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"Lee, Boram"
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The psychometric properties of the Generalized Anxiety Disorder scale (GAD-7) among Korean university students
OBJECTIVE: The seven-item Generalized Anxiety Disorder scale (GAD-7) is a practical self-report measure that screens for the severity of Generalized Anxiety Disorder in primary care. Previous studies have shown that the GAD-7 is theoretically sound, but the results regarding its psychometric properties have been somewhat inconsistent with both adult and student samples. Despite these findings, the psychometric properties of the GAD-7 have remained untested among Korean university students, for whom the identification of efficient measures of these constructs is especially important. To determine the psychometric properties of the GAD-7, the present study examined the internal consistency, convergent validity, and underlying factor structure of the GAD-7 with a sample of Korean university students.
METHODS: The sample consisted of 582 students attending a four-year university in South Korea. All participants completed the Korean version of the GAD-7, the Depression Anxiety, and Stress Scale-21 (DASS-21), and the Patient Health Questionnaire (PHQ-9). The factor structure of the GAD-7 was assessed by exploratory factor analysis (EFA) and confirmatory factor analysis (CFA), and its convergent validity was determined by investigating its correlations with the DASS-21 and PHQ-9.
RESULTS: CFA procedures confirmed that a modified one-factor model was an acceptable solution. The internal consistency of the scale was excellent. The GAD-7 showed a moderate to strong correlation with the three subscales of the DASS-21 and with the PHQ-9, confirming convergent validity.
CONCLUSIONS: The findings indicate that the modified GAD-7 is a reliable and valid instrument for assessing generalized anxiety symptoms in university students. Its use for research and health care practice is warranted.
Journal Article
Restoration of BAP1 activity via base editing suppresses anchorage-independent survival in kidney cancer
BAP1, a deubiquitinase with a ubiquitin C-terminal hydrolase domain, functions as a tumor suppressor involved in diverse cellular processes, including DNA repair, genome stability, and apoptosis. Inactivating mutations in BAP1—particularly missense and deletion variants—are recurrent across multiple cancers, with a high prevalence in clear cell renal cell carcinoma (ccRCC), mesothelioma, and uveal melanoma. Among these, the Glu31Lys mutation in ccRCC impairs BAP1’s enzymatic activity, protein stability, and DNA repair functions. Here, we investigated the physiological impact of this recurrent mutation using isogenic KMRC-20 ccRCC cell clones in which the Glu31Lys substitution was precisely corrected to wild-type glutamate via CRISPR-Cas9–mediated adenine base editing. BAP1 reactivation restored anchorage-dependent growth in KMRC-20 cells—a hallmark of non-transformed epithelial cells—and increased apoptosis under non-adherent conditions, indicating reinstated sensitivity to anoikis. Mechanistically, this phenotypic switch was accompanied by post-transcriptional downregulation of N-cadherin and β-catenin under anchorage-free conditions, implicating BAP1 in the regulation of adhesion- and Wnt-related survival pathways. Furthermore, transcriptomic profiling revealed broad gene expression changes upon BAP1 restoration, suggesting that these combined alterations contribute to the re-establishment of anchorage-dependent growth in KMRC-20 cells. These findings uncover a previously unrecognized role for BAP1 in suppressing anchorage-independent survival, providing new insights into BAP1-driven tumorigenesis and underscoring the therapeutic potential of precise gene editing to restore tumor suppressor function in ccRCC.
Journal Article
From Control to Connection: A Child-Centred User Experience Approach to Promoting Digital Self-Regulation in Preschool-Aged Children
Although smart device use among children is increasing, most interventions overlook their cognitive and emotional development or rely too heavily on external control. Such approaches often overlook the developmental needs of children for emotional regulation and autonomy. Therefore, this study aims to propose a child-centred user experience (UX) framework to support digital self-regulation in preschool-aged children. The proposed system integrates multiple psychological theories—including Piaget’s concept of animistic thinking, executive function theory, Self-Determination Theory, and Acceptance and Commitment Therapy—to support cognitive and emotional regulation during screen use. Key features include persistent visual cues to enhance time awareness and behavioural anticipation, narrative-based character interactions to foster empathy and agency, and ritualised closure routines supported by multimodal and tangible interaction elements. Developed as a mobile prototype, the system was iteratively refined through two-stage consultations with child and adolescent psychiatrists and a developmental psychologist, including formative design feedback and follow-up expert review. Their feedback provided preliminary validation of the system’s developmental validity and emotional coherence. These findings suggest that affectively attuned UX design is a viable alternative to conventional control-based screen-time interventions in early childhood.
Journal Article
Construct validity of the perceived stress scale (PSS-10) in a sample of early childhood teacher candidates
OBJECT: The 10-item Perceived Stress Scale (PSS-10) is one of the most widely used psychological instruments for measuring stress perception in practice and research but has sparked some controversy regarding its factor structure. Further, no study has been conducted to date using a sample of Korean university students to test the reliability and validity of the PSS and the factorial structure of this instrument. Likewise, more data on the psychometric properties of the Korean version of the scale (K-PSS-10) are also needed. Hence, the purpose of the present study was to examine the construct validity of the K-PSS-10 among Korean university students.
METHODS: A total of 250 university students currently attending the Department of Early Childhood Education (a four-year university curriculum) completed the K-PSS-10. The collected data were subjected to confirmatory factor analysis, which tested three alternative plausible models suggested by the extant literature: single factor, correlated two-factor and bifactor.
RESULTS: The results indicated that the bifactor model best fit the data, with one general factor reflecting the overlap across all 10 items, and 2 additional specific factors representing perceived distress (6 negatively worded items) and perceived coping (4 positively worded items). Internal consistencies of the total scale and its two subscales were adequate (α > 0.70).
CONCLUSIONS: The findings of this study support the use of the K-PSS-10 as a reliable and valid measure to assess perceived stress in a sample of early childhood teacher candidates.
Journal Article
Real-world evidence of characteristics and factors influencing herbal medicine use for weight loss in adults
Obesity imposes a significant socioeconomic burden owing to its high prevalence. In response to the adverse outcomes associated with conventional pharmacotherapy and the challenges of low adherence to lifestyle interventions, herbal medicine has surfaced as an actively utilized approach for weight loss. Therefore, this study aimed to analyze the characteristics and influencing factors of herbal medicine users for weight loss in adults.
Overall, 22,080 participants were included based on data from the Korea National Health and Nutrition Examination Survey from 2010 to 2019. Simple logistic regression analyses were used to derive the associations between herbal medicine use for weight loss and individual characteristics. Three models were constructed utilizing multiple logistic regression analyses to assess the associations between herbal medicine use for weight loss and the combined characteristics of predisposing, enabling, and need factors according to Andersen's model.
In the full adjustment model, women, younger adults, those with higher incomes, and individuals reporting higher levels of perceived stress were more prone to use herbal medicine for weight loss in the past year. Adults who identified body image as being fat/very fat, those who consumed alcohol, and those classified as severely obese by body mass index were also more prone to use herbal medicine for weight loss. In particular, adults with a higher rate and amount of weight loss in the past year were more likely to use herbal medicine for weight loss compared to those experiencing weight gain/no changes/loss of 0-3 kg.
Our study was the first to derive the characteristics and influencing factors of herbal medicine users for weight loss among adults. These findings hold significant promise for informing future research endeavors and policy decision-making for effective resource distribution for obesity treatment.
Journal Article
WCRP COordinated Regional Downscaling EXperiment (CORDEX): a diagnostic MIP for CMIP6
The COordinated Regional Downscaling EXperiment (CORDEX) is a diagnostic model intercomparison project (MIP) in CMIP6. CORDEX builds on a foundation of previous downscaling intercomparison projects to provide a common framework for downscaling activities around the world. The CORDEX Regional Challenges provide a focus for downscaling research and a basis for making use of CMIP6 global climate model (GCM) output to produce downscaled projected changes in regional climates and assess sources of uncertainties in the projections, all of which can potentially be distilled into climate change information for vulnerability, impacts and adaptation studies. CORDEX Flagship Pilot Studies advance regional downscaling by targeting one or more of the CORDEX Regional Challenges. A CORDEX-CORE framework is planned that will produce a baseline set of homogeneous high-resolution, downscaled projections for regions worldwide. In CMIP6, CORDEX coordinates with ScenarioMIP and is structured to allow cross comparisons with HighResMIP and interaction with the CMIP6 VIACS Advisory Board.
Journal Article
The Strengths and Difficulties Questionnaire: the factor structure in a sample of Korean immigrant parents in New Zealand
OBJECTIVE: The Strengths and Difficulties Questionnaire (SDQ) is a widely used, brief, 25-item instrument for screening for adaptive and problematic behaviour in children and adolescents. Despite its widespread application in child and adolescent research, concerns regarding the construct validity of the instrument have been expressed. Further, to date, limited research has been conducted using Korean and Korean immigrant samples to provide data about the reliability and validity of the SDQ and the factorial structure of this instrument. The purpose of this study was to examine the construct validity, based on pre-existing models suggested by the extant literature, for the parent-informant version of the questionnaire.
METHODS: A sample of 207 Korean immigrant parents in New Zealand completed the SDQ for their children (ages 6 and 10). The resulting data were subjected to confirmatory factor analysis (CFA), testing four competing models: a three-factor model (internalization dimension, externalization dimension, and a prosocial factor), a five-factor model (emotional symptoms, peer problems, conduct problems, hyperactivity, and prosocial), a six-factor model (a separated uncorrelated method factor, four symptom factors, and the single prosocial factor), and a hierarchical model in which the four first-order problem-oriented scales form a higher order difficulties factor.
RESULTS: CFA of the SDQ partially supported the traditional five-factor conceptualization of the SDQ, although some modifications were necessary to reach an acceptable fit. Reliability was a concern particularly for Emotional Symptoms and Peer Problems.
CONCLUSIONS: The use of the revised five-factor model of the SDQ in the present setting should be interpreted with caution. Some items need to be further evaluated and revised to capture the originally intended constructs.
Journal Article
Risk factors for discontinuation of intravenous patient-controlled analgesia after general surgery: a retrospective cohort study
Identifying patients at risk for developing side effects secondary to intravenous patient-controlled analgesia (IV PCA) and making the necessary adjustments in pain management are crucial. We investigated the risk factors of discontinuing IV PCA due to side effects following general surgery; adult patients who received IV PCA after general surgery (2020–2022) were included. Data on postoperative pain intensity, PCA pain relief, side effects, continuity of PCA use, and PCA pump settings were collected from the records of the acute pain management team. The primary outcome was identifying the risk factors associated with PCA discontinuation due to side effects. Of the 8745 patients included, 94.95% used opioid-containing PCA, and 5.05% used non-steroidal anti-inflammatory drug (NSAID)-only PCA; 600 patients discontinued PCA due to side effects. Female sex (adjusted odds ratio [aOR] 3.31, 95% confidence interval [CI] 2.74–4.01), hepato-pancreatic-biliary surgery (aOR 1.43, 95% CI 1.06–1.94) and background infusion of PCA (aOR 1.42, 95% CI 1.04, 1.94) were associated with an increased likelihood of PCA discontinuation. Preoperative opioid use (aOR 0.49, 95% CI 0.28–0.85) was linked with a decreased likelihood of PCA discontinuation. These findings highlight the importance of individualized pain management, considering patient characteristics and surgical procedures.
Journal Article
Changes in ovarian cancer survival during the 20 years before the era of targeted therapy
Background
The survival of patients with ovarian cancer has improved because of surgery and chemotherapy. This study aimed to estimate the changes in survival rates among Korean women with ovarian cancer prior to the introduction of targeted therapy for ovarian cancer.
Methods
Data were obtained from the Korea Central Cancer Registry regarding patients who were diagnosed with epithelial ovarian cancer between 1995 and 2014. The relative survival rates were calculated for 5-year periods using the Ederer II method. Cox proportional hazard models were created to assess the associations of demographic and clinicopathological factors with ovarian cancer survival.
Results
During the study period, 22,880 women were diagnosed with epithelial ovarian cancer. The 5-year relative survival rate improved from 57.2% during 1995–1999 to 63.8% during 2010–2014 (
P
< 0.001). Survival outcomes improved between 1995 and 1999 and 2010–2014 for the serous and endometrioid carcinoma subtypes (
P
< 0.001). However, no improvements were observed for the mucinous and clear cell carcinoma subtypes (
P
= 0.189 and
P
= 0.293, respectively). Multivariate analysis revealed that younger age, early stage, recent diagnosis, primary surgical treatment, and non-serous histological subtype were favorable prognostic factors.
Conclusion
Survival outcomes have improved for serous and endometrioid epithelial ovarian cancer in the last 20 years. However, no improvement was observed for patients with mucinous and clear cell carcinoma subtypes.
Journal Article