A study on volumetric change of mandibular condyles with osteoarthritis using cone-beam computed tomography.

This study aimed to quantitatively assess three-dimensional changes in the mandibular condyle with osteoarthritis using cone-beam computed tomography (CBCT). Pre- and post-treatment CBCT images of temporomandibular joints (TMJs) from 66 patients were used to assess longitudinal changes in condylar volume within individual patients using 3D slicer software. Total volume difference (dV), net increase (dV + , bone deposition), and net decrease (dV- , bone resorption) after treatment were analyzed based on clinical and radiological factors. Condyles with surface erosion at their first visit showed significantly decreased volume after treatment compared to condyles without erosion (p < 0.05). Amounts of bone resorption and deposition were higher in condyles with surface erosion (both p < 0.01). In patients with condylar erosion, the presence of joint pain was associated with a decrease in condylar volume and an increase in net resorption (both p < 0.01). When both joint pain and condylar erosion were present, patients with parafunctional habits showed reduced condylar volume after treatment (p < 0.05). Condylar volume change after treatment was negatively correlated with the duration of pain relief (R = - 0.501, p < 0.05). These results indicate that condylar erosion and TMJ pain could be significant variables affecting TMJ volume changes after treatment. Establishing appropriate treatment strategies is crucial for managing condylar erosion and TMJ pain.

The moderating role of neighborhood social cohesion in the mediation effects of the loneliness between acculturation stress and post-traumatic growth among female North Korean defectors.

Loneliness negatively predicts post-traumatic growth (PTG) among North Korean defectors (NKD), one of the representative groups of refugees. Additionally, evidence also suggests that females, who account for 70% of NKDs entering South Korea, are vulnerable not only to past trauma but also to the current acculturation stress and loneliness affected by neighborhood social cohesion. This study explores whether the mediating effect of loneliness on the relationship between acculturation stress and PTG was moderated by the neighborhood social cohesion among female NKDs. In this study, the data of 166 female NKDs who completed an online survey regarding acculturation stress, PTG, loneliness, and neighborhood social cohesion were used. Moderated mediation analysis was conducted using SPSS PROCESS macro program. Loneliness was associated with PTG (B = - 1.896, p < 0.001), and mediated the association between acculturation stress and PTG (indirect effect = - 0.278, 95% LLCI - 0.403, 95% ULCI - 0.166). Neighborhood social cohesion moderated the mediation effect of loneliness on the association between acculturation stress and PTG (B = - 0.016, 95% LLCI 0.001, 95% ULCI 0.035). The indirect effect of acculturation stress on PTG through loneliness was notably high for those with low neighborhood social cohesion. Therefore, increasing neighborhood social cohesion would reduce loneliness caused by acculturation stress and support the positive growth among female NKDs. This represents the most effective approach to aiding female NKDs in achieving growth, even after suffering trauma.

Properties of Patient-Reported Outcome Measures for Post-Traumatic Stress Disorder in North Korean Defectors: A Scoping Review.

OBJECTIVE: Posttraumatic stress disorder (PTSD) is highly prevalent among North Korean defectors. This scoping review aimed to appraise the measurement properties of patient-reported outcome measures (PROMs) that assess PTSD among North Korean defectors. METHODS: A systematic search was conducted using Research Information Sharing Service, ScienceON, PubMed, and Embase from their inception up to September 15, 2022. Each measurement properties of the included PROMs were evaluated using COnsensus-based Standards for the selection of health status Measurement INstruments (COSMIN) methodology. First, the methodological quality of each study on measurement properties was evaluated using the COSMIN Risk of Bias checklist. Second, the result of each single study on a measurement property was rated against the updated criteria for good measurement properties. RESULTS: After screening the articles, nine instruments from 40 studies were included. Among these instruments, Impact of Event ScaleRevised was the most frequently used (13 studies [38.1%]), followed by the Trauma Scale for North Korean Refugees, PTSD Checklist, and Posttraumatic Diagnostic Scale. The theoretical basis of all PROMs was secure in terms of content validity. The most frequently tested characteristics in measurement properties for internal structure were internal consistency, criterion validity, and convergent validity. No study reported sufficient structural validity as confirmatory factor analysis results with a model fit. CONCLUSION: There is insufficient evidence to support the recommendation of a specific PROM for use among North Korean defectors with PTSD.

A cross-sectional study of nursing students' eHealth literacy and COVID-19 preventive behaviours.

AIM: This study explored nursing students' eHealth literacy, lifestyle behaviours and COVID-19-related preventive behaviours and associated factors. DESIGN: A cross-sectional comparative correlational study. METHODS: Nursing students (n = 358) from a metropolitan area of South Korea were recruited for an online survey. The online questionnaire included: The eHealth Literacy Scale, the Health Promoting Lifestyle Profile-II and the COVID-19-related preventive behaviour scale. RESULTS: COVID-19-related preventive behaviours correlated positively with satisfaction with one's major, time spent seeking health information online, eHealth literacy and lifestyle behaviours. Significant factors affecting COVID-19-related preventive behaviours were the following: being female (ß = 0.194, p < .001), time spent seeking health information online (ß = 0.114, p = .002), eHealth literacy (ß = 0.167, p = .001) and lifestyle behaviours (ß = 0.266, p < .001). CONCLUSIONS: Findings highlight the need to strengthen searching behaviours to access accurate health information online and reinforce eHealth literacy and health-promoting lifestyle behaviours to improve COVID-19 preventive behaviours among nursing students.

e-Health for Traumatized Refugees: A Scoping Review.

Background: High prevalence of post-traumatic stress disorder (PTSD) is reported among refugees exposed to traumatic experiences, while escaping from their home country, entering a third country, and adjusting to a new society. Electronic health (e-health) treatments have been utilized to overcome challenges such as high costs, limited access to care, and a shortage of resources faced by traumatized refugees. Objective: The aim of this scoping review was to summarize the current science on e-health to screen and treat PTSD in traumatized refugees, examine its benefits and challenges, and suggest strategies for future research. Methods: We conducted a scoping review guided by Arksey and O'Malley's 6-stage scoping review framework. Results: Of the 2,782 articles identified, 8 studies were included for the final analysis. Due to the heterogeneity of studies, the synthesis of results was not feasible. However, the findings of individual studies were examined. The most commonly used technology modality was the smartphone (n = 5). One study revealed the possibility of telephonic screening of PTSD to be equally efficacious as in-person screening, and all interventions through smartphone and the internet reported high feasibility and acceptability. Conclusion: e-Health is suggested to be a novel and scalable platform to provide mental health care in settings with limited resources. Larger and highly robust studies in refugee populations with PTSD-targeted, theory-based approaches and diverse technological formats such as video conferencing and virtual reality are warranted.

Patient safety measurement tools used in nursing homes: a systematic literature review.

BACKGROUND: An increase in the number of older adults has highlighted the important issue of the safety of residents in nursing homes. This review aimed to review previous studies on patient safety of older adults living in nursing homes, analyze the tools used to measure it, and identify factors affecting patient safety of older adult residents in nursing homes. METHODS: A literature search was conducted using EMBASE, PubMed, CINHAL, and COCHRANE. The main search terms were "nursing home" or "skilled nursing facility" or "long-term care facility" and "patient safety." In total, 13,586 articles were identified. Two authors independently assessed the quality of each selected study using the Crowe Critical Appraisal Tool. RESULTS: Twenty-five studies were included in the analysis. There were a total of seven tools used to measure patient safety in nursing homes: the Nursing Home Survey on Patient Safety Culture (10 studies) and Hospital Survey on Patient Safety Culture (nine studies). Furthermore, the Nursing Home Survey on Patient Safety Culture-China, Safety Attitudes Questionnaire, Safety Attitudes Questionnaire in a Skilled Nursing Facility, Safety Attitudes Questionnaire-Ambulatory Version, and Modified Stanford Patient Safety Culture Survey Instrument were used in one study each. The most used tool among them was the Nursing Home Survey on Patient Safety Culture. Most tools used to measure patient safety in nursing homes were related to patient safety culture and employee attitudes. CONCLUSION: Organizational factors, such as the staff education system and the composition of appropriate personnel, should be strengthened to establish a patient safety culture in nursing homes, for which policy support is crucial.

The validity of ICD-11 PTSD and complex PTSD in North Korean defectors using the International Trauma Questionnaire.

Background: The International Trauma Questionnaire (ITQ) is a self-report assessment focused on the core features of Post-Traumatic Stress Disorder (PTSD) and complex Post-Traumatic Stress Disorder (CPTSD). It is consistent with the organizing principles of the 11th revision to the WHO's International Classification of Diseases (ICD-11). Since the 1990s, the number of North Korean defectors (NKD) entering South Korea to escape human rights violations has been increasing rapidly, with 33,815 NKD settled by 2021. The South Korean government faces an important challenge in supporting NKD to successfully adapt and settle in South Korean society. NKD experience various traumatic events during the process of defecting and repatriation. Therefore, it is essential to understand the psychological disorders of NKD, especially PTSD and CPTSD. Objective: This study aimed to test the validity of the ITQ assessment and explore the differences in symptoms and quality of life between PTSD and CPTSD. Method: The study sample comprised 503 trauma-exposed NKD. Confirmatory factor analysis (CFA) and latent class analysis (LCA) were used to evaluate the validity of ITQ. One-way analysis of variances and post-hoc analyses revealed the difference in the Depression and Somatic Symptoms Scale (DSSS) and WHOQOL-BREF results among PTSD and CPTSD symptom LCA classes. Results: The CFA and LCA results supported the ICD-11 conceptualization of PTSD and CPTSD in NKD. The CFA results confirmed that both the first- and second-order models were statistically fit, but for community-dwelling NKD the first-order model had better model fit than the second-order model. The LCA findings revealed a four-class model with 'PTSD', 'CPTSD', 'DSO', and 'low symptom' classes. Compared to the PTSD class, CPTSD class had higher levels of depression and somatic symptoms and a lower quality of life. Conclusion: This study provided evidence that ITQ is a valid tool to assess PTSD or CPTSD in community-dwelling NKD.

Antecedentes: El Cuestionario Internacional de Trauma (ITQ en su sigla en inglés) es una evaluación de autoreporte focalizado en las características principales del Trastorno de Estrés Postraumático (TEPT) y del Trastorno de Estrés Postraumático complejo (TEPT-C). Es consistente con los principios organizadores de la onceava revisión de la Clasificación International de las Enfermedades (CIE-11) de la OMS. Desde 1990, ha aumentado rápidamente el número de desertores de Corea del Norte (NKD en su sigla en inglés) que han entrado a Corea del Sur para escapar de las violaciones a los derechos humanos, con 33,815 NKD instalados hasta 2021. El gobierno de Corea del Sur enfrenta un desafío importante en apoyar a los NKD para adaptarse e instalarse en la sociedad de Corea del Sur. Los NKD experimentan varios eventos traumáticos durante el proceso de deserción y repatriación. Por lo tanto, es esencial entender los trastornos psicológicos de NKD, especialmente TEPT y TEPT-C.Objetivo: Este estudio busca evaluar la validez de la evaluación ITQ y explorar las diferencias en los síntomas y la calidad de vida entre TEPT y TEPT-C.Método: La muestra del estudio estuvo compuesta de 503 NKD expuesto a trauma. Se usaron el análisis factorial confirmatorio (CFA en su sigla en inglés) y análisis de clases latentes (LCA en su sigla en inglés) para evaluar la validez de ITQ. Los análisis de una vía de las varianzas y los análisis post-hoc revelaron la diferencia en los resultados de la Escala de los Síntomas somáticos y Depresión (DSSS en su sigla en inglés) y WHOQOL-BREF entre los síntomas TEPT y TEPT-C de las clases de los LCA.Resultados: Los resultados de CFA y LCA apoyan la conceptualización del TEPT y TEPT-C de la CIE-11 en NKD. Los resultados del CFA confirmaron que tanto los modelos de primer y de segundo orden fueron estadísticamente adecuados, pero para los NKD viviendo en residencias comunitarias, el modelo de primer orden tuvo un mejor ajuste que el modelo de segundo orden. Los hallazgos del LCA revelaron un modelo de cuatro clases con las clases 'TEPT', 'TEPT-C', 'DSO', y 'baja sintomatología'. En comparación con la clase TEPT, la clase TEPT-C tuvo niveles más altos de síntomas somáticos y depresión y una calidad de vida más baja.Conclusión: Este estudio proporciona evidencia que el ITQ es una herramienta válida para evaluar TEPT o TEPT-C en NKD viviendo en residencias comunitarias.

Factors affecting the quality of life of family caregivers of patients with heart failure: A cross-sectional study.

Heart failure is a chronic disease requiring lifetime self-management at home by patients, who often require additional support. However, the long-term nature of this self-management presents great challenges for both heart failure patients and their family caregivers. The role of family caregivers is critical, but little is known about the relationship between the burden, stress, depressive symptoms, and quality of life in the family caregivers of heart failure patients. We aimed to explore caregiver burden, stress, depressive symptoms, and quality of life in both patients with heart failure and their family caregivers and identify the factors associated with family caregivers' quality of life. The sample included 120 participants (60 heart failure patients and 60 corresponding family caregivers) from cardiovascular outpatient clinics at 2 university-affiliated hospitals in South Korea from September 2018 to July 2019. The mean ages of the heart failure patients and their caregivers were 72.72 (SD = 12.73) and 57.03 (SD = 13.42) years, respectively. Caregiver burden (r = -0.601, P < .001) and caregiver depressive symptoms (r = -0.535, P < .001) were negatively correlated with the caregivers' quality of life. The result of the hierarchical multiple regression analysis identified 3 significant factors related to the family caregivers' quality of life: caregiver's age (ß = -0.257, P = .012), caregiver burden (ß = -0.408, P = .002) and caregiver depressive symptoms (ß = -0.298, P = .018), with overall explanatory power of 47.5%. It is necessary to develop practical strategies to improve family caregivers' quality of life by alleviating their burden and depressive symptoms. Healthcare providers should be engaged with not only heart failure patients but also their family caregivers during the disease management process to improve patients' outcomes.

Effect of abutment neck taper and cement types on the amount of remnant cement in cement-retained implant restorations: an in vitro study.

PURPOSE: The present study aims to analyze the effect of abutment neck taper and types of cement on the amount of undetected remnant cement of cement-retained implant prostheses. MATERIALS AND METHODS: Three neck taper angles (53°, 65°, 77°) and three types of cement (RMGI: resin-modified glass ionomer, ZPC: zinc phosphate cement, ZOE: zinc oxide eugenol cement) were used. For each group, the surface percentage was measured using digital image and graphic editing software. The weight of before and after removing remnant cement from the abutment-crown assembly was measured using an electronic scale. Two-way ANOVA and Duncan & Scheffe's test were used to compare the calculated surface percentage and weight of remnant cement (α = .05). RESULTS: There were significant differences in remnant cement surface percentage and weight according to neck taper angles (P < .05). However, there were no significant differences in remnant cement surface percentage and weight on types of cement. No interaction was found between neck taper angles and types of luting cement (P > .05). The wide abutment with a small neck taper angle showed the most significant amount of remnant cement. And the types of luting cement did not influence the amount of residual cement. CONCLUSION: To remove excess cement better, the emergence profile of the crown should be straight to the neck taper of the abutment in cement-retained implant restoration.

Factors associated with posttraumatic growth among North Korean defectors in South Korea.

Refugees experience various kinds of trauma during the migration process, which can cause psychiatric problems such as posttraumatic stress disorder. However, in the process of overcoming traumatic experiences, they may also experience posttraumatic growth (PTG). This study examined the level of PTG and its associated factors among North Korean defectors, including posttraumatic stress symptoms (PTSS). In total, 212 North Korean defectors completed self-report questionnaires measuring PTG (PTG inventory), PTSS (Posttraumatic Stress Disorder Checklist, PCL-5), quality of life (WHOQOL-BREF), and various sociodemographic variables. Participants completed the survey online, from July 27 to August 4, 2020. Participants reported a moderate level of PTG scores (51.7 ± 15.4, range 0-80). To determine the impact of PTSS on PTG among North Korean defectors, we conducted a hierarchical multiple regression analysis. In the final model, several sociodemographic factors (years in South Korea, education in North Korea, religion, and employment status), overall quality of life (ß = 0.321, p < 0.001), and PTSS (ß = 0.162, p = 0.035) were positively associated with PTG, whereas living with family (ß = - 0.1261, p = 0.040) and loneliness (ß = - 0.401, p < 0.001) were negatively associated with PTG, accounting for 36.6% of the variance in PTG scores (p < 0.001). This is the first large-scale study describing the level of PTG and its associated factors among North Korean defectors residing in South Korea. Further, our study provides suggestions for future research in this area, and interventions for improving PTG among this group.

Resveratrol activates GABAA and/or glycine receptors on substantia gelatinosa neurons of the subnucleus caudalis in mice.

Although a number of studies have reported that resveratrol has analgesic effects, the direct effect of resveratrol on substantia gelatinosa (SG) neurons of the trigeminal subnucleus caudalis (Vc) involved in orofacial nociceptive transmission has not been clearly examined. Thus, the objective of this study was to investigate effects of resveratrol on SG neurons of Vc in mice using a whole-cell patch-clamp technique. Resveratrol (500 µM) induced repeatable inward currents without desensitisation. Resveratrol-induced inward currents were shown in a concentration-dependent manner. Resveratrol-induced responses were sustained in the presence of tetrodotoxin, 6-cyano-7-nitroquinoxaline-2,3-dione (CNQX), and DL-2-Amino-5-phosphonovaleric acid (DL-AP5). However, resveratrol-induced inward currents were suppressed in the presence of picrotoxin and strychnine. These results indicate that resveratrol can directly act on SG neurons of Vc with possible inhibitory effects on SG neurons through activation of GABAA receptors and/or glycine receptors. Thus, resveratrol can be a potential therapeutic for orofacial pain modulation.

Correction: Measurement of Digital Literacy Among Older Adults: Systematic Review.

[This corrects the article DOI: 10.2196/26145.].

Preventive Behavioral Insights for Emerging Adults: A Survey during the COVID-19 Pandemic.

Emerging adulthood is an important period for establishing health behavior patterns in life. This study aimed to examine factors related to preventive behaviors of emerging adults during the COVID-19 pandemic. A descriptive online survey design was used. Data were collected using a self-administrated, 28-item questionnaire completed by 239 undergraduate students from a university in Seoul, South Korea. The questionnaire was developed based on previous studies and the guidelines of the World Health Organization about COVID-19 preventive behaviors. The mean age of participants was 21.97 years, and the average score for COVID-19 preventive behaviors was 4.13 (SD: ±0.42) on a 5-point scale. Hierarchical regression analyses revealed that subjective norms related to parents (ß = 0.425, p < 0.001), issue involvement related to COVID-19 (ß = 0.160, p = 0.024), and sex (ß = 0.137, p = 0.029) were significant factors related to preventive behaviors of emerging adults after controlling for demographic characteristics. The variables explained 20.1% of the variance in preventive behaviors. The results of this study suggest that better strategies for subjective norms related to parents and issue involvement related to COVID-19 must be considered to improve emerging adults' preventive behaviors.

Correction: Measurement of Digital Literacy Among Older Adults: Systematic Review.

[This corrects the article DOI: 10.2196/26145.].

Measurement of Digital Literacy Among Older Adults: Systematic Review.

BACKGROUND: Numerous instruments are designed to measure digital literacy among the general population. However, few studies have assessed the use and appropriateness of these measurements for older populations. OBJECTIVE: This systematic review aims to identify and critically appraise studies assessing digital literacy among older adults and to evaluate how digital literacy instruments used in existing studies address the elements of age-appropriate digital literacy using the European Commission's Digital Competence (DigComp) Framework. METHODS: Electronic databases were searched for studies using validated instruments to assess digital literacy among older adults. The quality of all included studies was evaluated using the Crowe Critical Appraisal Tool (CCAT). Instruments were assessed according to their ability to incorporate the competence areas of digital literacy as defined by the DigComp Framework: (1) information and data literacy, (2) communication and collaboration, (3) digital content creation, (4) safety, and (5) problem-solving ability, or attitudes toward information and communication technology use. RESULTS: Searches yielded 1561 studies, of which 27 studies (17 cross-sectional, 2 before and after, 2 randomized controlled trials, 1 longitudinal, and 1 mixed methods) were included in the final analysis. Studies were conducted in the United States (18/27), Germany (3/27), China (1/27), Italy (1/27), Sweden (1/27), Canada (1/27), Iran (1/27), and Bangladesh (1/27). Studies mostly defined older adults as aged ≥50 years (10/27) or ≥60 years (8/27). Overall, the eHealth Literacy Scale (eHEALS) was the most frequently used instrument measuring digital literacy among older adults (16/27, 59%). Scores on the CCAT ranged from 34 (34/40, 85%) to 40 (40/40, 100%). Most instruments measured 1 or 2 of the DigComp Framework's elements, but the Mobile Device Proficiency Questionnaire (MDPQ) measured all 5 elements, including "digital content creation" and "safety." CONCLUSIONS: The current digital literacy assessment instruments targeting older adults have both strengths and weaknesses, relative to their study design, administration method, and ease of use. Certain instrument modalities like the MDPQ are more generalizable and inclusive and thus, favorable for measuring the digital literacy of older adults. More studies focusing on the suitability of such instruments for older populations are warranted, especially for areas like "digital content creation" and "safety" that currently lack assessment. Evidence-based discussions regarding the implications of digitalization for the treatment of older adults and how health care professionals may benefit from this phenomenon are encouraged.

Quantitative analysis of metal artefacts of dental implant in CBCT image by correlation analysis to micro-CT: A microstructural study.

OBJECTIVES: Quantification of dental implant metal artefacts in CBCT images using correlation analysis of trabecular microstructural parameters from CBCT and micro-CT, and analysis of the effect of varying the angular position of the subject. METHODS: Polyurethane synthetic bone blocks were first scanned without implants by micro-CT and CBCT. Two dental implants were then placed parallel in the bone blocks and these specimens were scanned by CBCT with different alpha angles. Three volumes of interest (VOI) were set for further analysis. Six microstructural parameters were measured: trabecular thickness (TbTh), trabecular spacing (ThSp), bone volume per total volume (BV/TV), bone surface per total volume (BS/TV), connectivity density (CD) andfractal dimension (FD). Micro-CT measurements were used as a gold standard for CBCT. Spearman correlation coefficients for each microstructural parameter from CBCT and micro-CT were calculated and compared using Steiger's Z test. RESULTS: Without the implants, in VOI1, the Spearman correlation coefficients of TbTh, TbSp, BV/TV, BS/TV, CD and FD were 0.599, 0.76, 0.552, 0.566, 0.664 and 0.607, respectively. With the implants, the correlation coefficients decreased sharply in VOI1. As the alpha angle increased from zero to 90°, the correlation coefficients increased and became significant. Similar results appeared in VOI2. In contrast, in VOI3, the correlation coefficient decreased as the alpha angle increased. CONCLUSIONS: Metal artefacts were successfully quantified using microstructural parameters in terms of the image quality of the CBCT. Changes in alpha angle affected the quality of the CBCT image.

Reducing metal artifacts between implants in cone-beam CT by adjusting angular position of the subject.

OBJECTIVES: To reduce inter-implant metal artifacts in cone-beam CT (CBCT) imaging by adjusting angular position of the subject relative to the source-detector plane. MATERIALS AND METHODS: Two dental implants were placed in a block made of homogeneous dental impression material. Using a custom-made apparatus, the specimen was scanned with a CBCT machine at seven different angles (0°, 15°, 30°, 45°, 60°, 75°, and 90°) along three different spatial axes, yielding 21 experimental groups. Thirteen volumes of interest (VOI) including inter- and peri-implant areas were selected from each axial reconstruction perpendicular to the implants. Gray values (GVs) of each pixel within these VOIs were measured. Mean differences in GV (ΔGV) between the VOIs and control area were calculated and expressed as a percentage. These ΔGVs from different spatial angle were compared and analyzed by Welch's analysis of variance (ANOVA) and linear regression using SPSS 25.0 software. RESULTS: As alpha angle increased, the ΔGV of the inter-implant area increased from - 62.02% to near-zero while the standard deviation decreased. Welch's ANOVA and linear regression analysis revealed ΔGV increased significantly with alpha angle (p < 0.001, R2 = 0.406). VOIs on the extension line of two implants showed similar results. After adjusting the beta and gamma angles, there was no significant change in ΔGV. CONCLUSIONS: Increasing the alpha angle can reduce metal artifacts in the inter-implant area in CBCT images.

Autonomy is not but competence and relatedness are associated with physical activity among colorectal cancer survivors.

PURPOSE: The main objective of this study was to use the framework of the self-determination theory, incorporating both internal and external sources of motivation, to identify factors influencing physical activity among colorectal cancer survivors (CRC-S) in Korea. METHOD: In total, 242 patients at a university-affiliated hospital in Seoul, Korea, responded to a descriptive survey, which comprised questionnaire sets including the Global Physical Activity Questionnaire and the Patient Health Questionnaire. Motivation was then assessed on three scales: the Treatment Self-Regulation (autonomy), Perceived Competence (competence), and the multidimensional Scale of Perceived Social Support (relatedness). Logistic regression analysis was then used to identify factors associated with physical activity. RESULT: The mean physical activity score was 16.07 metabolic equivalent hours per week, and only 23.3% of patients had an appropriate level of exercise. In the logistic regression analysis, physical activity was associated with competence (odds ratio (OR) = 1.36, 95% confidence interval (CI): 1.06-1.74), relatedness (OR = 1.11, 95% CI: 1.04-1.18), depression (OR = 0.84, 95% CI: 0.75-0.94), and stage I or II disease (OR = 3.33, 95% CI: 1.28-1.86). This study indicated that competence, relatedness, depression, and the disease stage contributed to physical activity among these subjects while autonomy did not. CONCLUSION: Future interventions to achieve the recommended levels of physical activity among CRC-S could benefit from taking into account the disease stage as well as psychosocial factors including motivation and depression.

Genomic Profiling and Clinicopathological Characteristics of Neuroendocrine Tumors of the Lung in East Asian Patients.

BACKGROUND/AIM: In recent years, the genomic landscape of neuroendocrine tumors (NETs) of the lung has been investigated. However, more data are necessary to elucidate the heterogeneous nature of NETs, especially in East Asian patients. PATIENTS AND METHODS: A total of 64 patients who underwent surgical resection for lung NETs [26 typical or atypical carcinoid tumors, 21 large-cell neuroendocrine carcinomas (LCNECs), and 19 small-cell lung carcinomas (SCLCs)] were enrolled, and samples from 46 patients were subjected to targeted next-generation sequencing. RESULTS: Co-mutations of tumor protein p53 (TP53) and RB transcriptional corepressor 1 (RB1) were detected in 15%, 42%, and 93% of carcinoid tumors, LCNECs, and SCLCs, respectively. Oncogenic or targetable genetic alterations identified in this study included mutations of KRAS proto-oncogene (KRAS), phosphatidylinositol-4,5-bisphosphate 3-kinase catalytic subunit alpha (PIK3CA), ALK receptor tyrosine kinase (ALK), mitogen-activated protein kinase kinase 1 (MAP2K1), and isocitrate dehydrogenase 1 (IDH1), as well as amplifications of erb-b2 receptor tyrosine kinase 2 (ERBB2), fibroblast growth factor receptor 1 (FGFR1), CD274 molecule (CD274), and MYCN proto-oncogene (MYCN). These alterations were more frequently found in high-grade NETs than in carcinoid tumors (33.3% vs. 7.7%). Programmed cell death-ligand 1 expression was strongly associated with the LCNEC subtype among NETs (p=0.002). CONCLUSION: The mutational status of TP53 and RB1 was significantly associated with NET subtypes in East Asian patients. Targeted therapy or immunotherapy may serve as a treatment option in a subset of patients with high-grade NETs.

Prognostic factors of acinar- or papillary-predominant adenocarcinoma of the lung.

OBJECTIVE: Histologic types are correlated with prognosis in lung adenocarcinoma. The acinar/papillary type is most common, although this group comprises heterogeneous tumor types. However, the prognostic factors in this group have not been well studied. Therefore, we investigated the prognostic factors of acinar/papillary lung adenocarcinomas and attempted to define the so-called "intermediate grade" group of lung adenocarcinoma. MATERIALS AND METHODS: We classified surgically resected invasive non-mucinous adenocarcinomas of the lung and analyzed their clinicopathological features and prognostic factors, focusing on the acinar/papillary type. RESULTS: A total of 301 cases with stage I-III lung adenocarcinoma were enrolled, of which 193 were acinar/papillary type (64.1%). In survival analysis of the entire cohort, acinar/papillary types showed intermediate survival compared with lepidic and micropapillary/solid types. In the univariate survival analysis for acinar/papillary types, stage, age, lymphovascular invasion, spread through air spaces, presence of micropapillary or solid pattern, and programmed death-ligand 1 (PD-L1) positivity were associated with poor recurrence-free survival and overall survival. In multivariate analysis, spread through air spaces and PD-L1 expression were independent poor prognostic factors of recurrence-free survival and overall survival in the acinar/papillary cohort, respectively. CONCLUSIONS: Evaluation of spread through air spaces and PD-L1 expression may be useful to stratify patients with acinar/papillary lung adenocarcinomas in terms of prognosis.