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: The purpose of this study was to examine the mediating effect of perceptions regarding the importance of patient safety management in the relationship between incident reporting attitudes and patient safety care activities for nurses in small-and medium-sized general hospitals. The objective was to provide a basis for planning tailored training programs aimed at improving patient safety care activities.METHODS: This study was conducted with 187 participants in small- and medium-sized general hospitals in K city in South Korea from March 15 to March 31, 2019. The data collected from participants were analyzed using descriptive statistics, a t-test, ANOVA, Pearson's correlation coefficients, and a multiple regression using IBM SPSS/WIN 21.0 software.RESULTS: Patient safety care activities were found to be correlated with incident reporting attitudes (r=.27, p < .001) and perceptions of the importance of patient safety management (r=.59, p < .001). Further, perceptions of the importance of patient safety management had a complete mediating effect (β=.409, p < .001) on the relationship between incident reporting attitudes and patient safety care activities.CONCLUSION: Based on the findings of this study, tailored training programs regarding patient safety care activities focused on boosting perceptions of the importance of patient safety management are highly recommended to improve nurses' patient safety care activities in small- and medium-sized general hospitals.
Education ; Hospitals, General ; Humans ; Korea ; Negotiating ; Patient Safety ; Risk Management ; Safety Management

PURPOSE: The purpose of this study was to identify the moderating and mediating effects of resilience in the relationship between emotional labor and job satisfaction among nurses working in intensive care units (ICUs).METHOD: The participants were 144 ICU nurses from three university hospitals. Data were collected using structured questionnaires and analyzed by t-test, ANOVA, Scheffé test, Pearson correlation coefficients, and multiple regression analysis, using SPSS 25.0. The mediating effect of resilience in the relationship between emotional labor and job satisfaction was analyzed by multiple regression analysis according to Baron and Kenny's procedure.RESULTS: Statistically significant negative correlations were found between emotional labor and resilience (r=−.21, p<.014) and between emotional labor and job satisfaction (r=−.34, p<.001). A significant positive correlation was found between resilience and job satisfaction (r=.31 p<.001). A partial mediating effect by resilience was found between emotional labor and job satisfaction (Z=−2.11, p =.034), but no moderating effect was found.CONCLUSION: To improve the job satisfaction of ICU nurses, evaluation of their emotional labor, resilience, and interventions are necessary to alleviate emotional labor and improve resilience.
Hospitals, University ; Intensive Care Units ; Job Satisfaction ; Methods ; Negotiating

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

High-intensity focused ultrasound (HIFU) is a promising ablation technique for benign thyroid nodules. Current evidence has found good short- to medium-term outcomes, similar to those of better-established ablation techniques such as radiofrequency and laser ablation. The fact that it does not require insertion of a needle into the target makes HIFU a truly non-invasive treatment. Although it is not without risks, its low risk profile makes it an attractive alternative to surgery. There is much room for future development, starting from expanding the current indications to enhancing energy delivery. Relapsed Graves disease and papillary microcarcinoma are diseases that can benefit from HIFU treatment. Its role in the mediation of immune responses and synergistic effects with immunotherapy are promising in the fight against metastatic cancers.
Ablation Techniques ; Goiter, Nodular ; Graves Disease ; High-Intensity Focused Ultrasound Ablation ; Hyperthermia, Induced ; Immunotherapy ; Laser Therapy ; Needles ; Negotiating ; Thyroid Diseases ; Thyroid Gland ; Thyroid Nodule ; Ultrasonography ; Ultrasonography, Interventional

Particulate matter (PM), which refers to the mixture of particles present in the air, can have harmful effects. Damage to cells by PM, including disruption of organelles and proteins, can trigger autophagy, and the relationship between autophagy and PM has been well studied. However, the cellular regulators of PM-induced autophagy have not been well characterized, especially in keratinocytes. The Aryl Hydrocarbon Receptor (AhR) is expressed in the epidermis and is activated by PM. In this study, we investigated the role of the AhR in PM-induced autophagy in HaCaT cells. Our results showed that PM led to AhR activation in keratinocytes. Activation of the AhR-target gene CYP1A1 by PM was reduced by co-treatment with α-naphthoflavone (α-NF), an AhR inhibitor. We also evaluated activation of the autophagy pathway in PM-treated keratinocytes. In HaCaT cells, treatment with PM treatment led to the induction of microtubules-associated proteins light chain 3 (LC3) and p62/SQSTM1, which are essential components of the autophagy pathway. To study the role of the AhR in mediating PM-induced autophagy, we treated cells with α-NF or used an siRNA against AhR. Expression of LC3-ІІ induced by PM was decreased in a dose dependent manner by α-NF. Furthermore, knockdown of AhR with siAhR diminished PM-induced expression of LC3-ІІ and p62. Together, these results suggest that inhibition of the AhR decreases PM-induced autophagy. We confirmed these results using the autophagy-inhibitors BAF and 3-MA. Taken together, our results indicate that exposure to PM induces autophagy via the AhR in HaCaT keratinocytes.
Autophagy ; Cytochrome P-450 CYP1A1 ; Epidermis ; Keratinocytes ; Negotiating ; Organelles ; Particulate Matter ; Receptors, Aryl Hydrocarbon ; RNA, Small Interfering