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

This study investigated the effect of emotional stability (ES) on insomnia through anxiety in preoperative patients with cataracts. Fifty-four subjects completed a self-questionnaire that included the Insomnia Severity Index (ISI), the International Personality Item Pool (IPIP) for ES, and the Hospital Anxiety and Depression scale (HADS). Pathway analysis was performed to analyze the mediating effects of ES, the anxiety subscale scores of the HADS, and the ISI scores. The low-ES group exhibited an insomnia severity that was significantly higher than that of the high-ES group (p=0.048). According to the pathway analysis, the significant indirect effect of ES on the ISI scores was mediated by the scores on the anxiety subscale of the HADS. Cataract patients with low ES waiting to undergo surgery have a high risk of experiencing insomnia due to anxiety. Before surgery, it is essential to identify patients’ personality characteristics and provide appropriate intervention.
Anxiety ; Cataract ; Depression ; Humans ; Negotiating ; Sleep Initiation and Maintenance Disorders

OBJECTIVE: The relationship among chronic fatigue, depressive symptoms, and post-traumatic stress symptoms (PTSSs) among Middle East respiratory syndrome (MERS) survivors is poorly understood. METHODS: Of 148 survivors who consented to be registered and underwent assessments at 12 months (T1) and 18 months (T2) after the MERS outbreak, 72 (48.65%) were evaluated for chronic fatigue, depressive symptoms, and PTSSs based on the Impact of Event ScaleRevised (IES-R), the Patient Health Questionnaire-9 (PHQ-9), and the Fatigue Severity Scale (FSS). Data from 52 subjects, who completed both assessments, were analyzed using a regression-based serial multiple mediation model (PROCESS Model 6). RESULTS: Bootstrap analyses indicated no direct effects of T1 FSS on T2 IES-R but significant positive indirect effects of T1 FSS on T2 IESR through T1 PHQ-9 and T2 PHQ-9 (B=2.1601, SE=1.3268, 95% confidence interval=0.4250–6.1307). In other words, both T1 PHQ-9 and T2 PHQ-9 fully mediated the relationship between T1 FSS and T2 IES. CONCLUSION: Chronic fatigue 12 months after MERS had indirect effects on prolonged PTSSs 18 months after MERS via persisting depression in MERS survivors. This finding supports the need to promote interventional programs for emerging infectious disease survivors with chronic fatigue to reduce depression and prevent prolonged PTSSs.
Communicable Diseases, Emerging ; Coronavirus Infections ; Depression ; Fatigue ; Humans ; Middle East ; Negotiating ; Survivors

PURPOSE: Hepatocellular carcinoma (HCC) is a highly aggressive malignant tumor, the prognosis of which remains poor. Recently, microRNAs have been reported to play crucial functions in multiple tumors, including HCC. However, the molecular mechanisms of miR-370 in HCC still remain largely unknown. The present study focused on the effects of miR-370 on HCC migration, invasion, and epithelial-mesenchymal transition (EMT). MATERIALS AND METHODS: We investigated the key roles and possible regulatory mechanism of miR-370 in regulating HCC metastasis with functional assays, such as transwell assay. Quantitative real-time PCR (qRT-PCR) was used to detect miR-370 and guanylylcyclase domain containing 1 (GUCD1) expression in HCC tissues and cells. Subsequently, we performed transwell assays to determine the functions of miR-370 in HCC cell invasion and migration. Western blot was used to determine protein expressions of relevant genes. Luciferase reporter assays were conducted to confirm the target gene of miR-370. RESULTS: qRT-PCR analysis demonstrated that miR-370 was dramatically downregulated in HCC. Moreover, downregulated miR-370 was found to be associated with poor survival and adverse clinicopathologic characteristics of HCC patients. Transwell assays revealed that miR-370 overexpression dramatically suppressed HCC invasion and migration. Meanwhile, miR-370 restoration prominently inhibited EMT progression in HCC cells. Luciferase reporter assays confirmed GUCD1 as a downstream target gene of miR-370. GUCD1 expression in HCC tissues was prominently increased and inversely correlated with miR-370 expression. Furthermore, GUCD1 was verified as mediating the suppressive influence of miR-370 on cell metastasis and EMT in HCC. CONCLUSION: Taken together, our study confirmed that miR-370 suppressed HCC cell metastasis and EMT via regulating GUCD1. Accordingly, the miR-370/GUCD1 axis may potentially acts as attractive therapeutic targets and novel biomarkers for HCC treatment.
Biomarkers ; Blotting, Western ; Carcinoma, Hepatocellular ; Epithelial-Mesenchymal Transition ; Humans ; Luciferases ; MicroRNAs ; Negotiating ; Neoplasm Metastasis ; Prognosis ; Real-Time Polymerase Chain Reaction

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

The development of next generation sequencing (NGS) has led to marked advancement of our understanding of genetic events mediating the initiation and progression of thyroid cancers. The NGS studies have confirmed the previously reported high frequency of mutually-exclusive oncogenic alterations affecting BRAF and RAS proto-oncogenes in all stages of thyroid cancer. Initially identified by traditional sequencing approaches, the NGS studies also confirmed the acquisition of alterations that inactivate tumor protein p53 (TP53) and activate phosphatidylinositol-4,5-bisphosphate 3-kinase catalytic subunit alpha (PIK3CA) in advanced thyroid cancers. Novel alterations, such as those in telomerase reverse transcriptase (TERT) promoter and mating-type switching/sucrose non-fermenting (SWI/SNF) complex, are also likely to promote progression of the BRAF(V600E)-driven thyroid cancers. A number of genetically engineered mouse models (GEMM) of BRAF(V600E)-driven thyroid cancer have been developed to investigate thyroid tumorigenesis mediated by oncogenic BRAF and to explore the role of genetic alterations identified in the genomic analyses of advanced thyroid cancer to promote tumor progression. This review will discuss the various GEMMs that have been developed to investigate oncogenic BRAF(V600E)-driven thyroid cancers.
Animals ; Carcinogenesis ; Catalytic Domain ; Mice ; Mice, Transgenic ; Negotiating ; Proto-Oncogene Proteins B-raf ; Proto-Oncogenes ; Telomerase ; Thyroid Gland ; Thyroid Neoplasms

PURPOSE: This study aimed to develop a model for estimating the quality of life mediated by adaptation to changes experienced after stomach cancer diagnosis and surgery in patients with gastrectomy and to verify the model based on the Cancer Survivor Adaptation Model by Naus et al. (2009) and literature reviews. METHODS: Data was collected from 297 gastric cancer patients who underwent a gastrectomy at an outpatient clinic of two university hospitals in Daegu city from May to August, 2016. The exogenous variableswere perceived gastrointestinal symptoms, self-efficacy, anxiety, social support, and spiritual well-being. The endogenous variableswere adaptation and quality of life, and adaptationwas themediating variable. For data analysis, structural equation modeling was performed using IBM SPSS 21.0 and AMOS 18.0. RESULTS: The fitness parameters of the final model showed a reasonable fit to the data. Based on R², the exogenous variables explained 73.9% of the quality of life of stomach cancer patients who underwent surgery, through the mediation of adaptation; adaptation alone explained 73.5% of quality of life. Adaptation of stomach cancer patients with gastrectomy was a factor that strongly influenced their quality of life. CONCLUSION: It is important for gastric cancer patients with gastrectomy to adapt well to changes after surgery in order to improve the quality of life. Nursing interventions to aid successful adaptation would ultimately exert positive influences and improve the patients' quality of life.
Ambulatory Care Facilities ; Anxiety ; Daegu ; Diagnosis ; Gastrectomy ; Hospitals, University ; Humans ; Negotiating ; Nursing ; Quality of Life ; Statistics as Topic ; Stomach Neoplasms ; Survivors