Regulation of the human thioredoxin gene promoter and its key substrates: a study of functional and putative regulatory elements.

BACKGROUND: The thioredoxin system maintains redox balance through the action of thioredoxin and thioredoxin reductase. Thioredoxin regulates the activity of various substrates, including those that function to counteract cellular oxidative stress. These include the peroxiredoxins, methionine sulfoxide reductase A and specific transcription factors. Of particular relevance is Redox Factor-1, which in turn activates other redox-regulated transcription factors. SCOPE OF REVIEW: Experimentally defined transcription factor binding sites in the human thioredoxin and thioredoxin reductase gene promoters together with promoters of the major thioredoxin system substrates involved in regulating cellular redox status are discussed. An in silico approach was used to identify potential putative binding sites for these transcription factors in all of these promoters. MAJOR CONCLUSIONS: Our analysis reveals that many redox gene promoters contain the same transcription factor binding sites. Several of these transcription factors are in turn redox regulated. The ARE is present in several of these promoters and is bound by Nrf2 during various oxidative stress stimuli to upregulate gene expression. Other transcription factors also bind to these promoters during the same oxidative stress stimuli, with this redundancy supporting the importance of the antioxidant response. Putative transcription factor sites were identified in silico, which in combination with specific regulatory knowledge for that gene promoter may inform future experiments. GENERAL SIGNIFICANCE: Redox proteins are involved in many cellular signalling pathways and aberrant expression can lead to disease or other pathological conditions. Therefore understanding how their expression is regulated is relevant for developing therapeutic agents that target these pathways.

Fermented Kamut Sprout Extract Decreases Cell Cytotoxicity and Increases the Anti-Oxidant and Anti-Inflammation Effect.

Kamut sprouts (KaS) contain several biologically active compounds. In this study, solid-state fermentation using Saccharomyces cerevisiae and Latilactobacillus sakei was used to ferment KaS (fKaS-ex) for 6 days. The fKaS-ex showed a 26.3 mg/g dried weight (dw) and 46.88 mg/g dw of polyphenol and the ß-glucan contents, respectively. In the Raw264.7 and HaCaT cell lines, the non-fermented KaS (nfKaS-ex) decreased cell viability from 85.3% to 62.1% at concentrations of 0.63 and 2.5 mg/mL, respectively. Similarly, the fKaS-ex decreased cell viability, but showed more than 100% even at 1.25 and 5.0 mg/mL concentrations, respectively. The anti-inflammatory effect of fKaS-ex also increased. At 600 µg/mL, the fKaS-ex exhibited a significantly higher ability to reduce cytotoxicity by suppressing COX-2 and IL-6 mRNA expressions as well as that for IL-1ß mRNA. In summary, fKaS-ex exhibited significantly lower cytotoxicity and increased anti-oxidant and anti-inflammatory properties, indicating that fKaS-ex is beneficial for use in food and other industries.

Structural analysis and serological test of arginine periplasmic binding protein 2 from Chlamydophila pneumoniae.

The 'art' genes encode specific arginine uptake proteins, and are repressed by the repressible promoters of ArgR, affecting transcription of artJ. Cpb0502, the arginine-binding periplasmic protein 2 precursor from Chlamydophila pneumoniae TW-183 strains, is responsible for arginine transport. As C. pneumoniae is difficult to isolate and culture, there have been many studies of better ways to detect it. A microimmunofluorescence assay (MIF) is still considered to be the 'gold standard' for detecting C. pneumoniae. Although MIF has its own limitations, a number of immunogenic antigens have been shown to be C. pneumoniae specific by this test. Here, we report Cpb0502 as a specific immunogenic antigen against C. pneumoniae as it was detected only in human infection sera of C. pneumoniae but not in Legionella pneumophila and Mycoplasma pneumoniae infection sera, showing high specificity and sensitivity by MIF, western blot and ELISA analysis. And also the crystal structure of Cpb0502 was determined to be a dimer at 2.07Å, revealing a similar backbone structure to a histidine kinase receptor, HK29S. Therefore we may suggest that Cpb0502 is a candidate immunogenic antigen for better diagnosis of C. pneumoniae.

Assessing the Risk-Rescue Rating Scale and Acute Physiology and Chronic Health Evaluation II scores for investigating factors related to intensive care unit admissions of deliberate self-poisoning patients visiting emergency departments

Objective@#The Risk-Rescue Rating Scale (RRRS) is generally implemented to predict the lethality of suicide attempts, whereas the Acute Physiology and Chronic Health Evaluation II (APACHE-II) scoring system is applied as an accurate measure of the severity of patient condition of patients admitted to intensive care units (ICUs). Using the RRRS and APACHE-II scores, in this study, we aimed to investigate the factors related to ICU admissions of deliberate self-poisoning (DSP) patients admitted to emergency departments (EDs). @*Methods@#The epidemiologic and psychologic factors, electronic medical records, and laboratory tests of DSP patients were prospectively collected and analyzed. We divided the patients into two groups, an ICU admission group and a nonICU admission group. @*Results@#This study included 387 patients, 333 (86.0%) of which were in the non-ICU group and 54 (14.0%) in the ICU admission group. Multivariate logistic analysis was conducted to independently associate the ICU admissions with RRRS (odds ratio [OR], 1.40; 95% confidence interval [CI], 1.27-1.55; P<0.01), APACHE-II scores (OR, 1.11; 95% CI, 1.03- 1.21; P=0.01), and amylase values (OR, 1.01; 95% CI, 1.00-1.01; P=0.02). A receiver operating characteristics (ROC) curve analysis of the decision for admission to the ICU yielded the following scores for RRRS and APACHE II—cutoff values of 39.5 and 8.5, sensitivity of 96% and 66.0%, specificity of 74.0% and 75.1%, and area under the ROC curve (AUC) values of 0.95 and 0.74, respectively (P<0.01). @*Conclusion@#The RRRS and APACHE-II scores could be used to determine ICU admissions in DSP patients admitted to the ED.

General anesthesia using propofol infusion for implantation of an implantable cardioverter defibrillator in a pediatric patient with Andersen-Tawil syndrome: a case report

Andersen-Tawil syndrome (ATS) is a rare genetic disease characterized by a triad of episodic flaccid muscle weakness, ventricular arrhythmias, and physical anomalies. ATS patients have various cardiac arrhythmias that can cause sudden death. Implantation of an implantable cardioverter-defibrillator (ICD) is required when life-threatening cardiac arrhythmias do not respond to medical treatment. An 11-year-old girl underwent surgery for an ICD implantation. For general anesthesia in ATS patients, anesthesiologists should focus on the potentially difficult airway, serious cardiac arrhythmias, such as ventricular tachycardia (VT), and delayed recovery from neuromuscular blockade. We followed the difficult airway algorithm, avoided drugs that can precipitate QT prolongation and fatal cardiac arrhythmias, and tried to maintain normoxia, normocarbia, normothermia, normoglycemia, and pain control for prevention of sympathetic stimulation. We report the successful application of general anesthesia for ICD implantation in a pediatric patient with ATS and recurrent VT.

Early countermeasures to COVID-19 at long-term care facilities in Gwangju Metropolitan City, Republic of Korea

Objectives@#The coronavirus disease 2019 (COVID-19) pandemic has continued since its first detection in the Republic of Korea on January 20, 2020. This study describes the early countermeasures used to minimize the risk of COVID-19 outbreaks during cohort quarantine and compares the epidemiological characteristics of 2 outbreaks in long-term care facilities (LTCFs) in Gwangju Metropolitan City in summer 2020. @*Methods@#An epidemiological investigation was conducted via direct visits. We investigated epidemiological characteristics, including incidence, morbidity, and mortality rates, for all residents and staff members. Demographic characteristics were analyzed using a statistical program. Additionally, the method of managing infection in LTCFs is described. @*Results@#Residents and caregivers had high incidence rates in LTCF-A and LTCF-B, respectively. LTCF-B had a longer quarantine period than LTCF-A. The attack rate was 20.02% in LTCF-A and 27.9% in LTCF- B. The mortality rate was 2.3% (1/43) in LTCF-B, the only facility in which a COVID-19 death occurred. @*Conclusion@#Extensive management requires contact minimization, which involves testing all contacts to mitigate further transmission in the early stages of LTCF outbreaks. The findings of this study can help inform and prepare public health authorities for COVID-19 outbreaks, particularly for early control in vulnerable facilities.

Results of contact tracing for SARS-CoV-2 Omicron sub-lineages (BA.4, BA.5, BA.2.75) and the household secondary attack risk

Objectives@#This study aimed to assess the contact tracing outcomes of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) Omicron sub-lineages BA.4, BA.5, and BA.2.75 within Republic of Korea, and to generate foundational data for responding to future novel variants. @*Methods@#We conducted investigations and contact tracing for 79 confirmed BA.4 cases, 396 confirmed BA.5 cases, and 152 confirmed BA.2.75 cases. These cases were identified through random sampling of both domestically confirmed and imported cases, with the goal of evaluating the pattern of occurrence and transmissibility. @*Results@#We detected 79 instances of Omicron sub-lineage BA.4 across a span of 46 days, 396 instances of Omicron sub-lineage BA.5 in 46 days, and 152 instances of Omicron sub-lineage BA.2.75 over 62 days. One patient with severe illness was confirmed among the BA.5 cases; however, there were no reports of severe illness in the confirmed BA.4 and BA.2.75 cases. The secondary attack risk among household contacts were 19.6% for BA.4, 27.8% for BA.5, and 24.3% for BA.2.75. No statistically significant difference was found between the Omicron sub-lineages. @*Conclusion@#BA.2.75 did not demonstrate a higher tendency for transmissibility, disease severity, or secondary attack risk within households when compared to BA.4 and BA.5. We will continue to monitor major SARS-CoV-2 variants, and we plan to enhance the disease control and response systems.

Trends of axillary surgery in breast cancer patients with axillary lymph node metastasis: a comprehensive single-center retrospective study

Purpose@#Based on the results of previous trials, de-escalation of axillary surgery after neoadjuvant chemotherapy (NAC) has increased in patients with axillary lymph node (ALN) metastasis at presentation. This study aimed to review the trends of axillary surgery by time period and molecular subtype in patients with ALN metastasis. @*Methods@#We analyzed the rates of sentinel lymph node biopsy (SLNB) and ALN dissection (ALND) based on time period and subtype. The time period was divided into 3 subperiods to determine the rate of axillary surgery type over time (period 1, from 2009 to 2012; period 2, from 2013 to 2016; and period 3, from 2017 to July 2019). @*Results@#From 2009 to July 2019, 2,525 breast cancer patients underwent surgery. Based on subtype, the ALND rate of hormone receptor-positive (HR+)/human epidermal growth factor receptor 2-negative (HER2–) disease decreased by 13.0% from period 1 to period 3 (period 1, 99.4%; period 2, 97.5%; and period 3, 86.4%; P < 0.001). Conversely, the ALND rate in HR+/HER2+, HR–/HER2+, and triple-negative breast cancer (TNBC) significantly decreased by 43.7%, 48.8%, and 35.2% in period 1, period 2, and period 3, respectively (P < 0.001). In the patient group receiving NAC, HR+/HER2– had a significantly higher ALND rate (84.1%) than HR+/HER2+, HR–/HER2+, and TNBC (60.8%, 62.3%, and 70.7%, respectively; P < 0.001). @*Conclusion@#The SLNB rate in patients with ALN metastasis has increased over time. However, the ALND rate in HR+/ HER2– was significantly higher than in other subtypes.

Single‑port versus multiport robotic total mesorectal excision for rectal cancer: initial experiences by case‑matched analysis of short‑term outcomes

Purpose@#The da Vinci single-port (SP) system has been used in various surgical fields, including colorectal surgery.However, limited experience has been reported on its safety and feasibility. This study aims to evaluate the short-term outcomes of SP robotic surgery for the treatment of rectal cancer compared with multiport (MP) robotic surgery. @*Methods@#Rectal cancer patients who underwent curative resection in 2020 were reviewed. A total of 43 patients underwent robotic total mesorectal excision (TME), of which 26 (13 in each group, SPTME vs. MPTME) were included in the case-matched cohort for analysis. Intraoperative and postoperative outcomes and pathological results were compared between the 2 groups. @*Results@#Median tumor height was similar between the 2 groups (SPTME vs. MPTME : 5.9 cm [range, 2.2–9.6 cm] vs. 6.7 cm [range, 3.4–10.0 cm], P = 0.578). Preoperative chemoradiotherapy was equally performed (38.5%). The median estimated blood loss was less (20.0 mL [range, 5.0–20.0 mL] vs. 30.0 mL [range, 20.0–30.0 mL], P = 0.020) and the median hospital stay was shorter (7 days [range, 6–8 days] vs. 8 days [range, 7–9 days], P = 0.055) in the SPTME group. Postoperative complications did not differ (SPTME vs. MPTME : 7.7% vs. 23.1%, P = 0.587). One patient in the SPTME group and 3 in the MPTME group experienced anastomotic leakage. @*Conclusion@#SP robotic TME showed perioperative outcomes similar to MP robotic TME. The SP robotic system can be considered a surgical option for the treatment of rectal cancer. Further prospective randomized trials with larger cohorts are required.

Efficacy of air leak test in detection of anastomotic leaks after rectal excision: a retrospective case-controlled study

Purpose@#Although its efficacy is uncertain, an intraoperative air leak test (ALT) is commonly used to detect mechanical defects following bowel anastomosis. This study aimed to evaluate the efficacy of ALT to detect anastomotic leakage (AL) following rectal excision. @*Methods@#We reviewed our database for patients with rectal cancers who had undergone curative surgery between January 2012 and January 2018. Patients were grouped according to whether or not an ALT was performed. Propensity score analyses were performed to compare outcomes for groups in a 1:1 case-matched cohort. @*Results@#In total, 1,191 patients underwent rectal excision; 438 (219 in each group) formed the case-matched cohort for analysis. The protective stoma rate was 16.0% and 14.6% in the ALT and the no-ALT groups, respectively (P = 0.791). In the ALT group, 2 patients (0.9%) showed a positive result and were treated with rectal tube drainage, resulting in no leakage.There was no significant difference in postoperative AL rate between the groups (ALT group: 4.6% vs. no-ALT group: 4.1%, P > 0.999). @*Conclusion@#ALT played a minimal role in detecting AL following rectal excision. Further studies are warranted to validate our results and clarify whether AL can be prevented with ALT or alternative methods.

Cancer Statistics in Korea: Incidence, Mortality, Survival, and Prevalence in 2020 / Journal of the Korean Cancer Association, 대한암학회지

Purpose@#The current study provides national cancer statistics and their secular trends in Korea, including incidence, mortality, survival, and prevalence in 2020. @*Materials and Methods@#Incidence, survival, and prevalence rates of cancer were calculated using the Korea National Cancer Incidence Database, from 1999 to 2020, with survival follow-up until December 31, 2021. Deaths from cancer were assessed using causes-of-death data obtained from Statistics Korea. @*Results@#The number of new cancer diagnoses in 2020 decreased by 9,218 cases (3.6%) compared to 2019. In 2020, newly diagnosed cancer cases and deaths from cancer were reported as 247,952 (age-standardized rate [ASR], 262.2 per 100,000) and 82,204 (ASR, 69.9 per 100,000), respectively. The overall cancer incidence rates increased by 3.3% annually from 1999 to 2012, and decreased by 5.0% annually from 2012 to 2015, thereafter, followed by nonsignificant changes. Cancer mortality rates have been decreasing since 2002, with more rapid decline in recent years. The 5-year relative survival between 2016 and 2020 was 71.5%, which contributed to prevalent cases reaching over 2.2 million in 2020. @*Conclusion@#In 2020, the number of newly diagnosed cancer patients decreased due to the coronavirus disease 2019 pandemic, but the overall trend is on the rise. Cancer survival rates have improved over the past decades. As the number of cancer survivors increases, a comprehensive cancer control strategy should be implemented in line with the changing aspects of cancer statistics. The long-term impact of the coronavirus disease 2019 pandemic on cancer statistics needs to be investigated in the future.

Prediction of Cancer Incidence and Mortality in Korea, 2023 / Journal of the Korean Cancer Association, 대한암학회지

Purpose@#This study aimed to report the projected cancer incidence and mortality for the year 2023 to estimate Korea’s current cancer burden. @*Materials and Methods@#Cancer incidence data from 1999 to 2020 were obtained from the Korea National Cancer Incidence Database, and cancer mortality data from 1993 to 2021 were acquired from Statistics Korea. Cancer incidence and mortality were projected by fitting a linear regression model to observed age-specific cancer rates against their respective years and then by multiplying the projected age-specific rates by the anticipated age-specific population for 2023. A joinpoint regression model was used to determine the year in which the linear trend changed significantly; we only used the data of the latest trend. @*Results@#In total, 273,076 new cancer cases and 81,818 cancer deaths are expected to occur in Korea in 2023. The most common cancer site is expected to be the lung, followed by the thyroid, breast, colon and rectum, and stomach. These five cancers are expected to represent half of the overall burden of cancer in Korea. The most common type of cancer leading to death is expected to be lung cancer, followed by liver, colorectal, pancreatic, and gallbladder cancers. @*Conclusion@#The incidence rates for all types of cancer in Korea are estimated to gradually decrease. These up-to-date estimates of the cancer burden in Korea could be an important resource for planning and evaluating cancer-control programs.

The tert-butylhydroquinone-mediated activation of the human thioredoxin gene reveals a novel promoter structure.

Thioredoxin is a redox-active protein that plays multiple roles in regulating cell growth, cell signalling and apoptosis. Here, we have demonstrated that a complex mechanism involving multiple regulatory elements is involved in the tBHQ [tert-butylhydroquinone or 2,5-di-(t-butyl)-1,4-hydroquinone]-mediated activation of the thioredoxin gene. Luciferase assays, utilizing various wild-type and mutated thioredoxin promoter fragments, revealed roles for the ORE (oxidative stress responsive element), ARE (antioxidant responsive element), three Sp1 (specificity protein 1)-binding sites and the TATA box in the activation of the thioredoxin gene by tBHQ. The ORE required the presence of the ARE to elicit its response, whereas the independent removal of three Sp1-binding sites and the TATA box also decreased activation of the thioredoxin gene, with mutation of the TATA box having the greatest effect. Real-time RT (reverse transcriptase)-PCR analysis also revealed varying roles for two TSSs (transcription start sites) in the activation of the thioredoxin gene by tBHQ. Transcription was initiated from both TSSs; however, different response rates and fold inductions were observed. Together, these results suggest that the thioredoxin gene is controlled by a novel arrangement of two overlapping core promoter regions, one containing a TATA box and the other TATA-less. Altering the intracellular levels of thioredoxin in a breast cancer cell line also influenced the induction of thioredoxin transcription in response to tBHQ. Stable transfections with a redox-inactive thioredoxin mutant produced 3.6 times higher induction levels of thioredoxin transcription compared with control cells, indicating an intrinsic form of control of promoter activity by the thioredoxin system itself.

Service Demand for and Awareness of a Primary Healthcare Pilot Project for People With Disabilities

Background@#This study investigated the demand for and awareness of a primary healthcare pilot project for people with disabilities; it also sought to identify relevant determinants for demand and awareness using Andersen’s behavioral model of health service use. @*Methods@#This study is a secondary analysis of data from the population-based survey conducted in Gyeonggi Regional Health & Medical Center for People with Disabilities. The data was designed with quota random sampling based on the population with disabilities in each district (city [si] and county [gun]) across the Gyeonggi province (do) to evaluate the health and healthcare accessibility of the disabled people living in the Gyeonggi province. The data was collected through the mobile-based survey of 1,140 people with disabilities living in Gyeonggi-do between March 2021 and June 2021. @*Results@#Awareness of the service (12.1%) was remarkably low, while the demand (80.5%) was high. The gap between respondents who needed the service but were unaware of it differed according to age, education, activities of daily living, health information sources, chronic disease, depression, subjective health status, and unmet healthcare needs. Chronic disease (odds ratio [OR], 1.86; P = 0.001) and an unmet need for medical care (OR, 2.30;P= 0.002) had significant influences on demand for the service. Furthermore, living alone (OR, 0.42; P = 0.023), medical aid program beneficiary status (OR, 2.10; P = 0.020), access to health information from health service centers (OR, 4.00; P = 0.002), chronic disease (OR, 1.68; P = 0.043), severity of disability (OR, 1.78; P = 0.025), and subjective health status (OR, 4.51; P < 0.001) significantly affected awareness of the program. @*Conclusion@#Chronic disease and an unmet need for medical care were key determinants of service demand, while the severity of disability was not. Thus, there is a need to review the initiative that defines service beneficiaries as people with severe disabilities. Policy makers should consider advertising programs to improve service awareness among people with disabilities.

Resistance exercise training‑induced skeletal muscle strength provides protective effects on high‑fat‑diet‑induced metabolic stress in mice / 한국실험동물학회지

Background@#Resistance exercise training is known to improve metabolic disorders, such as obesity and type2 diabetes. In this study, we investigated whether the beneficial effects of resistance exercise training persisted even after the discontinuation of training with high-fat diet (HFD)-induced metabolic stress. We further evaluated whether the improvement in skeletal muscle strength and endurance by training were correlated with improved metabolism. Eight-week-old male C57BL/6N mice were divided into groups that remained sedentary or had access to daily resistance exercise via ladder climbing for 8 weeks. Trained and untrained mice were fed an HFD for 1 week after the exercise training intervention (n = 5–8 per group). @*Results@#Resistance exercise-trained mice had a lean phenotype and counteracted diet-induced obesity and glucose tolerance, even after exercise cessation. Grip strength was significantly inversely correlated with the body weight, fat mass, and glucose tolerance. However, hanging time was significantly inversely correlated with body weight only. @*Conclusions@#These results have strong implications for the preventive effect of resistance exercise-induced metabolic improvement by enhancing skeletal muscle strength rather than endurance.

Cancer Statistics in Korea: Incidence, Mortality, Survival, and Prevalence in 2019 / Journal of the Korean Cancer Association, 대한암학회지

Purpose@#The current study provides national cancer statistics and their secular trends in Korea, including incidence, mortality, survival, and prevalence in 2019. @*Materials and Methods@#Incidence, survival, and prevalence rates of cancer were calculated using the Korea National Cancer Incidence Database, from 1999 to 2019, with survival follow-up until December 31, 2020. Deaths from cancer were assessed using causes-of-death data obtained from Statistics Korea. @*Results@#In 2019, newly diagnosed cancer cases and deaths from cancer were reported as 254,718 (ASR, 275.4 per 100,000) and 81,203 (ASR, 72.2 per 100,000), respectively. For the first time, lung cancer (n=29,960) became the most frequent cancer in Korea, excluding thyroid cancer. The overall cancer incidence rates increased by 3.3% annually from 1999 to 2012, and decreased by 5.3% annually from 2012 to 2015, thereafter, followed by nonsignificant changes. The incidence of thyroid cancer increased again from 2016 (annual percentage change, 6.2%). Cancer mortality rates have been decreasing since 2002, with more rapid decline in recent years (annual decrease of 2.7% from 2002 to 2013; 3.3% from 2013 to 2019). The 5-year relative survival between 2015 and 2019 was 70.7%, which contributed to prevalent cases reaching over 2 million in 2019. @*Conclusion@#Cancer survival rates have improved over the past decades, but the number of newly diagnosed cancers is still increasing, with some cancers showing only marginal improvement in survival outcomes. As the number of cancer survivors increases, a comprehensive cancer control strategy should be implemented in line with the changing aspects of cancer statistics.

Fatigue and Associated Factors among Airline Pilots / 항공우주의학회지

Purpose@#This study aimed to identify the prevalence of fatigue and its associated factors leading to the fatigue among Korean commercial airline pilots. @*Methods@#An anonymous, web-based questionnaire collecting data on sleep related characteristics was completed by airline pilots. The final 1,029 samples of completed questionnaires were analyzed. The association of the risk factors with fatigue was determined using logistic regression analysis. @*Results@#The prevalence of fatigue was 60% (Fatigue Severity Scale index≥3.2), disturbed sleep 28% (Pittsburgh Sleep Quality Index≥9), daytime sleepiness 17% (Epworth Sleepiness Scale≥10), and sleep apnea (Berlin Questionnaire≥2) 11%. Thefully adjusted logistic regression showed that quality of life (odds ratio [OR]=0.16, confidence interval [CI]=0.11–0.24), daytime sleepiness (OR=1.26, CI=1.18–1.34), sleep quality (OR=1.44, CI=1.29–1.61), mental workload (OR=1.10, CI=1.05–1.14),vigorous physical activity (OR=0.82, CI=0.72–0.92), late starts (OR=1.25, CI=1.06–1.46) and average weekly flying hours (OR=1.02, CI=1.00–1.03) were associated with higher levels of fatigue. @*Conclusion@#Lower quality of life, disturbed sleep, more subjective sleepiness, shorter sleep duration, higher mental workload, less vigorous physical activity, frequent late starts, and longer flying hour were shown to be risk factors for fatigue in airline pilots.These findings should be taken into account in the development of sleep and fatigue countermeasures for airline pilots.

Development and Effect of a Behavior Program for Reducing Exposure to Endocrine Disrupting Chemicals in Unmarried Women

Purpose@#This study was conducted to develop a behavior program for reducing exposure to endocrine disrupting chemicals (EDCs), thereby to improve perceived benefits and self-efficacy as well as reduce the perceived barriers and prevalence of dysmenorrhea in unmarried women. @*Methods@#The study used a nonequivalent control group pretest-posttest design. Participants were randomly assigned to an experiment (n=18) or control group (n=18). The behavior program for reducing exposure to EDCs was developed based on Pender's health promotion model and previous research results. The program was conducted for 12 weeks, consisting of 4 weeks of face-to-face intervention and 8 weeks of mobile intervention. @*Results@#The behavior program we developed was verified as an effective intervention that could improve the perceived benefits and self-efficacy of reducing one's exposure to EDCs. It also decreases the perceived barriers and prevalence of dysmenorrhea in unmarried women. @*Conclusion@#Our results showed that the program was an effective nursing intervention in unmarried women. Therefore, this behavior program for reducing exposure to EDCs can be applied in the context of unmarried women.

The Effect of a Dietary Companion on Metabolic Syndrome in Adult Women

Purpose@#This study aimed to compare the differences in the prevalence of metabolic syndrome between menopausal women and women of childbearing age and to determine the risk of metabolic syndrome among women in each group depending on whether they eat alone. @*Methods@#Data of 1,813 women from the seventh Korea National Health and Nutrition Examination Survey (2016) were used. The collected data were analyzed using SPSS 20.0, and complex sample frequency analysis, descriptive statistics, complex sample cross analysis, complex sample general linear regression, and complex sample logistic regression analysis were performed. @*Results@#According to the results of the study, there was no difference in the prevalence and risk of metabolic syndrome according to the presence of companions during meals between women of childbearing age and post-menopausal women, but there was a difference in health behavior. In other words, women of childbearing age who ate alone had a lot of experience of drinking, and menopausal women who ate alone did not tend to make any efforts to control their weight and did not perform aerobic exercise. In particular, the negative health behavior of menopausal women who ate alone increased the risk of prevalence of metabolic syndrome. @*Conclusion@#The findings indicate that, for women who eat alone, interventions to prevent metabolic syndrome should be differentiated before and after menopause. Therefore, it is suggested to offer an educational program to prevent metabolic syndrome in women of childbearing age as well as provide regular assessments to diagnose metabolic syndrome and health behavior improvement programs for menopausal women.

Associations between Depressive Symptoms and Work-Related Musculoskeletal Symptoms, and Health-Promoting Behaviors among Korean Coast Guards

Background@#The purpose of the study was to examine associations between depressive symptoms and work-related musculoskeletal symptoms, and health-promoting behaviors in Korean Coast Guards who are exposed to a vulnerable working environment. @*Methods@#A cross-sectional correlational study was conducted with 271 Korean Coast Guards in Gangwon-do. Depressive symptoms were measured using the Korean version of Center for Epidemiologic Studies Depressive Scale-Revised. Work-related musculoskeletal symptoms were measured using the KOSHA (Korea Occupational Safety and Health Agency) GUIDE H-9-2012. Health-promoting behaviors were measured using the Health Promoting Lifestyle Profile-II. @*Results@#Of all the Korean Coast Guards, 17.3% represents the risk of clinical depression, and 43.5% reported work-related musculoskeletal symptoms in any body parts. The average score of health-promoting behaviors were 2.4 (range, 1-4 scores). Depressive symptoms and work-related musculoskeletal symptoms were significantly negatively associated with health-promoting behaviors, respectively. Depressive symptoms were significantly negatively associated with the spiritual growth, interpersonal relationship, physical activity, and stress management in subscales of the Health Promoting Lifestyle Profile-II. Work-related musculoskeletal symptoms were significantly negatively associated with the physical activity and stress management in subscales of the Health Promoting Lifestyle Profile-II. @*Conclusions@#Among Korean Coast Guards, health-promoting behaviors were significantly associated with depressive symptoms and work-related musculoskeletal symptoms. Therefore, nursing strategies to promote health-promoting behaviors may be enhanced psychological health and physical health outcome of Korean Coast Guards.