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

OBJECTIVES: In recent decades, due to the high prevalence of divorce in numerous countries and the detrimental aftermath thereof, it has become increasingly important to study the components of marital stability. The current study explored fundamental protective factors in long-term marriage through a systematic review.METHODS: Searches for relevant publications were conducted in Embase, Web of Science, PubMed, Scopus, Science Direct, Magiran, and Scientific Information Database from their inception through January 30, 2019. Through the keyword search, 1,706 articles were found, of which 25 articles remained after screening based on the eligibility criteria.RESULTS: The extracted protective factors associated with marital stability in long-term marriage were classified as interpersonal and intrapersonal. Notable extracted factors included spirituality and religion, commitment, sexual relationship, communication, children, love and attachment, intimacy, and conflict resolution approach. These findings show that some aspects of relationships, such as commitment, act to preserve the pillars of marriage in critical situations, while other aspects, such as intimacy, help to construct marital identity and satisfaction.CONCLUSIONS: The identified components of marital stability are structures that enhance a couple's identity and sense of togetherness. Identifying the specific aspects of marital relationships that contribute to marital stability may help specialists and researchers to target specific types of marital interaction that may enhance the happiness and longevity of relationships, thereby preventing avoidable divorces.
Child ; Divorce ; Happiness ; Humans ; Longevity ; Love ; Marriage ; Mass Screening ; Negotiating ; Prevalence ; Protective Factors ; Specialization ; Spirituality

OBJECTIVES: Although smoking is associated with both low socioeconomic status and blood cadmium (Cd) levels, the association between socioeconomic status and Cd levels remains unclear. Therefore, our study aimed to examine this association and to clarify whether smoking is a confounding or mediating variable in this relationship.METHODS: Data (n=7,734) were drawn from the Korea National Health and Nutrition Examination Survey (KNHANES, 2008- 2011), including years that contained data on blood Cd and urinary cotinine levels. We investigated the associations of income, education, and occupation with blood Cd levels. Smoking was investigated by categorizing participants by smoking status (never, former, and current) and pack-years into quartiles. The weekly frequency of rice and barley intake was analyzed to gain insights into participants' dietary patterns. Additionally, urinary cotinine levels were used to ensure the validity of the smoking variables.RESULTS: Participants earning a low income and with less formal education had higher blood Cd levels. After controlling for smoking, the association between income and Cd levels substantially weakened. Further controlling for education, the association between income and Cd levels disappeared. However, there was a strong negative association between education and Cd levels, even after controlling for smoking history, pack-years, and urinary cotinine levels.CONCLUSIONS: In cross-sectional data from the KNHANES, blood Cd levels were significantly higher among those with a low income and less formal education. Smoking history contributed to, but did not fully explain, these associations.
Cadmium ; Cotinine ; Education ; Hordeum ; Korea ; Negotiating ; Nutrition Surveys ; Occupations ; Smoke ; Smoking ; Social Class

We previously demonstrated that atherogenic Ldlr(−/−)Apobec1(−/−) (LDb) double knockout mice lacking both low-density lipoprotein receptor (LDLR) and apolipoprotein B mRNA-editing catalytic polypeptide-1 (Apobec1) had increased serum IL-17 levels, with T cell programming shifted towards Th17 cells. In this study, we assessed the role of proprotein convertase subtilisin/kexin type 9 (PCSK9) in T cell programming and atherogenesis. We deleted the Pcsk9 gene from LDb mice to generate Ldlr(−/−)Apobec1(−/−)Pcsk9(−/−) (LTp) triple knockout mice. Atherosclerosis in the aortic sinus and aorta were quantitated. Lymphoid cells were analyzed by flow cytometry, ELISA and real-time PCR. Despite of dyslipidemia, LTp mice developed barely detectable atherosclerotic lesions. The IL-17, was very low in plasma and barely detectable in the aortic sinus in the LTp mice. In the spleen, the number of CD4⁺CD8⁻ cells and splenocytes were much lower in the LDb mice than LTp mice, whereas, the IL-17-producing cells of γδTCR⁺ T cells and effector memory CD4⁺ T cells (CD44(hi)CD4⁺) in the spleen were significantly higher in the LDb mice than in the LTp mice. The Rorc mRNA expression levels were elevated in LDb mice compared to LTp mice. When re-stimulated with an anti-CD3 Ab, CD44(hi)CD4⁺ T cells from LDb mice secreted more IL-17 than those from LTp mice. T cells from LDb mice (with PCSK9) produce more IL-17 at basal and stimulated conditions when compared with LTp mice (without PCSK9). Despite the dyslipidemic profile and the lack of LDLR, atherogenesis is markedly reduced in LTp mice. These results suggest that PCSK9 is associated with changes in T cell programming that contributes to the development of atherosclerosis.
Animals ; Aorta ; Apolipoproteins ; Atherosclerosis ; Dyslipidemias ; Enzyme-Linked Immunosorbent Assay ; Flow Cytometry ; Hyperlipidemias ; Interleukin-17 ; Lymphocytes ; Memory ; Mice ; Mice, Knockout ; Negotiating ; Plasma ; Proprotein Convertases ; Real-Time Polymerase Chain Reaction ; Receptors, Lipoprotein ; RNA, Messenger ; Sinus of Valsalva ; Spleen ; T-Lymphocytes ; Th17 Cells

PURPOSE: This study was done to identify trends in leadership-related research by reviewing studies on hospital nurses in South Korea.METHODS: The research was conducted from April 2 to 14, 2018 and search databases were RISS, KISS, DBpia, KM base, NAL, and NDSL. Search terms were ‘leadership’ and ‘nursing’ in the Korean language, and total 141 papers were selected.RESULTS: Analysis of the research on leadership showed that 96.4% of research methods were quantitative research, and 60.3% were predictive researches. For study settings, 46.2% were general hospitals, 96.5% were staff nurses. In the study of leadership variables, 60.3% were independent variables and recent leadership was used as a mediating variable (4.3%) and a moderating variable (2.8%). Among the leadership types, self-leadership (31.2%) was the most common, and the main variable related to leadership was job satisfaction (25.8%).CONCLUSION: These results provide useful data for deriving new research ideas about nursing leadership. Furthermore, this study has significance for providing the evidence for developing new leadership programs and policies in nursing organizations.
Hospitals, General ; Job Satisfaction ; Korea ; Leadership ; Negotiating ; Nursing ; Nursing Research

PURPOSE: This study was conducted to examine the mediating effect of meaning in life on the relationship between social connectedness and depression among middle-aged women.METHODS: A descriptive correlational design was employed. One hundred and forty-two middle-aged women who visited welfare centers or churches in Seoul and Gyeonggi Province participated in the study. The data were collected from May to June, 2019 and analyzed using descriptive statistics, Pearson's correlation coefficients, and multiple linear regression analyses based on Baron and Kenny criteria.RESULTS: Social connectedness was significantly positively correlated with meaning in life (r=.52, p < .001) and negatively with depression (r=−.53, p < .001). Meaning in life was also significantly negatively correlated with depression (r=−.50, p < .001). Furthermore, meaning in life had a significant mediating effect on the relationship between social connectedness and depression (β=−.31, p < .001).CONCLUSION: Our study findings suggest that meaning in life plays an important role in maintaining mental health and well-being for middle-aged women. Therefore, it is necessary to develop a nursing intervention program that can enhance the meaning in life to promote mental health and well-being.
Depression ; Female ; Gyeonggi-do ; Humans ; Linear Models ; Mental Health ; Negotiating ; Nursing ; Seoul

PURPOSE: The aim of this research was to identify the mediating effect of sleep quality on the relationship between job stress and stress response of shift-working nurses.METHODS: The participants in this study were 150 nurses who had more than 6 months of shift-working experience. A survey was conducted from May to June 2017 in a hospital in Gyeonggi-do, South Korea. The data were collected through self-report questionnaires. The collected data were analyzed using SAS 9.4 program. The analysis was based on Baron and Kenny's model to examine the mediating effects of sleep quality on the relationship between job stress and stress response of shift-working nurses.RESULTS: In the first and second steps, job stress was identified as a significant predictor of sleep quality (β=.29, p=.001) and stress response (β=.24, p=.004). In the third step, sleep (β=.55, p < .001) was observed as a significant predictor of stress response, and the direct relationship between job stress and stress response was not significant (β=.07, p=.291). Sleep quality was found to exhibit complete mediating effect on the relationship between job stress and stress response.CONCLUSION: The results of this study suggest that strategies for managing the stress of shift-working nurses should include effective ways to ensure sleep quality.
Gyeonggi-do ; Korea ; Negotiating

Acute kidney injury (AKI) due to renal ischemia reperfusion (IR) is a major clinical problem without effective therapy and is a significant and frequent cause of morbidity and mortality during the perioperative period. Although the pathophysiology of ischemic AKI is not completely understood, several important mechanisms of renal IR-induced AKI have been studied. Renal ischemia and subsequent reperfusion injury initiates signaling cascades mediating renal cell necrosis, apoptosis, and inflammation, leading to AKI. Better understanding of the molecular and cellular pathophysiological mechanisms underlying ischemic AKI will provide more targeted approach to prevent and treat renal IR injury. In this review, we summarize important mechanisms of ischemic AKI, including renal cell death pathways and the contribution of endothelial cells, epithelial cells, and leukocytes to the inflammatory response during ischemic AKI. Additionally, we provide some updated potential therapeutic targets for the prevention or treatment of ischemic AKI, including Toll-like receptors, adenosine receptors, and peptidylarginine deiminase 4. Finally, we propose mechanisms of ischemic AKI-induced liver, intestine, and kidney dysfunction and systemic inflammation mainly mediated by Paneth cell degranulation as a potential explanation for the high mortality observed with AKI.
Acute Kidney Injury ; Apoptosis ; Cell Death ; Cell Degranulation ; Endothelial Cells ; Epithelial Cells ; Inflammation ; Intestines ; Ischemia ; Kidney ; Leukocytes ; Liver ; Mortality ; Necrosis ; Negotiating ; Perioperative Period ; Receptors, Purinergic P1 ; Reperfusion ; Reperfusion Injury ; Toll-Like Receptors