Chronic Disease Patterns and Their Relationship With Health-Related Quality of Life in South Korean Older Adults With the 2021 Korean National Health and Nutrition Examination Survey: Latent Class Analysis.

BACKGROUND: Improved life expectancy has increased the prevalence of older adults living with multimorbidities, which likely deteriorates their health-related quality of life (HRQoL). Understanding which chronic conditions frequently co-occur can facilitate person-centered care tailored to the needs of individuals with specific multimorbidity profiles. OBJECTIVE: The study objectives were to (1) examine the prevalence of multimorbidity among Korean older adults (ie, those aged 65 years and older), (2) investigate chronic disease patterns using latent class analysis, and (3) assess which chronic disease patterns are more strongly associated with HRQoL. METHODS: A sample of 1806 individuals aged 65 years and older from the 2021 Korean National Health and Nutrition Examination Survey was analyzed. Latent class analysis was conducted to identify the clustering pattern of chronic diseases. HRQoL was assessed by an 8-item health-related quality of life scale (HINT-8). Multiple linear regression was used to analyze the association with the total score of the HINT-8. Logistic regression analysis was performed to evaluate the odds ratio of having problems according to the HINT-8 items. RESULTS: The prevalence of multimorbidity in the sample was 54.8%. Three chronic disease patterns were identified: relatively healthy, cardiometabolic condition, arthritis, allergy, or asthma. The total scores of the HINT-8 were the highest in participants characterized as arthritis, allergy, or asthma group, indicating the lowest quality of life. CONCLUSIONS: Current health care models are disease-oriented, meaning that the management of chronic conditions applies to a single condition and may not be relevant to those with multimorbidities. Identifying chronic disease patterns and their impact on overall health and well-being is critical for guiding integrated care.

Latent class analysis of health behaviors, anxiety, and suicidal behaviors among Korean adolescents.

BACKGROUND: This study examined how health behavior patterns are associated with anxiety and suicidal behaviors among Korean adolescents. METHODS: Data were collected from a national cross-sectional sample of adolescents (n = 54,948, 51.5 % boys) in the 2020 Korea Youth Risk Behavior Web-based Survey. Latent class analysis was conducted based on 12 health behaviors (e.g., eating habits, physical activity, and substance use) using the R-based Jamovi 2.3.21 program. RESULTS: Four classes of health behaviors were identified: Class 1 (boys: 45.4 %, girls: 34.4 %) engaged in healthy behaviors; Class 2 (boys: 31.7 %; girls: 22.3 %) had unhealthy eating habits; Class 3 (boys: 18.0 %; girls: 39.9 %) had the lowest physical activity; and Class 4 (boys: 5.0 %, girls: 3.4 %) engaged in substance use, including smoking, drinking, and problematic smartphone use. Overall, girls had a higher odds ratio (OR) for anxiety and suicidal behaviors than boys did. Among girls, Class 4 had a higher OR for anxiety (OR = 2.78, 95 % confidence interval [CI] = 2.40-3.21), suicidal ideation (OR = 3.99, 95 % CI = 3.46-4.62), suicide plan (OR = 3.32, 95 % CI = 2.66-4.16), and suicide attempts (OR = 5.62, 95 % CI = 4.43-7.12) than Class 1. LIMITATIONS: This study has a few limitations including the participants' response bias, the use of a self-report survey, and the lack of diagnosis by clinicians. CONCLUSION: Adolescents engaging in substance abuse (Class 4) were more prone to anxiety symptoms and suicidal behaviors (ideation, plan, and attempts) than those engaged in healthy behaviors (Class 1). We suggest that more attention is needed to develop suicide prevention strategies that consider adolescent substance use patterns such as current smoking, drinking, and problematic smartphone use.

Suicide warning signs that are challenging to recognize: a psychological autopsy study of Korean adolescents.

BACKGROUND: In South Korea, the leading cause of youth death has been suicide for about 20 years. In this study, we conducted a multi-method psychological autopsy to identify the psychiatric diagnosis, developmental history, personality traits, family history, school life, warning signs of suicide, and risk factors related to suicide for the first time in Korea. METHODS: This was a postmortem, retrospective, and descriptive study of 36 adolescents who died by suicide between August 2015 and July 2021 in South Korea. We obtained qualitative and quantitative data from the Korean Psychological Autopsy of Adolescent, conducted by the Suicide and School Mental Health Institute, the official student mental health policy-focused research institute of the Korean Ministry of Education. RESULTS: The adolescents comprised equal percentage of girls and boys. Approximately half of the deaths (55.6%) occurred at home and most (72.2%) involved jumping from a height. Most of the adolescents (97.2%) had one major psychiatric disorder before death, with depressive disorder being the most prevalent (75%). They were at a high risk for internet addiction before death. The most common personality trait was avoidance (28.6%), followed by submissiveness (27.3%). Half of the parents reported that the adolescents were satisfied with their school life and the teachers observed that they had no behavioral problems. One year before death, seven (19.4%) adolescents injured themselves and five (13.9%) had attempted suicide. Most of the deceased (80.6%) had expressed suicide warning signs to their families within one year before death. Adolescents had a long experience of family-related adverse events. CONCLUSIONS: Most of the adolescents had mental health disorders and expressed suicidal intentions using verbal and nonverbal signs. However, it was challenging for families to recognize the risk signs because of adolescents' personality traits or a good school life. To prevent adolescent suicide, adolescents, parents, and teachers need to be educated to recognize signs of suicide warning signs and equipped to guide adolescents to appropriate care.

Promising Effect of the Children in Disaster: Evaluation and Recovery Intervention on Trauma Symptoms and Quality of Life for Children and Adolescents: A Controlled Study.

OBJECTIVE: The Children in Disaster: Evaluation and Recovery (CIDER) program in Korea was developed to treat children and adolescents exposed to trauma. This study aimed to demonstrate the effectiveness of the CIDER through a comparison with controls. METHODS: A total of 85 participants consisted of the intervention group (n=41) and control group (n=44). We assessed the changes in trauma-related symptoms, depression, anxiety, and improvements in quality of life before and after the intervention. RESULTS: In total, bullying and school violence (44.7%) were the most common trauma, followed by sexual abuse (17.6%). Acute stress disorder and post-traumatic stress disorder (PTSD) accounted for 41.2%, and attention-deficit/hyperactivity disorder (ADHD) and developmental disorder were the most common comorbidities (51.8%). The symptoms of trauma, depression, anxiety, and quality of life improved significantly in the intervention group, while the control group did not show significant changes. CONCLUSION: Compared with the control group, the CIDER improved symptoms and quality of life in children and adolescents who had experienced trauma. The CIDER program was practical and easy to apply, even for different ages, types of traumas, and comorbidities.

A Comparison of Changes in Health Behavior, Obesity, and Mental Health of Korean Adolescents Before and During the COVID-19 Pandemic: Online Cross-Sectional Study.

OBJECTIVE: The health behavior and mental health problems of adolescents have shown a variety of changes due to the coronavirus disease-2019 (COVID-19) pandemic. This study compared health behavior, obesity, and mental health among Korean adolescents before and during the early COVID-19 pandemic. METHODS: Population-based and cross-sectional data from the 2019 and 2020 Korea Youth Risk Behavior Web-Based Surveys were used. Data of 57,048 and 54,948 adolescents from the 2019 and 2020 surveys, respectively, were compared. Multiple logistic regression analysis was conducted to compare health behavior, obesity, and mental health before and during the COVID-19 pandemic. RESULTS: The adjusted odds ratio (aOR) of overweight, obesity, and body image perceived subjectively as fat, were higher in the 2020 sample compared to the 2019 sample. The aOR of the frequency (more than 3 times a week) of fast-food consumption was higher in 2020 than in 2019. However, the aOR of physical activity, alcohol use, and smoking experience were lower in 2020 than in 2019. In addition, during COVID-19, adolescents were less likely to have perceived severe stress, depressive moods, and suicidal ideation. CONCLUSION: Current evidence suggests the co-occurrence of positive and negative changes in health behavior, obesity, and mental health among Korean adolescents during the early COVID-19 pandemic. The results contribute insights for monitoring adolescents' health behavior and promoting their mental health during school shutdowns.

Problematic Smartphone Use and Its Relationship With Anxiety and Suicidal Ideation Among South Korean Adolescents.

OBJECTIVE: This study aimed to investigate the prevalence of problematic smartphone use (PSU) among adolescents and its association with anxiety and suicidal ideation. METHODS: The 16th cross-sectional, population-based Korea Youth Risk Behavior Web-Based Survey was administered in 2020 and included 54,948 adolescents. We used the Korean version of the smartphone overdependence scale and the 7-item Generalized Anxiety Disorder scale to assess PSU and anxiety. Suicidal ideation was assessed through responses to the self-report question. Multiple logistic regression analyses with complex sampling were conducted to identify the association of PSU with anxiety and suicidal ideation. RESULTS: In total, 25.1% of the adolescents reported PSU, 33.2% had anxiety symptoms, and 10.9% had seriously considered suicide during the past 12 months. Girls with PSU had a higher risk of anxiety (adjusted odds ratio [aOR], 2.81; 95% confidence interval [CI], 2.65 to 2.97) and suicidal ideation (aOR, 1.77; 95% CI, 1.64 to 1.91) than non-PSU girls. Boys with PSU reported more anxiety (aOR, 2.89; 95% CI, 2.72 to 3.07) and suicidal ideation (aOR, 1.82; 95% CI, 1.66 to 1.99) than the non-PSU group. In addition, girls with the lowest household income reported more suicidal ideation than girls with the highest household income (aOR, 3.40; 95% CI, 2.69 to 4.28). CONCLUSION: This study demonstrated the prevalence of PSU among South Korean adolescents in 2020. The prioritization of the detection of PSU and the identification of psychological factors may help improve the diagnosis and management of mental health problems and potentially yield significant psychosocial benefits.

Association of Social Support and Postpartum Depression According to the Time After Childbirth in South Korea.

OBJECTIVE: This study examined the association between social support and postpartum depression (PPD) according to the time after childbirth within 12 months in South Korea. METHODS: Data were collected from 1,481 women in Chungnam Province, South Korea from September 21 to 30, 2022. Multivariate logistic regression models were used to examine the association between social support and PPD. Subgroup analysis of the associations of support from family, friends, and significant others with PPD according to the time after childbirth was undertaken using crude and adjusted models. RESULTS: Of the participants, 39.91% had PPD. The prevalence of PPD was 36.05% at <3 months, 37.50% at 3≤ to <6 months, and 44.41% at 6≤ to <12 months. A 1-point increase in the social support score was associated with an increase in the adjusted odds ratio of PPD of 0.91 (95% confidence interval=0.90-0.93). Social support from family was significantly associated with PPD regardless of the time after childbirth. Support from significant others was significantly associated with PPD after 6≤ to <12 months. CONCLUSION: Family support should be provided consistently to women after birth; social connections with significant others can prevent PPD.

Attention, Externalizing and Internalizing Problems Mediated Differently on Internet Gaming Disorder Among Children and Adolescents With a Family History of Addiction as an Adverse Childhood Experience.

BACKGROUND: This study aimed to examine the factors associated with internet gaming disorder (IGD) and the mediating role of pediatric symptoms (attention, externalizing problems and internalizing problems) in children and adolescents with a family history of addiction as an adverse childhood experience (ACE). METHODS: A total of 2,586 children and adolescents (mean age = 14.04 ± 2.34; age range = 11-19 years; 50.5% boys) completed the Internet Game Use-Elicited Symptom Screen and the Pediatric Symptom Checklist-17. IBM SPSS Statistics 21 was used to calculate descriptive statistics and Pearson correlation coefficients and to conduct multiple regression analyses. Mediation analysis was performed using the Sobel test and the SPSS PROCESS macro. Serial multiple mediation analysis was performed using bootstrapping with 5,000 replications. RESULTS: The higher levels of Attention problems (ß = -0.228, P < 0.001) and externalizing problems (ß = -0.213, P < 0.001) were associated with IGD. Furthermore, the indirect effect of the independent variable on the dependent variable through the mediators was significant (Sobel's T: Z = -5.006, P < 0.001). These findings suggest that attention and externalizing problems mediate the effect of family history of addiction on IGD. CONCLUSION: This study demonstrated the associations among the family history of addiction, IGD, and pediatric symptoms (attention, externalizing problems, and internalizing problems) among Korean children and adolescents. Therefore, we need to pay attention to pediatric symptoms and develop systematic alternatives to improve mental health among Korean children and adolescents with a family history of addiction as ACEs.

Is social support associated with postpartum depression, anxiety and perceived stress among Korean women within the first year postpartum?

PURPOSE: This study aimed to examine the association between social support, postpartum depression (PPD), anxiety and perceived stress among women within 12 months of childbirth in South Korea. METHODS: A cross-sectional, web-based survey was conducted from 21 to 30 September 2022 and included women within 12 months of childbirth in Chungnam Province, South Korea. A total of 1486 participants were included. Multiple linear regression models were used to evaluate the association between social support and mental health. RESULTS: In total, 40.0% of the participants had mild to moderate PPD; 12.0%, anxiety symptoms; and 8.2%, perceived severe stress. Social support (from family and significant others) is significantly associated with PPD, anxiety and perceived severe stress. Current maternal health problems, unplanned pregnancy and low household income were risk factors for PPD, anxiety and perceived stress. The increase in the time elapsed after childbirth showed a positive association with PPD and perceived severe stress. CONCLUSIONS: Our findings provide insights to identify at-risk mothers and emphasize the importance of social support in families, early screening and continuous monitoring for postpartum women to prevent PPD, anxiety and stress.

IFT46 gene promoter-driven ciliopathy disease model in zebrafish.

Ciliopathies are human genetic disorders caused by abnormal formation and dysfunction of cellular cilia. Cilia are microtubule-based organelles that project into the extracellular space and transduce molecular and chemical signals from the extracellular environment or neighboring cells. Intraflagellar transport (IFT) proteins are required for the assembly and maintenance of cilia by transporting proteins along the axoneme which consists of complexes A and B. IFT46, a core IFT-B protein complex, is required for cilium formation and maintenance during vertebrate embryonic development. Here, we introduce transgenic zebrafish lines under the control of ciliated cell-specific IFT46 promoter to recapitulate human ciliopathy-like phenotypes. We generated a Tg(IFT46:GAL4-VP16) line to temporo-spatially control the expression of effectors including fluorescent reporters or nitroreductase based on the GAL4/UAS system, which expresses GAL4-VP16 chimeric transcription factors in most ciliated tissues during embryonic development. To analyze the function of IFT46-expressing ciliated cells during zebrafish development, we generated the Tg(IFT46:GAL4-VP16;UAS;nfsb-mCherry) line, a ciliated cell-specific injury model induced by nitroreductase (NTR)/metrodinazole (MTZ). Conditionally, controlled ablation of ciliated cells in transgenic animals exhibited ciliopathy-like phenotypes including cystic kidneys and pericardial and periorbital edema. Altogether, we established a zebrafish NTR/MTZ-mediated ciliated cell injury model that recapitulates ciliopathy-like phenotypes and may be a vertebrate animal model to further investigate the etiology and therapeutic approaches to human ciliopathies.

The risk of obstructive sleep apnea is highly correlated with depressive symptoms among the Korean adults population: results from the 2020 Korea National Health and Nutrition Examination Survey.

OBJECTIVES: We aimed to examine the association between Obstructive Sleep Apnea (OSA) risk, health behaviors, and depressive symptoms in a representative Korean sample. METHODS: Cross-sectional data from the 2020 Korea National Health and Nutrition Examination Survey (KNHANES) were analyzed. The sample included 4,352 adults aged 40 years and older. Multiple linear regression analysis was performed to examine the association between OSA risk, health behaviors, and depressive symptoms. RESULTS: In total, 23.1% of the participants reported a high risk of OSA. Of the respondents, 39.8%, 19.0%, 27.2%, and 8.7% reported hypertension, snoring, tiredness, and observed apnea, respectively. The prevalence of moderate-severe depressive symptoms among adults with high-risk OSA was 7.5%. The significant associations between OSA risk and sex with PHQ-9 were shown in univariate linear regression. In the multiple linear regression analysis, the association between high risk of OSA and PHQ-9 showed in total (B = 1.58; P < 0.001), male (B = 1.21; P < 0.001), and female (B = 1.93; P < 0.001). CONCLUSIONS: A high risk of OSA was associated with an increased prevalence of depressive symptoms. Monitoring the risk factors of depressive symptoms, including OSA, or unhealthy behaviors may decrease the mental health issues of middle-aged and older adults.

Can We Notice the Suicidal Warning Signs of Adolescents With Different Psychometric Profiles Before Their Death?: Analysis of Teachers' Reports.

BACKGROUND: This study aimed to analyze the suicidal warning signs of Korean students with different psychometric profiles based on teacher reports. METHODS: This was a retrospective cohort study based on Korean school teachers' responses to the Student Suicide Report Form. In total, 546 consecutive cases of student suicide were reported from 2017 to 2020. After missing data were excluded, 528 cases were included. The report consisted of demographic factors, the Korean version of the Strengths and Difficulties Questionnaire (SDQ) for teacher reporting, and warning signs of suicide. Frequency analysis, multiple response analysis, the χ² test, and Latent Class Analysis (LCA) were performed. RESULTS: Based on the scores of the Korean version of the teacher-reported SDQ, the group was divided into nonsymptomatic (n = 411) and symptomatic (n = 117) groups. Based on the LCA results, four latent hierarchical models were selected. The four classes of deceased students showed significant differences in school type (χ² = 20.410, P < 0.01), physical illness (χ² = 7.928, P < 0.05), mental illness (χ² = 94.332, P < 0.001), trigger events (χ² = 14.817, P < 0.01), self-harm experience (χ² = 30.618, P < 0.001), suicide attempts (χ² = 24.072, P < 0.001), depressive symptoms (χ² = 59.561, P < 0.001), anxiety (χ² = 58.165, P < 0.001), impulsivity (χ² = 62.241, P < 0.001), and social problems (χ² = 64.952, P < 0.001). CONCLUSION: Notably, many students who committed suicide did not have any psychiatric pathology. The proportion of the group with a prosocial appearance was also high. Therefore, the actual suicide warning signals were similar regardless of students' difficulties and prosocial behaviors, so it is necessary to include this information in gatekeeper education.

Trends in health behaviors and mental health among Korean adolescents in Korea over 5 years, 2017-2021: focusing on the comparisons before and during the COVID-19 pandemic.

Objectives: We investigated recent trends in health behaviors and mental health conditions among Korean adolescents from 2017 to 2021 and compared the changes before and during the coronavirus disease 2019 (COVID-19) pandemic. Methods: Data analysis was conducted on 289,415 adolescents participating in the Korea Youth Risk Behavior Web-Based Survey, an annual cross-sectional study from 2017 to 2021. All analysis was conducted using sex stratification, and the annual percentage change (APC) was calculated. Results: Alcohol consumption and smoking decreased in the first year of the COVID-19 pandemic compared with before, except for girls from the low-income level. The prevalence of inadequate physical activity for both boys and girls increased in 2020 compared with the pre-COVID-19 period and decreased again by 2021. The prevalence of obesity in both sexes increased regardless of the period (boys, APC = 8.2%, 95% confidence intervals (CI), 6.4-10.1; girls, APC = 3.3%, 95% CI, 1.8-4.8). The prevalence of stress, depression, and suicidal ideation, plans, and attempts for both sexes decreased in 2020 compared to the pre-COVID-19 period. By 2021, this prevalence had returned to a level similar to before the pandemic. No significant APC changes were observed in the prevalence of mental health. Conclusions: These findings demonstrate the trends and APCs in health behaviors and mental health conditions among Korean adolescents over the last 5 years. We must pay attention to the heterogeneous and multifaceted features of the COVID-19 pandemic.

Pilot Study About the Effects of the Soma Experiencing Motion (Soma e-Motion) Program on Interoceptive Awareness and Self-Compassion.

OBJECTIVE: The purpose of this study was to examine the effects of the Soma experiencing motion (Soma e-motion) program on interoceptive awareness and self-compassion among novices. METHODS: A total of 19 adults (clinical group=9, non-clinical group=10) participated in the intervention. Psychological and physical changes after program were qualitatively analyzed using in-depth interviews. The Korean Multidimensional Assessment of Interoceptive Awareness (K-MAIA) and the Korean version of the Self-Compassion Scale (K-SCS) were used as quantitative measures. RESULTS: The non-clinical group showed statistically significant differences in the K-MAIA scores (z=-2.805, p<0.01) and K-SCS scores (z=-2.191, p<0.05); however, the clinical group showed no significant differences (K-MAIA: z=-0.652, p>0.05; K-SCS: z=-0.178, p>0.05). According to the in-depth interviews, the results of the qualitative analysis were categorized into five dimensions (psychological and emotional, physical, cognitive, behavioral, and aspects participants found challenging and needs improvement). CONCLUSION: The Soma e-motion program was feasible for improving interoceptive awareness and self-compassion in the non-clinical group. However, further research is needed to investigate the clinical efficacy of the Soma e-motion program for clinical group.

High-quality genome assembly and genetic mapping reveal a gene regulating flesh color in watermelon (Citrullus lanatus).

The unique color and type characteristics of watermelon fruits are regulated by many molecular mechanisms. However, it still needs to be combined with more abundant genetic data to fine-tune the positioning. We assembled genomes of two Korean inbred watermelon lines (cv. 242-1 and 159-1) with unique color and fruit-type characteristics and identified 23,921 and 24,451 protein-coding genes in the two genomes, respectively. To obtain more precise results for further study, we resequenced one individual of each parental line and an F2 population composed of 87 individuals. This identified 1,539 single-nucleotide polymorphisms (SNPs) and 80 InDel markers that provided a high-density genetic linkage map with a total length of 3,036.9 cM. Quantitative trait locus mapping identified 15 QTLs for watermelon fruit quality-related traits, including ß-carotene and lycopene content in fruit flesh, fruit shape index, skin thickness, flesh color, and rind color. By investigating the mapping intervals, we identified 33 candidate genes containing variants in the coding sequence. Among them, Cla97C01G008760 was annotated as a phytoene synthase with a single-nucleotide variant (A → G) in the first exon at 9,539,129 bp of chromosome 1 that resulted in the conversion of a lysine to glutamic acid, indicating that this gene might regulate flesh color changes at the protein level. These findings not only prove the importance of a phytoene synthase gene in pigmentation but also explain an important reason for the color change of watermelon flesh.

Heterozygous variants in SIX3 and POU1F1 cause pituitary hormone deficiency in mouse and man.

Congenital hypopituitarism is a genetically heterogeneous condition that is part of a spectrum disorder that can include holoprosencephaly. Heterozygous mutations in SIX3 cause variable holoprosencephaly in humans and mice. We identified two children with neonatal hypopituitarism and thin pituitary stalk who were doubly heterozygous for rare, likely deleterious variants in the transcription factors SIX3 and POU1F1. We used genetically engineered mice to understand the disease pathophysiology. Pou1f1 loss-of-function heterozygotes are unaffected; Six3 heterozygotes have pituitary gland dysmorphology and incompletely ossified palate; and the Six3+/-; Pou1f1+/dw double heterozygote mice have a pronounced phenotype, including pituitary growth through the palate. The interaction of Pou1f1 and Six3 in mice supports the possibility of digenic pituitary disease in children. Disruption of Six3 expression in the oral ectoderm completely ablated anterior pituitary development, and deletion of Six3 in the neural ectoderm blocked the development of the pituitary stalk and both anterior and posterior pituitary lobes. Six3 is required in both oral and neural ectodermal tissues for the activation of signaling pathways and transcription factors necessary for pituitary cell fate. These studies clarify the mechanism of SIX3 action in pituitary development and provide support for a digenic basis for hypopituitarism.

Associations between binge drinking experience, depressive mood, and suicidality in adolescents: Based on the 2021 Korea Youth Risk Behavior Web-based Survey.

BACKGROUND: This study aimed to investigate the associations between binge drinking experience (BDE), depressive mood, and suicidality among Korean adolescents. METHODS: We analyzed the 17th population-based and cross-sectional data from the Korean Youth Risk Behavior Web-based Survey. Multiple logistic regression analysis was performed to compare BDE, depressive mood, and suicidality by sex. RESULTS: In 54,848 adolescents, the prevalence of BDE was 5.3 % in boys and 4.4 % in girls. The prevalence of suicidal ideation, plans, and attempts among girls was 7.8 %, 2.4 %, and 1.4 %, respectively. The prevalence of suicide attempts among girls with both BDE and depressive moods was higher than that among boys. Boys with both BDE and depressive mood had 12.60 times and 14.50 times higher adjusted odds ratio (aOR) of suicide ideation and plan, respectively, compared with the non-drinking/non-depressed group. Girls with both BDE and depressive mood had 22.06 times higher aOR of suicide attempts than the non-drinking/non-depressed group. LIMITATIONS: The study has few limitations including the use of self-report questionnaires, participants' response bias, and lack of diagnosis by mental health professionals. CONCLUSIONS: These findings represent the prevalence of suicidality among South Korean adolescents with BDE or depressive mood. Since adolescents with both BDE and depressive mood showed particularly high suicidality, it is necessary to establish mental health services, such as proper prevention strategies and targeted interventions.

Vegf signaling between Müller glia and vascular endothelial cells is regulated by immune cells and stimulates retina regeneration.

In the zebrafish retina, Müller glia (MG) can regenerate retinal neurons lost to injury or disease. Even though zebrafish MG share structure and function with those of mammals, only in zebrafish do MG function as retinal stem cells. Previous studies suggest dying neurons, microglia/macrophage, and T cells contribute to MG's regenerative response [White et al., Proc. Natl. Acad. Sci. U.S.A. 114, E3719 (2017); Hui et al., Dev. Cell 43, 659 (2017)]. Although MG end-feet abut vascular endothelial (VE) cells to form the blood-retina barrier, a role for VE cells in retina regeneration has not been explored. Here, we report that MG-derived Vegfaa and Pgfa engage Flt1 and Kdrl receptors on VE cells to regulate MG gene expression, Notch signaling, proliferation, and neuronal regeneration. Remarkably, vegfaa and pgfa expression is regulated by microglia/macrophages, while Notch signaling in MG is regulated by a Vegf-dll4 signaling system in VE cells. Thus, our studies link microglia/macrophage, MG, and VE cells in a multicomponent signaling pathway that controls MG reprogramming and proliferation.

A zebrafish model of congenital nephrotic syndrome of the Finnish type.

Nephrotic syndrome (NS) is a disease characterized by proteinuria and subsequent hypoalbuminemia, hyperlipidemia and edema due to the defective renal glomerular filtration barrier (GFB). Mutations of NPHS1, encoding NEPHRIN, a podocyte protein essential for normal GFB, cause congenital nephrotic syndrome (CNS) of the Finnish type (CNF), which accounts for about 50% of CNS cases. We generated zebrafish nphs1 mutants by using CRISPR/Cas9. These mutants completely lack nephrin proteins in podocytes and develop progressive peri-orbital and whole-body edema after 5 days post fertilization. Ultra-structurally, loss of nephrin results in absence of slit-diaphragms and progressive foot process effacement in zebrafish pronephric glomeruli, similar to the pathological changes in human CNF patients. Interestingly, some nphs1 mutants are viable to adulthood despite ultra-structural defects in renal glomeruli. Using a reporter line Tg (l-fabp:VDBP-GFP) expressing GFP-tagged vitamin-D-binding protein in the blood plasma, we observed a reduction of intravascular GFP fluorescence in the nphs1 mutants, a hypoalbuminemia-like phenotype. In addition, we detected excretion of GFP by the nphs1 mutants, reminiscent of proteinuria. Therefore, we have demonstrated that the nphs1 mutant zebrafish recapitulate the human NS phenotypes and provide a novel and relevant animal model useful for screening therapeutical agents for this disease.

Mental health literacy of Internet gaming disorder and problematic smartphone use among Korean teenagers.

The last few decades have seen an increased interest in 'Mental Health Literacy (MHL)' which addresses knowledge and beliefs relating to mental health problems and is likely to hinder treatment-seeking behaviors. Although MHL research to date has explored various mental disorders, far too little attention has been paid to Internet Gaming Disorder (IGD) and Problematic Smartphone use (PSU). The objective of this study is to develop an MHL questionnaire for IGD and PSU by adopting the MHL approach in the previous literature and examine MHL of IGD and PSU in Korean teenagers by focusing on their ability to recognize addictions, and perceptions and help-seeking attitudes towards a person with addictions. The current study also aimed to compare Korean teenagers' MHL depending on low- and high-risk of IGD and PSU. A total of 169 teenagers aged 10 and 16 years were recruited from schools and children's centers in Seoul and completed the newly developed MHL questionnaire and screening questionnaires for IGD and PSU. The MHL questionnaire for IGD and PSU was designed as a vignette-based questionnaire that depicted behavioral characteristics of a severe problem with Internet and smartphone usage. Korean teenagers had a poor ability to recognize IGD and PSU and were more prone to seek parental help than professional help. The current study also showed that teenagers had better recognition of IGD than PSU and perceived that a person with IGD has a more difficult life than a person with PSU. Furthermore, a low-risk or high-risk group of IGD or PSU showed minimal differences in MHL. The current study provided empirical evidence to support a need to develop educational programs to improve Korean teenagers' MHL for both IGD and PSU.