powders ; administration & dosage ; metabolism ; Probiotics ; metabolism ; Tumor Necrosis Factor-alpha ; immunology