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Ubiquitin regulatory X (UBX) domain-containing protein 6 (UBXN6) is an essential cofactor for the activity of the valosin-containing protein p97, an adenosine triphosphatase associated with diverse cellular activities. Nonetheless, its role in cells of the innate immune system remains largely unexplored. In this study, we report that UBXN6 is upregulated in humans with sepsis and may serve as a pivotal regulator of inflammatory responses via the activation of autophagy. Notably, the upregulation of UBXN6 in sepsis patients was negatively correlated with inflammatory gene profiles but positively correlated with the expression of Forkhead box O3, an autophagy-driving transcription factor. Compared with those of control mice, the macrophages of mice subjected to myeloid cell-specific UBXN6 depletion exhibited exacerbated inflammation, increased mitochondrial oxidative stress, and greater impairment of autophagy and endoplasmic reticulum-associated degradation pathways. UBXN6-deficient macrophages also exhibited immunometabolic remodeling, characterized by a shift to aerobic glycolysis and elevated levels of branched-chain amino acids. These metabolic shifts amplify mammalian target of rapamycin pathway signaling, in turn reducing the nuclear translocation of the transcription factor EB and impairing lysosomal biogenesis. Together, these data reveal that UBXN6 serves as an activator of autophagy and regulates inflammation to maintain immune system suppression during human sepsis., (© 2024. The Author(s).)

The emergence of multidrug-resistant (MDR) and extensively drug-resistant (XDR) strains of Mycobacterium tuberculosis (Mtb) poses a significant threat to health globally. During searching for new chemical entities regulating MDR- and XDR-Mtb, chemical investigation of the black oil beetle gut bacterium Micromonospora sp. GR10 led to the discovery of eight new members of arenicolides along with the identification of arenicolide A (Ar-A, 1), which was a previously reported macrolide with incomplete configuration. Genomic analysis of the bacterial strain GR10 revealed their putative biosynthetic pathway. Quantum mechanics-based computation, chemical derivatizations, and bioinformatic analysis established the absolute stereochemistry of Ar-A and arenicolides D-K (Ar-D-K, 2-9) completely for the first time. Biological studies of 1-9 revealed their antimicrobial activity against MDR and XDR strains of Mtb. Ar-A had the most potent in vitro antimicrobial efficacy against MDR- and XDR-Mtb. Mechanistically, Ar-A induced ATP depletion and destabilized Mtb cell wall, thereby inhibiting growth. Notably, Ar-A exerted a significant antimicrobial effect against Mtb in macrophages, was effective in the treatment of Mtb infections, and showed a synergistic effect with amikacin (AMK) in a mouse model of MDR-Mtb lung infection. Collectively, our findings indicate Ar-A to be a promising drug lead for drug-resistant tuberculosis., (© 2024 Wiley‐VCH GmbH.)

The Korean Gynecologic Oncology Group (KGOG) was established in 2002 and is the only organization in Korea conducting multi-center clinical trials for gynecologic cancers. Since its re-establishment as a non-profit organization in 2021, KGOG has grown significantly, now including 207 gynecologic oncology specialists from 76 hospitals. This growth is a testament to the dedication and hard work of all those involved in the organization. KGOG is committed to maximizing the activation of multi-center clinical research through policies that support patients with rare diseases and gynecologic cancer research, focusing on strengthening institutional capacity, equalizing participation opportunities, and enhancing information sharing. A significant milestone for KGOG was becoming a member of the US Gynecologic Oncology Group (GOG) in 2005, allowing participation in GOG clinical trials. KGOG later joined the Gynecologic Cancer InterGroup (GCIG) and strengthened its capabilities by hosting the first Endometrial Cancer Consensus Conference-Clinical Research (ECCC-CR) in 2023. KGOG holds biannual meetings and symposia, as well as 224 operating committee meetings annually to review the discussions of the Tumor Site Committee. KGOG has conducted 156 investigator-initiated trial (IIT) or sponsor-initiated trial (SIT) studies as KGOG-led or participated in research. Currently, 18 studies are registered, and 10 are in preparation. To date, 68 papers have been published. KGOG conducts six national projects and collaborates with external organizations such as the NRG Oncology Foundation, Gynecologic Oncology Group Partners (GOG-P), GCIG, East Asian Gynecologic Oncology Trial group (EAGOT), and the Japanese Gynecologic Oncology Group (JGOG). Through collaboration with renowned international research institutions, KGOG has significantly expanded the scope of its research, achieving noteworthy clinical outcomes. This report not only introduces the history and recent status of KGOG but also presents the exciting future direction of the organization, filled with potential breakthroughs and advancements in gynecologic oncology research.

Using three-dimensional (3D) printing technology to fabricate Bi 2 Te 3 -based thermoelectric (TE) generators opens a potential way to create shape-conformable devices capable of recovering waste heat from thermal energy sources with diverse surface morphologies. However, pores formed in 3D-printed Bi 2 Te 3 -based materials by the removal of the organic ink binder result in unsatisfactory performance compared to the bulk materials, which has limited the widespread application of the ink-based 3D printing process. Furthermore, managing the volatile Se element in the n-type materials poses significant technological challenges compared to the p-type counterparts, resulting in a scarcity of research on 3D printing of n-type Bi 2 Te 3 . Here, we synthesized edge-oxidized graphene (EOG)-incorporated Se-free n-type Bi 1.7 Sb 0.3 Te 3 (BST) using a direct ink writing (DIW) process with a binder-free novel ink. The incorporated EOG provides connectivity between small BST grains separated by pores and induces a bimodal-like grain structure during the DIW and sintering process. The optimal EOG content of 0.1 wt % in 3D-printed n-type BST simultaneously achieved both carrier transport control and active phonon scattering, due to its unique microstructure. A maximum ZT of 0.71 was obtained in the 0.1 wt % EOG/BST materials at 448 K, comparable to commercial bulk n-type Bi 2 Te 3 -based materials. Further, a single-element device composed of the EOG-BST material exhibited a 2-fold improvement in performance compared to pure-BST. These results open a technological route for the application of 3D printing technology for ink-based TE materials.

Thermoelectric devices have received significant attention because of their potential for sustainable energy recovery. In these devices, a thermal design that optimizes heat transfer and dissipation is crucial for maximizing the power output. Heat dissipation generally requires external active or passive cooling devices, which often suffer from inevitable heat loss and heavy systems. Herein, the design of heat-sink integrated thermoelectric legs is proposed to enhance heat dissipation without external cooling devices, realized by finite element model simulation and 3D printing of ternary silver chalcogenide-based thermoelectric materials. Owing to the self-induced surface charges of the synthesized AgBiSe 2 (n-type) and AgSbTe 2 (p-type) particles, these particle-based colloidal inks exhibited high viscoelasticity, which enables the creation of complex heat-dissipation architectures via 3D printing. Power generators made from 3D-printed heat-dissipating legs exhibit higher temperature differences and output power than traditional cuboids, offering a new strategy for enhancing thermoelectric power generation., (© 2024 The Author(s). Advanced Science published by Wiley‐VCH GmbH.)

Se-free n-type (Bi,Sb) 2 Te 3 thermoelectric materials, outperforming traditional n-type Bi 2 (Te,Se) 3 , emerge as a compelling candidate for practical applications of recovering low-grade waste heat. A 100% improvement in the maximum ZT of n-type Bi 1.7 Sb 0.3 Te 3 is demonstrated by using melt-spinning and excess Te-assisted transient liquid phase sintering (LPS). Te-rich sintering promotes the formation of intrinsic defects (Te Bi ), elevating the carrier concentration and enhancing the electrical conductivity. Melt-spinning with excess Te fine-tunes the electronic band, resulting in a high power-factor of 0.35 × 10 -3 W·m -1 K -2 at 300 K. Rapid volume change during sintering induces the formation of dislocation networks, significantly suppressing the lattice thermal conductivity (0.4 W·m -1 K -1 ). The developed n-type legs achieve a high maximum ZT of 1.0 at 450 K resulting in a 70% improvement in the output power of the thermoelectric device (7.7 W at a temperature difference of 250 K). This work highlights the synergy between melt-spinning and transient LPS, advancing the tailored control of both electronic and thermal properties in thermoelectric technology.

To investigate alteration of outer nuclear layer (ONL) and choroidal vascularity index (CVI) in different status of central serous chorioretinopathy (CSC). A retrospective review of 65 CSC eyes with subretinal fluid (manifest CSC) and 40 control eyes was conducted in a single tertiary university hospital. Differences in best-corrected visual acuity (BCVA), ONL, and CVI were compared. CVI was assessed both in the entire choroid (CVI-EC) and around the 1500 μm leakage area (CVI-1500). Measurements were repeated after the subretinal fluid resorption (quiescent CSC), and compared. CSC eyes showed worse BCVA, thinner ONL and greater CVI than controls. Quiescent CSC showed a recovery of ONL compared to the manifest CSC, along with the BCVA improvement. The resolution of the CSC revealed a decrease across all three choroidal areas (total, stromal and luminal), with a more pronounced reduction in the stromal than in the luminal choroidal area, leading to an increase in the CVI. This phenomenon was shown in both CVI-EC and CVI-1500. Conclusively, ONL thickness can be used as a quantitative biomarker for photoreceptor function in CSC. Increased CVI may reflect a disease activity. The stromal choroidal area is particularly sensitive in illustrating leakage from the choroidal vasculature., (© 2024. The Author(s).)

Objectives: Intraoperative ultrasonography (IOUS) offers the advantage of providing real-time imaging features, yet it is not generally used. This study aims to discuss the benefits of utilizing IOUS in spinal cord surgery and review related literature., Materials and Methods: Patients who underwent spinal cord surgery utilizing IOUS at a single institution were retrospectively collected and analyzed to evaluate the benefits derived from the use of IOUS., Results: A total of 43 consecutive patients were analyzed. Schwannoma was the most common tumor (35%), followed by cavernous angioma (23%) and ependymoma (16%). IOUS confirmed tumor extent and location before dura opening in 42 patients (97.7%). It was particularly helpful for myelotomy in deep-seated intramedullary lesions to minimize neural injury in 13 patients (31.0% of 42 patients). IOUS also detected residual or hidden lesions in 3 patients (7.0%) and verified the absence of hematoma post-tumor removal in 23 patients (53.5%). In 3 patients (7.0%), confirming no intradural lesions after removing extradural tumors avoided additional dural incisions. IOUS identified surrounding blood vessels and detected dural defects in one patient (2.3%) respectively., Conclusions: The IOUS can be a valuable tool for spinal cord surgery in identifying the exact location of the pathologic lesions, confirming the completeness of surgery, and minimizing the risk of neural and vascular injury in a real-time fashion., Competing Interests: All the authors confirmed no conflict of interest regarding this study., (Copyright: © 2024 Park et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.)

Carbonate minerals are ubiquitous in nature, and their dissolution impacts many environmentally relevant processes including preferential flow during geological carbon sequestration, pH buffering with climate-change induced ocean acidification, and organic carbon bioavailability in melting permafrost. In this study, we advance the atomic level understanding of calcite dissolution mechanisms to improve our ability to predict this complex process. We performed high pressure and temperature (1300 psi and 50 °C) batch experiments to measure transient dissolution of freshly cleaved calcite under H 2 O, H + , and H 2 CO 3 -dominated conditions, without and with an inhibitory anionic surfactant present. Before and after dissolution experiments, we measured dissolution etch-pit geometries using laser profilometry, and we used density functional theory to investigate relative adsorption energies of competing species that affect dissolution. Our results support the hypothesis that calcite dissolution is controlled by the ability of H 2 O to preferentially adsorb to surface Ca atoms over competing species, even when dissolution is dominated by H + or H 2 CO 3 . More importantly, we identify for the first time that adsorbed H + enhances the role of water by weakening surface Ca-O bonds. We also identify that H 2 CO 3 undergoes dissociative adsorption resulting in adsorbed HCO 3 - and H + . Adsorbed HCO 3 - that competes with H 2 O for Ca acute edge sites inhibits dissolution, while adsorbed H + at the neighboring surface of CO 3 enhances dissolution. The net effect of the dissociative adsorption of H 2 CO 3 is enhanced dissolution. These results will impact future efforts to more accurately model the impact of solutes in complex water matrices on carbonate mineral dissolution.

Background: Management of hypertension and hyperlipidemia, which are common comorbid risk factors for cardiovascular diseases, require multiple medications. The development of a fixed-dose combination (FDC) containing ezetimibe, rosuvastatin, telmisartan, and amlodipine aims to enhance patient adherence and persistence, but the potential interactions among the four medications have not been studied. This study aimed to evaluate the pharmacokinetic (PK) interactions between the FDC of ezetimibe/rosuvastatin 10/20 mg (ER) and the FDC of telmisartan/amlodipine 80/5 mg (TA)., Methods: An open-label, single-sequence, three-period, three-treatment crossover study was conducted in healthy male subjects. All subjects received ER for 7 days, TA for 9 days and ER combined with TA for 7 days during each treatment period. For PK analysis of total/free ezetimibe, rosuvastatin, telmisartan, and amlodipine, serial blood samples were collected for 24 hours at steady state. Safety profiles were assessed throughout the study., Results: Thirty-eight subjects were enrolled, and 34 subjects completed the study. The systemic exposure to each active ingredient after coadministration of the two FDCs was similar to that after each FDC alone. The geometric mean ratios and 90% confidence intervals for the maximum plasma concentration (µg/L) and the area under the plasma concentration-time curve (h·µg/L) of the combination therapy to monotherapy, assessed at steady state, were as follows: total ezetimibe, 1.0264 (0.8765-1.2017) and 0.9359 (0.7847-1.1163); free ezetimibe, 1.5713 (1.2821-1.9257) and 0.9941 (0.8384-1.1788); rosuvastatin, 2.1673 (1.7807-2.6379) and 1.1714 (0.9992-1.3733); telmisartan, 1.0745 (0.8139-1.4186) and 1.1057 (0.8379-1.4591); and amlodipine, 0.9421 (0.8764-1.0126) and 0.9603 (0.8862-1.0405). Both combination therapy and monotherapy were well tolerated by the subjects., Conclusion: The coadministration of ezetimibe/rosuvastatin 10/20 mg and ezetimibe/rosuvastatin 10/20 mg was well tolerated in healthy subjects, and the PK interaction between those two FDCs was not clinically significant., Competing Interests: Kyung Tae Kim is a full-time employee of Addpharma. The other authors report no conflicts of interest associated with this work., (© 2024 Ryu et al.)

Purpose: To evaluate the ocular adverse event (OAE) and the incidence rate that can occur after the COVID-19 vaccination., Methods: Patients who visited with an ophthalmologic diagnosis within a month of COVID-19 vaccination were retrospectively analyzed. OAEs were categorized as ischemia and inflammation by their presumed pathogenesis and were compared by types of vaccine: messenger RNA (mRNA) and viral vector vaccine. The crude incidence rate was calculated using data from the Korea Disease Control and Prevention Agency., Results: Twenty-four patients with OAEs after COVID-19 vaccination were reviewed: 10 patients after mRNA and 14 after viral vector vaccine. Retinal vein occlusion (nine patients) and paralytic strabismus (four patients) were the leading diagnoses. Ischemic OAE was likely to occur after viral vector vaccines, while inflammatory OAE was closely related to mRNA vaccine (p = 0.017). The overall incidence rate of OAE was 5.8 cases per million doses: 11.5 per million doses in viral vector vaccine and 3.4 per million doses in mRNA vaccine., Conclusions: OAEs can be observed shortly after the COVID-19 vaccination, and their category was different based on the types of vaccine. The information and incidence of OAE based on the type of vaccine can help monitor patients who were administered the COVID-19 vaccine.

Purpose: To investigate the association between visual outcomes and choroidal changes in patients with macula-off rhegmatogenous retinal detachment., Methods: This study retrospectively reviewed 63 eyes of patients with macula-off rhegmatogenous retinal detachment who underwent vitrectomy. Their fellow eyes were analyzed as a control group. The choroidal vascularity index (CVI), ellipsoid zone/external limiting membrane integrity, central foveal thickness, and subfoveal choroidal thickness were documented and analyzed. Linear regression analyses were performed to identify factors affecting the final best-corrected visual acuity., Results: Eyes with rhegmatogenous retinal detachment showed increased CVI (68.8 ± 4.1) compared with the control group (66.1 ± 8.8, P = 0.028). Multivariate linear regression analysis revealed that patients with a poor final best-corrected visual acuity had a longer detachment duration ( P = 0.002), worse baseline best-corrected visual acuity ( P = 0.034), thinner central foveal thickness ( P = 0.005), and greater CVI ( P = 0.001) and were more likely to be tamponated with silicone oil ( P = 0.001). Choroidal vascularity index was particularly increased in eyes with poor ellipsoid zone/external limiting membrane integrity, prolonged detachment duration, thin central foveal thickness, and worse best-corrected visual acuity., Conclusion: Increased CVI could indicate poor visual outcomes in patients with macula-off rhegmatogenous retinal detachment. Choroidal remodeling could be associated with the disruption of the ellipsoid zone/external limiting membrane integrity.

Following the alarming reports of microplastic pollution in the marine environment, increased attention has been given to microplastics in other environmental media. Despite the attention, there is limited research available on the depth-distribution of microplastics in freshwater. Specifically, in the case of water sources used for drinking or tap, the height of intake facilities varies, and it is highly likely that there is a correlation between the vertical distribution of microplastics and these water intake structures. Further, because the size of microplastics varies widely in the environment, the commonly used sampling devices are not suitable for selectively extracting microplastics without causing cross-contamination. Thus, we developed a suitable device for microplastics of size 5-20 µm and studied microplastic distribution in freshwater at various depths by considering various types of microplastics and aqueous systems. Lake and river, two major water sources, were selected for the study of microplastics distribution in water system. The microplastic distribution characteristics in both water systems showed that polypropylene and polyethylene were the most abundant across all depths because of their production volume. Plastic types with higher density were found only at the lower layers, and polystyrene was found in the upper layers because of the environmental effects on its buoyancy caused pore diameter and surface area. The lake and river had higher microplastic distribution in the lower layer and upper layer, respectively. This was because the flow rate in river was higher than that of lake. The higher flow rate reduced the settling velocity in river. Thus, hydrodynamic stability influences the vertical distribution and concentrations of microplastics in the water systems. These results are expected to be used for understanding the behavioral characteristics of microplastics in water systems and to manage water sources., (© 2023. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.)

Pancreatic cancer is an aggressive malignant cancer that shows the lowest survival rates. Recently, the 5-year survival rate of pancreatic cancer has been increasing, owing to early diagnosis and therapeutic advancement. The purpose of this study was to investigate the clinical characteristics and significant prognostic factors of spinal metastatic pancreatic cancer. Seventeen patients diagnosed with spinal metastases originating from pancreatic cancer from January 2005 to December 2022 were divided into 2 groups: those who underwent spinal surgery and those who did not. We collected patients' demographic data, clinical features, prognosis, and radiologic data. Age, sex, neurologic symptoms, symptom duration, metastasis location, non-neurologic symptoms, adjuvant therapy, overall survival, survival after spinal metastasis, pain score, and quality of life were compared. The average age was 64.05 (50-80) years. The average interval from pancreatic cancer diagnosis to spinal metastasis diagnosis was 12.53 (0-39) months. Eleven patients underwent spinal surgery, while six did not. Preoperative European Cooperative Oncology Group performance status score of the surgery group was 1.91 ± 1.04 and that of the non-surgery group was 2.5 ± 0.84. Survival time after spinal metastasis in the surgical group was 6.14 ± 6.0 months, while that in the non-surgery group was 2.54 ± 2.38 months. The 1-year survival rate after spinal metastasis was 18% in the surgical group, while that of the non-surgery group was 0% (P = .042). Pancreatic cancer patients with spinal metastases showed poor prognoses and extremely short survival rates. Despite poor prognosis, appropriate surgical treatment may improve prognoses., Competing Interests: The authors have no funding and conflicts of interest to disclose., (Copyright © 2023 the Author(s). Published by Wolters Kluwer Health, Inc.)

AgCl nanomaterials recently attracted scientific interest as useful structural building blocks for producing metallic nanomaterials owing to their facile synthesis, controllable morphology, and ease of removal under ambient conditions. However, their complex chemical reactivity has primarily been studied in association with water solubility or reducibility. This study investigates the pivotal role of precursor ligands in the photochemical synthesis of metallic cubic mesh nanostructures on the AgCl templates. The side reactions between AgCl and Au precursors with different ligands are thoroughly discussed along with their influence on the byproduct formation and the structural stability of the resulting metallic nanostructures. Importantly, we introduce for the first time the partial destruction of AgCl and the formation of undesirable byproducts caused by the presence of highly oxidizing and Cl-containing AuCl 4 - . In addition, a synthetic route for producing highly pure and stable metallic nanostructures using a halogen-free Au precursor or Pt-priming is proposed. Further, the photothermal properties of these replicated metallic nanostructures are presented as a new evaluation tool for analyzing their overall structural stability. Discovering the role of precursor ligands in the reaction system will prove useful as a guide for the synthesis of functional noble metal nanomaterials using silver halide templates., Competing Interests: The authors declare no competing financial interest., (© 2023 The Authors. Published by American Chemical Society.)

Frequency-modulated continuous wave (FMCW) radar system synchronization using external clock signals can cause repeated Range-Doppler (R-D) map corruption when clock signal asynchronization problems occur between the transmitter and receiver. In this paper, we propose a signal processing method for the reconstruction of the corrupted R-D map owing to the FMCW radar's asynchronization. After calculating the image entropy for each R-D map, the corrupted ones are extracted and reconstructed using the normal R-D maps acquired before and after the individual maps. To verify the effectiveness of the proposed method, three target detection experiments were conducted: a human target detection in an indoor environment and a wide place and a moving bike-rider target detection in an outdoor environment. The corrupted R-D map sequence of observed targets in each case was reconstructed properly and showed the validity by comparing the map-by-map range and speed changes in the detected target with the ground-truth information of the target.

Background: Paralysis of medical systems has emerged as a major problem not only in Korea but also globally because of the COVID-19 pandemic. Therefore, early identification and treatment of COVID-19 are crucial. This study aims to develop a machine-learning algorithm based on bio-signals that predicts the infection three days in advance before it progresses from mild to severe, which may necessitate high-flow oxygen therapy or mechanical ventilation., Methods: The study included 2758 hospitalized patients with mild severity COVID-19 between July 2020 and October 2021. Bio-signals, clinical information, and laboratory findings were retrospectively collected from the electronic medical records of patients. Machine learning methods included random forest, random forest ranger, gradient boosting machine, and support vector machine (SVM)., Results: SVM showed the best performance in terms of accuracy, kappa, sensitivity, detection rate, balanced accuracy, and run-time; the area under the receiver operating characteristic curve was also quite high at 0.96. Body temperature and SpO 2 three and four days before discharge or exacerbation were ranked high among SVM features., Conclusions: The proposed algorithm can predict the exacerbation of severity three days in advance in patients with mild COVID-19. This prediction can help effectively manage the reallocation of appropriate medical resources in clinical settings. Therefore, this algorithm can facilitate adequate oxygen therapy and mechanical ventilator preparation, thereby improving patient prognosis, increasing the efficiency of medical systems, and mitigating the damage caused by a global pandemic., (© 2023. The Author(s).)

To investigate the changes in outer nuclear layer (ONL) thickness during anti-vascular endothelial growth factor (VEGF) treatment in type 1 choroidal neovascularization (CNV) and its impact on vision. Type 1 CNV eyes (n = 94) were retrospectively compared to normal control eyes (n = 35). Along with best-corrected visual acuity (BCVA), the location of CNV, foveal ONL thickness, and subretinal fluid height were measured using optical coherence tomography (OCT) and analyzed. Visual outcome and OCT biomarkers were compared. As a result, the CNV group had thinner foveal ONL and worse BCVA compared to the control group. ONL thickness recovered partially along with visual improvement following 3 monthly initial loading doses of aflibercept injections, and it correlated with the final BCVA during the 1-year follow-up. Eyes achieved foveal ONL recovery over + 10 µm had lower subfoveal CNV (45.5%) and showed better visual outcomes than eyes with stationary ONL or suboptimal ONL recovery (76.0%, p = 0.012). In conclusion, type 1 CNV eyes that recovered foveal ONL thickness at initial loading of anti-VEGF demonstrated good final visual outcome during the 1-year follow-up. Monitoring the foveal ONL thickness during early anti-VEGF treatment can give information about the visual outcomes in type 1 CNV., (© 2023. The Author(s).)

Objective: To perform a systematic review and meta-analysis of randomized controlled trials (RCTs) on the use of noninvasive ventilation (NIV) for acute respiratory failure (ARF) in pediatric patients., Data Sources: We searched PubMed, EMBASE, the Cochrane Central Register of Clinical Trials, and Clinicaltrials.gov with a last update on July 31, 2022., Study Selection: We included RCTs comparing NIV with any comparator (standard oxygen therapy and high-flow nasal cannula [HFNC]) in pediatric patients with ARF. We excluded studies performed on neonates and on chronic respiratory failure patients., Data Extraction: Baseline characteristics, intubation rate, mortality, and hospital and ICU length of stays were extracted by trained investigators., Data Synthesis: We identified 15 RCTs (2,679 patients) for the final analyses. The intubation rate was 109 of 945 (11.5%) in the NIV group, and 158 of 1,086 (14.5%) in the control group (risk ratio, 0.791; 95% CI, 0.629-0.996; p = 0.046; I2 = 0%; number needed to treat = 31). Findings were strengthened after removing studies with intervention duration shorter than an hour and after excluding studies with cross-over as rescue treatment. There was no difference in mortality, and ICU and hospital length of stays., Conclusions: In pediatric patients, NIV applied for ARF might reduce the intubation rate compared with standard oxygen therapy or HFNC. No difference in mortality was observed., Competing Interests: The authors have disclosed that they do not have any potential conflicts of interest., (Copyright © 2022 by the Society of Critical Care Medicine and the World Federation of Pediatric Intensive and Critical Care Societies.)

Background: The purpose of this study was to investigate the association between responses to intravitreal bevacizumab injection and renal function in diabetic macular edema (DME) patients. Methods: A retrospective study of the medical records of 104 treatment-naïve DME patients who received intravitreal bevacizumab injection (IVBI) was conducted. Based on the estimated glomerular filtration rate (eGFR, mL/min/1.73 m2), the participants were classified into three groups. Intergroup comparisons of the best-corrected visual acuity (BCVA) and central subfield retinal thickness (CST) changes were performed after three-monthly consecutive IVBIs. In the groups with decreased renal function, the response to further treatment with a different drug was investigated. Results: A total of 104 participants were included in the study: 60 participants in the preserved renal function group (eGFR ≥ 60), 25 participants in the moderate chronic kidney disease (CKD) group (30 ≤ eGFR < 60), and 19 participants in the severe CKD group (eGFR < 30). After three-monthly consecutive IVBIs, BCVA (p < 0.001) and CST (p < 0.001) were significantly improved only in the preserved renal function group. Following further treatment of patients with decreased renal function, the treatment results were significantly better in those who were switched to aflibercept or dexamethasone implant than in those who were maintained on IVBI. Conclusions: From this preliminary study, we observed that renal function might affect the response to IVBI treatment in patients with DME. In the case of a poor response to initial IVBI treatment for DME in patients with moderate to severe CKD, our study supports switching to the aflibercept or dexamethasone implant.

Background: Pressure injuries are likely to develop in the operating room due to the high temperature and humidity underneath the patients. This study was designed to reduce sacral pressure injuries using donut-shaped cushions on patients undergoing open heart surgery in a supine position for more than three hours., Materials and Methods: Patients undergoing open heart surgery for more than three hours were randomly allocated. Depending on the allocation, either the donut-shaped cushion (donut group) or hydrophilic foam dressing (control group) was applied before draping. Patients were evaluated for the development of pressure injuries, National Pressure Ulcer Advisory Panel (NPUAP) stage, and injury size immediately after surgery, 48 hours, and seven days after surgery., Results: Forty-five patients were enrolled in this study. Twenty-two were assigned to the donut group and 23 were assigned to the control group. Three patients developed pressure injuries of NPUAP stage I or higher. All injuries occurred in the control group, but there was no statistically significant difference ( P = 0.083)., Conclusions: Patients who underwent cardiac surgery for more than three hours and used a donut-shaped cushion did not develop pressure injuries, although no statistical difference was noted. Specific preventative measures in the operating room may play a crucial role in preventing pressure injuries, and further research should be pursued., Competing Interests: There are no conflicts of interest., (Copyright: © 2022 Saudi Journal of Anesthesia.)

Ginseng flower bud (GFB), as an inexpensive part of Panax ginseng , attracted significant attention as a beneficial functional food with medicinal potentials due to its high content of ginsenosides. A few studies focused on the utilization of heat treatment and citric acid treatment to process ginseng flowers, converting its polar ginsenosides into rare ginsenosides to improve its biological activities. Thus, in this study, we compared the changes of ginsenosides in GFB after citric acid and heat treatment by HPLC method. The results revealed that less-polar ginsenoside, Rg 6 and F 4 , increased to 1.01 and 0.27% by heat treatment, respectively. Further, ginsenoside F 2 increased to 1.13% with 1 M citric acid treatment. Furthermore, based on the combination of these two processing methods for the first time, the conversion rate of less-polar ginsenosides surged to 80%. The content of ginsenoside Rg3(s) and Rg 5 increased to 1.509 and 1.871%, respectively, by simultaneous heat and citric acid treatment. Therefore, a processing approach that simultaneously performs heat and citric acid treatments has been proposed, and this considerably inexpensive and convenient processing method could be applied to the processing of GFBs and produce less-polar ginsenosides.

To evaluate the pharmacokinetic interactions among rosuvastatin, ezetimibe, and telmisartan, a randomized, open-label, 3-period, 6-sequence crossover study was conducted in healthy subjects. Subjects received one of the following treatments once daily for 7 days in each period with a 1-week washout: a fixed-dose combination of ezetimibe/rosuvastatin 10/20 mg, telmisartan 80 mg, combination therapy of ezetimibe/rosuvastatin 10/20 mg, or telmisartan 80 mg. Blood samples were collected up to 24 hours postdose at steady state. Geometric mean ratios (GMRs) and their 90% confidence intervals (CIs) of the combination therapy to monotherapy for the maximum plasma concentration (C max,ss ), and the area under the time-concentration curve within a dosing interval at steady state (AUC tau,ss ) were estimated. Among the 36 randomized subjects, 31 subjects completed the study. The GMRs and 90%CIs of C max,ss and AUC tau,ss of total ezetimibe were not significantly altered. The C max,ss of free ezetimibe was increased (GMR, 1.85; 90%CI, 1.56-2.19) but not for the AUC tau,ss (GMR, 1.16; 90%CI, 1.06-1.26). Similarly, the C max,ss of rosuvastatin was increased (GMR, 2.13; 90%CI, 1.88-2.43) without a change in the AUC tau,ss (GMR, 1.09; 90%CI, 1.03-1.15). The C max,ss (GMR, 1.16; 90%CI, 1.01-1.32) and AUC tau,ss (GMR, 1.26; 90%CI, 1.17-1.37) of telmisartan were slightly increased. Considering the therapeutic range of the components, the interaction would have limited clinical impact., (© 2021, The American College of Clinical Pharmacology.)

Background: Postoperative pain control after the minimally invasive repair of pectus excavatum (MIRPE) is essential, but there is a controversy about a better analgesic method between epidural and intravenous (IV) analgesia. This systematic review and meta-analysis aimed to compare the effect of epidural versus IV analgesia following MIRPE., Methods: We searched PubMed, MEDLINE, EMBASE, Cochrane Central Register, and ClinicalTrials.gov for randomized controlled trials (RCTs) dated up to 31st May 2021. The primary outcome was the area under the curve (AUC) of the weighted mean visual analog scale (VAS) after MIRPE. The secondary outcomes were postoperative nausea, operation time, total operating room time, and postoperative length of hospital stay., Results: Four RCTs involving 243 patients were finally included in this meta-analysis. The AUC of the weighted mean VAS was 343.62 in the epidural group and 375.24 in the IV group. The epidural group showed lower VAS than the IV group at 12 to 48 h after the surgery. Postoperative nausea, operation time and length of hospital stay was not different between two groups. The epidural group had a significantly longer total operating room time due to epidural catheter insertion time., Conclusions: Epidural analgesia after the MIRPE had a better analgesic effect than IV analgesia. However, IV analgesia may also be a viable option, and physicians should wisely choose analgesic modalities after MIRPE.

Fouling mitigation using chaotic advection caused by herringbone-shaped grooves in a flat membrane module is numerically investigated. The feed flow is laminar with the Reynolds number (Re) ranging from 50 to 500. In addition, we assume a constant permeate flux on the membrane surface. Typical flow characteristics include two counter-rotating flows and downwelling flows, which are highly influenced by the groove depth at each Re. Poincaré sections are plotted to represent the dynamical systems of the flows and to analyze mixing. The flow systems become globally chaotic as the groove depth increases above a threshold value. Fouling mitigation via chaotic advection is demonstrated using the dimensionless average concentration (c¯w*) on the membrane and its growth rate. When the flow system is chaotic, the growth rate of c¯w* drops significantly compared to that predicted from the film theory, demonstrating that chaotic advection is an attractive hydrodynamic technique that mitigates membrane fouling. At each Re, there exists an optimal groove depth minimizing c¯w* and the growth rate of c¯w*. Under the optimum groove geometry, foulants near the membrane are transported back to the bulk flow via the downwelling flows, distributed uniformly in the entire channel via chaotic advection.

Background: To analyze the long-term effects of persistent subretinal fluid (SRF) on visual/anatomic outcomes according to the type of macular neovascularization (MNV) during relaxed treat-and-extend regimen with anti-vascular endothelial growth factor (anti-VEGF) agents in age-related macular degeneration (AMD) patients., Methods: Patients with fovea-involving type 1 or type 2 MNV, treated with a relaxed treat-and-extend regimen for 2 years were retrospectively reviewed. Eyes with SRF observed more than three times per year were defined as the 'persistent SRF (+) group'. To exclude the effects of IRF as much as possible, the eyes with persistent IRF were excluded. The effects of persistent SRF on the best-corrected visual acuity (BCVA), central subfield retinal thickness (CST), and changes in the photoreceptor layer (PRL) thickness and outer retinal bands (external limiting membrane, ellipsoid zone, and cone outer segment tip line) after anti-VEGF injection were analyzed for each MNV type., Results: Seventy-seven eyes with type 1 MNV (44 eyes with persistent SRF) and 53 eyes with type 2 MNV (18 eyes with persistent SRF) were enrolled. Following a relaxed treat-and-extend regimen with anti-VEGF agents, BCVA and CST improved for each MNV type. In comparison between persistent SRF (+) and persistent SRF (-) group, there were no differences in the amount of change in BCVA and CST between the two groups for each MNV type during 2-year follow-up periods. In addition, there were no differences in the amount of reduction in PRL thickness and state of the outer retinal bands between the two groups for each MNV type., Conclusions: Using a relaxed treat-and-extend regimen with anti-VEGF agents, persistent SRF did not have additional effects on visual and anatomic outcomes by 2 years, regardless of the MNV type., (© 2021. The Author(s).)

Semiconducting single-walled carbon nanotubes (s-SWCNTs) have gathered significant interest in various emerging electronics due to their outstanding electrical and mechanical properties. Although large-area and low-cost fabrication of s-SWCNT field effect transistors (FETs) can be easily achieved via solution processing, the electrical performance of the solution-based s-SWCNT FETs is often limited by the charge transport in the s-SWCNT networks and interface between the s-SWCNT and the dielectrics depending on both s-SWCNT solution synthesis and device architecture. Here, we investigate the surface and interfacial electro-chemical behaviors of s-SWCNTs. In addition, we propose a cost-effective and straightforward process capable of minimizing polymers bound to s-SWCNT surfaces acting as an interfering element for the charge carrier transport via a heat-assisted purification (HAP). With the HAP treated s-SWCNTs, we introduced conformal dielectric configuration for s-SWCNT FETs, which are explored by a carefully designed wide array of electrical and chemical characterizations with finite-element analysis (FEA) computer simulation. For more favorable gate-field-induced surface and interfacial behaviors of s-SWCNT, we implemented conformally gated highly capacitive s-SWCNT FETs with ion-gel dielectrics, demonstrating field-effect mobility of ~8.19 cm 2 /V⋅s and on/off current ratio of ~10 5 along with negligible hysteresis.

Power generation through the thermoelectric (TE) effect in small-sized devices requires a submillimeter-thick film that is beneficial to effectively maintain Δ T compared with a micron-scale thin film. However, most TE thick films, which are fabricated using printing technologies, suffer from low electrical conductivity due to the porous structures formed after sintering of the organic binder-mixed TE ink. In this study, we report an n-type TE thick film fabricated through bar-coating of the edge-oxidized-graphene (EOG)-dispersed Bi 2.0 Te 2.7 Se 0.3 (BTS) paste with copper dopants. We have found that EOG provides the conducting pathway for carriers through electrical bridging between the separated BTS grains in porous TE thick films. The simultaneous enhancement in electrical conductivity and the Seebeck coefficient of the EOG-bridged TE film result in a maximum power factor of 1.54 mW·m -1 ·K -2 with the addition of 0.01 wt % EOG. Furthermore, the single element made of an n-type EOG-bridged BTS exhibits a superior output power of 1.65 μW at Δ T = 80 K. These values are 5 times higher than those of bare BTS films. Our results clearly indicate that the utilization of EOG with a metal dopant exerts a synergistic effect for enhancing the electrical output performance of n-type TE thick films for thermal energy harvesters.

This retrospective, consecutive interventional study investigated the long-term clinical outcomes of combined vitrectomy with intraoperative dexamethasone implants for non-tractional refractory diabetic macular edema (DME). The study included 43 eyes from 39 participants with DME that had continued for more than 6 months despite repeated non-surgical treatment. Postoperative changes in best-corrected visual acuity (BCVA) and central macular thickness (CMT) were evaluated over 3 years. A Kaplan-Meier curve was obtained for any additional non-surgical treatment, and the average number of non-surgical treatments required for DME before and after surgery was compared. Other postsurgical complications were also investigated. The logMAR BCVA improved from 0.526 ± 0.417 (20/67) preoperatively to 0.294 ± 0.374 (20/39) 3 years postoperatively (p < 0.001, generalized estimating equation). The CMT improved from 478 ± 122 μm preoperatively to 314 ± 90 μm 3 years postoperatively (p < 0.001, generalized estimating equation). Additional non-surgical treatment was not required for 29 (67%) eyes. The average number of annual non-surgical treatments decreased from 5.04 times preoperatively to 0.34 times postoperatively. Seventeen (40%) eyes developed temporary ocular hypertension after surgery, which normalized after antihypertensive eye drop instillation. In conclusion, vitrectomy combined with intraoperative dexamethasone implantation provides satisfactory long-term clinical outcomes for non-tractional refractory DME while reducing the number of intraocular injections for DME.

The development of novel dielectric materials with reliable dielectric properties and low-temperature processibility is crucial to manufacturing flexible and high-performance organic thin-film transistors (OTFTs) for next-generation roll-to-roll organic electronics. Here, we investigate the solution-based fabrication of high-k aluminum oxide (Al 2 O 3 ) thin films for high-performance OTFTs. Nanocluster-based Al 2 O 3 films fabricated by highly energetic photochemical activation, which allows low-temperature processing, are compared to the conventional nitrate-based Al 2 O 3 films. A wide array of spectroscopic and surface analyses show that ultralow-temperature photochemical activation (<60 °C) induces the decomposition of chemical impurities and causes the densification of the metal-oxide film, resulting in a highly dense high-k Al 2 O 3 dielectric layer from Al-13 nanocluster-based solutions. The fabricated nanocluster-based Al 2 O 3 films exhibit a low leakage current density (<10 -7 A/cm 2 ) at 2 MV/cm and high dielectric breakdown strength (>6 MV/cm). Using this dielectric layer, precisely aligned microrod-shaped 2,7-dioctyl[1]benzothieno [3,2-b][1] benzothiophene (C8-BTBT) single-crystal OTFTs were fabricated via solvent vapor annealing and photochemical patterning of the sacrificial layer.

The increasing interest in flexible and wearable electronics has demanded a dramatic improvement of mechanical robustness in electronic devices along with high-resolution implemented architectures. In this study, a site-specific stress-diffusive manipulation is demonstrated to fulfill highly robust and ultraflexible amorphous indium-gallium-zinc oxide (a-IGZO) thin-film transistors (TFTs) and integrated circuits. The photochemically activated combustion sol-gel a-IGZO TFTs on a mesa-structured polyimide show an average saturation mobility of 6.06 cm 2 V -1 s -1 and a threshold voltage of -0.99 V with less than 9% variation, followed by 10 000 bending cycles with a radius of 125 μm. More importantly, the site-specific monolithic formation of mesa pillar-structured devices can provide fully integrated logic circuits such as seven-stage ring-oscillators, meeting the industrially needed device density and scalability. To exploit the underlying stress-diffusive mechanism, a physical model is provided by using a variety of chemical, structural, and electrical characterizations along with multidomain finite-element analysis simulation. The physical models reveal that a highly scalable and robust device can be achieved via the site-specific mesa architecture, by enabling generation of multineutral layers and fine-tuning the accumulated stresses on specific element of devices with their diffusion out into the boundary of the mesa regions., (© 2020 Wiley-VCH GmbH.)

Purpose: To evaluate the correlation between en-face optical coherence tomography (OCT) parameters and functional outcomes before and after idiopathic epiretinal membrane (ERM) surgery., Methods: This retrospective cohort study involved 80 eyes from 80 patients who underwent surgery for idiopathic ERM. Best-corrected visual acuity, metamorphopsia assessment (M-score), and OCT were assessed before surgery and six months after. The adhesive zone (A-zone) and retinal fold, a novel en-face OCT parameter reflecting inner retinal layer changes, were evaluated. Correlations between the area of A-zone and the number of retinal folds on en-face OCT images and other B-scan OCT parameters were evaluated regarding visual outcomes before and after ERM surgery., Results: The defect size of the ellipsoid zone, interdigitation zone, and external limiting membrane were significantly correlated with preoperative and postoperative 6-month best-corrected visual acuity (all P < 0.05). The central foveal thickness, A-zone area, number of marginal retinal folds, and fovea involvement in the A-zone were correlated with the preoperative and postoperative 6-month M-score (all P < 0.05). The A-zone area was significantly associated with the preoperative and postoperative 6-month M-score in a multiple linear regression model (P < 0.001, P = 0.008, respectively), and the number of marginal retinal folds was significantly associated with the preoperative M-score (P < 0.001) and marginally significantly with the postoperative 6-month M-score (P = 0.106)., Conclusion: The A-zone area and the number of marginal retinal folds were significantly associated with the M-score before and after ERM surgery. These novel en-face OCT parameters can serve as a novel surrogate tool for predicting the functional outcomes in idiopathic ERM.

Obesity is a major health concern worldwide, and it is leading to worsening disease morbidity and mortality. Herbal supplements and diet-based therapies have attracted interest in the treatment of obesity. It is known that Garcinia cambogia (GA) and mulberry leaf, which contain polyphenols, have anti-obesity activity. Herein, we developed a combined tablet consisting of GA extract and bioconverted mulberry leaf extract (BMUL) using a statistical design approach. The ratio and amount of sustained polymers were set as factors. In the cell study, the combination of GA and BMUL showed synergistic anti-obesity activity. In a statistical model, the optimized amounts of hydroxypropyl methylcellulose 2208 (HPMC 2208) and polyethylene oxide 303 (POLYOX 303) were 41.02% and 58.98%, respectively. Additionally, the selected ratio of microcrystalline cellulose (MCC) was 0.33. When the release, hardness, and friability of the GABMUL tablet were evaluated, the error percentages of the response were lower than 10%. This indicates that the GABMUL tablet was successfully prepared.

Surface oxide (Al 2 O 3 ) of reactive fine aluminum (Al) particles for solid fuels, propellants, and brazing materials often restricted oxidative performance, though the passivation film acts to protect Al particles from exploding. Here, we report fine Al particles fully covered with a polytetrafluoroethylene (PTFE) layer instead of an Al 2 O 3 film on the surface. This advance is based on the introduction of strong Al-F bonds, known to be an alternative to the Al-O bonds of surface oxides. The DSC results on the PTFE-coated Al particles exhibit higher reactive-exothermic enthalpy energy (12.26 kJ g -1 ) than 4.85 kJ g -1 by uncoated Al particles. The artificial aging test of the PTFE layer on the Al particles show long-time stability to the external circumstance compared to those by Al 2 O 3 . The activation energy for oxidation was investigated from cyclic voltammetry assessment and the measured peak potentials of the anode curve for PTFE/Al (- 0.45 V) and uncoated Al (- 0.39 V) are achieved, respectively. This means that the PTFE layer is more stable against a sudden explosion of Al particles compared to Al 2 O 3 . These results are very useful given its capability to control both the reactivity and stability levels during the oxidation of Al particles for practical applications.

Purpose: To investigate the differences in natural course, intravitreal bevacizumab injection (IVB) responsiveness, and optical coherence tomography angiography findings according to the type of pigment epithelial detachment (PED) in patients with central serous chorioretinopathy (CSC)., Methods: A retrospective review of angiographically proven CSC patients was conducted. Pigment epithelium detachment was classified as flat irregular or focal. To identify the natural course of CSC, we had observed whether subretinal fluid was improved without any treatment until symptom duration was >3 months. When CSC symptom duration was >3 months, IVB injection was performed. Symptom duration, central subfield thickness, subfoveal choroidal thickness, presence of subretinal fluid, natural course, optical coherence tomography angiography findings, and IVB responsiveness were compared between the PED types., Results: One hundred eyes were included (64 flat irregular PED vs. 34 focal PED). Flat irregular PED had a longer symptom duration than focal PED (7.20 ± 11.52 vs. 3.69 ± 3.98 months, P = 0.03). In untreated cases, the rate of complete resolution of subretinal fluid was significantly lower in flat irregular PED than in focal PED (34.78% vs. 65.22%, P = 0.017). In contrast to the natural course, responsiveness to IVB was significantly better in flat irregular PED (72.41% vs. 31.58%, P = 0.005). Optical coherence tomography angiography revealed more CNV in flat irregular PED (42.90% vs. 10.00%, P = 0.014). Subfoveal choroidal thickness in flat irregular PED was significantly thicker., Conclusion: In CSC patients with flat irregular PED, the natural course was poor, but treatment response to IVB was favorable. Flat irregular PED patients showed longer symptom duration and thicker subfoveal choroidal thickness than those with focal PED. Optical coherence tomography angiography revealed more choroidal neovascularization in flat irregular PED. These findings suggest that CSC with flat irregular PED could be considered a form of pachychoroid neovasculopathy.

Purpose: To investigate the associations between early anatomical responses and intraocular pressure (IOP) changes in macular edema (ME) due to retinal vascular diseases treated with an intravitreal dexamethasone (DEX) implant., Methods: A retrospective review was conducted involving ME patients who underwent intravitreal DEX implantation. The eyes were divided into increased IOP (IIOP) or non-IIOP (nIIOP) groups according to the presence or absence of significant IOP elevation. Significant IOP elevation was defined by both the absolute value of IOP elevation (5 mmHg or higher) and an elevation percentage of the baseline IOP (an increase equal to 30% of the pre-injection IOP or higher). We analyzed the difference in central subfield thickness (CST) change according to the IOP elevation after DEX implantation. Relationships between IOP change and CST reduction after intravitreal DEX implantation were analyzed by Pearson correlation coefficients., Results: A total of 49 eyes, 29 with diabetic ME and 20 with ME due to retinal vein occlusion (RVO), were included in this study. Of the 49 eyes, 18 eyes (36.7%) were classified as IIOP group and 31 (63.3%) as nIIOP group. Significant differences in mean CST reductions over baseline one week after DEX implantation were observed between the groups. The degree of CST reduction from baseline to 1 week was significantly correlated with the degree of IOP change from baseline at 1 week and 1 month after intravitreal DEX implantation., Conclusions: In patients with ME due to retinal vascular diseases, we noted an early anatomical response significantly correlated with IOP change after intravitreal DEX implantation. Therefore, patients with favorable early anatomical responses to DEX implantation should be carefully monitored for IOP elevation.

Background: Seroprevalence studies of coronavirus disease 2019 (COVID-19) from many countries have shown that the number of undiagnosed missing cases is much larger than that of confirmed cases, irrespective of seroprevalence levels. Considering the strategy of Korea entailing massive testing and contact tracing from the beginning of epidemic, the number of undiagnosed missing cases in Korea may be negligible. This study was conducted to estimate the seroprevalence of COVID-19 among individuals who were never diagnosed with COVID-19 in Daegu, the epicenter of COVID-19 epidemic in Korea., Methods: Serologic testing for immunoglobulin G antibody based on immunochromatographic assay was conducted in 103 patients and 95 guardians aged 18 to 82 years without any history of COVID-19 diagnosis, who visited outpatient clinics of a single university-affiliated hospital from May 25 to June 5, 2020., Results: The estimated seroprevalence was 7.6% (95% confidence interval, 4.3%-12.2%) with 15 positive cases. Among them, only one had a polymerase chain reaction (PCR)-confirmed case among their close contacts and 13 did not experience COVID-19-related symptoms. Seroprevalence was similar between patients and guardians. Based on this figure, the number of undiagnosed missing cases in Daegu was estimated to be a dozen times more than the number of confirmed cases based on PCR testing., Conclusion: Despite the limitation of a small and unrepresentative sample, this is the first study on seroprevalence of COVID-19 in Korea. Our study suggested that the number of undiagnosed missing cases was substantial even with the stringent strategy adopted in Korea, similar to that of other countries., Competing Interests: The authors have no potential conflicts of interest to disclose., (© 2020 The Korean Academy of Medical Sciences.)

Background: To evaluate long-term visual/anatomic outcome after anti-vascular endothelial growth factor (anti-VEGF) therapy in patients with fovea-involving fibrovascular pigment epithelium detachment (PED) presenting with choroidal neovascularization (CNV) on optical coherence tomography angiography (OCTA)., Methods: Patients with fibrovascular PED or subretinal CNV confirmed by OCTA who were treated by a relaxed treat-and-extend regimen for 2 years were retrospectively reviewed. The best-corrected visual acuity (BCVA) and central subfield retinal thickness (CST) before and after anti-VEGF injection were analyzed. Furthermore, changes in photoreceptor layer (PRL) thickness and outer retinal bands in the fovea after injection were evaluated., Results: A total of 31 eyes with fibrovascular PED and 24 eyes with subretinal CNV were included. Following a relaxed treat-and-extend regimen with anti-VEGF agents, BCVA and CST were improved, and the PRL thickness was decreased significantly. There were no differences in BCVA, CST, changes in PRL thickness, or the status of outer retinal bands between the groups. However, the difference in the amount of decrease in PRL thickness between the two groups was increased at 2 years, and the slope tended to be steeper in the subretinal CNV group., Conclusions: Exudative age-related macular degeneration (AMD) with fibrovascular PED or subretinal CNV showed good visual/anatomic outcomes after anti-VEGF treatment, regardless of the CNV type. By 2 years, fibrovascular PED did not have an additional protective effect on the outer retina, compared with subretinal CNV over 2 years. Further follow-up study might be needed to conclude that fibrovascular PED has a protective effect on the surrounding photoreceptor area.

Purpose: To investigate the long-term incidence and risk factors of macular hole (MH) development in the fellow eyes of patients with unilateral idiopathic MH., Methods: The retrospective case-control study involved the fellow eyes of 215 consecutive patients with idiopathic MH. The patients were classified into two groups according to the presence or development of MH in the fellow eye. The spectral domain optical coherence tomography features and clinical characteristics of each group were compared., Results: Twelve (5.6%) patients presented with bilateral MH at the initial visit, whereas 20 (9.3%) initially unilateral patients developed MH in the fellow eye over a median interval of 44 months. Vitreomacular traction and inner foveal cyst were noted more frequently in the baseline spectral domain optical coherence tomography scans of fellow eyes of the bilateral group (P < 0.01). An outer foveal defect was found in five patients (35.7%) of the bilateral MH group (P < 0.01)., Conclusion: The incidence of MH in fellow eyes was approximately 10%. The presence of outer foveal defect, inner foveal cyst, and vitreomacular adhesion or traction on spectral domain optical coherence tomography in the fellow eye was the risk factor for MH.

The aim of our study is to provide new type skeleton of α-glucosidase inhibitor from food source. A new 6'-O-(E)-cinnamoyl-7-methoxy-aloin A (1) was isolated from Aloe vera. Also, known chysalodin (2) was the first report for A. vera. These structures were identified with based on HR-ESI Mass and 1/2D-NMR spectra. These isolated compounds were tested for their inhibitory activities against α-glucosidase by using spectrophotometer. Of these, compound 2 exhibited inhibitory activity, with an IC 50 value of 13.4 ± 1.5 μM. An enzyme kinetic study identified the mechanism of binding of the ligand with the enzyme; the ligand binds in the active site of the enzyme in a competitive mode. Additionally, fluorescence quenching between the ligand and receptor revealed a two-to-one reaction. Finally, this finding provides that anthraquinone dimer (2) could be a starting point for the design of new class of α-glucosidase inhibitor., Competing Interests: Declaration of competing interest The authors have declared no conflict of interest., (Copyright © 2020. Published by Elsevier B.V.)

Diabetes mellitus (DM) has become a major health problem in most countries of the world. DM causes many complications, including hyperglycemia, diabetic ketoacidosis, and death. In Asia, mulberry has been used widely in the treatment of DM. Combination of drugs with herbal medicine may reduce the unwanted side effects caused by drugs. In this study, the influence of extended mulberry leaves extract (MLE) intake on metformin (Met) was evaluated in terms of pharmacokinetics and pharmacodynamics in DM-induced rats. Three week-treatment of MLE alone produced the anti-hyperglycemic effect (around 24%) if compared to the control. Interestingly, Met administration after MLE treatment for 3 weeks enhanced about 49% of the anti-hyperglycemic effect of Met. In addition, the extended intake of MLE potentiated the anti-hyperglycemic effect of Met on various concentrations. This potentiated anti-hyperglycemic effect of Met appears to be due to the pharmacokinetic change of Met. In this study, 3 week-treatment of MLE reduced the elimination of Met in DM-induced rats. In addition, MLE reduced the human organic cation transporter 2 (hOCT2) activity in a concentration-dependent manner. Thus, these findings suggest that MLE lowered the elimination of Met via inhibiting the hOCT2., Competing Interests: The authors declare no conflict of interest.

Purpose: To evaluate the visual prognostic factors in patients with pseudophakic epiretinal membrane (ERM) after vitrectomy using spectral domain optical coherence tomography (SD-OCT)., Method: A retrospective review of patients with pseudophakic ERM having undergone vitrectomy was conducted. Best corrected visual acuity (BCVA) and SD-OCT were conducted before and 1, 3, and 6 months after vitrectomy. Known visual prognostic factors, such as inner-retina irregularity index, central foveal thickness (CFT), central inner retinal layer thickness (CIRLT), cone outer segment tip defect length, and photoreceptor outer segment length, were reviewed and their correlation with BCVA was analyzed., Results: Forty-three patients (mean age: 64.88 ± 10.46 years) with pseudophakic ERM were included. BCVA significantly improved after vitrectomy (logMAR 0.30 ± 0.24 vs. 0.11 ± 0.14, p < 0.001). The preoperative high inner-retina irregularity index significantly correlated with poor postoperative BCVA in patients with pseudophakic ERM (correlation coefficient 0.583, p < 0.001). Postoperative improvements of inner retinal SD-OCT findings, such as inner-retina irregularity index, CFT, and CIRLT, were significantly associated with the amount of BCVA improvement after ERM surgery (correlation coefficients were as follows: inner-retina irregularity index - 0.711, p < 0.001; CFT - 0.462, p = 0.002; CIRLT - 0.596, p < 0.001). However, preoperative outer retinal SD-OCT findings were not associated with postoperative visual prognosis., Conclusion: From this study, we determined the visual prognostic factors of ERM surgery without confounding factors, such as visual acuity improvement following combined cataract surgery, and inner retinal SD-OCT findings more significantly associated with the visual prognosis of ERM surgery compared to outer retinal SD-OCT findings., (© 2019 S. Karger AG, Basel.)

Purpose: Long-term results of total hip arthroplasty (THA) using highly cross-linked polyethylene (HXLPE) and metal femoral head with more than 10 years of follow-up have already been reported. However, most studies included results with a head size of 28 mm that could affect wear rates. The aim of this study was to evaluate the results of 36-mm metallic femoral heads on first-generation HXLPE in patients less than 60 years of age with a minimum follow-up of 10 years., Methods: Retrospective analysis included 54 cases from 47 patients. The mean age at the time of surgery was 47.22 years and the mean follow-up period was 131.04 months. Porous-coated cementless acetabular cups (Trilolgy®; Zimmer Inc., Warsaw, Indiana, USA) and HXLPE acetabular liners (Longevity®; Zimmer Inc.) were used for all cases. Acetabular cup abduction angles, anteversion angles, and wear rates of liner were measured using polyWare pro 3D distal version 5.10., Results: The average modified Harris hip score at the final follow-up was 88.48 (range 80-96). Average Merle d'Aubigne and Postel score was 15.57 (range 14-18). There was no acetabular cup or femoral stem failing due to aseptic loosening. The average steady-state wear rate determined using radiographs taken at 1 year postoperatively and at the latest follow-up was 0.053 ± 0.025 mm/year. There were no statistically significant differences in liner wear rate with respect to age, variety of the femoral stem, or liner thickness., Conclusion: Results of THA with 36-mm metallic femoral heads on first-generation HXLPE in patients less than 60 years of age were satisfactory.