The role of temperament and character in the anxiety-depression spectrum among Korean adults.

BACKGROUND: Temperament and character are useful in risk assessment and therapy of individuals in the anxiety-depression spectrum but understudied in South Korea. OBJECTIVE: The study aimed to identify the temperament and character features associated with anxiety and/or depression in individuals with clinical disorders and in the general population. METHODS: A representative sample of 1384 Korean adults over 18 years old (58 % female) were assessed with the Beck Depression Inventory (BDI), State-Trait Anxiety Inventory (STAI), and Temperament and Character Inventory (TCI). Multivariate analyses, including structural equation modeling and complex systems analysis, evaluated how personality influenced risk and resilience for anxiety and/or depression. RESULTS: The three groups with anxiety and/or depression were strongly distinguished by temperament and character: (i) In AD (n = 58), Harm Avoidance and Reward Dependence were higher than in DD, and Self-directedness was higher than in AD+DD; (ii) In DD (n = 90), Persistence, Self-Directedness and Cooperativeness were higher than in AD+DD; and (iii) In AD+DD (n = 101), Harm Avoidance was highest and Persistence and Self-directedness were lowest (i.e., they were lowest in Resilience). Structural equation models confirmed these risk relations with strong character development reducing the adverse effects of emotional hyperreactivity from extreme temperaments. LIMITATIONS: Self-reports were measured only at one point in time, requiring collateral experimental data to support causal interpretation. CONCLUSIONS: Interactions of temperament and character are strongly predictive of risk and resilience to anxiety and/or depression by regulating both positive and negative affect. Character mediates the adverse effects of extreme temperaments on affect.

Association between WHO First-Step Analgesic Use and Risk of Breast Cancer in Women of Working Age.

We assessed the association between breast cancer and analgesic use in women of a specific working-age group. The Korean National Health Insurance Service-National Sample Cohort database (KNHIS-NSC) data were analyzed. We calculated hazard ratios (HRs) with 95% confidence intervals (CIs) for patients' cancer risk based on whether the women participated in economic activity (PEA or not PEA (NPEA) groups) and analgesic use. Additionally, breast cancer incidence variations by age group, and PEA or NPEAs, health behavior, Charlson Comorbidity Index, and analgesic use were evaluated. The PEA group had a higher cancer risk than the NPEA group (HR = 1.542, 95% CI: 1.345-1.768, p < 0.001). Breast cancer risk was high in the PEA, high income, and no history of exercise groups, but significantly reduced in the regular-use-of-analgesics group. Notably, the working age group of 40~49 years, within the PEA group, had the highest HR of breast cancer development (HR = 1.700, 95% CI = 1.361-2.124, p < 0.001); whereas regular analgesic use in those aged 25~39 years decreased breast cancer risk (HR = 0.611, 95% CI = 0.427-0.875, p < 0.05). In conclusion, our results suggest that individuals at a high-risk of comorbidity may benefit from regular use of analgesics, which may prove to be a useful strategy for breast cancer prevention in the Young-aged group.

Clean mucosal area detection of gastroenterologists versus artificial intelligence in small bowel capsule endoscopy.

Studies comparing the detection of clean mucosal areas in capsule endoscopy (CE) using human judgment versus artificial intelligence (AI) are rare. This study statistically analyzed gastroenterologist judgments and AI results. Three hundred CE video clips (100 patients) were prepared. Five gastroenterologists classified the video clips into 3 groups (≥75% [high], 50%-75% [middle], and < 50% [low]) according to their subjective judgment of cleanliness. Visualization scores were calculated using an AI algorithm based on the predicted visible area, and the 5 gastroenterologists' judgments and AI results were compared. The 5 gastroenterologists evaluated CE clip video quality as "high" in 10.7% to 36.7% and as "low" in 28.7% to 60.3% and 29.7% of cases, respectively. The AI evaluated CE clip video quality as "high" in 27.7% and as "low" in 29.7% of cases. Repeated-measures analysis of variance (ANOVA) revealed significant differences in the 6 evaluation indicators (5 gastroenterologists and 1 AI) (P < .001). Among the 300 judgments, 90 (30%) were consistent with 5 gastroenterologists' judgments, and 82 (91.1%) agreed with the AI judgments. The "high" and "low" judgments of the gastroenterologists and AI agreed in 95.0% and 94.9% of cases, respectively. Bonferroni's multiple comparison test showed no significant difference between 3 gastroenterologists and AI (P = .0961, P = 1.0000, and P = .0676, respectively) but a significant difference between the other 2 with AI (P < .0001). When evaluating CE images for cleanliness, the judgments of 5 gastroenterologists were relatively diverse. The AI produced a relatively universal judgment that was consistent with the gastroenterologists' judgements.

Effects of early medication treatment and metformin use for cancer prevention in diabetes patients: a nationwide sample cohort study in Korea using extended landmark time analysis.

OBJECTIVES: This study investigated the effectiveness of early medication treatment and metformin use for cancer prevention in type 2 diabetes patients. METHODS: Population-based cohort data were used from the Korean National Health Insurance Service-National Sample Cohort database (KNHIS-NSC) for 2002-2013. Patient-specific medication prescription status was defined by the landmark time (LMT; a fixed time after cohort entry), considering both pre- and post-LMT prescriptions to control methodological biases in observational research. The LMT was set to 2 years. Logistic regression analysis with multivariable adjustment was conducted to analyze cancer incidence by patient-specific medication prescription status. RESULTS: Only 33.4% of the subjects were prescribed medication early (before the LMT) with compliance. Cancer incidence in individuals with early prescription and compliance was 25% lower (odds ratio [OR], 0.75; 95% confidence interval [CI], 0.67 to 0.84) than in those without. As early-prescribed medications, metformin monotherapy and metformin combination therapy were associated with 34% (OR, 0.66; 95% CI, 0.51 to 0.83) and 25% (OR, 0.75; 95% CI, 0.64 to 0.88) lower cancer risk than non-use, respectively. Patients who were prescribed late (post-LMT) but did not comply with the prescription had a 24% (OR, 1.24; 95% CI, 0.97 to 1.58) higher cancer incidence than non-users. Among patients who started monotherapy early without changes throughout the entire follow-up period, those who started on metformin had a 37% (OR, 0.63; 95% CI, 0.41 to 0.99) lower risk of cancer than non-metformin users. CONCLUSIONS: Doctors must prescribe antidiabetic medication early, and patient compliance is required, regardless of the prescription time, to prevent cancer. Metformin monotherapy or combination therapy is recommended as an early prescription.

Prescribing patterns in breast cancer survivors: A Korean National Health Insurance Service cohort study.

PURPOSE: Breast cancer survivors often manifest comorbidities that require medication management. This study aimed to investigate the prescription patterns of drugs prescribed frequently among breast cancer survivors and to provide data to monitor adverse effects using other covariates in these patients. MATERIALS AND METHODS: We analyzed a Korean national sample cohort database. The diagnosis of breast cancer, survival, survival duration, and frequency of drug prescription were first defined and extracted. We then analyzed the frequency of drug prescription in breast cancer by survival duration. Factors associated with drug prescribing patterns were analyzed using logistic regression analysis. RESULTS: Among 2,410 breast cancer survivors, anti-hormonal agents, gastrointestinal drugs, calcium, and anxiolytics were most frequently prescribed. Gastrointestinal disturbance and depression are most commonly observed among breast cancer survivors. Survivors who were 3 to < 5 years post treatment were frequently prescribed calcium. In addition to gastrointestinal drugs, anxiolytics were frequently prescribed among survivors manifesting comorbidities. In addition to anti-hormone agents, which were frequently prescribed to breast cancer patients, gastrointestinal drugs were the second most frequently prescribed, and anxiolytics were often co-prescribed. Calcium was also frequently co-prescribed in patients requiring anti-depressants. CONCLUSION: In the Korean National Cohort, gastrointestinal drugs, calcium, and anxiolytics were frequently prescribed to older patients, suggesting that older patients diagnosed with cancer experience a wide array of toxicities requiring supportive care.

Opposite Effects of Work-Related Physical Activity and Leisure-Time Physical Activity on the Risk of Diabetes in Korean Adults.

The object of this study was to examine the effects of domestic and work-related physical activity (DWPA) and leisure-time physical activity (LTPA) on the risk of diabetes, by categorizing fasting blood glucose (FBG) levels into normal, Impaired Fasting Glucose (IFG), and diabetes. The sample consisted of 4661 adults aged 30 years or above, and was chosen from the 2017 Korean National Health and Nutrition Examination Survey (KNHANES) data. Of all the subjects, 14.6% engaged in high-intensity DWPA and 6.25% in moderate-intensity DWPA; while 11.68% and 24.80% engaged in high- and moderate-intensity LTPA, respectively. The effects of both types of physical activities on the risk of diabetes were analyzed using a Bayesian ordered probit model. For those with high-intensity DWPA, the probability of the FBG level being normal was 5.10% (SE = 0.25) lower than for those with non-high-intensity DWPA, and the probabilities of IFG and diabetes were 3.30% (SE = 0.15) and 1.79% (SE = 0.09) higher, respectively. However, for those with high-intensity LTPA, the probability of the FBG level being normal was 2.54% (SE = 0.09) higher, and the probabilities of IFG and diabetes were 1.74% (SE = 0.07) and 0.80% (SE = 0.03) lower, respectively, than those with non-high-intensity LTPA. Likewise, for moderate-intensity DWPA and LTPA, the results were the same compared to low-intensity physical activities though the magnitude of the effects were smaller than for high-intensity. Thus, the activities related to work have a negative effect and those related to leisure have a positive effect. The criteria for physical activities to reduce the risk of diabetes should be set by separating these domains of physical activity, and new management strategies for diabetes are needed for people with moderate- or high-intensity DWPA.

Assessment of human estrogen receptor agonistic/antagonistic effects of veterinary drugs used for livestock and farmed fish by OECD in vitro stably transfected transcriptional activation assays.

The presence of veterinary drug residues in foods and the environment could potentially cause adverse effects on humans and wildlife. Several veterinary drugs were reported to exhibit endocrine disrupting effects via binding affinities to sexual hormone receptors such as estrogen and androgen receptors. Therefore, we confirmed the human estrogen receptor (ER) agonistic/antagonistic effects of 135 chemicals that were used as veterinary drugs in Korea by the official Organization for Economic Cooperation and Development (OECD) in vitro ER transcriptional activation (TA) assay using the VM7Luc4E2 cell line. In the case of ER agonist screening, 7 veterinary drugs (cefuroxime, cymiazole, trenbolone, zeranol, phoxim, altrenogest and nandrolone) were determined to be ER agonists. In addition, only zeranol was found to exhibit weak ER antagonistic activity. These 7 veterinary drugs, which were determined as ER agonists and/or antagonists by an OECD in vitro assay, were also found to have binding affinity to ERs. These results indicate that various veterinary drugs possess potential (anti-)estrogenic effects. However, further study is needed to determine the precise endocrine-disrupting effects of these compounds.

[Effects of an elder health promotion program using the strategy of elder health leader training in senior citizen halls].

PURPOSE: This study was conducted to develop and test the effects of an elder health promotion program and apply strategies for elder health leader training sessions with elders at senior citizen halls. METHODS: A nonequivalent control group pretest-posttest design was used. Participants were 49 elders at a senior citizen hall (intervention: 27, control: 22). The elder health promotion program consisted of health education and exercise. A professional leader led the program for 4 weeks, and then an elder health leader and research assistant led for 8 weeks (total 12 weeks). Scales for elder health promoting behaviors, perceived health status, life satisfaction and senior citizen hall capability were used and physical fitness levels were measured. Data were collected between April 21 and July 28, 2010 and analyzed using Chi-square, Fisher's exact test, t-test, and repeated measure ANOVA with SPSS/WIN 12.0. RESULTS: Health promoting behaviors, physical fitness, perceived health status, and senior citizen hall capacity were significantly better in the experimental group after the intervention compared to the control group. CONCLUSION: Study findings indicate that elder health promotion programs applying strategies of elder health leader training are effective and can be recommended as nursing interventions for health promotion of these elders.

Identifying differentially expressed genes in meta-analysis via Bayesian model-based clustering.

A Bayesian model-based clustering approach is proposed for identifying differentially expressed genes in meta-analysis. A Bayesian hierarchical model is used as a scientific tool for combining information from different studies, and a mixture prior is used to separate differentially expressed genes from non-differentially expressed genes. Posterior estimation of the parameters and missing observations are done by using a simple Markov chain Monte Carlo method. From the estimated mixture model, useful measure of significance of a test such as the Bayesian false discovery rate (FDR), the local FDR (Efron et al., 2001), and the integration-driven discovery rate (IDR; Choi et al., 2003) can be easily computed. The model-based approach is also compared with commonly used permutation methods, and it is shown that the model-based approach is superior to the permutation methods when there are excessive under-expressed genes compared to over-expressed genes or vice versa. The proposed method is applied to four publicly available prostate cancer gene expression data sets and simulated data sets.

[Meta-analysis of the research findings concerning functional relationships of explanatory variables to hope].

PURPOSE: The purpose of the study was to meta-analyze the relationships of major concepts, which were made by synthesizing similar explanatory variables into more comprehensive concepts, to hope. METHOD: The relevant researches from Jan 1980 to Dec 2003, performed in adults or adult patients, were collected. Using the SAS program, meta-analysis were done with the input data of the number of subjects, the correlation coefficients provided from most of the studies or a few transformed correlation coefficients from F value. In order to get the analysis to be done in homogeneous status of the data regarding each relationship of each major concept to hope (p>0.05), heterogeneous data were eliminated in repeating Q-test. RESULT: The major variable regarding relationship to self/transcendental being/life (spiritual wellbeing & self esteem) and social support (social support & family support) have very large positive effects on hope (D=1.72, D=1.27). The negative effect of the variable regarding captive state(uncertainty in illness, perceived unhealthiness status, & fatigue) and positive effect of coping (approach coping) on hope are in the level between moderate to large (D=-0.61, D=0.78). All the effects of the major concepts on hope were verified as significant statistically(p=.000). The Fail-Safe numbers showed the significant effects of the three major concepts except coping on hope were reliable. CONCLUSION: The results can be a guide to advance hope theory for nursing.

Objective assessment of involved surface area in patients with psoriasis.

BACKGROUND/AIMS: Although difficult, it is essential to assess the disease severity of psoriasis objectively. The visual grading method currently used for assessing the involved surface area in patients with psoriasis, which is included on the Psoriasis Area and Severity Index (PASI) scoring system, is a subjective method. The aim of this study was to establish the reliable objective method, in estimating the involved surface area in patients with psoriasis. METHODS: Thirty patients with psoriasis participated in this study. The skin lesions of each patient were estimated using the visual grading method and an image analysis system. RESULTS: The differences between five dermatologists' estimates of the involved surface area obtained from the visual grading method were highly significant (P<0.05, Kruskal-Wallis test). The comparison between the visual grading method and the image analysis system showed that the involved areas measured by the visual grading method were significantly higher than those from the image analysis (P<0.05, Wilcoxon signed rank test). CONCLUSIONS: The visual grading method was neither objective nor reproducible. On the other hand, the image analysis system can be used as an objective method of measuring the involved surface area of patients with psoriasis. Therefore, the image analysis system can be used as a standard for the assessment of the involved area of patients with psoriasis.