SPATA20 deficiency enhances the metastatic and angiogenic potential of cancer cells by promoting HIF-1α synthesis.

Hypoxia-inducible factors (HIFs) regulate cellular oxygen balance and play a central role in cancer metastasis and angiogenesis. Despite extensive research on HIFs, successful therapeutic strategies remain limited due to the intricate nature of their regulation. In this study, we identified SPATA20, a relatively understudied protein with a thioredoxin-like domain, as an upstream regulator of HIF-1α. Depleting SPATA20 induced HIF-1α expression, suggesting a tumor-suppressive role for SPATA20 in cancer cells. SPATA20 depletion increased HIF-1α protein levels and transcriptional activity without affecting its degradation. It appears that SPATA20 inhibits the de novo synthesis of HIF-1α, possibly by repressing the cap-dependent translation process involving AKT phosphorylation. Additionally, depletion of SPATA20 promoted cancer cell migration and invasion, which can be reversed by pharmacological inhibition of HIF-1α. Clinical data analysis revealed an inverse correlation between SPATA20 expression and colorectal cancer progression, providing evidence of its role as a potential biomarker. Utilizing SPATA20 as an indicator for HIF-1α-targeting therapy may be an attractive strategy for treating patients with hypoxia-driven cancers. In conclusion, this study demonstrates that SPATA20 deficiency promotes cancer progression by activating the HIF-1α signaling pathway.

An Investigation of the Effect of Virtual Reality on Alleviating Anxiety in Patients With Breast Cancer Undergoing Radiation Therapy: A Randomized Controlled Trial.

PURPOSE: The aim of this study was to evaluate the anxiety-reducing effects of virtual reality (VR) on patients with breast cancer undergoing adjuvant radiation therapy (RT). METHODS AND MATERIALS: This randomized controlled trial was conducted among patients with breast cancer receiving RT at a single institution. Of 196 enrolled and randomized patients, 97 were assigned to a VR explanation group (intervention) and 99 were assigned to the standard-of-care group (control). Anxiety levels were measured using the Amsterdam Preoperative Anxiety and Information Scale (APAIS) as the primary endpoint and the State-Trait Anxiety Inventory (STAI) and Linear Analogue Scale Assessment (LASA) as secondary endpoints. Knowledge of the RT procedure, patient satisfaction, and time spent for counseling were also assessed. RESULTS: Intervention significantly reduced patient anxiety immediately, not only on the primary endpoint, APAIS, but also on the STAI and LASA anxiety scales. Specifically, in the intervention group, there were immediate reductions of 26.0%, 16.1%, and 55.8% for APAIS, STAI, and LASA, respectively, whereas in the control group, the respective reductions were 8.1%, 8.5%, and 13.7%. Among the 3 anxiety scales, long-term anxiety reduction was observed only when anxiety was measured by LASA. Subgroup analyses showed that the effect on anxiety did not differ based on the physician, baseline anxiety level, use of hormone therapy, or health literacy. The intervention also significantly improved knowledge of the RT procedure (81.9/100 vs 76.8/100; P = .006) and patient satisfaction with the explanation manner (6.56 vs 5.72; P < .001) compared with the control group. CONCLUSIONS: Immersive VR applied to the current procedure reduces anxiety during RT planning for patients with breast cancer. Further research is necessary to investigate the long-term effects of VR on anxiety.

Does Forest Therapy Have Physio-Psychological Benefits? A Systematic Review and Meta-Analysis of Randomized Controlled Trials.

Forest therapy involves visiting forests or conducting forest-based treatment activities to improve one's health. Studies have investigated the health benefits of forests, but consensus has not been reached. This study comprised a systematic review and meta-analysis to determine how forest therapy affects the physiological and psychological health of adults. The Cumulative Index to Nursing and Allied Health Literature, Embase, and Medline databases were searched on 31 August 2021. Systematic review and meta-analysis, risk evaluation, GRADE evaluation, and advertisement effect evaluation were performed for each article. The effect size was calculated by dividing blood pressure as a physiological indicator and depression as a psychological indicator. Of the 16,980 retrieved studies, 17 were selected based on the inclusion criteria. Of these, eight studies were included in the meta-analysis. The effect size of forest therapy on improving systolic and diastolic blood pressure was not significant; however, it significantly reduced depression. While the results have limited generalizability due to the inclusion of few studies, the effects of forest therapy on reducing depression have been confirmed. Since the application of forest therapy was heterogeneous in these studies, a moderator effect analysis or subgroup analysis in meta-analysis should be performed in the future.

Efficiency in reducing air pollutants and healthcare expenditure in the Seoul Metropolitan City of South Korea.

This study analyzes efficiency in the reduction of air pollutants and the associated healthcare costs using a stochastic frontier cost function panel data approach. For the empirical analysis, we use monthly data covering 25 districts in the Seoul metropolitan city of South Korea observed over the period January 2010 to December 2017. Our results show large variations in air pollution and healthcare costs across districts and over time and their efficiency in reducing air pollutants. The study concludes that efforts are needed to apply the World Health Organization's air quality standards for designing and implementing location-specific customized policies for improving the level of air quality and its equal distribution, provision of health services, and improved efficiency in improving air quality standards. The study identifies a number of determinants of air pollutants and efficiency enhancement which provide useful pointers for policymakers for addressing the current environmental problems in South Korea.

Clinicopathological features of 70 desmoid-type fibromatoses confirmed by ß-catenin immunohistochemical staining and CTNNB1 mutation analysis.

Desmoid-type fibromatosis (DF) is a locally aggressive neoplasm characterized by mutations in the CTNNB1 gene, which encodes the ß-catenin protein. We reviewed 85 cases of DF and performed Sanger sequencing for detecting mutations in CTNNB1 and immunostaining for detecting ß-catenin localization. We included 70 DF samples, of which 56 cases demonstrated nuclear ß-catenin localization and 43 cases harboured CTNNB1 mutations. CTNNB1-mutant DF samples consistently displayed nuclear ß-catenin expression and were derived from larger-sized tumours compared to samples with wild-type CTNNB1. When we further classified DF cases into 2 subgroups based on the type of specimen, excised specimens with nuclear ß-catenin expression frequently displayed CTNNB1 mutation and no statistical correlation between nuclear ß-catenin expression and CTNNB1 mutation was observed in biopsies. When we classified CTNNB1 mutation cases into 2 subgroups (DF with T41A or T41I, and DF with S45F or S45P), T41A or T41I mutations were observed more frequently in males than in females. Additionally, DF tumours harbouring S45F or S45P mutations were located more frequently in the abdominal wall than tumours with T41A or T41I mutations. In conclusion, CTNNB1 mutation correlates with nuclear ß-catenin expression in larger or excised DF tumours, and DF harbouring CTNNB1 mutations manifest variable clinical presentations.

HNF-1ß as an immunohistochemical marker for distinguishing chromophobe renal cell carcinoma and hybrid oncocytic tumors from renal oncocytoma.

The histologic features of renal oncocytoma (RO) are similar to those for the more aggressive chromophobe renal cell carcinoma (ChRCC). To assess immunohistochemical markers of the two, the sensitivity and specificity of cytokeratin 7 (CK7) and C-kit, as well as hepatocyte nuclear factor-1ß (HNF-1ß), were analyzed. Typical cases of ChRCC and RO at Severance Hospital between July 2014 and July 2018 were selected retrospectively. Among 44 cases, 17 were unanimously compatible with ChRCC, 16 were RO, and 11 cases were indeterminate. Samples from all selected cases were used for immunostaining with antibodies against CK7, C-kit, HNF-1ß, and CD10. Immunostaining demonstrated complete loss of HNF-1ß expression in 11 out of 17 (64.7%) ChRCC cases and a partial, but significant loss in > 50% of tumor cells in the remaining 6 cases (35.3%). In contrast, HNF-1ß expression was preserved in tumor cells of RO cases. Fourteen of 17 ChRCC cases (82.4%) were diffusely positive for CK7, whereas cases of RO were focal positive or negative. C-kit staining did not show a significant difference between ChRCC and RO. Two of five ChRCC cases showing diffuse immunoreactivity for CD10 had poor prognoses of local invasion, distant metastasis, or death. Loss of HNF-1ß expression is a useful marker with which to diagnose ChRCC, especially in cases with confusing histologic findings or equivocal CK7 staining. Additionally, CD10 staining in high-grade ChRCC aids in diagnosis and prediction of the clinical prognosis.

Sex Differences in Risk Factors for Metabolic Syndrome in the Korean Population.

With an increase in the obese population, the prevalence of metabolic syndrome is increasing in Korea. This study aimed to identify sex- and age-specific risk factors for metabolic syndrome. A secondary data analysis was performed using the Korean National Health and Nutritional Examination Survey. Participants comprised 6144 adults aged 20-79 years. The prevalence of metabolic syndrome was high in the middle- and old-aged men (31.9% and 34.5%, respectively) and in old-aged women (39.1%). Risk factors for metabolic syndrome showed different patterns for men and women. In men, alcohol drinking was identified as the main risk factor for hypertension (odds ratio (OR); young = 3.3 vs. middle age = 2.0), high triglycerides (young = 2.4 vs. middle age = 2.2), and high fasting blood sugar (middle age = 1.6). In women, the main risk factors were household income and education level, showing different patterns in different age groups. In conclusion, the vulnerable groups at high risk of metabolic syndrome are those of middle-aged men and women. The pattern of risk factors is sex-specific.

Human herpesvirus 8-negative effusion-based lymphoma with indolent clinical behavior in an elderly patient: A case report and literature review.

Primary effusion lymphoma (PEL) is a B-cell non-Hodgkin's lymphoma that is usually characterized by lymphomatous effusions in the body cavity without any detectable tumor masses. According to the World Health Organization (WHO) schema for tumor classification, PEL is defined by the presence of human herpesvirus 8 (HHV8) in malignant lymphoid cells. However, a subset of effusion-based B-cell lymphoma is not HHV8-positive and exhibits different clinicopathological characteristics. The 2017 WHO Classification of Tumors of Hematopoietic and Lymphoid Tissues does not list HHV8-negative effusion-based lymphoma, which remains an underappreciated B-cell lymphoma, as an individual entity. The present study reports a case of this rare type of lymphoma with indolent clinical behavior in a 75-year-old male patient receiving only symptomatic treatment. Additionally, a review of similar cases reported in the English literature is presented.

The relationship between air pollutants and healthcare expenditure: empirical evidence from South Korea.

This study analyzes the relationship between air pollutants (represented as the air quality index or AQI) and healthcare expenditure. It uses balanced monthly panel data that provides information about the healthcare expenditure, concentration of air pollutants, and regional characteristics. It considers all the variables for 16 cities and provinces in Korea for the period January 2010 to September 2017. It uses the panel data methodology to estimate the effects of air pollutants on healthcare expenditure conditional on controlling for different determinants of healthcare expenditure. The important determinants of variations in healthcare expenditure that this study identifies include the following: five air pollutants' quality indices, personal income, population share of the elderly and the young, per capita registered and operated cars, the number of industries, and atmospheric factors. Results indicate that air pollutants, NO2, O3, and PM10 exert a positive effect on healthcare expenditure. The study also sheds light on the socially optimal allocation of future healthcare resources in South Korea and shows that South Korea could reduce its healthcare expenditure by following the World Health Organization's air quality standards. The findings have three implications: developing health-conscious air quality standards; design and implementation of location-specific customized policies; health benefits of improved air quality standards. This research also provides useful evidence for policymakers to address current environmental problems.

The Thermal Effects of Water Immersion on Health Outcomes: An Integrative Review.

Hydrotherapy is widely used for the treatment and rehabilitation of patients, but it can also be applied to prevent diseases in healthy people. This review investigates the health effects of water immersion, a form of hydrotherapy, and the mechanisms by which the properties of water elicit such an effect. We searched PubMed, EMBASE, Cochrane Library, and CINAHL to identify relevant articles, of which 13 met the inclusion criteria. Various factors of water immersion were investigated in the 13 selected articles, including water temperature, immersion height, and application area. With respect to health effects, warm and cold water immersion affects the cardiovascular and neuromuscular systems, respectively. Nine articles focused on the effects of warm water immersion, explaining its thermal effect in relation to changes in disease-related serum substance levels and hemodynamic changes. While the sample population in most studies comprised young adults, two articles applied partial water immersion to the legs of elderly subjects to assess its effect on sleep. Because the water immersion protocols applied in the 13 articles were inconsistent, the health benefits could not be clearly explained. However, we expect the present findings to be beneficial for providing research guidelines for studies on the application of water immersion.

Realist Review: Understanding Effectiveness of Intervention Programs for Dementia Caregivers.

PURPOSE: Caring for patients with dementia is a challenging issue entailing heavy responsibility. Many interventions for caregivers have been developed, but their effectiveness is not clear. This study aimed to examine how, why, and under what circumstances interventions for dementia caregivers affected their burden of caring. METHODS: Authors used a realist review approach to explore the evidence for how different interventions reduce the burden of dementia caregivers. We completed the literature review about the burden of dementia caregivers and extracted the theoretical concepts to explain context-mechanism-outcome configuration why an intervention may be effective in some situations and not others. Six databases were searched for experimental or quasi-experimental studies conducted from 2008 to 2017. Of 1,225 screened studies, 10 studies were eligible for inclusion. RESULTS: None of the studies included all the derived contexts while explaining in detail the mechanism of the intervention effectiveness. Among contexts, the variable of other family members requiring care was not included in all studies. Among the analyzed studies, no studies have applied repeated intervention. Most studies included only some variables of context and mechanism, and these variables did not directly explain the effectiveness of intervention. The effect of outcome variables was significant for each study, and the effects of research intervention and national services could not be separately described. CONCLUSION: Authors conclude that Korean culture's emphasis on relationships with others increases the burden of care. In context, Confucian norms and traditional femininity of Korea were reflected in the core. It is necessary to check the homogeneity of participants and the design of intervention to verify the effectiveness of the outcome variable of psychological burden.

[The reliability and validity of a Drinking Refusal Self-Efficacy Questionnaire-Revised (DRSEQ-R) in Korean college students].

PURPOSE: This study was to test the reliability and validity of a Drinking Refusal Self-Efficacy Questionnaire-Revised (DRSEQ-R) in Korean college students. METHODS: The DRSEQ-R was designed to assess an individual's belief in their ability to refuse drinking alcohol by Oei et al. (2005) and consisted of three factors (social pressure, opportunity, and emotional relief). A methodological study design with an exploratory factor analysis for validity and correlation coefficients for reliability was used. DRSEQ-R was translated into Korean and a translation equivalency was obtained. DRSEQ-R was tested with a sample of 201 college students in Korea. The subjects consisted of 106 males and 95 females. Principal component factor analysis was used for construct validity and Cronbach's alpha was used to evaluate for internal consistency of the instrument. RESULTS: The factor analysis showed three factors explaining 66.3% of total variance and the corresponding factors were emotional relief (48.01%), drinking contextual opportunity (11.18%), and social pressure (7.14%). The internal consistency was acceptable (Cronbach's alpha=.937). All three factors of DRSEQ-R negatively correlated with alcohol dependency and a heavy drinker showed a lower DRSEQ-R than a moderate drinker. CONCLUSION: Based on the findings, DRSEQ-R is a reliable and valid instrument to measure for drinking refusal self-efficacy in Korean college students.

[Alcohol experience, alcohol knowledge, and alcohol expectancy in early adolescents].

PURPOSE: This study was to explore the prevalence of alcohol experiences and to identify the expectancy on the effects of alcohol and alcohol knowledge in early adolescents. METHOD: The cross-sectional survey of 1854 students from seven middle schools in one district of Seoul was conducted by convenience sampling. Alcohol experience and early onset of alcohol use were measured by the Youth Risk Behavior Survey. Alcohol expectancy was measured by an Alcohol Effects Questionnaire. RESULT: Over sixty five percent of adolescents reported that they had previous drinking experiences. The participants with no alcohol drinking experience had a lower level of alcohol knowledge than those with experience(t=2.73, p=.007). In expectancy on effects of alcohol, girls had a more positive alcohol expectation than boys(t=-2.54, p=.011). Alcohol knowledge negatively correlated with alcohol expectancy(r=-.40 p=.000). In regression of alcohol expectancy, gender and alcohol knowledge were significant predictors explaining 17%. CONCLUSION: The results support that alcohol expectancy is an important link with early drinking experiences and alcohol knowledge, focusing on the importance of gender differences. Therefore, an alcohol prevention program in early adolescence is needed and should be focused on multidimensionality of the alcohol expectancy with developmental and psychosocial factors for early adolescents.

[The effects of a physical activity-behavior modification combined intervention(PABM-intervention) on metabolic risk factors in overweight and obese elementary school children].

PURPOSE: The purpose of this study was to identify the effects of a physical activity-behavior modification combined intervention(PABM-intervention) on metabolic risk factors in overweight and obese elementary school children. METHODS: Thirty-two participants (BMI>or=85 percentile or relative obesity>or=10) were allocated to the PABM-intervention group and behavior modification only intervention group. The PABM-intervention was composed of exercise intervention consisting of 50 minutes of physical activity(Hip-hop dance & gym-based exercises) twice a week and the behavior modification intervention consisted of 50 minutes of instruction for modifying lifestyle habits(diet & exercise) once a week. Effectiveness of intervention was based on waist circumference, BP, HDL-cholesterol, TG, and fasting glucose before and after the intervention. RESULTS: The proportion of subjects with 1, 2, 3 or more metabolic risk factors were 28.1, 43.8, and 15.6%, respectively. After the 8-week intervention, waist circumference, systolic BP, diastolic BP, and HDL-cholesterol changed significantly(p<.01) in the PABM group. CONCLUSION: This provides evidence that a PABM-intervention is effective in changing metabolic risk factors such as waist circumference, systolic BP, diastolic BP, and HDL-cholesterol in overweight and obese elementary school children.

[Family resiliency factors for the adaptation of family who have a congenital heart disease].

PURPOSE: The purpose of this study was to explore the relationships of family strain, perceived social support, family hardiness, and family adaptation and identify the family resiliency factors for the adaptation of families who have a child with congenital heart disease. METHOD: The sample consisted of 90 families who had a child diagnosed with congenital heart disease and completed surgical treatment. Data was collected from parents using a questionnaire. RESULTS: Results from path analyses revealed that family strain had a direct effect on both perceived social support and family hardiness, and an indirect effect on family adaptation. Also, the findings revealed that perceived social support had a direct effect on both family hardiness and family adaptation, and family hardiness had a direct effect on family adaptation. Thus, these results indicated that perceived social support and family hardiness had a mediating effect on family strain. CONCLUSION: Findings provide the evidence for the theoretical and empirical significance of perceived social support and family hardiness as family resiliency factors for family adaptation. Clinical implications of these findings might be discussed in terms of family-centered nursing interventions for the families who have a child with congenital heart disease based on an understanding of family resiliency for adaptation.

[Depressive symptoms and related risk factors in old and oldest-old elderly people with arthritis].

PURPOSE: This study was to investigate the prevalence of depressive symptoms and risk factors in elderly people (old vs oldest-old) with arthritis. METHODS: The Korean Longitudinal Study of Aging (KLoSA) was used with a sample of 1,084 elderly people with arthritis aged 65 or above. RESULTS: We found that the prevalence of depressive symptom was greater for oldest-old people (66.7%) compared to old people (56%). Significant differences between old people and oldest-old people were found for education, living with spouse, number of generation, regular exercise, body mass index (BMI), ADL limitation, self-rated health, and depression. Significant differences existed between depression and non-depression in terms of all variables except region and BMI among old people. But, among the oldest people, ADL limitation and self-rated health showed differences. The Logistic regression analysis revealed that religion, medical comorbidity, ADL limitation, self-rated health were significantly associated with depressive symptoms in old people. But, in oldest-old people, none of the variables were associated with depressive symptoms. CONCLUSION: The findings show that there are age differences in depression and related factors in elderly people with arthritis. Longitudinal studies, which covered depressive symptom severity and which are controlled for a large number of potential confounders, will need to complement the results of this study in the future.

[Prevalence of cardiovascular risk factors in school-aged children].

OBJECTIVES: This study was conducted to assess the distribution of cardiovascular risk factors (serum lipid profiles, BMI, blood pressure, fasting blood sugar) and evaluate the risk profile of CVD by the clustering of the cardiovascular risk factors in school-aged children in the Kyoung-Gi area. METHODS: The study sample consists of 208 11 year-old children (51.4% boys, 48.6% girls) who participated in a cross-sectional screening of cardiovascular risk factors. We surveyed their socio-demographic characteristics, measured the anthropometric variables and analyzed the biochemical markers. RESULTS: Of the cardiovascular risk factors, the percentage risk of the BMI, dyslipidememia and hypertension were highest. The prevalence rates of total cholesterol and LDL-cholesterol in girls was higher than in boys. Also, the associations of the BMI, total cholesterol, LDL-cholesterol, HDL-cholesterol, triglycerides, systolic and diastolic blood pressures were highly significant. In addition, the proportion of subjects with 1, 2, 3 and 4 or more risk factors were 29.3, 12.5, 2.9 and 1.9%, respectively; therefore, a total of 97 subjects (46.6%) had at least one more risk factor. CONCLUSIONS: From these findings, we concluded that the rates of hypercholesterolemia, cardiovascular risk groups and obesity prevalence of these groups were relatively high. These data provide further evidence that the early intervention for cardiovascular health prevention and promotion in school-aged children is necessary at the population level.