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

A male elderly patient came with buccal mucosa swelling associated with tooth 46 and 47. Periapical radiograph confirmed the presence of periapical lesion and narrow root canals on both teeth. Challenging impediments were sensed upon negotiating most of the narrow root canals which were common in elderly patients. Glide path creation involved pre-flaring, K-file bending, watch winding movement, and very gentle strokes. After achieving patency, shaping, cleaning, and sealing phase can be performed.
Aged ; Negotiating

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: 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