Objective: This study aims to develop a practical procedure to assess retired Thoroughbreds for their suitability for equestrian sports or leisure purposes and to assess if horses identified as having reactive temperaments in response to a standardized startle test, will have improved test results following a period of transition training. Methods: Behavioral reactivity data and cardiac autonomic responses to a startle test (comprising of a plastic bag applied to the neck area) were collected from twelve retired Thoroughbred racehorses (6 males and 6 females; average age: 4.33 ± 0.89 years old; average body weight 465.17 ± 25.33 kg), before and after the three-month transition training for equestrian sports. A priori power calculation indicated a requirement of 12 individuals for a power of 80%. Results: Following the training, there was a significant reduction in the behavioral score (BS), peak heart rate (HR), and response duration (RD) of all horses compared to their pre-training scores. However, 25% of horses (3/12) retained a BS of 2 or above post-training, exhibiting significantly higher peak HR and longer RD compared to those with a BS below 2.Post-training, the females demonstrated a significant increase in the root mean square of the successive differences between normal heartbeats compared to their pre-training levels. Conclusions and Relevance: Transition training of retired Thoroughbreds can assist in improving horses' suitability for equestrian sports, based on their successive responses to a novel startle test.

Objective: This study aims to develop a practical procedure to assess retired Thoroughbreds for their suitability for equestrian sports or leisure purposes and to assess if horses identified as having reactive temperaments in response to a standardized startle test, will have improved test results following a period of transition training. Methods: Behavioral reactivity data and cardiac autonomic responses to a startle test (comprising of a plastic bag applied to the neck area) were collected from twelve retired Thoroughbred racehorses (6 males and 6 females; average age: 4.33 ± 0.89 years old; average body weight 465.17 ± 25.33 kg), before and after the three-month transition training for equestrian sports. A priori power calculation indicated a requirement of 12 individuals for a power of 80%. Results: Following the training, there was a significant reduction in the behavioral score (BS), peak heart rate (HR), and response duration (RD) of all horses compared to their pre-training scores. However, 25% of horses (3/12) retained a BS of 2 or above post-training, exhibiting significantly higher peak HR and longer RD compared to those with a BS below 2.Post-training, the females demonstrated a significant increase in the root mean square of the successive differences between normal heartbeats compared to their pre-training levels. Conclusions and Relevance: Transition training of retired Thoroughbreds can assist in improving horses' suitability for equestrian sports, based on their successive responses to a novel startle test.

Objective: This study aims to develop a practical procedure to assess retired Thoroughbreds for their suitability for equestrian sports or leisure purposes and to assess if horses identified as having reactive temperaments in response to a standardized startle test, will have improved test results following a period of transition training. Methods: Behavioral reactivity data and cardiac autonomic responses to a startle test (comprising of a plastic bag applied to the neck area) were collected from twelve retired Thoroughbred racehorses (6 males and 6 females; average age: 4.33 ± 0.89 years old; average body weight 465.17 ± 25.33 kg), before and after the three-month transition training for equestrian sports. A priori power calculation indicated a requirement of 12 individuals for a power of 80%. Results: Following the training, there was a significant reduction in the behavioral score (BS), peak heart rate (HR), and response duration (RD) of all horses compared to their pre-training scores. However, 25% of horses (3/12) retained a BS of 2 or above post-training, exhibiting significantly higher peak HR and longer RD compared to those with a BS below 2.Post-training, the females demonstrated a significant increase in the root mean square of the successive differences between normal heartbeats compared to their pre-training levels. Conclusions and Relevance: Transition training of retired Thoroughbreds can assist in improving horses' suitability for equestrian sports, based on their successive responses to a novel startle test.

Objective: This study aims to develop a practical procedure to assess retired Thoroughbreds for their suitability for equestrian sports or leisure purposes and to assess if horses identified as having reactive temperaments in response to a standardized startle test, will have improved test results following a period of transition training. Methods: Behavioral reactivity data and cardiac autonomic responses to a startle test (comprising of a plastic bag applied to the neck area) were collected from twelve retired Thoroughbred racehorses (6 males and 6 females; average age: 4.33 ± 0.89 years old; average body weight 465.17 ± 25.33 kg), before and after the three-month transition training for equestrian sports. A priori power calculation indicated a requirement of 12 individuals for a power of 80%. Results: Following the training, there was a significant reduction in the behavioral score (BS), peak heart rate (HR), and response duration (RD) of all horses compared to their pre-training scores. However, 25% of horses (3/12) retained a BS of 2 or above post-training, exhibiting significantly higher peak HR and longer RD compared to those with a BS below 2.Post-training, the females demonstrated a significant increase in the root mean square of the successive differences between normal heartbeats compared to their pre-training levels. Conclusions and Relevance: Transition training of retired Thoroughbreds can assist in improving horses' suitability for equestrian sports, based on their successive responses to a novel startle test.

Purpose: The increase in thyroid cancer incidence has inevitably led to an increase in thyroid cancer surgeries. This meta-regression analysis aimed to determine if the rate of post-thyroidectomy complications changes by year. Materials and Methods: PubMed and Embase databases were used to perform a systematic literature search of studies published from January 1, 2005, using the keywords “thyroidectomy” and “complication.” A meta-regression was performed for post-thyroidectomy hypocalcemia and bleeding. Results: This meta-analysis included 25 studies involving 927751 individuals. Through the years of publications in this study, there was no significant difference in the proportion of post-thyroidectomy hypocalcemia and bleeding (p=0.9978, 0.6393). Conclusion Although the number of thyroid surgeries has recently increased, the incidence of post-thyroidectomy hypocalcemia and bleeding did not significantly increase.

Purpose: The purpose of this study is to examine the mediating effect of professional quality of life among hospital nurses in the effects of workplace bullying, social support and resilience on retention intention. Methods: A descriptive and cross-sectional study was conducted on 414 hospital nurses who worked for at least two months at a general hospital in the Seoul metropolitan area. The data were analyzed using IBM SPSS 23.0/AMOS 22.0 programs and employed reliability verification, descriptive statistics include frequency analysis, confirmatory factor analysis, structural equation modeling, and bootstrapping. Results: As a result of the study's structural modeling verification, workplace bullying had a negative effect, social support had a positive effect, resilience had a positive effect on professional quality of life, and professional quality of life had a positive effect on retention intention. Also, workplace bullying, social support, and resilience did not directly impact on retention intention. However, the professional quality of life had a complete mediating effect in the relationships between workplace bullying, social support, resilience and retention intention. The study results verified the mediating effect of professional quality of life affecting the retention intention. Conclusion In order to improve professional quality of life and retention intention, strategies to prevent workplace bullying and promote social support and resilience are needed.

Purpose: The purpose of this study is to examine the mediating effect of professional quality of life among hospital nurses in the effects of workplace bullying, social support and resilience on retention intention. Methods: A descriptive and cross-sectional study was conducted on 414 hospital nurses who worked for at least two months at a general hospital in the Seoul metropolitan area. The data were analyzed using IBM SPSS 23.0/AMOS 22.0 programs and employed reliability verification, descriptive statistics include frequency analysis, confirmatory factor analysis, structural equation modeling, and bootstrapping. Results: As a result of the study's structural modeling verification, workplace bullying had a negative effect, social support had a positive effect, resilience had a positive effect on professional quality of life, and professional quality of life had a positive effect on retention intention. Also, workplace bullying, social support, and resilience did not directly impact on retention intention. However, the professional quality of life had a complete mediating effect in the relationships between workplace bullying, social support, resilience and retention intention. The study results verified the mediating effect of professional quality of life affecting the retention intention. Conclusion In order to improve professional quality of life and retention intention, strategies to prevent workplace bullying and promote social support and resilience are needed.

Purpose: The introduction of immune checkpoint inhibitors represents a major advance in the treatment of lung cancer, allowing sustained recovery in a significant proportion of patients. Nivolumab is a monoclonal anti–programmed death cell protein 1 antibody licensed for the treatment of locally advanced or metastatic non-small cell lung cancer (NSCLC) after prior chemotherapy. In this study, we describe the demographic and clinical outcomes of patients with advanced NSCLC treated with nivolumab in the Korean expanded access program. Materials and Methods: Previously treated patients with advanced non-squamous and squamous NSCLC patients received nivolumab at 3 mg/kg every 2 weeks up to 36 months. Efficacy data including investigator-assessed tumor response, progression data, survival, and safety data were collected. Results: Two hundred ninety-nine patients were treated across 36 Korean centers. The objective response rate and disease control rate were 18% and 49%, respectively; the median progression-free survival was 2.1 months (95% confidence interval [CI], 1.87 to 3.45), and the overall survival (OS) was 13.2 months (95% CI, 10.6 to 18.9). Patients with smoking history and patients who experienced immune-related adverse events showed a prolonged OS. Cox regression analysis identified smoking history, presence of immune-related adverse events as positive factors associated with OS, while liver metastasis was a negative factor associated with OS. The safety profile was generally comparable to previously reported data. Conclusion This real-world analysis supports the use of nivolumab for pretreated NSCLC patients, including those with an older age.

PURPOSE: Head and neck squamous cell carcinoma (HNSCC) is a deadly disease in which precision medicine needs to be incorporated. We aimed to implement next-generation sequencing (NGS) in determining actionable targets to guide appropriate molecular targeted therapy in HNSCC patients. MATERIALS AND METHODS: Ninety-three tumors and matched blood samples underwent targeted sequencing of 244 genes using the Illumina HiSeq 2500 platform with an average depth of coverage of greater than 1,000×. Clinicopathological data from patients were obtained from 17 centers in Korea, and were analyzed in correlation with NGS data. RESULTS: Ninety-two of the 93 tumors were amenable to data analysis. TP53 was the most common mutation, occurring in 47 (51%) patients, followed by CDKN2A (n=23, 25%), CCND1 (n=22, 24%), and PIK3CA (n=19, 21%). The total mutational burden was similar between human papillomavirus (HPV)–negative vs. positive tumors, although TP53, CDKN2A and CCND1 gene alterations occurred more frequently in HPV-negative tumors. HPV-positive tumors were significantly associated with immune signature-related genes compared to HPV-negative tumors. Mutations of NOTCH1 (p=0.027), CDKN2A (p < 0.001), and TP53 (p=0.038) were significantly associated with poorer overall survival. FAT1 mutations were highly enriched in cisplatin responders, and potentially targetable alterations such as PIK3CA E545K and CDKN2A R58X were noted in 14 patients (15%). CONCLUSION: We found several targetable genetic alterations, and our findings suggest that implementation of precision medicine in HNSCC is feasible. The predictive value of each targetable alteration should be assessed in a future umbrella trial using matched molecular targeted agents.
Biomarkers ; Carcinoma, Squamous Cell* ; Cisplatin ; Epithelial Cells* ; Head* ; Humans ; Korea ; Molecular Targeted Therapy ; Neck* ; Precision Medicine ; Statistics as Topic

PURPOSE: Sonic hedgehog (Shh) signaling pathway is known to play a crucial role in carcinogenesis in various malignancies, including lung cancer regarding tumorigenesis, angiogenesis, and cellular differentiation. The aim of this study was to investigate the value of components of Shh pathway as a prognostic marker in extensive stage small cell lung cancer (ES-SCLC) patients. MATERIALS AND METHODS: We retrospectively analyzed data of 36 patients who were diagnosed with ES-SCLC between 2008 and 2012 at a single center. We performed immuo-histochemistry for glioma-associated oncogene homolog zinc finger protein 1 (Gli1), patched, Shh, and Ptch-mediated repression of smoothened (Smo) proteins using formalin-fixed, paraffin-embedded tissue derived from primary tumors. We then conducted survival analysis to evaluate the prognostic impact of these markers. RESULTS: All 36 patients received platinum-based doublet chemotherapy. The median progression free survival and median overall survival were 6.9 months [95% confidence interval (CI), 6.5–7.3] and 11.7 months (95% CI, 9.1–14.3), respectively. The overall response rate was 84%. Of the 36 tissue specimens examined, over-expression of Gli1, Patched, Shh, and Smo was found in 12 (33.3%), five (13.9%), five (13.9%), and six (16.7%) cases, respectively. We found that high expression of Shh was associated with worse progression free survival (6.3 vs. 7.6 months, p=0.005) and overall survival (9.2 vs. 12.0 months, p=0.039) by both univariate and multivariate analyses, whereas other markers were not related to patient prognosis. CONCLUSION: A high proportion of small cell lung cancer tumors express proteins related to Shh pathway, and over-expression of Shh is correlated with poor prognosis.
Carcinogenesis ; Disease-Free Survival ; Drug Therapy ; Hedgehog Proteins ; Hedgehogs ; Humans ; Lung Neoplasms ; Multivariate Analysis ; Oncogenes ; Prognosis ; Repression, Psychology ; Retrospective Studies ; Small Cell Lung Carcinoma ; Zinc Fingers