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Purpose: This study aims to evaluate the treatment approaches and locoregional patterns for adenoid cystic carcinoma (ACC) in the breast, which is an uncommon malignant tumor with limited clinical data. Materials and Methods: A total of 93 patients diagnosed with primary ACC in the breast between 1992 and 2022 were collected from multi-institutions. All patients underwent surgical resection, including breast-conserving surgery (BCS) or total mastectomy (TM). Recurrence patterns and locoregional recurrence-free survival (LRFS) were assessed. Results: Seventy-five patients (80.7%) underwent BCS, and 71 of them (94.7%) received post-operative radiation therapy (PORT). Eighteen patients (19.3%) underwent TM, with five of them (27.8%) also receiving PORT. With a median follow-up of 50 months, the LRFS rate was 84.2% at 5 years. Local recurrence (LR) was observed in five patients (5.4%) and four cases (80%) of the LR occurred in the tumor bed. Three of LR (3/75, 4.0%) had a history of BCS and PORT, meanwhile, two of LR (2/18, 11.1%) had a history of mastectomy. Regional recurrence occurred in two patients (2.2%), and both cases had a history of PORT with (n=1) and without (n=1) irradiation of the regional lymph nodes. Partial breast irradiation (p=0.35), BCS (p=0.96) and PORT in BCS group (p=0.33) had no significant association with LRFS. Conclusion: BCS followed by PORT was the predominant treatment approach for ACC of the breast and LR mostly occurred in the tumor bed. The findings of this study suggest that partial breast irradiation might be considered for PORT in primary breast ACC. [ABSTRACT FROM AUTHOR]

Background: Breast cancer-related lymphedema (BCRL) reduces the quality of life of patients and limits their activities of daily living. Even though resistance exercises seemed to be safe in BCRL patients, it was still controversial that resistance exercises improve lymphedema. Therefore, we sought to evaluate the effects of forearm-targeted resistance exercises on BCRL using segmental bioelectrical impedance analysis (BIA). Methods: This study was a pilot-controlled randomized trial, with patients divided into the intervention and the control group. Both groups received 30 min of complete decongestive therapy (CDT) for 2 weeks. In addition, the intervention group received forearm strengthening training including warm-up and cool-down for an extra 20 min, and the control group received stretching exercises. 5 kHz impedance ratios were assessed by segmental BIA before and after treatments. Results: Among the eighteen patients enrolled, ten were assigned to the intervention group, and eight were in the control group. Only the 5 kHz impedance ratio in the forearm segment of the intervention group showed a statistically significant difference. The effect sizes of the groups were 0.71 for the intervention group and 0.93 in the between-group comparison. Conclusions: Forearm resistance exercises in patients with BCRL showed a significant decrease in extracellular fluid in the proximal forearm segment when using segmental BIA. Therefore, we suggest that resistance exercises targeting the forearm might be effective in treating lymphedema. [ABSTRACT FROM AUTHOR]

Background: We explored the changes in metabolic dysfunction-associated steatotic liver disease (MASLD) severity over time by analyzing data from the placebo arms of randomized controlled trials (RCTs), focusing on the presence of diabetes. Methods: RCTs on MASLD that included a placebo arm were identified using a systematic search of the literature. Primary outcomes were changes in hepatic steatosis and fibrosis. Results: The meta-analysis included 8 RCTs involving 386 patients without diabetes and 24 RCTs involving 637 patients with diabetes. The pooled estimate of mean change in steatosis grade was − 0.1 in patients without diabetes, and − 0.37 in patients with diabetes (P = 0.066). The mean change in fibrosis stage was 0.05 in patients without diabetes, and − 0.03 in patients with diabetes (P = 0.359). The mean change in nonalcoholic fatty liver disease activity score was − 0.55 in patients without diabetes, and − 1.50 in patients with diabetes (P = 0.100). The mean change in ALT and AST were significantly larger in patients without diabetes compared to those with diabetes (P < 0.05). Conclusion: Placebo treatment had a greater effect in improving liver steatosis in patients with diabetes compared to those without. These findings highlight the importance of tailored treatment strategies in MASLD, particularly considering diabetes status. [ABSTRACT FROM AUTHOR]

Inflammatory bowel disease (IBD), caused by environmental factors associated with the host's genetic traits, is represented by Crohn's disease and ulcerative colitis. Despite the increasing number of patients with IBD, the current treatment is limited to symptomatic therapy. A complex IBD model mimicking the human IBD etiology is required to overcome this limitation. Herein, we developed novel complex IBD models using interleukin 2 receptor subunit gamma (Il2rg)-deficient mice, high-fat diet, dextran sodium sulfate, and Citrobacter rodentium. The more IBD factors applied complexly, colon length shortened and inflammation worsened. The levels of pro-inflammatory cytokines increased with increased IBD factors. Anti-inflammatory cytokine decreased in all factors application but increased in Il2rg deficiency and Westernized diet combination. Additionally, the pro-inflammatory transcription factors and leaky intestinal epithelial marker were upregulated by a combination of IBD factors. Species diversity decreased with IBD factors. Phylogenetic diversity decreased as IBD factors were applied but increased with combined Il2rg deficiency and Westernized diet. The more IBD factors applied complexly, the more severe the dysbiosis. Finally, we developed a novel complex IBD model using various IBD factors. This model more closely mimic human IBD based on colonic inflammation and dysbiosis than the previous models. Based on these results, our novel complex IBD model could be a valuable tool for further IBD research. [ABSTRACT FROM AUTHOR]

Background: Chemo-endocrine therapy can lead to various side effects associated with ovarian dysfunction. Predicting menstrual recovery is necessary to discuss the treatment-related issues regarding fertility and premature menopause with patients. Methods: In the ASTRRA trial, patients who resumed ovarian function within 2 years after chemotherapy were randomized to receive tamoxifen for 5 years or OFS with tamoxifen for 2 years. With these 1298 patients, we developed a model that predicts when menstrual recovery will occur within a 3-year period after chemotherapy using variables including age, body mass index, chemotherapy regimen and duration, and serum estradiol and follicle-stimulating hormone levels. Results: The data of 957 patients were used to develop the prediction model, and those of 341 patients were used for validation. In the development group, menstruation resumed in 450 patients (47.0%) within 5 years. In multivariable analysis, younger age (< 35 vs. 45, HR 7.85, 95% CI 4.63–13.30, p < 0.0001), anthracycline-based chemotherapy without taxane (vs. with taxane, HR 1.81, 95% CI 1.37–2.38, p < 0.0001), and chemotherapy duration (≤ 90 days vs. > 90 days, HR 1.32, 95% CI 1.01–1.72, p = 0.045) correlated with menstrual recovery. Using combined age, regimen, and duration of chemotherapy, we developed a simplified scoring system to estimate recovery chances and used a concordance index of 0.679 overall and 0.744 at 3 years for validation. Conclusion: This model predicted timing and probability of menstrual recovery, based on their individual age, type and duration of chemotherapy in premenopausal women diagnosed with breast cancer who received tamoxifen after chemotherapy. [ABSTRACT FROM AUTHOR]

Acanthopanax senticosus belongs to Araliaceae family and is traditionally used as a tonic. The roots and stems are mainly used as treatments for hypodynamia, rheumatism, and hypertension, but their frequent use may lead to extinction. However, comprehensive and simultaneous analysis of the remaining parts were still limited. There is a need to reorganize them for standardization of functional foods. In this study, 50 phenolic compounds and 82 triterpenoid saponins from the shoots, leaves, fruits, and stems of were characterized using UPLC-QTOF-MS and UPLC-QTRAP-MS/MS. Among them, 52 compounds were newly determined as the cis and malonyl-bound phenolic acids and were found to be structural isomers of Acanthopanax flavonoids and saponins. All compounds were absolutely/relatively quantified, and shoots had the highest content. Peroxynitrite and α-glucosidase inhibitory activities were performed, followed by evaluation of structure-activity relationships. Particularly, hederasaponin B and ciwujianoside B showed remarkable efficacy, which were affected by the C-23 hydroxylation, the C-20(29) double bond, and the presence of rhamnose. These detailed profiling can be used as fundamental data for increasing the utilization of A. senticosus and developing them into functional foods. [ABSTRACT FROM AUTHOR]

Aim: To evaluate the efficacy and safety of dapagliflozin versus placebo as an add‐on in patients with type 2 diabetes who did not achieve adequate glycaemic control with evogliptin and metformin combination. Patients and Methods: In this multicentre, randomized, double‐blind, placebo‐controlled Phase 3 trial, patients with glycated haemoglobin (HbA1c) levels ≥7.0% (≥53 mmol/mol) and ≤10.5% (≤91 mmol/mol) who had received stable‐dose metformin (≥1000 mg) and evogliptin (5 mg) for at least 8 weeks were randomized to receive dapagliflozin 10 mg or placebo once daily for 24 weeks. Participants continued treatment with metformin and evogliptin. The primary endpoint was change in HbA1c level after 24 weeks of treatment from baseline level. Results: In total, 198 patients were randomized, and 195 patients were included in the efficacy analyses (dapagliflozin: 96, placebo: 99). At Week 24, dapagliflozin significantly reduced HbA1c levels. The least squares mean difference in HbA1c level change from baseline after 24 weeks of treatment was −0.70% (−7.7 mmol/mol) (p < 0.0001). The proportion of participants achieving HbA1c <7.0% (≥53 mmol/mol) was higher in the dapagliflozin group than in the placebo group. Compared to placebo, dapagliflozin significantly reduced fasting plasma glucose, mean daily glucose, 2‐h postprandial plasma glucose, fasting insulin, uric acid and gamma‐glutamyl transferase levels, homeostatic model assessment for insulin resistance index, body weight, hepatic steatosis index, and albuminuria. Adiponectin level significantly increased from baseline level after 24 weeks of dapagliflozin treatment. Adverse event rates were similar in the two groups. Conclusion: Dapagliflozin add‐on to evogliptin plus metformin improved glycaemic control and was well tolerated by the target patients. [ABSTRACT FROM AUTHOR]

Background: This study aimed to investigate the factors associated with the time that community-dwelling stroke survivors spent walking. Methods: We analyzed the cross-sectional data of 1534 community-dwelling stroke survivors from the Korean National Health and Nutrition Examination Survey. Complex-sample logistic regression analyses were performed to determine the factors associated with insufficient walking time (<90 min/wk). The mean time spent walking was examined according to age, sex, resistance exercise level, and self-reported disability using complex-sample general linear models. Results: Women (odds ratio [OR] 1.5; 95% confidence interval [CI], 1.0–2.3), current smokers (OR 1.7; 95% CI, 1.1–2.8), insufficient resistance exercise (OR 2.3; 95% CI, 1.5–3.5), and those with rural residences (OR 1.4; 95% CI, 1.0–1.9) were independently associated with insufficient walking time. The mean time spent walking was significantly lower in older adults aged ≥65 years than in young adults aged <65 years (200.0 ± 42.0 min/wk vs 287.2 ± 36.6 min/wk, P =.002), in women than in men (200.9 ± 44.9 vs 286.2 ± 37.7 min/wk, P =.027), and in individuals engaging in insufficient resistance exercise compared with those engaging in sufficient resistance exercise (203.2 ± 36.2 vs 283.9 ± 43.0 min/wk, P =.008). The mean walking time did not vary according to the presence of self-reported disabilities. Conclusions: Environmental and personal factors are associated with insufficient walking time in community-dwelling stroke survivors. [ABSTRACT FROM AUTHOR]

Several perinatal factors influence the intestinal microbiome of newborns during the first days of life, whether during delivery or even in utero. These factors may increase the risk of developing necrotizing enterocolitis (NEC) by causing dysbiosis linked to a NEC-associated microbiota, which may also be associated with other gastrointestinal problems. The objective of our study was to evaluate the potential risks associated with microbial shifts in newborns with gastrointestinal symptoms and identify the intestinal microbiota of neonates at risk for NEC.During the study period, 310 preterm and term newborns' first passed meconium occurring within 72 h of birth were collected, and the microbiome was analyzed. We identified the risk factors in the NEC/FI group. Regarding microbiota, we compared the bacterial abundance between the NEC/FI group at the phylum and genus levels and explored the differences in the microbial composition of the 1st stool samples. A total of 14.8% (n = 46) of the infants were diagnosed with NEC or FI. In univariate analysis, the mean gestational age and birth weight were significantly lower in the NEC/FI group (p < 0.001). Prolonged rupture of membranes (PROM) > 18 h, chorioamnionitis, and histology were significantly higher in the NEC/FI group (p < 0.001). Multivariate analysis showed that gestational age (GA), prolonged membrane rupture (> 18 h), and early onset sepsis were consistently associated with an increased risk of NEC/FI. Infants diagnosed with NEC/FI exhibited a significantly lower abundance of Actinobacteria at the phylum level than the control group (p < 0.001). At the genus level, a significantly lower abundance of Streptococcus and Bifidobacterium which belong to the Actinobacteria phylum, was observed in the NEC/FI group (p < 0.001). Furthermore, the NEC/FI had significantly lower alpha diversities (Shannon Index,3.39 vs. 3.12; P = 0.044, respectively). Our study revealed that newborns with lower diversity and dysbiosis in their initial gut microbiota had an increased risk of developing NEC, with microbiota differences appearing to be associated with NEC/FI. Dysbiosis could potentially serve as a predictive marker for NEC- or GI-related symptoms. [ABSTRACT FROM AUTHOR]

Purpose: To determine whether switching to contrast media based on the sharing of N-(2,3-dihydroxypropyl) carbamoyl side chain reduces the recurrence of iodinated contrast media (ICM)-associated adverse drug reactions (ADRs). Materials and methods: This single-center retrospective study included 2133 consecutive patients (mean age ± SD, 56.1 ± 11.4 years; male, 1052 [49.3%]) who had a history of ICM-associated ADRs and underwent contrast-enhanced CT examinations. The per-patient and per-exam-based recurrence ADR rates were compared between cases of switching and non-switching the ICM from ICMs that caused the previous ADRs, and between cases that used ICMs with common and different carbamoyl side chains from ICMs that caused the previous ADRs. Downgrade rates (no recurrence or the occurrence of ADR less severe than index ADRs) were also compared. Propensity score matching (PSM) and inverse probability of treatment weighting (IPTW) analysis were additionally performed. Results: In per-patient analysis, switching of ICM showed a lower recurrence rate (switching, 10.4% [100/965] vs. non-switching, 28.4% [332/1168]), with the adjusted odds ratio (OR) of 0.27 (95% CI: 0.21, 0.34; p < 0.001). The result was consistent in PSM (OR, 0.29 [95% CI: 0.22, 0.39]; p < 0.001), IPTW (OR, 0.28 [95% CI: 0.22, 0.36]; p < 0.001), and in per-exam analysis (5.5% vs. 13.8%; OR, 0.32 [95% CI: 0.27, 0.37]; p < 0.001). There was lower per-exam recurrence (5.0% [195/3938] vs. 7.8% [79/1017]; OR, 0.63 [95% CI: 0.47, 0.83]; p = 0.001) and higher downgrade rates (95.6% [3764/3938] vs. 93.3% [949/1017]; OR, 1.51 [95% CI: 1.12, 2.03]; p = 0.006) when using different side chain groups. Conclusion: Switching to an ICM with a different carbamoyl side chain reduced the recurrent ADRs and their severity during subsequent examinations. Clinical relevance statement: Switching to an iodinated contrast media with a different carbamoyl side chain reduced the recurrent adverse drug reactions and their severity during subsequent examinations. Key Points: Patients who experience adverse drug reactions from iodinated contrast media (ICM) may need to undergo contrast-enhanced studies again. Switching of ICM away from the ICM that caused the previous adverse drug reactions showed significantly lower recurrence rates. Compared to common side chain groups, there were significant differences in the per-exam recurrence rates and downgrade rates when using ICMs with different side chains. [ABSTRACT FROM AUTHOR]

Aims: To evaluate the long‐term safety and efficacy of enavogliflozin monotherapy (0.3 mg/day) in individuals with type 2 diabetes mellitus (T2DM). Materials and Methods: Following a 24‐week randomized, double‐blind treatment period with enavogliflozin 0.3 mg/day (n = 77) or placebo (n = 69), consenting participants received enavogliflozin 0.3 mg/day for an additional 28 weeks during an open‐label extension (OLE) period. The safety and efficacy of enavogliflozin were assessed at Week 52. Results: A total of 37 participants continued enavogliflozin (maintenance group), and 26 participants switched from placebo to enavogliflozin (switch group). No additional adverse drug reactions related to enavogliflozin were observed during the OLE period. At Week 52, glycated haemoglobin (HbA1c) and fasting plasma glucose were significantly lower than at the baseline, by 0.9% and 24.9 mg/dL, respectively, in the maintenance group (p < 0.0001 for both), and by 0.7% and 18.0 mg/dL, respectively, in the switch group (p < 0.0001 and p = 0.002). The proportions of participants reaching HbA1c 7.0% (53 mmol/mol) at Week 52 were 69.4% in the maintenance group and 65.4% in the switch group. A significant increase in urine glucose‐to‐creatinine ratio was observed at Week 52, by 84.9 g/g and 67.1 g/g in the maintenance and switch groups, respectively (p < 0.0001 for both). Body weight in both groups decreased significantly (p < 0.0001) from baseline to Week 52, by 3.5 kg and 3.8 kg in the maintenance and switch groups, respectively. Conclusions: Enavogliflozin 0.3 mg monotherapy provides long‐term glycaemic control in T2DM and is safe and well tolerated during a 52‐week treatment period. [ABSTRACT FROM AUTHOR]

Aim: To evaluate the efficacy and safety of gemigliptin and dapagliflozin dual add‐on therapy (GEMI + DAPA) to metformin in type 2 diabetes (T2D) patients who had inadequate glycaemic control on metformin alone, compared with a single add‐on of either gemigliptin (GEMI) or dapagliflozin (DAPA) to metformin. Materials and Methods: In this randomized, double‐blind, double‐dummy, active‐controlled, parallel‐group, phase 3 study, 469 T2D patients treated with a stable dose of metformin for 8 weeks or longer were randomized to receive GEMI + DAPA (n = 157) and either GEMI (n = 156) or DAPA (n = 156). The primary endpoint was change in HbA1c levels from baseline at week 24. Results: Baseline characteristics including body mass index and T2D duration were similar among groups. At week 24, the least square mean changes in HbA1c from baseline were −1.34% with GEMI + DAPA, −0.90% with GEMI (difference between GEMI + DAPA vs. GEMI −0.44% [95% confidence interval {CI}: −0.58% to −0.31%], P <.01) and −0.78% with DAPA (difference between GEMI + DAPA vs. DAPA −0.56% [95% CI: −0.69% to −0.42%], P <.01). Both upper CIs were less than 0, demonstrating the superiority of GEMI + DAPA for lowering HbA1c. The rates of responders achieving HbA1c less than 7% and less than 6.5% were greater with GEMI + DAPA (84.9%, 56.6%) than with GEMI (55.3%, 32.2%) and DAPA (49.3%, 15.3%). The incidence rate of adverse events was similar across groups, with low incidence rates of hypoglycaemia, urinary tract infection and genital infection. Conclusions: These results suggest that the addition of GEMI + DAPA to metformin as triple combination therapy was effective, safe and well‐tolerated, especially for T2D patients who experienced poor glycaemic control on metformin alone. [ABSTRACT FROM AUTHOR]

This study investigates how the uncertainty surrounding cryptocurrency affects cryptocurrency returns (CR) by employing various wavelet techniques. We concentrate on the recently published cryptocurrency uncertainty index (UCRY) and the top eight cryptocurrencies by market capitalization from December 30, 2013, to June 30, 2023. Our results showed that the UCRY index strongly predicted CR. In particular, the UCRY index has a leading position at all frequencies for all cryptocurrencies in our sample. Additionally, when the impacts of economic policy uncertainty and the volatility index are eliminated, the significant comovement of UCRY-CR remains unchanged for the short-, medium-, and long-term investment horizons. Therefore, we conclude that the UCRY-CR relationship is both persistent and pervasive. Our study contributes toward the literature on the relationships between cryptocurrencies and market uncertainties, as well as toward investors who use uncertainty indices to design investment strategies for their portfolios. [ABSTRACT FROM AUTHOR]

Allergy is an immune-mediated disorder characterized by an exaggerated response of the immune system to non-hazardous substances, resulting in allergic symptoms such as rash, itching, and runny nose. Current therapeutic interventions include antihistamines and steroids; however, they induce several side effects. Although 5,7-dihydroxy-4-methylcoumarin, a phytochemical derivative, has been demonstrated to exhibit antioxidant, anti-apoptotic, and anti-aggregatory effects, its anti-allergic properties and underlying molecular mechanisms remain elusive. Therefore, this study was conducted to investigate the anti-allergic effects of 5,7-dihydroxy-4-methylcoumarin in two experimental models: rat basophilic leukemia-2H3 cells sensitized using dinitrophenyl-specific immunoglobulin E (IgE)/human serum albumin and a passive cutaneous anaphylaxis (PCA) murine model. Our findings demonstrated that 5,7-dihydroxy-4-methylcoumarin reduced the release of histamine and β-hexosaminidase and downregulated the mRNA expression of allergic-inflammatory cytokines, such as interleukin (IL)-4, IL-13, and tumor necrosis factor-alpha, as well as the inflammatory enzyme cyclooxygenase-2. Furthermore, 5,7-dihydroxy-4-methylcoumarin reduced the phosphorylation of mitogen-activated protein kinases such as extracellular signal-regulated kinase and p38, as well as protein kinase B. In vivo, 5,7-dihydroxy-4-methylcoumarin reduced PCA reaction, as evidenced by reduced Evans blue dye extravasation in IgE-mediated local allergic responses. Collectively, these results suggest that 5,7-dihydroxy-4-methylcoumarin holds promise as a novel candidate for the development of anti-allergic drugs. [ABSTRACT FROM AUTHOR]

Obstructed hemivagina and ipsilateral renal agenesis (OHVIRA), also called Herlyn–Werner–Wunderlich syndrome, is an extremely rare Müllerian duct anomaly accompanied by Wolffian duct anomalies. A 10-year-old intact female Yorkshire Terrier weighing 3.35 kg was presented with anorexia, depression, vomiting, and abdominal pain. Radiography, ultrasonography, and computed tomography revealed uterine didelphys, obstructed hemivagina, a cystic structure around the right uterus, and right renal agenesis, leading to the diagnosis of OHVIRA syndrome. An ovariohysterectomy and decompression of the obstructed right hemivagina were performed, and the cystic structure near the right uterine horn was removed by en bloc resection, along with the right uterus and ovary. After the surgical intervention, the patient's symptoms including abdominal pain, anorexia, and depression were immediately resolved. The patient was followed up for 1 month postoperatively with ultrasonography at 2-week intervals, which revealed the progression of mild fluid retention in the right hemivagina. However, no additional urogenital findings were identified, and the patient continued to exhibit no overt clinical symptoms. This case report describes the diagnosis and surgical treatment of the first documented case of OHVIRA syndrome in an animal. Unlike in human medicine, where vaginal septectomy is performed to prevent dilatation of the obstructed hemivagina and thereby resolve clinical symptoms, performing ovariohysterectomy combined with fluid aspiration from the obstructed hemivagina showed a favorable postoperative prognosis in the dog. [ABSTRACT FROM AUTHOR]

Introduction: Heart failure (HF) is a chronic condition with an unpredictable trajectory, making effective communication between patients and healthcare providers crucial for optimizing outcomes. This study aims to investigate and compare the communication needs regarding HF trajectory and palliative care between patients and healthcare providers and to identify factors associated with the communication needs of patients with HF. Methods: A cross-sectional study design was employed, involving 100 patients with HF and 35 healthcare providers. Data were collected using structured questionnaires assessing communication needs, health literacy, self-care behavior, and social support. Statistical analyses were performed, including Spearman's rank correlation, Pearson's correlation, and multiple regression analyses. Results: Patients prioritized communication related to device-related questions, whereas healthcare providers focused more on aspects of HF in daily life. Both groups ranked end-of-life communication as the lowest priority. The communication needs of patients were positively correlated with health literacy (r = 0.27, p =.007), self-care behavior (r = 0.32, p =.001), and social support (r = 0.24, p =.016). Multiple regression analyses indicated that self-care behavior was a significant factor influencing the communication needs of patients (β = 0.27, p =.011). Conclusions: Enhanced patient-centered communication strategies are required to address the communication priority gaps between patients and healthcare providers. Improving health literacy, supporting self-care behaviors, and leveraging social support are critical in meeting patients' communication needs. Tailored communication training for healthcare providers can bridge this gap and improve overall HF management. [ABSTRACT FROM AUTHOR]

Allergic reactions occur when the immune system overreacts to generally harmless substances, leading to both acute and chronic diseases, which can be fatal. Mast cells are critical mediators of allergic reactions as they bind allergens and trigger the release of inflammatory mediators. In this study, we investigated the anti-allergic effects of the coumarin derivative 3-bromo-4-(2-hydroxyethyl)-7-methoxy-2H-chromen-2-one in rat basophilic leukemia (RBL)-2H3 cells sensitized to dinitrophenyl (DNP)-immunoglobulin E (IgE) and human serum albumin (HSA). Our results demonstrated that 3-bromo-4-(2-hydroxyethyl)-7-methoxy-2H-chromen-2-one effectively reduces the release of β-hexosaminidase and histamine, inhibiting mast cell degranulation. Additionally, 3-bromo-4-(2-hydroxyethyl)-7-methoxy-2H-chromen-2-one suppressed the production of allergy-related pro-inflammatory cytokines (IL-4, IL-13, and TNF-α) and inhibited key signaling pathways, including MAPK, AKT, and NF-κB. Furthermore, in a passive cutaneous anaphylaxis (PCA) mouse model, 3-bromo-4-(2-hydroxyethyl)-7-methoxy-2H-chromen-2-one reduced ear edema and Evans blue infiltration, further confirming its anti-allergic effects. Collectively, these findings suggest that 3-bromo-4-(2-hydroxyethyl)-7-methoxy-2H-chromen-2-one is a promising candidate for the development of anti-allergic therapeutics. [ABSTRACT FROM AUTHOR]

Highlighting the importance of micro, small, and medium-sized enterprises (MSMEs) for economic development and growth, and the appearance of their supply chain vulnerability due to the pandemic attack. Thus, the aim of this research is to propose a framework linking the supply chain management practices (SCMPs) of MSMEs to CRM objectives for the purpose of improving MSMEs' operational performance. This article conducted a systematic review of all available publications from two prominent databases (WoS and Scopus) through PRISMA guidelines to explore the relationship between variables upon which the theoretical framework will be identified. Followed by semi-structured interviews with MSMEs' eco-system stakeholders to validate the proposed framework using content analysis based on NVivo software. The findings revealed the relationship between SCMPs and CRM objectives through MSMEs' operational performance, and a set of indicators has been determined for each variable, upon which a theoretical framework has been developed. Moreover, content analysis for interviews validates the key determinants for SCMPs, operational performance, customer satisfaction, and loyalty for MSMEs, upon which a proposed framework has been developed. This research provides a framework that can be used by academics and practitioners to assess the impact of SCMPs on CRM objectives through improving MSMEs' operational performance and corrective action for MSMEs' procedures. [ABSTRACT FROM AUTHOR]

This study aimed to elucidate the effect of hatching status on in vitro fertilization (IVF) outcomes in frozen–thawed blastocyst transfer cycles. Frozen–thawed embryo transfer (FET) cycles performed at a single fertility center between 2016 and 2021 were retrospectively assessed. Analyses were restricted to 6,821 frozen–thawed blastocyst transfers in women aged 24–47 years. For optimal comparability, double embryo transfer (ET) cycles consisting of one hatching and one hatched blastocyst were excluded. The implantation and pregnancy rates were evaluated and compared between the hatching and hatched blastocyst transfer groups based on patients' age (<38 vs. ≥38 years), blastocyst grade (good vs. bad grade), and the number of transferred embryos (single ET vs. double ET). Hatched blastocyst transfer was associated with higher implantation and clinical pregnancy rates in the single ET group (15.7% and 15.6%, respectively; p<0.001). The transfer of two hatched blastocysts had higher implantation and clinical pregnancy rates compared to the transfer of two hatching blastocysts (19.5% and 20.4%, respectively; p<0.001) in the double ET group. In the hatched blastocyst transfer group, the clinical pregnancy and implantation rates were higher, regardless of each woman's age and embryo quality. The IVF treatment outcomes were improved when the blastocysts were hatched during FET cycles. Hence, hatched blastocyst transfer in FET cycles could be considered a superior method in IVF practice. [ABSTRACT FROM AUTHOR]

Purpose: The Korean Cancer Study Group (KCSG) is a nationwide cancer clinical trial group dedicated to advancing investigator-initiated trials (IITs) by conducting and supporting clinical trials. This study aims to review IITs conducted by KCSG and quantitatively evaluate the survival and financial benefits of IITs for patients. Materials and Methods: We reviewed IITs conducted by KCSG from 1998 to 2023, analyzing progression-free survival (PFS) and overall survival (OS) gains for participants. PFS and OS benefits were calculated as the difference in median survival times between the intervention and control groups, multiplied by the number of patients in the intervention group. Financial benefits were assessed based on the cost of investigational products provided. Results: From 1998 to 2023, KCSG conducted 310 IITs, with 133 completed and published. Of these, 21 were included in the survival analysis. The analysis revealed that 1,951 patients in the intervention groups gained a total of 2,558.4 months (213.2 years) of PFS and 2,501.6 months (208.5 years) of OS, with median gains of 1.31 months in PFS and 1.58 months in OS per patient. When analyzing only statistically significant results, PFS and OS gain per patients was 1.69 months and 3.02 months, respectively. Investigational drug cost analysis from six available IITs indicated that investigational products provided to 252 patients were valued at 10,400,077,294 won (approximately 8,046,481 US dollars), averaging about 41,270,148 won (approximately 31,930 US dollars) per patient. Conclusion: Our findings, based on analysis of published research, suggest that IITs conducted by KCSG led to survival benefits for participants and, in some studies, may have provided financial benefits by providing investment drugs. [ABSTRACT FROM AUTHOR]

The common data model (CDM) has found widespread application in healthcare studies, but its utilization in cancer research has been limited. This article describes the development and implementation strategy for Cancer Clinical Library Databases (CCLDs), which are standardized cancer-specific databases established under the Korea-Clinical Data Utilization Network for Research Excellence (K-CURE) project by the Korean Ministry of Health and Welfare. Fifteen leading hospitals and fourteen academic associations in Korea are engaged in constructing CCLDs for 10 primary cancer types. For each cancer type-specific CCLD, cancer data experts determine key clinical data items essential for cancer research, standardize these items across cancer types, and create a standardized schema. Comprehensive clinical records covering diagnosis, treatment, and outcomes, with annual updates, are collected for each cancer patient in the target population, and quality control is based on six-sigma standards. To protect patient privacy, CCLDs follow stringent data security guidelines by pseudonymizing personal identification information and operating within a closed analysis environment. Researchers can apply for access to CCLD data through the K-CURE portal, which is subject to Institutional Review Board and Data Review Board approval. The CCLD is considered a pioneering standardized cancer-specific database, significantly representing Korea's cancer data. It is expected to overcome limitations of previous CDMs and provide a valuable resource for multicenter cancer research in Korea. [ABSTRACT FROM AUTHOR]

Samples of Sn1-xCoxS (x = 0, 0.025, 0.075, 0.1) were synthesized via the thermal evaporation approach under N2 gas. The phase characterization of the synthesized samples was conducted employing HighScore plus software. The quantitative assessment of the resulting phases and their structure and microstructure parameters were determined using Rietveld refinement methodology. The SEM images validated the formation of two-dimensional sheets firmly stacked in building blocks, and the corresponding EDS analysis substantiated the incorporation of Co ions in the samples. FTIR and Raman spectroscopic techniques were utilized to corroborate the established phases, chemical composition and the inclusion of Co within the samples. The impact of doping on the absorption and reflectance features of Sn1-xCoxS samples was investigated. The substantial absorption that forms a plateau in the visible range suggests that all samples possess the capability for effective utilization of visible light. In the UV and visible regions, the sample with x = 0.025 revealed the highest absorbance, while in the IR region, the sample with x = 0.1 displayed the peak absorbance value. The lowest optical band gap energy values (1.15 and 3.38 eV) were obtained at x = 0.075. The influence of nano Sn1-xCoxS samples on the rate of hydrogen generation through the utilization of sodium borohydride (NaBH4) is explored. Sample containing 10% Co exhibits the highest generation rate at 59382 mL min−1g−1. Highlights: Sn1-xCoxS samples have two phases (SnS and SnO2). The layer structure is confirmed by the SEM imaging. The Raman spectra confirmed the nanocrystalline nature of the samples. The absorption spectrum was increased upon Co-doping with x = 0.025, followed by a decrease with higher doping levels. Nano Sn0.9Co0.1S sample demonstrates the highest rate of hydrogen production. [ABSTRACT FROM AUTHOR]

A weight-bearing lateral radiograph (WBLR) of the foot is a gold standard for diagnosing adult-acquired flatfoot deformity. However, it is difficult to measure the major axis of bones in WBLR without using auxiliary lines. Herein, we develop semantic segmentation with a deep learning model (DLm) on the WBLR of the foot for enhanced diagnosis of pes planus and pes cavus. We used 300 consecutive WBLRs from young Korean males. The semantic segmentation model was developed based on U2-Net. An expert orthopedic surgeon manually labeled ground truths. We used 200 radiographs for training, 100 for internal validation, and two external datasets for external validation. The model was trained using a hybrid loss function, combining Dice Loss and boundary-based loss, to enhance both overall segmentation accuracy and precise delineation of boundary regions between pes planus and pes cavus. Angle measurement errors with minimum moment of inertia (MMI) and ellipsoidal fitting (EF) based on the segmentation results were evaluated. The DLm exhibited better results than human observers. For internal validation, the absolute angle errors of the DLm using MMI and EF were 0.92 ± 1.32° and 1.34 ± 2.07°, respectively. In external validation, these errors were 1.17 ± 1.60° and 1.60 ± 2.42° for AMC's dataset, and 1.23 ± 1.39° and 1.68 ± 1.98° for the LERA dataset, respectively. The DLm showed higher overall diagnostic accuracy than human observers in identifying flatfoot angles, regardless of the measurement methods. The absolute angle errors and diagnostic accuracy of the developed DLm are superior to those of the three human observers. Furthermore, when comparing the angle measurement methods within the DLm, the MMI method proves to be more accurate than EF. Finally, the proposed deep learning model, particularly with the implementation of the U2-Net demonstrates enhanced boundary segmentation and achieves sufficient external validation results, affirming its applicability in the real clinical setting. [ABSTRACT FROM AUTHOR]

The characteristics of proteins extracted from two kinds of edible insects (Gryllus Bimaculatus and Tenebrio Molitor, for G.B and T.M, respectively) were compared after roasting at 180 °C for 15 min and 200 °C for 10 min, respectively. The amino acid content decreased by roasting, and the degree of decrease varied depending on the type of edible insect and roasting temperature. Antioxidant activity increased by 5.2–11.3% following roasting, with no significant differences by roasting temperature. The results of Infrared (IR) spectrum and gas chromatography (GC) analysis revealed that compounds contributing to a strong waxy scent and sour taste decreased, whereas those associated with aroma and floral scent increased as a result of roasting. In conclusion, roasting led to an enhancement in the olfactory characteristics of proteins extracted from edible insects, and roasting at 180 °C for 20 min for G.B and 200 °C for 15 min for T.M could be considered optimal. [ABSTRACT FROM AUTHOR]

In breast-conserving surgery (BCS), clear resection margins are crucial to prevent recurrence. Accurate imaging is vital for precise BCS, with MRI being the most accurate. However, MRI has limitations in identifying the exact extent of breast cancer in patients who have undergone neoadjuvant chemotherapy (NACT). A 3D-Printed Breast Surgical Guide (3DP-BSG) can address this issue by effectively pinpointing cancer extent in NACT patients, thus enhancing surgical accuracy. This retrospective single-institution cohort study focused on female patients diagnosed with invasive breast cancer who underwent NACT. Between November 2015 and October 2021, patients received BCS with the aid of a 3DP-BSG. Personalized 3DP-BSG targeted tumors by tracking changes in breast and tumor anatomy on MRI before and after NACT. 203 patients with invasive breast cancer were enrolled in the study. According to exclusion criteria, 197 patients were analyzed. The median follow-up period was 35.3 months (range: 2.2–96.8 months). 3 patients (1.5%) had positive resection margins. During the follow-up period, 17 patients (8.6%) experienced recurrence, with one patient (0.5%) confirmed local recurrences. The application of MRI-based 3DP-BSG is effective in achieving low positive margins and local recurrence in patients undergoing BCS after NACT, offering a promising approach for improving surgical outcomes. [ABSTRACT FROM AUTHOR]

Objective: The present study aimed to evaluate the accuracy of previous equations for estimating gross energy (GE) in feed ingredients and to develop the novel equations. Methods: A total of 2,279 ingredient samples consisted of barley (n = 58), corn (n = 319), corn distillers dried grains with solubles (n = 13), corn gluten feed (n = 583), copra expellers (n = 156), copra meal (n = 234), cottonseed meal (n = 12), palm kernel expellers (n = 504), rapeseed meal (n = 114), soybean meal (n = 138), wheat (n = 70), and wheat bran (n = 78) were analyzed for dry matter (DM), crude protein (CP), ether extract (EE), crude fiber, ash, and GE. The 2,279 ingredient samples were used for evaluating the previous equations and developing novel equations. Using data from 62 ingredients in the swine NRC publication in 2012, the old equations and the novel equations were evaluated. Results: Based on the evaluation using 2,279 samples, the equation developed by Ewan in 1989 underestimates GE by 218 kcal/kg DM (standard error = 4 and p<0.001) on average and underestimates more for lowGE ingredients (linear bias = -0.121; standard error = 0.025 and p<0.001). The equation reported by Sauvant, Perez, and Tran in 2004 also underestimates GE by 135 kcal/kg DM (standard error = 4 and p<0.001) on average. Novel equations for estimating GE concentration (kcal/kg DM) in feeds were developed: GE = 4,299+7xCP +53xEE, with R2 = 0.342 and p<0.001; GE = 4,341+11xCP+54xEE--24xash, with R² = 0.372 and p<0.001, where all independent variables are in % DM. In the validation using 62 feed ingredients in the NRC publication, the equations developed in the present study were accurate whereas the previous equations were not. Conclusion: The novel equations developed in the present study fairly accurately estimate gross energy concentrations in concentrate feeds. [ABSTRACT FROM AUTHOR]

Purpose: To evaluate the feasibility of robot-assisted ureteral reconstruction as a minimally invasive alternative to open surgery for managing ureteric complications in transplanted kidneys. Materials and Methods: From January 2020 to December 2023, robot-assisted ureteral reconstruction was performed on fifteen kidney transplant patients with vesicoureteral reflux (VUR) or ureteral stricture who had previously failed endoscopic treatments. Results: Twelve females and three males, with a mean age of 48.6±6.6 years, were included in the study. Nine patients (60.0%) underwent surgery due to VUR (grade III or higher) of the transplanted kidney, and six patients (40.0%) had transplanted ureteral strictures. Postoperative voiding cystourethrogram (VCUG) was performed at 3.2±1.6 months. Seven patients (77.8%) became VUR-free, while two patients (22.2%) had VUR regression from grade IV to I. All six patients who underwent reconstruction due to anastomosis site stricture became stenosis-free without the need for an indwelling ureteral catheter. In cases where the ureter was too short for reimplantation, a Boari flap or end-to-end anastomosis with the native ureter was performed. The mean hospital stay was 5.9±4.5 days. The urethral catheter was removed after 15.1±5.4 days, and the ureteral catheter was removed after 4.9±1.5 weeks. The mean follow-up period was 23.9±6.8 months, with no additional interventions required after surgery. No complications above Clavien-Dindo grade I were recorded. Conclusions: Robotic ureteral reconstruction is technically feasible and offers an effective, minimally invasive treatment for ureteric complications in kidney transplant patients, serving as an alternative to open surgery. [ABSTRACT FROM AUTHOR]

Introduction: Insulin resistance is a key factor in metabolic syndrome. Identifying indicators of insulin resistance through endoscopic findings could be valuable in assessing a patient's systemic metabolic status. Thus, we conducted a retrospective study to investigate the association between endoscopic findings and insulin resistance. Methods: We reviewed 1,070 patients who underwent screening endoscopy with a rapid urease test at Bundang Jesaeng General Hospital from February 2023 to June 2023. Patients were classified based on insulin resistance using the Homeostatic Model Assessment for Insulin Resistance (HOMAIR). Propensity score matching was performed to adjust for baseline characteristics. Results: After matching, 420 patients without insulin resistance and 210 with insulin resistance were selected. Endoscopic findings showed a significant association between insulin resistance and the presence of erosive esophagitis (p = 0.040). Furthermore, the severity of erosive esophagitis was positively correlated with the degree of insulin resistance, as indicated by an increased HOMAIR. Multivariate analysis showed that erosive esophagitis significantly increased the risk of insulin resistance, while the presence of regular arrangement of collecting venules (RAC) was associated with a lower risk of insulin resistance. Conclusion: Insulin resistance is significantly associated with specific endoscopic findings, particularly erosive esophagitis and the absence of RAC, suggesting associations that may be useful in guiding further research into endoscopic indicators of metabolic complications. Moreover, we observed a proportional relationship between the severity of erosive esophagitis and the degree of insulin resistance. Further research is needed to explore these associations. [ABSTRACT FROM AUTHOR]

Objectives: To investigate whether ultrafast sequence improves the diagnostic performance of conventional dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) in differentiating additional suspicious lesions (ASLs) on preoperative breast MRI. Materials and methods: A retrospective database search identified 668 consecutive patients who underwent preoperative breast DCE-MRI with ultrafast sequence between June 2020 and July 2021. Among these, 107 ASLs from 98 patients with breast cancer (36 multifocal, 42 multicentric, and 29 contralateral) were identified. Clinical, pathological, conventional MRI findings, and ultrafast sequence-derived parameters were collected. A prediction model that adds ultrafast sequence-derived parameters to clinical, pathological, and conventional MRI findings was developed and validated internally. Decision curve analysis and net reclassification index statistics were performed. A nomogram was constructed. Results: The ultrafast model adding time to peak enhancement, time to enhancement, and maximum slope showed a significantly increased area under the receiver operating characteristic curve compared with the conventional model which includes age, human epidermal growth factor receptor 2 expression of index cancer, size of index cancer, lesion type of index cancer, location of ASL, and size of ASL (0.92 vs. 0.82; p = 0.002). The decision curve analysis showed that the ultrafast model had a higher overall net benefit than the conventional model. The net reclassification index of ultrafast model was 23.3% (p = 0.001). Conclusion: A combination of ultrafast sequence-derived parameters with clinical, pathological, and conventional MRI findings can aid in the differentiation of ASL on preoperative breast MRI. Clinical relevance statement: Our prediction model and nomogram that was based on ultrafast sequence-derived parameters could help radiologists differentiate ASLs on preoperative breast MRI. Key Points: Ultrafast MRI can diminish background parenchymal enhancement and possibly improve diagnostic accuracy for additional suspicious lesions (ASLs). Location of ASL, larger size of ASL, and higher maximum slope were associated with malignant ASL. The ultrafast model and nomogram can help preoperatively differentiate additional malignancies. [ABSTRACT FROM AUTHOR]

Objectives: We assessed the value of the diffusion-weighted image (DWI) for predicting intrahepatic biliary complications (IHBC) after ABO-incompatible liver transplantation (ABOi-LT), potentially leading to refractory cholangitis. Materials and methods: In this retrospective study at a single center, 56 patients who underwent ABOi-LT from March 2021 to January 2023 were analyzed. All received magnetic resonance cholangiopancreatography (MRCP) and DWI during the postoperative hospitalization. MRCP findings, including bile duct DWI hyperintensity, were assessed. Participants suspected of having a biliary infection or obstructive jaundice underwent endoscopic retrograde cholangiopancreatography (ERCP) or percutaneous transhepatic biliary drainage (PTBD) during the follow-up. Non-anastomotic biliary strictures on cholangiography were classified as IHBC, as either perihilar or diffuse form. DWI hyperintensity was compared between groups with and without IHBC. Logistic regression analysis was performed to identify independent risk factors for IHBC. Results: Of the 55 participants (median age 55 years, 39 males), IHBC was diagnosed in eight patients over a median follow-up of 15.9 months (range 5.6–31.1). Bile duct DWI hyperintensity was observed in 18 patients. Those with DWI hyperintensity exhibited a higher IHBC incidence (6/18, 33.3% vs. 2/36, 5.6%; p = 0.01), and more frequently developed the diffuse type IHBC (4/18, 22.2% vs. 1/36, 2.8%; p = 0.04). Regression analysis indicated that bile duct DWI hyperintensity is an independent risk factor for IHBC (odds ratio (OR) 10.1; 95% confidence interval (CI) 1.4, 71.2; p = 0.02) and its diffuse form (OR 15.3; 95% CI 1.2, 187.8; p = 0.03). Conclusion: Postoperative DWI hyperintensity of bile ducts can serve as a biomarker predicting IHBC after ABOi-LT. Clinical relevance statement: Postoperative diffusion-weighted image hyperintensity of the bile duct can be used as a biomarker to predict intrahepatic biliary complications and aid in identifying candidates who may benefit from additional management for antibody-mediated rejection. Key Points: Intrahepatic biliary complications following ABO-incompatible liver transplantation can cause biliary stricture and biloma formation. Bile duct hyperintensity on early postoperative diffusion-weighted imaging was associated with increased intrahepatic biliary complication risk. This marker is an additional method for identifying individuals who require intensive management to prevent complications. [ABSTRACT FROM AUTHOR]

This study aimed to investigate alterations in a multilayer network combining structural and functional layers in patients with end-stage kidney disease (ESKD) compared with healthy controls. In all, 38 ESKD patients and 43 healthy participants were prospectively enrolled. They exhibited normal brain magnetic resonance imaging (MRI) without any structural lesions. All participants, both ESRD patients and healthy controls, underwent T1-weighted imaging, diffusion tensor imaging (DTI), and resting-state functional MRI (rs-fMRI) using the same three-tesla MRI scanner. A structural connectivity matrix was generated using the DTI and DSI programs, and a functional connectivity matrix was created using the rs-fMRI and SPM programs in the CONN toolbox. Multilayer network analysis was conducted based on structural and functional connectivity matrices using BRAPH. Significant differences were observed at the global level in the multilayer network between patients with ESKD and healthy controls. The weighted multiplex participation was lower in patients with ESKD than in healthy controls (0.6454 vs. 0.7212, adjusted p = 0.049). However, other multilayer network measures did not differ. The weighted multiplex participation in the right subcentral gyrus, right opercular part of the inferior frontal gyrus, right occipitotemporal medial lingual gyrus, and right postcentral gyrus in patients with ESKD was lower than that in the corresponding regions in healthy controls (0.6704 vs. 0.8562, 0.8593 vs. 0.9388, 0.7778 vs. 0.8849, and 0.6825 vs. 0.8112; adjusted p < 0.05, respectively).This study demonstrated that the multilayer network combining structural and functional layers in patients with ESKD was different from that in healthy controls. The specific differences in weighted multiplex participation suggest potential disruptions in the integrated communication between different brain regions in these patients. [ABSTRACT FROM AUTHOR]

Background: Intraoperative hypotension is very common during surgery and is linked to major organ dysfunction and mortality. Current perioperative blood pressure management is largely based on universal blood pressure thresholds ranging from a mean arterial pressure of 60–70 mmHg. However, the effectiveness of this conventional management remains unproven in prospective randomized trials. Therefore, we will conduct this study to test if individualized perioperative blood pressure management decreases the incidence of postoperative major adverse outcomes. Methods: This multicenter, randomized controlled superiority trial will enroll 1896 high-risk patients undergoing major noncardiac surgery from five tertiary university hospitals in South Korea. In the control group, mean arterial pressure will be maintained at ≥ 65 mmHg and systolic blood pressure ≥ 90 mmHg during surgery. In the intervention group, mean arterial pressure and systolic blood pressure will be maintained at no less than 20% of their baseline values. The baseline values are calculated as the average of all values measured from the day before surgery until the morning of surgery. These targets will be maintained until the patient is discharged from the post-anesthesia care unit or, for those who are transferred to the intensive care unit after surgery, until the end of the surgery. No specific restrictions, except for these blood pressure targets, will be applied to perioperative management. The primary composite outcome consists of all-cause death, stroke, myocardial infarction, new or worsening congestive heart failure, unplanned coronary revascularization, and acute kidney injury within 7 days after noncardiac surgery or until hospital discharge, whichever occurs first. Discussion: This study will reveal if individualized perioperative blood pressure management decreases the risk of major adverse outcomes in patients at high-risk undergoing noncardiac surgery. Trial registration: ClinicalTrials.gov NCT06225453. Registered on January 26, 2024. [ABSTRACT FROM AUTHOR]

Background: The long-term relationship between body composition and lung function has not yet been fully demonstrated. We investigated the longitudinal association between muscle-to-fat (MF) ratio and lung function among middle-aged general population. Methods: Participants were enrolled from a community-based prospective cohort between 2005 and 2014. Lung function parameters (forced vital capacity [FVC], forced expiratory volume in 1 s [FEV1], and FEV1/FVC) and the MF ratio (total body muscle mass [kg]/fat mass [kg]) were assessed biannually via spirometry and bioelectrical impedance analysis, respectively. Results: We followed up 4,712 participants (age 53.9 ± 7.9 years, men 45.8%) for 8 years. With an increase in MF ratio of 1, in men, the FVC increased by 43.9 mL, FEV1 by 37.6 mL, and FEV1/FVC by 0.320%, while in non-smoking women, the FVC increased by 55.8 mL, FEV1 by 44.3 mL, and FEV1/FVC by 0.265% (all P < 0.001). The MF ratio-decreased group showed further annual deterioration in lung function than the MF ratio-increased group (men: FVC − 44.1 mL vs. -28.4 mL, FEV1 -55.8 mL vs. -39.7 mL, FEV1/FVC − 0.53% vs. -0.42%; non-smoking women: FVC − 34.2 mL vs. -30.3 mL, FEV1 -38.0 mL vs. -35.2 mL; all P < 0.001, except FEV1 in non-smoking women; P = 0.005). The odds ratio for the incidence of airflow obstruction according to the MF ratio was 0.77 (95% CI, 0.68–0.87) in men and 0.85 (95% CI, 0.74–0.97) in non-smoking women. Conclusions: Long-term changes in the MF ratio are related to lung function deterioration and incidence of airflow obstruction in middle-aged general population. [ABSTRACT FROM AUTHOR]

Sodium–glucose cotransporter 2 (SGLT-2) inhibitors are the only medications that improve clinical outcomes regardless of baseline left ventricular ejection fraction. Despite the recognized effectiveness of SGLT-2 inhibitors, there remains a paucity of research on the discontinuation of these medications. The objective of this study is to analyze the rate of discontinuation of SGLT-2 inhibitors, to evaluate the impact of discontinuation on the clinical outcome, and to identify the factors associated with discontinuation. From 2015 to 2021, 775 heart failure patients prescribed an SGLT-2 inhibitor were retrospectively collated at Samsung Medical Center, Seoul, Republic of Korea. The SGLT-2 inhibitor discontinuation rate and the effect of SGLT-2 inhibitor discontinuation on clinical outcome were analyzed using the Kaplan–Meier survival curve. Factors related to discontinuation were analyzed through Cox regression and competing risk survival analysis. The discontinuation rate of SGLT-2 inhibitors was 7.5% at 1 year and 20% at 5 years. General weakness, over-diuresis and volume depletion, renal dysfunction progression, and urinary tract infections are the major reasons for discontinuing SGLT-2 inhibitors in general medical practice. The group that stopped using SGLT-2 inhibitors had a higher rate of heart failure hospitalization than the control group (adjusted HR 2.600, 95% CI [1.233–5.481], P = 0.012). In multivariable Cox regression analysis, the factors associated with total SGLT-2 inhibitor discontinuation were women (HR 2.478, 95% CI [1.553–3.953], P < 0.001) and lower estimated glomerular filtration rate (eGFR) (HR 0.884 per 10 ml/min/1.73 m2, 95% CI [0.789–0.991], P = 0.034). Patients who discontinued SGLT-2 inhibitors experienced an increased risk of heart failure hospitalization, and the rate of discontinuation was higher in women and those with lower eGFR. [ABSTRACT FROM AUTHOR]

Background: Intraoperative fluid balance significantly affects patients' outcomes. Goal-directed fluid therapy (GDFT) has reduced the incidence of major postoperative complications by 20% for 30 days after open abdominal surgery. Little is known about GDFT during laparoscopic surgery. Aim: We investigated whether GDFT affects the postoperative outcomes in laparoscopic hepatobiliary or pancreatic surgery compared with conventional fluid management. Methods: This interventional comparative study with a historical control group was performed in the tertiary care center. Patients were allocated to one of two groups. The GDFT (n = 147) was recruited prospectively and the conventional group (n = 228) retrospectively. In the GDFT group, fluid management was guided by the stroke volume (SV) and cardiac index (CI), whereas it had been performed based on vital signs in the conventional group. Propensity score (PS) matching was performed to reduce selection bias (n = 147 in each group). Postoperative complications were evaluated as primary outcome measures. Results: The amount of crystalloid used during surgery was less in the GDFT group than in the conventional group (5.1 ± 1.1 vs 6.3 ± 1.8 ml/kg/h, respectively; P <0.001), whereas the amount of colloid was comparable between the two groups. The overall proportion of patients who experienced any adverse events was 57.8% in the GDFT group and 70.1% in the conventional group (P = 0.038), of which the occurrence of pleural effusion was significantly lower in the GDFT group than in the conventional group (9.5% vs. 19.7%; P = 0.024). During the postoperative period, the proportion of patients admitted to the intensive care unit (ICU) was lower in the GDFT group than that in the conventional group after PS matching (4.1% vs 10.2%; P = 0.049). Conclusions: GDFT based on SV and CI resulted in a lower net fluid balance than conventional fluid therapy. The overall complication rate in laparoscopic hepatobiliary or pancreatic surgery decreased after GDFT, and the frequency of pleural effusion was the most affected. [ABSTRACT FROM AUTHOR]

Striatal cholinergic interneurons (ChIs) provide acetylcholine tone to the striatum and govern motor functions. Nicotine withdrawal elicits physical symptoms that dysregulate motor behavior. Here, the role of striatal ChIs in physical nicotine withdrawal is investigated. Mice under RNAi‐dependent genetic inhibition of striatal ChIs (ChIGI) by suppressing the sodium channel subunit NaV1.1, lessening action potential generation and activity‐dependent acetylcholine release is first generated. ChIGI markedly reduced the somatic signs of nicotine withdrawal without affecting other nicotine‐dependent or striatum‐associated behaviors. Multielectrode array (MEA) recording revealed that ChIGI reversed ex vivo nicotine‐induced alterations in the number of neural population spikes in the dorsal striatum. Notably, the drug repurposing strategy revealed that a clinically‐approved antimuscarinic drug, procyclidine, fully mimicked the therapeutic electrophysiological effects of ChIGI. Furthermore, both ChIGI and procyclidine prevented the nicotine withdrawal‐induced reduction in striatal dopamine release in vivo. Lastly, therapeutic intervention with procyclidine dose‐dependently diminished the physical signs of nicotine withdrawal. The data demonstrated that the striatal ChIs are a critical substrate of physical nicotine withdrawal and that muscarinic antagonism holds therapeutic potential against nicotine withdrawal. [ABSTRACT FROM AUTHOR]

Background: Paclitaxel resistance and recurrence are major obstacles in ovarian cancer, which is the leading cause of death among gynecologic cancers. During cancer cell progression, cyclin-dependent kinase 1 (CDK1) drives cells through the G2 phase and into mitosis. In this study, we demonstrated that CDK1 played a crucial role in switching paclitaxel-resistant ovarian cancer cells from mitotic arrest to apoptosis following combined treatment with paclitaxel and duloxetine, an antidepressant known as a serotonin-norepinephrine reuptake inhibitor (SNRI). Methods: Cell viability was assessed by MTT assay. Apoptotic cell death and mitochondrial membrane potential (MMP) were detected by flow cytometry. Protein expression levels were explored using western blotting. Mitochondrial and cytosolic fractionation were performed to determine the mitochondrial localization of proteins. Immunofluorescence was used to detect protein expression levels and localization. Results: Combined treatment with paclitaxel and duloxetine induced apoptotic cell death in paclitaxel-resistant ovarian cancer cells. We suggested that combined treatment of these drugs induced CDK1 activation and increased mitochondrial localization of activated CDK1, which caused phosphorylation of the antiapoptotic Bcl-2 and Bcl-xL proteins. Selective CDK1 inhibitors blocked Bcl-2 and Bcl-xL phosphorylation induced by paclitaxel and duloxetine, and strongly suppressed apoptotic cell death. Furthermore, we demonstrated that S6K is a potential upstream mediator of the proapoptotic activation of CDK1. Conclusion: Taken together, switching CDK1 to a proapoptotic role through the combination of paclitaxel and duloxetine could overcome paclitaxel resistance in ovarian cancer cells, providing promising therapeutic strategies for treating paclitaxel-resistant ovarian cancer. [ABSTRACT FROM AUTHOR]

Background: Hallux valgus is a prevalent foot deformity conventionally treated with open surgical techniques, which carry risk of complications due to extensive soft tissue dissection. Minimally invasive surgeries (MISs) as alternatives offer comparable outcomes, reduced pain, and faster recovery; however, their challenges include the risk of shortening of the first metatarsal. This study aimed to assess the efficacy of our modified MIS hallux valgus correction technique and investigate the factors that affect first metatarsal shortening. Methods: Twenty-nine feet treated with modified MIS hallux valgus surgery between 2017 and 2022 were included with an average follow-up of 29 months. Clinical outcomes were evaluated with the Manchester–Oxford Foot Questionnaire (MOXFQ), Foot Function Index (FFI), and visual analog scale for pain. Radiographic evaluations included the intermetatarsal angle (IMA), hallux valgus angle (HVA), distal metatarsal articular angle (DMAA), first metatarsal length, and sesamoid grade. Results: Functional and radiographic outcomes were significantly improved (p < 0.0001 and p < 0.001, respectively). Significant correlations between patient satisfaction and the MOXFQ, FFI, and VAS scores were found, with no significant correlations between patient satisfaction and radiographic outcomes. Non-purchasing of the lateral cortex of the proximal osteotomy site was identified to increase risk of first metatarsal shortening (odds ratio [OR] = 22.09, p = 0.0064). Conclusions: Our modified MIS for hallux valgus correction showed favorable radiographic and functional outcomes. Proximal lateral cortex purchasing should be targeted to reduce postoperative shortening of the first metatarsal. [ABSTRACT FROM AUTHOR]

Objective: Osteoporosis is prevalent in patients with chronic kidney disease (CKD), with risk increasing as CKD progresses, subsequently elevating fracture risk. While previous studies have shown a link between low skeletal muscle mass and osteoporosis in the general population, there is limited research exploring this relationship in patients with advanced CKD (stages 3-5D). This study aimed to evaluate whether skeletal muscle area (SMA), as measured by abdominal CT, is correlated with bone mineral density (BMD) in advanced CKD patients beginning hemodialysis. Methods: This single-center, retrospective cohort study included patients who started maintenance hemodialysis at Daejeon St. Mary's Hospital from January 2018 to September 2021. Patients who underwent abdominal CT and BMD assessments within three months of dialysis initiation were enrolled, resulting in a sample of 87 individuals. Baseline characteristics were analyzed, with patients stratified by sex and SMA quartiles. Pearson's correlation and multivariate regression analyses were conducted to the relationship between SMA and BMD T-scores. Results: The study cohort had an average age of 65.4 years, with 52.9% of participants being male. Male patients exhibited significantly higher SMA and BMD T-scores in both the lumbar spine and femur compared to female patients. SMA showed the strongest positive correlation with BMD at both sites (lumbar spine, r = 0.424; femur, r = 0.514; p < 0.001). Multivariate analysis identified SMA as an independent positive predictor of BMD, while alkaline phosphatase (ALP) was independently associated with lower femur BMD. In the SMA-based subgroup analysis, patients with lower SMA had significantly lower BMD T-scores and a higher risk of osteoporosis. Logistic regression indicated that patients in the lowest SMA quartile had substantially increased odds of osteoporosis compared to those in the highest quartile, with an adjusted odds ratio of 30.59 (p = 0.008). Conclusions: Lower skeletal muscle mass is significantly associated with lower bone density and a higher risk of osteoporosis in advanced CKD patients initiating hemodialysis. SMA, as measured by abdominal CT, may serve as a useful marker for identifying patients at elevated osteoporosis risk in this population. [ABSTRACT FROM AUTHOR]

Simple Summary: Siberian musk deer (Moschus moschiefrus) is a vulnerable species on the IUCN Red list, facing threats from illegal poaching and habitat loss. Understanding its dietary habits and ecological needs is essential for supporting conservation efforts. This study is the first to use Next-Generation Sequencing to analyze the diet of M. moschiferus. Our results revealed that the species primarily fed on woody plants in April, with Morus and Quercus being the most consumed genera. Almost half of the identified genera had not previously been reported as part of the M. moschiferus diet using conventional methods, highlighting the need for DNA metabarcoding to more accurately compare the dietary composition of M. moschiferus across different regions. This research provides valuable insights into the types of plants M. moschiferus may consume during the spring season. Understanding the dietary composition of the Siberian musk deer (Moschus moschiferus) is critical for informing conservation efforts, particularly given the species' vulnerable status in the Republic of Korea and its limited ecological data. Previous dietary studies have relied on conventional methods with limitations in taxonomic precision, hindering comprehensive insights into their feeding ecology. To address this gap, we used Next-Generation Sequencing to analyze 16 fecal samples collected in April from Gangwon Province, the habitat of M. moschiferus. Our results revealed 213 unique plant species, with Morus, Quercus, and Prunus accounting for the majority of the diet. Notably, nearly half of the identified genera, including Morus, Actinidia, and Viscum, were reported for the first time as dietary plants of M. moschiferus. This study confirms that M. moschiferus is a concentrate feeder that primarily relies on woody plants (98.8%) and may exhibit tree-climbing behavior to access parasitic shrubs like Viscum. These findings provide a foundation for future dietary analysis research and serve as valuable baseline data for the long-term conservation of M. moschiferus. [ABSTRACT FROM AUTHOR]

For advancing next‐generation optoelectronics, a versatile strategy for fabricating π‐conjugated polymer (π‐CP)/chiral‐small molecule (SM) hybrid films through co‐crystallization‐mediated chirality transfer is reported. The transfer of optical chirality from 1,1′‐binaphthyl–2,2′‐diamine (BN), a representative chiral inducer SM, to thin films of various achiral π‐CPs, including non‐fluorene π‐CPs, is achieved by simply blending the π‐CPs with BN using aromatic organic solvents. The resulting π‐CP/chiral‐SM hybrid films exhibit chiroptical responses at the main electronic absorption bands of various π‐CPs. Studies of the morphology, crystalline structure, and phase‐separation structure of a representative hybrid system of poly(3‐hexylthiophene) (P3HT) and BN reveal that these hybrid films exhibit a characteristic lamellar structure where the π‐CPs co‐crystallize with chiral BN molecules, facilitated by aromatic solvent‐assisted intermolecular π–π interactions. In‐depth photophysical analysis suggests that BN molecules co‐crystallized in the P3HT lamellar structure induce asymmetrically misaligned transition dipoles along the P3HT conjugated backbone, transferring optical chirality from BN to P3HT under circularly polarized light illumination. As a proof‐of‐concept, chiroptical photodiodes based on π‐CP/chiral‐SM hybrid films and printed micropatterns, exhibiting a distinguishable photocurrent response depending on the direction of circularly polarized light are successfully demonstrated. [ABSTRACT FROM AUTHOR]

The fruit of Hovenia dulcis Thunb. (HD) is renowned for its medicinal properties and is rich in bioactive compounds, traditionally used in East Asian medicine as a natural antidote for alcohol intoxication. A randomized, double-blind, crossover, placebo (PLA)-controlled clinical trial was conducted to compare the effects of beverages containing 0.475% HD (HDB), HD combined with 0.1% Pueraria lobata extract (HDPB), and HD combined with 0.02% glutathione yeast extract (HDGB) with the PLA on the symptoms of a hangover. Subjects (n = 30) were randomized into six test groups consuming three beverages, including the PLA. After ingestion, blood alcohol and blood acetaldehyde concentrations were measured at 0, 0.25, 0.5, 1, 2, 4, 6, and 15 h post-alcohol consumption. No significant differences in hematology tests and vital signs were observed amongst the treatment groups; however, at 0.5 and 6 h, the blood alcohol concentrations of the HDB and HDPB groups were significantly lower compared to the PLA group (p < 0.05). Additionally, the blood acetaldehyde concentrations in the HDPB group showed significantly lower values than the PLA after 6 h (p < 0.05). These findings suggest that HD may aid in alcohol detoxification and limit acetaldehyde accumulation. This indicates the potential for HD as a functional food ingredient for alleviating hangover symptoms. [ABSTRACT FROM AUTHOR]

Alcohol consumption is associated with both short- and long-term adverse effects, including hangover symptoms. The objective of this study was to examine the potential benefits of traditional beverages containing a combination of Hovenia dulcis extract (HD) with either Pueraria lobata extract (HDPB) or glutathione yeast extract (HDGB) in abbreviating alcohol intoxication and mitigating hangover symptoms. A total of 25 participants between the ages of 19 and 40 who had previously experienced a hangover were evaluated in a randomized, double-blind, crossover, placebo (PLA)-controlled clinical trial. Results showed that lower blood alcohol concentrations in the HDPB and HDGB groups were significantly lower than in the PLA group at 0.25 and 0.5 h, suggesting that HD aids in early alcohol metabolism (0 h, p < 0.05). Analysis of the hourly Acute Hangover Scale (AHS) showed that all treatment groups had significantly reduced gastrointestinal disorder symptoms compared to the PLA group (p < 0.05). It can be confirmed that hangover symptoms can be significantly improved by consuming HD combination drinks, apart from the effect of reducing blood alcohol and acetaldehyde concentrations. Therefore, it is predicted that the consumption of natural phytochemicals added to HD is safe for humans and may help accelerate recovery from hangover symptoms. [ABSTRACT FROM AUTHOR]

Simple Summary: Bone metastases are a common complication in lung cancer patients, significantly affecting their quality of life and prognosis. Recent advances in systemic treatments have improved survival rates, but managing these patients remains complex due to the lack of disease-specific guidelines. This study reviewed survival factors in 3759 patients across 15 studies and developed a treatment algorithm to aid multidisciplinary decision-making. Key prognostic factors included EGFR mutation status, ECOG performance, and systemic therapy use. The proposed algorithm highlights the importance of personalized and collaborative care in managing lung cancer bone metastases effectively. Background: The prognosis for patients with lung cancer bone metastases has improved with the use of novel systemic agents. These patients might need surgery or radiotherapy to alleviate symptoms or maintain function. However, there is currently no disease specific algorithm to guide multidisciplinary decisions. Methods: The inclusion criteria encompassed studies with ≥10 patients offering multivariate analysis data on survival that were published after 2000 until September 2023. Clinical factors were categorized based on their characteristics and the pooled hazard ratios (HRs) for each category were calculated. A treatment algorithm was proposed based on clinical importance and the pooled HRs. Results: Fifteen studies involving 3759 patients with lung cancer bone metastases were included. The median survival ranged between 1.8–28.3 months (median: 12.4). Among the studies involving patients with EGFR+ or treated with TKIs, the median survival ranged between 19.5–28.3 months. The most reported significant factor was ECOG performance (nine studies) followed by chemotherapy use (six studies). In the pooled analyses, the pooled HR [95% confidence interval (CI)] of the EGFR status category was 2.109 (1.345–3.305); the ECOG performance category was 2.007 (1.536–2.622); the visceral metastases category was 2.060 (1.370–3.098); the bone metastases characteristics category (e.g., multiplicity, weight-bearing bone metastases) was 1.910 (1.443–2.527); the body weight category was 1.805 (1.334–2.442); the anti-absorbants category was 1.784 (1.448–2.196); the systemic treatment category was 1.695 (1.407–2.041); the skeletal-related event category was 1.616 (1.063–2.458); the smoking status category was 1.530 (1.306–1.793); the gender category was 1.482 (1.270–1.729); and the histology category was 1.450 (1.186–1.772). Conclusions: Oncological prognoses are influenced by various interrelated factors. Our treatment algorithm supports multidisciplinary strategies for managing NSCLC bone metastases, considering the complex factors influencing prognosis. [ABSTRACT FROM AUTHOR]