Search

Background: Cerebral vasospasm is a prevalent complication in traumatic brain injury (TBI), particularly in cases of traumatic subarachnoid hemorrhage (T-SAH), for which monitoring and treatment policies remain undefined.Methods: A study was conducted on 49 T-SAH patients with multiple traumas to investigate cerebral vasospasm following T-SAH. Participants underwent transcranial doppler (TCD) and brain CT angiography (CTA) upon hospitalization and subsequent follow-up within seven days. Vasospasm was diagnosed through a comprehensive evaluation of TCD, CTA, and symptoms, with risk factors analyzed accordingly. The initial clinical status was assessed using the Glasgow Coma Scale (GCS), modified Fisher scale (mFS), and Hunt-Hess grade (HHG), while examining various factors to identify underlying risks and evaluating overall body damage via the Injury Severity Score (ISS).Results: Cerebral vasospasm was confirmed in 19 out of the total 49 patients, which is 38.8%. Furthermore, the characteristics that had a statistically significant correlation with the vasospasm group were low GCS (p=0.03, odd ratio=0.592) and high ISS (p=0.022, odd ratio=1.124). Moreover, patients with vasospasm exhibited worse prognoses based on the Glasgow Outcome Scale (GOS) and modified Rankin Scale (mRS).Conclusion: These findings suggest that T-SAH patients with severe initial brain and systemic damage or neurological deficits should undergo active monitoring using modalities such as TCD and CTA, followed by treatment to prevent and manage vasospasm.

Neurogenic thoracic outlet syndrome (NTOS) is a complex disorder characterized by compression of the brachial plexus, resulting in pain, weakness, and sensory changes in the upper extremity. Traditional surgical treatments, such as first rib resection or anterior scalene muscle resection, can be invasive and associated with significant morbidity. We present a unique case of a patient diagnosed with NTOS who underwent a preoperative magnetic resonance imaging with the shoulder in an abduction position to identify the cause of NTOS. A minimally invasive subclavius muscle resection was subsequently performed, resulting in a dramatic reduction in pain and significant improvement in motor symptoms. This less invasive approach led to a quicker recovery time and reduced morbidity compared to traditional surgical methods. This case report suggests that before surgery, thoroughly investigating the causes of NTOS and selectively performing decompression only on the structures requiring intervention could also be considered a viable treatment option.

Objective We aimed to explore whether nursing professionals’ psychological states affect their grief response for a patient’s death in the coronavirus disease-2019 (COVID-19) inpatients’ ward.Methods Survey was conducted among frontline nursing professionals working in COVID-19 inpatients wards at three tertiary-level affiliated hospitals of the University of Ulsan during April 7–26, 2022. Participants’ information such as age, years of employment, or marital status were collected, and their responses to rating scales including Pandemic Grief Scale (PGS) for healthcare workers, Stress and Anxiety to Viral Epidemics-9 items (SAVE-9), Patient Health Questionnaire-9 (PHQ-9), Loneliness and Social Isolation Scale, and Insomnia Severity Scale (ISI) were collected.Results All 251 responses were analyzed. We observed that 34% reportedly suffered from depression. The linear regression analysis showed that a high PGS score was expected by high SAVE-9 (β=0.12, p=0.040), high PHQ-9 (β=0.25, p

Chiral perovskites have emerged as promising candidates for polarization-sensing materials. Despite their excellent chiroptical properties, the nature of their multiple-quantum-well structures is a critical hurdle for polarization-based and spintronic applications. Furthermore, as the origin of chiroptical activity in chiral perovskites is still illusive, the strategy for simultaneously enhancing the chiroptical activity and charge transport has not yet been reported. Here, we demonstrated that incorporating a Lewis base into the lattice can effectively tune the chiroptical response and electrical properties of chiral perovskites. Through solid-state nuclear magnetic resonance spectroscopic measurements and theoretical calculations, it was demonstrated that the material property manipulation resulted from the change in the time-averaged structure induced by the Lewis base. Finally, as a preliminary proof of concept, a vertical-type circularly polarized light photodetector based on chiral perovskites was developed, exhibiting an outstanding performance with a distinguishability of 0.27 and a responsivity of 0.43 A W

Rope entanglement injury is a rare entity. Previous reported studies mainly consisted of finger-related injuries. We describe three cases of rope entanglement injury of the lower leg. In the first patient, a belowthe- knee amputation was performed as the primary treatment for unilateral amputated lower limb. In the second patient, a below-the-knee amputation and perineal wound management were simultaneously performed. The third patient had vascular injury combined with internal soft tissue injury without related bone fracture. He suffered serious sequelae from a delay in transfer from a local hospital. Rope entanglement injuries of the lower leg do not present in a consistent manner, and the treatment of accompanying injuries should be considered from an early stage. Care should be taken to ensure that there are no internal injuries missed because the exterior appears to be stable.

Objectives : In this study, a learning-based optimization method is proposed and implemented for determining new monitoring sites when expanding the roadside air pollution monitoring network. Utilizing the bigdata available in Seoul, this decision-making tool is developed that takes into account the objectives of selecting new monitoring sites and incorporates social, economic, and environmental characteristics. The optimized results can suggest potential locations for new roadside air pollution monitoring sites. Additionally, the capability of this tool to facilitate objective decision-making processes is evaluated by determining the influence range providing reliable air pollution information with the addition of the new monitoring sites.Methods : The proposed learning-based optimization algorithm is a new approach for selecting the new optimal monitoring sites by comprehensively considering social, economic, and environmental factors aligned with the installation purpose of the monitoring system in Seoul. The algorithm starts with genetic algorithms to select candidate locations for new monitoring sites that maximize the influence area of the expanded monitoring network compared to the existing monitoring network, capture a high overall level of air pollution, and do not overlap with the existing monitoring network. After that, PROMETHEE method is applied to evaluate the solutions generated by the genetic algorithm and choose the final solution that best fits six evaluation factors (Information entropy, number of new monitoring sites, distance from point sources, wind speed, traffic volume, and population) to be considered when installing new monitoring sites.Results and Discussion : The learning-based optimization algorithm selects 10 potential new monitoring sites adding to the existing roadside air pollution monitoring network having 15 monitoring sites. The explainable spatiotemporal range of the air pollution information that can be expected after the installation of the new monitoring sites is quantified to cover 84.33% of Seoul, reducing the uncertainty of the air pollution information of existing monitoring network by 26.15%. The final solution, selected from several solutions, can get new optimal roadside air pollution monitoring sites reflecting the regional characteristics of Seoul and the installation purpose of the monitoring system by having a small number of newly established monitoring locations, being close to air pollution emissions facilities, and having a high population and traffic volume.Conclusion : The proposed learning-based optimization method, using relevant variables for the installation purpose of the monitoring system, can derive the objective solution for deciding new monitoring locations of the roadside air pollution monitoring network, considering additional social factors as opposed to urban air pollution monitoring network. The final solution obtained through the optimization algorithm has great potential for future use, as it can guide to determine practical and feasible new monitoring sites with additional on-site verification. Furthermore, this optimized approach can be applied widely during the decision-making process for the expansion of other environmental monitoring networks.

BRCA1 mutations are associated with increased breast and ovarian cancer risk. BRCA1-mutant tumors are high-grade, recurrent, and often become resistant to standard therapies. Herein, we performed a targeted CRISPR-Cas9 screen and identified MEPCE, a methylphosphate capping enzyme, as a synthetic lethal interactor of BRCA1. Mechanistically, we demonstrate that depletion of MEPCE in a BRCA1-deficient setting led to dysregulated RNA polymerase II (RNAPII) promoter-proximal pausing, R-loop accumulation, and replication stress, contributing to transcription-replication collisions. These collisions compromise genomic integrity resulting in loss of viability of BRCA1-deficient cells. We also extend these findings to another RNAPII-regulating factor, PAF1. This study identifies a new class of synthetic lethal partners of BRCA1 that exploit the RNAPII pausing regulation and highlight the untapped potential of transcription-replication collision-inducing factors as unique potential therapeutic targets for treating cancers associated with BRCA1 mutations.

Objective We aimed to develop a distributed, immutable, and highly available cross-cloud blockchain system to facilitate federated data analysis activities among multiple institutions. Materials and Methods We preprocessed 9166 COVID-19 Structured Query Language (SQL) code, summary statistics, and user activity logs, from the GitHub repository of the Reliable Response Data Discovery for COVID-19 (R2D2) Consortium. The repository collected local summary statistics from participating institutions and aggregated the global result to a COVID-19-related clinical query, previously posted by clinicians on a website. We developed both on-chain and off-chain components to store/query these activity logs and their associated queries/results on a blockchain for immutability, transparency, and high availability of research communication. We measured run-time efficiency of contract deployment, network transactions, and confirmed the accuracy of recorded logs compared to a centralized baseline solution. Results The smart contract deployment took 4.5 s on an average. The time to record an activity log on blockchain was slightly over 2 s, versus 5–9 s for baseline. For querying, each query took on an average less than 0.4 s on blockchain, versus around 2.1 s for baseline. Discussion The low deployment, recording, and querying times confirm the feasibility of our cross-cloud, blockchain-based federated data analysis system. We have yet to evaluate the system on a larger network with multiple nodes per cloud, to consider how to accommodate a surge in activities, and to investigate methods to lower querying time as the blockchain grows. Conclusion Blockchain technology can be used to support federated data analysis among multiple institutions.

Background The study is aimed to identify brain functional connectomes predictive of depressed and elevated mood symptomatology in individuals with bipolar disorder (BD) using the machine learning approach Connectome-based Predictive Modeling (CPM). Methods Functional magnetic resonance imaging data were obtained from 81 adults with BD while they performed an emotion processing task. CPM with 5000 permutations of leave-one-out cross-validation was applied to identify functional connectomes predictive of depressed and elevated mood symptom scores on the Hamilton Depression and Young Mania rating scales. The predictive ability of the identified connectomes was tested in an independent sample of 43 adults with BD. Results CPM predicted the severity of depressed [concordance between actual and predicted values (r = 0.23, pperm (permutation test) = 0.031) and elevated (r = 0.27, pperm = 0.01) mood. Functional connectivity of left dorsolateral prefrontal cortex and supplementary motor area nodes, with inter- and intra-hemispheric connections to other anterior and posterior cortical, limbic, motor, and cerebellar regions, predicted depressed mood severity. Connectivity of left fusiform and right visual association area nodes with inter- and intra-hemispheric connections to the motor, insular, limbic, and posterior cortices predicted elevated mood severity. These networks were predictive of mood symptomatology in the independent sample (r ⩾ 0.45, p = 0.002). Conclusions This study identified distributed functional connectomes predictive of depressed and elevated mood severity in BD. Connectomes subserving emotional, cognitive, and psychomotor control predicted depressed mood severity, while those subserving emotional and social perceptual functions predicted elevated mood severity. Identification of these connectome networks may help inform the development of targeted treatments for mood symptoms.

Objectives Peak exposure to extremely low-frequency magnetic fields (ELF-MF) among semiconductor workers was characterized by type of factory, operation, and job. Methods A portable EMDEX meter was used to monitor the ELF-MF exposure of 117 semiconductor workers who are involved in wafer fabrication (fab) and assembly operations. ELF-MF measurements were logged every 3 s and categorized by process and job or activity during working hours. Two values of 0.5 and 1 μT were adopted subjectively as cutoff values of peak exposure levels based on a literature review. Results All semiconductor workers who were involved in diffusion, ion implanter operation, module, and chip test were exposed to ELF-MF higher than 0.5 μT during their entire working time. Engineers who maintained electric facilities in the semiconductor operations were exposed to the highest ELF-MF peak levels (2.5 μT on average above 0.5 μT and 3.6 μT on average above 1 μT). Operators working in chip testing showed the highest daily contribution of their peak levels to their daily average ELF-MF exposure levels (98.1% and 83.9%). In contrast, chemical mechanical planarization engineers, wafer test operators, and administrative workers outside clean rooms showed average exposure to less than 0.5 μT and a low proportion of duration of time exposed above either the 0.5 μT or 1 μT peak level points, along with a low daily contribution of peak exposure levels (16.0, 11.9, and 18.7%). Conclusions Most of the activities and working locations next to machines generating ELF-MF in semiconductor operations showed high contributions of ELF-MF peak exposure to daily exposure dose despite their relative minor fraction of workers’ daily time.

The purpose of this study was to measure bone age using an artificial intelligence program based on the Greulich-Pyle (GP) method to find out the bone age corresponding to each stage of cervical vertebral maturation (CVM) and the middle phalanx of the third finger (MP3). This study was conducted on 3,118 patients who visited pediatric dentistry at Kyung Hee University Dental Hospital and Pusan National University Dental Hospital from 2013 to 2021. The CVM stage was divided into 5 stages according to the classification by Baccetti, and the MP3 stage was divided into 5 stages according to the methods of Hägg and Taranger. Based on the GP method, bone age was evaluated using an artificial intelligence program. The pubertal growth spurt in the CVM stage was CVM II and III. The mean bone age in CVM II was 11.00 ± 1.81 years for males and 10.00 ± 1.49 years for females, and in CVM III, 13.00 ± 1.46 years for males and 12.00 ± 1.44 years for females (p < 0.0001). The pubertal growth spurt in the MP3 stage was MP3 - G stage. The bone age at the MP3 - G stage was 13.14 ± 1.07 years for males and 11.40 ± 1.09 years for females (p < 0.0001). Bone age evaluation using artificial intelligence is worth using in clinical practice, and it is expected that a faster and more accurate diagnosis will be possible.

Volunteering not only benefits nonprofit organizations but also may contribute to volunteers’ well-being. This study examines the benefits of volunteering on the psychological well-being of persons with physical disabilities. Method: Using a sample of 3,440 individuals drawn from national survey data in South Korea, we applied propensity score matching (PSM), a quasi-experimental design that reduces potential bias in models using multiple regression. Results: Our findings revealed the positive effect of volunteering on the psychological well-being of people with physical disabilities. Volunteer participants (treatment group) showed significantly better psychological well-being than non-volunteers (control group). Conclusion: Empirical evidence from this study supports the benefits of volunteering for those with physical disabilities, indicating that participating in such prosocial behaviors may play an important role in their psychological well-being.

Sungyeun Bae,1 Jihoon Kwon,2 Mi-Hye Lee,3 Kyung-Sang Yu,1 SeungHwan Lee1 1Department of Clinical Pharmacology and Therapeutics, Seoul National University College of Medicine and Hospital, Seoul, Republic of Korea; 2Department of Statistics, APACE, Seoul, Republic of Korea; 3Yungjin Pharmaceutical Co., Ltd, Seoul, Republic of KoreaCorrespondence: SeungHwan Lee, Department of Clinical Pharmacology and Therapeutics, Seoul National University College of Medicine and Hospital, 101 Daehak-ro, Jongno-gu, Seoul, 03080, Republic of Korea, Tel +82-2-2072-1920, Fax +82-2-742-9252, Email leejh413@snu.ac.krPurpose: Proton pump inhibitors (PPIs) are the first-line therapy for gastroesophageal reflux disorder (GERD). Unlike conventional PPIs, non-enteric coated PPIs with antacid salt enable a faster acid suppression through the rapid absorption of the PPI. YPI-011 is a newly developed fixed-dose combination of a rabeprazole with sodium bicarbonate (NaHCO3). This study compared the pharmacokinetics (PKs) and pharmacodynamics (PDs) of YPI-011 to the conventional enteric-coated rabeprazole (Pariet®).Materials and Methods: A randomized, open-label, two-treatment, two-sequence crossover study was conducted with two different doses (10 and 20 mg) and 44 subjects in each group. They randomly received either a test or reference treatment for 7 days in the first period and the other treatment in the second period. Blood samples for the PK analysis were taken after the single- and multiple-dose. Intragastric pH monitoring for the PD analysis was implemented for baseline and after the single- and multiple-dose.Results: Gastric acid suppression evaluated by the percentage decrease from baseline in the integrated gastric acidity for a 24-hour interval after the multiple-dose was similar between the treatments in both dose groups. The systemic exposure of rabeprazole at steady state after the multiple-dose was also similar between the treatments in both dose groups. The time to reach the maximum rabeprazole concentration was faster in the test treatment. The PK-PD relationship of PPI is well known, and the faster absorption of rabeprazole resulted in a more rapid mode of action in acid suppression.Conclusion: The fixed dose combination of rabeprazole with NaHCO3 showed a faster absorption and consequently, a more rapid gastric acid suppression with a similar systemic exposure of rabeprazole at steady state compared to the conventional enteric-coated rabeprazole.Keywords: comparative pharmacokinetics/pharmacodynamics, intragastric pH monitoring, gastroesophageal reflux disease, immediate release

Background: Korea recently established 70 emergency medical service areas. However, there are many concerns that medical resources for stroke could not be evenly distributed through the country. We aimed to compare the treatment quality and outcomes of acute stroke among the emergency medical service areas.Methods: This study analyzed the data of 28,800 patients admitted in 248 hospitals which participated in the 8th acute stroke quality assessment by Health Insurance Review and Assessment Service. Individual hospitals were regrouped into emergency service areas according to the address of the location. Assessment indicators and fatality were compared by the service areas. We defined the appropriate hospital by the performance of intravenous thrombolysis.Results: In seven service areas, there were no hospitals which received more than 10 stroke patients for 6 months. In nine service areas, there were no patients who underwent intravenous thrombolysis (IVT). Among 167 designated emergency medical centers, 50 hospitals (29.9%) responded that IVT was impossible 24 hours a day. There are 97 (39.1%) hospitals that meet the definitions of appropriate hospital. In 23 service areas (32.9%) had no appropriate or feasible hospitals. The fatality of service areas with stroke centers were 6.9% within 30 days and 15.6% within 1 year from stroke onset than those without stroke centers (7.7%, 16.9%, respectively).Conclusions: There was a wide regional gap in the medical resource and the quality of treatments for acute stroke among emergency medical service areas in Korea. The poststroke fatality rate of the service areas which have stroke centers or appropriate hospitals were significantly low.