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 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

OBJECTIVES: Internet gaming disorder (IGD) is associated with attention deficit/hyperactivity disorder (ADHD) or depression etc. We tried to examine the mediating effects of depression in the relationship between ADHD and IGD.METHODS: This study was conducted on 2000 people who participated in on-line survey among 14–39 year-old men and women in 2017. And we clarified the relationship among IGD, ADHD, and depression and tested the mediation model. The mean and standard deviation of the main variables were calculated and correlation analysis was performed to confirm the relationship among the main variables. In order to test the mediating effect of depression on the relationship between ADHD and IGD, the structural equation model was implemented using AMOS 21 (IBM).RESULTS: There were significant correlations among the variables; IGD, ADHD and depression. Depression had a mediating effect 0.23 (95% confidence interval : 0.17–0.28) in the relationship between IGD and ADHD.CONCLUSIONS: This study showed that depression can mediate ADHD and IGD. Therefore, the evaluation and management of depression and ADHD should be included in the diagnosis and treatment of IGD.
Depression ; Diagnosis ; Female ; Humans ; Immunoglobulin D ; Internet ; Male ; Negotiating

BACKGROUND: Individual attitudes toward suicide are known to markedly influence suicidal ideation and suicidal behavior. Therefore, this study aimed to determine the factors associated with attitudes toward suicide.METHODS: This study was conducted on 3,213 adult men and women living in a province of Korea. After excluding 281 participants because of unreliable responses, the remaining 2,932 were included in the data analysis. Demographic factors were investigated, and psychological factors were evaluated. Attitudes toward suicide were evaluated using the Attitudes Towards Suicide-20, physical symptoms were evaluated using the Patient Health Questionnaire-15 (PHQ-15), self-compassion was evaluated using the Korean Self-Compassion Scale, and stress was evaluated using the Global Assessment of Recent Stress (GARS) scale. One-way analysis of variance was used to examine the psychological characteristics of attitudes toward suicide.RESULTS: Differences in various factors based on demographic characteristics were observed regarding attitudes toward suicide. Significant differences in attitudes toward suicide were observed based on severity of suicide, acceptability (F=20.332, p<0.001), prevention of suicide (F=7.700, p<0.001), and universality (F=13.741, p<0.001). The duration of suicidal ideation, self-kindness, self-judgment, common humanity, isolation, and over-identification showed differences, as did the GARS and PHQ-15 scores.CONCLUSION: This study explored the demographic and psychological factors affecting attitudes toward suicide. Adequate mediation of these factors is needed to prevent suicidal ideation and behavior.
Adult ; Demography ; Empathy ; Female ; Humans ; Korea ; Male ; Negotiating ; Psychology ; Statistics as Topic ; Stress, Psychological ; Suicidal Ideation ; Suicide

OBJECTIVES: This study examined the mediating effects of basic psychological needs between patient autonomy support from healthcare providers, and self-management among cancer survivors.METHODS: This study collected data from 148 cancer patients who had visited D hospitals in B city, Korea. A structured questionnaire was distributed to determine patient characteristics, healthcare provider autonomy support, basic psychological needs, and self-management. Data were analyzed using descriptive statistics, Pearson's correlation coefficient, and regression analysis that implemented Baron and Kenny's method for mediation were used for analyses.RESULTS: Self-management was significantly correlated with the level of healthcare provider autonomy support (r = 0.38, p < 0.001), autonomy (r = 0.40, p < 0.001), competence (r = 0.25, p = 0.002), and relatedness (r = 0.32, p < 0.001). Furthermore, autonomy (β = 0.30, p < 0.001) and relatedness (β = 0.22, p = 0.008) had partial mediating effects on the relationship between healthcare provider autonomy support and self-management (Z = 3.13, p = 0.002 and Z = 2.29, p = 0.022, respectively).CONCLUSION: Autonomy and relatedness mediated the impact of healthcare provider autonomy support for self-management among cancer survivors. This suggests that strategies for enhancing autonomy and relatedness should be considered when developing self-management interventions for cancer survivor patients.
Delivery of Health Care ; Health Personnel ; Humans ; Korea ; Mental Competency ; Methods ; Negotiating ; Self Care ; Survivors