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Lignin, renowned for its abundance of hydroxyl groups, was utilized in three dimensions to fabricate a hydrogel matrix. In this study, the optimal conditions for the preparation of a lignin-crosslinked hydrogel and its potential for dye and antioxidant removal were investigated. The hydrogel was synthesized through a cross-linking reaction, with varying amounts of cross-linking agent (poly(ethylene glycol) diglycidyl ether) added to adjust for the lignin content. Chemical structure analysis of the lignin-crosslinked hydrogel was conducted using Fourier-transform infrared spectroscopy and X-ray photoelectron spectroscopy, confirming successful hydrogel formation. Additionally, thermal analysis revealed an increase in the maximum thermal decomposition temperature with increasing cross-linker content. The lignin cross-linked hydrogel demonstrated a significantly higher swelling ability at pH 7 compared to pH 3. The dye adsorption capacity of the lignin-crosslinked hydrogel, which was evaluated using crystal violet (CV), showed a maximum adsorption capacity of 106 mg·g-1. The CV adsorption behavior followed Freundlich isotherms and pseudo-first-order kinetics. Moreover, the lignin-crosslinked hydrogel exhibited notable antioxidant activity, which was attributed to the phenolic hydroxyl groups of lignin macromolecules. Therefore, lignin-crosslinked hydrogels prepared using cross-linking agents have promising application potential in various fields. [ABSTRACT FROM AUTHOR]

Background: The medial canthal region features a complex three-dimensional and internal anatomical structure. When reconstructing a defect in this area, it is crucial to consider both functional and aesthetic aspects, which presents significant challenges. Generally, local flaps are preferred for reconstruction; however, skin grafts can be used when local flaps are not feasible. Therefore, we conducted a comparative analysis of surgical outcomes skin grafts when local flaps were not feasible, to determine which surgical method is more effective for medial canthal region reconstruction. Methods: Twenty-five patients who underwent medial canthal region reconstruction using skin grafts or local flaps from 2002 to 2021 were enrolled. Patient information was obtained from medical records. Five plastic surgeons evaluated the surgical outcomes based on general appearance, color, contour, and symmetry. Results: Skin grafts were used in eight patients and local flaps were used in 13. Combined reconstructions were employed in four cases. Minor complications arose in four cases but improved with conservative treatment. No major complications were reported. Recurrence of the skin cancer was noted in two cases. All categories showed higher scores for the local flap compared to both skin graft and combined reconstruction; however, the differences were not statistically significant respectively. Conclusion: The choice of appropriate surgical methods for reconstructing defects in the medial canthal region depends on various factors, including the patient's overall health, the size and depth of the defect, and the degree of involvement of surrounding structures. When a local flap is not feasible, a skin graft may provide favorable surgical outcomes. Therefore, a skin graft can serve as a viable alternative for reconstructing the medial canthal region. [ABSTRACT FROM AUTHOR]

The article discusses the impact of the COVID-19 pandemic on the clinical features of benign convulsions with mild gastroenteritis (CwG). The frequency of CwG was not significantly influenced by the pandemic, but the pandemic did diversify the etiologic enteric viral pathogens of CwG. The article also mentions a decrease in the prevalence of enteric viruses in children during the pandemic. The study analyzes data from a single tertiary center in South Korea and identifies three significant findings related to CwG. Further research is needed to understand the clinical differences in CwG based on the causative virus. [Extracted from the article]

Mucormycosis encompasses a range of fungal infections that can impact various organs. Although pulmonary mucormycosis is relatively rare, it poses a significant threat, particularly to individuals with compromised immune systems. Pulmonary mucormycosis presents with various radiological manifestations. Notably, the involvement of the angioinvasive pulmonary artery in pulmonary mucormycosis cases has seldom been documented. In this report, we showcase the radiological characteristics of angioinvasive mucormycosis, which can mimic pulmonary thromboembolism or a pulmonary artery tumor, in a patient diagnosed with myelodysplastic syndrome. [ABSTRACT FROM AUTHOR]

Background: There is still a lack of research on which diabetic drugs are more effective in preventing stroke. Our network metaanalysis aimed to compare cerebrovascular benefits among glucose-lowering treatments. Methods: We searched MEDLINE, EMBASE, the Cochrane Central Register of Controlled Trials, and the ClinicalTrials.gov registry for clinical trials from inception through May 25, 2021. We included both prespecified cerebrovascular outcomes and cerebrovascular events reported as severe adverse events. Subgroup analyses were conducted by stroke subtype, publication type, age of patients, baseline glycosylated hemoglobin (HbA1c), duration of type 2 diabetes mellitus, and cardiovascular risks. Results: Of 2,861 reports and 1,779 trials screened, 79 randomized controlled trials comprising 206,387 patients fulfilled the inclusion criteria. In the pairwise meta-analysis, the use of glucagon-like peptide-1 (GLP-1) agonist was associated with a lower risk of total stroke compared with placebo (relative risk [RR], -0.17; 95% confidence interval [CI], -0.27 to -0.07). In the network meta-analysis, only the use of sodium-glucose cotransporter-2 (SGLT-2) inhibitor was associated with a reduction of total stroke, compared with placebo (RR, 0.81; 95% CI, 0.67 to 0.98). In the subgroup analyses, the use of SGLT-2 inhibitor and GLP-1 agonist was associated with a lower risk of stroke in those with high HbA1c (=8.0) and low-risk of cardiovascular disease, respectively. Conclusion: SGLT-2 inhibitors and GLP-1 agonists were shown to be beneficial for stroke prevention in patients with type 2 diabetes mellitus. [ABSTRACT FROM AUTHOR]

The article discusses a study on left bundle branch-optimized cardiac resynchronization therapy (LOT-CRT) in patients with atrial fibrillation (AF) accompanied by slow ventricular response (SVR). The study aimed to evaluate the effectiveness of LOT-CRT in improving heart function and reducing symptoms in these patients. The results showed that LOT-CRT, which combines left bundle branch pacing with biventricular pacing, may offer a more effective treatment option for AF patients with heart failure. The study suggests that LOT-CRT could be a promising approach to improve outcomes in this patient population. [Extracted from the article]

Background: Available studies on the relationship between central sensitization and neuropathic pain, and on their association with patient-reported outcome measures (PROMs), following total knee arthroplasty (TKA) are insufficient. The purpose of the present study was to investigate this association. Methods: A total of 316 patients who underwent primary unilateral TKA for the treatment of end-stage osteoarthritis (OA) of the knee were enrolled. Central sensitization was defined as a score of ≥40 on the Central Sensitization Inventory. Neuropathic pain was defined as a score of ≥19 on the pain DETECT Questionnaire (PDQ). PROMs were also evaluated on the basis of the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) score preoperatively and at 2 years postoperatively. The patients were divided into 4 groups: Group 1 had both central sensitization and neuropathic pain, Group 2 had central sensitization only, Group 3 had neuropathic pain only, and Group 4 had neither central sensitization nor neuropathic pain. Preoperative and postoperative PROMs were compared among the groups. Results: All individuals who participated in the study were Asian, especially Korean. Fifty-five patients (17.4%) had both central sensitization and neuropathic pain, 68 (21.5%) had central sensitization only, 35 (11.1%) had neuropathic pain only, and 158 (50.0%) had neither condition. All WOMAC subscores showed significant differences among the 4 groups before and after surgery (p < 0.05 for all). In a post hoc analysis of the preoperative results, Groups 1, 2, and 3 showed significantly inferior WOMAC pain, function, and total scores compared with Group 4 (p < 0.05 for all). At 2 years postoperatively, Group 1 showed inferior WOMAC pain, function, and total scores compared with the other groups (p < 0.05 for all). Also, Groups 2 and 3 had worse WOMAC pain, function and total scores compared with Group 4 (p < 0.05 for all). Conclusions: Each condition, central sensitization and neuropathic pain, was associated with inferior PROMs following TKA. Furthermore, patients with both central sensitization and neuropathic pain showed worse PROMs compared with patients with either condition alone or without either condition. Level of Evidence: Prognostic Level III. See Instructions for Authors for a complete description of levels of evidence. [ABSTRACT FROM AUTHOR]

This study introduces a process based on Bayesian inference, enhancing the accuracy of random failure probability estimation, outlined in a detailed six-step procedure. This method focuses on comprehensive data analysis and precise probability estimations, proving particularly beneficial for limited datasets. Applied to brake disc random failure probability assessment, our approach's results were compared with those obtained through Maximum Likelihood Estimation (MLE) across various specimen sizes. This comparative analysis included both graphical and statistical evaluations. The experimental findings demonstrate that our Bayesian inference-based process effectively addresses the challenges posed by small datasets, significantly enhancing estimation accuracy. This methodology is especially advantageous in scenarios where data collection is difficult, providing reliability engineers with an essential framework for leveraging prior information to improve risk management in diverse industrial applications. [ABSTRACT FROM AUTHOR]

The article compares two surgical procedures, Robotic Assisted Simple Prostatectomy (RASP) and Holmium Laser Enucleation of the Prostate (HoLEP), for the treatment of huge Benign Prostatic Hyperplasia (BPH). The study finds that RASP offers advantages over HoLEP, including a wider field of view, easier access, and the ability to perform sophisticated procedures. RASP also reduces complications related to urethral stenosis and sphincter damage. However, HoLEP has shorter hospitalization and lower costs, making it more economically advantageous. The choice of surgery may depend on factors such as patient age, insurance coverage, and the size of the prostate. [Extracted from the article]

Abscess formation due to Candida albicans infection is extremely rare. Radiological diagnosis of an atypical abscess at an uncommon site is challenging. In this study, we present a case of insidious onset multifocal chest wall and spinal abscess after candidemia in a young woman in the intensive care unit due to postpartum bleeding. [ABSTRACT FROM AUTHOR]

Background/Aims: To date, there is no prospective study that specifically investigated the efficacy of infliximab in intestinal Behçet’s disease (BD). This study evaluated the efficacy of infliximab in patients with moderate-to-severe active intestinal BD that are refractory to conventional therapies. Methods: This phase 3, interventional, open-label, single-arm study evaluated clinical outcomes of infliximab treatment in patients with moderate-to-severe intestinal BD. The coprimary endpoints were clinical response, decrease in disease activity index for intestinal BD (DAIBD) score ≥20 from weeks 0 to 8 for the induction therapy and week 32 for the maintenance therapy. Results: A total of 33 patients entered the induction therapy and were treated with infliximab 5 mg/kg intravenously at weeks 0, 2, and 6. The mean DAIBD score changed from 90.8±40.1 at week 0 to 40.3±36.4 at week 8, with a significant mean change of 50.5±36.4 (95% confidence interval, 37.5 to 63.4; p<0.001). Thirty-one (93.9%) continued to receive 5 mg/kg infliximab every 8 weeks during the maintenance therapy. The mean change in the DAIBD score after the maintenance therapy was statistically significant (61.5±38.5; 95% confidence interval, 46.0 to 77.1; p<0.001, from weeks 0 to 32). The proportion of patients who maintained a clinical response was 92.3% at week 32. No severe adverse reactions occurred during the induction and maintenance therapies. Conclusions: This study provided evidence that infliximab 5 mg/kg induction and maintenance therapies are efficacious and well-tolerated in patients with moderate-to-severe active intestinal BD. [ABSTRACT FROM AUTHOR]

Background: Prolonged mechanical ventilation (PMV) is a common complication after liver transplantation surgery. However, owing to the clinical and economic benefits of early extubation, many efforts have been used to assess the clinical predictors for PMV. The aim of our study was to explore the impact of perioperative risk factors, including candidate gene polymorphisms, for PMV in patients undergoing liver transplantation. Methods: One hundred forty patients who underwent liver transplantation surgery were enrolled. The duration of mechanical ventilation after surgery was examined, along with the length of intensive care unit and hospital stay, and 30-day mortality. Patient-related clinical factors and single nucleotide polymorphisms of candidate genes were assessed with regard to PMV, which was defined as mechanical ventilation for > 48 h. Results: Twenty-six (19%) patients continued to receive mechanical ventilation at 48 h after surgery. Intraoperative continuous renal replacement therapy (CRRT) and an elevated serum lactate level during the postoperative period were significantly associated with the PMV group, compared to the non-PMV group (odds ratio [OR] = 24.731 [1.077, 567.915] versus OR = 3.008 [1.497, 6.045]). A significant association existed between the HLADPA1 rs8486 polymorphism and the risk of PMV under the allele model (OR = 8.060 [1.451, 44.765]). Conclusions: The rs8486 polymorphism in HLA-DPA1 can independently affect the risk of PMV in liver transplantation recipients, along with intraoperative CRRT application, and elevated lactate level during the postoperative period. [ABSTRACT FROM AUTHOR]

The name Rosa davurica var. alpestris (Nakai) Kitag. was published in 1979 as a new combination based on R. rubro-stipullata var. alpestris Nakai. It is generally accepted as a deciduous shrub occurring in Russia, Manchuria, Japan, and the northern part of the Korean Peninsula and is distinguished by the presence of eglandular leaves. Rosa rubro-stipullata var. alpestris was originally described as a new variety with a leaf size relatively smaller than that of R. rubro-stipullata var. rubro-stipullata. However, the observation of various specimens showed the leaf size of var. alpestris to be of minor importance, and it was included in var. rubro-stipullata as a synonym. Due to the priority of autonyms, a new combination is required to replace R. davurica var. alpestris. Additionally, it should be noted that the epithet “rubro-stipullata” is derived from the Latin word “stipula” rather than “stipulla.” Therefore, for this variety, we propose a new combination, R. davurica var. rubro-stipulata (Nakai) D. C. Son & Y. S. Kim, comb. nov. & stat. nov. [ABSTRACT FROM AUTHOR]

Three fertility surveys were carried out in Korea in the 1960s through funding provided by the Population Council. In this study, I reveal the sociological turn in population studies in Korea that occurred over the 1960s and 1970s by focusing on sociologist Yi Hae-yeongs 1965 fertility survey and a 1972 scholarly conference hosted by the Korean Sociological Association under the title "Sociological Evaluation of Korean Family Planning Research Activities." I analyze the academic foundations of fertility surveys in the 1960s (i.e., 'coupling to American academia'), internal changes of the actors implementing the surveys in the field (i.e., 'feedback from the field'), and the discursive challenge to medical doctor-led implementation of fertility surveys initiated by tacit knowledge of survey (i.e., 'competition for institutional resources'). Thus, I review the attempt at the Koreanization of social surveys in the field of sociology and the sociological turn in population studies, and explore the reason this legacy has been forgotten. [ABSTRACT FROM AUTHOR]

Using cross-national data containing information on the status rank of network alters, this study investigates the potential negative effects of "upward status heterophily," ties to and perceived interaction with higher status others. According to our main finding, upward status heterophily is associated with poor physical health and lower subjective well-being. We also find that this focal relationship varies across individual and contextual moderators. For subjective well-being only, it is weaker among people who are better educated, have larger nonkin network, and possess greater self-efficacy. Moreover, there is a significant cross-level interaction: For both health outcomes, the relationship is more pronounced in subnational regions that are economically more unequal. Our findings shed light on the mechanisms of the "dark side of social capital" by operationalizing perceived status differential as a proxy for upward social comparison and showing its deleterious consequences in the East Asian context. [ABSTRACT FROM AUTHOR]

Immunoglobulin G4 (IgG4)-related disease (IgG4-RD) is a fibroinflammatory disorder that can involve any organ system; however, myocarditis is extremely rare. A 52-year-old male with dyspnea and chest discomfort underwent cardiac MRI that revealed edema and nodular, patchy, mesocardial and subendoardial delayed enhancement of left ventricle, suggesting myocarditis. Laboratory findings revealed elevated serum IgG4 and eosinophilia. Cardiac biopsy confirmed eosinophilic myocarditis with IgG4-positive cells. Here, we present an unusual case of IgG4-RD manifesting as eosinophilic myocarditis. [ABSTRACT FROM AUTHOR]

Background: During the coronavirus disease 2019 (COVID-19) pandemic, the everyday use of face masks massively increased to prevent the spread of infection. Many people complain of ear pain and erosion when wearing a mask for extended periods of time. If prolonged mask usage is uncomfortable for ordinary people, a question arises--how much more inconvenient must mask wearing be for patients with a full-thickness skin graft (FTSG) donor site in the retroauricular region? Herein, we evaluated complications related to face mask use in 27 patients with a retroauricular FTSG donor site, with the goal of clarifying whether the retroauricular region is still an appropriate FTSG donor site in the context of the COVID-19 pandemic. Methods: Complications in 27 patients treated by FTSGs harvested from the retroauricular region from 2019 to 2021 were investigated. A questionnaire comparing the normal and the operated sides was administered. Pain, itching, soreness, deformity, and symmetry were further investigated. Results: Pain and itching were the only observed complications. The operated side was slightly more painful than the normal side in four patients (14.8%), and four patients (14.8%) reported itching on the operated side. However, all patients who experienced complications stated that the pain or itching did not interfere with mask wearing. Most symptomatic patients were older than 60 years of age (23.8%, p= 0.185) and wore masks for longer periods of time (28.5%, p= 0.326). Conclusion: Few retroauricular donor site-related complications occurred, and none of these complications caused inconvenience in daily life. Therefore, in the COVID-19 pandemic, the use of the retroauricular region as an FTSG donor site remains appropriate. [ABSTRACT FROM AUTHOR]

Background: We investigated whether metabolic dysfunction-associated fatty liver disease (MAFLD) is associated with an elevated risk of all-cause and cardiovascular mortality using a large-scale health examination cohort. Methods: A total of 394,835 subjects in the Kangbuk Samsung Health Study cohort were enrolled from 2002 to 2012. Participants were categorized by the presence of nonalcoholic fatty liver disease (NAFLD) and MAFLD as follows: normal subjects; patients with both NAFLD and MAFLD; patients with NAFLD only; and patients with MAFLD only. Cox proportional hazards models were used to analyze the risk of mortality. Results: During a median 5.7 years of follow-up, 20.69% was patients with both NAFLD and MAFLD, 1.51% was patients with NAFLD only, and 4.29% was patients with MAFLD only. All-cause and cardiovascular death was higher in patients with MAFLD than those without MAFLD (P<0.001, respectively). In patients with MAFLD only, the hazard ratio (HR) of all-cause and cardiovascular death was 1.35 (95% confidence interval [CI], 1.13 to 1.60) and 1.90 (95% CI, 1.26 to 2.88) after adjusting for age, which lost its statistical significance by multivariable adjustments. Compared to patients with less than two components of metabolic dysfunction, patients with more than two components of metabolic dysfunction were a higher risk of cardiovascular death (HR, 2.05; 95% CI, 1.25 to 3.38) and only women with more than two components of metabolic dysfunction were a higher risk of allcause death (HR, 1.44; 95% CI, 1.02 to 2.03). Conclusion: MAFLD criteria could identify a high-risk group for all-cause and cardiovascular death. [ABSTRACT FROM AUTHOR]

Two 1-year-old Korean native steers in the same herd presented severe hemorrhagic diarrhea. Case 1 had severe dehydration and died after 3 days, whereas case 2 had anorexia, depression, and severe diarrhea with mucus and blood. Only case 2 was necropsied, and bovine viral diarrhea virus-2a (BVDV2a) was detected in the tissues of its alimentary tract. Gross lesions, including erosion, ulceration, and extensive hemorrhage, were observed in the digestive tract mucosa. Immunohistochemistry revealed marked positive staining for BVDV2a antigen in the large intestine. These findings are indicative of hemorrhagic disease caused by BVDV2a in a native Korean steer. [ABSTRACT FROM AUTHOR]

Purpose: This study aimed to compare the characteristics of asymptomatic and symptomatic nephrolithiasis in patients who underwent surgical treatment for kidney stones. Materials and Methods: Between 2015 and 2019, 245 patients who underwent percutaneous nephrolithotomy or retrograde intrarenal surgery for kidney stones were included. The patients were divided into asymptomatic (n=124) and symptomatic (n=121) groups. All patients underwent blood and urine tests, preoperative non-contrast computed tomography, and postoperative stone composition analysis. We retrospectively analyzed and compared the characteristics of the patients and stones, operation time, stone-free rate, and postoperative complications between the two groups. Results: In the asymptomatic group, mean body mass index (BMI) was significantly higher (25.7±3.8 kg/m² vs. 24.3±2.8 kg/m², p=0.002) and urine pH was significantly lower (5.6±0.9 vs. 5.9±0.9, p=0.013). The ratio of calcium oxalate dihydrate stones was significantly higher in the symptomatic group (5.3% vs. 15.5%, p=0.023). No significant differences were observed in stone characteristics, postoperative outcomes, or complications. In the multivariate logistic regression analysis for predicting variables for asymptomatic renal stones, BMI (odds ratio [OR], 1.144; 95% confidence interval [CI], 1.038-1.260; p=0.007), and urine pH (OR, 0.608; 95% CI, 0.407-0.910; p=0.016) were independent predictive variables for asymptomatic renal stones. Conclusions: This study demonstrated that thorough medical check-ups are needed for the early detection of renal stones in individuals with a high BMI or low urine pH. [ABSTRACT FROM AUTHOR]

A diagnosis of an intracranial aneurysm depends on the angiographic configuration and should be cautiously differentiated from aneurysm mimics. In cases of duplicate anterior choroidal arteries (AChAs), infundibular widening of the distal minor AChA can be an aneurysm mimic. If the minor AChA with a smaller diameter is obscured angiographically due to poor contrast filling, an associated infundibular widening beside the proximal large AChA can misinterpreted as a typical AChA aneurysm in angiograms. The authors report on two such cases of duplicate AChAs with infundibular widening presenting like a typical AChA aneurysm in angiograms. Surgical exploration revealed a perforating artery emitting from the dome of the saccular lesion, confirming infundibular widening of a duplicate AChA. No reparative procedure was applied to the infundibular widening in a 48-year-old man, while two vascular outpouchings from the infundibular widening were clipped preserving the duplicate AChA in a 55-year-old woman. [ABSTRACT FROM AUTHOR]

Chronic right ventricular (RV) pacing can exacerbate heart failure in patients with a low left ventricular ejection fraction (LVEF). Left bundle branch area pacing (LBBAP) has emerged as a novel physiological pacing technique; however, information remains limited on its use among patients with a low EF. This study investigated the safety and short-term clinical outcomes of LBBAP among patients with impaired left ventricular (LV) function. This retrospective analysis of pacemakers at Chosun University Hospital, South Korea, included all patients with impaired LV function (EF<50%) who underwent pacemaker implantation for atrioventricular blockage from 2019-2022. Clinical characteristics, 12-lead electrocardiography findings, echocardiography findings, and laboratory parameters were evaluated. Composite outcomes were defined as all-cause mortality, cardiac death, and hospitalization due to heart failure during the 6-month follow-up. Altogether 57 patients (25 men; mean age, 77.4±10.8 y; LVEF, 41.5±3.8%) were divided into LBBAP (n=16), biventricular pacing (BVP; n=16), and conventional RV pacing (RVP; n=25) groups. In the LBBAP group, the mean paced QRS duration (pQRSd) was narrower (119.5±14.7 vs. 140.2±14.3 vs. 163.2±13.9; p<0.001) and cardiac troponin I level was elevated post-pacing (1.14±1.29 vs. 0.20±0.29 vs. 0.24±0.51, p=0.001). Lead parameters were stable. One patient was hospitalized, and four died (one patient each from heart failure admission, myocardial infarction, unexplained death, and pneumonia in RVP vs. one from intracerebral hemorrhage in BVP) during the follow-up period. In conclusion, LBBAP is feasible in patients with impaired LV function without acute or significant complications and provides a remarkably narrower pQRSd with a stable pacing threshold. [ABSTRACT FROM AUTHOR]

Background: Euonymus alatus (Thunb.) Siebold (EA) is a medicinal plant used in some Asian countries to treat various diseases, including cancer, hyperglycemia, diabetes, urticaria, dysmenorrhea, and arthritis. Owing to the wide range of pharmacological applications of EA, various roles of EA are being studied. Objective: We evaluated the immune-enhancing effect of EA treatment in a cyclophosphamide (Cy)-induced immunosuppressed rat model. Design: We analyzed the immune enhancement effect of EA on macrophages by western blotting. In addition, cell viability and natural killer (NK) cell activity were analyzed in splenocytes following EA treatment. For in vivo studies, analysis of weekly body weight, spleen weight, immune cell count, cytokine levels, and spleen histological findings was performed following EA administration in Cy-induced immunocompromised rats. Results: EA significantly increased cell viability and phospho-nuclear factor-kappa B and phosphor-extracellular signal-regulated kinase protein levels in the macrophages. EA significantly increased NK cell activity in splenocytes compared with the control group. In Cy-induced immunosuppressed rats, EA administration increased spleen tissue weight and the contents of leukocytes, lymphocytes, granulocytes, intermediate cells, and plasma cytokines (tumor necrosis factor-α and interferon-γ). In addition, improvement in the damaged spleen tissue was observed. Conclusions: These findings confirm that EA exerts an immune-enhancing effect, thereby suggesting its potential as an immunostimulatory agent or functional food. [ABSTRACT FROM AUTHOR]

Objective: To evaluate whether advanced maternal age (35–39 years, AMA)/very advanced maternal age (≥40 years, VAMA) impacts neonatal outcomes of very-low-birth-weight (VLBW) infants. Methods: Data of VLBW infants admitted to our unit were reviewed. Demographic findings and neonatal outcomes were compared among maternal age [(<35 years, not advanced maternal age, n = 329), AMA (n = 209), and VAMA (n = 43)] groups. Univariate and multivariate analyses were performed to identify the associated risk factors for neonatal outcomes. Result: Mortality and overall morbidities showed no significant intergroup differences, except for massive pulmonary hemorrhage (MPH). Multivariate analysis revealed that AMA/VAMA was not significantly associated with MPH development, while ≥ two doses of surfactant administration was. Higher gestational age and antenatal corticosteroid administration were protective. Conclusion: AMA/VAMA is not associated with neonatal mortality and morbidities. Since the proportion of AMA/VAMA mothers is expected to increase, perinatal medicine practitioners should focus on approaches before and immediately after birth of such infants. [ABSTRACT FROM AUTHOR]

Objective: This study was conducted to evaluate the effects of selenium (Se) source and level on the physiological response, reproductive performance, serum Se level, and milk composition in gestating sows. Methods: A total of 54 multiparous sows (Yorkshire×Landrace) with average body weight (BW), backfat thickness (BF), and parity were assigned to one of five treatments with 10 or 11 sows per treatment using a 2×2 factorial arrangement with one additional treatment in a completely randomized design. Inorganic or organic Se (IS or OS) sources were added to the diet at 0.30 ppm and 0.50 ppm Se. A non-Se-fortified corn-soybean meal basal diet served as a negative control. Treatments were as follows: i) Control: corn-soybean based diet, ii) IS30: control+inorganic Se 0.30 ppm, iii) IS50: control+inorganic Se 0.50 ppm, iv) OS30: control+ organic Se ppm, and v) OS50: control+organic Se 0.50 ppm. Results: At day 21 of lactation, piglet weight and weight gain in the OS treatments were higher than those in the IS treatments (p<0.05). Meanwhile, adding 0.5 ppm Se also resulted in the same significant differences in piglet BW and weight gain (p<0.05). Colostrum and milk Se concentrations increased (p<0.05) with Se level for both Se sources but were greater when sows were fed organic Se (p<0.05). Except for 24 hours postpartum, the Se concentrations were higher when sows were fed organic Se (p<0.05). Sow serum Se content was greater as Se levels increased from 0.3 ppm to 0.5 ppm at day 110 of gestation, 24 hours postpartum and day 21 of lactation (p<0.05). The pig serum Se concentration increased as the dietary Se level increased (p<0.05) and was higher when the sow dietary Se source was organic (p<0.05). Organic Se 0.5 ppm also had the highest serum Se level at two measured points (p<0.05). Conclusion: Consequently, supplementation with organic Se or 0.5 ppm Se in a gestating diet could improve piglet performance, the Se status of sows and piglets and milk composition, but organic Se at 0.5 ppm is optimal. [ABSTRACT FROM AUTHOR]

In this paper, a direct current (DC) motor speed control system with proportional-integral-derivative (PID) controller and Kalman filter is presented with consideration of disturbance, system variation, and feedback sensor noise and verified through computer simulations. Initially, a mathematical model for a DC motor system is introduced, after which the performance degradation due to disturbance and system variation in the basic open-loop control is revealed. To resolve this problem, a PID controller based feedback system is designed for the DC motor speed control system. Third, to improve the performance degradation due to feedback sensor noise that may occur during the feedback process, the Kalman filter is applied for the DC motor speed control system. Ultimately, it is verified that the designed DC motor speed control system with PID controller and Kalman filter not only satisfies all performance criteria but also has the ability to reject disturbance, cope with system variation and reduce feedback sensor noise. [ABSTRACT FROM AUTHOR]

A 76-year-old female visited the emergency department with complaining of dizziness and syncope. She had a history of paroxysmal atrial fibrillation (AF) and had been prescribed flecainide 50 mg and apixaban 5 mg 12-hourly in another hospital 1 day before the presentation. Upon admission, her electrocardiogram showed profound bradycardia and extremely long sinus arrest, which required temporary cardiac pacing. Within 24 hours, her intrinsic rhythm was restored, and the temporary pacemaker was removed. Transthoracic and transesophageal echocardiography revealed no structural heart disease or thrombus in the left atrial appendage. Cardiac computed tomography showed no coronary artery stenosis, but a pulmonary thrombus in the right pulmonary artery. She underwent an electrophysiology study, and four pulmonary vein (PV) isolations were attempted to treat the paroxysmal AF. A bidirectional PV conduction block was acquired in all PVs despite spontaneous dissociation of PV potential in the right PV. Programmed stimulation following ablation resulted in sinus node dysfunction. After the procedure, the patient did not complain of dizziness and syncope for 72 hours of telemetry monitoring. She was discharged with anticoagulant and did not show any further symptoms for 6 months. Flecainide acetate is a class Ic antiarrhythmics, and its clinical efficacy has been confirmed in several clinical trials. However, it can unmask sinus node dysfunction in asymptomatic patients with paroxysmal AF. Clinicians should screen candidates for sinus nodal diseases when prescribing flecainide. [ABSTRACT FROM AUTHOR]

Objective: This study was conducted to investigate the effects of selenium benefits on the physiological responses, litter performance, blood profiles and milk composition of lactating sows and tissue concentration of their progeny when mixed form of selenium was provided in a lactation diet. Methods: A total of 45 multiparous sows (Yorkshire×Landrace) with similar body weight, backfat thickness, and parity were assigned to one of three treatments with 15 sows per treatment in a completely randomized design. Organic and inorganic selenium were mixed and added to the diet at 0.15 ppm and 0.25 ppm, respectively. A non-Se-fortified corn-soybean meal basal diet served as a negative control. Treatments were as follows: i) Control: corn-soybean meal based diet, ii) ISOS15: control+ inorganic Se 0.15 ppm+organic Se 0.15 ppm, iii) ISOS25: control+inorganic Se 0.25 ppm+organic Se 0.25 ppm. Results: Serum selenium concentrations of sows and piglets were increased by the supplemental Se mixture at 7 days of lactation compared with the control (p<0.01, respectively). The kidney and muscle selenium concentrations of piglets were increased by the supplemental Se mixture at 21 days of lactation compared with the control (p = 0.03; p = 0.04, respectively). Conclusion: Consequently, supplementation with mixed inorganic and organic selenium in a lactating diet could improve the selenium status of sows and piglets; no differences were observed among the mixing levels. [ABSTRACT FROM AUTHOR]

Objective: The recently updated World Health Organization classification divides endocervical adenocarcinomas (ADCs) into human papillomavirus (HPV)-associated (HPVA) and HPV-independent (HPVI) ADCs. This study aimed to investigate the differences in the clinical features and treatment outcomes between patients with HPVA and HPVI. Methods: We retrospectively reviewed the electronic medical records and pathology slides of 123 patients with endocervical ADC who underwent radical hysterectomy and adjuvant radiation therapy. Tumor characteristics, patterns of failure, and survival outcomes were compared between HPVA and HPVI ADCs. Results: Eighty-one (65.9%) and 42 (34.1%) patients were diagnosed with HPVA and HPVI ADCs, respectively. HPVI ADC showed more frequent positive vaginal resection margin (VRM) and peritoneal seeding than HPVA ADC. After a median follow-up of 58.1 months, local recurrence and distant metastasis were more frequently observed in HPVI ADC than in HPVA ADC. Both local recurrence-free survival (77.3% vs. 91.8%) and distant metastasis-free survival (50.1% vs. 73.7%) rates of HPVI ADC were lower than those of HPVA ADC. Diseasefree survival was not significantly different between HPVI and HPVA ADCs. Conclusion: We demonstrated that HPVI ADC exhibited higher rates of VRM involvement and peritoneal seeding than those of HPVA ADC, resulting in higher rates of local recurrence and distant metastasis. Further studies with larger populations are warranted to explore optimal treatment strategies based on the histological subtypes of endocervical ADC. [ABSTRACT FROM AUTHOR]

This pilot study explored graduate nurse educator students’ perceptions of the application of narrative pedagogy in an online environment. Four major themes were identified in 15 student discussion posts: adapting challenges, increasing digital human interactions, enabling strategies, and creating a partnership for learning. Results illustrate how integrating narrative pedagogy into online classes enables a transformation of student thinking and learning by providing alternate ways for nurse educators to promote active learning. [ABSTRACT FROM AUTHOR]

Background/Aims: Gastrointestinal bleeding (GIB) risk for non-vitamin K antagonist oral anticoagulants (NOACs) compared with warfarin is largely unknown. We aimed to determine the risk of overall and post-polypectomy GIB for NOACs and warfarin. Methods: Using the Korean National Health Insurance database, we created a cohort of patients who were newly prescribed NOACs or warfarin between July 2015 and December 2017 using propensity score matching (PSM). Kaplan-Meier analysis with log-rank test was performed to compare the risk of overall and post-polypectomy GIB between NOACs (apixaban, dabigatran, and rivaroxaban) and warfarin. Post-polypectomy GIB was defined as bleeding within 1 month after gastrointestinal endoscopic polypectomy. Results: Out of 234,206 patients taking anticoagulants (187,687 NOACs and 46,519 warfarin), we selected 39,764 pairs of NOACs and warfarin users after PSM. NOACs patients showed significantly lower risk of overall GIB than warfarin patients (log-rank P< 0.001, hazard ratio, 0.86; 95% confidence interval, 0.78-0.94; P= 0.001). Among NOACs, apixaban showed the lowest risk of GIB. In the subgroup of 7,525 patients who underwent gastrointestinal polypectomy (lower gastrointestinal polypectomy 93.1%), 1,546 pairs were chosen for each group after PSM. The NOACs group showed a high risk of postpolypectomy GIB compared with the warfarin group (log-rank P= 0.001, hazard ratio, 1.97; 95% confidence interval, 1.16-3.33; P= 0.012). Conclusions: This nationwide, population-based study demonstrates that risk of overall GIB is lower for NOACs than for warfarin, while risk of post-polypectomy GIB is higher for NOACs than for warfarin. [ABSTRACT FROM AUTHOR]

Purpose: This study compared screw and Kirschner-wire (K-wire) fixation for intra-articular fractures of the proximal phalanx head regarding the success of union and functional outcomes. Methods: In this retrospective study, we enrolled patients with closed intra-articular fractures of the proximal phalangeal head treated between January 2011 and December 2021. Patients with open wounds, tendon or neurovascular injuries, comminuted fractures, or middle phalangeal fractures were excluded. Patients' demographics, bone union, proximal interphalangeal (PIP) joint range of motion (ROM), grip power, and complications were collected and analyzed. The percentage of intra-articular surface involvement and the number of bone fragments were also analyzed in relation to the functional results. Results: Among 41 patients, 21 were managed with screw fixation, and the remaining 20 with K-wire fixation. The mean union rate was 100% in the screw fixation group and 95.0% in the K-wire fixation group, with no statistically significant difference (p=0.488). Other functional parameters (PIP joint ROM, time to bone union, and grip power) were not significantly different between the two groups. Regardless of the treatment modality, the PIP joint ROM showed significant negative associations with the involvement of more intra-articular surfaces (p<0.001) and the presence of a greater number of bone fragments (p=0.040). Conclusion: In intra-articular fractures of the proximal phalanx head, the treatment modality (screw or K-wire) did not affect the treatment outcome. Instead, the percentage of intra-articular surface involvement and the number of bone fragments showed significant negative associations with the PIP joint ROM after treatment. [ABSTRACT FROM AUTHOR]

Myocardial calcification can develop owing to several conditions. It is a rare complication following sepsis and renal failure. We report a case of rapid development of left ventricular mid-wall calcification observed using CT and cardiac MRI in a patient after recovery from sepsis and acute renal failure. [ABSTRACT FROM AUTHOR]

Objective: To compare the biomechanical properties of the glenohumeral joint capsule between adhesive capsulitis (AC) after breast cancer surgery and idiopathic AC and demonstrate the effects of hydrodilatation (HD) with corticosteroid injection for AC after breast cancer surgery. Methods: Twenty-three prospective patients with AC after breast cancer surgery (BC group) and 44 retrospective patients with idiopathic AC without breast cancer (CON group) underwent HD with corticosteroid injection and home exercise training. We compared their biomechanical characteristics (capsular capacity, maximal pressure, and capsular stiffness). In the BC group, the passive range of motion (ROM) of the affected shoulder and a questionnaire (Shoulder Pain and Disability Index [SPADI]) were evaluated at baseline and 2 and 4 weeks after treatment. Results: The BC group showed higher biomechanical characteristics (maximal pressure and capsular stiffness) than did the CON group. The mean maximal pressure and capsular stiffness were 519.67±120.90 mmHg and 19.69±10.58 mmHg/mL in the BC group and 424.78±104.42 mmHg and 11.55±7.77 mmHg/mL in the CON group (p=0.002 and p=0.001, respectively). And, the BC group showed significant improvements in all ROMs (abduction, flexion, and external rotation) and the SPADI pain and disability sub-scores following the treatment. Conclusion: The glenohumeral joint capsular stiffness was greater in the patients with AC after breast cancer surgery than in those with idiopathic AC. HD with corticosteroid injection was effective in treating AC after breast cancer surgery. [ABSTRACT FROM AUTHOR]

Objectives Many studies have reported noticeable increases in the proportion of employees working either relatively short or relatively long hours. Such trends have been accompanied by an increasing concern that how much subjective mental well-being of employees would be influenced by their hours of work. The aim of this study was to investigate the association between work hours and clinically relevant depressive symptoms with demographic variables adjusted. Methods Participants were employees of a total of 56 private companies and local government organizations in Korea, aged 19 to 65 years. A self-report questionnaire that included items on working hour, job stress, levels of depression, and socio-demographic factors was administered to 15360 Korean employees, with 14477 valid responses. Hierarchical linear regression analyses, adjusted for sociodemographic factors, job related demographic factors, job stress, were used additionally to estimate the association between working hours and depressive scores. Results We found that working more than 40 hours per week correlated positively with the level of depressive symptoms after adjusting for demographic variables and the level of job stress. Furthermore, working 40 or fewer hours per week correlated negatively with the level of depressive symptoms. Being younger (β = -0.078, β = -0.099), being a female (β = 2.770, β = 1.268), and possessing a lower level of education (β = -0.315, β = -1.125) were significantly associated with higher level of depressive symptoms in all respondents. Conclusions Both of working excessively long or short hours is significantly associated with the prevalence of depressive symptoms. Establishing proper office hours for employees is critical to improving the quality of working conditions and maintaining good mental health in the workplace. [ABSTRACT FROM AUTHOR]

Purpose: An ankylosed elbow should be released with consideration of the nature of the stiffness and location of the pathologic structures, and care should be taken to avoid damage to the surrounding musculature and neurovascular structures. We report the clinical results of a combined anterior and posterior approach, which allowed safe access with good visibility, for severe elbow stiffness. Methods: We retrospectively reviewed patients who underwent surgical release for elbow ankylosis from August 2014 to May 2020. All operations were performed by the same surgeon at a single institution. The final outcomes were assessed by measuring the range of motion, calculating the Mayo Elbow Performance Score (MEPS), and reading radiologic images. Results: Eight patients with a mean age of 43 years (range, 21--65 years) were included in the study, and the mean follow-up period was 22 months. The average range of motion was 13° of flexion contracture (range, 0°--40°) and 123° of further flexion (range, 100°--140°) at the last follow-up. The average net improvement in the total arc compared to patients' preoperative status was 68° (range, --10°--130°). The mean post-operative MEPS was 89 points (range, 70--100 points). The development of heterotopic ossification and recalcitrant rheumatoid arthritis caused relatively poor outcomes. Conclusion: The combined anterior and posterior approach allows safe access with good visibility for elbow ankylosis, while minimizing the risk of neurovascular injury and preserving the medial and lateral muscles. [ABSTRACT FROM AUTHOR]

In urban public space planning, changes in land use, structure, and construction impact the urban environment to a certain degree. Land usage changes the urban surface water environment by impacting it through numerous ways. This paper studies about prediction of land use changes on surface water pollution in public space planning. This paper analyzes the characteristics of land use changes in public space planning from the quantitative characteristics of land use types, land use structure characteristics, and land usage degree in different years. The protection of natural resources is important, and water is one of the most important natural resources consumed by human beings. The environmental changes impacting these natural resources are to be studied to preserve the natural resources. The prediction of over-consumption of natural resources using soft computing techniques can certainly provide a solution for appropriate decision making. The prediction of relationship between land use changes and surface water pollution is required. In order to achieve this, the regression analysis on land use changes of different spatial scales with four surface water pollution indicators in the dry and wet seasons is performed to obtain the regression of each water pollution indicator. According to the determination coefficient, the determination coefficient of the model uses the comprehensive pollution index method to predict the impact of land use changes on surface water pollution. The experimental results show that the prediction accuracy of the proposed method is high and it is helpful in studying the impact of land use change on surface water pollution. It can help in decision making on consumption of natural resources to preserve the natural resources for next generations. [ABSTRACT FROM AUTHOR]

Background: Data on pulmonary hemodynamic parameters in patients with acute respiratory distress syndrome (ARDS) receiving extracorporeal membrane oxygenation (ECMO) are scarce. Methods: The associations between pulmonary artery catheter parameters for the first 7 days of ECMO, fluid balance, and hospital mortality were investigated in adult patients (aged ≥19 years) who received venovenous ECMO for refractory ARDS between 2015 and 2017. Results: Twenty patients were finally included in the analysis (median age, 56.0 years; interquartile range, 45.5–68.0 years; female, n=10). A total of 140 values were collected for each parameter (i.e., 7 days×20 patients). Net fluid balance was weakly but significantly correlated with systolic and diastolic pulmonary arterial pressures (PAPs; r=0.233 and P=0.011; r=0.376 and P<0.001, respectively). Among the mechanical ventilation parameters, above positive end-expiratory pressure was correlated with systolic PAP (r=0.191 and P=0.025), and static compliance was negatively correlated with diastolic PAP (r=−0.169 and P=0.048). Non-survivors had significantly higher systolic PAPs than in survivors. However, in multivariate analysis, there was no significant association between mean systolic PAP and hospital mortality (odds ratio, 1.500; 95% confidence interval, 0.937–2.404; P=0.091). Conclusions: Systolic PAP was weakly but significantly correlated with net fluid balance during the early ECMO period in patients with refractory ARDS receiving ECM. [ABSTRACT FROM AUTHOR]

Foreign bodies pose a diagnostic challenge to clinicians, and nasal foreign bodies have the potential to lead to significant morbidity. Although foreign bodies in the nasal cavity are a commonly encountered problem in pediatric patients, a foreign body in the nasal cavity not associated with a trauma history is rare in adults. We recently experienced a 35-year-old man who presented with a foreign body in his right nasal cavity and anterior tooth pain. He was not sure what the material was, and we were not able to confirm the material type preoperatively. However, we found that a very large and thick material was impacted and totally obstructed the right anterior nasal cavity. We surgically removed it as a bone block and confirmed postoperatively that the material was glass. This case provided several lessons, and we would like to share our experience. [ABSTRACT FROM AUTHOR]

The kinetic-energy dependences of the reactions M+ + CO where M+ = Re+, Os+, and Ir+ are studied using guided ion-beam tandem mass spectrometry. Formation of both MO+ and MC+ was observed in endothermic processes for all three metals. Modeling of the data provides thresholds that yield 0Kbond dissociation energies (BDEs, in eV) of 4.67 ± 0.09 (Re+-O), 4.82 ± 0.14 (Os+-O), 4.25 ± 0.11 (Ir+-O), 5.13 ± 0.12 (Re+-C), 6.14 ± 0.14 (Os+-C), and 6.58 ± 0.12 (Ir+-C). These BDEs agree well with literature values within experimental uncertainties demonstrating that ground state products are formed for all cases even though some of the reactions are formally spin forbidden. Quantum mechanical calculations at several levels of theory and using several basis sets were performed for MC+ and MO+ (with comparable results taken from the literature in some cases). B3LYP and CCSD(T) calculated ground state BDEs agree reasonably well with experimental values. The ground states in B3LYP and CCSD(T)/CBS calculations are 3Σ-(ReC+), 2▵ (OsC+), and 1Σ+ or 3▵ (IrC+) after including spin-orbit considerations. Relaxed potential energy surfaces (PESs) for the M+ + CO reactions show crossings between surfaces of different spin states such that products can be formed with no barriers in excess of the substantial endothermicities. Unlike results for these metal cations reacting with O2, the kinetic energy dependent cross sections for the formation of MO+ in the M+ + CO reactions exhibit only one feature. Reasons for this differential behavior are discussed in detail. [ABSTRACT FROM AUTHOR]

Background/Aims: Complementary and alternative medicine (CAM) is prevalent in East Asia. However, information on CAM in East Asian patients with inflammatory bowel disease (IBD) is scarce. We aimed to profile the prevalence and pattern of CAM use among East Asian IBD patients and to identify factors associated with CAM use. We also compared physicians' perspectives on CAM. Methods: Patients with IBD from China, Japan, and South Korea were invited to complete questionnaires on CAM use. Patient demographic and clinical data were collected. Logistic regression analysis was applied for predictors of CAM use. Physicians from each country were asked about their opinion on CAM services or products. Results: Overall, 905 patients with IBD participated in this study (China 232, Japan 255, and South Korea 418). Approximately 8.6% of patients with IBD used CAM services for their disease, while 29.7% of patients sought at least 1 kind of CAM product. Current active disease and Chinese or South Korean nationality over Japanese were independent predictors of CAM use. Chinese doctors were more likely to consider CAM helpful for patients with IBD than were Japanese and South Korean doctors. Conclusions: In 8.6% and 29.7% of East Asian patients with IBD used CAM services and products, respectively, which does not differ from the prevalence in their Western counterparts. There is a significant gap regarding CAM usage among different Asian countries, not only from the patients' perspective but also from the physicians' point of view. [ABSTRACT FROM AUTHOR]

Purpose: The purpose of this preliminary study is to evaluate the efficacy and safety of the Enterprise stent for intracranial atherosclerotic disease (ICAD) in patients who presented with acute stroke due to vessel steno-occlusion and in patients with symptomatic disease despite optimum medical management. Materials and Methods: A retrospective data analysis was performed on 15 consecutive patients who were treated with Enterprise stenting for recanalization of symptomatic intracranial steno-occlusive arteries due to underlying ICAD. Their clinical and radiological data were reviewed to evaluate procedural results, periprocedural and postprocedural complications, and clinical outcome. Results: Enterprise stents were deployed as a rescue method in 15 patients for recanalization of steno-occlusion. All patients achieved final modified thrombolysis in cerebral infarction (mTICI) score improvement (53.3% with a mTICI score from 0 to 2b or 3, 46.7% with a mTICI score from 1 to 3). Two postprocedural complications (1 symptomatic intracranial hemorrhage and 1 severe brain edema, 13.3%) occurred among 15 patients. Among 12 patients with acute ischemic stroke (AIS), 6 patients (50%) had improvement in their National Institute of Health Stroke Scale of more than 4 at discharge. Seven patients (58.3%) had a good functional outcome with 3-month modified Rankin Score (mRS)≤2, and mortality occurred (mRS=6) in 2 patients (16.7%). None of the 10 AIS and 3 transient ischemic attack patients experienced further ischemic events attributable to the treated steno-occlusion during the follow-up period (ranged from 4 to 36 months, median 12 months). Conclusion: This retrospective study suggests that Enterprise stenting can effectively and safely achieve recanalization in symptomatic steno-occlusive intracranial arteries. [ABSTRACT FROM AUTHOR]

The aim of this study was to analyze the effects of the planting distance and depth on the power take-off (PTO) load spectrum of a small riding-type transplanter for the optimal design of the transplanter. To measure load data during actual planting operation, a load measurement system was developed using a torque sensor, a data acquisition system, and an inverter. Field experiments were conducted at four planting distances (26 cm, 35 cm, 43 cm, and 80 cm) and three planting depths (85 mm, 105 mm, and 136 mm) in a field with similar soil conditions. The measured load data were inverted into a load spectrum using rain-flow counting and Smith-Watson-Topper (SWT) methods. The safety factor of a transplanter according to the planting conditions was analyzed using the converted load spectrum and commercial software. The load spectrum for all planting conditions showed torque ratios similar within a high cycle region of 108 to 109. The torque ratio increased when the planting depth increased and planting distance decreased in the low cycle region under less than 108 cycles. The safety factors of the PTO driving gear and the driven gear increased as the planting distance increased at all planting depths. When the planting depth decreased at the same planting distance, the safety factor of the PTO gears increased. The results of this study might provide useful information for a transplanter PTO design considering the working load according to the various planting conditions. [ABSTRACT FROM AUTHOR]

Purpose: This study aimed to evaluate the clinical efficacy of enzalutamide in chemotherapy-naïve metastatic castration-resistant prostate cancer (mCRPC) patients using real-world data from Korean patients. Materials and Methods: We retrospectively reviewed the medical records of 199 chemotherapy-naïve patients with mCRPC at 13 tertiary centers in Korea between 2014 and 2017. All patients received enzalutamide daily and 89 patients received concurrent androgen deprivation therapy (ADT). Results: The median age of the patients was 74 years. Initial results showed that 81.5% of the patients had Gleason score =8 and 33.3% of the patients had European Cooperative Oncology Group Performance Status 0. The overall mortality rate was 12%. The median OS was not archieved and 76.7% of patients were alive at 30 months. Median time until PSA progression was 6 months. The overall survival rate at 2 years was significantly higher (84.6% vs. 71.7%, p=0.015) and the duration of PSA progression-free survival was significantly longer (8.0 vs. 4.6 months, p=0.008) in patients receiving concurrent ADT than in those receiving enzalutamide alone. The incidence of adverse events of grade 3 or higher was 1.7%. Multivariate Cox proportional hazard analysis indicated that ADT administered concurrently with enzalutamide significantly improved the overall survival (hazard ratio, 0.346; 95% confidence interval, 0.125-0.958). Conclusions: Enzalutamide is effective and safe for chemotherapy-naïve patients with mCRPC. Furthermore, the overall survival was significantly higher in patients receiving enzalutamide and concurrent ADT than in patients receiving enzalutamide alone. [ABSTRACT FROM AUTHOR]

Background Single free flaps are a commonly used reconstructive method for multiple soft tissue defects in digits. We analyzed the flap size, division timing, and degree of necrosis in cases with various types of flap division. Methods We conducted a retrospective review of the medical charts of patients who had undergone single free flap reconstruction for multiple soft tissue defects across their digits from 2011 to 2020. The flap types included were the lateral arm free flap, venous forearm free flap, thenar free flap, hypothenar free flap, anterolateral thigh free flap, medial plantar free flap, and second toe pulp free flap. Flap size, anastomosed vessels, division timing, and occurrence of flap necrosis were retrospectively investigated and then analyzed using the ttest. Results In total, 75 patients were included in the analysis. The success rate of the free flaps was 97.3%. All flaps were successfully divided after at least 17 days, with a mean of 47.17 days (range, 17-243 days) for large flaps and 42.81 days (range, 20-130 days) for the medium and small flaps (P=0.596). The mean area of flap necrosis was 2.38% in the large flaps and 2.58% in the medium and small flaps (P=0.935). Severe necrosis of the divided flap developed in two patients who had undergone flap division at week 6 and week 34. Conclusions In cases where blood flow to the flap has been stable for more than 3 weeks, flap division can be safely attempted regardless of the flap size. [ABSTRACT FROM AUTHOR]

The UNCLOS prescribes basic principles on maritime boundary delimitations, but interpretation and application of the relevant provisions differ, and the views expressed on them still leave ample room to be unilaterally interpreted and applied. So, it is undeniable that conflicts over ocean waters among the concerned countries are serious and difficult to overcome. To solve these problems, the UNCLOS calls for the countries concerned to make every effort to enter into provisional arrangements of a practical nature. Korea and Japan have maritime boundary problems in the waters surrounding the Korean peninsula, and so, in order to solve those problems, both nations established a joint development zone (JDZ) in the East China Sea in 1974. The zone can be terminated in 2028. Therefore, this study examines and analyzes the impact of the JDZ agreement between Korea and Japan over the East China Sea as to the delimitations of the continental shelf/EEZ. [ABSTRACT FROM AUTHOR]