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 was designed to examine both actor and partner effects of perceived marital relationship on quality of life, as well as the mediating effect of holding back cancer-related concerns.METHODS: This was a cross-sectional study in an outpatient setting. Participants were 150 couples consisting of patients with lung cancer and their spouses. Perceived marital relationship, holding back cancer-related concerns, and quality of life were measured with self-report scales. Actor and partner effects on quality of life were analyzed using the actorepartner interdependence mediation model by using structural equation modeling.RESULTS: A couple's quality of life had a significant direct actor effect on the perceived marital relationship. However, the partner effect and the indirect effect of holding back cancer-related concerns on quality of life was not significant.CONCLUSION: When patients with lung cancer and their spouses perceived their marital relationship positively, they assessed their quality of life positively. They were also found to be less hesitant when talking about cancer-related concerns. However, holding back on talking concerns did not have a significant impact on the quality of life (of either oneself or the spouse). Therefore, nurses should first check how they perceive their marital relationship before encouraging communication between patients with lung cancer and their spouses. Nurses can assess these risk factors and intervene if needed, along their cancer trajectory.
Cross-Sectional Studies ; Family Characteristics ; Humans ; Lung Neoplasms ; Lung ; Marriage ; Negotiating ; Outpatients ; Quality of Life ; Risk Factors ; Spouses ; Weights and Measures

PURPOSE: This study examined the mediating effects of self-esteem and resilience on the relationship between internalized stigma and quality of life in people with schizophrenia.METHODS: The participants were 123 people with schizophrenia (mean age = 41.87 years; 62.6% men) recruited from Soonchunhyang university hospital, a mental health center, and daytime rehabilitation facilities located in Seoul and Gyeonggi Province in South Korea. Using a cross-sectional survey, participants completed structured questionnaires with psychometric adequacy. The regression method of Baron and Kenny was used to test the mediating effects of self-esteem and resilience on the relationship between internalized stigma and quality of life.RESULTS: Self-esteem and resilience were found to be full and partial mediators, respectively, in the relationship between internalized stigma and quality of life.CONCLUSION: The findings of this study imply that effective future intervention strategies should target improvements in self-esteem and resilience to reduce the negative impact of internalized stigma on the quality of life of people with schizophrenia.
Cross-Sectional Studies ; Gyeonggi-do ; Korea ; Mental Health ; Methods ; Negotiating ; Psychometrics ; Quality of Life ; Rehabilitation ; Resilience, Psychological ; Schizophrenia ; Seoul ; Social Stigma

PURPOSE: The purpose of this study was to investigate whether the effects of emotional intelligence and working environment on nursing performance of nurses caring for cancer patients in small and medium hospitals were mediated by communication competence.METHODS: The data was collected between Aug. 1 and Aug. 30, 2018 from 240 nurses caring for cancer patients from 11 small and medium hospitals in B city. Variables included in this study were the Wong and Law Emotional Intelligence Scale (WLEIS), the Practice Environment Scale of Nursing Work Index (PES-NWI), the Global Interpersonal Communication Competence (GICC), and nursing performance. The collected data were analyzed by t-tests, ANOVA and Scheffe's test, Pearson's correlation coefficients, and 3 step multiple regression using SPSS/WIN 24.0 and the Sobel test.RESULTS: Communication competence, in the relationship between emotional intelligence and nursing working environment on nursing performance in nurses caring for cancer patients in small and medium hospitals, showed a partial mediating effect (Z=5.24, p < .001; Z=2.44, p=.001 respectively).CONCLUSION: The results of this study showed the effects of emotional intelligence and nursing working environment on nursing performance of nurses caring for cancer patients in small and medium hospitals were mediated by communication competence.
Emotional Intelligence ; Humans ; Jurisprudence ; Mental Competency ; Negotiating ; Nursing

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

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

PURPOSE: This study examined the mediating and moderating effects of multicultural efficacy in the relationship between cultural empathy and cultural competence in child care teachers. METHODS: A cross-sectional descriptive survey design was used. The participants were 277 child care teachers at private and public daycare centers in G and S districts of Seoul. The survey instruments included a cultural empathy questionnaire, a multicultural efficacy scale, and a cultural competence scale. Data were analyzed using the SPSS and AMOS programs. For data analysis, descriptive statistics, correlation, and mediating and moderating effect analyses were performed. Bootstrapping was implemented to verify the mediating effect of the model developed herein. RESULTS: Positive correlations among cultural empathy, multicultural efficacy, and cultural competence were noted. Multicultural efficacy showed a significant mediating effect on the relationships between cultural empathy and cultural competence. However, there was no moderating effect. CONCLUSION: In order to enhance the cultural competence of child care teachers, it is necessary to develop a strategy that can promote their cultural empathy and multicultural efficacy. Furthermore, these results will ultimately enhance the role of child care teachers, thus contributing to the normal growth and development of multicultural children.
Child ; Child Care ; Child ; Cultural Competency ; Cultural Diversity ; Empathy ; Growth and Development ; Humans ; Negotiating ; Self Efficacy ; Seoul ; Statistics as Topic