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Background : Emotional Freedom Techniques (EFT) have gained attention as a potential therapy for reducing depressive symptoms. However, the evidence remains inconsistent. This meta-analysis aims to assess the overall efficacy of EFT in treating depressive symptoms and explore moderators influencing its effectiveness. Methods : A meta-analysis of 18 randomized controlled trials (RCTs) was conducted, with depressive symptom reduction as the primary outcome. Meta-regression explored moderators such as the EFT format, duration, age, and depression severity. Results : The analysis showed a significant overall effect size of 1.268 for EFT in reducing depressive symptoms. A moderator analysis revealed that group-based EFT interventions were more effective than individual ones, and participants with moderate depression experienced the greatest benefits. Additionally, shorter interventions were found to be highly effective. Conclusions : EFT effectively reduces depressive symptoms, particularly in group settings and for those with moderate depression. Shorter, well-structured interventions may enhance treatment efficiency. Further studies should explore long-term effects and broader applications.

Background : Eye Movement Desensitization and Reprocessing (EMDR) therapy has gained attention for its potential effectiveness in treating depression beyond its initial use for PTSD. This systematic review and meta-analysis aims to evaluate the efficacy of EMDR in treating depression and to identify the variables influencing its effectiveness. Methods : A comprehensive search was conducted across databases, including MEDLINE, PubMed, and EMBASE, covering studies up to January 2023. A total of 521 studies were screened, and 25 studies with 1042 participants (522 EMDR, 520 control) met the inclusion criteria and were included in the meta-analysis. The inclusion criteria involved randomized controlled trials (RCTs) comparing EMDR to control conditions such as usual care or waitlist groups, with outcomes focused on changes in depression symptoms. Results: The results show that EMDR had a significant effect on reducing depression symptoms (Hedges' g = 0.75), with moderate heterogeneity being observed. The meta-regression indicated that the severity of depression was a significant predictor of EMDR's effectiveness, with greater effects in severe cases. Additionally, the systematic review analyzed and evaluated various theoretical models and related studies that explain how EMDR works for the treatment of depression, reporting on neurobiological models proposed in previous research. Conclusions: This study confirms that EMDR is effective in treating depression, particularly in severe cases, and highlights its potential as a non-pharmacological intervention. However, this study highlights the need for more standardized research and long-term evaluations to assess EMDR's lasting impact. Integrating EMDR into multimodal treatment plans and primary care, especially for treatment-resistant depression, could significantly improve patient outcomes.

Objectives: While older adults showed higher mortality during COVID-19 pandemic, protective behaviours (knowledge regarding coping with COVID-19 symptoms and preventive behaviours) were highlighted to be important to prevent the spread of infection. This study aimed to identify individual and community-level variables influencing deficient knowledge regarding coping with COVID-19 and not-practicing COVID-19 of older adults during the pandemic., Design: This is a secondary analysis of a cross-sectional study using the 2020 Korea Community Health Survey (KCHS)., Setting: 255 community public health centres nationwide, South Korea., Methods and Analysis: Using 2020 KCHS data, multilevel logistic regression analysis was conducted on 55 005 adults aged 65 years or older., Results: Older adults who reside alone, as opposed to with their spouse and who lack the support of another individual exhibited insufficient COVID-19 coping-related knowledge (OR: 1.142, p<0.001) and poor preventive behaviours (OR: 1.177, p<0.001). Furthermore, lower municipal social welfare budget levels were associated with worse health behaviours (OR: 0.062, p<0.001). Specifically, older adults living in rural areas were less likely to engage in COVID-19 preventive behaviours compared with those in urban areas (OR: 1.247, p<0.001). Additionally, the effectiveness of mass media as a motivating factor for adopting preventive measures was only significant in rural populations (OR: 0.944, p<0.05)., Conclusions: Both individual-level and community-level approaches are necessary as an initial response during the pandemic. Since elderly people living alone with low socioeconomic status are vulnerable groups with poor health behaviours, it is helpful to provide social support on how to respond to infectious diseases and manage symptoms. In addition, it is important to expand the municipal social welfare budget to promote health equity between regions through appropriate health behaviour education and the strengthening of public medical services., Competing Interests: Competing interests: None declared., (© Author(s) (or their employer(s)) 2024. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.)

Sleep disturbance is associated with the development of neurodegenerative disease. We aimed to address the effects of sleep quality on brain glucose metabolism measured by 18 F-Fl uorodeoxyglucose ( 18 F-FDG) positron emission tomography (PET) in healthy middle-aged adults. A total of 378 healthy men (mean age: 42.8±3.6 years) were included in this study. Participants underwent brain 18 F-FDG PET and completed the Korean version of the Pittsburgh Sleep Quality Index (PSQI-K). Additionally, anthropometric measurements were obtained. PETs were spatially normalized to MNI space using PET templates from SPM5 with PMOD. The Automated Anatomical Labeling 2 atlas was used to define regions of interest (ROIs). The mean uptake of each ROI was scaled to the mean of the global cortical uptake of each individual and defined as the standardized uptake value ratio (SUVR). After the logarithmic transformation of the regional SUVR, the effects of the PSQI-K on the regional SUVR were investigated using Bayesian hierarchical modeling. Brain glucose metabolism of the posterior cingulate, precuneus, and thalamus showed a negative association with total PSQI-K scores in the Bayesian model ROI-based analysis. Voxel-based analysis using statistical parametric mapping revealed a negative association between the total PSQI-K scores and brain glucose metabolism of the precuneus, postcentral gyrus, posterior cingulate, and thalamus. Poor sleep quality is negatively associated with brain glucose metabolism in the precuneus, posterior cingulate, and thalamus. Therefore, the importance of sleep should not be overlooked, even in healthy middle-aged adults., Competing Interests: Declaration of competing interest Nothing to declare, (Copyright © 2024 The Author(s). Published by Elsevier Inc. All rights reserved.)

Background: Although the association between tuberculosis (TB) and cardiovascular disease (CVD) has been reported in several studies and is explained by mechanisms related to chronic inflammation, few studies have comprehensively evaluated the association between TB and CVD in Korea., Methods: Using the Korea National Health and Nutrition Survey, we classified individuals according to the presence or absence of previous pulmonary TB was defined as the formal reading of a chest radiograph or a previous diagnosis of pulmonary TB by a physician. Using multivariable logistic regression analyses, we evaluated the association between the 10-year atherosclerotic cardiovascular disorder (ASCVD) risk and TB exposure, as well as the 10-year ASCVD risk according to epidemiological characteristics., Results: Among the 69,331 participants, 4% ( n  = 3,101) had post-TB survivor group. Comparing the 10-year ASCVD risk between the post-TB survivor and control groups, the post-TB survivor group had an increased 10-year ASCVD risk in the high-risk group (40.46% vs. 24.00%, P  < 0.001). Compared to the control group, the intermediate- and high-risk groups had also significantly increased 10-year ASCVD risks (odds ratio [OR] 1.14, 95% confidence interval [CI] 1.04-1.23 and OR 1.69, 95% CI 1.59-1.78, respectively) in the post-TB survivor group. In the association of CVD among post-TB survivors according to epidemiologic characteristics, age [adjusted OR (aOR) 1.10, 95% CI 1.07-1.12], current smoking (aOR 2.63, 95% CI 1.34-5.14), a high family income (aOR 2.48, 95% CI 1.33-4.62), diabetes mellitus (aOR 1.97, 95% CI 1.23-3.14), and depression (aOR 2.06, 95% CI 1.03-4.10) were associated with CVD in the post-TB survivor group., Conclusions: Our study findings suggest a higher 10-year ASCVD risk among TB survivors than healthy participants. This warrants long-term cardiovascular monitoring and management of the post-TB population., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (© 2024 Yang, Kim, Sim, Gu, Seok, Bae, Cho, Lee, Choe, Lee, Yang and Min.)

To maintain current cognitive function and access greater cognitive reserves, nonpharmacological interventions may be a viable alternative for older adults with or without cognitive impairment. This study aimed to compare different nonpharmacological interventions for enhancing global cognition, including mind-body exercise, physical exercise, non-invasive brain stimulation, cognitive training intervention (CTI), acutherapy (ACU), meditation, and music therapy, by applying a network meta-analysis (NMA). Sixty-one randomized controlled trials evaluating the efficacy of interventions on global cognition in older adults with or without mild cognitive decline were selected. An NMA was conducted to compare the efficacy of different nonpharmacological interventions. The NMA revealed that mind-body exercise (standardized mean difference, 1.384; 95% confidence interval, 0.777-1.992); ACU (1.283; 0.478-2.088); meditation (0.910; 0.097-1.724); non-invasive brain stimulation (1.242; 0.254-2.230); CTI (1.269; 0.736-1.802); and physical exercise (0.977; 0.212-1.742), showed positive effects compared to passive controls. There were no significant differences between the efficacies of other interventions. Nonpharmacological interventions may potentially enhance and maintain global cognition through various pathways, such as memorizing movements and enhancing brain plasticity by reducing stress in the older adult population. Additional studies are needed to clarify the impact of other variables, including intervention methods or psychological variables., (© 2024. The Author(s).)

Introduction: Previous systematic reviews and meta-analyses have mainly focused on improvements in the number of metabolic syndrome risk factors and individual changes in each risk factor, making it challenging to examine the impact of comprehensive lifestyle modification interventions on adherence to recommended health behaviors. To address this gap, we conducted a systematic and meta-analysis aimed at identifying clinical parameter levels associated with lifestyle modification outcomes and adherence to recommended health behaviors for individuals with metabolic syndrome., Methods: A total of seven studies retrieved from four databases (CINAHL, Medline via PubMed, American Psychological Association PsycINFO, and Embase) were included in the review. The selected studies, which demonstrated improvements in health behaviors, all included diet and exercise as main factors of comprehensive lifestyle modification in home settings., Results: Our findings suggest that a 6-month comprehensive intervention including diet and exercise can be effective in decreasing glucose levels and systolic blood pressure. However, given the limited available data, further studies investigating the efficacy of interventions of varying durations are needed., Discussion: Although our review included a small number of studies, comprehensive lifestyle modifications consisting of at least two components (primarily diet and exercise) can improve health behaviors and some clinical parameters among individuals with metabolic syndrome. Future studies are needed to investigate the long-term effects of lifestyle modifications on health behavior adherence and explore effective interventions to address certain clinical parameters, such as high-density lipoprotein levels. Also, we recommend using objective and quantifiable measure to compare adherence to recommended lifestyle modifications across studies., Clinical Relevance: This research provides empirical evidence of the effectiveness of comprehensive lifestyle modification and emphasizes the need to develop long-term nursing strategies in public health that can be used to effectively manage metabolic syndrome., (© 2023 The Authors. Journal of Nursing Scholarship published by Wiley Periodicals LLC on behalf of Sigma Theta Tau International.)

Background: Over half of the older adults living with dementia have behavioral and psychological symptoms of dementia (BPSD), including sleep disturbance; however, little is known about physiological markers. Salivary cortisol and melatonin have been identified as potential biomarkers of BPSD, with evidence suggesting a relationship between these biomarkers and various behavioral factors, as well as sleep and activity patterns., Objectives: The aim of this study was to investigate the time-dependent changes in salivary cortisol and melatonin levels in older adults with dementia, their relationship with the sleep-wake cycle, and their correlation with BPSD symptoms and behavioral factors., Methods: This observational study conducted in Seoul and Gyeonggi-do, South Korea, used data from 172 older adults with dementia, measuring sleep and activity patterns for 2 weeks using a wearable device, in addition to administering questionnaires for neuropsychiatric and psychological symptoms-the Neuropsychiatric Inventory, Cohen-Mansfield Agitation Inventory, and Cornell Scale for Depression in Dementia. Salivary cortisol and melatonin levels were measured at four time points and divided into four groups based on a dual-trajectory model. Differences among the groups were analyzed using one-way analysis of variance., Results: The participants showed normal but heterogeneous patterns of salivary cortisol and melatonin levels. Dual-trajectory pattern analysis showed that higher levels of melatonin during the daytime were correlated with poor nighttime sleep efficiency and decreased disinhibited behaviors, and higher levels of cortisol at all four time points were associated with decreased physical activity., Discussion: Measuring and analyzing periodic changes in cortisol and melatonin levels can predict various behavioral symptoms (e.g., sleep disturbances, activity counts, and disinhibition) in older adults with dementia. A study with an experimental design is needed to discover the direct physiological interactions between cortisol, melatonin, and these symptoms., Competing Interests: The authors have no conflicts of interest to disclose., (Copyright © 2023 Wolters Kluwer Health, Inc. All rights reserved.)

Although remimazolam is an ultra-short-acting benzodiazepine with a shorter elimination half-life and faster recovery time than midazolam, studies evaluating its safety and efficacy during bronchoscopy are limited. This study aimed to compare the safety and efficacy of remimazolam with those of midazolam for bronchoscopy. This prospective randomized parallel-group study was conducted at a single institution. The primary outcome was the time from the end of the procedure to full alertness. Other procedural time parameters, satisfaction profiles, and adverse effects were thoroughly evaluated. The time taken to reach peak sedation and the time from the end of the procedure to full alertness was significantly shorter in the remimazolam group than in the midazolam group (median [interquartile range], 2 min [1-4] vs. 3 min [2-5], P = 0.006; and median, 2 min [1-5] vs. 5 min [1-12], P = 0.035, respectively). In patients with non-biopsy procedures (n = 79), participant satisfaction was significantly higher in the remimazolam group than in the midazolam group (median rated scale, 10 vs. 7, P = 0.042). Physician satisfaction and willingness to repeat the procedure were similar between groups. Although the incidence of adverse effects was similar between the groups and there was no significant difference, the midazolam group had a higher antidote administration rate than the remimazolam group (15.7% vs. 4.1%, P = 0.092). Remimazolam is effective and safe for achieving adequate sedation, with a shorter onset time and faster neuropsychiatric recovery than midazolam. It may be a new option for sedation during bronchoscopy.Trial registration: The trial registration number is NCT05994547, and the date of first registration is 16/08/2023., (© 2023. The Author(s).)

Background and Purpose: Myokines include cytokines secreted by muscle fibers, which are the final targets of myasthenia gravis (MG). This pilot study investigated whether myokine plasma concentrations are altered in patients with MG and assessed the association between the concentration of each myokine and disease severity., Methods: We compared the plasma concentrations of 15 myokines in 63 patients with acetylcholine receptor antibody (Ab)-positive MG and 14 with muscle-specific tyrosine kinase Ab-positive MG (MuSK MG) with those in 15 healthy controls. Plasma myokine concentrations were measured using a Luminex multiplex assay kit with magnetic beads that contained Abs for 15 myokines. Correlations between myokine concentration and clinical scale results were analyzed., Results: The concentration of fractalkine in plasma was higher in MG (median [interquartile range]=419.6 [38.7-732.5] pg/mL) than in controls (158.5 [0.0-313.2] pg/mL, p =0.034). The leukemia inhibitory factor concentration was also found to be higher in MuSK MG (29.9 [8.7-40.1] pg/mL) than in healthy controls (7.6 [0.0-15.6] pg/mL, p =0.013). Fatty-acid-binding protein 3 (FABP3) concentrations in plasma were positively associated with clinical parameters for MG severity, including scores on the Quantitative Myasthenia Gravis score ( p =0.008), Myasthenia Gravis Activities of Daily Living ( p =0.003), and Myasthenia Gravis Composite ( p =0.024) scales. FABP3 concentration in plasma tended to decrease after treatment in patients without additional relapse but increased in those with further relapse., Conclusions: The plasma myokine profile was significantly altered in patients with MG. FABP3 concentration may be useful in assessing disease severity and predicting the treatment response., Competing Interests: The authors have no potential conflicts of interest to disclose., (Copyright © 2023 Korean Neurological Association.)

To conduct a systematic review of the comparative efficacy of various psychotropic medications for the treatment of disruptive behavior (DBs) in youths. To this aim, we systematically reviewed randomized clinical trials (RCTs) of various psychotropic medications targeting symptoms of DBs and applied network meta-analysis to investigate their relative efficacy. Fifty-five RCTs meeting the inclusion criteria were selected. To predict and interpret relative treatment efficacy, we compared the efficacy of various psychotropic medications prescribed for DB symptoms based on their mechanism of action. Network meta-analysis revealed that for reducing DBs, second-generation antipsychotics, stimulants, and non-stimulant ADHD medications were more efficacious than placebo, and second-generation antipsychotics were the most efficacious. The dopaminergic modulation of top-down inhibitory process by these medications is discussed in this review. This study offers information on the relative efficacy of various psychotropic medications for the treatment of DB, and insight into a potential neurobiological underpinning for those symptoms. It also illustrates the potential utility of these neurobiological mechanisms as a target for future treatment studies., (© 2023. The Author(s).)

Background: Although behavioral and psychological symptoms of dementia are a global public health challenge, non-pharmacological interventions using information and communication technologies can be an affordable, cost-effective, and innovative solution., Objectives: This study aimed to examine the effectiveness of non-pharmacological interventions using information and communication technologies on the behavioral and psychological symptoms of dementia and identify potential moderators of intervention effects., Design: Systematic review and meta-analysis of randomized controlled trials., Methods: A systematic literature review was conducted using PubMed, CINAHL, PsycINFO, Embase, and the Cochrane Library from May 2022. Randomized controlled trials that examined the effects of non-pharmacological interventions using information and communication technologies on the behavioral and psychological symptoms of dementia were included. A meta-analysis using a random-effects model was performed to calculate the pooled standardized mean differences between overall symptoms and each type of symptom. For moderator analyses, subgroup and meta-regression analyses were performed., Results: Sixteen trials (15 articles) met the eligibility criteria. The interventions were grouped into activity engagement interventions using digital health that provided music and reminiscence therapy, physical exercise, social interaction interventions using social robots, and telehealth-based care aid interventions that provided coaching or counseling programs. Pooled evidence demonstrated that non-pharmacological interventions using information and communication technologies exerted a large effect on depression (SMD = -1.088, 95% CI -1.983 to -0.193, p = 0.017), a moderate effect on overall behavioral and psychological symptoms of dementia (SMD = -0.664, 95% CI -0.990 to -0.338, p < 0.001), and agitation (SMD = -0.586, 95% CI -1.130 to -0.042, p = 0.035). No effects on neuropsychiatric symptoms (SMD = -0.251, 95% CI -0.579 to 0.077, p = 0.133), anxiety (SMD = -0.541, 95% CI -1.270 to 0.188, p = 0.146), and apathy (SMD = -0.830, 95% CI -1.835 to 0.176, p = 0.106) were reported. Moderator analyses identified the mean age of the participants as a potential moderator of intervention effects., Conclusions: Evidence from this systematic review and meta-analysis suggests that non-pharmacological interventions, using information and communication technologies, were an applicable approach to managing behavioral and psychological symptoms among older adults with dementia, with moderate to large effect sizes. However, evidence on anxiety and apathy is inconclusive due to the limited number of existing randomized controlled trials. Future studies with subgroup analyses are warranted to conclude the most effective types of intervention using information and communication technologies for each type of symptom., Registration: CRD42021258498., Competing Interests: Declaration of Competing Interest None., (Copyright © 2022 The Author(s). Published by Elsevier Ltd.. All rights reserved.)

The brain plays a major role in controlling the desire to eat. This meta-analysis aimed to assess the association between dopamine receptor (DR) availability and dopamine transporter (DAT) availability, measured using positron emission tomography, and obesity. We performed a systematic search of MEDLINE (from inception to November 2020) and EMBASE (from inception to November 2020) for articles published in English using the keywords "dopamine receptor," "dopamine transporter," "obesity," and "neuroimaging." Body mass index (BMI) and the corresponding binding potential (BP ND ) were extracted from figures in each study using Engauge Digitizer, version 12.1, and plotted for radiopharmaceuticals and regions of interest (ROIs). Five studies involving 119 subjects with DR and five studies including 421 subjects with DAT were eligible for inclusion in this study. In overweight or obese subjects with BMI of 25 kg/m 2 or higher, DR availability from 11 C-Racloprie was negatively associated with BMI. However, DR availability from 11 C-PHNO was positively associated with BMI. DAT ratio was calculated after dividing DAT availabilities of overweight/obese BMI with mean DAT availabilities of normal BMI. The association between DAT ratio and BMI was not significant regardless of radiopharmaceuticals. In conclusion, dopamine plays a main role in the reward system with regard to obesity. Overweight and obese subjects had negative association between DR availability from 11 C-Raclopride and BMI. However, the association of DR availability with BMI was dependent on radiopharmaceuticals. DAT availability did not show the significant relationship with BMI regardless of radiopharmaceuticals., (© 2022 Wiley Periodicals LLC.)

Positron emission tomography with 18 F-sodium fluoride (NaF) radioligand has been actively investigated in atherosclerosis research because it is known to detect microcalcification activity within atheroma. We studied whether NaF shows any uptake in the brain tissue of patients with acute ischemic stroke. This is a post-hoc analysis of previously reported cerebral atherosclerosis research with positron emission tomography which applied the two radioligands, 18 F-fluorodeoxyglucose and NaF for the detection of culprit atheroma among 20 acute cerebral infarction patients (mean age = 75.1 ± 9.0 years; 10 women). In this study, we measured the maximum and mean standardized uptake value (SUVmax and SUVmean) of NaF uptake level in the cerebral infarct region between lesions with and without diffusion weighted image (DWI) positivity, indicating acute ischemic cell death. Correlation analysis was performed between NaF uptake levels and imaging and clinical variables, including neurological severity. The NaF uptake levels were significantly higher in DWI positive lesions than in negative lesions (SUVmax: 2.0 [0.60-4.2] versus 0.20 [0.10-0.40], p = 0.021 by Mann-Whitney U test). The intensity of NaF uptake (SUVmax) was significantly correlated with the initial neurological severity (Spearman's ρ = 0.579, p= 0.007) and white blood cell count (Spearman's ρ = 0.626, p p 0.003). During ischemic stroke NaF was concentrated in brain tissue undergoing acute cell death and its uptake intensity was correlated with neurological severity, suggesting that NaF could reflect acute ischemic cell death after stroke., (© 2022. The Author(s).)

Background: With the number of older people living alone continuously rising, health-monitoring systems using information and communication technology (ICT) have been developed to manage their health issues. Life logging and human body communication sensor, types of ICT, have been adapted to manage and monitor health status of the elderly. However, its feasibility and efficacy remain unclear. This study aimed to examine the feasibility of TouchCare system which combined life logging with human body communication technology and its effect on the physical and psychological status of older adults living alone., Methods: The TouchCare system, which consisted of a wearable watch, touchpad sensors, TouchCare application, and context-aware artificial intelligence, was developed by DNX Co. Ltd and used by the participants for 5 months. Out of the 111 selected participants, 91 replied to the satisfaction survey, and 22 participated in further investigation regarding their physical and psychological status. Finally, health assessment from 14 participants and sensor data from 13 participants (mean age = 77.4; SD = 3.8) were analyzed to compare their health status and health-related behaviors before and after use of the system., Results: Out of the 91 participants who took the survey, 51.6% were satisfied with the system. Nutritional status (pre-intervention (10.6 ± 2.0) vs. post-intervention (11.8 ± 1.9), P = 0.04) and fall efficacy (pre-intervention (89.2 ± 15.3) vs. post-intervention (99.9 ± 0.5), P = 0.001) significantly improved after use of the system. Chronic pain (pre-intervention (4.8 ± 2.5) vs. post-intervention (4.4 ± 3.7), P = 0.78) and depressive symptoms (pre-intervention (5.7 ± 3.9) vs. post-intervention (5.4 ± 3.1), P = 0.60) reduced, while cognitive function (pre-intervention (4.1 ± 1.4) vs. post-intervention (4.6 ± 1.1), P = 0.15) and physical performance related to walking improved (pre-intervention (3.9 ± 0.2) vs. post-intervention (4.0 ± 0), P = 0.35), but were not significant. Behaviors related to physical activity and gait improved after use of the system; touch counts of refrigerator and microwave also increased with a decrease in night touch counts., Conclusions: The TouchCare system was acceptable to older people living alone, and it efficiently managed their daily living while promoting their health-related behaviors. Further experimental studies are required to verify the effectiveness of the system, and to develop the system which meet the individualized needs of older people living alone., (© 2022. The Author(s).)

Background: Androgen receptor (AR) is a potential therapeutic target in triple-negative breast cancer (TNBC). We aimed to elucidate the association of AR expression with glucose metabolic features in TNBC., Methods: Two independent datasets were analyzed: FDG PET data of our institution and a public dataset of GSE135565. In PET analysis, patients with TNBC who underwent pretreatment PET between Jan 2013 and Dec 2017 were retrospectively enrolled. Clinicopathologic features and maximum standardized uptake value (SUVmax) of tumors were compared with AR expression. In GSE135565 dataset, glycolysis score was calculated by the pattern of glycolysis-related genes, and of which association with SUVmax and AR gene expression were analyzed., Results: A total of 608 female patients were included in the PET data of our institution. SUVmax was lower in AR-positive tumors (P < 0.001) and correlated with lower AR expression (rho = -0.26, P < 0.001). In multivariate analysis, AR was a deterministic factor for low SUVmax (P = 0.012), along with other key clinicopathologic features. In the GSE135565 dataset, AR expression also exhibited a negative correlation with SUVmax (r = -0.34, P = 0.001) and the glycolysis score (r = -0.27, P = 0.013)., Conclusions: Low glucose metabolism is a signature of AR expression in TNBC. It is suggested that evaluation of AR expression status needs to be considered in clinical practice particularly in TNBC with low glucose metabolism., Competing Interests: The authors have declared that no competing interests exist.

Purpose: Post-stroke cognitive impairment can affect up to one third of stroke survivors. Since cognitive function greatly contributes to patients' quality of life, an objective quantitative biomarker for early prediction of dementia after stroke is required. We developed a deep-learning (DL)-based signature using positron emission tomography (PET) to objectively evaluate cognitive decline in patients with stroke., Methods: We built a DL model that differentiated Alzheimer's disease (AD) from normal controls (NC) using brain fluorodeoxyglucose (FDG) PET from the Alzheimer's Disease Neuroimaging Initiative database. The model was directly transferred to a prospectively enrolled cohort of patients with stroke to differentiate patients with dementia from those without dementia. The accuracy of the model was evaluated by the area under the curve values of receiver operating characteristic curves (AUC-ROC). We visualized the distribution of DL-based features and brain regions that the model weighted for classification. Correlations between cognitive signature from the DL model and clinical variables were evaluated, and survival analysis for post-stroke dementia was performed in patients with stroke., Results: The classification of AD vs. NC subjects was performed with AUC-ROC of 0.94 (95% confidence interval [CI], 0.89-0.98). The transferred model discriminated stroke patients with dementia (AUC-ROC = 0.75). The score of cognitive decline signature using FDG PET was positively correlated with age, neutrophil-lymphocyte ratio and platelet-lymphocyte ratio and negatively correlated with body mass index in patients with stroke. We found that the cognitive decline score was an independent risk factor for dementia following stroke (hazard ratio, 10.90; 95% CI, 3.59-33.09; P < 0.0001) after adjustment for other key variables., Conclusion: The DL-based cognitive signature using FDG PET was successfully transferred to an independent stroke cohort. It is suggested that DL-based cognitive evaluation using FDG PET could be utilized as an objective biomarker for cognitive dysfunction in patients with cerebrovascular diseases., (© 2021. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.)

Obesogens are a type of endocrine-disrupting chemicals (EDCs) that disrupt the human endocrine system, resulting in obesity and metabolic disease. Several obesogens, including bisphenol A, tolylfluanid, and some pesticides, have been identified and studied previously; however, the underlying molecular mechanisms by which obesogens interfere with adipogenesis and induce insulin resistance in adipocyte remain unknown. This study aims to determine which type of chemical is the most potent obesogen and to investigate its effect on adipogenesis-related gene expressions. 3T3-L1, a pre adipocyte cell line, was differentiated into mature adipocytes with either vehicle or various obesogens, including bisphenol A, tolylfluanid, and endrin, as well as corticosterone, at the same dose. Subsequently, intracellular and secreted triglyceride levels were measured, and the expression of genes and proteins involved in adipogenesis and lipogenesis was investigated. We found that endrin was the most potent regulator of adipogenic differentiation, as compared to tolylfluanid, bisphenol A, and corticosterone. Endrin increased intracellular and secreted triglyceride levels and enhanced the expression of adipogenic transcription factors as well as the terminal differentiation marker in a dose-dependent manner. During the early stages of differentiation, endrin enhanced mammalian target of rapamycin (mTOR) activity, which was suppressed by the pharmacological blockade of the protein kinase B-mTOR pathway, with repressed adipogenic differentiation. However, endrin did not change the expression levels of the downstream members of the mTOR signaling pathway or proteins related to lipolysis in response to insulin. Thus, we suggest that endrin potentiates early-stage adipogenic differentiation by activating the mTOR pathway., (Copyright © 2021 Elsevier Inc. All rights reserved.)

Aim: To review and examine the effectiveness of non-pharmacological interventions on behavioural and psychological symptoms of dementia using information and communication technology., Design: This is a systematic review and meta-analysis., Methods: The databases including PubMed, CINAHL with Full Text (EBSCOhost), PsycINFO, Embase, and the Cochrane Library will be searched for all published studies. Studies will be screened and selected with criteria described in PICOS format. Risk of bias will be assessed by the National Institute for Health and Clinical Excellence checklist. Data will be extracted from eligible studies and used to perform a meta-analysis examining the overall effects and effects on individual outcomes. Additionally, we will conduct meta-regression to examine the association between explanatory variables and behavioural and psychological symptoms. This study has been funded since June 2020., Discussion: This study will be the first to reveal the effects of non-pharmacological interventions using information and communication technology on behavioural and psychological symptoms of dementia. Furthermore, this study will provide updated and valid evidence of interventions using this for managing behavioural and psychological symptoms of dementia., Impact: Although non-pharmacological interventions using information and communication technology for older adults living with dementia are continuously developing, their direct effect remains unclear. This study will evaluate the effectiveness of these interventions on behavioural and psychological symptoms of dementia and provide the evidence to implement these interventions among older adults living with dementia. Thus, caregivers and nursing staff can manage behavioural and psychological symptoms of dementia more effectively by incorporating information and communication technology., (© 2021 John Wiley & Sons Ltd.)

Severe irritability is common in youths with psychiatric disorders and results in significant dysfunction across domains (academic, social, and familial). Prior structural MRI studies in the pediatric population demonstrated that aberrations of cortical thickness (CT) and gray matter volume (GMV) in the fronto-striatal-temporal regions which have been associated with irritability. However, the directions of the correlations between structural alteration and irritability in the individual indices were not consistent. Thus, we aim to address this by implementing comprehensive assessments of CT, GMV, and local gyrification index (LGI) simultaneously in youths with severe levels of irritability by voxel-based morphometry and surface-based morphometry. One hundred and eight adolescents (46 youths with severe irritability and 62 healthy youths, average age = 14.08 years, standard deviation = 2.36) were scanned with a T1-weighted MRI sequence. The severity of irritability was measured using the affective reactivity index. In youths with severe irritability, there was decreased CT, GMV, and LGI in the right superior frontal gyrus (SFG) compared to healthy youths, and negative correlations between these indices of the SFG and irritability. Our findings suggest that structural deficits in the SFG, potentially related to its role in inhibitory control, may be critical for the neurobiology of irritability., (© 2021 The Authors. Human Brain Mapping published by Wiley Periodicals LLC.)

Purpose: Acute appendicitis is the most common nonobstetric indication for surgical intervention during pregnancy. In the argument of the optimal surgical approach to acute appendicitis in pregnancy, laparoscopy seems to be won with a similar complication rate and shorter postoperative recovery than open. We aimed to compare perioperative outcomes of appendectomy in pregnant and nonpregnant women in the totally laparoscopic age., Methods: We retrospectively analyzed 556 nonincidental appendectomies performed in women (aged 18-45 years) between January 2014 and December 2018. To reduce the confounding effects, we used propensity score considering the variables age, American Society of Anesthesiologists physical status classification, and the operative finding; whether the appendicitis was simple or complicated. After propensity score matching, the outcomes of 15 pregnant women were compared with those of the 30 nonpregnant women., Results: All the operations were performed with laparoscopy. Most of the pregnant cases were in their first and second trimester. The postoperative morbidity rate was significantly higher in the pregnant group before propensity score matching; however, the significance disappeared after matching. Operative outcomes and the parameters related to the postoperative recovery were not different between the two groups. Two patients in their first trimester decided to terminate the pregnancy after appendectomy. One patient in her second trimester experienced preterm labor which was resolved spontaneously. There was no other obstetric adverse outcome., Conclusion: In the laparoscopy age, appendectomy during pregnancy is safe and not associated with a significantly increased risk of postoperative complication., Competing Interests: All authors have no conflicts of interest to declare., (Copyright © 2021 The Journal of Minimally Invasive Surgery. All rights reserved.)

Background: DNA methylation inhibits gene expression by preventing transcription factors from binding to DNA. Functioning of nigrostriatal dopaminergic neurons is influenced by the expression of the dopamine transporter (DAT), and genetic variations in the gene encoding DAT contribute to differences in reward processing. We aimed to investigate the action of DAT methylation on DAT protein expression measured by positron emission tomography (PET)., Methods: The emission data were acquired over 90 min with 50 frames after injection of 18 F-FP-CIT using PET. Binding potentials (BP ND s) of ventral striatum, caudate nucleus, putamen were measured with the simplified reference tissue method. Genomic DNA was extracted from subjects' blood sampling. Methylation of 4 regions in SLC6A3 gene was assessed using bisulfite pyrosequencing. The mean percentage of methylation (%) for each cluster was calculated by taking the average of all CpG site methylation levels measured within the cluster. Subjects were assessed with the Generalized Reward and Punishment Expectancy Scales (GRAPES) that consists of 30 items related with the reward and punishment that individuals expect for their behaviors., Results: Thirty-five healthy males, with an age range between 20 and 30 years, and a mean age of 24.4 ± 2.7 years, were included in this study. The mean percentage of methylation (%) from cluster C showed a trend of positive correlation with DAT availability of ventral striatum (rho = 0.3712, p = 0.0281), not significant after correction for multiple comparisons, and a significant correlation with GRAPES A: reward expectancy scale (rho = 0.7178, p < 0.0001)., Conclusion: DAT methylation from peripheral blood showed a trend of positive correlation with DAT availability of ventral striatum in healthy subjects; however, it was not significant after correction for multiple comparison. The degrees of methylation from cluster C of DAT in peripheral blood were significantly correlated with reward scales of GRAPES A: reward expectancy scale. The association between DAT methylation and DAT expression needs to be investigated further.

Background: Major depressive disorder (MDD) is a mood disorder associated with disruptions in emotional control. Previous studies have investigated abnormal regional activity and connectivity within the fronto-limbic circuit. However, condition-specific connectivity changes and their association with the pathophysiology of MDD remain unexplored. This study investigated effective connectivity in the fronto-limbic circuit induced by negative emotional processing from patients with MDD. Methods: Thirty-four unmedicated female patients with MDD and 28 healthy participants underwent event-related functional magnetic resonance imaging at 7T while viewing emotionally negative and neutral images. Brain regions whose dynamics are driven by experimental conditions were identified by using statistical parametric mapping. Effective connectivity among regions of interest was then estimated by using dynamic causal modeling. Results: Patients with MDD had lower activation of the orbitofrontal cortex (OFC) and higher activation of the parahippocampal gyrus (PHG) than healthy controls (HC). In association with these regional changes, we found that patients with MDD did not have significant modulatory connections from the primary visual cortex (V1) to OFC, whereas those connections of HC were significantly positively modulated during negative emotional processing. Regarding the PHG activity, patients with MDD had greater modulatory connection from the V1, but reduced negative modulatory connection from the OFC, compared with healthy participants. Conclusions: These results imply that disrupted effective connectivity among regions of the OFC, PHG, and V1 may be closely associated with the impaired regulation of negative emotional processing in the female patients with MDD.

Background and Purpose: We investigated 18F -fluorodeoxyglucose (FDG) uptake levels in the lumbar vertebrae, liver, and spleen of stroke patients with carotid atherosclerosis., Methods: This study analyzed acute ischemic stroke patients with carotid atherosclerosis who underwent whole-body FDG positron-emission tomography between October 2015 and January 2017. FDG uptake in the lumbar vertebrae, liver, and spleen was measured and compared between stroke patients and control subjects without stroke history. Multivariate linear regression analysis was performed to identify independent factors related to FDG uptake in the proximal internal carotid artery (ICA)., Results: Twenty stroke patients aged 75.1±9.0 years (mean±standard deviation; 10 females) and 20 control subjects aged 62.9±10.7 years (6 females) were included. In comparison with the control group, the stroke group showed significantly higher FDG uptake in the proximal ICA (1.16±0.26 vs. 0.87±0.19, p <0.01), but significantly lower FDG uptake in the lumbar vertebrae (1.09±0.26 vs. 1.38±0.38, p =0.007) and liver (1.71±0.30 vs. 2.01±0.34, p =0.005). Multivariate linear regression analysis showed that the lumbar FDG uptake was negatively correlated with FDG uptake in the proximal ICA (standardized coefficient=-0.367, p =0.013) after adjusting for age and hypertension., Conclusions: Stroke patients showed decreased FDG uptake in the lumbar vertebrae. Further studies are warranted to evaluate the pathophysiological link between cerebral atherosclerosis and bone., Competing Interests: The authors have no potential conflicts of interest to disclose., (Copyright © 2021 Korean Neurological Association.)

Atherosclerosis is the leading cause of life-threatening morbidity and mortality, as the rupture of atherosclerotic plaques leads to critical atherothrombotic events such as myocardial infarction and ischemic stroke, which are the 2 most common causes of death worldwide. Vascular calcification is a complicated pathological process involved in atherosclerosis, and microcalcifications are presumed to increase the likelihood of plaque rupture. Despite many efforts to develop novel non-invasive diagnostic modalities, diagnostic techniques are still limited, especially before symptomatic presentation. From this point of view, vulnerable plaques are a direct target of atherosclerosis imaging. Anatomic imaging modalities have the limitation of only visualizing macroscopic structural changes, which occurs in later stages of disease, while molecular imaging modalities are able to detect microscopic processes and microcalcifications, which occur early in the disease process. Na[ 18 F]-fluoride positron emission tomography/computed tomography could allow the early detection of plaque instability, which is deemed to be a primary goal in the prevention of cardiac or brain ischemic events, by quantifying the microcalcifications within vulnerable plaques and evaluating the atherosclerotic disease burden., Competing Interests: Conflict of Interest: The authors have no conflicts of interest to declare., (Copyright © 2020 The Korean Society of Lipid and Atherosclerosis.)

The purpose of this experiment is to evaluate the physical properties of contact lenses made by adding hydrophilic Hyaluronic acid (HA) and Methacrylic acid (MA) as additives and Graphene oxide nanocolloids. As a contact lens, AIBN (Azobisisobutyronitrile) was used as an initiator with HEMA (2-hydroxy methyl methacrylate) and EGDMA (ethylene glycol dimethacrylate) as a cross-linker. Hyaluronic acid (HA) and methacrylic acid (MA) were added at 5%, respectively. Graphene oxide nanocolloids were added at 0.1%, 0.3% and 0.5%, respectively. Each prepared contact lens was hydrated in 99% NaCl saline solution for 24 hours. And the basic physical properties of contact lenses were evaluated and compared. The refractive index of the sample with hyaluronic acid and MA added was 1.4390, which was not significantly different from that of the basic combination contact lens sample. When Graphene oxide nanocolloids, a nanomaterial, were added, the refractive index decreased with increasing amount of Graphene oxide nanocolloids from 1.4209 to 13959. In the case of water content, the sample with 5% Hyaluronic acid and MA added slightly increased to 41.01%. In the case of Graphene oxide nanocolloids added, 48.76%~53.56% of Graphene oxide nanocolloids were added. Especially, it was observed that the water content increased sharply in the 0.1% sample of Graphene oxide nanocolloids. When the amount of graphene oxide nanocolloids added to the contact lens material was increased, the refractive index, which is a basic physical property, gradually decreased as the contact lens material was added together with Hyaluronic acid, MA, and Graphene oxide nanocolloids added as a nanomaterial. The water content tended to increase gradually. Therefore, the combination of Graphene oxide and hydrophilicmaterials shows a synergistic effect of physical properties, which is considered to be suitable as a material for contact lenses.

Objectives: PET using F-fluorodeoxyglucose (FDG) has proven to be valuable in staging and monitoring of treatment response in breast cancer. We aimed to assess the prognostic value of metabolic tumor volume (MTV) and total lesion glycolysis (TLG) in patients with breast cancer., Methods: A systematic search of MEDLINE and EMBASE was performed using the keywords of breast cancer, PET, and volume. Inclusion criteria were F-FDG PET used as an initial imaging tool; studies limited to patients with breast cancer who had not undergone any treatment before PET scans; and studies reporting survival data. Event-free survival (EFS) and overall survival (OS) were considered markers of outcome., Results: Nine studies comprising 975 patients were included in this study. The pooled hazard ratio (HR) for adverse events was 33.73 (P < 0.00001; I = 0%) with MTV from primary tumor and 2.89 (P < 0.00001; I = 45%) with TLG from primary tumor, meaning that primary tumors with high volumetric parameters were associated with progression or recurrence. However, the combined HRs for EFS of MTV, and TLG, and those for OS of MTV from whole-body tumor were NS. The pooled HR for OS of TLG from whole-body tumor was 2.95 (P = 0.18; I = 71%)., Conclusion: Volumetric parameters from F-FDG PET are significant prognostic factors for outcome in patients with breast cancer. Patients with a high MTV or TLG from primary tumor have a higher risk of adverse events. Patients with a high TLG from whole-body tumor have a higher risk of deaths.

Background: The hippocampus reportedly plays a crucial role in memory. However, examining individual human hippocampal-subfield function remains challenging because of their small sizes and convoluted structures. Here, we identified hippocampal subregions involved in memory types (implicit and explicit memory) and stages (encoding and retrieval)., Methods: We modified the serial reaction time task to examine four memory types, i.e. implicit encoding, explicit encoding, implicit retrieval, and explicit retrieval. During this task, 7-T functional magnetic resonance imaging was used to compare brain activity evoked by these memory types., Results: We found hippocampal activation according to all memory types and stages and identified that the hippocampus subserves both implicit and explicit memory processing. Moreover, we confirmed that cornu ammonis (CA) regions 1-3 were implicated in both memory encoding and retrieval, whereas the subiculum was implicated only in memory retrieval. We also found that CA 1-3 was activated more for explicit than implicit memory., Conclusions: These results elucidate human hippocampal-subfield functioning underlying memory and may support future investigations into hippocampal-subfield functioning in health and neurodegenerative disease.

Background: Chronic steroid treatment causes an increase in visceral adiposity and osteoporosis. It is believed that steroids may alter a balance between differentiation of mesenchymal stem cells (MSCs) into either adipocytes or osteoblasts; however, the detailed molecular mechanisms are unclear. We previously identified Dexras1 as a critical factor that potentiates adipogenesis in response to glucocorticoids. Thus, in this study, we investigated the role of Dexras1 in maintaining the balance between chronic steroid treatment-associated adipogenesis and osteoporosis., Material and Methods: We treated wild type (WT) and Dexras1 knockout (KO) mice with dexamethasone for five weeks followed by 60% HFD for additional two weeks with dexamethasone. The changes of glucocorticoid-induced body weight gain and osteoporosis were analyzed. Bone marrow derived stromal cells (BMSCs) and mouse embryonic fibroblasts (MEFs) extracted from WT and Dexras1 KO mice, as well as MC3T3-E1 pre-osteoblasts and osteoclasts differentiated from RAW264.7 were analyzed to further define the role of Dexras1 in osteoblasts and osteoclasts., Results: Dual-energy X-ray absorptiometry and micro-computed tomography analyses in murine femurs revealed that Dexras1 deficiency was associated with increased osteogenesis, concurrent with reduced adipogenesis. Furthermore, Dexras1 deficiency promoted osteogenesis of BMSCs and MEFs in vitro, suggesting that Dexras1 deficiency prevents steroid-induced osteoporosis. We also observed that Dexras1 downregulated SMAD signaling pathways, which reduced the osteogenic differentiation capacity of pre-osteoblast MC3T3-E1 cells into mature osteoblasts., Conclusion: We propose that Dexras1 is critical for maintaining the equilibrium between adipogenesis and osteogenesis upon steroid treatment., Competing Interests: Declaration of competing interest We declare that we have no conflict of interest., (Copyright © 2020 The Author(s). Published by Elsevier Inc. All rights reserved.)

Background: The aim of this study was to develop a scoring system to stratify the risk of papillary thyroid cancer (PTC) and to select the proper management., Methods: We performed a systematic search of MEDLINE and Embase. Data regarding patients' prognoses were obtained from the included studies. Odds ratios (ORs) with statistical significance were extracted from the publications. To generate a risk scoring system (RSS), ORs were summed (RSS1), and summed after natural-logarithmic transformation (RSS2). RSS1 and RSS2 were compared to the eighth edition of the American Joint Committee on Cancer (AJCC) staging system and the 2015 American Thyroid Association (ATA) guidelines for thyroid nodules and differentiated thyroid carcinoma., Results: Five meta-analyses were eligible for inclusion in the study. Eight variables (sex, tumour size, extrathyroidal extension, BRAF mutation, TERT mutation, histologic subtype, lymph node metastasis, and distant metastasis) were included. RSS1 was the best of the analysed models., Conclusion: We developed and validated a new RSS derived from previous meta-analyses for patients with PTC. This RSS seems to be superior to previously published systems.

Although numerous neuroimaging studies have evaluated the characteristics of intermittent explosive disorder (IED), studies on the structural alterations and focal dysfunction in the brain in this condition are limited. This study aimed to identify gray matter deficits and functional alterations in individuals with IED using voxel-based morphometry (VBM) and functional magnetic resonance imaging (fMRI) analyses. Fifteen men with IED and 15 age- and sex-matched healthy controls participated in this study. Gray matter volume and brain activation while viewing the anger-inducing films were measured using 7T MRI. VBM results indicated that individuals with IED had significantly reduced gray matter volume in the insula, amygdala, and orbitofrontal area, relative to controls. Gray matter volume in the left insula was negatively correlated with composite aggression scores. fMRI results demonstrated that relative to healthy controls, individuals with IED showed greater activation in the insula, putamen, anterior cingulate cortex, and amygdala during anger processing. Left insular activity was positively correlated with composite aggression scores. Collectively, these findings suggest that structural and functional alterations in the left insula are linked to IED; this provides insight into the neural mechanisms underlying IED., (Copyright © 2020 Seok and Cheong.)

Background and Aims: Individuals with problematic hypersexual behavior (PHB) are unable to control their sexual cravings, regardless of other situational factors. This inability to control cravings is a common trait in patients with neurological pathologies related to response inhibition. Until recently, however, it was unclear whether individuals with PHB have decreased inhibition and altered neural responses in the brain regions associated with inhibition compared to healthy control individuals, especially in the presence of distracting sexual stimuli. In this study, we examined the neural and psychological underpinnings of inhibition in individuals with PHB., Methods: Thirty individuals with PHB and 30 healthy subjects underwent functional magnetic resonance imaging while performing a modified go/no-go task with neutral or sexual backgrounds used as distractors., Results: Individuals with PHB showed poorer response inhibition than healthy subjects, especially when sexual distractors were present. Further, compared to healthy control subjects, individuals with PHB showed decreased activation in the right inferior frontal gyrus (IFG) and reduced functional connectivity between the IFG and the pre-supplementary motor area (preSMA) when response inhibition was required. Finally, the reduced activation and connectivity were more pronounced in the presence of sexual distractors than in the presence of neutral distractors., Discussion: These findings suggest that individuals with PHB show reduced ability to inhibit responses that might be related to lower IFG activation and IFG-preSMA connectivity during response inhibition. Our results provide insights into the neurobiological underpinnings of poor response inhibition in individuals with PHB.

Preadipocyte differentiation can be induced upon a hormonal treatment, and various factors secreted by the cells may contribute to adipogenesis. In this study, RNA-seq revealed Serpina3c as a critical factor regulating the signaling network during adipogenesis. Serpina3c is a secretory protein and is highly expressed in fat tissues. Knockdown of Serpina3c decreased adipogenesis by attenuating the mitotic clonal expansion of 3T3-L1 cells. These cells exhibited decreases in integrin α5, which abolished the phosphorylation of integrin β3. We found that Serpina3c inhibits a serine protease that regulates integrin α5 degradation. Knockdown of Serpina3c disrupted integrin-mediated insulin growth factor 1 (IGF-1) signaling and ERK activation. Serpina3c-mediated regulation of integrin-IGF-1 signaling is also associated with AKT activation, which affects the nuclear translocation of GSK3β. Altogether, our results indicate that Serpina3c secreted from differentiating adipocytes inhibits serine proteases to modulate integrin/IGF-1-mediated ERK and AKT signaling and thus is a critical factor contributing to adipogenesis., Competing Interests: Declaration of Interest The authors declare no conflict of interest., (Copyright © 2020 The Author(s). Published by Elsevier Inc. All rights reserved.)

In this study, the functional ophthalmic hydrogel lens containing graphen oxide nanoparticles, PVP (polyvinylpyrrolidone) were manufactured. For 2-hydroxyethyl methacrylate (HEMA), which is the main component of the ophthalmic hydrogel lens, and azobisisobutyronitrile (AIBN), an initiator for thermal polymerization. And for photopolymerization, 2-hydroxy-2-methylpropiophenone (2H2M). And used for cross linker ethylene glycol dimethacrylate (EGDMA). The prepared ophthalmic hydrogel lens samples were hydrated in a sterile physiological saline solution for 24 hours before evaluating their physical properties, such as optical transmittance, refractive index, and water content. The surface characteristics of the lenses were also evaluated by measuring the AFM and contact angle. The results of this study suggest that PVP and graphene oxide nanoparticles have high wettability as additives, and that the lens manufactured by using the photopolymerization method demonstrated an ultraviolet shielding effect, thereby prompting us to conclude its suitability as a highly functional ophthalmic lens.

Objective: We aimed to evaluate the association between the availability of serotonin transporter (SERT) measured by ioflupane-DaTSCAN ( 123 I-FP-CIT) and imaged by single photon emission tomography (SPET) and memory function in healthy subjects., Subjects and Methods: Specific binding of 123 I-FP-CIT indicating SERT was achieved using a region of interest analysis. Spherical volumes of interest for midbrain and pons were defined. The cerebellum was chosen as a reference region. Specific binding ratios (SBR) in midbrain and pons representing SERT availability were measured as follows: SBR=(target-cerebellum)/cerebellum. A hundred and eighty-one healthy subjects (117 male, 64 female) were included in this study., Results: Specific binding ratios of both midbrain (P=0.025) and pons (P=0.006) of males was higher than that of females. None of the SBR showed a correlation with age both in males: (midbrain; P=0.736, pons; P=0.875) and in females (midbrain; P=0.294, pons; P=0.170). In all our cases, SERT availability of midbrain correlated positively with total recall score (rho=0.159, P=0.033), and delayed recall score (rho=0.149, P=0.046). In females, the correlation between SERT availability in midbrain and delayed recall score was significant (rho=0.320, P=0.010), however, not in males (rho=0.112, P=0.229)., Conclusion: In conclusion, we demonstrated that SERT availability was associated with memory function in healthy females from the PPMI database. Further studies are needed to clarify underlying mechanisms of this phenomenon.

Objective: The objective of this study was to analyze uptake patterns and intensity of 18 F-fluorodeoxyglucose (FDG) and 18 F-sodium fluoride (NaF) radioligands in carotid atheroma among stroke patients according to carotid atheroma characteristics., Methods: Between September 2015 and January 2017, consecutive acute stroke or transient ischemic attack patients with 50% or more proximal internal carotid artery stenosis on brain computed tomography angiography were prospectively enrolled. All patients received FDG and NaF positron emission tomography (PET) evaluation when their neurological status was stabilized. Uptake values of FDG and NaF were compared by target to blood ratio (TBR) according to the calcification burden, atheroma volume and the presence of a necrotic core of carotid atheroma., Results: A total of 18 patients with 36 carotid arteries were finally enrolled, with 10 patients diagnosed as acute cerebral infarction due to symptomatic carotid stenosis. FDG uptake at symptomatic carotid arteries was significantly more increased than that at asymptomatic arteries (TBR: 1.17±0.23 vs. 1.01±0.15, Mann-Whitney U -test, p =0.02), but NaF uptake was not different (TBR: 1.38±0.49 vs. 1.51±0.40, p =0.40). In terms of calcification degree, NaF uptake increased as calcification burden increased (none, 1.28±0.36; spotty, 1.29±0.29; linear, 1.74±0.44; analysis of variance, p =0.02)., Conclusion: Carotid evaluation by FDG is superior to NaF PET in the detection of symptomatic carotid atherosclerosis among stroke patients. NaF PET uptake reflects the overall calcification burden., Competing Interests: Conflict of Interest: The authors have no conflicts of interest to declare., (Copyright © 2019 The Korean Society of Lipid and Atherosclerosis.)

Purpose : Acute kidney injury (AKI) affects cancer therapy outcome and increases morbidity and mortality in cancer patients. We investigated the incidence, risk factors, and clinical outcomes of AKI caused by palliative chemotherapy in lung cancer patients. Materials and Methods : Between January 2005 and November 2014, 207 lung cancer patients who had been treated with first-line palliative chemotherapy were enrolled. Renal function was assessed during every cycle of chemotherapy. AKI was defined based on changes in serum creatinine levels as described in the Kidney Disease: Improving Global Outcomes guidelines. Clinical outcomes were evaluated depending on AKI occurrence during the first-line chemotherapy. Results : Of the 207 patients, 36 (17.4%) experienced AKI. Among the 36 patients who developed AKI during chemotherapy, 33 (91.8%) had AKI stage I. Although 19 patients (52.7%) with AKI during chemotherapy progressed to chronic kidney disease (CKD), no patients were reported to progress to end-stage renal disease (ESRD). The number of chemotherapy cycles was independently associated with chemotherapy-induced AKI in multivariate analysis (OR = 1.71, 95% CI 1.29-2.26, p < 0.001). The median follow-up duration was 83 months. Patients with AKI during chemotherapy (AKI group) showed significantly longer time to treatment failure than patients without AKI (non-AKI group) (4.2 vs. 2.5 months, p < 0.001). However, the median overall survival (11.7 vs. 8.8 months, p = 0.147) and progression-free survival (5.5 vs. 5.2 months, p = 0.347) were not different between the groups. Conclusions : AKI that developed during chemotherapy was mostly of mild degree and its prognosis was favorable. The occurrence of AKI was associated with the number of chemotherapy cycles administered. AKI did not adversely affect survival of lung cancer patients during chemotherapy., Competing Interests: Competing Interests: The authors have declared that no competing interest exists., (© The author(s).)

Fluctuating body weight is a commonly reported nonmotor feature in patients with Parkinson's disease (PD). We hypothesised that striatal dopamine transporter (DAT) density at the time of diagnosis might play an important role in weight regulation in patients with PD. DAT density was measured from 123 I-FP-CIT single-photon emission computed tomography. Region-of-interest analyses were performed to measure the specific binding of 123 I-FP-CIT to DAT, and the putamen-to-caudate nucleus ratio (PCR) was calculated. Body weight was measured at baseline (W0) and at 48 months (W48). We classified subjects into three groups: weight loss, stable, and weight gain. In final analyses, 163 patients (106 men, 57 women) were included. PCR significantly differed by group in men, but not in women or across all patients. In men, PCR was slightly negatively associated with the percentage change in weight. No such correlation was found across all patients or in women. In univariate and multivariate logistic regression analyses, low PCR was associated with future weight gain in men with PD but not in women. In conclusion, striatal DAT availability at the time of diagnosis could predict subsequent weight change in men with PD.

Objective: Thyroid cancer is the most common malignant endocrine tumour, and its incidence has continuously increased worldwide over the past three decades. We focused on the association of multifocal papillary thyroid carcinoma (PTC) with messenger RNA (mRNA) expression to characterize how molecular and histopathologic features relate to multifocality., Design: A retrospective cohort study., Patients: The primary and processed data were downloaded from The Cancer Genome Atlas. A total of 490 patients were included in this study., Methods: The statistical significance of differences in sex, age, histology, LN metastasis and recurrence were analysed using chi-squared test. To identify differentially expressed genes between BRAF (+) multifocal and unifocal PTCs and between BRAF (-) multifocal and unifocal PTCs, we used the Significance Analysis of Microarray. Over-representation analysis is conducted using CPDB., Results: A total of 237 patients had BRAF (+) PTCs, whereas 253 had BRAF (-) PTCs. There were 110 patients with multifocal PTCs and 127 with unifocal PTCs in the BRAF (+) group and 116 patients with multifocal PTCs and 137 with unifocal PTCs in the BRAF (-) group. In BRAF (+) group, multifocal PTCs had increased expression of 158 mRNAs as compared to that in unifocal PTCs. Ten mRNAs were involved in Wnt-related pathways, and seven mRNAs were included in pluripotency-related pathways., Conclusion: Multifocal PTCs have higher expression of mRNAs in Wnt- and pluripotency-related pathways when BRAF mutation is present. This might be the mechanism that accounts for the difference between multifocal and unifocal PTCs., (© 2018 John Wiley & Sons Ltd.)

Little is known about how anger-associated brain regions integrate and modulate external input. Therefore, we investigated the neural connectivity architecture of anger processing using a dynamic causal modeling (DCM) approach. Thirteen subjects underwent functional magnetic resonance imaging (fMRI) while viewing anger-inducing film clips. Conventional fMRI and DCM analyses were conducted to identify a dominant connectivity model. Viewing anger-inducing film clips led to activation in the left superior temporal gyrus, left insula, and left orbitofrontal cortex (OFC). The results of a group-level comparison of eight connectivity models based on conventional fMRI findings showed superiority of the model including reciprocal effective connectivities between the left insula, left superior temporal gyrus, and left orbitofrontal gyrus and bottom-up connectivity from the left superior temporal gyrus to the left orbitofrontal gyrus. Positive coupling effects were identified for connectivities between the left superior temporal gyrus and left insula and the left superior temporal gyrus and left OFC. A negative coupling effect was identified for connectivity between the left OFC and left insula. In conclusion, we propose a model of effective connectivity associated with the anger experience based on dynamic causal modeling. The findings have implications for various psychiatric disorders related to abnormalities in anger processing., (Copyright: © 2019 University of Economics and Human Sciences in Warsaw.)

Accumulating evidence suggests a relationship between problematic hypersexual behavior (PHB) and diminished executive control. Clinical studies have demonstrated that individuals with PHB exhibit high levels of impulsivity; however, relatively little is known regarding the neural mechanisms underlying impaired executive control in PHB. This study investigated the neural correlates of executive control in individuals with PHB and healthy controls using event-related functional magnetic resonance imaging (fMRI). Twenty-three individuals with PHB and 22 healthy control participants underwent fMRI while performing a Stroop task. Response time and error rates were measured as surrogate indicators of executive control. Individuals with PHB exhibited impaired task performance and lower activation in the right dorsolateral prefrontal cortex (DLPFC) and inferior parietal cortex relative to healthy controls during the Stroop task. In addition, blood oxygen level-dependent responses in these areas were negatively associated with PHB severity. The right DLPFC and inferior parietal cortex are associated with higher-order cognitive control and visual attention, respectively. Our findings suggest that individuals with PHB have diminished executive control and impaired functionality in the right DLPFC and inferior parietal cortex, providing a neural basis for PHB.

Purpose: The present study investigated associations between dopamine transporter (DAT) availability and α-synuclein levels in cerebrospinal fluid, as well as synuclein gene (SNCA) transcripts, and the effect of single nucleotide polymorphism of SNCA on DAT availability in healthy subjects., Materials and Methods: The study population comprised healthy controls who underwent ¹²³I-FP-CIT single-photon emission computed tomography screening. Five SNCA probes were used to target the boundaries of exon 3 and exon 4 (SNCA-E3E4), transcripts with a long 3'UTR region (SNCA-3UTR-1, SNCA-3UTR-2), transcripts that skip exon 5 (SNCA-E4E6), and the rare short transcript isoforms that comprise exons 1-4 (SNCA-007)., Results: In total, 123 healthy subjects (male 75, female 48) were included in this study. DAT availability in the caudate nucleus (p=0.0661) and putamen (p=0.0739) tended to differ according to rs3910105 genotype. In post-hoc analysis, DAT availability in the putamen was lower in subjects of TT genotype than those of CC/CT (p=0.0317). DAT availability in the caudate nucleus also showed a trend similar to that in the putamen (p=0.0597). Subjects of CT genotype with rs3910105 showed negative correlations with DAT availability in the putamen with SNCA-E3E4 (p=0.037, rho=-0.277), and SNCA-E4E6 (p=0.042, rho=-0.270), but not those of CC/TT genotypes., Conclusion: This is the first study to investigate the association of rs3910105 in SNCA with DAT availability. rs3910105 had an effect on DAT availability, and the correlation between DAT availability and SNCA transcripts were significant in CT genotypes of rs3910105., Competing Interests: The authors have no financial conflicts of interest., (© Copyright: Yonsei University College of Medicine 2018.)

Neuroimaging studies on the characteristics of hypersexual disorder have been accumulating, yet alternations in brain structures and functional connectivity in individuals with problematic hypersexual behavior (PHB) has only recently been studied. This study aimed to investigate gray matter deficits and resting-state abnormalities in individuals with PHB using voxel-based morphometry and resting-state connectivity analysis. Seventeen individuals with PHB and 19 age-matched healthy controls participated in this study. Gray matter volume of the brain and resting-state connectivity were measured using 3T magnetic resonance imaging. Compared to healthy subjects, individuals with PHB had significant reductions in gray matter volume in the left superior temporal gyrus (STG) and right middle temporal gyrus. Individuals with PHB also exhibited a decrease in resting-state functional connectivity between the left STG and left precuneus and between the left STG and right caudate. The gray matter volume of the left STG and its resting-state functional connectivity with the right caudate both showed significant negative correlations with the severity of PHB. The findings suggest that structural deficits and resting-state functional impairments in the left STG might be linked to PHB and provide new insights into the underlying neural mechanisms of PHB., (Copyright © 2018 Elsevier B.V. All rights reserved.)