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Background Alopecia areata (AA) has a poor clinical course in children. There are no reliable therapeutic options for children with severe AA, including alopecia totalis (AT) and alopecia universalis (AU). Objectives We evaluated the efficacy and adverse effects of a potent topical corticosteroid (TCS) under occlusion in paediatric patients with severe AA. Methods We reviewed records of 23 patients under the age of 10 years with AT or AU treated with a potent TCS (0.05% clobetasol propionate or 0.3% diflucortolone valerate) for 8 h under occlusion with a plastic film. We used the Severity of Alopecia Tool (SALT) to measure clinical improvement. The primary endpoint was a SALT score of ≤ 20 at 6 months. We analysed the change in cortisol levels to identify the long-term safety of TCS therapy on the hypothalamus–pituitary–adrenal axis. Results Nineteen of the 23 patients (83%) reached SALT ≤ 20 at 6 months. Six patients relapsed over the 6-month follow-up period. Four patients were suspected of having adrenal insufficiency. However, the cortisol levels of the patients recovered to normal within 1 month of lowering the TCS potency or changing to nonsteroidal treatments. Limitations include the retrospective design and small sample size. Conclusions This study shows that a potent TCS occlusion may be a safe treatment option in paediatric patients with severe AA. Further long-term studies are required to evaluate the safety and recurrence of TCS occlusion therapy for paediatric AA. [ABSTRACT FROM AUTHOR]

The long‐term stability of Ni‐based catalysts, employed in the anode of anion exchange membrane water electrolyzers (AEMWE), has been a persisting concern. In this work, through a simple and powerful electrochemical anodization process, vertically aligned β‐NiOOH atomic sheets (vertical‐β‐NiOOH) grown on Fe‐doped Ni nanoplates (FeNi nanoplates) as a solution are offered. This innovative electrocatalyst demonstrates sustained stability of constant current density for over 120 d during the oxygen evolution reaction.The zero‐gap AEMWE cell harnessing the anodized FeNi nanoplates achieves a remarkable current density of 2.26 A cm−2 at 1.80 V with an energetic efficiency of 85.1%. It is anticipated that the electrochemically produced highly active, stable Ni‐based nanostructures demonstrate the potential in pushing the boundaries of AEMWE technology. [ABSTRACT FROM AUTHOR]

Background: Intractable xerostomia is defined as the subjective perception of dry mouth and persistent salivary gland hypofunction. Pilocarpine is an approved salivary sialagogue that is frequently prescribed for the treatment of intractable xerostomia; however, it often exhibits more side effects at high-doses and limited effectiveness at low-doses. Baekhogainsam-Tang (BIT) is a common herbal formula used by patients complaining of sore throats and thirst. It seems that BIT can compensate for the insufficient effect of low-dose pilocarpine. However, no clinical trials have studied the efficacy of combined administration of BIT and low-dose pilocarpine for intractable xerostomia. We aim to assess the non-inferior efficacy and fewer side effects of combined administration of BIT and low-dose pilocarpine compared with the administration of high-dose pilocarpine. Methods: A randomized, open-label, parallel-group, multi-center trial will be conducted. A total of 120 patients with Sjogren's syndrome having an unstimulated salivary flow rate (SFR) ≤0.1 mL/min or who have undergone radiotherapy to the head and neck with an unstimulated SFR ≤0.25 mL/min will be recruited competitively. They will be randomly allocated to either the experimental or control groups. The experimental group will receive BIT herbal granules three times and pilocarpine (2.5-mg) four times daily; meanwhile, the control group will receive only 5-mg pilocarpine four times daily for 12 weeks. The primary outcome is unstimulated SFR after 12 weeks of treatment. Secondary outcomes are stimulated SFR after 12 weeks of medication, as well as differences and mean percentage changes in unstimulated and stimulated SFR, visual analog scale, salivary scintigraphy, and questionnaires for both oral symptoms and quality of life during the clinical trial. An independent T test or Mann-Whitney U test will be performed to compare values between the two groups. The Paired T test or Wilcoxon signed-rank test will be performed to compare intragroup continuous values. Conclusion: This trial will be significant evidence on the efficacy and safety of combined use of BIT and low-dose pilocarpine to treat intractable xerostomia. Clinical trial registration: The Clinical Research Information Service of the Republic of Korea (ISRCTN, KCT0005982). Registered on 10 February 2021. [ABSTRACT FROM AUTHOR]

Background: HER2-positivity is an essential marker for therapeutic decisions, while HER2 expression is heterogenous. In recent years, there has been increasing recognition of a subgroup of breast cancer patients who have low levels of HER2 expression, also known as HER2-low because trastuzumab deruxtecan offers clinical benefit for patients with HER2-low metastatic breast cancer. Despite the growing interest in HER2-low breast cancer, there is limited research on how multigene assays can help differentiate between HER2-low and HER2-negative breast cancer. Among HR + HER2- breast cancer, we compared genomic characteristics between HER2-low and HER2-zero using the 21-gene assay. Methods: A retrospective review of clinical records was performed in 2,295 patients who underwent Oncotype DX® test in two hospitals between 2013 and 2020. Patients were classified into two groups as the HER2-zero and HER2-low based on HER2 immunohistochemistry. In cases with HER2 2+, no amplification of HER2 gene was confirmed by silver in situ hybridization. High genomic risk was defined as cases with 21-gene recurrence score (RS) > 25. Multivariable binary logistic-regression analysis was performed. Results: Of these, 944 (41.1%) patients were assigned to the HER2-zero group, while 1351 (58.9%) patients were assigned to the HER2-low group. The average Recurrence Score (RS) was found to be 17.802 in the HER2-zero breast cancer group and 18.503 in the HER2-low group, respectively (p-value < 0.005). When comparing the proportion of high RS between the two groups, the HER2-zero group had a high RS rate of 12.4% (117 out of 944), while the HER2-low group had a high RS rate of 17.0% (230 out of 1351) (p = 0.002). The HER2 score identified by qRT-PCR was 8.912 in the HER2-zero group and 9.337 in the HER2-low group (p < 0.005). In multivariable analysis, HER2-low status was found to be an independent factor for high RS, with an odds ratio of 1.517 (1.172–1.964), independent of ER, PR, and Ki67. Within the subgroup of patients with invasive ductal carcinoma, the high RS rates were 19% in the HER2-low group and 14% in the HER2-zero group. However, when considering all patients, there were no significant differences observed in recurrence-free survival and overall survival between the HER2-low and HER2-zero groups. Conclusion: Within HR + HER2- breast cancer, HER2-low tumors are associated with high RS, especially for histologically invasive ductal carcinoma. A prognostic influence of HER2-low expression among HR + HER2- breast cancer remains as an area that requires further study. [ABSTRACT FROM AUTHOR]

Objective: Hepatopulmonary syndrome (HPS) is a rare complication of metabolic associated fatty liver disease (MAFLD) occurring subsequent to hypopituitarism, often developing after resection of hypothalamic or pituitary tumors. The aim of this study is to report an illustrative case of an HPS patient who was successfully treated with growth hormone replacement therapy, without liver transplantation which is conventionally regarded as the only treatment option. Additionally, we conducted a comprehensive review of published case reports of HPS in the pediatric population. Methods: We systematically searched literature databases to identify case reports and case series of HPS associated with hypopituitarism diagnosed in childhood. The search included MEDLINE/PubMed, Scopus, Embase, and Google Scholar from 1990 to 2023. The review process adhered to the PRISMA checklist for comprehensive reporting and methodological transparency. Results: An 18-year-old female, who had been followed up for MAFLD after craniopharyngioma resection, presented with cyanosis and progressive dyspnea. She was diagnosed with severe degree of HPS. The patient began treatment with recombinant human growth hormone, leading to a significant improvement in respiratory symptoms within 3 months, and normalization of lung shunt ratio after 6 months of therapy. In our systematic review, nine patients from nine studies across six countries were identified. The median age at diagnosis of hypopituitarism was 10.5 years (range 1–16 years), and HPS was diagnosed at a median interval of 7 years later (range 0–26 years). Half of the patients had not received growth hormone therapy after being diagnosed with hypopituitarism, which subsequently led to the diagnosis of HPS. Three patients underwent liver transplantation, but non-alcoholic steatohepatitis recurred in all cases. Six patients were successfully treated with growth hormone replacement therapy without undergoing liver transplantation. Conclusions: HPS can occur in pediatric patients with MAFLD who have undergone resection of the tumor in the hypothalamus or pituitary gland. Our findings suggest that growth hormone replacement therapy can be a possible alternative to liver transplantation for HPS patients. However, further investigations need to be performed to validate the efficacy of growth hormone treatment in different causes of HPS cases. [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]

Background: Fluoroscopy-guided PTNB for fluoroscopy-identifiable lung lesions has been suggested as a useful method for the pathological diagnosis of lung lesions; however, it is lacking in accuracy and safety compared to CT-guided PTNB. Thus, we aimed to investigate the diagnostic accuracy and complications of fluoroscopy-guided percutaneous transthoracic needle biopsy (PTNB) with the aid of pre-procedural planning cone-beam computed tomography (CBCT) in order to take advantage of their respective strengths. Methods: A total of 255 fluoroscopy-guided PTNBs with the aid of planning CBCT were performed. Pre-procedural planning CBCT was conducted to calculate the shortest length from the skin puncture site to the margin of the target lesion for the needle trajectory. No intra-procedural CBCT was performed. The diagnostic performance of fluoroscopy-guided PTNB with the aid of planning CBCT was calculated. The prognostic factors for diagnostic failures and complications were evaluated using logistic regression analysis. Results: The accuracy, sensitivity, specificity, PPV, and NPV were 97.3%, 88.0%, 90.9%, 100%, and 62.5%, respectively. There were 29 diagnostic failures (11.8%), and the multivariable analysis showed that a longer lesion depth on CBCT and a shorter specimen length were each associated with diagnostic failure (p = 0.010 and 0.012, respectively). Complications occurred in 34 PTNBs (13.3%). The multivariable analysis showed that an increased total number of biopsies per lesion, a longer length of lung aeration via needle insertion, a smaller lesion size on CT imaging (≤20 mm), and the presence of an air bronchogram were associated with the occurrence of complications (p = 0.027, <0.001, 0.003, and 0.020, respectively). Conclusions: Excellent diagnostic accuracy was obtained by fluoroscopy-guided PTNB with the aid of planning CBCT. Compared to that of CT- or CBCT-guided PTNB, the procedure-related complication rate was acceptably low, but the radiation dose to patients could be potentially reduced. [ABSTRACT FROM AUTHOR]

Phase locked loop (PLL) is commonly used for grid synchronization in inverter system. The stability of the grid connected inverter system can be negatively affected by the PLL bandwidth and grid impedance easily. The use of large bandwidth PLL to yield fast response might deteriorate the system stability under high grid impedance conditions. In this work, a model predictive current control (MPC) method considering the PLL dynamics is proposed, which maintains the stability of the control in the case of high grid impedance with large band width of PLL which is compared and analyzed with the existing MPC method. Analyzed results demonstrate that the proposed control method is suitable for maintaining the system stability under various short circuit ratio conditions (SCR). The optimal controller gains are obtained using the linear matrix inequality (LMI) optimization-based model predictive control. Simulations are carried out to validate the performance of the proposed control scheme. [ABSTRACT FROM AUTHOR]

Erwinia pyrifoliae, the Gram-negative bacterial pathogen responsible for black shoot blight, exhibits symptoms similar to E. amylovora (fire blight), though with distinct molecular characteristics. Given its prevalence primarily in South Korea and the availability of only nine assembled genomes, there is a lack of high-quality genome sequences and annotated genetic information for E. pyrifoliae. We present the sequencing and assembly of a Korean E. pyrifoliae strain, YKB12327, isolated from a diseased apple tree branch, using a combination of long Oxford Nanopore Technologies and short Illumina sequence reads. This genome comprises a circular chromosome and three plasmid sequences, totaling 4,061,634 bp. Annotation of YKB12327 identifies 3123 coding sequence protein-coding genes, 22 rRNA genes (5S, 16S, and 23S), and 76 tRNA genes. Our sequence data will enrich the current E. pyrifoliae genome resources and facilitate in understanding its evolution, diversity and structural variations, as well as the molecular basis of pathogenesis. [ABSTRACT FROM AUTHOR]

Coronaviruses (CoVs) belonging to the Gamma-CoV and Delta-CoV genera are widespread in poultry and wildfowl. Migratory birds, particularly duck species, serve as hosts for CoVs and play a pivotal role in transmitting the viruses to other species, including mammals. Despite the potential risks to animals and humans, there remains a narrow knowledge of the genetic and epidemiological properties of CoVs in wild birds. The current research aimed to detect and characterize CoVs present in migratory duck species (Anas acuta, Anas platyrhynchos, and Anas poecilorhyncha) from South Korea. Employing two rounds of pan‐CoV real‐time reverse transcription‐polymerase chain reaction (RT‐PCR) and nested PCR (nPCR) assays amplifying the conserved RNA‐dependent RNA polymerase (RdRp) portion common to all known CoVs, we screened 2120 duck fecal samples collected during 2022–2023. The results indicated the presence of CoVs in 4.2% (91/2120) of samples from migratory ducks. Nucleotide sequencing of the RdRp gene revealed that all identified CoVs were clustered within the Gamma-CoV genus. Further phylogenetic analysis suggested that South Korean gamma‐CoVs belong to the Igacovirus subgenus and share similarities with those found worldwide, highlighting the critical role of migratory ducks in introducing and exporting avian CoVs. We discovered two clade VII igacovirus strains in wild ducks closely related to those in pigeons, implying potential cross infection between these avian species. Overall, our study underscores the importance of active surveillance and monitoring of avian CoVs in wild birds as a preemptive response against the forthcoming emergence of new CoV species that can threaten both animal and human health. [ABSTRACT FROM AUTHOR]

To orchestrate behaviors for survival, multiple psychological components have evolved. The current theories do not clearly distinguish the distinct components. In this article, we provide a unified theoretical framework. To optimize survival, there should be four components; (1) "need", an alarm based on a predicted deficiency. (2) "motivation", a direct behavior driver. (3) "pleasure", a teacher based on immediate outcomes. (4) "utility", a teacher based on final delayed outcomes. For behavior stability, need should be accumulated into motivation to drive behavior. Based on the immediate outcome of the behavior, the pleasure should teach whether to continue the current behavior. Based on the final delay outcome, the utility should teach whether to increase future behavior by reshaping the other three components. We provide several neural substrate candidates in the food context. The proposed theoretical framework, in combination with appropriate experiments, will unravel the neural components responsible for each theoretical component. [ABSTRACT FROM AUTHOR]

Meta-analysis methodology has evolved with the development of more robust statistical techniques; however, few reviews in special education have focused specifically on methodological rigor in meta-analyses. In this study, we examined 29 meta-analyses of mathematics interventions published from 2000 to 2022 to determine the extent to which researchers have applied four best practices in meta-analyses focused on mathematics interventions for students with disabilities. Our findings were (a) studies used three primary moderator techniques: meta-regression (k = 10), subgroup analysis (k = 8), analysis of variance (k = 3), and both subgroup analysis and meta-regression (k = 1); (b) only one study considered small sample corrections for hypothesis tests; (c) few researchers handled the dependence between multiple effect sizes (k = 3); and (d) the funnel plot was commonly used to detect publication bias (k = 8). Based on our findings, we make recommendations for methodological considerations for future meta-analyses. [ABSTRACT FROM AUTHOR]

We present an efficient numerical method to approximate the flux variable for the Darcy flow model. An important feature of our new method is that the approximate solution for the flux variable is obtained without approximating the pressure at all. To accomplish this, we introduce a user‐defined parameter delta, which is typically chosen to be small so that it minimizes the negative effect resulting from the absence of the pressure, such as inaccuracy in both the flux approximation and the mass conservation. The resulting algebraic system is of significantly smaller degrees of freedom, compared to the one from the mixed finite element methods or least‐squares methods. We also interpret the proposed method as a single step iterate of the augmented Lagrangian Uzawa applied to solve the mixed finite element in a special setting. Lastly, the pressure recovery from the flux variable is discussed and an optimal‐order error estimate for the method is obtained. Several examples are provided to verify the proposed theory and algorithm, some of which are from more realistic models such as SPE10. [ABSTRACT FROM AUTHOR]

Purpose: Laryngopharyngeal reflux disease (LPRD) is mainly treated with proton pump inhibitors (PPI) such as esomeprazole, which have shortcomings like delayed absorption and increased osteoporosis. Fexuprazan is a novel potent potassium-competitive acid blocker that inhibits gastric acid secretion with rapid onset and long duration of action. To assess the efficacy and safety of fexuprazan compared to esomeprazole in patients with LPRD. Methods: This prospective, randomized, double-blinded, multicenter, active-controlled trial was conducted in nine otolaryngologic clinics. Patients with reflux symptom index (RSI) ≥ 13 and reflux finding score (RFS) ≥ 7 were randomly assigned to the fexuprazan or esomeprazole groups, and received fexuprazan 40-mg or esomeprazole 40-mg once daily for 8 weeks. The outcomes were (1) mean change, change rate, and valid rate in RSI, RFS, and LPR-related questionnaires; and (2) adverse events. Results: A total of 136 patients (fexuprazan n = 68, esomeprazole n = 68) were followed up for ≥ 1 month. Each parameter significantly improved after 4 and 8 weeks in each group, with no significant differences between the two groups. For those with severe symptoms (RSI ≥ 18), the fexuprazan group (n = 32) showed more improvement in the mean change and change rate in the RSI than esomeprazole group (n = 31) after 4 weeks (p =.036 and.045, respectively). This phenomenon was especially observed in hoarseness and troublesome cough. Conclusion: Fexuprazan improved symptoms and signs without no serious adverse events in patients with LPRD. In patients with severe symptoms, fexuprazan resulted in a faster symptom improvement than PPI. Trial registration: KCT0007251, https://cris.nih.go.kr/cris/search/detailSearch.do?seq=22100. [ABSTRACT FROM AUTHOR]

Aim: To examine the relationship between racial/ethnic disparities and substance use behaviours (alcohol and tobacco use) and their impact on the sleep health of South Korean adolescents. Design: Secondary analysis of cross‐sectional study data from the 2021 Korea Youth Risk Behaviour Web‐based Survey dataset. Methods: Given that Korean society has historically linked its racial/ethnic identity to a shared bloodline, we categorized 2644 adolescents from the Korea Youth Risk Behaviour Web‐based Survey based on their racial/ethnic status, determined by their parents' birthplaces. Using multiple linear regression, we investigated whether the impact of racial/ethnic disparities on sleep health (sleep duration, debt, and timing) varies depending on substance use behaviours (alcohol and tobacco use) after controlling for age, sex, household economic status, depressed mood, suicidal ideation, perceived excessive stress, and anxiety level. Results: Despite no statistical differences in sleep health and the prevalence of substance use between racial/ethnic groups, racial/ethnic minority adolescents experienced greater sleep debt than racial/ethnic majority adolescents when consuming alcohol. Moreover, racial/ethnic minority adolescents were more likely to report psychosocial distress and had lower parental education level. Conclusion: Racial/ethnic minority adolescents were more vulnerable to the detrimental effects of alcohol use on sleep health compared to racial/ethnic majority adolescents. This heightened vulnerability may be attributed to the more pronounced psychosocial challenges and the lower socioeconomic status of parents in the racial/ethnic minority group. Impact: Racial/ethnic disparities are concerning in South Korea, particularly since the negative effects of substance use on sleep health are intensified among racial/ethnic minority adolescents. Nurses and other healthcare providers should recognize the importance of addressing the social disadvantages linked to racial/ethnic disparities. Beyond just advocating for the cessation of substance use, it is crucial to address these underlying issues to reduce sleep disparities among South Korean adolescents. Patient or Public Contribution: No patient or public contribution. [ABSTRACT FROM AUTHOR]

Introduction: The aim of this study was to investigate the predictive factors for persistent disease activity following anti-vascular endothelial growth factors (anti-VEGF) and their long-term effects in patients to be treated for neovascular age-related macular degeneration (nAMD) under real-world conditions. Methods: Retrospective data analysis of the PROOF study, a multi-center real-world retrospective chart review conducted across Korea in patients with nAMD included treatment-naive patients with nAMD who received first anti-VEGF (ranibizumab, bevacizumab, or aflibercept) between January 2017 and March 2019 was performed. All 600 patients (cohort 1) had a minimum follow-up of 12 months of which 453 patients (cohort 2) were followed-up for 24 months from baseline. Results: At month 12 after anti-VEGF therapy, 58.10% (95% confidence interval [CI]: 54.09, 62.12) of patients and at month 24, 66.02% of patients continued to have persistent retinal fluid. At both months 12 and 24, predictive factors for persistent disease activity were fibrovascular pigment epithelial detachments (PED) (P = 0.0494) and retinal fluid at month 3 after loading phase (P = 0.0082). The mean changes in visual acuity were + 6.2, + 10.1, and + 13.3 letters and in the central subfield thickness were − 79.1 µm, − 96.3 µm, and − 134.4 µm at 12 months from baseline, in the bevacizumab, aflibercept, and ranibizumab groups, respectively. Conclusions: The presence of retinal fluid after loading phase and fibrovascular PED were predictors of persistent disease activity after at least 1 year of anti-VEGF treatment. [ABSTRACT FROM AUTHOR]

Objectives: To compare prostate monoparametric MRI (monoMRI), which uses only diffusion-weighted imaging (DWI), with biparametric (bpMRI) and multiparametric MRI (mpMRI) in detecting clinically significant cancer (CSC) and to evaluate the effect of the combination of monoMRI results and prostate-specific antigen (PSA) level. Methods: In this study, 193 patients (average age 70.5 years; average PSA 7.9 ng/mL) underwent prebiopsy MRI and subsequent prostate biopsy from January 2020 to February 2022. Two radiologists independently reviewed the 3 MRI protocols using the Prostate Imaging Reporting and Data System (PI-RADS). Interreader agreement was assessed using the intraclass correlation coefficient (ICC), and diagnostic performance was evaluated with receiver operating characteristic (ROC) curve analysis. The Youden index was used to determine the new cutoff value of PSA for detecting CSCs in patients with negative monoMRI results. Results: CSC was confirmed in 109 patients (56.5%). The interreader agreement on monoMRI (ICC = 0.798) was comparable to that on bpMRI and mpMRI (ICC = 0.751 and 0.714, respectively). ROC curve analysis of the 3 protocols revealed no difference in detecting CSCs (P > 0.05). Applying a new PSA cutoff value (9.5 and 7.4 ng/mL, respectively) in monoMRI-negative patients improved the sensitivity of monoMRI from 89.9% to 96.3% for Reader 1, and from 95.4% to 99.1% for Reader 2. Conclusions: MonoMRI based solely on DWI demonstrated similar diagnostic performance to bpMRI and mpMRI in detecting CSCs, and the combination of PSA level with monoMRI has the potential to effectively triage patients with a high likelihood of CSCs. Advances in knowledge: Monoparametric MRI conducted only with diffusion-weighted imaging (DWI), may show comparable performance to biparametric and multiparametric MRI in detecting clinically significant prostate cancer. In patients with negative monoparametric MRI results, implementing a new PSA cutoff value to determine the need for a biopsy could decrease the number of missed prostate cancer. [ABSTRACT FROM AUTHOR]

Objectives: To compare prostate monoparametric MRI (monoMRI), which uses only diffusion-weighted imaging (DWI), with biparametric (bpMRI) and multiparametric MRI (mpMRI) in detecting clinically significant cancer (CSC) and to evaluate the effect of the combination of monoMRI results and prostate-specific antigen (PSA) level. Methods: In this study, 193 patients (average age 70.5 years; average PSA 7.9 ng/mL) underwent prebiopsy MRI and subsequent prostate biopsy from January 2020 to February 2022. Two radiologists independently reviewed the 3 MRI protocols using the Prostate Imaging Reporting and Data System (PI-RADS). Interreader agreement was assessed using the intraclass correlation coefficient (ICC), and diagnostic performance was evaluated with receiver operating characteristic (ROC) curve analysis. The Youden index was used to determine the new cutoff value of PSA for detecting CSCs in patients with negative monoMRI results. Results: CSC was confirmed in 109 patients (56.5%). The interreader agreement on monoMRI (ICC = 0.798) was comparable to that on bpMRI and mpMRI (ICC = 0.751 and 0.714, respectively). ROC curve analysis of the 3 protocols revealed no difference in detecting CSCs (P > 0.05). Applying a new PSA cutoff value (9.5 and 7.4 ng/mL, respectively) in monoMRI-negative patients improved the sensitivity of monoMRI from 89.9% to 96.3% for Reader 1, and from 95.4% to 99.1% for Reader 2. Conclusions: MonoMRI based solely on DWI demonstrated similar diagnostic performance to bpMRI and mpMRI in detecting CSCs, and the combination of PSA level with monoMRI has the potential to effectively triage patients with a high likelihood of CSCs. Advances in knowledge: Monoparametric MRI conducted only with diffusion-weighted imaging (DWI), may show comparable performance to biparametric and multiparametric MRI in detecting clinically significant prostate cancer. In patients with negative monoparametric MRI results, implementing a new PSA cutoff value to determine the need for a biopsy could decrease the number of missed prostate cancer. [ABSTRACT FROM AUTHOR]

Two ASTM A295 52100 bearing steels with different concentrations of Al (0.02 and 1.90 wt%) were nitrided by three processes: pure nitriding (gas), oxy-nitrocarburizing (gas) and salt bath nitriding. To assess their electrical performance, the area-specific resistance (ASR) of the surface was measured by the four-point probe method. The microstructure of the surface layer was investigated by using X-ray diffraction (XRD), scanning electron microscopy (SEM) and transmission electron microscopy (TEM). The results showed that the ASR of the non-nitrided sample was only approximately 0.005 Ω cm2, but it became larger after all nitriding processes. Among the 0.02 wt% Al-added samples, the greatest ASR was approximately 30 Ω cm2 for the sample nitrided in a salt bath, which can be ascribed to the large amount of oxides (Fe3O4) in the compound layer that exhibits higher electrical resistivity than other nitrides (ε-Fe3N and γ′-Fe4N) observed in the pure or oxy-nitrocarburized samples. Additionally, the addition of Al significantly increased the ASR in the salt bath nitrided sample, which indicated that the Al2O3 formed along the pores in the compound layer played an important role in improving the electrical resistance. [ABSTRACT FROM AUTHOR]

To investigate disparities in sensitisation to Staphylococcus aureus enterotoxin A/B (SEA/SEB) and olfactory function in patients with chronic rhinosinusitis (CRS) with nasal polyps (CRSwNP), those with CRS without nasal polyps (CRSsNP), and healthy controls who underwent septoplasty only. We retrospectively reviewed the medical records of 388 subjects aged ≥ 8 years, collected between January 2021 and June 2023. We analysed patient demographics, medical history, serum IgE levels against staphylococcal enterotoxins (SEs), and serum total IgE levels against inhalant allergens. We performed olfactory and taste function tests in the participants to evaluate the relationship between olfactory function and SEs. Of 388 patients enrolled, 145 were healthy controls, 111 had CRSsNP, and 133 had CRSwNP. The prevalence of SEA/SEB positivity was significantly higher among the patients with CRSwNP than among those in the CRSsNP and healthy controls. The olfactory test results showed significant differences among the groups; anosmia was observed in 9.7% of healthy controls, 22.7% of patients with CRSsNP, and 45.1% of patients with CRSwNP. Olfactory threshold deterioration was evident in patients with CRS. Distinction and identification were more impaired in patients with CRSwNP than in those of the other groups. Finally, the olfactory function scores decreased as the serum levels of SEs increased. Sinusitis patients seem to suffer from perceiving odours, and patients with CRSwNP have difficulty distinguishing odours. Olfactory function test scores decreased in patients with a history of asthma, and as serum levels of staphylococcus enterotoxin and blood eosinophil percentage increase. Furthermore, our result suggests a potential role for SE sensitisation and eosinophil percentage in deteriorating olfaction, especially in patients with CRSwNP. [ABSTRACT FROM AUTHOR]

Backgrounds: Preoperative imaging, particularly with magnetic resonance imaging (MRI) and computed tomography (CT) scans, plays a crucial role in distinguishing between benign and malignant parotid gland tumors, while the reliability of Ultrasound-Guided Fine Needle Aspiration (FNA) in diagnosing these masses remains a topic of debate. Methods: This two-center retrospective analysis was conducted on 347 patients with parotid gland tumors who had FNA and preoperative imaging (CT or MRI). All patients underwent surgery and final histopathological examination was available, along with complete medical records between January 2008 and May 2023. Results: Among the 347 patients, 318 (92%) had benign and 10 (3%) had malignant tumors based on FNA, with 19 (5%) unsatisfactory specimens. Final histological diagnosis revealed 303 (87%) benign and 44 (13%) malignant lesions, with a false-negative rate of 10.6% for FNA. Multivariate analysis identified irregular shape and invasion as independent predictors of malignancy in patient with benign or unsatisfactory FNA results. The odds ratio for irregular shape was 3.06 and for invasion was 12.73. Conclusion: Imaging characteristics, such as irregular shape and invasion may indicate towards malignant parotid tumors, even in patients with false-negative benign findings in FNA. [ABSTRACT FROM AUTHOR]

Background This study aimed to determine the proportion of organ donors suitable for donation after circulatory death and investigate the current process followed by critical care physicians for declaring circulatory death to establish organ donation. Methods This observational study involved potential organ donors who had recently died after discontinuation of life support. We conducted an online survey of intensivists to determine how these deaths were confirmed. Results Among the 177 patients who died after withdrawal of life-sustaining treatment across 19 intensive care units in 11 institutions, 49 (27.7%) were considered potential donors. According to general medical criteria for organ donation, 20 (11.3%) patients were identified as medically suitable donors. Notably, 116 (73.9%) patients exhibited a flat electrocardiogram within 5 min after the loss of pulse. In the survey, 90 physicians (59.2%) agreed to implement the concept of the 5-min no-touch period for the declaration of circulatory death. Conclusions This study found that 11.3% of the patients who died following the withdrawal of life-sustaining treatment in the intensive care units were identified as suitable donors after circulatory death. Most of critical care physicians agree with the concept of a 5-min no-touch period for the declaration of circulatory death. [ABSTRACT FROM AUTHOR]

All-solid-state batteries (ASSBs) containing solid electrolytes can offer high energy density and enhanced safety compared to conventional Li-ion batteries. Among solid electrolytes, sulfide-based materials have garnered significant attention owing to their high ionic conductivity and facile processability. In this study, Li argyrodite solid electrolytes containing both BH4− and Br− anions were prepared using a straightforward two-step milling method without heat treatment. The synthesized materials exhibited an impressive ionic conductivity of up to 14.4 mS cm−1 at room temperature, which surpassed previously reported values of borohydride-substituted argyrodite electrolytes. To elucidate the effect of Br− anion replacement in the thiophosphate local structure, Raman and 31P solid-state nuclear magnetic resonance spectroscopic analyses were performed. The results showed that the total proportion of the PS43− units in the argyrodite phase, including both BH4− and Br− anions, determined the Li ionic conductivity of the solid electrolytes. The prepared solid electrolyte samples were stable up to 5 V vs. Li+/Li without any notable side reactions. The rate performance of the ASSBs, including both the Br− and BH4−-substituted solid electrolytes, was superior to that of the cell with the BH4−-substituted solid electrolyte. [ABSTRACT FROM AUTHOR]

We present a catalog of stellar parameters (effective temperature T eff, surface gravity log g , age, and metallicity [Fe/H]) and elemental-abundance ratios ([C/Fe], [Mg/Fe], and [ α /Fe]) for some five million stars (4.5 million dwarfs and 0.5 million giant stars) in the Milky Way, based on stellar colors from the Javalambre Photometric Local Universe Survey (J-PLUS) DR3 and Gaia EDR3. These estimates are obtained through the construction of a large spectroscopic training set with parameters and abundances adjusted to uniform scales, and trained with a kernel principal component analysis. Owing to the seven narrow/medium-band filters employed by J-PLUS, we obtain precisions in the abundance estimates that are as good as or better than those derived from medium-resolution spectroscopy for stars covering a wide range of the parameter space: 0.10–0.20 dex for [Fe/H] and [C/Fe], and 0.05 dex for [Mg/Fe] and [ α /Fe]. Moreover, systematic errors due to the influence of molecular carbon bands on previous photometric-metallicity estimates (which only included two narrow/medium-band blue filters) have now been removed, resulting in photometric-metallicity estimates down to [Fe/H] ∼ −4.0, with typical uncertainties of 0.40 dex and 0.25 dex for dwarfs and giants, respectively. This large photometric sample should prove useful for the exploration of the assembly and chemical-evolution history of our Galaxy. [ABSTRACT FROM AUTHOR]

Background and Purpose: Nutritional status can influence the outcomes and mortality of various diseases. The association between initial nutritional status and ischemic stroke outcomes, however, remains poorly understood. This study investigated whether the Controlling Nutritional Status (CONUT) score at admission could predict functional recovery, complications, and survival following an ischemic stroke. Methods: We enrolled a total of 938 patients experiencing their first acute ischemic stroke and categorized them into three groups based on their CONUT score at admission: CONUT 0–1, CONUT 2–4, and CONUT 5–12. The CONUT score was assessed using the serum albumin, total cholesterol, and lymphocyte count. We evaluated the incidence of complications during their hospital stay. Outcomes, including the Modified Rankin Scale (mRS), Functional Independence Measurement (FIM), Functional Ambulatory Classification (FAC), and mortality, were assessed at baseline, as well as at three and six months post-stroke. Results: CONUT scores were significantly associated with functional outcomes (mRS, FIM, and FAC) and mortality during the six-month follow-up period post-stroke (all p < 0.05). The CONUT 5–12 group exhibited significantly poorer improvements in mRS, FIM, and FAC scores (all p < 0.05) and a lower survival rate (p < 0.01) during the six-month follow-up compared to the CONUT 0–1 and CONUT 2–4 groups. Additionally, the incidence of pneumonia, urinary tract infections, pressure sores, falling injuries, and fractures was significantly higher in the CONUT 5–12 group than in the other groups (all p < 0.01). Conclusions: CONUT scores at admission are associated with functional recovery, mortality, and the incidence of complications following a first-ever ischemic stroke. Consequently, the early identification of patients at risk of malnutrition via CONUT scores can be crucial in enhancing patient assessment after an acute stroke. [ABSTRACT FROM AUTHOR]

Potassium imide salt (KCTFSI), featuring cyano (C≡N) and trifluoromethanesulfonyl (TFSI) branches, is reported for the first time as a promising electrolyte for aqueous potassium‐ion batteries (KIBs). In contrast to the limited solubility of symmetric KTFSI (1.5m), asymmetric KCTFSI achieves a high saturation concentration of 32.2m within a "water‐in‐salt" region. Experimental and theoretical studies reveal that the remarkable enhancement of solubility is associated with the asymmetry of CTFSI anions and likely the preferential formation of contact‐ion pairs through C≡N coordination. The 32.2m KCTFSI solution not only extends the electrochemical stability window (3.80 V on Al) but also maintains a liquid state at low temperatures (−15 °C) for an extended period, in sharp contrast to the immediate solidification of potassium bis(fluorosulfonyl)imide (KFSI, 30m) and potassium trifluoromethanesulfonate (KOTF, 22m) solutions. Thanks to its wide voltage window and supercooling behavior, KCTFSI demonstrates excellent compatibility with perylene‐3,4,9,10‐tetracarboxylic diimide (PTCDI) anode and KVPO4F (or K2Fe[Fe(CN)6]·2H2O) cathode over a wide temperature range. For instance, full cells of PTCDI/KCTFSI/KVPO4F exhibit reasonable cyclability with an average discharge voltage of 1.7 V over 300 charge/discharge cycles at −15 °C. it is anticipated that this work will inspire new designs of hybrid electrolytes based on CTFSI to advance the realization of viable aqueous KIBs. [ABSTRACT FROM AUTHOR]

Purpose: Metachromatic leukodystrophy (MLD) is a lysosomal storage disease caused by arylsulfatase A deficiency, which leads to progressive demyelination in both the central and peripheral nervous systems, resulting in significant gross motor deterioration. This study aimed to analyze data concerning neuroimaging and clinical phenotypes of MLD patients, categorized by disease subtype. Methods: Patients diagnosed with MLD based on arylsulfatase A enzymatic activity, demyelination observed in brain magnetic resonance images, and/or pathogenic mutations were included in this study. The medical charts of 10 patients with confirmed MLD were retrospectively reviewed. We used a simplified magnetic resonance imaging (MRI) scoring system and clinical status, including survival. We analyzed the correlations between the scores of specific neuroimaging lesions and clinical status in two groups, categorized as late-infantile and juvenile types based on the age at symptom onset. Results: We detected a positive relationship between clinical function deterioration and MRI score (rho=0.59, P=0.002) in patients with MLD. This correlation was stronger in the late-infantile type (rho=0.700, P=0.003) than in the juvenile type (rho=0.513, P=0.029). A strong relationship was also noted in patients with high signal intensities in the pons and basal ganglia, and cerebellar atrophy, but not in those with lesions in the midbrain. MLD with a high MRI score was associated with poor clinical function. Conclusion: The identified correlations between modified MRI scores and clinical function scales may help predict the prognosis of patients with MLD, thereby aiding in the identification of treatment options and enhancing the quality of life for these patients. [ABSTRACT FROM AUTHOR]

The International Maritime Organization collaborates with member states to develop the Maritime Autonomous Surface Ships (MASS) Code to establish an international agreement framework. In December 2023, an agreement was reached on the European Union (EU) Artificial Intelligence (AI) Act within the MASS Code. It was officially finalized and implemented on 1 August 2024. While the Act's full application is set for two years later, certain provisions regarding safety against AI risks will take effect sooner. This study utilized a multiple-streams analysis method to examine how the EU AI Act impacted shipyards and shipping companies, focusing on ethical AI use and user safety. The findings indicate that technical completeness, safety enhancement, and AI system regulation through risk classification influence autonomous ship innovation. The challenges of reviewing the commercialization of new technologies for autonomous ships may result in market failures or decreased industry competitiveness. The study emphasizes the need to balance AI safety and ethical responsibility with autonomous ship development innovations. To ensure the sustainable application of AI technology, innovators must adapt to the EU AI Directive. Hence, this study confirms that the ethical and legal regulation of AI technology is crucial in technological innovation and development related to autonomous ships. [ABSTRACT FROM AUTHOR]

Background and purpose: The co‐occurrence of amyloid‐β pathology in Parkinson's disease (PD) is common; however, the role of amyloid‐β deposition in motor prognosis remains elusive. This study aimed to investigate the association between striatal amyloid deposition, motor complications and motor prognosis in patients with PD. Methods: Ninety‐six patients with PD who underwent 18F florbetaben (FBB) positron emission tomography were retrospectively assessed. The ratio of the striatum to global (STG) FBB uptake was obtained for each individual, and patients were allotted into low and high STG groups according to the median value. The effect of STG group on regional amyloid deposition, the occurrence of motor complications and longitudinal change in levodopa equivalent dose (LED) requirement were investigated after controlling for age, sex, LED and disease duration at FBB scan. Results: The high STG group was associated with lower cortical FBB uptake in the parietal, occipital and posterior cingulate cortices and higher striatal FBB uptake compared to the low STG group. Patients in the high STG group had a higher risk of developing wearing off and levodopa‐induced dyskinesia than those in the low STG group, whereas the risk for freezing of gait was comparable between the two groups. The high STG group showed a more rapid increase in LED requirements over time than the low STG group. Conclusions: These findings suggest that relatively high striatal amyloid deposition is associated with poor motor outcomes in patients with PD. [ABSTRACT FROM AUTHOR]

Piezo1 mechanosensitive ion channel plays a important role in vascular physiology and disease. This study aimed to elucidate the altered signaling elicited by Piezo1 activation in the arteries of type 2 diabetes. Ten- to 12-week-old male C57BL/6 (control) and type 2 diabetic mice (db−/db−) were used. The second-order mesenteric arteries (~ 150 μm) were used for isometric tension experiments. Western blot analysis and immunofluorescence staining were performed to observe protein expression. Piezo1 was significantly decreased in mesenteric arteries of type 2 diabetic mice compared to control mice, as analyzed by western blot and immunofluorescence staining. Piezo1 agonist, Yoda1, concentration-dependently induced relaxation of mesenteric arteries in both groups. Interestingly, the relaxation response was significantly greater in control mice than in db−/db− mice. The removal of endothelium reduced relaxation responses induced by Yoda1, which was greater in control mice than db−/db− mice. Furthermore, the relaxation response was reduced by pre-treatment with various types of K+ channel blockers in endothelium-intact arteries in control mice. In endothelium-denuded arteries, pre-incubation with charybdotoxin, an Ca2+-activated K+ channel (BKCa channel) blocker, significantly attenuated Yoda1-induced relaxation in db−/db− mice, while there was no effect in control mice. Co-immunofluorescence staining showed co-localization of Piezo1 and BKCa channel was more pronounced in db−/db− mice than in control mice. These results indicate that the vascular responses induced by Piezo1 activation are different in the mesenteric resistance arteries in type 2 diabetic mice. [ABSTRACT FROM AUTHOR]

Financial institutions are currently undergoing a significant shift from traditional robo-advisors to more advanced generative artificial intelligence (GenAI) technologies. This transformation has motivated us to investigate the factors influencing consumer responses to GenAI-driven financial advice. Despite extensive research on the adoption of robo-advisors, there is a gap in our understanding of the specific contributors to, and differences in, consumer attitudes and reactions to GenAI-based financial guidance. This study aims to address this gap by analyzing the impact of personalized investment suggestions, human-like empathy, and the continuous improvement of GenAI-provided financial advice on its authenticity as perceived by consumers, their utilitarian attitude toward the use of GenAI for financial advice, and their reactions to GenAI-generated financial suggestions. A comprehensive research model was developed based on service-dominant logic (SDL) and Artificial Intelligence Device Use Acceptance (AIDUA) frameworks. The model was subsequently employed in a structural equation modeling (SEM) analysis of survey data from 822 mobile banking users. The findings indicate that personalized investment suggestions, human-like empathy, and the continuous improvement of GenAI's recommendations positively influence consumers' perception of its authenticity. Moreover, we discovered a positive correlation between utilitarian attitudes and perceived authenticity, which ultimately influences consumers' responses to GenAI's financial advisory solutions. This is manifested as either a willingness to engage or resistance to communication. This study contributes to the research on GenAI-powered financial services and underscores the significance of integrating GenAI financial guidance into the routine operations of financial institutions. Our work builds upon previous research on robo-advisors, offering practical insights for financial institutions seeking to leverage GenAI-driven technologies to enhance their services and customer experiences. [ABSTRACT FROM AUTHOR]

Pectocin M1 (PM1), the bacteriocin from phytopathogenic Pectobacterium carotovorum which causes soft rot disease, has a unique ferredoxin domain that allows it to use FusA of the plant ferredoxin uptake system. To probe the structure‐based mechanism of PM1 uptake, we determined the X‐ray structure of full‐length PM1, containing an N‐terminal ferredoxin and C‐terminal catalytic domain connected by helical linker, at 2.04 Å resolution. Based on published FusA structure and NMR data for PM1 ferredoxin domain titrated with FusA, we modeled docking of the ferredoxin domain with FusA. Combining the docking models with the X‐ray structures of PM1 and FusA enables us to propose the mechanism by which PM1 undergoes dynamic domain rearrangement to translocate across the target cell outer membrane. [ABSTRACT FROM AUTHOR]

Background and Objectives: Few comparative studies have evaluated wearable single-lead electrocardiogram (ECG) devices and standard multi-lead ECG devices during exercise testing. This study aimed to validate the accuracy of a wearable single-lead ECG monitor for recording heart rate (HR) metrics during graded exercise tests (GXTs). Methods: A cohort of 50 patients at a tertiary hospital underwent GXT while simultaneously being equipped with wearable single- and conventional multi-lead ECGs. The concordance between these modalities was quantified using the intraclass correlation coefficient and Bland–Altman plot analysis. Results: The minimum and average HR readings between the devices were generally consistent. Parameters such as ventricular ectopic beats and supraventricular ectopic beats showed strong agreement. However, the agreement for the Total QRS and Maximum RR was not sufficient. HR measurements across different stages of the exercise test showed sufficient agreement. Although not statistically significant, the standard multi-lead ECG devices exhibited higher noise levels compared to the wearable single-lead ECG devices. Conclusions: Wearable single-lead ECG devices can reliably monitor HR and detect abnormal beats across a spectrum of exercise intensities, offering a viable alternative to traditional multi-lead systems. [ABSTRACT FROM AUTHOR]

Speaker recognition is a technology that identifies the speaker in an input utterance by extracting speaker-distinguishable features from the speech signal. Speaker recognition is used for system security and authentication; therefore, it is crucial to extract unique features of the speaker to achieve high recognition rates. Representative methods for extracting these features include a classification approach, or utilizing contrastive learning to learn the speaker relationship between representations and then using embeddings extracted from a specific layer of the model. This paper introduces a framework for developing robust speaker recognition models through contrastive learning. This approach aims to minimize the similarity to hard negative samples—those that are genuine negatives, but have extremely similar features to the positives, leading to potential mistaken. Specifically, our proposed method trains the model by estimating hard negative samples within a mini-batch during contrastive learning, and then utilizes a cross-attention mechanism to determine speaker agreement for pairs of utterances. To demonstrate the effectiveness of our proposed method, we compared the performance of a deep learning model trained with a conventional loss function utilized in speaker recognition with that of a deep learning model trained using our proposed method, as measured by the equal error rate (EER), an objective performance metric. Our results indicate that when trained with the voxceleb2 dataset, the proposed method achieved an EER of 0.98% on the voxceleb1-E dataset and 1.84% on the voxceleb1-H dataset. [ABSTRACT FROM AUTHOR]

The burgeoning interest in natural components in personal care products has led to significant research and development of ingredients such as plant extracts, antioxidants, peptides, and probiotics. These components have been recognized for their potential to enhance skin health through various mechanisms, addressing consumer demand for products that are both effective and benign. Plant extracts, known for their rich composition of bioactive compounds, offer a myriad of benefits including antioxidant, anti-inflammatory, and antimicrobial properties, making them invaluable in skin care formulations. Antioxidants, derived from both plants and other natural sources, play a pivotal role in protecting the skin from oxidative damage, thereby preventing premature aging and promoting skin vitality. Bioactive peptides have garnered attention owing to their multifunctional activities that include promoting collagen synthesis, inhibiting enzymes responsible for skin degradation, and reducing inflammation, thereby contributing to skin regeneration and anti-aging. Probiotics have expanded their utility beyond gut health to skin care, where they help in maintaining skin microbiome balance, thus enhancing skin barrier function and potentially mitigating various skin disorders. The purpose of this review is to explore the individual roles of plant extracts, antioxidants, peptides, and probiotics in personal care products, while emphasizing their synergistic effects when combined. By integrating these natural components, this paper aims to highlight the potential for developing innovative skincare formulations that not only address specific skin concerns but also contribute to overall skin health, aligning with the increasing consumer preference for natural and holistic skincare solutions. [ABSTRACT FROM AUTHOR]

Background: Lipopolysaccharide (LPS)-induced neuroinflammation is a well-established model for studying depression-like behavior, driven by pro-inflammatory cytokines such as TNF-α and IL-1β. Mast cells (MCs) contribute to neuroinflammation by releasing mediators that exacerbate depressive-like symptoms. This study evaluates the antidepressant-like and anti-inflammatory effects of Cannabis sativa L. inflorescence extract (CSL) in an LPS-induced neuroinflammation model. Methods: Male C57BL/6 mice were intraperitoneally injected with CSL at doses of 10, 20, and 30 mg/kg, 30 min prior to LPS (0.83 mg/kg) administration. Depressive behaviors were assessed using the sucrose preference test (SPT), tail suspension test (TST), and forced swimming test (FST). The neutrophil-to-lymphocyte ratio (NLR) was measured to assess systemic inflammation. Cytokine levels in the prefrontal cortex (PFC) were measured, and mast cell degranulation in the lymph nodes and dura mater was analyzed histologically (approval number: WKU24-64). Results: CSL significantly improved depressive-like behaviors and decreased the NLR, indicating reduced systemic inflammation. CSL also significantly reduced TNF-α and IL-1β levels in the PFC. Furthermore, CSL inhibited MC degranulation in the deep cervical lymph nodes and dura mater, with the strongest effects observed at 30 mg/kg. Conclusions: CSL demonstrated antidepressant-like and anti-inflammatory effects in an LPS-induced neuroinflammation model, likely through the modulation of cytokine expression and mast cell activity. These results suggest the potential of CSL as a therapeutic option for treating inflammation-related depression. [ABSTRACT FROM AUTHOR]

The Confusion Assessment Method for the Intensive Care Unit (CAM-ICU) is a robust and reliable instrument for discerning delirium within the specific context of the intensive care unit (ICU). Nonetheless, the CAM-ICU is burdened by various limitations, including a protracted learning curve and the need for frequent daily administration. The 4 A's Test (4AT) was formulated to assess delirium in hospitalized patients and may have distinct advantages over the CAM-ICU, particularly regarding practical applicability within the ICU bundle. This study was performed to assess the utility of the 4AT in detecting delirium in critically ill patients. This multicenter prospective observational study involved critically ill patients at four academic tertiary care hospitals in South Korea from June 2021 to September 2022. In total, 274 patients (median age, 64 years; 56.9% men) were included, and 75 (27.4%) developed delirium. The 4AT showed good performance in detecting ICU delirium (area under the curve, 0.879; P < 0.001). The 4AT showed a sensitivity of 74.0%, specificity of 95.4%, positive predictive value of 77.5%, negative predictive value of 94.6%, and accuracy of 91.7% for ICU detection of delirium. The sensitivity, specificity, positive predictive value, negative predictive value, and accuracy of the CAM-ICU for detecting ICU delirium were 71.3%, 97.1%, 83.8%, 94.1%, and 92.6%, respectively. The 4AT showed acceptable reliability and validity for detecting ICU delirium in critically ill patients. Because the 4AT is simpler and easier to learn, this scale could be a useful alternative to the CAM-ICU for detecting delirium in critically ill patients. [ABSTRACT FROM AUTHOR]

Background/Objectives: We aimed to investigate the genetic loci related to disc hemorrhage (DH) and the relationship of causation between DH and primary open-angle glaucoma (POAG) using a genome-wide association study (GWAS) in East Asian individuals. Methods: The GWAS included 8488 Koreans who underwent ocular examination including fundus photography to determine the presence of DH and POAG. We performed a GWAS to identify significant single-nucleotide polymorphisms (SNPs) associated with DH and analyzed the heritability of DH and genetic correlation between DH and POAG. The identified SNPs were utilized as instrumental variables (IVs) for two-sample Mendelian randomization (MR) analysis. The POAG outcome dataset was adopted from Biobank Japan data (n = 179,351). Results: We found that the rs62463744 (TMEM270;ELN), rs11658281 (CCDC42), and rs77127203 (PDE10A;LINC00473) SNPs were associated with DH. The SNP heritability of DH was estimated to be 6.7%, with an absence of a genetic correlation with POAG. MR analysis did not reveal a causal association between DH and POAG for East Asian individuals. Conclusions: The novel loci underlying DH in the Korean cohort revealed SNPs in the ELN, CCDC41, and LINC00473 genes. The absence of a causal association between DH and POAG implies that DH is a shared risk factor, rather than an independent culprit factor, and warrants further investigation. [ABSTRACT FROM AUTHOR]

Protein therapeutics are emerging as essential technologies due to their functional and chemical properties. However, their application is currently limited to delivery by oral and injection methods—the former being inefficient and the latter invasive and potentially tissue damaging. Researchers are, therefore, exploring noninvasive delivery systems for proteins through the skin, including transdermal and topical delivery. The large molecular size of proteins presents a key challenge for skin penetration, hindering their ability to penetrate the dense skin lamellar structure. This review focuses on using nanoparticles as carriers to increase protein stability and enhance skin penetration. The use of noninvasive or minimally invasive enhancers for controlling and improving penetration depth is also examined. Furthermore, the physical properties of nanoparticles that affect delivery are evaluated, aiming to propose ways to advance transdermal and topical delivery methods in the future. [ABSTRACT FROM AUTHOR]

Polyhydroxyalkanoate (PHA) is an environmental alternative to petroleum-based plastics because of its biodegradability. The polymer properties of PHA have been improved by the incorporation of different monomers. Traditionally, the monomer composition of PHA has been analyzed using gas chromatography (GC) and nuclear magnetic resonance (NMR), providing accurate monomer composition. However, sequential analysis of the thermal properties of PHA using differential scanning calorimetry (DSC) remains necessary, providing crucial insights into its thermal characteristics. To shorten the monomer composition and thermal property analysis, we directly applied DSC to the analysis of the obtained PHA film and observed a high correlation (r2 = 0.98) between melting enthalpy and the 3-hydroxyhexanoate (3-HHx) mole fraction in the polymer. A higher 3-HHx fraction resulted in a lower melting enthalpy as 3-HHx provided the polymer with higher flexibility. Based on this, we selected the poly(3-hydroxybutyrate-co-3-hydroxyhexanoate) (P(3HB-co-3HHx)) producing strain from Cupriavidus strains that newly screened and transformed with vectors containing P(3HB-co-3HHx) biosynthetic genes, achieving an average error rate below 1.8% between GC and DSC results. Cupriavidus sp. BK2 showed a high 3-HHx mole fraction, up to 10.38 mol%, with Tm (℃) = 171.5 and ΔH of Tm (J/g) = 48.0, simultaneously detected via DSC. This study is an example of the expansion of DSC for PHA analysis from polymer science to microbial engineering. [ABSTRACT FROM AUTHOR]

We present the results of seismic profiling aimed to characterize the structure of shallow formation in the Geoncheon Valley (GCV), an area we interpreted as the north tip of the Miryang Fault This profile was deployed in the GCV, near the City of Gyeongju, Republic of Korea. The Miryang Fault is one of the major faults of the Yangsan Fault System in the Cretaceous Gyeongsang Basin, the southeastern Korean Peninsula. Despite local earthquake records showing scattered micro-seismicity along the trace of Miryang Fault, other geophysical and geological information is rare. The location of the GCV is tectonically critical: it is on the major stratigraphic boundary in the Cretaceous Gyeongsang Basin: the Hayang Group (dominantly sedimentary rocks) to the north and Yucheon Group (volcanic and volcanoclastic rocks) to the south. The surface expression of the Miryang Fault in this area is difficult to define by geomorphology since the surface is covered by highly altered cultivated farmlands. We tackle this problem by conducting seismic profiling. On a 1,200-m long linear profile, we deployed a dense array using 3-component seismic sensors and acquired both passive and active seismic data. The passive seismic data acquisition lasted about 12 days. At the end of the deployment period directly before withdrawing the array, an active survey using a sledgehammer source was also conducted. The integrated seismic cross-section displays significant segmentation in the texture of the seismic image, the sediment-bedrock interface is between less than 10 meters to slightly greater than 20 meters with a general trend of dipping to the southeast. The preliminary seismic results suggest that it is likely the Miryang Fault terminates inside the GCV, and the type of tip damage zone appears to be a group of horsetail splays. [ABSTRACT FROM AUTHOR]

Background: Sentinel node navigation (SNN) has been known as the effective treatment for stomach-preserving surgery in early gastric cancer; however, SNN presents several technical difficulties in real practice. Objective: This study aimed to evaluate the feasibility of regional lymphadenectomy omitting SNN, using the post hoc analysis of a randomized controlled trial. Methods: Using data from the SENORITA trial that compared laparoscopic standard gastrectomy with lymphadenectomy and laparoscopic SNN, 237 patients who underwent SNN were included in this study. Tumor location was divided into longitudinal and circumferential directions. According to the location of the tumor, the presence or absence of lymph node (LN) metastases between sentinel and non-sentinel basins were analyzed. Proposed regional LN stations were defined as the closest area to the primary tumor. Sensitivities, specificities, positive predictive values, and negative predictive values (NPV) of SNN and regional lymphadenectomy were compared. Results: Metastasis to non-sentinel basins with tumor-free in sentinel basins was observed in one patient (0.4%). The rate of LN metastasis to non-regional LN stations without regional LN metastasis was 2.5% (6/237). The sensitivity and NPV of SNN were found to be significantly higher than those of regional lymphadenectomy (96.8% vs. 80.6% [p = 0.016] and 99.5% vs. 97.2% [p = 0.021], respectively). Conclusions: This study showed that regional lymphadenectomy for stomach-preserving surgery, omitting SNN, was insufficient; therefore, SNN is required in stomach-preserving surgery. [ABSTRACT FROM AUTHOR]

Background: Current guidelines recommend against the use of routine imaging tests to detect distant metastasis in asymptomatic breast cancer patients. However, recent advancements in effective therapeutics and diagnostic accuracy have raised the need to reassess the clinical efficacy of intensive metastasis surveillance. We report the results of a multicenter retrospective study to investigate the association between intensive imaging studies and survival outcomes. Patients and Methods: We retrospectively reviewed the data of 4130 patients who underwent surgery from 11 hospitals in Korea between January 2010 and December 2011. Patients were divided into two groups on the basis of the intensity of metastasis imaging studies during their disease-free period. The types and intervals of the imaging studies were based on each physician's decisions. Results: High-intensive screening showed a shorter distant metastasis-free survival [p < 0.001, hazard ratio (HR) 1.62; 95% confidence interval (CI) 1.29–2.04], especially for patients in whom bone or lung was the first site of metastasis. With a median follow-up period of 110.0 months, the 5-year breast cancer-specific survival (BCSS) rate was 96.5%. The high-intensity screening group showed significantly poorer BCSS compared with the low-intensity screening group (p < 0.001, HR 3.13; 95% CI 2.32–4.21). However, both multivariable analysis and propensity score matching analysis showed no significant association between the screening intensity and BCSS. Conclusions: Frequent imaging studies to detect distant metastasis were associated with earlier detection of distant metastasis, especially for lung and bone metastasis. However, intensive surveillance showed no apparent association with BCSS despite the use of currently available treatments. [ABSTRACT FROM AUTHOR]

Background and Objectives: Postoperative ileus (POI) is a delay in gastrointestinal transit following surgery that leads to various complications. There is limited understanding of its effective treatment options. CKD-495 and eupacidin are natural products licensed for treating mucosal lesions in acute and chronic gastritis; however, little is known about their effects on intestinal permeability. This study evaluated the effects of CKD-495, eupacidin, and its components (eupatilin and cinnamic acid) on intestinal permeability in an animal model of POI. Materials and Methods: Guinea pigs underwent surgical procedures and were randomly assigned to different treatment groups. Drugs were administered orally prior to surgery. Intestinal permeability, leukocyte count, and the expression of calprotectin and tight junction proteins were measured in the harvested ileum tissue. Results: The intestinal permeability and leukocyte count were higher in the POI group than in the control group. The pre-administration of CKD-495, cinnamic acid, eupacidin, and eupatilin effectively prevented these changes in the POI model. No significant differences were observed in the expression of tight junction proteins. Conclusions: CKD-495, cinnamic acid, eupacidin, and eupatilin exerted protective effects against increased intestinal permeability and inflammation in an animal model of POI. These natural products have potential as therapeutic options for the treatment of POI. [ABSTRACT FROM AUTHOR]

Background/Objectives: Relatively little has been established about the association of rapid ventricular response (RVR) with further recurrence of atrial fibrillation (AF). This study investigated the impact of RVR on the recurrence of AF. Methods: Data were obtained from a multicenter, prospective registry of non-valvular AF patients. RVR was defined as AF with a ventricular rate > 110 bpm. The primary endpoint was the recurrence of AF, defined as the first AF detected on 12-lead electrocardiography during follow-up. Secondary endpoints included manifestation of AF during follow-up and major adverse cardiovascular events (MACEs), a composite of thromboembolic events, major bleeding, myocardial infarction, and death. Results: Among 5533 patients, 493 (8.9%) presented RVR. Patients with RVR were younger, had smaller left atrial diameters, and more frequently had paroxysmal AF. During the mean follow-up duration of 28.6 months, the RVR group exhibited significantly lower recurrence of AF (hazard ratio: 0.58, 95% confidence interval: 0.53–0.65, p < 0.001). There was no significant difference in the occurrence of MACEs between patients with RVR and those without RVR (0.96, 0.70–1.31, p = 0.800). AF with RVR was identified as an independent negative predictor of AF recurrence (0.61, 0.53–0.71, p < 0.001). Conclusions: In patients with AF, those with RVR had a significantly lower recurrence of AF without an increase in MACEs. RVR is a favorable marker that may benefit from early rhythm control. [ABSTRACT FROM AUTHOR]