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Research on dispositional authenticity has accelerated in recent years. Using the Authenticity Scale and drawing upon Self-Determination Theory, we conducted a Latent Profile Analysis to determine whether two or more distinct classes of authentic self-development were identifiable across separate samples (Ns = 344 and 378) of emerging adults (18–22 year olds). We also tested whether multidimensional perfectionism and attachment insecurity were correlated with the classes of authentic self-development, and examined the association between class membership and levels of psychological need satisfaction and frustration. Our findings supported the presence of a 3-class configuration which we respectively labelled “Consolidated Authenticity,” “Unintegrated Authenticity,” and “Pre-Emergent Authenticity.” This class structure was replicated in a separate, independent sample. Results highlighted relevant variation in authentic self-development across the identified classes and yielded support for our model involving hypothesized influences on, as well as contemporary outcomes associated with, participants’ class membership.

Older adults are reported to die by suicide at higher rates than the general population. Suicide desire among older adults is associated with pain, and pain experiences have been found to differ based on race. To investigate the relationship between pain and suicidal desire, 437 racially diverse older adults who receive home-based services (home-delivered meals) in the Southeastern region of the United States completed standardized measures of psychological pain, chronic physical pain, and suicidal desire. Results identified race moderated the relationship between pain and suicidal desire, indicating a stronger relationship between pain and suicidal desire among Black older adults than White older adults. Chronic physical pain (i.e., emotional burden) interacted with race to predict Perceived Burdensomeness ( p = .011) and Thwarted Belongingness ( p = .032). Greater attention to pain experiences among Black older adults is warranted, considering the impact of COVID-19 on racial/ethnic minorities’ mental health.

Dramatic cellular reorganization in mitosis critically depends on the timely and temporal phosphorylation of a broad range of proteins, which is mediated by the activation of the mitotic kinases and repression of counteracting phosphatases. The mitosis-to-interphase transition, which is termed mitotic exit, involves the removal of mitotic phosphorylation by protein phosphatases. Although protein phosphatase 1 (PP1) and protein phosphatase 2A (PP2A) drive this reversal in animal cells, the phosphatase network associated with ordered bulk dephosphorylation in mitotic exit is not fully understood. Here, we describe a new mitotic phosphatase relay in which Wip1/PPM1D phosphatase activity is essential for chromosomal passenger complex (CPC) translocation to the anaphase central spindle after release from the chromosome via PP1-mediated dephosphorylation of histone H3T3. Depletion of endogenous Wip1 and overexpression of the phosphatase-dead mutant disturbed CPC translocation to the central spindle, leading to failure of cytokinesis. While Wip1 was degraded in early mitosis, its levels recovered in anaphase and the protein functioned as a Cdk1-counteracting phosphatase at the anaphase central spindle and midbody. Mechanistically, Wip1 dephosphorylated Thr-59 in inner centromere protein (INCENP), which, subsequently bound to MKLP2 and recruited other components to the central spindle. Furthermore, Wip1 overexpression is associated with the overall survival rate of patients with breast cancer, suggesting that Wip1 not only functions as a weak oncogene in the DNA damage network but also as a tumor suppressor in mitotic exit. Altogether, our findings reveal that sequential dephosphorylation of mitotic phosphatases provides spatiotemporal regulation of mitotic exit to prevent tumor initiation and progression.

Background: During lumbar epidural injection (LEI) using a midline approach, we might encounter failure of identifying the epidural space owing to an equivocal or absent loss of resistance (LOR) sensation. The reason for such absence of LOR sensation has been suggested as paucity of midline ligamentum flavum, paravertebral muscle, and cyst in the interspinous ligament of the lumbar spine. Despite its low specificity, LOR is the most commonly used method to identify the epidural space. Objectives: The purpose of this study was to analyze lumbar epidural pressure decrease patterns and identify factors contributing to this pressure decrease. Study Design: Prospective randomized trial. Setting: An interventional pain management practice in South Korea. Methods: This prospective study included 104 patients receiving LEI due to lumbar radiculopathy. A midline or paramedian approach of LEI was determined with randomization. Among various factors, gender, age, body mass index (BMI), and diagnosis were analyzed using a subgroup that included 60 cases of only a paramedian approach. Results: Grades I, II (abrupt decrease), and III (gradual decrease) were found as patterns of epidural pressure decrease. Abrupt pressure decrease was more frequently observed in the paramedian group (P < 0.001). Age, gender, BMI, and diagnosis did not show any significant difference in frequencies between abrupt and gradual pressure decrease. Limitations: We could not match LOR sensation with epidural pressure decrease shown in the monitor. Conclusions: This study demonstrates that abrupt pressure decrease occurs more frequently with the paramedian approach. However, age, gender, BMI, or diagnosis did not affect the incidence of epidural pressure decrease. Key words: Epidural, paramedian, midline, pressure decrease

Saline or local anesthetic injection into the epidural space increases intracranial pressure (ICP), at least transiently. Measurement of the optic nerve sheath diameter (ONSD) using ocular ultrasonography is one of the noninvasive methods for ICP assessment.The purpose of this study is to investigate the effects of the different volume on the ONSD and cerebral oxygen saturation (rSO2) during thoracic epidural saline injection under awake conditions.Prospective randomized, controlled trial.An interventional pain management practice in South Korea.This study included 71 patients receiving thoracic epidural catheterization for pain management, following upper abdominal or thoracic surgery. Following successful epidural space confirmation, patients were randomly allocated to receive 5 mL (5 mL group), 10 mL (10 mL group), and 20 mL (20 mL group) of epidural normal saline. Transorbital sonography was performed to measure the ONSD. This was measured at 3 mm posterior to the optic nerve head. An rSO2 was measured using cerebral oximeter sensors.All 3 groups showed significant increases of ONSD from 10 minutes to 40 minutes as compared to baseline (before procedure). Among the 3 groups, the 20 mL group demonstrated the most significantly increased ONSD, as compared to the 5 mL and 10 mL groups. At the 20 minute and 40 minute time points, the ONSD showed a volume-dependent increase (P = 0.0005, P = 0.014). All 3 groups showed the rSO2 to be distributed between 60~70% without any statistical difference.We could not determine the returning point of the normalized ONSD value.Twenty milliliters of normal saline epidural injection resulted in a significant increase of ONSD, as compared to the 5 mL and 10 mL groups. Our results also indicate that an increase of ONSD occurs in accordance with the injected volume of normal saline.

Transforaminal epidural injection (TFEI) is a useful intervention for radicular leg pain. Compared to TFEI in lumbar level, S1 TFEI is reported to have higher incidence rates of intravascular injection as well as technical difficulties.The purpose of this study is to compare the incidence rates of intravascular injection and foramen passage time between anteroposterior (AP) and oblique (OB) approaches.Prospective randomized trial.An interventional pain management practice in South Korea.One hundred forty-seven patients receiving S1 TFEI for radicular leg pain were randomly assigned to one of 2 approach methods (AP view vs OB view). For S1 TFEI in the OB view group, lineup of the L5-S1 endplate was performed by adjusting the cephalad-caudad tilt. Then C-arm was rotated at an ipsilateral oblique angle, approximately 10° to 15°. After final confirmation of intravascular injection with real time fluoroscopy, the foramen passage time and amount of radiation exposure during S1 TFEI were measured.The incidence rate of intravascular injection in the AP view group was 24.2% (24/99), whereas that of intravascular injection in the OB view group was 10.1% (17/99, P = 0.008). The radiation dose required to pass the S1 foramen was significantly higher in the AP view group than in the OB view group (51.3 ± 27.2 cGy/cm2 vs 41.0 ± 17.0 cGy/cm2, P = 0.002). The foramen passage time during S1 TFEI was significantly higher in the AP view group than in the OB view group (103.5 ± 44.1 second vs 84.9 ± 21.0 second, P = 0.001). The failure rate of S1 TFEI was significantly higher in the AP view group than in the OB view group (13% vs 4%, P = 0.022).The physicians involved in the present study were not blinded to the type of approach method (AP view vs OB view) by fluoroscopy.Our study demonstrated reduced incidence rates of intravascular injection and reduced foramen passage time and radiation dosage with the use of OB view method during S1 TFEI.

We evaluated the Short Almost Perfect Scale (SAPS; Rice et al., 2014) in South Korean ( N = 306) and United States ( N = 259) samples. Results supported partial metric invariance for the standards (perfectionistic strivings) and discrepancy (perfectionistic concerns) factors, and for depression and self-esteem. Item responses were unaffected by gender- or age-related bias. Differential item functioning analyses and tests of scalar invariance revealed noninvariance for several items that might reflect culturally relevant issues. There were no differences in SAPS factor means based on invariance tests using the alignment method. For both samples, the standards factor was positively and comparably associated with self-esteem and inversely predicted depression; the discrepancy factor yielded effects in the opposite direction. Results generally supported the use of the SAPS for United States–Korean correlational comparisons. Future work could develop and evaluate additional indicators of perfectionistic concerns for cross-national studies, and increase representation in the samples and breadth of criterion factors.

With increasing mental health problems witnessed among students, adequately addressing their well-being is becoming important on college campuses. This study compares international and domestic graduate students in the USA on domains that are relevant to both student groups (perfectionistic personality, academic stress) and how these factors combinedly predict satisfaction with life. With 531 international and 359 domestic graduate students, results found support for perfectionism and academic stress predicting life satisfaction in both groups with notable similarities and differences. For perfectionists in both student groups, the level of academic stress was an important factor that determines satisfaction with life. Interestingly, for international students only, a perfectionism dimension that has been traditionally considered adaptive (“Standards”) functioned in a maladaptive way. Findings from this study suggest that international and domestic students share similarities and differences that should be noted.

With increasing mental health problems witnessed among students, adequately addressing their well-being is becoming important on college campuses. This study compares international and domestic graduate students in the USA on domains that are relevant to both student groups (perfectionistic personality, academic stress) and how these factors combinedly predict satisfaction with life. With 531 international and 359 domestic graduate students, results found support for perfectionism and academic stress predicting life satisfaction in both groups with notable similarities and differences. For perfectionists in both student groups, the level of academic stress was an important factor that determines satisfaction with life. Interestingly, for international students only, a perfectionism dimension that has been traditionally considered adaptive (“Standards”) functioned in a maladaptive way. Findings from this study suggest that international and domestic students share similarities and differences that should be noted.

Background Although the tumor-suppressive effects of ginsenosides in cell cycle have been well established, their pharmacological properties in mitosis have not been clarified yet. The chromosomal instability resulting from dysregulated mitotic processes is usually increased in cancer. In this study, we aimed to investigate the anticancer effects of ginsenoside Rg1 on mitotic progression in cancer. Materials and methods Cancer cells were treated with ginsenoside Rg1 and their morphology and intensity of different protein were analyzed using immunofluorescence microscopy. The level of proteins in chromosomes was compared through chromosomal fractionation and Western blot analyses. The location and intensity of proteins in the chromosome were confirmed through immunostaining of mitotic chromosome after spreading. The colony formation assays were conducted using various cancer cell lines. Results Ginsenoside Rg1 reduced cancer cell proliferation in some cancers through inducing mitotic arrest. Mechanistically, it inhibits the phosphorylation of histone H3 Thr3 (H3T3ph) mediated by Haspin kinase and concomitant recruitment of chromosomal passenger complex (CPC) to the centromere. Depletion of Aurora B at the centromere led to abnormal centromere integrity and spindle dynamics, thereby causing mitotic defects, such as increase in the width of the metaphase plate and spindle instability, resulting in delayed mitotic progression and cancer cell proliferation. Conclusion Ginsenoside Rg1 reduces the level of Aurora B at the centromere via perturbing Haspin kinase activity and concurrent H3T3ph. Therefore, ginsenoside Rg1 suppresses cancer cell proliferation through impeding mitotic processes, such as chromosome alignment and spindle dynamics, upon depletion of Aurora B from the centromere.

Background: Radiofrequency thermal rhizotomy demonstrates an excellent treatment outcome with a high success rate among patients of intractable trigeminal neuralgia. The triangular plexus which is an immediate retrogasserian portion of the trigeminal root is suggested as the best place of lesioning during radiofrequency thermal rhizotomy. However, the anatomy of the triangular plexus has been relatively unrecognized, while the anatomical study related to therapeutic procedure is scarce. Objective: The purpose of this study is to confirm with gross and microscopic finding of the trigeminal system whether, if an electrode tip is placed on the petroclival junction in lateral cranial view, it actually arrives at the triangular plexus or not. In relation to therapeutic procedure, we examined the triangular plexus with morphological and histological methods. Study Design: Human cadaveric study. Setting: An anatomical laboratory in South Korea. Methods: Percutaneous procedure of radiofrequency thermal rhizotomy under C-arm guidance was performed in 8 cadavers. Final target of the electrode tip was the petroclival junction under true lateral cranial view. The location of the electrode tip was determined under observation of the presence of an injected dye. Triangular plexus size was measured grossly and microscopically. Gross and microscopic evaluation of the triangular plexus was performed. Results: Among 15 trigeminal systems, 8 showed dye appearance in the triangular plexus, while 6 showed it in the trigeminal ganglion. Overall, 53% of radiofrequency thermal rhizotomy could reach the triangular plexus when an electrode tip was placed on the petroclival junction. The grossly measured average triangular plexus vertical and transverse diameters were 0.8 cm and 1.3 cm, respectively. Limitation: Only radiologic landmark was used to confirm the location of the electrode tip. However, further study confirming the location of the electrode tip under the guidance of electrical stimulation is needed. Conclusion: When an electrode tip was placed on the petroclival junction, 53% of radiofrequency thermal rhizotomy could reach the triangular plexus. Key words: Petroclival junction, trigeminal neuralgia, triangular plexus, radiofrequency thermal rhizotomy

Background The digital health care field is expanding from the daily monitoring of chronic diseases to the detection of acute diseases, such as arrhythmia. Wolff-Parkinson-White (WPW) syndrome, a congenital cardiac disorder due to accessory pathways, causes tachycardia, syncope, and even sudden death. Case presentation We presented a 26-year-old female office worker with WPW syndrome managing the disease with a wearable device and discussed its significance in occupational medicine. After reviewing the worker's electrocardiogram results, symptoms, and pulse rate records extracted from the wearable device, we referred the worker to a cardiologist for further evaluations such as electrophysiology study. The worker monitors her symptom recurrence with the wearable device following successful radiofrequency catheter ablation of the bypass tract. Conclusions A case of an office worker with WPW syndrome managing the disease using a smart watch is presented. Further research is required to ensure its scientific validity, and we suggest policymakers promptly introduce digital health care to occupational environments.

Thoracolumbar or caudal epidural anesthesia affects intracranial pressure (ICP) in both animals and humans. Epidural injection increases ICP at least transiently. Measurement of the optic nerve sheath diameter (ONSD) using ultrasonography is one of the noninvasive methods for ICP assessment.The purpose of this study was to investigate the effect of the different posture during epidural saline injection to the ONSD under awake conditions.Prospective, randomized trial.An interventional pain management practice in South Korea.This study included 44 patients receiving thoracic epidural catheterization for pain management after upper abdominal or thoracic surgery. Following successful epidural space confirmation, patients were randomized to receive epidural saline while supine (A group) or in sitting position (B group), respectively. Transorbital sonography was performed for the measurement of the ONSD, and the ONSD was measured at 3 mm posterior to the optic nerve head.Both A and B groups showed significant increases of ONSD according to time. Mean ONSD values measured at T10, T20, and T40 significantly increased from the baseline value (T0) (*P0.05 vs. T0, †P0.001 vs. T0, ‡P0.005 vs. T0). The mean ONSD values measured at any of the time points and degrees of changes (T10-T0, T20-T0, and T40-T0) between groups A and B did not show any significant changes.Epidural pressure and ONSD measurement can make this study more reliable. Further study showing changes of epidural pressure with ONSD measurement is required.Thoracic epidural injection of 10 mL of normal saline resulted in a significant increase of ONSD compared with the baseline. However, the different posture did not affect the increase of ONSD.

The world is facing the largest number of displaced persons in history, with many refugee persons seeking safety in the United States. Among many challenges, refugee persons may face difficulty when navigating the world of work in the United States. We conceptualize career-related barriers for refugee persons residing in the United States, including economic constraints, acculturation challenges, and health disparities. Given these challenges, we describe the relevance of psychology of working theory as a potential theoretical model from which to conceptualize career concerns in refugee persons. Finally, based on previous research, we provide implications for counselors working with refugee persons with vocational concerns, as well as suggested areas for future research.

Late-life suicide is a complex public health issue, and older adults have a higher risk threshold than the national average (Drapeau & McIntosh, 2020). Most late-life suicide research focuses on elevated risk of older white males, and less is known about risk factors among Black older adults (Joe et al., 2014). Although fewer Black older adults die by suicide than White older adults, forms of suicidality do not differ between Black and White older adults (Cohen et al., 2008). Suicide risk factors, such as psychological distress (Watkins & Johnson, 2018) and chronic pain (Bazargan et al., 2016), are prevalent among Black older adults. According to the Interpersonal Theory of Suicide (IPTS; Van Orden et al., 2016), thwarted belongingness and perceived burdensomeness inform the development of suicidal desire. These findings have been corroborated among older adult samples, though lacking racial diversity. To better understand how the IPTS functions for older adults, and probe whether suicide risk pathways operate differently depending on race, we used data from over 400 homebound older adults residing in a U.S. metropolitan area to clarify if this suicide risk pathway is similar for Black and White older adults. Race moderated the relationship between physical and psychological pain and thwarted belongingness and perceived burdensomeness, with pain among Black older adults having a greater impact on their sense of belonging and burdensomeness. Findings illuminate the need for culturally nuanced understandings of suicidality in older adulthood. The presenters will demonstrate these results and discuss implications for cross-cultural suicide prevention frameworks.

The period around 1900 marks the threshold from “not knowing” to “knowing” about Korea. During this time the first German-language travelogue appeared. The study is based on four selected travelogues written between 1880 and 1915 and analyzes the representational strategies of the text and pictures on their “knowledge of Korea”. The material has hardly been explored to date. It is examined against the background of the complex relationship between travel literature and the generation and transfer of knowledge about the “other culture”, as well as the cultural practices and power structures associated with it. The perspective of the South Korean Germanist on the writings of “the others”, the German-speaking Europeans, about her “own” heritage, the Korean Culture, is extraordinarily revealing.

Background: Interlaminar epidural steroid injection (ESI) is a well-established intervention to improve radicular leg pain. However, few studies have demonstrated the prognostic factors for interlaminar ESI. Objective: To investigate the clinical effectiveness and prognostic indicators of parasagittal interlaminar ESI during a 2-week follow-up. Study Design: Prospective evaluation. Setting: An interventional pain management practice in South Korea. Methods: After Institutional Review Board approval, parasagittal interlaminar ESI under fluoroscopic guidance was performed in 55 patients with central spinal stenosis. The numerical rating scale (NRS) and the Oswestry Disability Index (ODI) (%) were used to evaluate clinical efficacy and prognostic indicators. To determine the prognostic indicators, treatment outcomes were classified as successful (decreased NRS ≥ 50%, decreased ODI ≥ 40%) and unsuccessful (decreased NRS < 50%, decreased ODI < 40%) results. Results: Parasagittal interlaminar ESI significantly improved the NRS and ODI (%) scores after 2 weeks compared to those measured pretreatment. Paresthesia provocation (P = 0.006) was a significant prognostic factor on the NRS, whereas the Beck Depression Inventory (BDI) score (P = 0.007), paresthesia provocation (P = 0.035), and epidurography finding (P = 0.038) were significant on the ODI (%) score between patients with successful and unsuccessful outcomes. Limitations: We included the method of parasagittal interlaminar ESI only, therefore, direct comparison with other techniques was not available. Conclusion: Parasagittal interlaminar ESI significantly improved the NRS and ODI (%) scores. Paresthesia provocation was a prognostic indicator on the NRS and ODI (%) scores, and BDI scores and epidurography findings were prognostic indicators for the ODI (%) score. Key words: Parasagittal interlaminar epidural steroid injection, spinal stenosis, radicular leg pain, prognostic indicator, paresthesia provocation, epidurography, Beck Depression Inventory

Background: Transforaminal epidural steroid injection (TFESI) is a commonly used interventional pain management procedures to treat radicular leg pain. Although most reported complications of TFESI are minor, serious morbidity has also been demonstrated including spinal cord infarction, paraplegia, and quadriparesis. Suggested mechanisms include direct vascular injury or intravascular injection of particulate steroid. Objective: We compared 2 different needle types, Whitacre and Quincke type needles, with regard to intravascular injection rate with total procedure time and the amount of radiation during lumbar TFESI. Study Design: Prospective, randomized trial. Setting: An interventional pain management practice in South Korea. Methods: After Institutional Review Board approval, 149 patients undergoing lumbar TFESI for radicular leg pain were randomly assigned to one of 2 needle groups (Whitacre needle or Quincke type needle). After final confirmation of intravascular injection with digital subtraction angiography, total procedure time and amount of radiation exposure during TFESI were measured. Results: The overall incidence of intravascular injection was 10.4% (28/269). We analyzed the overall incidence of intravascular injection according to the 2 different needle types. The incidence of intravascular injection of the Whitacre needle was 5.4% (8/146), whereas the incidence of intravascular injection of the Quincke needle was 16.2% (20/123). Total procedure time and amount of radiation required to complete the TFESI in the Whitacre and Quincke needle groups was 168.4 ± 57.9 (seconds) and 33.4 ± 15.9 (cGy/cm2 ), 131.9 ± 46.0 (seconds) and 33.2 ± 15.8 (cGy/cm2 ), respectively. Limitations: The physician who performed the TFESI was not blinded to the type of needle for detecting intravascular injection. This study was focused on lumbar TFESI, however, most TFESIs are performed at the L4-5 or L5-S1 level. Conclusion: The Whitacre needle had the benefit of reducing the incidence of intravascular injection with minimal differences in technical difficulties and the amount of radiation exposure during lumbar TFESI. Key words: Transforaminal epidural steroid injection, complication, intravascular injection, Whitacre needle, Quincke needle, procedure time, radiation, digital subtraction angiography

Background: Thoracic epidural anesthesia (TEA) is frequently used to maintain intraoperative analgesia. After injecting the initial bolus dose of epidural local anesthetics (LA), intermittent injection of LA through an epidural catheter is required to maintain the intraoperative analgesia. For intermittent epidural administration, usually 2 – 5 mL of LA has been used. However, no studies have suggested an optimal volume of LA of TEA for intermittent epidural administration of TEA. Objective: We focused on identifying an optimal volume of LA of TEA using epidurography of the thoracic level with 2 different volumes of contrast dye. Study Design: Prospective, randomized study. Setting: An interventional pain management practice in South Korea. Methods: After Institutional Review Board approval, 70 patients undergoing thoracic epidural catheterization for upper abdominal and thoracic surgery were randomly assigned to one of the 2 contrast dye volume groups of 35 patients each (A, 2.5 mL and B, 5.0 mL). Epidurography was evaluated to confirm how many spinal segments were covered by contrast dye. The spreads in the cephalad and caudad directions were also evaluated. Results: The total number of vertebral segments evaluated by contrast dye were 7.5 ± 2.0, and 8.4 ± 2.6, respectively in groups A and B. The number of patients who showed contrast dye spread of more than 5 vertebral segments was 34/35 (97%) in both groups. Group B resulted in higher contrast dye distribution in the cephalad direction compared to group A (T2.6 vs. T3.6 ). Limitations: We used a test dose of contrast dye to confirm the contrast was in epidural space, not intrathecal or vascular, before injection of the main dose of contrast dye. The present study did not include the volume of test dose. Conclusion: The volume of 2.5 mL for intermittent epidural administration would be enough for the analgesic effect of upper abdominal and thoracic surgery while avoiding excessive upper thoracic and cervical spread. Key words: Thoracic epidural anesthesia, intermittent epidural administration, optimal volume, epidurography, cephalad, caudad, analgesic effect