OBJECTIVE: We aimed to investigate the ability of readout-segmented echo-planar imaging (rs-EPI)-based diffusion tensor imaging (DTI) in assessing the microstructural change of extraocular muscles (EOMs) and optic nerves in patients with thyroid-associated orbitopathy (TAO) as well as in evaluating disease activity.MATERIALS AND METHODS: We enrolled 35 TAO patients and 22 healthy controls (HCs) who underwent pre-treatment rs-EPI-based DTI. Mean, axial, and radial diffusivity (MD, AD, and RD) and fractional anisotropy (FA) of the medial and lateral EOMs and optic nerve for each orbit were calculated and compared between TAO and HC groups and between active and inactive TAO groups. Factors such as age, sex, disease duration, mediation, and smoking history between groups were also compared. Logistic regression analysis was used to evaluate the predictive value of significant variables for disease activity.RESULTS: Disease duration was significantly shorter in active TAOs than in inactive ones (p < 0.001). TAO patients showed significantly lower FA and higher MD, AD, and RD than HCs for both medial and lateral EOMs (p < 0.001), but not the AD value of lateral EOMs (p = 0.619). Active patients had significantly higher FA, MD, and AD than inactive patients for medial EOMs (p < 0.005), whereas only FA differed significantly in the lateral EOMs (p = 0.018). The MD, AD, and RD of optic nerves were significantly lower in TAO patients than HCs (p < 0.05), except for FA (p = 0.129). Multivariate analysis showed that the MD of medial EOMs and disease duration were significant predictors for disease activity. The combination of these two parameters showed optimal diagnostic efficiency for disease activity (area under the curve, 0.855; sensitivity, 68.4%; specificity, 96.9%).CONCLUSION: rs-EPI-based DTI is promising in assessing microstructural changes of EOMs and optic nerves and can help to indicate the disease activity of TAO, especially through the MD of medial EOMs.
Anisotropy ; Diffusion Tensor Imaging ; Diffusion ; Echo-Planar Imaging ; Humans ; Logistic Models ; Multivariate Analysis ; Muscles ; Negotiating ; Optic Nerve ; Orbit ; Sensitivity and Specificity ; Smoke ; Smoking ; Troleandomycin

PURPOSE: The purpose of this study was to construct and test a structural equation model on nursing work outcomes based on Youssef and Luthans' positive psychological capital and integrated conceptual framework of work performance.METHODS: This study used a structured questionnaire administered to 340 nurses. Data were analyzed using structural equation modeling.RESULTS: Positive psychological capital showed indirect and direct effects on job satisfaction, retention intention, organizational citizenship behavior, and nursing performance. While, the nursing work environment had direct and indirect effects on job satisfaction and nursing performance, it only had indirect effects on intention to work and organizational citizenship behavior. Additionally, a mediating effect on retention intention and organizational citizenship behavior was found between job satisfaction and nursing performance variables.CONCLUSION: The nursing organization needs to build a supportive work environment and reinforce positive psychological capital to improve nursing performance. Additionally, it needs to actively manage the necessary parameters involved in the stages of job satisfaction, retention intention, nursing performance, and organizational citizenship behavior of nurses. The findings propose the continuous management of nursing personnel based on nurses' attitude outcome, behavioral intention, behavioral outcome, and stage of role performance.
Attitude of Health Personnel ; Intention ; Job Satisfaction ; Negotiating ; Nursing ; Psychology, Industrial ; Task Performance and Analysis ; Work Performance

The ezrin-radixin-moesin (ERM) proteins are a family of membrane-associated proteins known to play roles in cell-shape determination as well as in signaling pathways. We have previously shown that amphetamine decreases phosphorylation levels of these proteins in the nucleus accumbens (NAcc), an important neuronal substrate mediating rewarding effects of drugs of abuse. In the present study, we further examined what molecular pathways may be involved in this process. By direct microinjection of LY294002, a PI3 kinase inhibitor, or of S9 peptide, a proposed GSK3β activator, into the NAcc core, we found that phosphorylation levels of ERM as well as of GSK3β in this site are simultaneously decreased. These results indicate that ERM proteins are under the regulation of Akt-GSK3β signaling pathway in the NAcc core. The present findings have a significant implication to a novel signal pathway possibly leading to structural plasticity in relation with drug addiction.
Amphetamine ; Animals ; Glycogen Synthase Kinases ; Humans ; Membrane Proteins ; Microinjections ; Negotiating ; Neurons ; Nucleus Accumbens ; Phosphorylation ; Phosphotransferases ; Plastics ; Proto-Oncogene Proteins c-akt ; Rats ; Reward ; Signal Transduction ; Street Drugs ; Substance-Related Disorders

PURPOSE: This study examined the relationship among the use of food-related content (FRC), dietary behaviors, and dietary self-efficacy to demonstrate the need for nutrition education to help adolescents build healthy eating habits and provide evidence for developing nutrition education programs for adolescents. METHODS: Three hundred and eighty-one high school students in Seoul and Gyeonggi areas participated in the study. The subjects were divided into three groups (low, medium, and high) according to the level of use of the FRC, and their general characteristics, dietary behaviors, and dietary self-efficacy were analyzed. Correlation analysis was performed between FRC usage, dietary behaviors, and dietary self-efficacy, and the mediating effects of dietary self-efficacy on the relationship between the level of the use of FRC and dietary behaviors were estimated. RESULTS: A higher level of FRC usage was associated with an increased daily cost of eating out and snacking, but no difference was observed in the BMI range. The subjects in a group with a high level of FRC usage ate convenience store or instant foods instead of homemade meals (p = 0.033), had a late-night meal or snack (p = 0.024), and turned to emotional eating under stress (p < 0.001) more than those in the low level group. In addition, the high level group checked the nutrition facts label more carefully when purchasing processed foods (p = 0.016) and exercised at least 30 minutes daily, not considering physical education classes (p = 0.057). The higher level of FRC use, the lower the dietary self-efficacy, whereby the subscales ‘environmental stimulus control efficacy’ and ‘affective factor control efficacy’ showed complete mediating effects. CONCLUSION: Given that FRC has been increased recently, adolescents are in need of support to help them control and enhance their dietary self-efficacy as well as develop healthy dietary behaviors through proper nutrition education programs.
Adolescent ; Eating ; Education ; Gyeonggi-do ; Humans ; Meals ; Negotiating ; Physical Education and Training ; Seoul ; Snacks

OBJECTIVES: Suicide is the most frequent cause of death among Korean adolescents, and adolescents who have experienced trauma have an increased risk of post-traumatic stress disorder (PTSD) symptoms, depression, and suicide attempts. However, resilience and self-esteem are protective factors. We examined the effects of resilience and self-esteem on the relationship among traumatic experiences, PTSD symptoms, depression, and suicidal ideation. METHODS: Middle-school students (n=403) completed questionnaires assessing traumatic experiences, PTSD symptoms, depression, suicidal ideation, resilience, and self-esteem. Path analysis was performed to investigate the mediating effects of PTSD symptoms, resilience, self-esteem, and depression on the relationship between trauma exposure and suicidal ideation. RESULTS: Traumatic experience was positively correlated with PTSD symptoms, depression, and suicidal ideation. PTSD symptoms and depression were positively correlated with suicidal ideation. The relationship between traumatic experiences and suicidal ideation was mediated by PTSD symptoms, which had both direct and indirect effects on suicidal ideation; the indirect effect was mediated by resilience, self-esteem, and depression. CONCLUSION: Korean adolescents who had experienced trauma were more likely to develop PTSD symptoms, increasing their risk of depression and suicidal ideation. However, self-esteem and resilience may help protect against depression and suicidal ideation. Our findings could inform suicide prevention initiatives.
Adolescent ; Cause of Death ; Depression ; Humans ; Negotiating ; Protective Factors ; Stress Disorders, Post-Traumatic ; Suicidal Ideation ; Suicide

The aim of this study was to construct and test a structural equation model for the risk factors of metabolic syndrome in Korean adults. The structural equation model hypothesizes that eating alone and feeling depressed is a risk factor for metabolic syndrome. The data of this study were obtained from the Sixth Korea National Health and Nutrition Examination Survey which was cross-sectional data from the representative national survey. A total of 4,013 subjects replied to the survey item of lifestyle and completed the physical examinations among adults aged 19 years or older in South Korea was in 2015. The structural model in this study was composed of four latent variables: eating alone, depression, negative health behavior, and metabolic syndrome. Two variables, the rate of eating alone and depression, were exogenous variables. Negative health behavior was both a mediating variable and endogenous variable, and metabolic syndrome was the final endogenous variable. The data were analyzed using the Maximum Likelihood method and bootstrapping. The structural model was appropriate for the data based on the model fit indices. The results of this study can be summarized as follows: Eating alone is a direct risk factor of metabolic syndrome in Korean women. Depression can mediate metabolic syndrome through negative health behaviors. Negative health behavior had a direct impact on metabolic syndrome in both men and women. This study may be a guideline for interventions and strategies to reduce the incidence of metabolic syndrome in Korean adults.
Adult ; Depression ; Eating ; Female ; Health Behavior ; Humans ; Incidence ; Korea ; Life Style ; Male ; Methods ; Models, Structural ; Negotiating ; Nutrition Surveys ; Physical Examination ; Risk Factors

This study examined the effects of social identity (cognitive, affective, and evaluative social identity) on affective commitment and behavioral intention in premium food markets. Data were collected from customers who had visited the premium food markets within three months prior to the time of the survey. A total of 247 responses were analyzed using SPSS 25.0 for Windows. The three attributes of social identity (cognitive, affective, and evaluative social identity) had a significant positive effect on the affective commitment, while affective commitment had a positive effect on the behavioral intention in premium food markets. On the other hand, only evaluative social identity had a significant positive effect on the behavioral intention in premium food markets. These results revealed the mediating effect of affective commitment in the relationship between social identity and customers' behavioral intention. This suggests a positive affective commitment as a key factor for customers in premium food markets. The results would be applied to marketing strategies based on the attributes of premium food market customers.
Hand ; Intention ; Marketing ; Negotiating ; Social Identification

OBJECTIVE: Resilience and impulsivity have opposite effects on depression in stressful situations. This study aimed to investigate the association among resilience, impulsivity, and depression in young males. METHODS: The participants consisted of 429 conscripts who underwent military training over 5 weeks. The surveys included the Connors- Davidson Resilience Scale-Korean version, the Barratt Impulsiveness Scale-11-Revised, and the Center for Epidemiological Studies- Depression Scale. The surveys were administered both before and after training. RESULTS: When simultaneously considering impulsivity and resilience, resilience was not associated with depression. Impulsivity had a complete negative mediating effect on resilience and depressive symptoms. Impulsivity is a significant negative mediating factor for the protective effect of resilience on depression. CONCLUSION: This study recommends considering impulsivity when evaluating the protective role of resilience against depression.
Depression ; Humans ; Impulsive Behavior ; Male ; Military Personnel ; Negotiating

OBJECTIVE: This study aims to examine the parallel multiple mediators of depressive symptoms and sleep quality in the relations between stress and physical health-related quality of life (PHQOL)/mental health-related quality of life (MHQOL) among the women in late pregnancy. METHODS: Of 1120 pregnant women participated in the cross-sectional study which consisted of Perceived Stress Scale, Edinburgh Postnatal Depression Scale, Pittsburgh Sleep Quality Index and MOS 12-item Short Form Health Survey. Parallel multiple mediator models were used to analyze the relations between stress, depressive symptoms, sleep quality and PHQOL/MHQOL. RESULTS: The effect of perceived stress on PHQOL was partially through the indirect path of sleep quality (β=-0.061). But in the model for MHQOL, depressive symptoms and sleep quality played parallel mediators, and the indirect path effect of depressive symptoms (β=-0.179) was higher than sleep quality (β=-0.029). CONCLUSION: The findings contributed to the understanding about the influential mechanism of stress on PHQOL/MHQOL. And it reminded the importance of sleep quality and depressive symptoms for improving QOL in late pregnancy.
Cross-Sectional Studies ; Depression ; Depression, Postpartum ; Female ; Health Surveys ; Humans ; Negotiating ; Pregnancy ; Pregnant Women ; Quality of Life

Depression leads the higher personal and socio-economical burden within psychiatric disorders. Despite the fact that over 40 antidepressants (ADs) are available, suboptimal response still poses a major challenge and is thought to be partially a result of genetic variation. Pharmacogenetics studies the effects of genetic variants on treatment outcomes with the aim of providing tailored treatments, thereby maximizing efficacy and tolerability. After two decades of pharmacogenetic research, variants in genes coding for the cytochromes involved in ADs metabolism (CYP2D6 and CYP2C19) are now considered biomarkers with sufficient scientific support for clinical application, despite the lack of conclusive cost/effectiveness evidence. The effect of variants in genes modulating ADs mechanisms of action (pharmacodynamics) is still controversial, because of the much higher complexity of ADs pharmacodynamics compared to ADs metabolism. Considerable progress has been made since the era of candidate gene studies: the genomic revolution has made possible to assess genetic variance on an unprecedented scale, throughout the whole genome, and to analyze the cumulative effect of different variants. The results have revealed key information on the biological mechanisms mediating ADs effect and identified hypothetical new pharmacological targets. They also paved the way for future availability of polygenic pharmacogenetic panels to predict treatment outcome, which are expected to explain much higher variance in ADs response compared to CYP2D6 and CYP2C19 only. As the demand and availability of AD pharmacogenetic testing is projected to increase, it is important for clinicians to keep abreast of this evolving area to facilitate informed discussions with their patients.
Antidepressive Agents ; Biomarkers ; Clinical Coding ; Cytochrome P-450 CYP2C19 ; Cytochrome P-450 CYP2D6 ; Cytochromes ; Depression ; Genetic Variation ; Genome ; Humans ; Metabolism ; Negotiating ; Pharmacogenetics ; Precision Medicine ; Treatment Outcome