Search

Objective: Little is known about the hearing characteristics in patients with congenital round window atresia (CRWA). This study aimed to investigate hearing characteristics in patients with CRWA by comparing them with two relatively common congenital middle ear anomalies: congenital stapedial fixation (CSF) and congenital ossicular discontinuity (COD)., Methods: Literature searches yielded five patients with surgically confirmed CRWA (seven ears), who were included in the CRWA group, along with one of our patients. Air and bone conduction thresholds; air-bone gap (ABG); and presence and depth of the Carhart notch were analyzed. These audiometric variables in the CRWA group were compared with those in the CSF (n = 15) and COD (n = 22) groups, comprising patients identified from our institution's medical database., Results: Average bone and air conduction thresholds in the CRWA group were 16.4 (standard deviation [SD]: 2.9; 95 % confidence interval [CI]: 14.6-18.3) and 44.6 (SD: 3.5; 95 % CI: 42.6-47.3) dB hearing level (HL). Bone conduction thresholds at high frequencies (≥2 kHz) were higher than those at low frequencies (<2 kHz), while air conduction thresholds at high frequencies were lower than those at low frequencies: ABGs at high frequencies were significantly smaller than those at low frequencies (2 kHz vs. 0.5 kHz, p = 0.027; 2 kHz vs. 1 kHz, p = 0.041; 4 kHz vs. 0.5 kHz, p = 0.042; 4 kHz vs. 1 kHz, p = 0.027). There were no between-group differences in incidence and depth of the Carhart notch., Conclusion: CRWA could manifest as a distinct audiometric pattern with poorer bone conduction and better air conduction at ≥2 kHz, resulting in significantly smaller ABGs at higher frequencies than that at lower frequencies. Our findings indicated that this pattern differed from that of CSF and COD. The unique beer bottle-shaped audiogram associated with CRWA might facilitate its early diagnosis in patients with congenital conductive hearing loss., Competing Interests: Declaration of competing interest The authors declare that they have no competing interests., (Copyright © 2024 Elsevier B.V. All rights reserved.)

Background and Purpose: Genome-wide association studies (GWAS) of metabolic syndrome (MetS) have predominantly focused on non-Asian populations, with limited representation from East Asian cohorts. Moreover, previous GWAS analyses have primarily emphasized the significance of top single nucleotide polymorphisms (SNPs), poorly explaining other SNP signals in linkage disequilibrium. This study aimed to reveal the interaction between rs651821 and rs2266788, the principal variants of apolipoprotein A5 (APOA5), within the most significant loci identified through GWAS on MetS., Methods: GWAS on MetS and its components was conducted using the data from the Korean Genome and Epidemiology Study (KoGES) city cohort comprising 58,600 individuals with available biochemical, demographic, lifestyle factors, and the most significant APOA5 locus was analyzed further in depth., Results: According to GWAS of MetS and its diagnostic components, a significant association between the APOA5 SNPs rs651821/rs2266788 and MetS/triglycerides/high-density lipoprotein phenotypes was revealed. However, a conditional analysis employing rs651821 unveiled a reversal in the odds ratio for rs2266788. Therefore, rs651821 and rs2266788 emerged as independent and opposing signals in the extended GWAS analysis, i.e., the multilayered effects. Further gene-environment interaction analyses regarding lifestyle factors such as smoking, alcohol consumption, and physical activity underscored these multilayered effects., Conclusion: This study unveils the intricate interplay between rs651821 and rs2266788 derived from MetS GWAS. Removing the influence of lead SNP reveals an independent protective signal associated with rs2266788, suggesting a multilayered effect between these SNPs. These findings underline the need for novel perspectives in future MetS GWAS., (© 2024. The Author(s).)

Background: In this study, we examined the impact of a patient blood management (PBM) program on red blood cell (RBC) transfusion practices in cardiothoracic surgery., Methods: The PBM program had 3 components: monitoring transfusions through an order communication system checklist, educating the medical team about PBM, and providing feedback to ordering physicians on the appropriateness of transfusion. The retrospective analysis examined changes in the hemoglobin levels triggering transfusion and the proportions of appropriate RBC transfusions before, during, and after PBM implementation. Further analysis was focused on patients undergoing cardiac surgery, with outcomes including 30-day mortality, durations of intensive care unit and hospital stays, and rates of pneumonia, sepsis, and wound complications., Results: The study included 2,802 patients admitted for cardiothoracic surgery. After the implementation of PBM, a significant decrease was observed in the hemoglobin threshold for RBC transfusion. This threshold dropped from 8.7 g/dL before PBM to 8.3 g/dL during the PBM education phase and 8.0 g/dL during the PBM feedback period. Additionally, the proportion of appropriate RBC transfusions increased markedly, from 23.9% before PBM to 34.9% and 58.2% during the education and feedback phases, respectively. Among the 381 patients who underwent cardiac surgery, a significant reduction was noted in the length of hospitalization over time (p<0.001). However, other clinical outcomes displayed no significant differences., Conclusion: PBM implementation effectively reduced the hemoglobin threshold for RBC transfusion and increased the rate of appropriate transfusion in cardiothoracic surgery. Although transfusion practices improved, clinical outcomes were comparable to those observed before PBM implementation.

Background : This study investigated the potential link between blood pressure variability (BPV) and the incidence of aortic stenosis (AS) using Korean National Health Insurance Service data from 2002 to 2019. Methods : We collected annual systolic blood pressure variability (SBPV) measurements consisting of three consecutive blood pressure readings each year over three years. The obtained SBPV data was divided into five quantiles, with the highest quintile representing a high fluctuation of blood pressure. Results : Analyzing 9,341,629 individuals with a mean age of 40.7 years, the study found 3981 new AS diagnoses during an average 8.66-year follow-up. Independent predictors for AS included higher blood pressure levels and elevated systolic blood pressure variability (SBPV). The hazard ratios (HR) for different SBPV quintiles compared to the reference (1st quintile) were as follows: 2nd quintile HR 1.09 ( p = 0.18), 3rd quintile HR 1.13 ( p = 0.04), 4th quintile HR 1.13 ( p = 0.04), and 5th quintile HR 1.39 ( p < 0.001). Conclusion : Our findings suggest that both hypertension and high fluctuations in SBP during consecutive visits are associated with an increased risk of incident AS. These results emphasize the importance of blood pressure management and stability in the prevention of AS.

The catalytic efficacy of the monobipyridyl (η 6 - para -Cymene)Ru(II) half-metallocene, [( p -Cym)Ru(bpy)Cl] + was evaluated in both mixed homogeneous (dye + catalyst) and heterogeneous hybrid systems (dye/TiO 2 /Catalyst) for photochemical CO 2 reduction. A series of homogeneous photolysis experiments revealed that the ( p -Cym)Ru(II) catalyst engages in two competitive routes for CO 2 reduction (CO 2 to formate conversion via Ru II -hydride vs CO 2 to CO conversion through a Ru II -COOH intermediate). The conversion activity and product selectivity were notably impacted by the p K a value and the concentration of the proton source added. When a more acidic TEOA additive was introduced, the half-metallocene Ru(II) catalyst leaned toward producing formate through the Ru II -H mechanism, with a formate selectivity of 86%. On the other hand, in homogeneous catalysis with TFE additive, the CO 2 -to-formate conversion through Ru II -H was less effective, yielding a more efficient CO 2 -to-CO conversion with a selectivity of >80% (TON formate of 140 and TON CO of 626 over 48 h). The preference between the two pathways was elucidated through an electrochemical mechanistic study, monitoring the fate of the metal-hydride intermediate. Compared to the homogeneous system, the TiO 2 -heterogenized ( p -Cym)Ru(II) catalyst demonstrated enhanced and enduring performance, attaining TONs of 1000 for CO 2 -to-CO and 665 for CO 2 -to-formate.

Objectives: This study aims to evaluate and compare the surgical outcomes of endoscopic malleostapedotomy (EMS) and endoscopic incudostapedotomy (EIS)., Methods: A retrospective analysis was conducted on 36 consecutive ears in 33 patients who underwent stapes surgery using either EMS (EMS group) or EIS (EIS group). Operational practicability across surgical steps, postoperative hearing, operation time, switch of approach, and complications were compared between the two groups., Results: The EMS and EIS groups comprised seven (19.4%) and 29 ears (80.6%), respectively. The EMS group exhibited a greater proportion of moderate practicability in anchoring site exposure (42.9%, three of seven) and in securing the prosthesis (100%, seven of seven) in comparison to the EIS group, which had 0% (0 out of 29) and 41.4% (12 out of 29), respectively. Postoperative hearing improvements were equivalent between the groups, with EMS achieving a mean air-bone gap improvement of 28.8 dB and EIS of 23.2 dB. The ABG closure rates within 10 dB and 20 dB for the EMS group were 28.6% and 100%, respectively, and not significantly different from the EIS group ( p  = .103). However, the average surgical duration for EMS was extended by 77.4 min. The rate of complications was comparable between the groups (EMS 14.3%, EIS 10.3%, p  = 1.000)., Conclusion: The findings indicate that while EMS requires a longer operation time because of decreased practicability in specific surgical steps, it provides comparable outcomes to EIS, underscoring the potential of endoscopic techniques to establish malleostapedotomy as a surgical option as it is with traditional incudostapedotomy., Level of Evidence: 4., Competing Interests: The authors declare that they have no competing interests., (© 2024 The Author(s). Laryngoscope Investigative Otolaryngology published by Wiley Periodicals LLC on behalf of The Triological Society.)

Owing to their superior stability compared to those of conventional molecular dyes, as well as their high UV-visible absorption capacity, which can be tuned to cover the majority of the solar spectrum through size adjustment, quantum dot (QD)/TiO 2 composites are being actively investigated as photosensitizing components for diverse solar energy conversion systems. However, the conversion efficiencies and durabilities of QD/TiO 2 -based solar cells and photocatalytic systems are still inferior to those of conventional systems that employ organic/inorganic components as photosensitizers. This is because of the poor adsorption of QDs onto the TiO 2 surface, resulting in insufficient interfacial interactions between the two. The mechanism underlying QD adsorption on the TiO 2 surface and its relationship to the photosensitization process remain unclear. In this study, we established that the surface characteristics of the TiO 2 semiconductor and the QDs (i.e., surface defects of the metal oxide and the surface structure of the QD core) directly affect the QD adsorption capacity by TiO 2 and the interfacial interactions between the QDs and TiO 2 , which relates to the photosensitization process from the photoexcited QDs to TiO 2 (QD* → TiO 2 ). The interfacial interaction between the QDs and TiO 2 is maximized when the shape/thickness-modulated triangular QDs are composited with defect-rich anatase TiO 2 . Comprehensive investigations through photodynamic analyses and surface evaluation using X-ray photoelectron spectroscopy (XPS), transmission electron microscopy (TEM), and photocatalysis experiments collectively validate that tuning the surface properties of QDs and modulating the TiO 2 defect concentration can synergistically amplify the interfacial interaction between the QDs and TiO 2 . This augmentation markedly improved the efficiency of photoinduced electron transfer from the photoexcited QDs to TiO 2 , resulting in significantly increased photocatalytic activity of the QD/TiO 2 composite. This study provides the first in-depth characterization of the physical adhesion of QDs dispersed on a heterogeneous metal-oxide surface. Furthermore, the prepared QD/TiO 2 composite exhibits exceptional adsorption stability, resisting QD detachment from the TiO 2 surface over a wide pH range (pH = 2-12) in aqueous media as well as in nonaqueous solvents during two months of immersion. These findings can aid the development of practical QD-sensitized solar energy conversion systems that require the long-term stability of the photosensitizing unit.

Background: Despite its rarity and limited documentation, therapeutic neck dissection (ND) for cervical lymph node (LN) metastases from distant primary sites is increasingly practiced, potentially enhancing survival rates. However, the optimal ND extent remains unclear. This study aimed to determine the safety of excluding upper neck levels from ND., Methods: We retrospectively analyzed 25 patients who underwent ND for cervical LN metastases from remote primary tumors between 2015 and 2021 (12 with primary lung tumors, four with ovary, three with mammary gland, three with esophagus, two with thymus, and one with colon)., Results: Assessing clinical characteristics and occult metastasis rates, we observed LN metastases predominantly at levels III and IV. Occult metastases occurred in 14 out of 25 patients, primarily at neck levels III and IV (55.0% and 50.0%, respectively). The five-year disease-specific survival rate for all patients was 44.3%. While no statistically significant impact of occult metastasis on prognosis was confirmed, an association between the postoperative LN ratio and poor prognosis was revealed., Conclusions: Our findings suggest that prophylactic NDs at levels I, II, and Va may not be essential for managing cervical LN metastases from remote primary malignancies. This could lead to a more tailored and less invasive therapeutic strategy.

Objectives: The aim of this study was to investigate the effect of diaphragmatic breathing training with visual biofeedback on respiratory function in patients with multiple rib fractures., Patients and Methods: Between June 2021 and October 2021, a total of 16 patients (15 males, 1 female; mean age: 49.50±11.85 years; range, 25 to 66 years) who were diagnosed with multiple rib fractures were randomly assigned into two groups as the control group (CG, n=8) and the visual biofeedback group (VBG, n=8). The effect of each diaphragmatic breathing training on respiratory function was evaluated before and after eight interventions. For respiratory function, pulmonary function test was used to measure pulmonary function and respiratory muscle strength, and the Pain, Inspiratory capacity, Cough (PIC) score was used to evaluated pain, inspiratory capacity, and cough ability., Results: In both groups, the pulmonary function representing the ratio of measurements to predicted values of both forced vital capacity (CG mean difference=25.37±4.58, p=0.002, VBG mean difference=24.25±3.96, p=0.007) and forced expiratory volume in 1 sec (CG mean difference=32.38±5.7, p=0.002, VBG mean difference=26.15±5.73, p <0.001) increased significantly. The maximal inspiratory (CG mean difference=14.00±0.35, p=0.002, VBG mean difference=20.5±6.26, p=0.009) and expiratory pressure (CG mean difference=43.72±29.44, p=0.034, VBG mean difference=25.76±6.78, p=0.015), the indicators of respiratory muscle strength, increased significantly in both groups. The PIC score, which evaluated pain, inspiratory capacity, and cough ability, also increased significantly in both groups (CG mean difference=1.63±0.26, p≤0.001, VBG mean difference=3.13±0.19, p <0.001). The change of PIC score after intervention did not significantly differ between the groups (F=1.439, p=0.250); however, there was a significant difference over time (F=38.476, p <0.001). The change of PIC scores differed over time between the groups (F=2.806 p=0.011)., Conclusion: Diaphragmatic breathing training and diaphragmatic breathing training with visual biofeedback can improve pulmonary function, respiratory muscle strength, pain, inspiratory capacity, and cough ability in patients with multiple rib fractures., Competing Interests: Conflict of Interest: The authors declared no conflicts of interest with respect to the authorship and/or publication of this article., (Copyright © 2024, Turkish Society of Physical Medicine and Rehabilitation.)

Fluorescent microbeads (MBs) are widely used as next-generation biosensors for the detection of target chemicals at highly sensitive concentrations, and for imaging and tracking in vitro and in vivo . However, most known methods for producing fluorescent MBs require complicated multistep processes that result in low production rates. In this study, we report a method for fabricating micrometer-sized quantum dot microbeads (QD-MBs) using a microfluidic chip and specially designed QD photoresist (QD-PR). This on-demand lab-on-a-chip method yielded monodispersed QD-MBs ranging from 1.89 to 33 μm with a coefficient of variation of less than 10%. The size distribution of the fabricated QD-MBs was Gaussian with a peak around the mean diameter and a spread of sizes around the peak. Compared with nanoscale QDs, the fabricated QD-MBs showed no emission loss. The full-width at half-maximum of the emission peak of the QD-MBs was smaller than that of the colloidal QDs, indicating a more uniform distribution and a higher density of QDs within the MB structure. In addition, we investigated the microfluidic flow regime that yielded the most uniform and controllable QD-MB. The MBs in the dripping regime were spherical and monodisperse, with an excellent particle size distribution. In this study, we present a simple and effective strategy for producing QD-MBs with controllable sizes, which can be crucial in diverse fields such as biosensing, drug delivery, and imaging.

The pathological outcome of dengue disease results from complex interactions between dengue virus (DENV) and host genetics and immune response. Complement receptor types 1 and 2 (CR1 and CR2) mediate complement activation through the alternative pathway. This study investigated the possible association of genetic polymorphisms and plasma levels of CR1 and CR2 with dengue disease. A total of 267 dengue patients and 133 healthy controls were recruited for this study. CR1 and CR2 gene polymorphisms were analyzed by Sanger sequencing, while plasma CR1 and CR2 levels were measured by ELISA. The frequency of the CR1 minor allele rs6691117G was lower in dengue patients and those with severe dengue compared to healthy controls. Plasma CR1 and CR2 levels were decreased in dengue patients compared to healthy controls (P < 0.0001) and were associated with platelet counts. CR1 levels were lower in dengue patients with warning signs (DWS) compared to those without DWS, while CR2 levels were decreased according to the severity of the disease and after 5 days (T1) and 8 days (T2) of follow-up. CR2 levels were decreased in dengue patients positive for anti-DENV IgG and IgM and patients with bleeding and could discriminate DWS and SD from dengue fever patients (AUC = 0.66). In conclusion, this study revealed a reduction in CR2 levels in dengue patients and that the CR1 SNP rs6691117A/G is associated with the dengue severity. The correlation of CR2 levels with platelet counts suggests that CR2 could be an additional biomarker for the prognosis of severe dengue disease., (© 2023. Springer Nature Limited.)

Objective: To evaluate whether bilateral congenital ossicular anomalies (COAs) differ regarding ossicular anomalies and hearing loss severities between the ears of the individual., Study Design: Retrospective case review., Setting: Tertiary referral academic center., Methods: Between March 2012 and December 2022, 7 consecutive patients (14 ears) with surgically confirmed bilateral COAs were included in the study. Preoperative pure-tone thresholds, COA classification according to the Teunissen and Cremers system, surgical procedures, and postoperative audiometric results were compared between the 2 ears of each patient., Results: The median age of the patients was 11.5 (range: 6-25) years. Both ears of each patient were categorized based on the same classification. Three patients possessed class III COAs and the other 4 had class I COAs. The interaural differences in preoperative bone and air conduction thresholds were within 15 dB for all patients. Differences in postoperative air-bone gaps between ears were not statistically significant. The surgical procedures required for ossicular reconstruction were almost identical for both ears., Conclusion: The severity of ossicular abnormalities and hearing loss in patients with bilateral COAs were symmetrical between ears, thereby enabling prediction of the characteristics of the contralateral ear based on the findings observed in 1 ear. These symmetric clinical features can aid surgeons when operating on the contralateral ear., (© 2023 American Academy of Otolaryngology-Head and Neck Surgery Foundation.)

To investigate the excited-state properties of metal-organic bichromophores, including energy transfer mechanisms, a series of new homoleptic N -heterocyclic carbene (NHC)-based iridium(III) complexes were prepared by incorporating a peripheral naphthalene (Np) ( Ir(Nppmi) 3 : fac -/ mer -Ir(1-Nppmi) 3 and fac -/ mer -Ir(2-Nppmi) 3 ) or carbazole (Cz) ( Ir(Czpmi) 3 : fac -/ mer -Ir( o -Czpmi) 3 , fac -/ mer -Ir( m -Czpmi) 3 , and fac -/ mer -Ir( p -Czpmi) 3 ) unit to the phenyl moiety of the phenylimidazole (pmi) ligand. Through a series of photophysical analyses and femtosecond time-resolved absorption (fs-TA) spectroscopy, it was discovered that the phosphorescence of the Ir core, ( Ir(pmi) 3 ), was considerably quenched, while intense phosphorescence peaks arising from the excited triplet Np ( 3 Np*)/Cz ( 3 Cz*) species were primarily observed at room temperature (r.t.) and low temperature. Such amplified phosphorescence of the tethered organic Np and Cz units originated from triplet-triplet energy transfer (TTET) from the high-lying metal-to-ligand charge transfer ( 3 MLCT) state of the Ir(pmi) 3 core to the ligand-centered triplet state ( 3 LC) of the peripheral Np and Cz units. This result indicates that the exothermic intramolecular energy transfer (IET) in the excited triplet state realizes the efficient phosphorescent emission of geometrically confined organic tethers.

Blood pressure (BP) is a typical complex trait, and the genetic susceptibility of individuals to changes in BP induced by air pollution exposure is different. Although interactions of exposure to air pollutants with several candidate genes have been identified, genome-wide interaction studies (GWISs) are needed to understand the association between them with BP. Therefore, we aimed to discover the unique genetic loci for BP that interact with exposure to air pollutants in Korean adults. We ultimately included 1868 participants in the discovery step and classified them into groups of those with low-to-moderate exposure and high exposure to average annual concentration of particulate matter with an aerodynamic diameter ≤ 10 μm (PM 10 ). Because none of the single nucleotide polymorphisms (SNPs) achieved a genome-wide level of significance of p int  < 5 × 10 -8 for either systolic BP (SBP) or diastolic BP (DBP), we considered the top 10 ranking SNPs for each BP trait. To validate these suggestive SNPs, we finally selected six genetic variants for SBP and five variants for DBP, respectively. In a replication result for SBP, only one SNP (rs12914147) located in an intergenic region of the NR2F2 showed a significant interaction. We also identified several genetic susceptibility loci (e.g., CHST11, TEK, and ITGA1) implicated in candidate mechanisms such as inflammation and oxidative stress in the discovery step, although their interaction effects were not replicated. Our study reports the first GWIS finding to our knowledge, and the association between exposure to PM 10 and BP levels may be determined in part by several newly discovered genetic suggestive loci, including NR2F2., (© 2023. Springer Nature Limited.)

Underrepresentation of non-European (EUR) populations hinders growth of global precision medicine. Resources such as imputation reference panels that match the study population are necessary to find low-frequency variants with substantial effects. We created a reference panel consisting of 14,393 whole-genome sequences including more than 11,000 Asian individuals. Genome-wide association studies were conducted using the reference panel and a population-specific genotype array of 72,298 subjects for eight phenotypes. This panel yields improved imputation accuracy of rare and low-frequency variants within East Asian populations compared with the largest reference panel. Thirty-nine previously unidentified associations were found, and more than half of the variants were East Asian specific. We discovered genes with rare protein-altering variants, including LTBP1 for height and GPR75 for body mass index, as well as putative regulatory mechanisms for rare noncoding variants with cell type-specific effects. We suggest that this dataset will add to the potential value of Asian precision medicine.

Background: We examined the relationship between blood transfusion and long-term adverse events to evaluate the clinical impact of red blood cell (RBC) transfusion on patients undergoing cardiac valve surgery., Methods: From the National Health Insurance Service database, individuals undergoing heart valve surgery were verified, including aortic valve (AV), mitral valve (MV), tricuspid valve (TV), and complex valves (more than 2 valve surgeries). The interested outcomes were incidence of death, ischemic stroke, hemorrhagic stroke, and admission for myocardial infarction during follow-up. Associations between perioperative RBC transfusion and long-term cardiovascular events were analyzed with Cox-proportional hazard model., Results: Perioperative RBC transfusion (±2 days from the day of surgery) was categorized into 0, 1, 2, and >3 units based on the number of packs transfused. From 2003 to 2019, the data of 58,299 individuals were retrieved (51.6% were male and 58% were aged above 60 years). The median follow-up duration was 5.53 years. Of the total cohort, 86.5% received at least 1 transfusion. In multivariable analysis, adverse cardiovascular event risk proportionally increased with transfusion in a dose-dependent manner. The adjusted hazard ratios and 95% confidence intervals of outcomes after the transfusion of 1, 2, and ≥3 units compared to those with no transfusion were as follows: death, 1.53 (1.41-1.66), 1.97 (1.81-2.14), and 3.03 (2.79-3.29); ischemic stroke, 1.27 (1.16-1.39), 1.31 (1.19-1.44), and 1.51 (1.38-1.66); hemorrhagic stroke, 1.38 (1.16-1.66), 1.71 (1.43-2.05), and 2.31 (1.94-2.76); and myocardial infarction 1.35 (1.13-1.62), 1.60 (1.33-1.91), and 1.99 (1.66-2.38), respectively (all P < .01)., Conclusions: In the analysis of the national cohort, perioperative RBC transfusion during heart valve surgery was associated with adverse cardiovascular outcomes correlated with the volume of RBC transfusion., Competing Interests: The authors declare no conflicts of interest., (Copyright © 2022 International Anesthesia Research Society.)

Four sterically distorted quaterpyridyl ( qpy ) ligand - bridged Ir(III)-Re(I) heterometallic complexes ( Ir-qpy mm -Re , Ir-qpy mp -Re , Ir-qpy pm -Re , and Ir-qpy pp -Re ), in which the position of the coupling pyridine unit of the two 2,2'-bipyridine ligands was varied (meta ( m )- or para ( p )-position), pypy x -py x py ( x = m and m , qpy mm ; x = m and p , qpy mp ; x = p and m , qpy pm ; x = p and p , qpy pp ), were prepared, along with the fully π-conjugated Ir(III)-[π linker]-Re(I) complexes (π linker = 2,2'-bipyrimidine ( bpm ), Ir-bpm-Re ; π linker = 2,5-di(pyridin-2-yl)pyrazine ( dpp ), Ir-dpp-Re ) to elucidate the electron mediating and accumulative charge separation properties of the bridging π-linker in a bimetallic system (photosensitizer-π linker-catalytic center). From the photophysical and electrochemical studies, it was found that the quaterpyridyl ( qpy ) bridging ligand (BL), in which the two planar Ir/Re metalated bipyridine (bpy) ligands were connected but slightly canted relative to each other, linking the heteroleptic Ir(III) photosensitizer, [( piq C^N) 2 Ir III (bpy)] + , and catalytic Re(I) complex, (bpy)Re I (CO) 3 Cl, minimized the energy lowering of the qpy BL, which hampers the forward photoinduced electron transfer (PET) process from [( piq C^N) 2 Ir III (N^N)] + to (N^N)Re I (CO) 3 Cl ( E red1 = -(0.85-0.93) V and E red2 = -(1.15-1.30) V vs SCE). This result contrasts with the fully π-delocalized bimetallic systems ( Ir-bpm-Re and Ir-dpp-Re ) that show a significant energy reduction due to the considerable π-extension and deshielding effect caused by the neighboring Lewis acidic metals (Ir and Re) on the electrochemical scale ( E red1 = -0.37 V and E red2 = -1.02 and -0.99 V vs SCE). Based on a series of anion absorption studies and spectroelectrochemical (SEC) analyses, all Ir(III)-BL-Re(I) bimetallic complexes were found to exist as dianionic form (Ir(III)-[BL] 2- -Re(I)) after a fast reductive-quenching process in the presence of excess electron donor. In the photolysis experiment, the four Ir-qpy-Re complexes displayed the reasonable photochemical CO 2 -to-CO conversion activities (TON of 366-588 for 19 h) owing to the moderated electronic coupling between two functional Ir(III) and Re(I) centers through the slightly distorted qpy ligand, whereas Ir-bpm-Re and Ir-dpp-Re displayed negligible performances as a result of the strong electronic coupling via π-conjugation between the two functional components resulting in the energetic constraints for PET and an unwanted side reactions competing with the forward processes. These results confirm that the qpy unit can be utilized as an efficient BL platform in π-linked bimetallic systems.

Objective: To describe and analyze the surgical outcomes of transcanal endoscopic resection of the stapedial tendon (ST) and tensor tympani tendon (TT) in the management of middle ear myoclonus (MEM)., Study Design: A retrospective case series., Setting: Tertiary academic center., Patients: Seven consecutive patients (seven ears) with tinnitus were diagnosed with MEM., Intervention: Transcanal endoscopic resection of both the ST and TT using either microinstruments or a laser., Main Outcome Measures: The symptom of tinnitus, based on visual analog scale and Tinnitus Handicap Inventory scores, was analyzed preoperatively and postoperatively for each patient. The intraoperative findings and postoperative complications were also evaluated., Results: Amelioration of objective tinnitus with significant improvement in visual analog scale and Tinnitus Handicap Inventory scores was noted in all seven patients. The ST and TT were easily identified in the same endoscopic field, with minimal or no removal of the scutum. There was no need to perform an anterior tympanotomy to expose the TT. Resection of both the ST and TT and creating a gap between the cut edges were achieved by using either microinstruments or a laser under an endoscopic field. Conversion to or conjunction with the microscopic approach was unnecessary for any of the seven patients. No hearing loss or hyperacusis occurred postoperatively., Conclusions: Transcanal endoscopic resection of the ST and TT successfully ameliorated the symptom of tinnitus in patients with MEM. A transcanal endoscopic approach provides an alternative method to manage MEM, providing excellent visualization and minimal invasiveness., Competing Interests: The authors disclose no conflicts of interest., (Copyright © 2023, Otology & Neurotology, Inc.)

Thyroidectomy is a safe procedure that is frequently performed for benign or malignant thyroid disease. Complications after thyroidectomy occur in approximately 3%-5% of patients. Tracheal perforation is a very rare post-thyroidectomy complication, and delayed tracheal perforation without intraoperative tracheal injury is even rarer; only 25 case reports have been published globally, with varied management. We present the case of a 36-year-old man presenting with dyspnea and cough 2 weeks after left thyroidectomy. A defect measuring approximately 2 cm was confirmed on the anterior wall of the trachea by computed tomography and flexible laryngoscopy. The patient's symptoms improved with conservative treatment including systemic steroids, and surgical treatment was not required. Even in the absence of unusual intraoperative events, delayed tracheal necrosis and perforation should be considered as possible postoperative complications following thyroidectomy., Competing Interests: Declaration of Conflicting InterestsThe author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

We report the electron transfer (ET) dynamics in a series of Ir(III)-Re(I) photocatalysts where two bipyridyl ligands of Ir and Re moieties are conjugated at the meta ( m )- or para ( p )-position of each side. Femtosecond transient absorption (TA) measurements identify the intramolecular ET (IET) dynamics from the Ir to Re moiety, followed by the formation of one-electron-reduced species (OERS) via the intermolecular ET with a sacrificial electron donor (SED). The IET rate depends on the bridging ligand (BL) structures (∼25 ps for BL mm / mp vs ∼68 ps for BL pm / pp ), while the OERS formation happens on an even slower time scale (∼1.4 ns). Connecting the Re moiety at the meta -position of the bipyridyl of the Ir moiety can restrict the rotation around a covalent bond between two bipyridyl ligands by steric hindrances and facilitate the IET process. This highlights the importance of BL structures on the ET dynamics in photocatalysts.

Background: Studies regarding effects of therapeutic tapings when patients with patellofemoral pain syndrome (PFPS) descend stairs are limited., Objective: The purpose of this study was to investigate the effect of McConnell taping (MT) and Kinesio taping (KT) on kinematic variables when patients with PFPS descend stairs., Methods: Fifty PFPS patients were randomly assigned to either the MT group or the KT group. Pain and lower extremities joint angles were measured while descending stairs before and after the intervention. All outcomes measured were analyzed using either paired t tests or independent t tests to compare the difference within or between groups, respectively., Results: There was a statistically significant difference in both groups in anterior knee pain scale score (p< 0.05). As a result of analysis of lower extremities joint angles at initial contact, loading response, and terminal stance, there were statistically significant within-group differences in hip, knee flexion, abduction and lateral rotation angles in both groups (p< 0.05). There were statistically significant within-group differences in hip flexion, knee flexion, and dorsiflexion angles in pre-swing (p< 0.05). There was a statistically significant difference between the groups in the following events: (1) knee lateral rotation angle at initial contact; (2) hip flexion angle at loading response; (3) and hip flexion at terminal stance angle (p< 0.05)., Conclusion: MT and KT were effective in lowering knee pain and improving lower extremities joint angle when patients with PFPS descend stairs. In the comparison between the groups, the MT group showed significantly reduced anterior knee pain and increased range of motion of the lower extremities joint compared to the KT group.

Photocatalytic systems for CO 2 reduction operate via complicated multi-electron transfer (ET) processes. A complete understanding of these ET dynamics can be challenging but is key to improving the efficiency of CO 2 conversion. Here, we report the ET dynamics of a series of zinc porphyrin derivatives ( ZnPs ) in the photosensitization reactions where sequential ET reactions of ZnPs occur with a sacrificial electron donor (SED) and then with TiO 2 . We employed picosecond time-resolved fluorescence spectroscopy and femtosecond transient absorption (TA) measurement to investigate the fast ET dynamics concealed in the steady-state or slow time-resolved measurements. As a result, Stern-Volmer analysis of fluorescence lifetimes evidenced that the reaction of photoexcited ZnPs with SED involves static and dynamic quenching. The global fits to the TA spectra identified much faster ET dynamics on a few nanosecond-time scales in the reactions of one-electron reduced species ( ZnPs •- ) with TiO 2 compared to previously measured minute-scale quenching dynamics and even diffusion rates. We propose that these dynamics report the ET dynamics of ZnPs •- formed at adjacent TiO 2 without involving diffusion. This study highlights the importance of ultrafast time-resolved spectroscopy for elucidating the detailed ET dynamics in photosensitization reactions.

To elucidate the key parameters governing the emission properties of phenylimidazole (pim)-based Ir(III) emitters, including their electronic structure and the bulky aryl substitution effect, a series of pim-based iridium(III) complexes ( Ir( R pim-X) 3 , R pim-X = 1-R-2-(X-phenyl)-1 H -imidazole) bearing secondary pendants of increasing bulkiness [R = methyl (Me), phenyl (Ph), terphenyl (TPh), or 4-isopropyl terphenyl (ITPh)] and three different primary pim ligands (X = F, F 2 , and CN) were designed and synthesized. Based on photophysical and electrochemical analyses, it was found that the excited state properties are highly dependent on the bulkiness of the secondary substituent and the inductive nature of the primary pim ligand. The incorporation of bulky TPh/ITPh substituents in the second coordination sphere significantly enhanced the emission efficiencies in the solid state (Φ PL = 72.1-84.9%) compared to those of the methyl- or phenyl-substituted Ir(III) complexes (Φ PL = 30.4% for Ir( Me pim) 3 and 63.7% for Ir( Ph pim) 3 ). Further modification of the secondary aryl substituent ( Ir( TPh pim) 3 → Ir( ITPh pim) 3 ) through the incorporation of an isopropyl group and F substitution on the primary pim ligand ( Ir( TPh/ITPh pim) 3 → Ir( TPh/ITPh pim-F/F 2 ) 3 ) resulted in a slight decrease in the LUMO and a significant decrease in the HOMO energy levels, respectively; these energy level adjustments consequently amplified emission blue shifts, thereby enabling efficient blue electroluminescence in phosphorescent organic light-emitting diodes. Theoretical calculations revealed that the excited-state properties of pim-based Ir(III) complexes can be modulated by the nature of the peripheral substituent and the presence of an EWG substituent. Among the fabricated blue-emitting TPh/ITPh-substituted Ir(III) complexes, Ir( ITPh pim-F) 3 , Ir( TPh pim-F 2 ) 3 , and Ir( ITPh pim-F 2 ) 3 were tested as blue-emitting dopants for blue phosphorescent OLEDs owing to their high solid radiative quantum yields (Φ PL = 75.9-84.9%). The Ir( ITPh pim-F) 3 -doped multilayer device displayed the best performance with a maximum external quantum efficiency of 21.0%, a maximum current efficiency of 43.6 cd/A, and CIE coordinates of 0.18 and 0.31.

In this study, a p -type π-conjugated polymer chain, poly(3-hexylthiophene-2,5-diyl) ( P3HT ), was physically adsorbed onto n -type TiO 2 nanoparticles functionalized with a molecular CO 2 reduction catalyst, (4,4-Y 2 -bpy)Re I (CO) 3 Cl (ReP, Y = CH 2 PO(OH) 2 ), to generate a new type of P3HT -heterogenized hybrid system ( P3HT /TiO 2 /ReP), and its photosensitizing properties were assessed in a heteroternary system for photochemical CO 2 reduction. We found that P3HT immobilization on TiO 2 facilitated photoinduced electron transfer (PET) from photoactivated P3HT * to the n -type TiO 2 semiconductor via rapid interfacial electron injection (∼65 ps) at the P3HT and TiO 2 surface interface ( P3HT * → TiO 2 ). With such effective charge separation, the heterogenization of P3HT onto TiO 2 resulted in a steady electron supply toward the co-adsorbed Re(I) catalyst, attaining durable catalytic activity with a turnover number (TON) of ∼5300 over an extended time period of 655 h over five consecutive photoreactions, without deformation of the adsorbed P3HT polymer. The long-period structural stability of TiO 2 -adsorbed P3HT was verified based on a comparative analysis of its photophysical properties before and after 655 h of photolysis. To our knowledge, this conversion activity is the highest reported so far for polymer-sensitized photochemical CO 2 reduction systems. This investigation provides insights and design guidelines for photocatalytic systems that utilize organic photoactive polymers as photosensitizing units.

Background/aims: Acute-on-chronic liver failure (ACLF) is a widely recognized concept in which acute decompensation (AD) in patients with cirrhosis results in organ failure and high short-term mortality. On the other hand, few studies reflecting the various etiologies of cirrhosis are available. This study examined the clinical features of patients with hepatitis C virus (HCV)-related ACLF., Methods: Between January 2005 and December 2018, 109 HCV-related cirrhosis patients hospitalized for AD (ascites, hepatic encephalopathy, gastrointestinal hemorrhage, and bacterial infection) were enrolled for ACLF defined by the European Association for the Study of the Liver (EASL)., Results: ACLF developed in 35 patients (32.1%) on admission. Eight, eight, and 19 patients had ACLF grades 1, 2, and 3, respectively. The 28-day and 90-day mortality rates were very low (2.7% and 5.4%, respectively) in patients without ACLF and very high (60.0% and 74.3%, respectively) in those with ACLF. In patients with HCV-related ACLF, compared to previous studies on hepatitis B virus-related ACLF and alcohol-related ACLF, the prevalence of liver failure was very low (17.1%), whereas that of kidney failure was very high (71.4%). Compared with all other prognostic scores, the Chronic liver failure Consortium Organ Failure score predicted the 90-day mortality most accurately, with an area under the receiver operator characteristic of 0.921., Conclusions: HCV-related ACLF has unique clinical characteristics distinct from hepatitis B virus-related and alcohol-related ACLF. ACLF defined by EASL can be useful for predicting the short-term mortality in HCV-related cirrhosis.

Background: This study aimed to evaluate the association of hypertension with incident infective endocarditis (IE) by investigating the incidence of IE according to blood pressure levels using the National Health Insurance Service database., Methods: The data of 4 080 331 individuals linked to the health screening database in 2009 were retrieved (males, 55.08%; mean age, 47.12±14.13 years). From 2009 to 2018, the risk factors for the first episode of IE were investigated. Hypertension was categorized into normotension, prehypertension, hypertension, and hypertension with medication. The Cox proportional hazard model assessed the effect of blood pressure level during the health screening exam on incident IE., Results: During the 9-year follow-up, 812 (0.02%) participants were diagnosed with IE. The incidence rates of IE in the normotension, prehypertension, hypertension, and hypertension with medication groups were 0.9, 1.4, 2.6, and 6.0 per 100 000 person-years, respectively. Those with prehypertension, hypertension, and hypertension with medication were correlated with an increased risk of IE in a dose-response manner compared with the normotension group (hazard ratio, 1.33 [95% CI, 1.06-1.68]; hazard ratio, 1.98 [1.48-2.66]; hazard ratio, 2.56 [2.02-3.24], respectively, all P <0.001)., Conclusions: In a large national cohort study with an average follow-up of 9 years, increased blood pressure was identified as a risk factor for incident IE in a dose-dependent manner. Hypertension increases the public health care burden by acting as a risk factor for rare infective heart diseases.

Background: A substantial proportion of cardiac arrhythmias are paroxysmal in nature, and 12-lead electrocardiography (ECG) and Holter monitoring often fail to detect paroxysmal arrhythmias. We designed and evaluated a watch-type, electrocardiograph-recording, wearable device (w-ECG) to overcome the limitations of 12-lead ECG and Holter monitoring. Methods: We prospectively enrolled 96 patients with symptoms assumed to be related to cardiac arrhythmias. Electrocardiography recording was performed with both the w-ECG and Holter monitoring. Detection of any arrhythmia was the primary outcome endpoint and was compared between the w-ECG and Holter monitoring. Results: Any arrhythmia was detected in 51 (53.1%) and 27 (28.1%) patients by the w-ECG and Holter monitoring, respectively (odds ratio (OR) = 2.9, p < 0.001). The w-ECG was superior to Holter monitoring for the detection of clinically significant arrhythmias (excluding atrial premature contraction, ventricular premature contraction, and non-sustained atrial tachyarrhythmia) (OR = 2.34, p = 0.018). In 27 (28.1%) patients, cardiac arrhythmias were detected only by the w-ECG, with atrial fibrillation being the most frequent case (13 patients). Based on ECGs recorded by using the w-ECG, 17 patients (17.7%) received therapeutic interventions, including radiofrequency catheter ablation. Conclusions: The w-ECG is capable of recording ECGs of good quality, with a discernable P wave and distinguishable QRS morphology. The ability of the w-ECG to detect cardiac arrhythmias was significantly better than that of Holter monitoring, and a significant proportion of patients received therapeutic intervention based on ECGs recorded by the w-ECG.

To explore the excited-state electronic structure of the blue-emitting Ir(dmp) 3 dopant material (dmp = 3-(2,6-dimethylphenyl)-7-methylimidazo[1,2- f ]phenanthridine), which is notable for durable blue phosphorescent organic light-emitting diode (PhOLED), a series of homoleptic dmp-based Ir(III) complexes ( DMP-R , tris[3-(2,6-dimethylphenyl)-7- R -imidazo[1,2- f ]phenanthridin-12-yl-κ C 12 ,κ N 1 ]iridium, R = H, CH 3 , F, and CF 3 ) were prepared by introducing an electron-donating group (EDG; -CH 3 ) or an electron-withdrawing group (EWG; -F and -CF 3 ) at the 7-position of the imidazo-phenanthridine ligand. The photophysical analysis demonstrated that the alteration from EDG to EWGs led to redshifted structureless emission profiles, which were correlated with variations in the 3 MLCT/ 3 ILCT ratio in the T 1 excited state. From electrochemical studies and density functional theory calculations, it turned out that the excited-state nature of the dmp-based Ir(III) complexes was significantly affected by the inductive effect of the 7-substituent of the cyclometalating dmp ligand. As a result of the lowest unoccupied molecular orbital energy stabilization by the EWGs that suppressed the non-radiative pathway from the emissive triplet excited state to the 3 d - d state, the F- and CF 3 -modified Ir(dmp) 3 complexes ( DMP-F and DMP-CF 3 ) showed quantum yields of 27-30% in the solution state, which were at least 4- or 5-fold higher than those shown by DMP-H and DMP-CH 3 . A PhOLED device based on DMP-CF 3 [CIE chromaticity (0.17, 0.39)], which demonstrated a distinct 3 MLCT characteristic, exhibited better electroluminescent efficiencies with an external quantum efficiency of 13.5% than that based on DMP-CH 3 ., Competing Interests: The authors declare no competing financial interest., (© 2022 The Authors. Published by American Chemical Society.)

Background: Female pattern hair loss (FPHL), the most common cause of alopecia in adult women, is classified into two subtypes: early onset and late onset (or postmenopausal). Little is known about the clinical features and genetic characteristics of early onset female pattern hair loss (eFPHL)., Objectives: To investigate the clinical features and genetic characteristics of eFPHL., Methods: Patients with eFPHL and controls without eFPHL were prospectively recruited. The demographic and clinical features were collected. Single nucleotide polymorphisms (SNPs) located around the selected 30 candidate genes potentially associated with eFPHL were evaluated., Results: eFPHL patients (n = 63) manifested a decreased hair shaft density and cross-sectional area of the hair shaft compared to the control group (n = 341). eFPHL is associated with androgen-related features, including scalp greasiness, folliculitis, hirsutism, and polycystic ovary syndrome. Scalp pain and itching have been reported more frequently in patients with eFPHL. Forty-nine SNPs located around PPARGC1A, ABCC4, CYP11B2, FSHB, and CYP19A1 were found to be significant for eFPHL, including two PPARGC1A-associated SNPs: rs186530605 and rs192713767 (p = 3.94 × 10 -11 )., Conclusions: This study provided clinical features and genetic variants for eFPHL, which could provide insight into the underlying pathologic etiology. Considering the limited number of patients, a large-scale study is required in the future., Competing Interests: Conflict of interest The authors have no conflict of interest to declare., (Copyright © 2022 The Author(s). Published by Elsevier B.V. All rights reserved.)

The importance of an embedded wearable device with automatic detection and alarming cannot be overstated, given that 15-30% of patients with atrial fibrillation are reported to be asymptomatic. These asymptomatic patients do not seek medical care, hence traditional diagnostic tools including Holter are not effective for the further prevention of associated stroke or heart failure. This is likely to be more so in the era of COVID-19, in which patients become more reluctant on hospitalization and checkups. However, little literature is available on this important topic. For this reason, this study developed efficient deep learning with model compression, which is designed to use ECG data and classify arrhythmia in an embedded wearable device. ECG-signal data came from Korea University Anam Hospital in Seoul, Korea, with 28,308 unique patients (15,412 normal and 12,896 arrhythmia). Resnets and Mobilenets with model compression (TensorFlow Lite) were applied and compared for the diagnosis of arrhythmia in an embedded wearable device. The weight size of the compressed model registered a remarkable decrease from 743 MB to 76 KB (1/10000), whereas its performance was almost the same as its original counterpart. Resnet and Mobilenet were similar in terms of accuracy, i.e., Resnet-50 Hz (97.3) vs. Mo-bilenet-50 Hz (97.2), Resnet-100 Hz (98.2) vs. Mobilenet-100 Hz (97.9). Here, 50 Hz/100 Hz denotes the down-sampling rate. However, Resnets took more flash memory and longer inference time than did Mobilenets. In conclusion, Mobilenet would be a more efficient model than Resnet to classify arrhythmia in an embedded wearable device.

Background: Although acute hepatitis E is not fatal in healthy individuals, it is unclear whether hepatitis E superinfection increases the mortality in patients with pre-existing liver disease. Thus, we investigated the prognosis of patients with acute hepatitis E according to their cirrhosis diagnosis, and the prognosis according to the development of acute-on-chronic liver failure (ACLF) in patients with cirrhosis and chronic liver disease (CLD)., Methods: This study included 74 consecutive patients who were diagnosed with acute viral hepatitis E between January 2007 and December 2019. Of them, 39 patients without CLD, 13 patients with non-cirrhotic CLD, and 22 patients with cirrhotic CLD were analyzed., Results: Among the 74 patients with HEV infection, 7 (9.5%) died within 180 days: 5 with underlying cirrhosis (71.4%) and 2 without cirrhosis (28.6%). The 180-day mortality was significant higher for patients with cirrhosis than for patients without cirrhosis (22.7% vs. 3.8%, P = 0.013). The age- and sex-adjusted proportional-hazard model revealed an approximately eightfold increase in the 180-day mortality risk in patients with cirrhosis compared to patients without cirrhosis. In addition, development of hepatitis E virus-related ACLF due to acute liver function deterioration in patients with pre-existing CLD or cirrhosis worsened the 180-day mortality rate., Conclusions: Our findings suggest that the acute hepatitis E mortality rate was low in healthy individuals but higher in patients with cirrhosis, and especially high in those with ACLF., (© 2022. The Author(s).)

Quantum dots (QDs) have emerged as an important class of materials for diverse applications such as solid-state lighting, energy conversion, displays, biomedicine, and plasmonics due to their excellent photonic properties and durability. Soft lithography, inkjet printing, nanoimprinting, and polymer deep-pen lithography are primary lithography techniques employed to implement micro-patterns with QDs, however, there are limited reports on QD photolithography using conventional photolithography processes suitable for mass production. This study reports a QD photolithography technique using a custom-developed QD photoresist made of an organic-inorganic hybrid coating layer. Using this QD photoresist, various QD micro-patterns, including red or green micro lines, RGB color filters for smartphone displays at 340 ppi, and atypical micro logo patterns of the Korea University, were successfully fabricated. Furthermore, various process parameters were developed for the QD photolithography with this custom QD photoresist, and the optical properties of the QD films were also investigated. To demonstrate its applicability in contemporary smartphone displays, the color coordinates of the QD films were compared to those of the BT.2020 standard. The chromaticity of the QD photoresist in CIE 1931 color space covered 98.7% of the NTSC (1987) area while providing more expansive color space. Overall, the QD photoresist and its photolithography techniques reported in this study hold great promise in various fields of QD-based applications, including bio-labeling, optical detectors, and solar cells., Competing Interests: There are no conflicts to declare., (This journal is © The Royal Society of Chemistry.)

Introduction: Although previous genome-wide association studies (GWASs) have identified genetic susceptibility loci for abdominal adiposity, GWASs on Asian samples remain scarce. Therefore, we performed a GWAS for abdominal adipose tissue depots in a Korean population., Methods: A total of 1,937 Korean men were included in the study. Areas of abdominal fat were quantified by computed tomography. We performed a GWAS analysis under an additive model, and a replication study was conducted on 480 additional Korean adult men., Results: In the discovery step, we identified a total of 10 single-nucleotide polymorphisms (SNPs) associated with adiposity indicators (p < 1 × 10-5). The top SNP, rs1028014, for visceral adipose tissue (VAT) was located in the ZMAT4 gene and remained significant after adjustment for body mass index (BMI). Three additional SNPs were also associated with VAT-adj-BMI and located within the SLC26A10, FAM155A, and COL4A1-COL4A2 genes, respectively. In addition, we identified a SNP (rs4668224) of the MYO3B gene for visceral-to-subcutaneous fat ratio. For subcutaneous adipose tissue and total adipose tissue, two (rs6585735 and rs363527) and three SNPs (rs1487892, rs9357565, and rs1985358) were found, respectively. Overall, eight SNPs were used in the replication study; however, none of the SNPs reached our level of significance for replication (p < 0.0063). Nevertheless, rs4773144 of COL4A1-COL4A2 for VAT-adj-BMI was the most interesting SNP identified in previous GWASs for coronary artery disease (based on the same risk allele "G"), along with functional effects., Conclusion: This study suggests for the first time that an SNP (rs4773144) of COL4A1-COL4A2 may contribute to the increase in VAT level, especially in adult Korean men., (© 2022 The Author(s). Published by S. Karger AG, Basel.)

ConspectusDuring the last few decades, the design of catalytic systems for CO 2 reduction has been extensively researched and generally involves (1) traditional approaches using molecular organic/organometallic materials and heterogeneous inorganic semiconductors and (2) combinatory approaches wherein these materials are combined as needed. Recently, we have devised a number of new TiO 2 -mediated multicomponent hybrid systems that synergistically integrate the intrinsic merits of various materials, namely, molecular photosensitizers/catalysts and n -type TiO 2 semiconductors, and lower the energetic and kinetic barriers between components. We have termed such multicomponent hybrid systems assembled from the hybridization of various organic/inorganic/organometallic units in a single platform inorganometallic photocatalysts . The multicomponent inorganometallic (MIOM) hybrid system onto which the photosensitizer and catalyst are coadsorbed efficiently eliminates the need for bulk-phase diffusion of the components and avoids the accumulation of radical intermediates that invokes a degradation pathway, in contrast to the homogeneous system, in which the free reactive species are concentrated in a confined reaction space. In particular, in energetic terms, we discovered that in nonaqueous media, the conduction band (CB) levels of reduced TiO 2 (TiO 2 (e - )) are positioned at a higher level (in the range -1.5 to -1.9 V vs SCE). This energetic benefit of reduced TiO 2 allows smooth electron transfer (ET) from injected electrons (TiO 2 (e - )) to the coadsorbed CO 2 reduction catalyst, which requires relatively high reducing power (at least more than -1.1 V vs SCE). On the other hand, the existence of various shallow surface trapping sites and surface bands, which are 0.3-1.0 eV below the CB of TiO 2 , efficiently facilitates electron injection from any photosensitizer (including dyes having low excited energy levels) to TiO 2 without energetic limitation. This is contrasted with most photocatalytic systems, wherein successive absorption of single high-energy photons is required to produce excited states with enough energy to fulfill photocatalytic reaction, which may allow unwanted side reactions during photocatalysis. In this Account, we present our recent research efforts toward advancing these MIOM hybrid systems for photochemical CO 2 reduction and discuss their working mechanisms in detail. Basic ET processes within the MIOM system, including intervalence ET in organic/organometallic redox systems, metal-to-ligand charge transfer of organometallic complexes, and interfacial/outer-sphere charge transfer between components, were investigated by conducting serial photophysical and electrochemical analyses. Because such ET events occur primarily at the interface between the components, the efficiency of interfacial ET between the molecular components (organic/organometallic photosensitizers and molecular reduction catalysts) and the bulk inorganic solid (mainly n -type TiO 2 semiconductors) has a significant influence on the overall photochemical reaction kinetics and mechanism. In some TiO 2 -mediated MIOM hybrids, the chemical attachment of organic or organometallic photosensitizing units onto TiO 2 semiconductors efficiently eliminates the step of diffusion/collision-controlled ET between components and prevents the accumulation of reactive species (oxidatively quenched cations or reductively quenched anions) in the reaction solution, ensuring steady photosensitization over an extended reaction period. The site isolation of a single-site organometallic catalyst employing TiO 2 immobilization promotes the monomeric catalytic pathway during the CO 2 reduction process, resulting in enhanced product selectivity and catalytic performance, including lifetime extension. In addition, as an alternative inorganic solid scaffold, the introduction of a host porphyrin matrix (interlinked in a metal-organic framework (MOF) material) led to efficient and durable photocatalytic CO 2 conversion by the new MOF-Re(I) hybrid as a result of efficient light harvesting/exciton migration in the porphyrinic MOF and rapid quenching of the photogenerated electrons by the doped Re(I) catalytic sites. Overall, the case studies presented herein provide valuable insights for the rational design of advanced multicomponent hybrid systems for artificial photosynthesis involving CO 2 reduction.

Few studies have been conducted on group B Streptococcus (GBS) in Vietnam. We determined the GBS colonization and antimicrobial resistance vaginal-rectal profile of 3863 Vietnamese pregnant women over 5 years. Maternal GBS colonization was characterized by antibiotic susceptibility. Overall, the GBS colonization rate was 8.02% (95% CI: 7.20-8.94%). Compared to sampling ≥ 35 weeks of gestation, the GBS colonization rate was statistically higher (p = 0.004) with sampling < 35 weeks. Among 272 antimicrobial susceptibility testing isolates, all were susceptible to ampicillin, penicillin, ceftriaxone, cefotaxime, vancomycin, and quinupristin/dalfopristin. Resistance was highest for tetracycline (89.66%), followed by erythromycin (76.23%) and clindamycin (58.21%). Multidrug resistance and resistance to ≥ 6 different antibiotics were 60.66% and 8.82%, respectively. Resistance to clindamycin but not erythromycin (L phenotype) was 2.2%. The clindamycin resistance rate was significantly increased (p = 0.005) during the study period. These data demonstrate a low rate of maternal GBS colonization. The high rate of erythromycin, clindamycin, and multidrug resistance to GBS that can be transmitted to neonates is an important risk factor to consider. β-lactams continue to be appropriate for first-line treatment and prophylaxis in the study area. Ongoing monitoring should be considered in the future., (© 2021. The Author(s).)

While the incorporation of pendant Brønsted acid/base sites in the secondary coordination sphere is a promising and effective strategy to increase the catalytic performance and product selectivity in organometallic catalysis for CO 2 reduction, the control of product selectivity still faces a great challenge. Herein, we report two new trans (Cl)-[Ru(6-X-bpy)(CO) 2 Cl 2 ] complexes functionalized with a saturated ethylene-linked functional group (bpy = 2,2'-bipyridine; X = -(CH 2 ) 2 -OH or -(CH 2 ) 2 -N(CH 3 ) 2 ) at the ortho (6)-position of bpy ligand, which are named Ru-bpy OH and Ru-bpy diMeN , respectively. In the series of photolysis experiments, compared to nontethered case, the asymmetric attachment of tethering ligand to the bpy ligand led to less efficient but more selective formate production with inactivation of CO 2 -to-CO conversion route during photoreaction. From a series of in situ FTIR analyses, it was found that the Ru-formate intermediates are stabilized by a highly probable hydrogen bonding between pendent proton donors (-diMeN + H or -OH) and the oxygen atom of metal-bound formate (Ru I -OCHO···H- E -(CH 2 ) 2 -, E = O or diMeN + ). Under such conformation, the liberation of formate from the stabilized Ru I -formate becomes less efficient compared to the nontethered case, consequently lowering the CO 2 -to-formate conversion activities during photoreaction. At the same time, such stabilization of Ru-formate species prevents the dehydration reaction route (η 1 -OCHO → η 1 -COOH on Ru metal) which leads toward the generation of Ru-CO species (key intermediate for CO production), eventually leading to the reduction of CO 2 -to-CO conversion activity.

It has been reported that H. mollendorffii roots (HMR) have various pharmacological activities such as anti-inflammatory activity and immunostimulatory activity. However, the anti-obesity activity of HMR has not been studied. Thus, we evaluated in vitro anti-obesity of HMR in mouse preadipocytes, 3T3-L1 cells. HMR reduced the lipid accumulation and triglyceride (TG) contents in 3T3-L1 cells. HMR inhibited the protein expressions such as CCAAT/enhancer-binding protein alpha (CEBPα), peroxisome proliferator-activated receptor gamma (PPARγ), perilipin-1, adiponectin, fatty acid-binding protein 4 (FABP4), fatty acid synthase (FAS), and acetyl-CoA carboxylase (ACC) related to the lipid accumulation of the mature adipocytes. In addition, HMR induced the proteasomal degradation of CEBPα related to the differentiation of the preadipocytes into the mature adipocytes by activating c-Jun N-terminal kinases (JNK) and glycogen synthase kinase 3 beta (GSK3β). Based on the results of this study, HMR inhibited the differentiation of preadipocytes into mature adipocytes through the CEBPα degradation via JNK and GSK3β activation and subsequently blocked lipid accumulation of mature adipocytes through inhibiting lipid accumulation-related proteins such as CEBPα, PPARγ, perilipin-1, adiponectin, FABP4, FAS, and ACC., Competing Interests: The authors declare no conflict of interest., (© 2021 The Authors. Food Science & Nutrition published by Wiley Periodicals LLC.)

Herein, we employed a molecular Ru(II) catalyst immobilized onto TiO 2 particulates of (4,4'-Y 2 -bpy)Ru II (CO) 2 Cl 2 ( RuP ; Y = CH 2 PO(OH) 2 ), as a hybrid catalyst system to secure the efficient and steady catalytic activity of a molecular bipyridyl Ru(II)-complex-based photocatalytic system for CO 2 reduction. From a series of operando FTIR spectrochemical analyses, it was found that the TiO 2 -fixed molecular Ru(II) complex leads to efficient stabilization of the key monomeric intermediate, Ru II -hydride (LRu II (H)(CO) 2 Cl), and suppresses the formation of polymeric Ru(II) complex (-(L(CO) 2 Ru-Ru(CO) 2 L) n -), which is a major deactivation product produced during photoreaction via the Ru-Ru dimeric route. Active promotion of the monomeric catalytic route in a hetero-binary system (IrPS + TiO 2 / RuP ) that uses TiO 2 -bound Ru(II) complex as reduction catalyst led to highly increased activity as well as durability of photocatalytic behavior with respect to the homogeneous catalysis of free Ru(II) catalyst (IrPS + Ru(II) catalyst). This catalytic strategy produced maximal turnover numbers (TONs) of >4816 and >2228, respectively, for CO and HCOO - production in CO 2 -saturated N , N -dimethylformamide (DMF)/TEOA (16.7 vol % TEOA) solution containing a 0.1 M sacrificial electron donor.

Background: To determine the prevalence of dental caries in primary and permanent teeth and identify factors associated with dental caries among secondary school children in rural highland Vietnam., Methods: This was a cross-sectional study that included 1985 secondary schoolchildren. Dental examination was performed at school using World Health Organization criteria. Data collection on demographic characteristics and knowledge, attitude, and practices related to dental caries was conducted by interviewing children. Descriptive and inferential statistics using a multivariate logistic regression model were applied., Results: Prevalence of caries in primary and permanent teeth was 41.1 and 68.9 %, respectively. Prevalence of caries in primary teeth in the age group 11-12 years old (59.4 %) was significantly higher than in children in the age group of 13-14 years (27.8 %; p < 0.01). Factors associated with dental caries in primary teeth were age group of 11-12 years, belonging to the Jarai ethnic group, and having inadequate knowledge or attitude related to dental caries. Factors associated with dental caries in permanent teeth were having insufficient knowledge, attitude, and practices related to dental caries., Conclusions: The prevalence of dental caries in primary and permanent teeth was high among secondary school children in Vietnam's rural highlands. It is recommended that interventions focus on younger secondary school children and the Jarai minority ethnic group, and that interventions should emphasize improving knowledge, attitudes, and practices related to dental caries., (© 2021. The Author(s).)

Extended-spectrum β-lactamase-producing Enterobacterales (ESBL-E) resistance to commonly prescribed drugs is increasing in Vietnam. During pregnancy, ESBL-E may predispose women to reproductive tract infections and increases the risk for neonatal morbidity. Vaginal colonization and infections by Escherichia coli and Klebsiella pneumoniae are seldom studied in Vietnam. In this study, we investigated ESBL-producing Enterobacterales in the birth canal of pregnant women. Between 2016 and 2020, vaginal swabs were collected from 3104 pregnant women (mean gestational age of 31 weeks) and inoculated onto MacConkey agar plates. Colonies were subjected to direct identification and antimicrobial susceptibility testing using the VITEK ® -2 automated compact system and disk diffusion. ESBL production was determined phenotypically. E. coli , Klebsiella species were identified in 30% (918/3104) of the vaginal swabs, with E. coli being the most common (73%; 667/918). ESBL-production was detected in 47% (432/918) of Enterobacterales, with frequent multidrug-resistant phenotype. The overall prevalence of carbapenem resistance was low (8%). Over 20% of Klebsiella spp. were carbapenem-resistant. Pregnant women had a high prevalence of colonization and may transmit ESBL-E to neonates at birth, an important risk factor to be considered. The high rate of ESBL-producers and carbapenem resistance in Enterobacterales in Vietnam emphasizes the need for consequent surveillance and access to molecular typing.

An estimated 91,998,400 L of herbicides were stocked at three US airbases in Vietnam between 1962 and 1971. These herbicides were contaminated with 2,3,7,8-tetrachlorodibenzo-p-dioxin (2,3,7,8-tetraCDD). In 2017, we sampled blood from 120 male Vietnamese military workers in the three dioxin-contaminated airbases (Bien Hoa, Da Nang, and Phu Cat) and from 20 workers at an uncontaminated airbase. 2,3,7,8-tetraCDD concentrations were highest in samples from Bien Hoa (18.2 pg/g lipid), followed by samples from Da Nang (9.2 pg/g lipid), Phu Cat (3.7 pg/g lipid), and the reference base (2.1 pg/g lipid). In Bien Hoa, 31 of the 50 subjects had blood 2,3,7,8-tetraCDD levels in the range of 10-100 pg/g lipid and four subjects had 2,3,7,8-tetraCDD levels that exceeded 100 pg/g lipid. In Da Nang, almost half of the subjects had blood 2,3,7,8-tetraCDD concentrations in the range of 10-100 pg/g lipid. These findings suggest that military workers at contaminated bases are the population most vulnerable to dioxin exposure, especially at Bien Hoa., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2020 Elsevier Ltd. All rights reserved.)

Background: Extracorporeal membrane oxygenation (ECMO) has become increasingly accepted as a life-saving procedure for patients with severe acute respiratory distress syndrome (ARDS). This study investigated the relationship between cumulative fluid balance (CFB) and outcomes in adult ARDS patients treated with ECMO., Methods: We retrospectively analyzed the data of adult ARDS patients who received ECMO between December 2009 and December 2019 at Korea University Anam Hospital. CFB was calculated during the first 7 days after ECMO initiation. The primary endpoint was 28-day mortality., Results: The 74 patients were divided into survivor (n=33) and non-survivor (n=41) groups based on 28-day survival. Non-survivors showed a significantly higher CFB at 1-7 days (p<0.05). Cox multivariable proportional hazard regression revealed a relationship between CFB on day 3 and 28-day mortality (hazard ratio, 3.366; 95% confidence interval, 1.528-7.417; p=0.003)., Conclusion: In adult ARDS patients treated with ECMO, a higher positive CFB on day 3 was associated with increased 28-day mortality. Based on our findings, we suggest a restrictive fluid strategy in ARDS patients treated with ECMO. CFB may be a useful predictor of survival in ARDS patients treated with ECMO.

A porphyrinic metal-organic framework ( PMOF ) known as PCN-222(Zn) was chemically doped with a molecular Re(I) catalyst-bearing carboxylate anchoring group to form a new type of metal-organic framework (MOF)-Re(I) hybrid photocatalyst. The porphyrinic MOF-sensitized hybrid ( PMOF/Re ) was prepared with an archetypical CO 2 reduction catalyst, (L)Re I (CO) 3 Cl (Re(I); L = 4,4'-dicarboxylic-2,2'-bipyridine), in the presence of 3 vol % water produced CO with no leveling-off tendency for 59 h to give a turnover number of ≥1893 [1070 ± 80 μmol h -1 (g MOF) -1 ]. The high catalytic activity arises mainly from efficient exciton migration and funneling from photoexcited porphyrin linkers to the peripheral Re(I) catalytic sites, which is in accordance with the observed fast exciton (energy) migration (≈1 ps) in highly ordered porphyrin photoreceptors and the effective funneling into Re(I) catalytic centers in the Re(I)-doped PMOF sample. Enhanced catalytic performance is convincingly supported by serial photophysical measurements including decisive Stern-Volmer interpretation.

To evaluate the efficacy of ortho -arylation in the second coordination sphere of octahedral iridium complex, a series of homoleptic N -heterocyclic carbene (NHC)-based Ir(C ∧ C R ) 3 -type complexes were designed and prepared by introducing various substituents (R = H, Me, Ph, MePh, and diMePh) at the ortho -position of the aryl unit of the orthometalated phenyl group. In solution, an unnoticeable increase of emission quantum yields was observed within the variation of the ortho -substituent of the sterically demanding side-branch, a diMePh- group, showing the radiative quantum yield of mer -Ir(C ∧ C diMePh ) 3 (Φ PL = 1.9%), being higher than that of the unsubstituted carbene-based mer -Ir(C ∧ C H ) 3 (Φ PL = 1.2%), due to a considerable difference in the nonradiative decay rate ( k nr = 65.40 × 10 5 s -1 for mer -Ir(C ∧ C diMePh ) 3 vs k nr = 141.1 × 10 5 s -1 for mer -Ir(C ∧ C H ) 3 ). Such a difference is attributed to the reduction of nonradiative pathway via the 3 MLCT → 3 MC transition by the widening gap between triplet emissive states and 3 MC state, and a rigidity increase in structure by steric hindrance of bulky aryl substituent. In contrast, significant increase of emission quantum yield was observed in the films cast by spin coating, and fac - / mer -Ir(C ∧ C diMePh ) 3 (Φ PL = 60.1/49.1%) were the most efficient ones among NHC-Ir(III) complexes, compatible with the assumption that the secondary coordination effect, i.e. a peripheral constraint, was put into action. As the substituent R increases in size on going from H, Me, Ph, MePh, to diMePh, notable structural changes in the periphery are evident, while an increase of emission quantum yields is also seen. Such a peripheral difference was under scrutiny first with X-ray structural studies, and its manifestation in photophysics was investigated along with quantum calculations that finally addressed the peripheral effect being maximized at R = diMePh. In the application of PhOLED, the mer -Ir(C ∧ C diMePh ) 3 -doped multilayer device showed highly enhanced efficiency with an external quantum efficiency (EQE) of up to 8.1%, compared to that of the mer -Ir(C ∧ C H ) 3 -based device (1.2%), indicating the multiple positive effects of bulky aryl substitution of Ir(III) dopant. A deep-blue CIE chromaticity diagram (0.16, 0.09) was achieved from the device using mer -Ir(C ∧ C diMePh ) 3 as a dopant.

Background: While the World Health Organization (WHO) Southeast Asia region has the second highest incidence of malaria worldwide, malaria in Vietnam is focal to few provinces, where delayed parasite clearance to anti-malarial drugs is documented. This study aims to understand Plasmodium species distribution and the genetic diversity of msp1 and msp2 of parasite populations using molecular tools., Methods: A total of 222 clinical isolates from individuals with uncomplicated malaria were subjected to Plasmodium species identification by nested real-time PCR. 166 isolates positive for Plasmodium falciparum mono infections were further genotyped for msp1 (MAD20, K1, and RO33), and msp2 allelic families (3D7 and FC27). Amplicons were resolved through capillary electrophoresis in the QIAxcel Advanced system., Results: Mono-infections were high and with 75% P. falciparum, 14% Plasmodium vivax and 9% P. falciparum/P. vivax co-infections, with less than 1% Plasmodium malariae identified. For msp1, MAD20 was the most prevalent (99%), followed by K1 (46%) allelic family, with no sample testing positive for RO33 (0%). For msp2, 3D7 allelic family was predominant (97%), followed by FC27 (10%). The multiplicity of infection of msp1 and msp2 was 2.6 and 1.1, respectively, and the mean overall multiplicity of infection was 3.7, with the total number of alleles ranging from 1 to 7., Conclusions: Given the increasing importance of antimalarial drugs in the region, the genetic diversity of P. falciparum msp1 and msp2 should be regularly monitored with respect to treatment outcomes and/or efficacy studies in regions, where there are ongoing changes in the malaria epidemiology.

Herein, we report the synthesis, and photochemical and -physical properties, as well as the catalytic performance, of a series of heteroleptic Ir III photosensitizers (IrPSs), [Ir(C^N) 2 (N^N Aryl )] + , possessing ancillary ligands that are varied with aryl-substituents on bipyridyl unit [C^N=(2-pyridyl)benzo[b]thiophen-3-yl (btp); N^N Aryl =4,4'-Y 2 -bpy (Y=-Ph or -PhSi(Ph) 3 ]. We found that the π-extension of bipyridyl ligand by aryl-substitution put bipyridyl ligand in use as an electron relay unit that performed charge accumulation before delivering to the catalytic center, greatly improving the overall CO 2 -to-CO conversion activities. In a typical run, the aryl-substituted IrPS ( tBu IrP-Ph Si )-sensitized homogeneous systems (IrPS+Re I catalyst) gave a turnover number of 1340 (Φ CO =24.2 %) at the early stage of photolysis (<5 h). This study demonstrates that the π-character modulation on the ancillary bipyridyl ligand is critical for forthcoming catalytic performance., (© 2020 Wiley-VCH GmbH.)

Honeyberry (Lonicera caerulea) has long been used as a traditional medicine in China, Japan and northern Russia. Functional studies of honeyberry have mainly focused on the fruits, which have been reported to exert various pharmacological activities, including anti‑inflammatory activity, with limited or no studies on the other parts of the plant, such as the leaves and branches. In the present study, the anti‑inflammatory effects of extracts of the leaves (HBL), branches (HBB) and fruit (HBF) of honeyberry plant were evaluated in lipopolysaccharide (LPS)‑stimulated RAW264.7 cells. HBL and HBB significantly inhibited the production of pro-inflammatory mediators in LPS‑stimulated RAW264.7 cells, and the inhibitory effects of HBL and HBB were stronger than those of HBF. HBL and HBB blocked the nuclear accumulation of p65 independently of IκB‑α. HBL did not inhibit the phosphorylation of ERK1/2 or p38; however, HBB effectively inhibited the phosphorylation of p38 but not ERK1/2. HBL and HBB increased the expression of heme oxygenase‑1 (HO‑1) protein by inducing the nuclear accumulation of nuclear factor erythroid 2‑related factor 2 (Nrf2) through the activation of the reactive oxygen species (ROS)/p38 pathway; the reduction in inducible nitric oxide synthase (iNOS) and interleukin‑1β (IL‑1β) expression by HBL and HBB was inhibited by HO‑1 knockdown. In addition, HBL and HBB increased the expression of activating transcription factor‑3 (ATF3), and the reduction in iNOS and IL‑1β expression by HBL and HBB was inhibited by ATF3 knockdown. Collectively, HBL and HBB inhibited LPS‑induced nuclear factor‑κB activation by blocking the nuclear accumulation of p65, increasing HO‑1 expression through activation of the ROS/p38/Nrf2 pathway, and increasing ATF3 expression. Furthermore, HBB inhibited LPS‑induced p38 phosphorylation. These findings suggest that HBL and HBB may have great potential as natural products for the development of anti‑inflammatory drugs.

Objective: This study investigated whether adding outer-well medium to inhibit osmotic changes in culture media in a dry-type incubator improved the clinical outcomes of in vitro fertilization-embryo transfer (IVF-ET) cycles., Methods: In culture dishes, the osmotic changes in media (20 µL)-covered oil with or without outer-well medium (humid or dry culture conditions, respectively) were compared after 3 days of incubation in a dry-type incubator. One-step (Origio) and G1/G2 (Vitrolife) media were used., Results: The osmotic changes in the dry culture condition (308 mOsm) were higher than in the humid culture conditions (285-290 mOsm) after 3 days of incubation. In day 3 IVF-ET cycles, although the pregnancy rate did not significantly differ between the dry (46.2%) and humid culture (52.2%) groups, the rates of abortion and ongoing pregnancy were significantly better in the humid culture group (2.3% and 50.2%, respectively) than in the dry culture group (8.3% and 37.8%, respectively, p<0.05). In day 5 IVF-ET cycles, the abortion rate was significantly lower in the humid culture group (2.2%) than in the dry culture group (25.0%, p<0.01), but no statistically significant difference was observed in the rates of clinical and ongoing pregnancy between the dry (50.0% and 25.0%, respectively) and humid culture groups (59.5% and 57.3%, respectively) because of the small number of cycles., Conclusion: Hyperosmotic changes in media occurred in a dry-type incubator by evaporation, although the medium was covered with oil. These osmotic changes were efficiently inhibited by supplementation of outer-well medium, which resulted in improved pregnancy outcomes.

Heracleum moellendorffii ( H. moellendorffii ) is a family of Umbelliferae and has long been used for food and medicinal purposes. However, the immune-enhancing activity of H. moellendorffii has not been studied. Thus, we evaluated in vitro immune-enhancing activity of H. moellendorffii through macrophage activation using RAW264.7 cells. Heracleum moellendorffii Root extracts (HMR) increased the production of immunomodulators such as NO, iNOS, IL-1β, IL-6 IL-12, TNF-α, and MCP-1 and activated phagocytosis in RAW264.7 cells. Inhibition of TLR2 and TLR4 reduced the production of immunomodulators induced by HMR. Inhibition of MAPK signaling attenuated the production of immunomodulators induced by HMR, but inhibitions of NF-κB or PI3K/AKT signaling did not affect HMR-mediated production of immunomodulators. HMR activated MAPK signaling pathway, and activation of MAPK signaling pathways by HMR was reversed by TLR2 and TLR4 inhibition. Based on the results of this study, HMR is thought to activate macrophages through the production of immunomodulators and phagocytosis activation through TLR2/4-dependent MAPK signaling pathway. Therefore, it is thought that HMR has the potential to be used as an agent for enhancing immunity., Competing Interests: The authors declare no conflict of interest., (© 2020 The Authors. Food Science & Nutrition published by Wiley Periodicals LLC.)