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 tries to test mediating effects of hope and therapeutic relationship in the relation between general social functions and mental health recovery of community people with mental illness. METHODS: This study was carried out in a cross-sectional research design. The participants included 217 people with mental illnesses who were enrolled at eight Mental Health Welfare Centers in the Gyeonggi Province. Data were collected from February to May, 2018. The collected data were analyzed using a regression analysis, and SPSS PROCESS macro was used to test the mediating effects. RESULTS: This study analyzed the direct effects of general social functions on the hope, therapeutic relationship and mental health recovery. And general social functions had indirect effects on their mental health recovery via hope and therapeutic relationship. Both hope and therapeutic relationship had dual mediating effects in the influence of general social functions on mental health recovery. CONCLUSION: The role of hope and therapeutic relationship in the mental health recovery of community people with mental illness is important, and it is confirmed that hope is a powerful factor influencing mental health recovery.
Gyeonggi-do ; Hope ; Humans ; Mental Health ; Mentally Ill Persons ; Negotiating ; Professional-Patient Relations ; Research Design ; Social Adjustment

PURPOSE: The purpose of this study isto identify the mediating effects of interpersonal problems in the relationship between Social Network Service (SNS) use tendency and depression among university students. METHODS: Data were collected from April 28 to May 7, 2018 and the participants included 222 university students, who responded to the question regarding SNS use tendency, interpersonal problems and depression. The data were analyzed by descriptive statistics, t-test, ANOVA, Pearson's correlation coefficients, and multiple regression using the SPSS/WIN 23.0 program. RESULTS: A positive correlation is found between depression and SNS use tendency (r=.24, p<.001), and among interpersonal problems (r=.62, p<.001), SNS use tendency and interpersonal problems (r=.34, p<.001). Interpersonal problems have a full mediating effect on the relationship between SNS use tendency and depression (Sobel test: 5.24, p<.001). CONCLUSION: These results suggest that it is important to manage interpersonal problems to prevent depression caused by SNS use tendency.
Depression ; Humans ; Interpersonal Relations ; Negotiating

The development of next generation sequencing (NGS) has led to marked advancement of our understanding of genetic events mediating the initiation and progression of thyroid cancers. The NGS studies have confirmed the previously reported high frequency of mutually-exclusive oncogenic alterations affecting BRAF and RAS proto-oncogenes in all stages of thyroid cancer. Initially identified by traditional sequencing approaches, the NGS studies also confirmed the acquisition of alterations that inactivate tumor protein p53 (TP53) and activate phosphatidylinositol-4,5-bisphosphate 3-kinase catalytic subunit alpha (PIK3CA) in advanced thyroid cancers. Novel alterations, such as those in telomerase reverse transcriptase (TERT) promoter and mating-type switching/sucrose non-fermenting (SWI/SNF) complex, are also likely to promote progression of the BRAF(V600E)-driven thyroid cancers. A number of genetically engineered mouse models (GEMM) of BRAF(V600E)-driven thyroid cancer have been developed to investigate thyroid tumorigenesis mediated by oncogenic BRAF and to explore the role of genetic alterations identified in the genomic analyses of advanced thyroid cancer to promote tumor progression. This review will discuss the various GEMMs that have been developed to investigate oncogenic BRAF(V600E)-driven thyroid cancers.
Animals ; Carcinogenesis ; Catalytic Domain ; Mice ; Mice, Transgenic ; Negotiating ; Proto-Oncogene Proteins B-raf ; Proto-Oncogenes ; Telomerase ; Thyroid Gland ; Thyroid Neoplasms

PURPOSE: This study investigates the effect of pregnant women's growth mindset on the stress of pregnancy through ego-resilience. METHODS: The subjects included 551 pregnant women in Seoul and Gyeonggi area. Data were collected using a structured questionnaire; statistical, frequency, correlation, and structural equation analyses were performed using SPSS21 and M-plus 7.0. RESULTS: First, pregnant women's growth mindset had a direct effect on pregnancy stress. Second, the mediating pathway that influenced pregnancy stress through the ego-resilience of growth mindset was significant. CONCLUSION: These results suggest that it is important to devise and practice a method to improve the growth mindset of pregnant women, enhance ego-resilience, and reduce the negative effects of stress by reducing pregnancy stress.
Female ; Gyeonggi-do ; Humans ; Methods ; Negotiating ; Pregnancy ; Pregnant Women ; Seoul

PURPOSE: This paper is based on an ecological study. From 2008 to 2014, we identified the differences in the Low Birth Weight (LBW) rate according to land use rate among the 25 autonomous regions of Seoul. We also demonstrated the effects of ecological environmental differences on maternal outcomes. METHODS: The National Statistical Office obtained data of residential areas and rates, commercial areas and rates, industrial areas and rates, green areas and rates of the 25 autonomous regions from 2008 to 2014. It also obtained data regarding low birth weight rates for the same region and period. The rate of land use is divided into four stages by residential rate, three by commercial rate, three by industrial rate, and four by green area rate The higher the step, the higher the rate is. The method by Baron and Kenny was used to investigate the mediating effects of the concentration of air pollutants (PM10, PM2.5, SO2, NO2, O3, CO) on LBW and its relationship to land use in each district of Seoul. The relationship between the change of land use and LBW rate in each region was analyzed with general regression analysis and cluster analysis. RESULTS: This study shows that as the rate of green area to overall area increases in Seoul's industrial area, a causal effect is observed with low birth weight, mediated by SO2. Regression analysis revealed that LBW rates were significantly higher in heavily industrial areas (beta=1.27, SE=0.27, p<0.05), while LBW rate was significantly lower in considerably greener areas (beta=−2.21, SE=0.39, p<0.05). CONCLUSION: We confirmed differences in the relationship between residential, commercial, industrial, and green areas, air pollutants, and LBW rate. Areas with high industrial rates have a high LBW rate, while areas with high green rates have a low LBW rate. The autonomous land use ratio includes direct environmental factors. Therefore, pregnant women who are living in highly industrial areas should be especially careful to manage their living environment.
Air Pollutants ; Female ; Humans ; Infant, Low Birth Weight ; Infant, Newborn ; Methods ; Negotiating ; Pregnant Women ; Seoul

PURPOSE: The aim of this study was to examine the mediating effect of self-efficacy in the relationship of physical and psychological symptoms to exercise adherence in patients with heart failure. METHODS: The participants in this study were 186 patients with heart failure in two hospitals located in Busan. The measures included questions about general and disease characteristics, physical symptoms, psychological symptoms, self-efficacy for exercise, and exercise adherence. Data were analyzed using t-test, ANOVA, Pearson correlation coefficients, simple and multiple regression using Baron and Kenny steps for mediation. RESULTS: There were significant differences in age, gender and comorbidity on exercise adherence. There were also significant correlations among physical and psychological symptoms, self-efficacy for exercise, and exercise adherence. Self-efficacy for exercise showed partial mediating effects in the relationship between physical symptoms and exercise adherence. CONCLUSION: Based on the findings of this study, the enhancement of self-efficacy for exercise may positively affect the exercise compliance of the patients with health failure, even while they are experiencing physical symptoms. Therefore, it is necessary to develop effective strategies to enhance self-efficacy for exercise.
Busan ; Comorbidity ; Compliance ; Heart Failure ; Heart ; Humans ; Negotiating

PURPOSE: This study was done to identify the effects of nurses' time pressure on their safety care activities through the mediation of burnout. METHODS: Participants, 147 nurses with at least one year of work experience in two university hospitals were enrolled in this study. Data were collected using a self-reported questionnaire from July 31, to August 31, 2017 and analyzed with t-test, ANOVA, and Pearson's correlation coefficients. SPSS 23.0 was used for analysis. Mediating effects were examined with stepwise simple and complex regression, and statistical significance was verified with the Sobel test. RESULTS: Time pressure and burnout were significantly negatively correlated with safety care activities, and there was a positive correlation between time pressure and burnout. Regarding the mediating effects of burnout in the relationship between time pressure and safety care activity, time pressure had a significant effect on safety care activity both directly and indirectly through burnout, confirming a partial mediation effect of burnout. CONCLUSION: Strategies for enhancing work efficiency to reduce nurses' time pressure are needed to promote safety care activities. Furthermore, because burnout facilitated by time pressure among nurses influences their patient care activities, interventions for burnout management must also be implemented simultaneously.
Hospitals, University ; Negotiating ; Patient Care ; Patient Safety